Prevalence and severity of periodontal disease in a historical Austrian population.

OBJECTIVE: To assess the prevalence and severity of periodontitis based on different diagnostic methods in a historical Austrian population from the early middle ages. BACKGROUND: The description of the oral health status of archaeological material can provide interesting insights into prevalence, severity, and extent of oral diseases. Herein, the periodontal health status of the skeletal remains of medieval Avars (700-800 AD), which were considered as one of the earliest Avarian settlements in Austria, was investigated. METHODS: The skeletal remains of 128 Avars were examined; age and gender were estimated by standard forensic methods and tooth loss and root caries were recorded. Periodontitis was assessed by (a) measurement of the alveolar bone levels (ABL) and (b) evaluation of the interdental septa. RESULTS: A mean ABL of 4.8 mm was determined, root caries tended to accumulate in teeth with a higher alveolar bone loss, and on average, 6.2 teeth were lost antemortem. Independent of the diagnostic method >90% of the subjects were judged as periodontally diseased, and age and tooth type were significant predictors. However, on the tooth level the presence of periodontitis varied considerably depending on the diagnostic method; that is, 7.6% versus 47.2% of the teeth were judged as healthy based on ABL or interdental septa, respectively. CONCLUSION: The periodontal status of the skeletal remains of medieval Avars revealed a considerable high prevalence of periodontitis (ie, >90% of this population displayed periodontal tissue breakdown). However, the diagnostic method, disease definition, and data presentation should be considered when comparing results of archaeological material.

Oral pathological conditions of an Early Epipaleolithic human from Southwest Asia: Ohalo II H2 as a probable case of intentional dental ablation.

OBJECTIVE: To describe the oral pathological conditions of Ohalo II H2, an Early Epipaleolithic human from southwest Asia. MATERIALS: The dentognathic skeleton of Ohalo II H2 and relevant comparative data from similar chronological and/or geographic contexts. METHODS: Gross and x-ray observations of oral pathological conditions and occlusal wear were made following published protocols. A differential diagnosis of antemortem tooth loss is provided. RESULTS: Ohalo 2 has two carious lesions on the right M3, pulpal exposure of left M1, and mild to moderate anterior alveolar bone loss. The right I1 was lost antemortem, and there is probably agenesis of the left M3. CONCLUSIONS: The pathological conditions noted are not exceptional for a Late Upper Paleolithic forager. However, the antemortem missing right I1 is most parsimoniously explained by intentional dental ablation. SIGNIFICANCE: Ohalo 2 could represent the oldest example of dental ablation from the Late Pleistocene circum-Mediterranean world - predating the earliest examples from both North Africa and southwest Asia by several thousand years. The similarity of the Ohalo 2 ablation pattern with later Natufians provides further evidence of potential long-term behavioral trends related to the embodiment of social identities through international body modification within the Epipaleolithic of southwest Asia. LIMITATIONS: The pre-Natufian (∼23,000-14,500 cal BP) human fossil record is relatively sparse, making comparisons with the Natufian (∼14,500-11,500 cal BP) phases of the Epipaleolithic difficult. SUGGESTIONS FOR FURTHER RESEARCH: Documentation of oral pathological conditions for other pre-Natufian fossils would provide greater resolution of the temporospatial patterning of oral health and embodied social identities during the Epipaleolithic of southwest Asia.

Caries, antemortem tooth loss and tooth wear observed in indigenous peoples and Russian settlers of 16th to 19th century West Siberia.

OBJECTIVE: Increased prevalence of dental caries evidently is correlated with increasing intake of sugar and carbohydrate-rich foods. Preceding and accompanying this dietary alteration might have been a shift from a hunting-and-gathering subsistence strategy to one based on agriculture. We corroborated this conjecture by means of a study on the prevalence of caries, antemortem tooth loss (AMTL) and tooth wear among 16th to 19th century hunter-gatherers and agriculturalists who co-existed in West Siberia. DESIGN: Indigenous skeletons (n = 75) exhumed from Tatar, Selkup, Khant, and Nenet graves along with Russian settler skeletons (n = 79) from Izyuk were examined. The prevalence of caries, AMTL and tooth wear among the indigenous peoples were compared with those among the Russian settlers. The resulting statistical inferences were tested using package R. RESULTS: The agriculturalist Russian settlers showed a significantly higher prevalence of dental caries (11.88%) than did the non-agriculturalist indigenous Siberian people (3.85%). Among the latter, the prevalence was the lowest in the Khanty and the highest in the Tatars, suggesting that caries differently affected each sub-group of indigenous Siberian people. Correspondingly to the case of dental caries, the Russian settlers' AMTL prevalence also was higher than that of the indigenous Siberians, regardless of age. On the other hand, the native Siberians and the Russian settlers did not show statistical differences in tooth wear. CONCLUSION: In the study on 16th to 19th century West Siberian populations, we were able to corroborate our presumption that agriculturalists ingesting a carbohydrate-rich diet would have higher rates of dental caries and AMTL than would hunter-gatherers.

