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Scientists from the Institute of Archaeology and Ethnography of the Russian Academy and the Peter the Great Museum in St. Petersburg published on May 13, 2026, in the journal PLOS One, the study that describes a Neanderthal tooth dated 59,000 years with drilling made by a stone tool to treat a cavity.
A molar from an adult Neanderthal individual, found in the Chagyrskaya cave at the foothills of the Altai mountains in southern Siberia, revealed the oldest documented example of invasive dental surgery in the human evolutionary lineage. The discovery was made by a team of scientists from the Institute of Archaeology and Ethnography of the Siberian Branch of the Russian Academy of Sciences and the Peter the Great Museum in St. Petersburg. The study was published on May 13, 2026, in the scientific journal PLOS One and describes a tooth dated to about 59,000 years with clear signs of intentional drilling made by a stone tool to treat a deep cavity.
The researchers’ motivation in analyzing the material was simple and ambitious at the same time: to understand whether the marks on the tooth were the result of accidental damage or if they had been purposely made by someone intending to relieve the individual’s pain. According to Reuters, experiments conducted on modern human teeth with stone tools identical to those found in the cave confirmed the hypothesis of deliberate surgery, and the level of natural wear following the intervention shows that the Neanderthal lived for a considerable period using the same tooth after the primitive dental operation.
Where the tooth was found and what it reveals
The Chagyrskaya cave is located on the left bank of the Charysh River, at the foothills of the Altai mountains in southern Siberia. The site is known among archaeologists for the rich set of Neanderthal fossils already recovered during excavations carried out over the past decades. It was at this same site that the molar was unearthed.
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The Neanderthals occupied the Chagyrskaya cave between approximately 59,000 and 49,000 years ago, over a period of about 10,000 years of continuous presence. The space served as a base for the slaughter and consumption of bison and horse meat, but also functioned as a domestic living area, where child-rearing took place, as evidenced by the milk teeth found on the cave floor.
In the center of the molar analyzed by scientists, there is a deep hole that reaches the pulp chamber, the internal part of the tooth where the nerve endings and blood vessels are located. The microscopic marks present on the inner surface of the hole and the geometric shape of the perforation indicate, according to Russian researchers, that it is a deliberate modification, and not an accidental break from biting into some hard object.
How the scientists reconstructed the dental surgery
The confirmation that the perforation was intentional came from experiments conducted in the laboratory. The researchers replicated the process on three modern human teeth, using a small stone tool made of jasper, a type of quartz, similar to others found in the Chagyrskaya cave and attributed to Neanderthal occupation.
The result was revealing. A hole with the same shape and the same microscopic groove patterns could be created by drilling the molar with a similar stone tool, through rotational or manual drilling movements. The technique reproduced in the laboratory precisely matched the marks observed on the 59,000-year-old fossil.
The experimentation itself was conducted by Lydia Zotkina, co-author of the study and specialist in archaeological remains. According to her, the most effective movement to reproduce the original pattern was manual drilling with a small jasper tool. The co-author also hypothesized that the resulting cavity might have been filled with some material, such as wax, although no evidence of this has been found in the fossil so far.
What this procedure required from the Neanderthal
Archaeologist Ksenia Kolobova, the main author of the study, highlighted that the procedure revealed by the 59,000-year-old molar is much more sophisticated than it appears at first glance. The action involved several steps that depend on complex cognitive and technical skills.
“The procedure required diagnosing the source of the pain, understanding that removing the necrotic tissue could bring relief, carefully selecting an appropriate stone tool, and executing precise drilling with controlled finger movements,” stated Ksenia Kolobova in a team statement.
The set of skills necessary to perform the operation involves planning, empirical knowledge of anatomy, fine motor skills, and deliberate medical strategy. For Kolobova, the discovery directly challenges the outdated view that saw this type of complex behavior as an exclusive attribute of modern humans.
The extreme pain and willpower of the Neanderthal
Another element that impressed the researchers was the extent of the pain involved in the surgery. The cavity detected in the molar covered almost the entire chewing surface of the tooth, indicating an advanced stage of decay, with intense inflammation even before the procedure.
The intervention, performed without any anesthesia or pain relief medication, required impressive endurance from the individual. Lydia Zotkina expressed admiration for this aspect of the discovery in her analysis of the case.
