Dental caries in wild primates: Interproximal cavities on anterior teeth

Dental caries has been reported in a variety of primates, although it is still considered rare in wild populations. In this study, 11 catarrhine primate taxa (n = 339 individuals; 7946 teeth) were studied for the presence of caries. A differential diagnosis of lesions in interproximal regions of anterior teeth was undertaken, since they had been previously described as both carious and non-carious in origin. Each permanent tooth was examined macroscopically, with severity and position of lesions recorded. Two specimens were examined further, using micro-CT scans to assess demineralization. Differential diagnosis confirmed the cariogenic nature of interproximal cavities on anterior teeth (ICATs). Overall results show 3.3% of all teeth (i.e., anterior and posterior teeth combined) were carious (n = 262), with prevalence varying among species from 0% to >7% of teeth affected. Those with the highest prevalence of ICATs include Pan troglodytes verus (9.8% of anterior teeth), Gorilla gorilla gorilla (2.6%), Cercopithecus denti (22.4%), Presbytis femoralis (19.5%), and Cercopithecus mitis (18.3%). ICATs make up 87.9% of carious lesions on anterior teeth. These results likely reflect dietary and food processing differences among species, but also between the sexes (e.g., 9.3% of all female P. troglodytes verus teeth were carious vs. 1.8% in males). Processing cariogenic fruits and seeds with the anterior dentition (e.g., wadging) likely contributes to ICAT formation. Further research is needed in living primate populations to ascertain behavioral/dietary influences on caries occurrence. Given the presence of ICATs in frugivorous primates, their diagnosis in archaeological and paleontological specimens may shed light on diet and food processing behaviors in fossil primates.     

Dental Caries in the Elderly

Studies in the United States and other countries have shown that there is continued caries activity with advancing age. These studies, however, do not elaborate on the nature of the dental caries nor its anatomical location on the tooth. It has been assumed that dental caries occur on the coronal portion of retained teeth and that recurrent decay around existing restorations represents the major form of the disease. In addition to continued coronal caries activity in adults, the problem of carious lesions occurring on the exposed roots of teeth has been identified in a number of recent surveys. The exposure of the root surface to the oral cavity is a consequence of the apical migration of the periodontal attachment through periodontal disease and dental treatment which renders this part of the tooth at risk of the dental caries process. However, there are several distinct differences between coronal and root caries. The continued occurrence of coronal caries in adults and the projected increase m the prevalence of root caries suggests an expanded role for the restorative and preventive services for the older adult patient. Although the techniques relating to coronal caries are well-established, those relating to root caries are just beginning to be explored and developed. Many of the principles, materials and philosophies which have proved to be effective for coronal caries are not equally efficacious when the tooth root is involved. This area represents a fertile field for research and development in the older adult patient.     

Brief communication: A pilot study: Smooth surface early caries (caries incipiens) detection with kavo diagnodent in historical material

In many odontological studies concerning archeological material, there is no analysis of early caries lesions (caries incipiens) that manifest as a carious spot. At this stage of caries, the enamel is still hard, and thus, it is impossible to diagnose caries by visual methods. We assessed the usefulness of the DIAGNODent pen (DD laser) in analyzing noncavity lesions on the smooth surface sites of crowns from historical populations. Twenty‐seven individuals were examined: 18 from Radom (Poland), and nine from Tell Masaikh and Terqa (Syria). A total of 562 teeth were characterized. The series represented different climatic zones, but were dated from the similar period, 18th to 19th century AD. We used four diagnostic techniques: visual, DD laser, radiographic, and histological as the gold standard. DD laser showed that the mean values of healthy enamel in both series did not exceed 15 units. The mean values of smooth and rough spots in the Syrian population were significantly higher than those from Poland. This study showed that all the noncarious spots from the Radom series did not exceed 30 units. In the Syrian samples, this limit was higher at 44 units. These results were confirmed by histology and radiography. The DD laser provided good results in detecting dentine carious lesions in historical material, but its efficiency in diagnosing early caries (caries incipiens) remains uncertain based on the presented series. Am J Phys Anthropol, 2013. © 2013 Wiley Periodicals, Inc.     