Dental markers of poverty: Biocultural deliberations on oral health of the poor in mid-nineteenth-century Ireland.

OBJECTIVES: Despite subsisting on a low-cariogenic diet comprising virtually nothing more than potatoes and dairy products, poor oral health affected the quality of life for the poor of nineteenth-century Ireland. This study investigates potential biocultural reasons that may explain why this was the case. MATERIAL AND METHODS: A total of 6,860 teeth and 9,889 alveoli from 363 permanent dentitions from the skeletal remains of impoverished adult Irish males and females who died between 1847 and 1851 in the Kilkenny Union Workhouse were examined for evidence of dental caries, periodontal disease and ante-mortem tooth loss. Caries rates were quantified and assessed by crude prevalence, frequencies, corrected caries rates and a t-health index, and evaluated by sex and age groups. RESULTS: A higher rate of caries was present among 18-25-year-old males than females, while the opposite relationship was evident for older age groups. The prevalence rates of periodontal disease and ante-mortem tooth loss increased with age. When assessed by corrected caries rates, tooth decay is observed at a lower rate compared to contemporaneous lower to upper-class population samples from London. DISCUSSION: Despite being low cariogenic foods, the potato starch and milk lactose of a nineteenth-century Irish laborer's diet would have lowered oral pH-values thereby increasing the risk of bacterial fermentation in dental plaque resulting in caries. Nutritional features alone cannot explain the high rates of dental caries observed in the Kilkenny workhouse population sample, however, and lifestyle factors, particularly habitual clay-pipe smoking, is considered a significant cause of poor oral health.

Oral pathology patterns in late farmers of the Central Andes: A comparative perspective between coastal and highland populations.

Aiming at future comparisons with earlier hunter-gatherers or transitional populations, this paper intends to characterize and describe the oral pathology pattern of late agriculturalists from Central Andes dating to the Late Intermediate Period (LIP) and Inca periods (1000-1532 CE), and identify differences and/or similarities between coastal and highland populations. Although the botanical inventories of the LIP suggest carbohydrate-rich diets and similar components, it has been hypothesized that coastal and highland populations had, nevertheless, substantially different oral pathology patterns. We evaluated 14 indicators of oral pathology from Los Pinos (n=200) and Armatambo (n=25) sites in the Central Coast and two chronological phases from Laguna de los Cóndores site (LC-Inca, n=23; and LC-LIP, n=55), in the Peruvian northern highlands. The results showed a recurrent pattern of oral pathologies characterized by cervical caries (above 30%), extra-occlusal caries (above 60%), high rates of gross-gross caries, high frequency of ante mortem tooth loss, and signals of periodontal disease among these four populations. The diets of the coast were slightly more abrasive than those of the highlands. Oral pathology patterns were compatible with a slightly more cariogenic diet in the coast than in the highlands. In all four populations, those patterns were modulated by other common factors such as consumption of fermented drinks (maize beer - chicha) and the coca leaf chewing habit.

Dental investigation of mummies from the Capuchin Catacombs of Palermo (circa 18th-19th century CE).

Within the framework of the Sicily Mummy Project, the orofacial complex of a significant sample of individuals (n=111) from the Capuchin Catacombs of Palermo, Italy, was inspected. The heads and dentitions of the mummies were documented and the recorded findings described: the state of preservation of skeletal and soft tissues; dental pathologies such as carious lesions and alveolar bone loss; enamel hypoplasia; and ante- and post-mortem tooth loss. Despite limitations in data collection, the oral health of these mummies was assessed and the frequencies of pathologies were compared to those of similar populations. From their position within the corridors of the Catacombs, sex and social status of the mummies were also inferred, allowing the dental pathologies to be specified in the social and historical context. Most interestingly, the rate of oral health problems did not differ between the groups of the members of the Capuchin Order and the laymen of the city of Palermo, despite their different lifestyles.

