If you harbor some anxiety about visiting the dentist, you certainly aren’t alone. As many as 75% of adults report some level of dentophobia — fear of dentists.

For those who dread dental procedures, the best part of the experience is when it is over and they can return to a life free of men and women with sharp, pokey, metal objects who say, “You may experience a bit of a pinch….”

For some, departing the dentist’s office wasn’t the end of anxiety; it was just the beginning of a horrific experience that was truly fuel for nightmares. For them, horrible, growing, all-consuming pain threatened to drive them insane. Then, when it seemed things couldn’t get any worse — BANG!

Welcome to the mysterious maladies of detonating dental disaster.

Pennsylvania dentist W.H. Atkinson encountered a peculiar phenomenon among dental patients. Actually, “peculiar” doesn’t begin to describe it. “Utterly terrifying” would be a better categorization. The dentist began to hear reports of spontaneously-exploding teeth.

Much like the curious cases of spontaneously-exploding pants that would plague New Zealand’s farmers in the 1930s, Atkinson began to hear accounts of people whose mouths inexplicably erupted in a loud, powerful, painful, and destructive explosion.

He documented three case studies in The Dental Cosmos. In an article entitled “Explosion of Teeth With Audible Report.” [Volume 2, Issue 6, January 1861, pp. 318-319]

The first involved a respected clergyman, identified as Rev. D.A. This gentleman, in 1817, began experiencing some discomfort in his upper right bicuspid or canine. It started as mildly uncomfortable, but the pain quickly intensified to the point where the man was seen boring his head in the ground like an enraged animal. He also sought relief by poking at the inside of his mouth with a fence post or plunging his head into cold water.

None of the clergyman’s attempts at finding a remedy were successful. Unable to sleep, he was walking about in a state of delirium. At about 9:00 one morning, he heard a sharp crack like the shot of a pistol and felt his tooth burst into tiny fragments.

Although understandably startled by this development, he was more interested in the instant relief he felt in his mouth. He turned to his wife and said, “My pain is all gone.” He went to bed and slept soundly all that day and most of the succeeding night. Aside from having lost a tooth, he had no further issues after the mysterious mouth explosion.

The next case documented by Atkinson took place 13 years after Rev. D.A.’s experience. This involved a woman identified as “Mrs. Letitia D.” She lived near Atkinson. She came, seeking relief from a prolonged toothache. Despite treatment, the pain continued. It “[terminated] by bursting with report, giving immediate relief.”

The third case involved “Mrs. Anna P.A.” In 1855. She reported pain in her upper left canine. Her condition changed unexpectedly, following “a sudden, sharp report, and instant relief, as in the other cases, occurred in the left superior canine. She is living and healthy, the mother of a family of fine girls.” Atkinson noted that the explosion, in this case, caused the affected tooth to split from front to back.

Atkinson’s case studies were not unique. The British Dental Journal recently reprinted correspondence from 1965, describing additional dental detonations.

Among these incidents is one recorded in 1871 by American dentist, J Phelps Hibler. His treatment of a young female toothache patient ended spectacularly when molar, “bursted with a concussion and report, that well-nigh knocked her over.” It was so loud that the unfortunate woman was unable to hear for several days.

Another happened early in 1918. A U.S. naval officer came to a dentist, complaining of persistent pain in a lower left molar. Upon examination, the dentist noticed a “longitudinal fracture at right angle to the occlusal plane and probably passing through the line of bifurcation of the roots.” When he asked the sailor what happened, he learned that the man was in a boxing match the prior evening, when he “received a blow on his jaw, not under it, when the tooth seemed to explode.”

This phenomenon continued to be reported well into the latter half of the 20th century. One dentist received a letter from the mother of two girls. When the girls’ baby teeth fell out, the mother kept them. She wrote:

“These teeth became loose and fell out quite normally and didn’t appear to be damaged or cracked when I examined them as soon as they fell out. The double tooth was placed on the mantelpiece which gets warm but not excessively so; several hours later it ‘exploded’ sending pieces all over the room. I collected as many pieces as I could find but some are still missing. The two single teeth were put on the mantelpiece in a tortoiseshell snuffbox and I didn’t realise they were also split until some weeks afterwards.”

In the 1960s, explorers in the Antarctic returned home, reporting that during their expedition, their teeth spontaneously shattered. At the time it was attributed to the extreme cold temperatures. In retrospect, there may have been a different cause.

In his 1861 article, Atkinson offered two possible explanations. The first was that a substance which he called “free caloric” was building up in the tooth and causing a dramatic increase of pressure in the pulp. Later science has since discounted this as a possibility.

His second suggestion was that the explosions were caused by a buildup of highly-explosive gas, triggered by tooth decay. While the decay may not be the primary cause, Atkinson may have been on the right track. The answer may lie in the fillings used to treat the decay.

In the early 1800s, dentists used many different substances to fill cavities. Silver, lead, tin, and various alloys were common choices. One of the properties of metal is that it will generate an electrochemical charge when in contact with a different metal. It is conceivable that the right mixture of metals in a person’s teeth could turn the entire mouth into a low-voltage battery. Combine this with the gas buildup caused by untreated cavities or infection.

The premise is interesting and plausible. Unfortunately, the record does not reflect whether the afflicted 18th-century patients had fillings. Consequently, this explanation is speculation. and the official cause of the “mystery of the exploding teeth” remains a mystery.

We cannot leave this topic without also addressing Adkinson’s assessment of the differing philosophies for pain management among his colleagues. He wrote:

The merely “practical” observer, if clear and honest, says, Ah! I thank you for your suggestive lesson; and at once resorts to his drill, and promptly relieves his grateful patron by simulating nature’s law in relieving, but not in mutilating….

But we must not pass without due notice (respect?) the stubborn, self-sufficient know-nothing who has taken it upon him to offer surgical or dental advice to his fellows, who replies, when inquired of what would be best to do, “Why, bear it, for it is not half as much as you deserve to suffer for your sins and negligences;” instead of plainly acknowledging, like a man, that he did not know, and was only enabled to look upon such intense agony calmly because be had no real knowledge of what it was to suffer; and hence, because he was not the immediate subject of pain, he thought that “in fact they had no nerve to bear anything, were very easily set to complaining, etc.; all of which he would very readily take back if he could only be made to exchange places with the sufferer.

These men of nerve and endurance usually are like Falstaff — very courageous till put to the test. I have seen many of them bawl lustily when but slightly pained.

So while the cause of exploding teeth remains an unsolved mystery, we do have conclusive evidence of something many of us have suspected all along: some dentists are sadistic and delight in the misery of others.

Or are we reading too much into this?