The association between periodontal disease and periosteal lesions in the St. Mary Graces cemetery, London, England A.D. 1350-1538

Numerous studies have demonstrated significant associations between periodontal disease and many other diseases in living populations, and some studies have shown that individuals with periodontal disease are at elevated risks of mortality. Recent analysis of a medieval skeletal sample from London has also shown that periodontal disease was associated with increased risks of mortality in the past. This study examines whether periodontal disease is associated with periosteal lesions in a skeletal sample from the urban St. Mary Graces cemetery (n = 265) from medieval London. The results reveal a significant association between periodontal disease and periosteal lesions in the St. Mary Graces sample (i.e., individuals with periodontal disease were also likely to have periosteal lesions), and the association between the two is independent of age. The association between the two pathological conditions might reflect underlying reduced immune competence and thus heightened susceptibility to pathogens that cause periodontal disease or periosteal lesions, exposure to an environmental factor, or underlying heightened inflammatory responses.     

Sex differences in periodontal disease in catastrophic and attritional assemblages from medieval london

Periodontal disease is one of the most common chronic diseases in living populations, and most studies that have examined sex differences in periodontal disease have found higher frequencies in men compared to women. This study examines sex differences in periodontal disease in two cemeteries from medieval London: the East Smithfield cemetery (c. 1349–1350), an exclusively Black Death cemetery that represents catastrophic mortality (n = 161), and the St. Mary Graces cemetery (c. 1350–1538), a post‐Black Death attritional assemblage that represents normal medieval mortality (n = 100). The results reveal a significantly higher frequency of periodontal disease, independent of age, among males compared with females in St. Mary Graces, but no significant difference between the sexes in East Smithfield. The sex differences in the attritional assemblage might reflect heightened susceptibility to periodontal disease in the living population or sex differences in frailty. The differences in the sex patterns of periodontal disease between the two cemeteries might be the result of disproportionately negative effects of the Great Bovine Pestilence and consequent decreases in dairy availability on female oral health among victims of the Black Death. Am J Phys Anthropol, 2012. © 2012 Wiley Periodicals, Inc.     

Mortality Risk and Survival in the Aftermath of the Medieval Black Death

The medieval Black Death (c. 1347-1351) was one of the most devastating epidemics in human history. It killed tens of millions of Europeans, and recent analyses have shown that the disease targeted elderly adults and individuals who had been previously exposed to physiological stressors. Following the epidemic, there were improvements in standards of living, particularly in dietary quality for all socioeconomic strata. This study investigates whether the combination of the selective mortality of the Black Death and post-epidemic improvements in standards of living had detectable effects on survival and mortality in London. Samples are drawn from several pre- and post-Black Death London cemeteries. The pre-Black Death sample comes from the Guildhall Yard (n = 75) and St. Nicholas Shambles (n = 246) cemeteries, which date to the 11^th–12^th centuries, and from two phases within the St. Mary Spital cemetery, which date to between 1120-1300 (n = 143). The St. Mary Graces cemetery (n = 133) was in use from 1350–1538 and thus represents post-epidemic demographic conditions. By applying Kaplan-Meier analysis and the Gompertz hazard model to transition analysis age estimates, and controlling for changes in birth rates, this study examines differences in survivorship and mortality risk between the pre- and post-Black Death populations of London. The results indicate that there are significant differences in survival and mortality risk, but not birth rates, between the two time periods, which suggest improvements in health following the Black Death, despite repeated outbreaks of plague in the centuries after the Black Death.     

北票喇嘛洞三燕文化墓地人骨的牙病

本文对辽宁北标喇嘛洞三燕文化墓地出土人骨的牙病作了详细的观察。初步探讨了龋病和牙周病的罹患率与性别和年龄的关系,结果显示：（1）龋病的罹患率男女间差异不显著,而牙周病的罹患率性别差异显著。（2）龋病的罹患率与年龄变化具有一定关系,而牙周病的罹患率则与年龄变化关系密切。此外,对多生牙、先天缺额牙、融合牙、错位牙、第三臼齿的阻生情况也分别作了记录与分析。     