Sex differences of dental pathology in early modern samurai and commoners at Kokura in Japan.

So-called "Ohaguro", teeth blackening, in the married females was a general custom regardless of class in the early modern period. As a result, Ohaguro was thought to have enhanced the acid resistance of tooth substance and tightened gingiva and prevented tooth morbidity due to periodontal disease. For investigation into the influence of Ohaguro, the skeletal remains of early modern samurai and commoners at Kokura were examined for differences in the dental pathology based on sex. Though females from archeological sites have significantly more carious teeth and antemortem tooth loss (AMTL) than males in the previous studies, the prevalence of caries and AMTL in males was higher than in females among the early modern samurai and commoners in Kokura. The efficacies of Ohaguro may influence the good dental health of females. On the other hand, as females were considered inferior to males under the feudal system in Japan, males, including children, might tend to consume more nutritious foods compared to females. However, those foods are certainly not better with regard to dental health, since those foods are more highly cariogenic. These factors may have caused higher caries and AMTL prevalence among males compared to females in early modern Kokura.

Meta-analysis of teeth from European populations before and after the 18th century reveals a shift towards increased prevalence of caries and tooth loss.

Based on single studies, it has been hypothesised that Europeans have suffered less frequently from caries before the 18th century than after the 18th century and that females have higher caries prevalence, but systematic European-wide overviews are sparse. We collected published data on dental diseases (publication between 1981 and 2015 with reports on 29 cohorts with 4998 individuals and a total of 85817 teeth). Meta-analyses revealed that, over several hundred years, including the post-18th century era, Europeans had relatively constant frequencies of caries and ante-mortem tooth loss, but since the 18th century, the mean frequencies of these dental diseases increased (each p<0.05). Tooth loss correlated with caries and odontogenic abscesses (each p<0.05). Although the mean caries and ante-mortem tooth loss frequencies increased since the 18th century, there are overlaps with many pre-18th century cohorts. In addition, in contrast to previous hypotheses, no general increase of caries prevalence in females could in fact be verified. It is likely that changes in nutrition (more sugar) and dental health (possibly higher frequency of tooth extraction) could be the underlying factors which led to this minor to moderate shift of dental disease frequencies in Europe.

Dental health in antique population of Vinkovci - Cibalae in Croatia (3rd-5th century).

Roman city Cibalae (Vinkovci) - the birthplace of Roman emperors Valentinian I and Valens was a very well developed urban ares in the late antique what was evidenced by numerous archaeological findings. The aim of this paper is to get insight in dental health of antique population of Cibalae. One hundred individuals with 2041 teeth dated to 3rd - 5th century AD have been analyzed for caries, antemortem tooth loss, periapical diseases and tooth wear. Prevalence of antemortem tooth loss was 4.3% in males, 5.2% in females. Prevalence of caries per tooth was 8.4% in males, 7.0% in females. Compared to other Croatian antique sites, ancient inhabitants of Roman Cibalae had rather good dental health with low caries prevalence and no gender differences. Statistically significant difference was found between males in females in the prevalence of periapical lesions and degree of tooth wear. Periapical lesions were found only in males.

Dental Caries and Tooth Wear in a Byzantine Paediatric Population (7th to 10th Centuries AD) from Yenikapi-Constantinople, Istanbul.

Dental caries and wear are important conditions to record in archaeological collections. The aim of the present paper is to determine the frequency and distribution of dental caries and dental wear in a mediaeval Byzantine paediatric population in Yenikapi, Constantinople, Istanbul. The present research was carried out on the skeletal remains of 1 infant and 28 children with a total of 180 teeth (113 primary and 67 permanent teeth). The frequency of ante-mortem tooth loss in the sample was 1%. The total frequency of carious lesions in the sample was 2.2%. The frequency of dental wear was rather low (3.3%) exhibiting presence of dentin clusters mostly. The present study evaluated an archaeological collection with low dental wear and low dental caries prevalence indicating a fishing community.

