The prevalence of periodontal disease in a Romano-British population c. 200-400 AD.

OBJECTIVE: The aim of this study was to investigate the prevalence of moderate to severe periodontitis in an ancient British cohort c. 200-400 AD. DESIGN: Observational study to assess periodontal and other oral disease parameters. SETTING: Natural History Museum, London. SUBJECTS AND METHODS: 303 skulls from a Romano-British burial site in Poundbury, Dorset were examined for evidence of dental disease. MAIN OUTCOME MEASURES: The primary outcome measure was presence of moderate to severe periodontitis. Secondary outcomes included: amount of horizontal bone loss; prevalence of ante-mortem tooth loss; and presence of other dental pathologies. RESULTS: The overall prevalence of moderate to severe periodontitis was just greater than 5%. The prevalence rate remained nearly constant between ages 20 to 60, after which it rose to around 10%. The number of affected teeth increased with age. Horizontal bone loss was generally minor. Caries was seen in around 50% of the cohort, and evidence of pulpal and apical pathology was seen in around 25%. CONCLUSIONS: The prevalence of moderate to severe periodontitis was markedly decreased when compared to the prevalence in modern populations, underlining the potential importance of risk factors such as smoking and diabetes in determining susceptibility to progressive periodontitis in modern populations.

Exploring the relationship between weaning and infant mortality: an isotope case study from Asikli Höyük and Çayönü Tepesi.

We measured stable nitrogen isotope ratios in bone collagen of 60 individuals from the early Neolithic (9th-8th millennium Cal. BC) sites of Çayönü Tepesi and Asikli Höyük. Our aim was to identify the duration of exclusive breastfeeding (EBF), compare this with juvenile mortality at each site, and assess whether there was a relationship between them. The isotope analysis suggests that weaning commenced at about 1 year at Asikli Höyük and around 2 years at Çayönü Tepesi. The mortality data show equal numbers of infant deaths up to 24 months; however, after 24 months, the mortality rate increases at Çayönü Tepesi, and a Student's t-test confirms a significant difference in infant mortality between the sites. Weaning foods prepared in the early Neolithic from agricultural crops would have had low-iron content, poor nutritional value, and would have been prepared in nonsterilized containers. Therefore, later weaned infants in early Neolithic farming settlements, although capable of some immunological response, were probably undernourished putting them at a disadvantage when encountering bacteria in their weaning food. Our results suggest that infant feeding regimes that introduced infants to weaning foods in the first year of life may have had a positive effect on their survival.

Isotopic evidence for breastfeeding and possible adult dietary differences from Late/Sub-Roman Britain.

Historical documents indicate that breastfeeding and weaning practices have fluctuated in England through history. In order to obtain evidence for general breastfeeding patterns in Late/Sub-Roman Britain, stable carbon and nitrogen isotope values were measured in juvenile and adult skeletons (n = 87) from the cemetery of Queenford Farm, Dorchester-on-Thames, Oxfordshire. As the site contained few individuals between 0-1.5 years of age, it was not possible to determine the initial timing for the introduction of weaning foods. Between ages 2-4 years, the mean +/- SD delta(13)C results (-20.2 +/- 0.3 per thousand) are significantly more negative (t = -4.03, P < 0.001) compared to adult females (-19.7 +/- 0.3 per thousand). This is interpreted as evidence of a different diet being fed to children during weaning. After age 2, the delta(15)N values gradually decline, indicating complete cessation of breastfeeding by 3-4 years. Among adults, stature (males = 1.68 +/- 0.06 m; females = 1.58 +/- 0.07 m) and sexual dimorphism (106) were low, suggesting that the population was possibly under environmental stress. The delta(13)C results for adults are similar, but females show a small but statistically significantly (t = -2.86, P < 0.01) lower mean delta(15)N value (9.9 +/- 0.9 per thousand) compared to males (10.6 +/- 0.5 per thousand). These lower female delta(15)N values possibly reflect the different physiology of the sexes (pregnancy and/or lactation) or the reduced consumption of animal/fish protein by women, and this may have been influenced by individual preference, family needs, or societal values of the era.

Variation in crown and root formation and eruption of human deciduous teeth.

The aim of this study was to document variation of deciduous tooth formation and eruption. The material comprises 121 individuals of known or estimated age (using tooth length) from Spitalfields in London, and radiographs of 61 healthy living children aged 2-5 years. Other skeletal material from two medieval Scottish archaeological sites (Whithorn, N=74; Newark Bay, N=59) was also examined. Stages of crown and root formation as well as eruption (alveolar, midway, and occlusal levels) were assessed for each developing maxillary and mandibular tooth from radiographs or direct vision. Age of attainment for individual stages was calculated by probit analysis, and these data were also adapted for use in estimating age. The timing of crown completion was similar to previously reported studies, but apex completion times were later. Analysis of data relative to the first and second molars at the two stages D (crown complete) and F (root length > or =crown height) allowed comparison with the Scottish material. No significant differences were observed between population groups for tooth formation or eruption. These data fill several gaps in the literature, and will be useful in assessing maturity and predicting age during early childhood.

Developing permanent tooth length as an estimate of age.

Developing teeth are widely used to predict age in archaeology and forensic science. Regression equations of tooth length for age is a direct method, however, data for permanent teeth is incomplete. The aims of this study were: (a) to calculate regression equations predicting age from tooth length of all permanent teeth from birth to maturity, and (b) to evaluate the difference between radiographic and actual tooth length. The sample studied (N = 76, age range 0 to 19 years) was the Spitalfields juveniles of recorded age-at-death. Tooth length was measured from incisal tip to developing edge of crown or root of 354 dissected teeth. Data for upper and lower teeth were combined except for the lateral incisor. The least squares regression method was used to analyze the data for each tooth type; age being regressed against tooth length for prediction. For most tooth types, growth followed an S-shaped (polynomial) curve with initial fast growth and a further growth spurt around the time of mid root formation. No difference was found between radiographic and true tooth length. These regression equations provide an easy method of predicting age from any developing permanent tooth by measuring tooth length from isolated teeth or from unmagnified, undistorted radiographs.

Deciduous tooth size and morphogenetic fields in children from Christ Church, Spitalfields.

Deciduous tooth dimensions of a recent archaeological sample of 37 boys, 18 girls and 88 children of unknown sex from London were measured. Mesiodistal (maximum breadth at the contact point) and buccolingual measurements were recorded. A gradient of size variation was apparent with anterior teeth showing the highest variation and second molars the least. In general, the teeth of the children of Spitalfields were smaller than those of other groups from various archaeological and contemporary populations. Fluctuating asymmetry between left- and right-hand sides was greatest for the lateral incisor. Asymmetry of the mesiodistal dimension of the upper central incisor differed significantly from the buccolingual dimension (p < 0.01). Tooth size in both dimensions was generally larger in boys than in girls. The maxillary lateral incisor displayed significant dimorphism in the mesiodistal dimension (p < 0.05). The second molars (both upper and lower) were less variable and less asymmetrical than the first molars, suggesting that the second molar may be the key tooth of the deciduous molar field.

Calculus deposits and bone loss on the teeth of Romano-British and eighteenth-century Londoners.

The relation between dental calculus and periodontal disease is not clear but it is generally recognized that calculus is a significant pathogenetic factor. Skeletal material has previously been used to study some aspects of chronic adult periodontitis but few studies have quantified the extent of calculus in ancient populations and its relation to changes in alveolar bone height. This study records the presence and extent of calculus and its relation to alveolar bone loss in a Romano-British and eighteenth-century London population. There were significant differences in calculus deposition in the two populations but this appeared to have little effect on changes in alveolar bone contour. It is suggested that the amount of calculus may be related to diet but that changes in alveolar bone height seem to be independently controlled.

