The rise and fall of the smile in 18th-century Paris A study in dentistry

The rise and fall of the smile
in 18th-century Paris
A study in dentistry


by C. Jones, United Kingdom

Professor of History,
Queen Mary University, London;
Past President of the Royal Historical Society, UK

Madame Vigée Le Brun’s 1787 self-portrait, depicting her smiling and showing white teeth, seems a very modern form of self-representation. Yet when it was displayed at the Paris Salon, it attracted hostility as an unwelcome and unseemly innovation. The present article suggests that this smile can be tracked back partly through changes within French culture (including painting) in the eighteenth century, and partly through the emergence of dentistry. The age witnessed the passage from tooth-pulling to preventive dentistry, a movement led by Pierre Fauchard, the “Father of Modern Dentistry.” The demand for the kind of smile that Fauchard and his Parisian disciples could produce linked to wider changes within French culture: a move away from the formal style of bodily comportment associated with the royal court; a greater openness toward the display of the emotions; and a belief, that claimed to be grounded in science, that a smile of sensibility was a truthful representation of an individual’s inner essence. Yet though the smile of sensibility appeared to be carrying all before it by the late 1780s, the 1789 Revolution saw its calamitous decline. Again this linked to cultural and political changes,but also to thedeclineof Frenchdentistry.Thewhite-toothsmile would only reappear as a badge of individual identity in the twentieth century—and initially in the USA rather than in France. The cultural models offered by celebrity stardom and commercial advertising counted for something in this. So did the advent of excellent dentistry.

Medicographia. 2016;38:110-121 (see French abstract on page 121)

In the autumn of 1787, the painter Madame Élisabeth Louise Vigée Le Brun displayed a self-portrait at the Paris Salon, the celebrated biennial art exhibition held in the Louvre (which still houses the painting). She portrayed herself dandling her daughter on her lap, and with her own mouth set into a pleasing smile, her lips parting to reveal white teeth.

In our own day, a white-tooth smile like this is a banal and unremarkable social gesture. Projected by politicians, film stars, and advertising models, and adorning our own faces as soon as a camera hoves into view, it stares out at us from screens, billboards, and a million photo albums. Yet the 1787 Vigée Le Brun smile provoked a scandal. “An affectation which artists, connoisseurs, and people of good taste are unanimous in condemning,” noted a journalist, “and of which no example is found in Antiquity, is that in smiling Madame Vigée Le Brun shows her teeth.” Her evidently surprising smile seemed in its way quite as revolutionary as the political events which soon, in 1789, became the first modern-day Revolution.

Where did this putatively revolutionary smile come from? Why did it excite such harsh criticism? And where, moreover, did it go? For the white-tooth smile is not much in evidence throughout the nineteenth century in painting as in public life. The answer to these questions has much in fact to do with dentistry….

At this very moment in 1787 that saw the sudden and shocking blossoming of the white-tooth smile, the quality of mouth care offered in the French capital was in fact unrivalled throughout Europe and the wider world. Symptomatically, it was the French who gave the world the very word “dentist.” It arrived in English in the 1750s, but was a direct translation of the French word dentiste. That term had entered the French language in 1728, coined by the French practitioner Pierre Fauchard in his erudite two-volumed work Le Chirurgien Dentiste, ou Traité des Dents [The Dentist Surgeon, or Treatise on the Teeth]. Fauchard offers a rare—possibly unique— example of a dentist famous enough to be commemorated on a postage stamp, while the Pierre Fauchard Academy, the prestigious honorary organization for dentists worldwide, honors him as the “Father of Modern Dentistry.” So crucial was Fauchard in changing the quality of mouth care in the eighteenth- century French capital that it is indeed tempting to see Madame Vigée Le Brun’s smile as in some senses an advertisement for Parisian dentistry.