Carious lesions and maize consumption among the Prehispanic Maya: an analysis of a coastal community in northern Yucatan

Patterns of carious lesions were analyzed in the Classic period coastal Maya population of Xcambó, a salt production and administration center in northern Yucatan. To this end, the study investigated caries in the permanent dentitions of 163 adult skeletons, 23 from the Early Classic (AD 250-550) and 140 from the Late Classic period (AD 550-750), equally distributed between sexes. The archaeological and bioarchaeological evidence indicates a wealthy and socially homogeneous population dedicated to salt production and administration in the Early Classic that switched to pure administrative functions in the Late Classic. The results indicate an increase in caries from 7.4% and 21.2% (males and females respectively) from the Early Classic to 14.0% in males and 27.4% in females from the Late Classic period. The rate of caries in the Early and in the Late Classic phases of continuous occupation is not consistent with a simple interpretation of a heavier reliance on maize during the latter phase, characterized by a sedentary lifestyle, particularly for the male segment of the society now dedicated completely to the administration of the salt mines. Rather, the increase in caries rates in both sexes is best explained within a broader context of overall food habits, new cariogenic foods for both sexes, and the changes in lifestyle imposed by the increased socioeconomic role of the site. Our conclusions stress the limitations imposed by interpreting carious lesions solely in terms of single dietary components, such as maize consumption, without taking into account broader aspects of cultural and socioeconomic relevance.     

Observations of dental diseases among prehistoric populations of Hungary

The incidence of dental disease among people in developing countries today raises questions about the variation in the oral health of prehistoric populations. Considering these questions, we offer observations describing several types of dental disease which occurred among certain prehistoric populations of Hungary. The dental remains of 162 individuals recovered from seven sites of the Neolithic, Copper, and Bronze Age periods were examined for evidence of caries, hypoplasia, and periodontal disease. Appropriate methods were used to describe and record these dental lesions. The incidence of dental caries was low by comparison to other prehistoric agriculturists except for two forms of root caries: cervical and cemental. These types accounted for 68% of all the carious teeth recorded. Enamel hypoplasia was also lower than expected, occurring on only 4% of the total number of teeth. Periodontal abscesses were rare but other milder forms of periodontal lesions were frequent. Alveolar bone resorption occurred in varying degrees and followed the expected age distribution. The few exceptions were children or adolescents whose crania had other lesions suggesting a mineral metabolic disturbance. The lower incidence of enamel caries is likely due to high fluoride ingestion which also may have influenced the expression of enamel hypoplasia. No clear population trends were seen in dental disease incidence except for cemental caries which were found among Copper and Bronze Age remains.     

牛河梁红山文化人群龋齿的统计与分析

本文通过对牛河梁遗址出土的31例红山文化时期人类牙齿龋病的统计与分析, 获知: 1)牛河梁遗址男女两性的患龋率、龋齿率没有明显的性别差异; 2)他们的患龋率和龋齿率有随年龄增长逐步增高的趋势; 3)上颌的龋齿罹患率高于下颌; 4)龋齿的发生主要集中在臼齿,且以咬合面部位为主; 5)他们的患龋率和龋齿率均较低。牛河梁红山文化人群相对偏低的龋齿率可能暗示出他们的经济生活方式还处在以采集狩猎为主体的模式中, 农耕经济可能处于较低层次的状态。     

Epidemiology of Root Caries1

Over a dozen studies have been conducted on the prevalence of and factors associated with root caries, yet our knowledge of this disease process remains limited. This is due, in large part, to a lack of consistency of reporting among the studies undertaken and the wide spectrum of population groups investigated. Nevertheless, the occurrence of root caries is between 20 and 40 percent in healthy, urban adults. Certain population groups such as the institutionalized elderly and patients with periodontal disease tend to exhibit much larger prevalence rates. New root caries develops slowly and tends to be concentrated in a few individuals, usually on the buccal and proximal surfaces of teeth. It is generally accepted that only roots with gingival recession are susceptible to root caries and that age, sex, oral hygiene, diet, saliva, systemic fluoride and previous carious experience have been shown to be associated factors. The next wave of investigations of root canes should focus on testing hypotheses relating to causation so that efficacious preventive and treatment procedures can be developed.     