Implications of Dental Caries in Anatolia: From Hunting–Gathering to the Present

Teeth are considered one of the most informative and durable parts of the skeleton. In Dental Anthropology, they are used to obtain information on culture, health, diet, variability and evolutionary trends in dental morphology as well as development, eruption and dental pathologies in the past and modern populations. In this study, an attempt was made to evaluate the results of dental caries, which is the most common dental disease, in order to document changing patterns of health and diet ranging from the transitional period of hunting–gathering through agriculture to the present day in human history in Anatolia. From the total sample of 400 modern individuals, a total of 5,208 maxillary teeth and 5,153 mandibular teeth were studied. The percentage of the occurrence of dental caries based on the individuals was 77.8%, whereas the frequency of dental caries on tooth type and class was 17.1% (18.0% maxillary decay; 16.2% mandibular decay). A comparative study of the frequency of caries in certain periods indicates the following: in the hunting–gathering period it was 1%–2%, in the Early Neolithic it was 3%–5% (Catal Hoyuk), in the Neolithic (beginning of agriculture) it was 5.6% (Cayonu), in the Chalcolithic it was 11.7% (Norsuntepe), in the Roman period it was 11.1% (Panaztepe), and 16% (Datca), in the Late Byzantine it was 10.9% (Iznik) and in the Medieval it is 14.2% (Arslantepe). These findings contribute to understanding how dietary change and life conditions are interrelated with the changing patterns of dental diseases in Anatolian populations.     

Dental disease and risk of coronary heart disease and mortality.

OBJECTIVE--To investigate a reported association between dental disease and risk of coronary heart disease. SETTING--National sample of American adults who participated in a health examination survey in the early 1970s. DESIGN--Prospective cohort study in which participants underwent a standard dental examination at baseline and were followed up to 1987. Proportional hazards analysis was used to estimate relative risks adjusted for several covariates. MAIN OUTCOME MEASURES--Incidence of mortality or admission to hospital because of coronary heart disease; total mortality. RESULTS--Among all 9760 subjects included in the analysis those with periodontitis had a 25% increased risk of coronary heart disease relative to those with minimal periodontal disease. Poor oral hygiene, determined by the extent of dental debris and calculus, was also associated with an increased incidence of coronary heart disease. In men younger than 50 years at baseline periodontal disease was a stronger risk factor for coronary heart disease; men with periodontitis had a relative risk of 1.72. Both periodontal disease and poor oral hygiene showed stronger associations with total mortality than with coronary heart disease. CONCLUSION--Dental disease is associated with an increased risk of coronary heart disease, particularly in young men. Whether this is a causal association is unclear. Dental health may be a more general indicator of personal hygiene and possibly health care practices.     

Dental caries in nineteenth century Upper Canada

This study examines the presence of dental caries in a large sample of adult skeletons from the 19th century cemetery of St. Thomas' Anglican Church in Belleville, Ontario. The cemetery was used from 1821 to 1874. Caries prevalence and frequencies of diseased and missing teeth were calculated both by observing summary statistics of individual rates and by the total sample of teeth. Postmortem tooth loss is low in this sample and antemortem tooth loss is highest in first mandibular molars, all other molars and then premolars. Age at death, but not sex, was found to be significantly related to the overall Caries Rate while both age and sex were significantly associated with the Diseased-Missing Index. The increase in diseased and missing teeth in older individuals is expected while the sex difference is not explained by simple dietary factors. When compared to reports on British and American samples, caries and antemortem tooth loss in the St. Thomas' sample is most similar to a pre-1850 British group and higher than American samples. Although there is undoubtedly a complex of factors contributing to caries prevalence in this sample, more data are required from large historic samples, particularly from the American northeast and late 19th century Britain, to have a clearer understanding of the influence of diet, cultural, and environmental factors affecting caries rates in historic populations. Am J Phys Anthropol 104:71–87, 1997. © 1997 Wiley-Liss, Inc.     