The old régime of teeth

To grasp the extent of Fauchard’s influence and the impact of his example, we have only to explore the way that teeth were cared for before his arrival on the Parisian scene. In the Old Regime of Teeth, which characterized all of early modern Europe prior to this period, care of teeth was low on individuals’ agendas. Tooth loss after a certain age was the norm. It usually began before one’s forties and proceeded at a steady, unrelenting pace. With teeth vanished good looks. Capacity for speech suffered too, and talking transmuted into an affair of grunts and whistles. Discomfort, inconvenience, problems with chewing food, chronic indigestion, halitosis, and facial disfigurement caused by the bad state of the mouth were the substance of everyday middle-aged life.

Portrait of Pierre Fauchard, the “Father of modern dentistry,”
“with open collar.” Unsigned. Oil on canvas.

Private Collection. © Xavier Deltombe, with kind permission.

It was thus little wonder that people shunned smiling with an open mouth: the look might be too ghastly for tranquil contemplation. The problem did not seem to be getting any better, moreover: the arrival of colonial sugar in the diets of the urban middling and laboring classes probably made the state of their teeth worse in the eighteenth century than in any prior period of European history.

The Old Régime of Teeth encouraged utter fatalism about one’s teeth. If one’s teeth did not fall out of their own accord, then the only practitioners engaged in mouth care were specialists in tooth-pulling rather than in any other form of care. At the outset of the eighteenth century, physicians and elite surgeons were massively disinclined to soil their hands with such menial work. It therefore devolved on a group of self- trained and unqualified individuals whose most striking characteristics were a powerful right arm and a strong wrist. These figures often called themselves “operators on the teeth.” Most contemporaries, however, thought of them as tooth-pullers— and charlatans to boot, for most of them combined tooth pulling arts with outrageous claims for other medical services, and with various forms of showmanship. From the late sixteenth century, troupes of travelling Italian players had brought the commedia dell’arte repertoire into provincial France, setting up their trestle stages in fairs and market squares for their performances—and doing tooth-pulling on the side. Public tooth-pulling came to be associated with theater, acrobatics, singing, tightrope walking, the display of exotic animals, and comedy routines, plus the retailing of allegedly miraculous snakebite remedies.

Tooth-pulling was a performance in itself in fact. One famous tooth-puller, for example, was known for his trick of extracting a tooth with one hand while firing a pistol in the air with the other, and with his head in a sack. Others performed the act of extraction while seated on a horse: from the saddle, they placed the tip of a sword blade on the base of the throbbing tooth, achieving the desired result with a mere flick of the wrist.

The direness of the situation for the care of teeth was well exemplified in the ghastly dental trials of the mighty Louis XIV, king of France from 1643 to 1715. By the late 1670s, when the king was around 40, contemporaries were remarking on the loss of nearly all the king’s teeth. His few remaining teeth required increasing intervention. In his palace at Versailles, Louis had a medical household of dozens of eminent practitioners, but when in 1685 the remaining teeth on the upper right side of his jaw were causing discomfort, he had recourse to a simple tooth puller operator. Unfortunately, while extracting the teeth, the operator also accidentally took out much of the king’s jaw as well. The perforation of the king’s palate left a gaping hole in his oral cavity. Consequently, when he drank or gargled, the liquid came out through his nose like a gushing fountain. Worryingly, moreover, the hole in the king’s palate became nauseously infected. Realizing that there was simply no other way, Louis’s Premier Surgeon determined to undertake a full-blown operation on the royal mouth. In two fearful sessions, he cauterized the king’s palate, sealing it off from the maxillary sinus. The red hot iron which the surgeon deployed managed to block up the hole. After an extensive period of healing, the fountain dried up: Louis could eat normally again.

The example highlights the fact that even the most powerful ruler in Europe with the best level of health care that any individual could possibly have had at this time, was as medically unprotected against tooth loss and most mouth ailments as the poorest of his subjects. As he was undergoing the exquisitely painful and utterly exceptional cauterization, Louis is said to have remarked to the surgeons: “treat me like a peasant.” In the Old Régime of Teeth there was no royal road to good mouth care.

The Tooth Puller (detail), by Honthorst Van Gerrit (1590-1656).

Photo © RMN – Grand Palais (Musée du Louvre) / Stéphane Maréchalle.


