Body modification for aesthetic, social, and religious purposes is as old as civilization itself [1]. In nearly all parts of the world, the human need to express identity, affiliation, or status has been reflected through bodily interventions, including those involving teeth [2]. Teeth, as prominent and easily visible facial elements, have played a key role in many ritualistic and decorative practices. Their transformation—whether through pigmentation, the insertion of precious metals and gemstones, filing into various shapes, or even deliberate extraction—has been observed across different cultures. Such practices can be found among the civilizations of Mesoamerica, especially the Maya, in ancient Egyptian tombs, and throughout East and Southeast Asia—in Japan, China, and the Philippines [3,4]. Each of these cultures developed unique techniques and aesthetic norms that reflected their cosmologies, social hierarchies, and concepts of beauty [5].
This paper focuses on geographically and chronologically diverse examples of dental adornment throughout history, aiming to identify and analyze the cultural meanings, techniques, and materials used in these practices.

ANCIENT CIVILIZATIONS

One of the most striking forms of dental modification in ancient Mesoamerican civilization was the practice of tooth decoration among the Maya. This practice carried deep symbolic meanings and was closely tied to aesthetics, social status, and religious beliefs. The Maya often drilled small holes into their front teeth using rotary tools, into which they embedded semi-precious stones such as jade, turquoise, or hematite. Jade, symbolizing immortality, power, and a connection with deities, was especially reserved for members of the elite [6].
In addition to gemstone inlays, tooth reshaping through filing was also common, producing pointed, T-shaped, or notched forms. These procedures were typically performed during youth, likely as part of initiation rites, adding to their social and spiritual significance. Some communities even practiced staining or blackening of the teeth with special substances, which was considered a sign of purity and attractiveness. These sophisticated interventions demonstrate the high level of technical skill possessed by the ancient Maya, as well as the deeply rooted importance of oral aesthetics in their culture and daily life [7].
Among Andean peoples such as the Inca, symbolic tooth filing and the use of red or black pigments were practiced. Certain colors were believed to offer protection from evil spirits or aid in ritual transformation. Although the Incas did not embed decorations as the Maya did, the symbolic importance of teeth was evident in many ceremonial contexts.
In contrast to the Maya, there is no direct evidence of gemstone inlays or deliberate aesthetic reshaping of teeth among the ancient Egyptians. However, archaeological findings indicate that Egyptians placed great emphasis on oral hygiene and aesthetics. They also developed early forms of dental procedures, including the stabilization of loose teeth with gold wire, which some interpret as an early form of dental prosthetics. In the tombs of wealthy individuals, gold prostheses and inlays have been found, likely serving both aesthetic and symbolic purposes, as well as indicating social status. In some cases, teeth were wired together post-mortem as part of funerary preparations aimed at preserving bodily “wholeness” for the afterlife [8].

CHINA AND EAST ASIA

In East Asian cultures, dominant dental practices involved staining, blackening, and surface modification. In ancient China, particularly during the Han and Tang dynasties, tooth coloring was practiced in rural areas and especially among ethnic minorities. Blackening of teeth carried multiple meanings—from protection against evil spirits, to expressions of purity, and visual harmony aligned with Taoist principles of yin and yang [9].
This practice later spread to Vietnam. The most notable example in Japan was ohaguro, an aesthetic ritual of tooth blackening practiced from the Heian period (9th century) until the late 19th century. Ohaguro symbolized maturity, femininity, fidelity, and sophistication, and at times was also a component of samurai culture. The process involved a mixture of iron filings, vinegar, and plant-based pigments [10,11].
Unlike their Asian neighbors, ancient Filipino civilizations developed highly complex forms of dental ornamentation using gold restorations. Archaeological discoveries such as the famous Bolinao skull reveal that individuals during the precolonial era had gold inlays and engravings on their front teeth—serving both as status symbols and spiritual protection [12,13]. Some rulers and nobles even had diamond-encrusted restorations, highlighting an advanced level of dental technology and aesthetic standards in precolonial societies [14].
During the Vedic period in India, dental hygiene played a significant role in spiritual and health practices. While direct modifications of the teeth were uncommon, records exist of Ayurvedic preparations used for whitening and strengthening teeth, associated with the concept of spiritual and physical purity. Later, among some aristocratic classes, the use of gold inlays and ornamental dental elements was also documented [15].