The caries-attrition competition

Contradictory reports on the interreation of caries and attrition concerning their destructive activity at the occlusal surface of teeth required more investigation. Some suggested that the abrasive action of attrition worked against the progress of decay. Others proposed that attrition facilitated the development of caries in dentine exposed due to the dental wear. A comparison of the condition of teeth in western societies from an intermediate stage, with the preceding period characterized by excessive attrition, and with the following period of ongoing reduction of dental wear, might elucidate the mutual relationship. For this reason the almost complete dental assemblage of fifty men, whalers buried during their short sojourn in the Arctic in the 17th and 18th centuries at a Dutch whaling station, and the data of their contemporaries, were evaluated. The results confirmed the proposition that the rise in caries incidence from (pre-) medieval times on, was associated with an ongoing fall of dental attrition. Within this sample of an intermediate phase, one sees that the percentage of carious molars decreases considerably when the degree of dental wear increases. Besides, at the occlusal surface the decay was almost exclusively located in the natural fissures and pits of teeth, not in the exposed dentine due to wear. These findings strongly suggest a competitive relationship between progress of caries and attrition. The best impression of the attrition rate is gained by linkage of degree of dental attrition (i.e. functional age) to age at death. The wide age ranges fitting to the degrees of molar wear make it hazardous to use attrition for age determination.     

Prosthetic crowns and other clinical risk indicators of caries among old-old Swedish adults: findings from the KEOHS Project. Kungsholmen Elders Oral Health Study

Objectives: The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community‐dwelling persons over the age of 80 living in Kungsholmen, Sweden. This paper explored possible clinical risk indicators of coronal and root caries among the KEOHS subjects. Design: In this cross‐sectional study, dentate KEOHS subjects received a caries assessment using defined visual, tactile criteria. Setting: Examinations were carried out in two local clinics by standardized examiners. Subjects: One hundred twenty‐nine dentate persons were examined. Main Outcome Measures: The examination identified decayed and filled surfaces, prosthetic crowns, and missing teeth. Results: More root than coronal surfaces had untreated decay, and secondary root caries contributed the greatest number of decayed surfaces. Ninety percent of the examined dentate subjects had at least one prosthetic crown. Root surfaces exposed to crown margins were more likely to have caries than root surfaces not so exposed, particularly among women. The presence of untreated coronal caries (yes/no) was positively associated with having untreated root caries and an intermediate number (14–20) of teeth, but inversely associated with having 4+ prosthetic crowns. Active root caries (yes/no) was positively associated with having untreated coronal caries, 14–20 teeth, and 4+ prosthetic crowns. Nearly 20% of identified root lesions were present at or below the gingival margin, and most (88%) were secondary caries associated with crown margins (65%) or other restorations (23%). Conclusions: Our findings suggest that some dental characteristics, including the presence of prosthetic crowns, are risk indicators for the presence of untreated coronal and root caries.     

Study of dental caries and periapical lesions in a mediaeval population of the southwest France: Differences in visual and radiographic inspections

Dental caries and periapical lesions have often been studied in archaeological samples. The majority of these studies concern lesions detected clinically and, in some cases, radiography is used to improve the scoring results. The purpose of the present study was to compare and combine the two methods for recording caries and cysts. The studied dental material derived from a mediaeval sample from the south of France. The study included sixty mandibles (788 teeth). Each tooth was observed clinically and radiographically. Absence of teeth was noted and unerupted teeth, which could be viewed on radiographs were also noted. The location and degree of development of each lesion were recorded. Occlusal lesions of degree 1 were mostly detected clinically (5.1% vs.1.4% detected radiographically). Radiographic detection increased the score of approximal lesions of degree 2 (1.4% vs. 0.7%) and the detection of intraosseous lesions. This research has shown that the combination of radiographic and clinical examinations improves the caries detection and thus, increases the caries score in a studied dental sample.     

Aluminum concentrations in human deciduous enamel and dentin related to dental caries

The aluminum (Al) concentrations in the enamel and dentin of 314 human deciduous teeth were determined in order to examine the relationship between Al and dental caries. The sample teeth were divided into three groups: the sound tooth group, carious tooth group and filled tooth group. The teeth of the carious tooth group were further classified into three groups depending on the stage of caries. The Al content was determined using graphite furnace atomic absorption spectrometry. In both the enamel and dentin, the Al concentrations were unaffected by sex, but did depend on tooth type. In enamel, the Al concentration was significantly higher in the sound tooth group (42.8 +/- 37.3 microg/g) than in the three carious groups (20.7 +/- 17.1-24.9 +/- 22.0 microg/g) and the filled tooth group (27.3 +/- 25.5 microg/g). As for dentin, the Al concentration was also significantly higher in the sound tooth group (36.2 +/- 35.1 microg/g) than in the three carious groups (15.1 +/- 13.3-24.5 +/- 23.4 microg/g) and the filled tooth group (17.2 +/- 20.6 microg/g). Even when analyzing incisors alone, the Al concentrations were significantly higher in the sound tooth group than in the other groups, for both enamel and dentin. Furthermore, the Al levels in carious enamel and dentin did not decrease with the advance of caries. These findings indicated that the deciduous teeth containing higher Al concentrations on average had less caries than the teeth with lower Al concentrations, and suggest that Al acts as a possible cariostatic agent by itself.     