Dental health indicators of hunter-gatherer adaptation and cultural change in Siberia's Cis-Baikal

This investigation of the Cis-Baikal dental record focuses on health and lifestyle reconstruction of the region's mid-Holocene foragers, with particular interest in an apparent fifth millennium BC biocultural hiatus. The four cemetery populations considered represent two distinct biological and cultural groups separated by an apparent 700-year hiatus: the late Mesolithic-early Neolithic Kitoi culture (6800-4900 BC) and the middle Neolithic-early Bronze Age Serovo-Glaskovo cultural complex (4200-1000 BC). Research focuses on the frequency and severity of seven dental health indicators: enamel hypoplasia, caries, alveolar defects, periodontitis, antemortem tooth loss, dental calculus, and dental attrition. Together, these seven indicators provide a basis not only for better understanding mid-Holocene lifeways in the Cis-Baikal but also for independently assessing the relative effectiveness of the different adaptive strategies employed by pre- and posthiatus peoples. Results reveal some discrepancies between the Kitoi and Serovo-Glaskovo, specifically in their relative vulnerability to physiological stress, providing evidence to support previous interpretations of their distinct adaptive regimes (namely the narrower resource base and decreased mobility of the former). Results also suggest that some of the differences observed among the four sites may reflect geographical or environmental factors rather than simply cultural ones. However, despite these distinctions, the overriding trend appears to be one of general continuity, social equality, and good health among all mid-Holocene occupants of the Cis-Baikal, pre- and posthiatus alike.     

The effect of sex on risk of mortality during the Black Death in London,A.D. 1349–1350

The Black Death of 1347–1351 was one of the most devastating epidemics in human history, and though it is frequently assumed that the epidemic killed indiscriminately, recent research suggests that the disease was selective, at least with respect to frailty. The purpose of this study is to determine whether the Black Death was similarly selective with respect to biological sex—that is, did either sex face an elevated risk during the epidemic or were men and women at equal risk of dying? A sample of 298 victims of the Black Death, from the East Smithfield cemetery in London, is compared to a pre‐Black Death normal mortality sample of 194 individuals from two Danish urban cemeteries, St Mikkel Church (Viborg) and St Albani Church (Odense). To assess the effect of sex on risk of death, sex is modeled as a covariate affecting the Gompertz–Makeham model of adult mortality. The results suggest that sex did not strongly affect risk of death in either the normal mortality or Black Death samples. These results are important for improving our understanding of Black Death mortality patterns. This is essential for understanding the effects the Black Death had on European populations, and the methods used here can potentially be informatively applied to investigations of other episodes of epidemic diseases in past populations. Am J Phys Anthropol 2009. © 2009 Wiley‐Liss, Inc.     

The oral metagenome in health and disease

The oral cavity of humans is inhabited by hundreds of bacterial species and some of them have a key role in the development of oral diseases, mainly dental caries and periodontitis. We describe for the first time the metagenome of the human oral cavity under health and diseased conditions, with a focus on supragingival dental plaque and cavities. Direct pyrosequencing of eight samples with different oral-health status produced 1 Gbp of sequence without the biases imposed by PCR or cloning. These data show that cavities are not dominated by Streptococcus mutans (the species originally identified as the ethiological agent of dental caries) but are in fact a complex community formed by tens of bacterial species, in agreement with the view that caries is a polymicrobial disease. The analysis of the reads indicated that the oral cavity is functionally a different environment from the gut, with many functional categories enriched in one of the two environments and depleted in the other. Individuals who had never suffered from dental caries showed an over-representation of several functional categories, like genes for antimicrobial peptides and quorum sensing. In addition, they did not have mutans streptococci but displayed high recruitment of other species. Several isolates belonging to these dominant bacteria in healthy individuals were cultured and shown to inhibit the growth of cariogenic bacteria, suggesting the use of these commensal bacterial strains as probiotics to promote oral health and prevent dental caries.     

The oral microbiome of pregnant women facilitates gestational diabetes discrimination

The oral microbiota plays an important role in the development of various diseases,whereas its association with gestational diabetes mellitus (GDM) remains largely unclear.The aim of this study is to identify biomarkers from the oral microbiota of GDM patients by analyzing the microbiome of the saliva and dental plaque samples of 111 pregnant women.We find that the microbiota of both types of oral samples in GDM patients exhibits differences and significantly varies from that of patients with periodontitis or dental caries.Using bacterial biomarkers from the oral microbiota,GDM classification models based on support vector machine and random forest algorithms are constructed.The area under curve (AUC) value of the classification model constructed by combination of Lautropia and Neisseria in dental plaque and Streptococcus in saliva reaches 0.83,and the value achieves a maximum value of 0.89 by adding clinical features.These findings suggest that certain bacteria in either saliva or dental plaque can effectively distinguish women with GDM from healthy pregnant women,which provides evidence of oral microbiome as an informative source for developing noninvasive biomarkers of GDM.     

