A certain notion that frequently shows up in popular culture and online claims that everyone in the premodern world all had absolutely disgusting, crooked, and totally rotten teeth. There is some truth to this perception. Modern orthodontic practice did not exist in the premodern world, so the majority of people probably did not have perfectly straight teeth. Additionally, across the board, most people in the premodern world generally had poorer dental hygiene than what is considered normal in most western developed countries in the twenty-first century. Some premodern people did indeed have extremely disgusting, disease-ridden, and rotten teeth.
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Nevertheless, the popular perception ignores a great deal of contravening evidence. Some premodern people had naturally straight teeth, just as some people do today, and perfectly straight teeth with no gaps haven't necessarily always been seen as desirable in all cultures. Additionally, premodern people did have an interest in keeping their teeth clean and they had methods of cleaning their teeth, although ones that are not as effective as those in widespread use today.
Finally, most premodern people's teeth were not all totally rotted and falling out due primarily to the fact that they rarely or never consumed simple sugars, which are the primary cause of most tooth decay today. People who lived in areas close to the sea also tended to eat lots of seafood, which is high in fluoride, which may have helped to protect their teeth. Consequently, some ancient and medieval people actually had relatively nice-looking, healthy teeth even by twenty-first-century standards.
The prevalence of non-perfectly-aligned teeth in the premodern world
Modern orthodontics did not exist in the ancient or medieval worlds. Orthodontic braces, headgear, palatal expanders, and retainers did not exist. Consequently, the majority of people in premodern times most likely had teeth that were not perfectly in accordance with modern western dental aesthetic norms, which hold that teeth should be perfectly aligned and close together.
That being said, we know that some people did have naturally straight teeth, in the same way that some people today have naturally straight teeth without ever needing braces or other orthodontic treatment. Even among people who did have misaligned teeth, the degree of misalignment almost certainly varied considerably, with some people having more or less crooked teeth than others.
This, however, gets to a deeper issue. Twenty-first-century western culture usually portrays teeth that do not fit their aesthetic norms as ugly and most modern people have been taught to view them this way. Not all cultures throughout history, however, have necessarily shared the same normative view of what teeth should look like.
Notably, even today, despite the pervasive influence of western aesthetic norms, in some West African countries such as Nigeria and Ghana, it is widely regarded as highly attractive for a person to have a gap between their two front teeth, to such an extent that some people who don't naturally have gap teeth have had orthodontists give them treatments to give them tooth gaps.
Even within a single culture, attitudes about which kinds of teeth are aesthetically pleasing or attractive can vary. For instance, as this article published in The New York Times in February 2012 discusses, gap teeth apparently went through a phase of popularity in the western fashion industry in the early 2010s.