10/20/2010 10:19 am ET | Updated May 25, 2011

A President in Pain

As we observe yet another president graying quickly from the duties of the presidency, Americans are made aware of the heavy responsibility our presidents feel. A subject that is less frequently addressed is the various health issues that many presidents have faced that would have made many of their days in office an additional personal trial.

Franklin D. Roosevelt was severely incapacitated by polio; Ronald Reagan suffered a gunshot wound while in office; John F. Kennedy, we learned belatedly, suffered from debilitating back pain. Even our first president, George Washington (1732-1799) lived daily with a high degree of pain and discomfort.

This realization came to me when I stumbled on a side note about the fact that George Washington's false teeth were not made of wood, as is so often rumored. This sent me to investigate what Ron Chernow's exhaustive research for his new biography, Washington, A Life (Penguin 2010) had to say about Washington's teeth.

Ron Chernow confirms that Washington's teeth were not made of wood. The teeth were made of ivory and Chernow writes that the myth that the teeth were made from wood probably originated because ivory can stain along hairline fractures, which might have made them seem to be made of a grainy wood.

But it becomes very clear that toothaches and mouth pain were a bothersome daily issue for George Washington. What's more, he was very self-conscious as to how the substitute teeth made him look. In one letter to his dentist he commented, they "bulge my lips out in such a manner as to make them appear considerably swelled."

Dentistry in its Infancy
In the late 1700s, dentistry was in its infancy. There was some understanding about the importance to keeping one's teeth clean, and there were surgeons who specialized in tooth-pulling, but there was no understanding of how to heal swollen gums, and anesthesia (to make tooth-pulling more bearable) did not come into existence until the 1840s.

As early as 1760 when Washington would have been only 28, one of Washington's aides wrote that Washington generally kept his mouth firmly closed but when he opened it he revealed "defective" teeth. Shortly after Washington's marriage to Martha, the household records showed that he ordered from London six bottles of a "brew" that was designed to cleanse teeth and cure toothaches.

During the Revolutionary War, Washington relied on a dentist by the name of Baker. Unfortunately for Washington, one of his letters to Baker was intercepted by the British. The letter contained teeth and a note about the mouth bridge Washington requested that Baker make for him. After obtaining the letter, the British took great pleasure in making fun of Washington and his teeth, and this caused Washington a great deal of distress.

One of the comments made by a British officer was overhead by a Dr. Jean-Pierre Le Mayeur and Le Mayeur soon made his services available to Washington. The French had actually advanced in dentistry more rapidly than had the English or the Americans, and Le Mayeur became a frequent guest at Mount Vernon. He loved horses and riding, and so his visits may have been mutually beneficial.

Dentures of Old
Dentures were made at that time and usually featured ivory shaped to look like teeth or natural teeth that a dentist or a rich person would buy from anyone willing to sell them; these substitute teeth were then held together in a bone and ivory framework.

Washington's letters to Le Mayeur were written in veiled language, never directly mentioning dental work or dentures, probably because of his embarrassment over the previously intercepted letter. Le Mayeur had had some luck with implanting teeth for at least one patient, but if he tried such a thing with Washington, it did not work. By the time Washington was inaugurated in 1789 he had only one tooth remaining.

By this time, Washington was relying on the dental services of John Greenwood, the son Isaac Greenwood, who is considered the first American-born dentist. When Washington moved to Philadelphia to assume the presidency, he was regretful of being separated from Greenwood who had fashioned for him his latest dentures. These were anchored to the one remaining tooth, a lower left bicuspid.

The dentures Greenwood fashioned for Washington used natural teeth inserted into a framework of hippopotamus ivory. (Some historians think the ivory was from walrus or elephant ivory.) Curved gold springs in the back of the mouth connected the upper and lower dentures. This apparatus meant that Washington was limited to eating only soft foods as dentures were not yet adequate for real chewing, and the springs made public speaking painful and difficult. Because dentures of the day were so uncomfortable, dentists routinely prescribed opiate based powder to use to alleviate pain.

As with Le Mayeur, Washington's correspondence with Greenwood as secretive: "The contents of the [box sent to Washington by Greenwood] were perfectly agreeable to me and will...answer the end proposed very well." While Greenwood offered to try to get to Philadelphia to make adjustments and may have done so, their correspondence makes it clear that Washington tinkered with them on his own, and he still suffered mightily. His diary entry for January 17, 1790 notes "Still indisposed with an aching tooth and swelled and inflamed gum."

Greenwood wrote back to Washington that the port wine Washington drank was having an ill effect on his dentures and darkened them: "I advise you to either take them out after dinner and put them in clean water and put in another set or clean them with a brush and some chalk scraped fine."

It was sometimes noted that Washington had a hair-trigger temper, and for anyone who has ever had a headache or a toothache, we can certainly see why.

Our round-the-clock coverage of recent presidents makes it clear that staying in bed with a headache or a bad cold is rarely an option for an American leader. While Washington might have had a little more freedom to take a day off now and then without the world being aware of it, the country's circumstances likely dictated that staying home to nurse one's pain was rarely an option. We can only admire the strength and fortitude he showed in putting his country's needs ahead of his own despite living with what must have been constant discomfort.

For more insight into our country's past, check out: