Biocultural implications of oral pathology in an ancient Central California population.

Bioarchaeologists have long noted two unusual trends in the dentitions of prehistoric Native Californian populations: high rates of wear and low prevalence of caries. The Central California site of CA-CCO-548 offers a unique opportunity to examine the relationship between oral pathology and extreme dental wear in a large (n = 480), ancient (4,300­3,100 BP), and temporally well-defined population sample. This study specifically examines three interrelated processes of the oral cavity in this population: dental wear, dental caries, and periodontal disease. The results show high levels of dental wear (average of 6.1, Smith system), low frequencies of carious lesions (2.5%), low frequencies of periodontal disease (17.8%), and high frequencies of periapical abscesses (10.7%). The pathological processes examined here have complicated multifactorial etiologies. However, they all share the common primary etiological agents of facultative pathogenic bacteria proliferation in the oral biofilm. Integration of the current etiological explanations for infections of the oral cavity, information from the ethnographic record pertaining to subsistence and activity patterns in Native Californian populations, and statistical analysis of specific disease and wear patterns leads to a novel explanation for the observed pattern of oral pathology in this population sample. Specifically, the introduction of antibacterial compounds through dietary items and non-alimentary tooth use is suggested as the most likely explanation for the unusually low prevalence of dental caries and periodontal disease.

Dental surgery in ancient Egypt.

Many different surgical procedures have over the years been attributed to the ancient Egyptians. This is also true regarding the field of dental surgery. The existence of dentists in ancient Egypt is documented and several recipes exist concerning dental conditions. However, no indications of dental surgery are found in the medical papyri or in the visual arts. Regarding the osteological material/mummies, the possible indications of dental surgery are few and weak. There is not a single example of a clear tooth extraction, nor of a filling or of an artificial tooth. The suggested examples of evacuation of apical abscesses can be more readily explained as outflow sinuses. Regarding the suggested bridges, these are constituted of one find likely dating to the Old Kingdom, and one possibly, but perhaps more likely, dating to the Ptolemaic era. Both seem to be too weak to have served any possible practical purpose in a living patient, and the most likely explanation would be to consider them as a restoration performed during the mummification process. Thus, while a form of dentistry did certainly exist in ancient Egypt, there is today no evidence of dental surgery.

Oral health and the postcontact adaptive transition: A contextual reconstruction of diet in Mórrope, Peru.

This work explores the effects of European contact on Andean foodways in the Lambayeque Valley Complex, north coast Peru. We test the hypothesis that Spanish colonization negatively impacted indigenous diet. Diachronic relationships of oral health were examined from the dentitions of 203 late-pre-Hispanic and 175 colonial-period Mochica individuals from Mórrope, Lambayeque, to include observations of dental caries, antemortem tooth loss, alveolar inflammation, dental calculus, periodontitis, and dental wear. G-tests and odds ratio analyses across six age classes indicate a range of statistically significant postcontact increases in dental caries, antemortem tooth loss, and dental calculus prevalence. These findings are associated with ethnohistoric contexts that point to colonial-era economic reorganization which restricted access to multiple traditional food sources. We infer that oral health changes reflect creative Mochica cultural adjustments to dietary shortfalls through the consumption of a greater proportion of dietary carbohydrates. Simultaneously, independent skeletal indicators of biological stress suggest that these adjustments bore a cost in increased nutritional stress. Oral health appears to have been systematically worse among colonial women. We rule out an underlying biological cause (female fertility variation) and suggest that the establishment of European gender ideologies and divisions of labor possibly exposed colonial Mochica women to a more cariogenic diet. Overall, dietary change in Mórrope appears shaped by local responses to a convergence of colonial Spanish economic agendas, landscape transformation, and social changes during the postcontact transition in northern Peru. These findings also further the understandings of dietary and biocultural histories of the Western Hemisphere.

Tooth wear and dental pathology at the advent of agriculture: new evidence from the Levant.

Differences in patterns of diet and subsistence through the analysis of dental pathology and tooth wear were studied in skeletal populations of Natufian hunter-gatherers (10,500-8300 BC) and Neolithic populations (8300-5500 BC, noncalibrated) from the southern Levant. 1,160 Natufians and 804 Neolithic teeth were examined for rate of attrition, caries, antemortem tooth loss, calculus, periapical lesions, and periodontal processes. While the Natufian people manifest a higher rate of dental attrition and periodontal disease (36.4% vs. 19%), Neolithic people show a higher rate of calculus. Both populations manifested low and similar rates of caries (6.4% in the Natufian vs. 6.7% in the Neolithic), periapical lesions (not over 1.5%), and antemortem tooth loss (3.7% vs. 4.5%, respectively). Molar wear pattern in the Neolithic is different than in the Natufian. The current study shows that the dental picture obtained from the two populations is multifactorial in nature, and not exclusively of dietary origin, i.e., the higher rate and unique pattern of attrition seen in the Natufian could result from a greater consumption of fibrous plants, the use of pestles and mortars (which introduce large quantities of stone-dust to the food), and/or the use of teeth as a "third hand." The two major conclusions of this study are: 1) The transition from hunting and gathering to a food-producing economy in the Levant did not promote changes in dental health, as previously believed. This generally indicates that the Natufians and Neolithic people of the Levant may have differed in their ecosystem management (i.e., gathering vs. growing grains), but not in the type of food consumed. 2) Changes in food-preparation techniques and nondietary usage of the teeth explain much of the variation in tooth condition in populations before and after the agricultural revolution.

Toothaches and death.

Deaths from dental abscesses today are so rare, that it is difficult to fathom that only 200 years ago, this was a leading cause of death. When the London (England) Bills of Mortality began listing the causes of death in the early 1600's, "teeth" were continually listed as the fifth or sixth leading cause of death. (This does not include the category of "Teething" which was probably erroneously blamed for many children's deaths. As we examine several historic factors of this period, it is apparent that the number of deaths attributed to "teeth" in the seventeenth and eighteenth centuries was probably fairly accurate, and it was not antibiotics, nor the discovery of asepsis, that brought about the dramatic reduction in these dental mortalities, but two much earlier dental innovations.

Fish-eaters and farmers: dental pathology in the Arabian Gulf.

Twelve skeletal samples, previously published, from the Arabian Gulf have been used to trace differences in diet and subsistence patterns through an analysis of dental pathology. The skeletons date from 3,000 BC to AD 1,500 and cover a variety of geographical locations: off-shore islands, Eastern Arabia, and Oman. The dental conditions analyzed are attrition, caries, calculus, abscessing, and antemortem tooth loss (AMTL). Results indicate four basic patterns of dental disease which, while not mutually exclusive, correspond to four basic subsistence patterns. Marine dependency, represented by the Ras el-Hamra population, is indicated by severe attrition, low caries rates, wear-caused abscessing, and a lack of AMTL. The second group of dental diseases--moderate attrition and calculus, low rates of caries, wear-caused abscessing, and low-moderate rates of AMTL--affects populations subsisting on a mixture of pastoralism or fishing and agriculture (Failaka, Umm an-Nar, Bronze Age Maysar, Bronze Age Shimal, and Iron Age Galilah). Mixed farming populations (Iron Age Maysar and Islamic Bahrain) experienced low-moderate attrition, high rates of caries and calculus, abscessing due to caries, and severe AMTL. The final group of dental diseases affects populations practicing intensive gardening (Bronze and Iron Age Bahrain, and Sites 3 and 5, Ras al-Khaimah). These groups experienced slight attrition, high rates of caries, low rates of calculus deposition, and severe AMTL.

Tooth dislocation: the relationship with tooth wear and dental abscesses.

Tooth dislocation (tilting) was recorded in 1,200 skulls from 34 museum collections. The findings of dislocation by tooth type, tooth wear, and abscess location are presented. A model for dislocation based upon the progressive loss of tooth support provides a rational explanation for the phenomenon. Physiological continuous tooth eruption was considered to account for a component of the progressive loss of tooth attachment. The process of attrition, pulp perforation, and dental abscess cavity formation resulted in further, more severe loss of tooth support. Heavy functional forces, in association with greatly reduced bone support, tilted the crown lingually and root buccally. When the tooth had tilted to such an extent that the root apices protruded from the bone and, presumably (in life) through the gingival/mucosal tissues, the infected root canals were effectively isolated from the internal environment. The tooth continued to function. The more typical consequence of severe attrition and dental abscess formation was tooth loss; it also isolated an infected tooth from living tissue, but without the benefit of retaining function.

Regional variation in tooth size and pathology in fossil hominids.

Tooth size and dental pathology in fossil hominids were studied to test for regional differences in these parameters. The results showed little regional variation in tooth size for the Middle and Upper Pleistocene sites compared (except for Krapina) but considerable differences in the severity of attrition and dental pathology. These differences were considered indicative of regional differences in the functional load borne by the teeth, and in view of the similar technological status of the groups studied, were attributed to environmental differences in the diet. Since, in all regions, reduction in tooth size appeared to continue at the same rate for the periods investigated, no association can be established between presumed selective pressures related to differences in functional demands made on the dentition, and tooth reduction.