The toothpick is humanity's oldest dental tool, dating back nearly two million years.

Health · Published 3 October 2026 Swipe more like this →

In short: Long before modern dentistry, our ancestors were already obsessively cleaning their teeth. From prehistoric hominins to 17th-century aristocrats who wore toothpicks as jewelry, this humble sliver of wood has a surprisingly deep history. Yet, beneath its simplicity lies a dangerous potential for internal injury that persists even today.

The toothpick holds the title of the oldest instrument for dental cleaning in human history. Evidence of its use spans millennia, with hominin remains from Dmanisi, Georgia, dated to approximately 1.8 million years ago, showing lesions consistent with repeated toothpick use. Neanderthals also utilized them to manage pain from periodontal disease and dental wear, as seen in a jawbone discovered in Spain. By the time of the Romans, toothpicks were crafted from mastic wood, while in the 17th century, they evolved into high-status luxury items, artfully stylized from precious metals and adorned with expensive stones.

Modern manufacturing of the wooden toothpick began in the late 19th century. In 1869, Marc Signorello developed the first machine for this purpose, followed by a patent from Silas Noble and J. P. Cooley in 1872. Today, these tools are typically produced from birch wood, which is spiral-cut into thin sheets, milled, and bleached. Despite their ubiquity, dentists now generally favor floss, toothbrushes, and oral irrigators. This preference stems from the risk of gum damage, enamel erosion, and potential harm to dental work like crowns and veneers.

The most severe risks, however, are internal. While most foreign bodies pass through the digestive system without incident, sharp toothpicks can perforate the gastrointestinal tract. Medical literature documents cases where ingested toothpicks migrated into adjacent organs, such as the liver or pancreas, causing abscesses or requiring surgical intervention. For instance, one case involved a 59-year-old man whose 6.5-cm toothpick penetrated his stomach wall and extended into his pancreas. Another case involved a 22-year-old woman whose ingested toothpick caused a 7 cm by 5.6 cm hepatic abscess. These incidents highlight why clinicians must maintain a high index of suspicion when patients present with persistent, unexplained abdominal pain.

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