Dental indicators of adaptation in the Sahara Desert during the Late Holocene.

The present paper examines dental diseases and linear enamel hypoplasia among the Garamantes, a Late Holocene Saharan population, and aims to draw conclusions about nutrition and adaptation to a hyper-arid environment. Archaeological evidence suggests that the Garamantian diet included animal protein and local, Mediterranean and Near Eastern plants. Moreoever, although the Garamantes had developed urban centres, the size of these was not large enough to allow for particularly unhygienic conditions to appear. The above archaeological findings were partly corroborated by the current bioarchaeological study. At an intra-population level, the Garamantes showed limited sex differences in dental disease prevalence, while all dental conditions increased in frequency with age, as expected. At an inter-population level, the frequency of all dental conditions was comparable to that found among other North African groups, with the exception of ante-mortem tooth loss. The low frequency of most dental conditions is an indication that the Garamantian diet was overall balanced, while the high frequency of ante-mortem tooth loss may be related to factors such as oral hygiene, food preparation or eating mode, which cannot be controlled for osteologically. Finally, the low frequency of enamel hypoplasia suggests either that the Sahara did not inflict particular stresses on the population, or, more likely, that the Garamantes had developed effective mechanisms for coping with their natural environment.

The neolithic demographic transition and oral health: The Southeast Asian experience.

The purpose of this article is to present new oral health data from Neolithic An Son, southern Vietnam, in the context of (1) a reassessment of published data on other Neolithic, Bronze, and Iron Age Southeast Asian dental series, and (2) predictions of the Neolithic Demographic Transition (NDT). To this end, frequencies for three oral conditions (caries, antemortem tooth loss, and alveolar lesions) were investigated for seven Southeast Asian adult dental series from Thailand and Vietnam with respect to time period, age-at-death and sex. A clear pattern of elevated rates for oral disease in the Neolithic followed by a marked improvement in oral health during the Bronze and Iron Ages was observed. Moreover, rates of caries and antemortem tooth loss for females were almost without exception higher than that for males in all samples. The consensus view among Southeast Asian bioarchaeologists that oral health did not decline with the adoption/intensification of agriculture in Southeast Asia, can no longer be supported. In light of evidence for (1) the low cariogenicity of rice; (2) the physiological predisposition of females (particularly when pregnant) to poorer oral health; and (3) health predictions of the NDT model with respect to elevated levels of fertility, the most plausible chief explanation for the observed patterns in oral health in Southeast Asia is increased levels of fertility during the Neolithic, followed by a decline in fertility during the subsequent Bronze and Iron Ages.

A comparison of antemortem tooth loss in human hunter-gatherers and non-human catarrhines: implications for the identification of behavioral evolution in the human fossil record.

Middle and Late Pleistocene fossil hominin specimens with severe antemortem tooth loss are often regarded as evidence for the precocious evolution of human-like behaviors, such as conspecific care or cooking, in ancient hominin species. The goal of this project was to ask whether the theoretical association between antemortem tooth loss and uniquely human behaviors is supported empirically in a large skeletal sample of human hunter-gatherers, chimpanzees, orangutans, and baboons. Binomial regression modeling in a Bayesian framework allows for the investigation of the effects of tooth class, genus, age, and sex on the likelihood of tooth loss. The results strongly suggest that modern humans experience more antemortem tooth loss than non-human primates and identify age in years as an important predictor. Once age is accounted for, the difference between the humans and the closest non-human genus (chimpanzees) is less pronounced; humans are still more likely on average to experience antemortem tooth loss though 95% uncertainty envelopes around the average prediction for each genus show some overlap. These analyses support theoretical links between antemortem tooth loss and modern human characteristics; humans' significantly longer life history and a positive correlation between age and antemortem tooth loss explain, in part, the reason why humans are more likely to experience tooth loss than non-human primates, but the results do not exclude behavioral differences as a contributing factor.

Dento-alveolar features and diet in an Etruscan population (6th-3rd c. B.C.) from northeast Italy.