Caries prevalence in the dentition of a late eighteenth century population.

Remains of 92 individuals of known age and a further 71 of unknown age were selected from nearly 1000 skulls exhumed from the crypt of Christ Church, Spitalfields. Ante- and post-mortem tooth loss was assessed and caries prevalence and distribution were studied. Post-mortem loss of teeth was highest in the oldest age group, suggesting that greater care is needed during exhumation to minimize this loss. Juvenile caries levels were high, especially on occlusal surfaces of deciduous molars. Approximal caries was less frequently seen and buccal and lingual sites were only slightly less frequently involved than approximal sites. Root caries was rare, even in the oldest age group. There were differences in prevalence and distribution between males and females but not between those of English and French origins. Caries levels were generally higher in those born after 1750. It is suggested that factors other than diet and oral hygiene may have influenced caries prevalence in this population.

Differences in proximal femur bone density over two centuries.

The incidence of osteoporotic hip fractures in northern Europe has been increasing over the past few decades faster than the rate adjusted for increased life expectancy. One important factor that determines osteoporotic fracture risk is bone density. The restoration of a London church, during which skeletal material dating from 1729 to 1852 was recovered, gave us the opportunity to compare the rate of bone loss in the femora of these samples with that of present-day women. The rate of bone loss, as judged by dual energy X-ray absorptiometry, was significantly greater in modern-day women than in the women from two centuries ago, both pre-menopausally (p < 0.05) and post-menopausally (p < 0.01). The difference in bone loss in the Ward's triangle region between the Spitalfields samples and present-day women remained even when the assumed age at menopause was increased to 48 years or decreased to 42 years. The results suggest that differences in rates of bone loss over two centuries may partly account for the increasing incidence of hip fracture in modern-day women. Reasons for these differences are unclear, but one factor may be a lower degree of physical activity in present-day women.

Increasing human tooth length between birth and 5.4 years.

Most previous studies of tooth development have used fractional stages of tooth formation to construct growth standards suitable for aging juvenile skeletal material. A simple alternative for determining dental age is to measure tooth length throughout development. In this study, data on tooth length development are presented from 63 individuals of known age at death, between birth and 5.4 years, from an archeological population recovered from the crypt of Christ Church, Spitalfields, London. Isolated developing teeth (304 deciduous, 269 permanent) were measured in millimeters and plotted against individual age. Regression equations to estimate age from a given tooth length, are presented for each deciduous maxillary and mandibular tooth type and for permanent maxillary and mandibular incisors, canines, and first permanent molars. Data on the earliest age of root completion of deciduous teeth and initial mineralization and crown completion of some permanent teeth in this sample are given, as well as the average crown height and total tooth length from a small number of unworn teeth. This method provides an easy, quantitative and objective measure of dental formation appropriate for use by archeologists and anthropologists.

The anthropological evidence for change through Romanisation of the Poundbury population.

Poundbury Camp cemetery was in use for about 500 Years and was the burial ground for an Iron Age Durotrigian group, a rural Roman settlement and an urban Romano-British community. Low variance of metrical characters and persistence of familial traits in the three groups suggest a continuity of the population and in situ growth. However evidence for an anthropological response to the cultural romanisation of the population has been found in a number of skeletal traits including squatting which was most often adopted by Durotrigian females. Dietary changes are indicted by variation in concentrations of trace elements, including lead, in the bones.

Continuing tooth eruption and alveolar crest height in an eighteenth-century population from Spitalfields, east London.

Earlier studies on dried skulls have shown that continuing eruption occurs throughout life to an extent which appears to compensate for occlusal attrition. Some investigators have interpreted the increasing distance between the tooth cervical margin and the alveolar crest as an indication of horizontal bone loss due to chronic inflammatory periodontal disease. In order to determine whether continuing eruption occurs in the absence of attrition, measurements were made on the jaws of an eighteenth-century population whose tooth wear had been minimal. Horizontal bone loss at the alveolar margin was minimal or absent. Continuing eruption had occurred, indicating that facial height probably increased throughout the life time of the individuals.