The birth of modern dentistry

In stark contrast to this sorry picture, Pierre Fauchard opened a window into a very different world of mouth care: a world in which the aim of professional care was not the removal of teeth, but their preservation as healthy and beautiful adornments to the smiling face. To a considerable extent, Fauchard set the template for what we expect from our dentists in the twenty first century.

Pierre Fauchard’s treatise:
Le Chirurgien Dentiste ou Traité
des Dents [The Dentist Surgeon
or Treatise on the Teeth] (1st
volume, 1746 edition).

© BIU Santé.

Pages from Pierre Fauchard’s treatise:
Le Chirurgien Dentiste ou Traité des
Dents [The Dentist Surgeon or Treatise
on the Teeth]. (1728 edition.)

© BIU Santé.

Fauchard (1678-1761) initially worked as an itinerary tooth puller, but seems to have been eager to learn about the teeth as an object of scientific knowledge. Based in Paris from the 1710s, he sought out contact with the city’s eminent surgeons. His 1728 Le Chirurgien-Dentiste presented as a noble branch of contemporary Enlightenment science that in the past had been viewed as an ignoble and rough-and-ready art, full of trade secrets. Fauchard’s opus magnum is incomparably longer, more detailed, and more sophisticated about the structure of the mouth and the illnesses of the teeth than any earlier work in any language. Its many illustrations highlighted a new zeal for scientific transparency and for the diffusion of dental knowledge. Fauchard prided himself on publishing freely and openly in the public sphere. This new spirit of scientific openness helped spawn a solid cohort of disciples drawing inspiration from Fauchard’s example. There were soon over thirty of them practicing in Paris. They all adopted the fashionable new title of dentiste.

Dentistry, for Fauchard and his disciples, was less about pulling out painful and diseased teeth, than preventing tooth decay in the first place. In the cause of prevention, they stressed the importance of hygiene in mouth care. Transforming the technical instruments that dental surgeons used allowed them to extend their range of services. They could extract teeth when this was absolutely essential of course, but they also knew how to clean dirty teeth, preventing them going bad, fill cavities, and file uneven teeth; they knew all about the separation and reduction of teeth, cauterizing, straightening, and po- sitioning, “firming” and “trepanning” (drilling to release infected matter). They practiced the transplantation of teeth (an art that was satirized by the English caricaturist Thomas Rowlandson). They whitened as well as cleaning teeth and cared for the gums and the soft parts of the mouth. Some specialized in the creation of dental pieces. Indeed, Fauchard invented the first spring-loaded dentures (which did however, have an unfortunate habit of unexpectedly launching themselves projectilely from a client’s mouth at unguarded moments!)

Some folkloric charlatanesque figures continued to prosper in eighteenth- century Paris. The legendary Le Grand Thomas, for example, practiced public tooth pulling on the Pont Neuf every day from the 1710s to the 1750s. However, increasingly, public favor fell on dentists rather than tooth pullers. Moreover, although they claimed scientific status, in fact the new Fauchardian dentists was also highly entrepreneurial. They advertised their wares in newspapers and their publications had a strong commercial as well as a scientific air about them. They stressed how good clean teeth were a necessary accoutrement for those spending their lives in the ambiance of the dynamic Parisian public sphere, urging the virtues of daily self-care by their clients. The invention of the humble toothbrush and its swift passage into the material paraphernalia of everyday life was a symptom of this change. An early example—namely, Napoleon Bonaparte’s monogrammed implement—may be viewed in the Wellcome Collection in London. And in 1788— around the same time that Madame Vigée Le Brun’s portrait smiled out so brazenly in the Salon—the Parisian surgeon Nicolas Dubois de Chémant launched porcelain white dentures, the very first of their kind. Far superior to their predecessors, they allowed the new white-tooth smile to be displayed even by individuals without a tooth of their own in their heads.

The Transplantation of Teeth. Cartoon by Thomas Rowlandson
(1756-1827), showing how teeth are taken from a poor person to
be transplanted into a rich person’s mouth.

Private Collection © Bridgeman Images.

The Great Thomas (Grand Thomas), a crowd-gathering tooth puller who performed his extractions in public on the Pont Neuf in Paris.
Engraving, 18th century.

© Roger-Viollet.

