Hygiene, nutrition and medicine (all good things!) also cause us to remain alive where previously natural selection would not have favoured those bearing too great a mutational load.
I doubt that existing mutations have been fully 'tested'. We know that the majority of mutations are harmful and that the brain is far from fully-developed prior to birth, for instance. Being complex there are many genes which control its development and it seems plausible that the result could be sub-optimal without obvious signs of disease or disability. Other things being equal, we could be slower, less resilient, less fertile, etc, than our 18th century forebears.