Studies on the temporomandibular joints of an eighteenth-century London population (Spitalfields).

The mandibular condyles and glenoid fossae of 93 adult skulls of known age at death were studied in skeletons exhumed from the crypt of Christ Church, Spitalfields, London. Antero-posterior and mesio-lateral dimensions were recorded, as were the shapes together with form and surface changes. In addition, the teeth present and the extent of occlusal attrition were noted. There was sexual dimorphism in the mesio-lateral size of the condyle, and although ante-mortem tooth loss was higher than in previously studied Romano-British skulls, form and surface changes of the condyle were less marked. It is concluded that tooth loss is not the main factor involved in remodelling of the condyle.

Social implications of mortality patterns of juveniles from Poundbury Camp, Romano-British Cemetery.

Attempts have been made to reconstruct the Romano-British population that was buried at Poundbury Camp, Dorchester, England. Over 1400 graves were excavated and about 1200 skeletons of adults and juveniles were recovered, dating from the 1st to the 5th Centuries AD. The burial patterns indicate that the family was the important unit in the community that was served by Poundbury Camp. The newborn but perhaps not the stillborn were buried in the cemetery. Infanticide was not practised. Infant mortality was high and weaning may have been at a very early age. There were relatively few children and family sizes must have been small. Among the adolescents there were three times as many girls as boys. This is interpreted as a consequence of the materialism of a society with an agrarian economy.

Quantitative assessment of tooth wear, alveolar-crest height and continuing eruption in a Romano-British population.

Although measurements from cement-enamel junction (CEJ) to alveolar crest (AC) have been used in assessing changes in alveolar-crest height as age or chronic inflammatory periodontal disease (CIPD) progresses, there is evidence from ancient populations that the position of AC remains almost constant throughout life and continuing eruption to compensate for attrition may explain why CEJ-AC measurements increase with age. Measurements of occlusal attrition and relationship of CEJ to AC were made on the cheek teeth of 500 Romano-British skulls by direct measurement or by reference to the fixed line of the inferior alveolar canal (IAC) on radiographs. Direct measurements indicated that there were usually no statistical differences between the vertical amounts of tooth substance lost by attrition and the change in the distance CEJ-AC as age progressed. Measurements on radiographs showed that posterior teeth continued to erupt to compensate for attrition and the AC remained static as age progressed. Bone deposition at the AC was seen in the majority of ground sections. Thus tooth wear appears to be compensated by continuing movement of teeth in an occlusal direction. The position of the AC remained almost constant throughout life; AC bone lost by CIPD seemed to be replaced during continuing tooth eruption.

Enlargement of the frontal sinus.

The enlargement of the frontal sinus has been analysed in a longitudinal study of 49 males and 47 females for whom a first lateral cephalogram was available at from 2 to 5 years of age for 88 subjects and from 6 to 11 years for 8 subjects. Thereafter the cephalograms were taken at approximately yearly intervals and in 28 subjects a last cephalogram was taken at 24 years or older. In only six subjects was enlargement of the sinus still proceeding at the time of the last cephalogram . The enlargement was assessed by a standardized measurement of the maximum vertical height of the sinus. The median age for the first appearance of the frontal sinus was 3 X 25 years for the boys and 4 X 58 years for the girls. It enlarged on average to 32 X 60 mm (SD 9 X 10) in the males and 26 X 60 mm (SD 7 X 50) in the females. The median age at which the main increase in size of the sinus ceased was 15 X 68 years for boys and 13 X 72 years for girls, thus suggesting that the enlargement of the frontal sinus, a mainly osteoclastic activity, follows very closely the trends for growth in bone lengths.