By the 1780s, Parisian dentistry was thus on top of the world. Practitioners from other countries could only look enviously or emulatively on. In no other city in the world was the dentist such an established feature of the urban landscape. Nowhere else could such a figure boast a more willing, devoted and well-heeled clientele. Fauchard’s disciples acquired international fame. Before she sent her daughter, Marie-Antoinette, to France in 1770 to marry the future Louis XVI, the Austrian Empress Maria Theresa thought it wise to summon to Vienna the very best that Europe could provide to reposition some of the princess’ teeth so that they would look “very beautiful and well arranged.” Her choice fell on a Parisian dentist. Across the Atlantic, when in the early 1780s the future first President of the United States, George Washington, was having toothache troubles, he availed himself of the expertise of a French expatriate dentist. Grand Tourists now made their stay-over in Paris the time for a dental checkup. Even the Italian roué Casanova, his charms failing and his teeth falling out, turned in desperation to Parisian dentures on the eve of the Revolution. The Parisian dentist really had arrived.

200-Year-old set of
false teeth
that once
belonged to a French
Archbishop, Arthur
Richard Dillon (1721-
1806) who fled from
Narbonne to England
to escape the guillotine.
The porcelain dentures,
by Nicolas Dubois de
Chémant, were still
securely set in the
Archbishop’s mouth
as his remains were
uncovered during excavations
in the Saint
Pancras cemetery in
London in 2006.

© Photo Matt Dunham/
Associated Press/SIPA.

Enigmatic (Mona Lisa), hieratic (Louis XIV), and ecstatic (Bacchante) expressions.
The Mona Lisa (1605, detail), by Leonardo da Vinci. Photo © RMN – Grand Palais (Musée du Louvre)
Michel Urtado.
Portrait of Louis XIV, aged 63, after Hyacinthe Rigaud (1659-1743), detail. Photo © RMN – Grand Palais (Musée du Louvre)
Christophe Fouin.
Bacchante (1785), by Élisabeth Louise Vigée Le Brun.

© Sterling and Francine Clark Art Institute, Williamstown, Massachusetts, USA / Bridgeman Images.


Smiles of sensibility

Historians of science and technology sometimes argue that inventions and innovative breakthroughs create their own market. In fact, it is rarely quite as simple. Although it is true that the entrepreneurial skills displayed by Parisian dentists helped stimulate demand for a white-tooth smile, that demand preexisted them. In the decades immediately following the death of Louis XV, even before Fauchard’s influence had started to make itself felt, a new kind of smile was starting to evolve that highlighted more natural modes of facial expression and good, healthy white teeth. This was the smile of sensibility.

The smile of sensibility evolved over the course of the eighteenth century as a reaction against the kind of smiling and facial comportment to be found at the royal court. Smiling was the exception at Versailles. The strictly-maintained preference there was for grave, mobile physiognomies that exuded dignitas and gravitas. Hyacinthe Rigaud’s 1701 portrait of Louis XIV captures the mood exactly. Yet if the painting is all the more intriguing in that the ruler’s hollow cheeks reveal his toothlessness, the main reason disposing the king to keep his mouth shut was his observance of rules of decorum which frowned on the opening of the mouth and most other forms of facial mobility. From the Renaissance onwards, conduct books drawing on the counsels of Antiquity and replicating long-established advice on civility had established the firmly shut mouth as the default model for anyone with pretensions to gentility. This was all the more important when royal courts came to set expected standards of behavior in all things for the social elite.

Cultural disapproval of open lips was based on the feeling that the gaping and toothless or gap-filled mouth was ugly and indecorous and indeed often quite disgusting. Opening the mouth was simply not good form—any more than picking the nose, eye-rubbing and squinting, cleaning out the ears, scratching the arse and, especially, unrestrained farting. Keeping the mouth shut was an important element within a more general and systematic policing of bodily orifices. The open mouth was like a Pandora’s box. If one smiled or laughed, then, it should be with mouth shut. No wonder Mona Lisa had not shown her teeth!

