Anthropologists believe that early men picked their teeth with sticks cut to a sharp point.
Evidence of Stone Age toothpicks is indirect but compelling and the demonstration is on fossil teeth. Analysis of their marks has led to the consensus that they were made by heavy toothpick use by our early ancestors.
The grooves were especially common in the teeth of Neanderthals who lived in Europe and Asia, about 100,000 years ago. Similar markings have been found in the fossilized teeth of both American Indians and Australian Aborigines.
At this age people did not know how to repair teeth and only good care was the method to maintain their teeth, so they tried clean their teeth instinctively and a branch of wood was the beginning of toothpick.

Toothpicks were introduced into Japan about 528 along with Buddhism via China and Korea. In India twigs from Neem tree were used but as they did not grow in China use was made of the willow tree, a spicebush, a cedar, a peach tree, or a bamboo.
The clean custom of the toothpick migrated from the usual life of Buddhist monks very shortly to the nobles. Soon officers of the Court and Shinto priests began to imitate their clean custom.

Romans and Greeks were also avid oral hygiene enthusiasts.
The early Romans had their own dental-care preferences. Pliny the Younger of Rome (61-113 A.D.) proclaimed that using a vulture quill as a toothpick would cause halitosis, but using a porcupine quill was acceptable because it 'made the teeth firm'.
In fifteenth-century Europe, picking the teeth was widely accepted until philosophers began to issue conduct warnings. Rhodes said: 'Pick not thy teeth with thy knyfe, but take a stick, or some clean thyng, then doe you not offend'.
Personal silver, gold or ivory toothpiks were widely used in the Middle Age and often were included in traveling sets together with knife and spoon.

At the beginning of 19th century, with the introduction of disposable wooden toothpicks, the use of figural holders suitable to display the toothpicks on the table, spread in Continental Europe.
Usually these holders had a pierced base or a small container where sunburst toothpicks ornamentations were inserted.

An excellent illustration of 'sunburst ornamentation' is displayed in this image of an Italian toothpick holder representing Napoleon standing in front of two cannons with toothpicks inserted into the cannon balls.   (Venice, before 1810, silversmith Bartolomeo Valazza)

Textured skin of hog and porcupine were particularly suitable for toothpick inserting. The rooting hog with curly ears on the left is Portuguese and the porcupine on a pedestal with four ball feet is French. The toothpick holders below are Italian, made in Venice by silversmith Luigi Merlo (on ther left) and Giovanni Fantini (on the right).

Other animals were used for figural toothpick holders

camel	curly-coated ram	lion holding a rectangular basket in its mouth

shaggy-haired goat	whippet	crowing rooster

birds on a bath held by a kneeling cupid or drinking from a fountain
 

poodle about to jump through a ring held by a clown   or holding two baskets in his mouth

or mythologic animals as wyvern and mermaid holding an anchor and buoy

Toothpick holders representing the mythological Deity of the Sea Neptune/Poseidon (3) and his wife, the Nereid Amphitrite, Goddess of the Sea, standing on pedestals and backed by shells

a set of 'putto' toothpick holders:

bacchus on a barrel	holding a flower	leaning on a stick	holding a garland	holding a cup and frond

a set of 'female figure' toothpick holders:

bacchanal figure holding a garland	dancing girl holding a garland	running girl holding a bird

girl holding a bud and a basket	girl waving a frond	girl with a flower and a leaf

a set of 'male figure' toothpick holders:

sailor standing near a barrel and anchor	chinamen holding a bud-form vase	shepherd with his dog	Mercury holding a caduceus

Indian holding a garland	bard leaning against a tree-stump	youth with cape	shepherd holding a flute

a set of 'others' figural toothpick holders:

All the toothpick holders in this selection belongs to 19th century 'Continental silver' production. They were made in Portugal (most), Italy (Venice and Turin), France, Spain and Austria