Candida albicans promotes tooth decay by inducing oral microbial dysbiosis

Candida albicans has been detected in root carious lesions. The current study aimed to explore the action of this fungal species on the microbial ecology and the pathogenesis of root caries. Here, by analyzing C. albicans in supragingival dental plaque collected from root carious lesions and sound root surfaces of root-caries subjects as well as caries-free individuals, we observed significantly increased colonization of C. albicans in root carious lesions. Further in vitro and animal studies showed that C. albicans colonization increased the cariogenicity of oral biofilm by altering its microbial ecology, leading to a polymicrobial biofilm with enhanced acidogenicity, and consequently exacerbated tooth demineralization and carious lesion severity. More importantly, we demonstrated that the cariogenicity-promoting activity of C. albicans was dependent on PHR2. Deletion of PHR2 restored microbial equilibrium and led to a less cariogenic biofilm as demonstrated by in vitro artificial caries model or in vivo root-caries rat model. Our data indicate the critical role of C. albicans infection in the occurrence of root caries. PHR2 is the major factor that determines the ecological impact and caries-promoting activity of C. albicans in a mixed microbial consortium.Subject terms: Biofilms, Bacteria, Fungi     

Methodological Issues Relative to the Quantification of Root Surface Caries1

The purpose of this study was to assess the effect upon the quantification of root surface caries (RSC) of (1) the separation of the disease into its discrete clinical phases, (2) the confounding caused by the presence of restored abraded surfaces, and (3) the decision rule formulated for dealing with lesions and restorations which involve both crown and root. It was found that the apparent prevalence of RSC varied widely depending upon arbitrary decisions as to what stages of the disease were included in the measurement scheme. The addition of restorations (confined to the root) greatly enlarged the various disease measures, but probably also introduced some degree of error since there are several indications from the data and the clinical patterns of affected surfaces which suggest that some of the restored surfaces were formerly abraded rather than carious. The inclusion of lesions and restorations involving both root and crown produced another conspicuous increment in all disease measures, which is a cause for concern given that these components are included in some studies and ignored in others. These findings serve as the basis for several recommendations for future prevalence and incidence studies of RSC.     

Demineralization and Remineralization of Root Surface Caries

Although enamel, cementum and dentin all develop carious lesions in roughly the same manner there are significant differences between enamel and the other two tissues. While early enamel lesions are white, root surface lesions in cementum or dentin are light brown or yellow. The color probably arises from extrinsic stain materials, and it is possible that very early, actively forming lesions are colorless. Cementum and dentin often acquire a hypermineralized surface when first exposed to the oral environment. When caries begins to form, this layer can enlarge or disappear. Therefore, it is possible to have lesions with hypermineralized surface layers, hypomineralized surface layers, or no surface layer. Hypermineralization can also occur deeply within a lesion, probably as a result of remineralization. When this occurs the lumen of the tubules fill with mineral and the crystals within the lesion body become larger. Fluoride is readily taken up by carious root tissues and contributes to remineralization. Remineralization of artificial root surfaces after treatment with monofluorophosphate has been shown. In these lesions much of the newly acquired mineral was found near the surface but some was also found in the lesion body.     

The prevalence of root surface caries amongst Irish adults

In a national survey of adult dental health conducted in the Republic of Ireland in 1989/90 a total of 1,527 subjects aged 25 and older were examined for root surface caries. It was found that the prevalence of root surface caries was highest in older age groups and also amongst males, residents of non-fluoridated communities and those earning low incomes. Tooth loss masked the potential prevalence of root surface caries. With more persons retaining their natural teeth into middle and old age the prevalence of root surface caries is likely to increase in the future.     