Louis XIV’s penchant for melancholic facial impassivity set the tone at court and provided the rules that courtiers lived by. Courtiers emulated their ruler in everything, but also eschewed expression of emotion because they were afraid of giving away their innermost feelings in the competitive aura of the royal court. The white face-paint they wore, known as le fard, made them seem like identikit marble statues. Overwhelmingly, the smiles that emanated from the court were sardonic, ironic, disdainful, proud, knowing, and contemptuous. A smile denoted not human camaraderie or spontaneous gaiety of heart, but elevated social distance, de haut en bas. One smiled snootily down, as indeed one laughed down, at the misfortunes of others. A gentleman’s smile was thus an unconvincing and artificial gesture that marked distinction and reinforced social hierarchy.

Where then did the Vigée Le Brun smile come from? A less stiff and overly dignified demeanor seems to have become more popular almost as soon as Louis XIV was dead. With his successor Louis XV merely a child, the Regent, the duc d’Orléans, abandoned Versailles for the pleasures of the capital and encouraged a much more open and freewheeling atmosphere among the social and political elite—that was, however, set back by Louis XV’s assumption of sole power in 1723. The young king returned the court to Versailles and for the remainder of his very long reign (he only died in 1774) punctiliously reimposed his predecessor’s formal and majestic protocol.

Yet while the court at Versailles seemed locked in the timeless rules of dignitas and gravitas, Paris was on the move. This showed initially in the more natural and accepting way that theater, fiction, and then art represented the human emotions and their free expression. From the 1720s and 1730s, so-called comédies larmoyantes, literally “tearful comedies,” became highly fashionable. Their plots featured everyday misfortunes that befall virtuous individuals, but which are resolved happily, with tears and smiles all round. Fiction took up the baton. The great novels of sensibility of the age—English author Samuel Richardson’s Pamela, Clarissa, and The History of Sir Charles Grandison, which were translated into French in the 1740s and 1750s, and especially Jean-Jacques Rousseau’s Julie, ou La Nouvelle Héloïse, published in 1761— gave the new smile cultural traction, causing a breakthrough in usage in French literary culture. The incidence of smiling in novels increased sharply and enduringly. And although the old malign courtier smile was still in place, it was now swamped by “natural” smiles said to be “enchanting,” “sweet” “good,” “agreeable,” “friendly,” and “virtuous.”Such smiles were no longer exchanged de haut en bas, but rather between moral equals. And increasingly they revealed white teeth.

Although portrait painting was initially slow to react—as the furore caused by Madame Vigée Le Brun in 1787 showed—genre painting started reflecting and relaying the smiling trend, particularly after 1750. Jean-Baptiste Greuze in particular could almost be accounted as an illustrator of the novels of sensibility, tears, smiles and all. Importantly, too the science of physiologists such as Thomas Willis and Albrecht von Haller gave sensibility endorsement as a core feature of the human makeup. Men and women, they argued, were made to be moved emotionally, and tears and smiles were thus the everyday currency of normal human exchange. The smile was thus no longer a hierarchical gesture of disdain or condescension, but an egalitarian sharing of self. It was also a token of a new and more optimistic account of human character. This chimed with the philosophy of perfectibility abroad in Enlightenment circles. The smile triggered optimism about the present and the future. It also fitted rather well within the institutions of sociability in Enlightenment Paris. Salons, promenades, coffee- houses and the like provided a more egalitarian and more accommodating framework for face-to-face encounters in which a smiling demeanor prevailed. Courtiers at Versailles still emulated the facial impassivity of their royal master. But citizens in the Parisian public sphere took their cues from the demeanor of the heroes of their favorite plays, paintings and, especially, novels. Crying, laughing, and smiling now became acceptable public gestures among the Parisian elite and middling classes, who seemed to be weaning themselves off cultural dependence on the model of behavior performed at Versailles. And thanks to Fauchard and his ilk, smiles on the stage, on the page, in the frame, and in everyday life, smiles now had pure white teeth.

The Death of Robespierre, on 28 July 1794, engraved by James Idnarpila,
published in 1799, now at the Musée de la Ville de Paris.

© Musée de la Ville de Paris, Musée Carnavalet, Paris, France/Bridgeman Images.


