For as long as human beings have had teeth, keeping them in good shape—in fact, keeping them at all—has been a challenge. While historians believe the practice of dentistry may date back to at least 7000 B.C., many centuries passed before professional dental care became widely available. As late as the 19th century, barbers often doubled as surgeons and dentists, yanking teeth as well as cutting hair. The familiar red-and-white striped barber pole of today can be traced to a time when barbers hung bloody rags out to dry after surgical procedures.

So, for countless generations of men and women, dental care was largely a do-it-yourself project. The tools available to our ancestors for that purpose have evolved but still bear a striking resemblance to what can be purchased in any drugstore today.

While theories about what causes tooth decay have changed over the centuries—from mysterious “tooth-worms” in ancient times to bacteria-breeding plaque today—people understood the importance of keeping their teeth clean. Before toothbrushes, many used chew sticks, thin twigs they would gnaw on until one end frayed, creating a sort of brush. Chew sticks remain in wide use in some cultures today.

The toothbrush, as we know it, appears to have been invented in China, sometime during the Tang Dynasty, from 618 to 907 A.D. The earliest models had handles of bamboo or bone and bristles made with boar’s hairs. Boar’s hair brushes also remain available to this day, often promoted as an environmentally friendly alternative to the nylon-bristled, plastic-handled variety.

William Addis, an Englishman, is credited as the first entrepreneur to mass-produce toothbrushes, supposedly creating his prototype in 1780, while in prison on rioting charges. In 1857, H. N. Wadsworth, a Washington, D.C. dentist, received the first U.S. patent for a toothbrush, which he claimed did a better job of scrubbing between the teeth. Numerous other innovations would follow, including the introduction of nylon bristles in 1938.

In 1937, American inventor Tomlinson I. Moseley patented a design for an electric toothbrush. The idea failed to catch on, however, until Philippe-Guy Woog, a Swiss scientist, introduced his own model in 1954. By some accounts, Woog’s Broxodent electric brush was intended to assist people with limited mobility, but it was soon promoted to the general public. One 1960s magazine ad even called it “the perfect gift for Mother's Day, Father's Day, weddings and graduations.”

Strangely, toothpaste actually pre-dates the toothbrush. “Around 3,000–5,000 B.C., ancient Egyptians first developed a dental cream which contained powdered ashes from oxen hooves, myrrh, egg shells and pumice,” Frank Lippert of the Indiana University School of Dentistry wrote in a 2003 monograph. “Persians then added burnt shells of snails and oysters along with gypsum, herbs and honey around 1,000 B.C.”

People continued to whip up their own toothpaste and powders even after the advent of commercially produced versions centuries later. An 1860 book titled The Practical Housewife, for example, recommended a mixture of powdered orris-root, powdered charcoal, powdered Peruvian bark, prepared chalk and oil of bergamot or lavender.

A Connecticut dentist, Washington Wentworth Sheffield, is credited with the idea of packing toothpaste in a squeezable tube in the 1880s. Before then, the American Dental Association notes, it was commonly “sold in bottles, porcelain pots or paper boxes.” That breakthrough, the ADA says, helped make it possible for toothpaste to be “mass-produced in factories, mass-marketed and sold nation-wide.”

In 1955, Crest launched the first toothpaste to contain fluoride, which research had shown to be effective in reducing cavities. Drawn by the illustrator Norman Rockwell, early Crest ads featured grinning boys and girls showing off reports from their latest dentist visits, with the tagline “Look Mom—no cavities!” Today all toothpaste bearing the ADA’s seal of acceptance must contain fluoride, and many municipalities add it to their drinking water.

The humble toothpick may be the oldest of all dental implements, dating back more than a million years, to prehistoric times, according to anthropologists. In that time, it has gone from an everyday object to a status symbol and back to an everyday object again.

The earliest toothpicks were probably small slivers of wood, although bone, ivory and other materials came into use at various points. Also popular: quills plucked from crows and geese.

During the Victorian era, toothpicks made of silver or gold became popular among people who could afford them. An ivory and gold toothpick once belonging to Charles Dickens and engraved with his initials, sold at auction in 2009 for $9,150.

In fact, tooth picking at meals apparently became so prevalent in the 19th-century society that etiquette books were compelled to address the topic. “It is very rude to pick your teeth at the table,” one advised in 1882, helpfully adding, “If it becomes necessary to do so, hold your napkin over your mouth.”

The toothpick began to return to its wooden roots in the 1860s when American entrepreneur Charles Forster figured out a way to mass-produce them. His Maine-based factory was soon turning out 500 million a year, and free toothpicks became ubiquitous restaurant giveaways.

Dental floss came into common use only in the 19th century, due to the efforts of an American dentist, Levi Spear Parmly. In an influential 1819 book, Parmly recommended running “waxed silken thread” between the teeth “to dislodge that irritating matter which no brush can remove, and which is the real source of disease.”

By the end of the 19th century, commercially manufactured dental floss of waxed or unwaxed silk became available. It would largely be replaced by nylon floss in the 1940s, driven in part by the scarcity of silk during World War II as well as by nylon’s greater resistance to shredding. Today, floss is made from a variety of synthetic fibers.

In the late 1950s, water flossers or oral irrigators, which shot jets of water between the teeth, arrived on the scene. The Waterpik, introduced in 1962, was the result of a collaboration between two Coloradans, a dentist and a hydraulic engineer, who reportedly perfected its pumping mechanism only on the 146th try.

All told, better self-care combined with advances in professional dentistry and fluoridation have had a remarkable effect.

Matthew J. Messina, an assistant professor at the Ohio State University College of Dentistry who has written on dental history, says that in 1960, 49 percent of Americans could be expected to lose all of their teeth during their lifetime. By 2010, that figure had dropped to 13 percent, despite a nearly 10-year rise in average life expectancy. “My grandparents took their [false] teeth out each night and put them in a glass on their bedside table,” he says. “My generation and our kids know that we can keep our smiles forever, and we expect to do that.”