“It seems to me that this is also proof of extraordinary willpower. Do you know many people who could undergo such an operation without anesthesia or special equipment? Or who could endure it alone? Every time I think about it, I am amazed,” stated the researcher.
The natural wear of the tooth after the drilling indicates that the patient lived for a long time after the surgery, continuing to use the molar for chewing. This means that the operation not only relieved the immediate pain but also saved the tooth from extraction or total deterioration, ensuring that the individual could continue eating normally.
The previous record and the chronological leap of the new discovery
Until the publication of the study on May 13, 2026, the oldest evidence of dental surgery was a tooth attributed to Homo sapiens, found in Italy and dated to about 14,000 years ago. In that case, the cavity had been scraped and cleaned with a stone tool, in a simpler procedure than the one now identified among Neanderthals.
The new discovery pushes the clock of the earliest known dental surgeries much further back. The Siberian molar is approximately 59,000 years old, representing a leap of more than 45,000 years compared to the previous record, significantly changing what is known about the history of primitive dentistry in the human evolutionary lineage.
More than extending the chronological limit of the procedure, the discovery also changes the author of the technique. Instead of the pioneering belonging to Homo sapiens, the new evidence indicates that Neanderthals were already performing complex dental interventions tens of thousands of years before the current human species. This transforms the chapter of medical history that had been told until then.
What we know about Neanderthals today
Neanderthals are extinct relatives of Homo sapiens. They were physically more robust and had more prominent brows, but science has been accumulating evidence for years that they were equally intelligent in various aspects of cognitive life.
Previous studies had already shown that Neanderthals created art, used complex group hunting methods, made symbolic objects, and probably used some form of spoken language. The discovery of the 59,000-year-old molar with signs of dental surgery adds a new layer to this portrait, showing that this species also possessed rudimentary medical knowledge and the ability to intervene in their own bodies to relieve suffering.
Neanderthals disappeared approximately 40,000 years ago. The cause of their disappearance is still debated by science, with hypotheses ranging from climate changes to direct competition with Homo sapiens newly arrived in Europe and Asia. Despite the extinction of the species, most people living today carry a small amount of Neanderthal DNA, the result of ancestral interbreeding between the two human lineages that coexisted for thousands of years.
Other signs of dental care among Neanderthals
The surgery identified in the 59,000-year-old molar was not the only evidence of dental care among Neanderthals. There are also signs that these individuals, including the patient whose history was reconstructed in the new study, used toothpicks to remove food stuck between their teeth.
The combination of these practices indicates that Neanderthals had an awareness of oral comfort and adopted behaviors to preserve oral health. The use of toothpicks suggests continuous attention to oral hygiene, while the surgery reveals an ability to intervene in extreme cases, forming a much more elaborate picture of dental care than science has attributed to this species until now.
These behaviors, seen together, reinforce the growing understanding that the simplistic division between intelligent modern humans and primitive Neanderthals does not correspond to the reality being revealed by recent archaeology. The cognitive boundaries between the two species are becoming increasingly blurred.
What may come next in research with Siberian fossils
The Chagyrskaya cave remains an active archaeological research site. Recent findings make it clear that the site still holds relevant information about the daily life, cultural practices, and technical capabilities of the Neanderthals who occupied the region between 59,000 and 49,000 years ago.
The combination of human fossils, stone tools, remains of hunted fauna, and now evidence of medical procedures transforms the Siberian site into one of the most important in the world for the study of this species. Each new finding has the potential to redefine part of what is known about Neanderthal intelligence, the limits of their technical skills, and the cultural boundaries between them and modern humans.
For medical science, the study also opens doors for reflections on the historical emergence of dentistry. If invasive dental surgery was already possible 59,000 years ago with stone tools and without anesthesia, the initial chapter of this medical specialty needs to be rewritten to include a Neanderthal chapter before the arrival of Homo sapiens on the scene.
The discovery of the 59,000-year-old molar in Siberia reinforces a clear trend of recent decades: with each new study, Neanderthals appear more complex, more intelligent, and more similar to modern humans than science supposed for much of the 20th century. The primitive dental surgery, performed with a stone tool, is yet another important chapter of this rediscovery.
And you, what do you think about this discovery? Did you already imagine that Neanderthals performed dental surgeries so many millennia ago? Do you believe that other advanced medical skills of this species are yet to be discovered? Leave your comment, share your opinion, and tag someone who loves archaeology and ancient history.
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