The decline of the smile of sensibility

Had Helen of Troy lost a front tooth, Louis-Sébastien Mercier noted in 1788, the Trojan War might never have taken place. This philosophical quip about the role of accidents in history highlights how much of human beauty and individual identity in late eighteenth-century Paris was thought to be invested in the smile, particularly the open-mouth, white-tooth smile of sensibility.

Yet in the event Madame Vigée Le Brun and, to a lesser extent, dentures-manufacturer Dubois de Chémant were not to be harbingers of a new dawn of human sensibility. The French Revolution of 1789 caused the white-tooth smile to go into abeyance for most of the ensuing century. The reasons for this are many and varied. But like the rise of the white-tooth smile its decline was a complicated process that interwove technical changes and cultural shifts.

Partly at least, the decline of the Parisian smile was a matter of dentistry. The science and professional practice of dentistry went into headlong retreat from the 1790s and the early nineteenth century witness saw their calamitous collapse. The productive niche that dentists had occupied within the pre- Revolutionary medical system was ended by Revolutionary legislation, and no proper training was established for a career in dental surgery. With no institutional status, dentists soon found themselves competing again with the tooth pulling charlatans of old. It was not until the very end of the nineteenth century that French dentistry began to professionalize— or rather reprofessionalize. This made the country a laggard behind its international rivals, notably the USA, where professionalization had begun in the 1830s and 1840s. In France, the erstwhile leader of world dentistry, the Old Régime of Teeth was back with a vengeance.

The decline of the smile owed much to cultural and political changes too. The mood of the Revolutionary decade—especially as the French nation lurched towards war and Terror (1792- 1794)—was generally far too serious for a smile (and all the more for a smile of sensibility) to seem apposite. If there was still plenty of laughter this tended to be either the aristocratic mocking, de haut en bas humor of the counterrevolutionary press or at the other extreme the full-throated plebeian humor generated by the radical popular movement in Paris. In the political mainstream, smiling could now be seen an unpatriotic as well as un-Revolutionary. People kept their heads and their smiles beneath the parapet and out of public view. French Revolutionary political culture fell out of love with the smile. Smiling lost its status as an emergent cultural norm and its iconic status in public life. The Napoleonic era (1799-1815) confirmed the trend, showing marked preference for neoclassical dramatic firmness of facial feature. Napoleon and his nineteenth-century successors would have felt more comfortable with Louis XIV’s facial immobility than with the world that Madame Vigée Le Brun had seemed to be inaugurating.

The quintessential Hollywood smile:
Marylin Monroe, in 1959.
div style= »font-size:11px »>© Bettmann/Corbis.

At a more subliminal level, too, other forces were at work to erode the positive aura around the French smile of sensibility. Prior to 1789, cultivated French men and women associated the open mouth with the new white-tooth smile. From 1789, the open mouth that people associated with the French revolutionaries brought up all manner of disturbing images: the image of the Revolution devouring the revolutionaries as Saturn devoured his children; the quasi-cannibalistic zest of the sansculotte buveur de sang; the facial mutilations of victims of crowd violence; and the last moments of Maximilien Robespierre, executed with half his jaw hanging off after a botched suicide attempt, uttering a piercing scream as his head met the blade and his remaining teeth hit the basket.

These were the kinds of images of the open mouth—very much in tune with the emergent modes of the gothic, the ghoulish, and the melodramatic—that lingered in the imagination from the French Revolution onwards and that crowded out memories of more innocent, smiling times. Even Dubois de Chémant’s gift bestowed on humanity of porcelain teeth were now object of the sarcastic mockery of English caricaturists.

The Parisian smile of sensibility of the late eighteenth century was thus to prove almost as evanescent as the smile itself. The white tooth smile went into hibernation as a public gesture for over a century. It was only really in the twentieth century that it reemerged—and initially in the USA rather than in France— under the influence of a range of factors, including new, highly visual advertising practices, Hollywood media presentation, and the final reemergence of decent, high-class dentistry. The twentieth century would experience a “smile revolution” of its own completely unaware of the eighteenth-century precursor.