That’s not some sort of metaphor or epithet. Apparently, there really were Stone Age dentists:

Neanderthals used stone drills to treat cavities almost 60,000 years ago in what is the earliest known evidence of dental treatment.

The single molar, which was unearthed in a cave in southern Siberia, features a deep hole that appears to have been created using a sharp, thin stone tool during the lifetime of the tooth’s owner.

While the prospect of stone age root canal treatment may be excruciating to even contemplate, archaeologists say the discovery provides remarkable insights into Neanderthals’ advanced behaviours – and possibly their gritty disposition.

Dr Kseniya Kolobova, an archaeologist at the Siberian branch of the Russian Academy of Sciences in Novosibirsk, said: “This discovery powerfully reinforces the now well-supported view that Neanderthals were not the brutish, inferior cousins of outdated stereotypes but a sophisticated human population with complex cognitive and cultural capacities. [It] adds an entirely new dimension – invasive medical treatment – to the growing list of advanced Neanderthal behaviours.”

The dentist was pretty good, too:

A dental professor, who reviewed images of the tooth but was not part of the research, rated the Neanderthal’s work as “a decent job”.

“If I was marking this for a dental student, I wouldn’t give it an A, but given the circumstances it’s pretty impressive,” said Justin Durham, a professor of orofacial pain at Newcastle University and the British Dental Association’s chief scientific adviser.

The smoothed edges of the drilled cavity, and wear patterns inside it, suggested the individual survived and continued to chew with the tooth for some time after the procedure.

The tooth, which has been dated to be 59,000 years old, was found in Chagyrskaya, where the remains of Neanderthals and thousands of stone tools have been excavated. The lower molar features a deep hole in the centre of the tooth extending into the pulp cavity. Microscopic X-ray imaging revealed changes in mineralisation that indicated severe tooth decay.

The researchers conducted experiments on three modern human teeth to demonstrate that a hole of the same shape and same patterns of microscopic grooves could be created by manually rotating a narrow, elongated tool made from local jasper, between two fingers.

That was in the Old Stone Age, the Paleolithic. The surgical technique thought till now to be oldest is trepanning – drilling holes in skulls – from the New Stone Age (Neolithic). It apparently was quite widespread:

Trepanation is a worldwide practice that was extremely common during the Neolithic era. The main pieces of archaeological evidence are in the forms of human remains. At one burial site in France dated to 6500 BCE, 40 out of 120 prehistoric skulls found had trepanation holes. At the time only around 40% of people survived the procedure.[13] A skull of a child in an Harappan burial at Lothal dated to 2200 BCE shows signs of trepanation.

More than 1,500 trephined skulls from the Neolithic period (representing 5–10% of all cranial remains from that era) have been uncovered throughout the world – from Europe, Siberia, China and the Americas. Most of the trephined crania belong to adult males, but women and children are also represented.

More and more of the findings these days about ancient humans indicate that they were more sophisticated than previously thought. And perhaps even more stoic.