We’ve been learning a lot about Neanderthals lately. In just the past few months, researchers have argued that they were much smarter than we previously gave them credit for, even if their lack of sociability may have killed them. We learned Neanderthal children hunted turtles for fun, and when they were babies, they were absolute units. We learned recently that they used rhino teeth as tools. Sticking with the dental theme, today, thanks to a new study published in PLOS One, we’ve learned that they practiced a primitive, brutal form of prehistoric dentistry.

Researchers studying a cave site in Siberia’s Altai Mountains discovered a 59,000-year-old Neanderthal molar with what looked like a massive cavity drilled straight into it. The tooth, known as Chagyrskaya 64, contained strange scratches and marks around the damaged area that didn’t appear natural. After running scans and comparing the tooth against experiments performed on modern human teeth, scientists concluded that someone probably used a sharp stone tool to intentionally carve out the infected section.

I think it would be wise to note that anesthesia was not invented until the 1840s, so it’s safe to assume the Neanderthals were hardcore.

The cavity extended into the tooth’s pulp chamber, where nerves and blood vessels sit, meaning the owner of this particular tooth was likely in extreme pain long before the procedure even started. Researchers believe another member of the group may have used pointed jasper tools found in the cave to drill or rotate into the infected tooth, removing decayed tissue and accidentally (or maybe intentionally?) deadening the nerves in the process.

As stated above, we recently discovered that Neanderthals were smarter than we once thought. The evidence to support that is seemingly being backed up by studies that are being released on a weekly basis. To perform any kind of dentistry on a fellow Neanderthal suggests they were much closer to us than we once assumed, as we had previously used Neanderthal as a derogatory term for a dummy or someone who is exhibiting some outdated thinking. But they planned, they knew how to use tools, and they even knew how to organize a system of caregiving. They understood the concept of pain, had a rough idea where it was coming from, and they kind of knew how to treat it.

For a primitive ancient culture that died out because we were simply better at certain things than they were, it’s getting harder and harder to claim that we won out because we were smarter. The Neanderthals knew what they were doing, even when it came to dentistry.