OBJECTIVES: The purpose of this study was to assess the prevalence of some dento-alveolar features (caries, dental calculus, tooth wear, enamel hypoplasia, abscesses, retraction of the alveolar bone, chipping, and ante mortem tooth loss) on an Iron Age sample from the Etruscan necropolis of Spina (North-Eastern Italy) and to make a relation with dietary evidence found in the archaeological records. These dental features were used to evaluate the oral health status and dietary habits with the aim of shedding light on the lifestyle and living conditions of this population. MATERIALS AND METHODS: The sample analysed consisted of 680 permanent teeth from 80 burials. RESULTS: Overall, individuals at Spina exhibited a low incidence of caries, abscesses and ante mortem tooth loss, high calculus rates and severe attrition, suggesting a subsistence pattern based on a mixture of fishing, pastoralism and agriculture. The low incidence of hypoplasia was probably related to their good nutritional conditions and weak metabolic stresses during early childhood. CONCLUSIONS: These findings, quite similar to those of Etruscans from other parts of Italy, are very different from those of other populations living in the same territory during the same time. This pattern is indicative of a general good health status in this Iron Age population and may be related, at least in part, to the Etruscan diet.

Socio-cultural factors in dental diseases in the Medieval and early Modern Age of northern Spain.

The aim of this study is to present, discuss and compare the results of pathological conditions in teeth from skeletal remains found in the northern part of the Iberian Peninsula (Spain) in four Medieval cemeteries (late 15th century) and three cemeteries from the Modern Age (late 18th century). The final objective was to evaluate the impact of socioeconomic and cultural changes that took place during the early Modern Age in Spain, on oral health. Dental caries and antemortem tooth loss were considered as indicators of dental disease. A significant increase of both dental caries and antemortem tooth loss occurred in Modern Age individuals when compared to Medieval values, as reported for other regions. Increased trade with other continents may explain this deterioration of dental health, as food exchanges (mainly with America) contributed to diet changes for the overall population, including higher carbohydrate consumption (introduction of potatoes) at the expense of other vegetables. A sex-specific increase of dental disease with age, and a significantly higher prevalence of carious lesions in Modern Age females than in males, were also found. These changes can be explained by women having had limited access to dental care after the Middle-Modern Age transition, as a consequence of socio-cultural and political changes. In these changes, an increasing influence of the Catholic Church in Spanish society has to be noted, as it can contribute to the explanation of the unequal dental health of men and women. Women were socially excluded from dental care by regulations inspired by religious precepts.

The number of missing teeth in people of the Edo period in Japan in the 17th to 19th centuries.

OBJECTIVE: The aims of this study were to examine the number of missing teeth in the people of the Edo period (or number of remaining teeth) and to contribute to the 8020 movement proposed in Japan to help people retain 20 or more of their own teeth until the age of 80. BACKGROUND: The study of dentition in ancient skeletal remains of our ancestors from multiple perspectives can yield information that can contribute to the study of physical anthropology and the leading edge of modern dental research. MATERIALS AND METHODS: The materials were 82 excavated individuals (52 males and 30 females) from 1603 to 1868 whose maxillas and mandibles were both examinable. The age and sex were estimated by anthropological methods, and the individuals were divided into five groups. The status of missing teeth was compared between groups, and a chi-square test was used to test significant differences between groups. The rates of tooth loss were examined in the maxillas and mandibles. RESULTS: In the people of the Edo period, many teeth remained in good condition until early to late middle age. There were more remaining teeth in these individuals than in modern-day individuals. However, the Edo people clearly showed increased tooth loss with age. There were no differences in tooth loss by sex. The tooth type with a high rate of tooth loss was posterior teeth, but incisor loss also occurred with ageing. Mandibular canines were most likely to be remaining. CONCLUSION: The Edo people had more remaining teeth than modern-day society. This finding was unexpected. The notion that "people of long past ages lost more teeth more quickly" does not seem to apply to people in the Edo period in Japan.

Caries prevalence and periodontal status in 18th century population of Pozega-Croatia.