Number of teeth and risk of root caries

Objective: This study aimed to investigate the association between number of natural teeth and prevalence of root caries. Design: A cross‐sectional design was adopted. A stratified multi‐stage purposive sampling method was used to select a wide range of elderly people from all social classes, educational levels and sexes. Data was collected through interviews and clinical examinations. Setting: Urban area in Chiang Mai‐Thailand. Participants: 549 elderly dentate aged 60‐74 years. Main Outcome Measures: Teeth with decay and filled roots (DF‐T). Results: The prevalence of root caries was 18.2% with a mean DF‐T of 0.58 (S.D. 2.02). Results of multiple logistic regression showed that number of teeth, DMF‐S scores, sex, and socio economic factors were statistically significantly associated with root caries (P<0.05). Adjusted odds ratios demonstrated a 14% increase in the chance of having root caries when the number of teeth increased one unit. Similarly, a 3% increase was observed for each unit increase in the DMF‐S scores (p<0.001). Being male, having more than four years of education and earning more than 1500 baht/month increased the chances of root caries by 76%, 139% and 85% respectively (p<0.001). Recession and age were not statistically significantly associated with root caries. Conclusions: Having more teeth, higher DMF‐S scores, earning more than 1500 baht/month, having more than 4 years of education and being male increased the likelihood of having root caries.     

两种脱矿体系制备人工龋损的病理学比较

目的评价两种不同脱矿体系在人牙釉质与牛牙釉质形成人工龋样损害的情况,确定模拟早期龋实验研究的脱矿系统。方法两种脱矿体系：部分饱和酸缓冲溶液和酸性凝胶溶液,分别在人牙釉质与牛牙釉质制备人工早期釉质龋损,采用偏振光显微镜和扫描电子显微镜观察实验人工龋的组织病理学变化。结果部分饱和的酸缓冲体系制备的人工龋损都具有完整的表层和表层下脱矿,牛牙釉质除了脱矿深度大于人牙釉质外,其它病理学特点都类似于人牙釉质,与早期自然龋损相似。而凝胶液脱矿体系形成的人工龋损不管是人牙还是牛牙都没有明显的表层结构,实验牙表面多出现被腐蚀或溶解。结论部分饱和的酸缓冲液脱矿系统形成的人工龋损病理学变化更接近于自然龋;与人牙具有相似化学组成的牛牙很适合代替人牙来检测脱矿和再矿化的效果。     

Coca chewing in prehistoric coastal Peru: dental evidence

In this study, we describe the dental health of four prehistoric human populations from the southern coast of Peru, an area in which independent archaeological evidence suggests that the practice of coca-leaf chewing was relatively common. A repeated pattern of cervical-root caries accompanying root exposure was found on the buccal surfaces of the posterior dentition, coinciding with the typical placement of coca quids during mastication. To further examine the association between caries patterning and coca chewing, caries site characteristics of molar teeth were utilized as indicators for estimating the likelihood of coca chewing for adults within each of the study samples. Likelihood estimates were then compared with results of a test for coca use derived from hair samples from the same individuals. The hair and dental studies exhibited an 85.7% agreement. Thus, we have demonstrated the validity of a hard-tissue technique for identifying the presence of habitual coca-leaf chewing in ancient human remains, which is useful in archaeological contexts where hair is not preserved. These data can be used to explore the distribution of coca chewing in prehistoric times. Simultaneously, we document the dental health associated with this traditional Andean cultural practice.     

Caries prevalence in skeletal series--is it possible to compare?

Because of the relationship with subsistence, dental caries is a central issue in paleopathological research. Usually, comparisons between caries prevalence exhibited in different skeletal series are made. Dietary variation is the most common explanation for cavities prevalence. The aim of this paper is to verify if it is possible to compare caries prevalence reported on papers for archaeological skeletal series. Another goal is to determine if other factors besides diet are implicated in dental cavity prevalence explanation. Twenty six papers about dental health with caries prevalences published from 1999 to 2004 were analyzed for completeness. This assessment includes carious lesion diagnosis and characteristics, age, sex and size characteristics of samples, and prevalence calculation method. The majority of the analyzed papers do not provide adequate information in the topics listed above. Only very few implicated factors other than diet as a contributor to caries lesions development.     

Caries and periodontal disease of the elderly in Pomerania, Germany: results of the Study of Health in Pomerania

Objective: The aim of this study was to describe the oral health status of older adults living in north‐eastern Germany. Materials and Methods: Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross‐sectional, population‐based study. Data on 1446 subjects aged 60–79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss. Results: The prevalence of edentulousness varied from 16% in the 60–65‐year‐old group to 30% in the 75–79‐year‐old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60–65 years) to one in the oldest (75–79 years). Among subjects aged 60–69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70–79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70–79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60–69 years: 85% vs. 71% in 70–79‐year‐old men; women aged 60–69 years: 71% vs. 62% in 70–79‐year‐olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern. Conclusions: It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.