AFRICA

Africa is a continent with some of the most diverse and enduring traditions of body modification, where dental decoration and reshaping have played an important role in many communities. The most common dental interventions involved deliberate tooth extraction, filing, sharpening, and pigmentation [16].
The Mangbetu people (Democratic Republic of Congo) are known for skull elongation, but also for the aesthetic shaping of teeth. Young girls and boys would have their front teeth sharpened into a triangular shape, which represented an ideal of beauty and group identity. These modifications were part of initiation rituals and symbolized physical readiness and aesthetic maturity [17].
Among the Yaka and Teke peoples (Congo and Angola), as well as the Makonde (Mozambique), tooth filing into sharp points was a ritual act of sexual maturity and also served as a means of intimidating enemies during times of war. Teeth were considered "windows to the soul," and their transformation and protection had a spiritual dimension. This process was painful and often performed during adolescence [18].
The practice of coloring teeth and tattooing the lips with black pigments among Fulani women in northern Mali and Niger is deeply rooted in their culture and aesthetics. This tradition, known as Tchoodi or tunpungalle, includes tattooing the gums, lips, and chin with natural pigments, often derived from plant sources such as ash and resins. The goal of these modifications is to highlight the whiteness of the teeth, which is seen as a symbol of purity, beauty, and spiritual balance. These practices are often performed during ceremonies and weddings, representing a rite of passage into adulthood and symbolizing courage and community belonging [19].
Members of the Beti and Fang peoples (Cameroon and Gabon) practiced the removal of upper front teeth as part of initiation into adulthood. It was believed that this act liberated the individual from childhood and opened a spiritual channel for communication with ancestors. The absence of teeth was not seen as a handicap, but as a sign of honor and bravery [20].
In East African tribes such as the Dinka and Nuer in Sudan, the removal of lower incisors has been practiced for centuries. It was believed that extracting these teeth made it easier to ingest food and medicine during illness, but it also had symbolic meaning—it marked the transition from childhood to adulthood [21].
Although more widely known for other forms of body modification (e.g., ear stretching), some Maasai warriors (Kenya and Tanzania) had their teeth removed during initiation as a symbol of sacrifice and masculinity. They also practiced forms of traditional dental therapy, often involving symbolic “treatment” of pain through pigmentation and rituals [22].

EUROPE

Dental decoration in Europe followed a distinct developmental path, differing from the traditions of other continents, and was mostly closely associated with social status, aesthetics, and the technological capabilities of the time.
Archaeological findings suggest that as early as ancient Rome, wealthier classes used dental inlays made of gold or bone. While the focus was on functionality and restoration, there were also aesthetic elements of adornment [23]. Concern for white teeth and oral hygiene was part of cultural norms, and well-preserved smiles were seen as a sign of refinement.
During the Middle Ages, the dominance of Christian dogma diminished the importance of bodily aesthetics, but among the European nobility in Italy and France, gold and silver teeth were status symbols. These modifications had no health-related purpose and were part of courtly luxury and personal aesthetics [24]. Simultaneously, in rural areas of Europe, such as Scotland and Ireland, coloring teeth with plant-based pigments—especially using tree bark—was common among women. Darker teeth were seen as a sign of modesty and piety.
The period from the 17th to the 19th century marked a revolution in dental prosthetics. In England and France, sophisticated prosthodontics were developed, and the aesthetic of a white smile became a dominant ideal linked to cleanliness and morality. This period is known for the phenomenon of “Waterloo teeth”—natural teeth collected from the battlefield after the Battle of Waterloo and used to make dentures for the wealthy [25].
During the Spanish Inquisition (1478–1834), the Catholic Church strictly forbade “unnatural adornment” of the body, including the teeth, deeming such practices heretical and contrary to religious norms. Although there is no concrete evidence of engravings on teeth as secret religious symbols, it is known that some clandestine religious orders used discreet body markings as signs of affiliation and spiritual devotion [26].
Among Slavic peoples, particularly in Ukraine and Russia, archaeological findings show practices of decorating teeth with metal wires and gold threads, often for ceremonial purposes. Warriors wore inlays as signs of courage and tribal affiliation, while aristocrats developed early forms of dental prosthetics using gold and mother-of-pearl [27].

CONTEMPORARY SUBCULTURES AND ARTISTIC PRACTICE

Modern technologies have made dental decoration less invasive, more accessible, and safer for patients. In the 20th and 21st centuries, European artistic and musical subcultures (e.g., punk, goth, and hip-hop communities) popularized dental adornment through piercings, decorative tooth covers (grillz), and laser engravings. In Germany and France, artists have emerged who engrave images and messages onto dental veneers, merging dentistry with art [28].
Tooth gems remain among the most popular aesthetic dental accessories. A recent trend emphasizes minimalism—tiny zirconia stones, diamonds, or shapes such as stars, moons, and similar symbols are commonly used [29]. The emergence of nano-tattoos for teeth introduces a novelty in aesthetic dentistry. These temporary tattoos are applied directly to the enamel and last from several days to a week. They are safe for use and often chosen for special occasions [30].
In urban styles, there is growing popularity of gold and metallic caps that cover a single tooth—most often a canine or lateral incisor. Contemporary versions of these accessories are sophisticated, often featuring matte finishes or rose gold coloring.
Tooth decorations that glow under UV light have become a trend among festivalgoers and attendees of nighttime events. These adornments are easy to apply and remove, do not damage the teeth, and come in various colors and shapes [31].
Although grillz have long been present in popular culture, modern examples are far more advanced—they are crafted using intraoral scanning and 3D design, often incorporating engravings, symbols, or initials, and are made from various metal alloys [32].
One of the most modern expressions in the field of dental aesthetics is the concept of geometric porcelain veneers—lovja. These veneers, known for their unique surface texture featuring multifaceted geometric shapes (dentagons), are made from highly aesthetic ceramics and are characterized by precision and individualized design [33].

CONCLUSION

Dental decoration throughout history reflects a complex connection between aesthetics, identity, and ritual. From ancient civilizations, where teeth symbolized status and religious beliefs, to modern trends that merge personal expression with technology, this phenomenon has evolved over time. Today, thanks to new dental technologies, tooth decoration is becoming more accessible and less invasive, allowing for greater personalization. Although the symbolic and social aspects have changed, dental decoration remains an important form of identification, with the potential to further evolve in response to the needs of contemporary society.

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