OBJECTIVE: The aim was to examine dental and periodontal status of adult Croatian 18th century population and compare the results with available literature data. MATERIALS AND METHODS: 104 specimens from the crypt of Pozega cathedral were grouped into three female and three male groups according to age. Caries was determined by visual inspection and dental probe. Ante and post mortem teeth losses were recorded. Periodontal status was determined according to the length of exposed tooth root from alveolar crest to cemento-enamel junction. The presence of dehiscences and fenestrations was recorded on facial and oral plate of alveolar bone. RESULTS: The whole sample exhibited ante- and post mortem teeth loss of 19.57% and 24.91%, respectively. The teeth most frequently lost postmortem were incisors. The canines were best preserved. The frequency of caries in both jaws was the highest in molars (26.63% in maxilla and 28.10% in mandible), whilst central incisors exhibited the least carious lesions (11.59 and 1.92%). The most frequently affected surfaces were occlusal, then proximal and facio-oral. The percentage of teeth with either moderate or considerable bone loss was higher in females. The frequency of considerable bone loss increased significantly with age. The frequency of dehiscences was 3.11%. It was higher in maxilla than in the mandible. The frequency of fenestrations was 5.65% and it was significantly higher in maxilla. CONCLUSIONS: The results demonstrate poor oral health amongst 18th century population of continental Croatia, exhibiting high antemortem teeth loss, high periodontal disease frequency and occlusal and proximal caries frequency.

Atrophy of the residual alveolar ridge following tooth loss in an historical population.

OBJECTIVES: To study the natural aetiopathology of jaw atrophy after tooth loss, unaltered by prosthetic procedures, an historical population without modern dental treatment was examined. METHODS: Based on the hypothesis that there are predictable changes in shape during jaw-atrophy, frequency and degree of atrophy as well as clinical aspects of bone quality and resorption were determined in the skeletal remains of 263 individuals. The potential association between age and frequency/severity of atrophy was analysed. RESULTS: Atrophy in at least one jaw segment was present in 45.2% of the analysed jaw specimens. The residual ridge underwent a series of changes in shape and height following the pattern of resorption described for modern populations. The severity of these alterations was associated with the age of the individual and the region within the jaw. Atrophy was frequently related to structural degradation of the covering cortical layer. CONCLUSIONS: These findings prove that atrophy of the jaw evidently does occur, displaying similar patterns of resorption in a population without modern prosthetics, where the negative effect of ill-fitting dentures is excluded. The basic information about alterations of shape and the cortical layer covering the residual crest might help to provide a deeper insight into aetiopathological mechanisms of this common oral disease.

Dental caries prevalence of medieval Korean people.

OBJECTIVES: Prevalence and distribution of dental caries in medieval Korean society were evaluated. MATERIALS AND METHODS: Two thousand and nine hundred teeth samples of 126 individuals collected from 16th to 18th century Korean tombs. RESULTS: Preservation status of sample was good. The prevalence of ante- and postmortem tooth loss was 4.4% and 14.2%, respectively. The total caries prevalence was 3.9%. The tooth surface most frequently affected by dental caries was occlusal (4.5%), followed by approximal (2.1%), buccal (1.5%), and lingual (1.1%) surfaces. DISCUSSION: The prevalence of dental caries in Joseon Dynasty skeleton collection was lower than have been found in other collections of similar chronology. The low consumption of refined sugar in medieval Korean society might be a possible explanation, though the technical limitations inherent in such comparison studies preclude definitive conclusions.

Dental caries in a Portuguese identified skeletal sample from the late 19th and early 20th centuries.

Dental caries was investigated in 600 adult dentitions belonging to the identified osteological collections of the Museum of Anthropology, University of Coimbra, Portugal (late 19th/early 20th centuries). The main advantage of this sample compared to an archaeological source is the presence of known demographic parameters such as age, sex, and occupation. The aim of this study is to investigate the issues involved in comparing caries data derived from archaeological death assemblages with statistics compiled from clinical studies of the living. When only the upper dentition was considered, higher rates were observed in females than in males. No differences were found between sexes for lower teeth. In both sexes, both the percentage of carious teeth and the severity of lesions were found to increase with age, demonstrating that caries activity continued throughout life. The slight decrease observed for the age group 70-79 years is probably due to the increased antemortem tooth loss in the elderly. Caries was most common at contact areas (32.9%) and rarest at smooth crown surfaces (6.5%). Root surface caries was graphed in relation to the exposure of roots, and it was confirmed that the degree of root exposure was not strongly related to the frequency of carious lesions on the exposed root surface, although both increased with age. Molars were attacked more frequently by caries as a whole than premolars, canines or incisors. The results are similar to studies of recent living populations with a limited access to professional dental care.