Dental anthropological indications of agriculture among the Jomon people of central Japan. X. Peopling of the Pacific

The high rate of crown caries (8.6%; 119/1,377 teeth) and other oral pathologies in 101 central Japan Middle to Late Jomon Period (ca. 1000 B.C.) crania indicate a level of carbohydrate consumption consistent with an agriculture hypothesis. Because Jomon dental crown and root morphology shows strong resemblances with past and present Southeast Asians, but not with ancient Chinese or modern Japanese, Jomon agriculture could be of great antiquity in the isolated Japanese islands. These dental data and other assembled facts suggest that ancestral Jomonese might have carried to Japan a cariogenic cultigen such as taro before the end of the Pleistocene from tropical Sundaland by way of the now-submerged east Asian continental shelf.     

Periodontal disease in the Mycenean (1450–1150 BC) population of Aghia Triada, W. Peloponnese, Greece

This study investigates the incidence of periodontitis in a Mycenaean population unearthed at the cemetery of Aghia Triada (West Peloponnese, Greece) during the 1989–1997 field season. The material consists of 172 dry skulls. Demographic parameters of sex and age were difficult to be assigned due to the bad state of preservation of the skeletal material. The ratio was 50 males, 48 females, 65 unidentified and 9 children, and we estimated an average age of 38 years. In this work we used traditional and modern methods to determine the incidence of periodontitis in the archeological human dental bone. We also recorded other dental diseases, such as ante mortem tooth loss, caries and attrition. The results showed that periodontitis has affected 35% of the jaws. A notable percentage of the individuals — 24% — lost three or more teeth during their lifetime and a total 53% of the population had extracted teeth before death. This paper points out that the ancient jaws present a high proportion of ante-mortem tooth loss, attrition and deep caries, whereas the frequency of periodontitis does not seem to differ from that of other prehistoric samples.     

Diabetes enhances dental caries and apical periodontitis in caries-susceptible WBN/KobSlc rats

Many epidemiologic studies have suggested that diabetes may be an important risk factor for periodontal disease. To determine whether diabetes induces or enhances periodontal disease or dental caries, dental tissue from diabetic male and nondiabetic female WBN/KobSlc rats and male and female age-matched nondiabetic F344 rats was analyzed morphologically and morphometrically for these 2 types of lesions. Soft X-ray examination revealed that the incidence and severity of both molar caries and alveolar bone resorption were much higher in male WBN/KobSlc rats with chronic diabetes than in nondiabetic female rats of the same strain. Histopathologic examination showed that dental caries progressed from acute to subacute inflammation due to bacterial infections and necrosis in the pulp when the caries penetrated the dentin. In the most advanced stage of dental caries, inflammatory changes caused root abscess and subsequent apical periodontitis, with the formation of granulation tissue around the dental root. Inflammatory changes resulted in resorption of alveolar bone and correlated well with the severity of molar caries. Our results suggest that diabetic conditions enhance dental caries in WBN/KobSlc rats and that periodontal lesions may result from the apical periodontitis that is secondary to dental caries.     

山东广饶县中南世纪城墓地出土明代人骨的初步研究

本文对广饶县中南世纪城墓地出土的明代人骨进行了多方面的生物考古学研究,包括性别、年龄的分布,身高的复原以及古病理的观察。牙病方面,对龋病、牙釉质发育不全和错(牙合)畸形进行了观察记录,从性别、年龄、龋患程度及好发牙位等方面对该人群的龋患情况进行统计分析。研究结果表明,该人群牙齿患龋率不具备明显的性别差异,与年龄变化也无显著相关性,好发牙位多为臼齿。此外,还观察到多孔性骨肥厚、骨关节疾病等病理现象以及一处愈合较好的骨折创伤。     

A new approach to the study of Romanization in Britain: a regional perspective of cultural change in late iron age and roman dorset using the siler and gompertz-makeham models of mortality

This is the first study of health in the Roman Empire to use the Siler and Gompertz-Makeham models of mortality to investigate the health consequences of the 43 AD conquest of Britain. The study examined late Iron Age and Romano-British populations (N = 518) from Dorset, England, which is the only region of Britain to display continuity in inhumation burial practice and cemetery use throughout the two periods. Skeletal evidence for frailty was assessed using cribra orbitalia, porotic hyperostosis, periosteal lesions, enamel hypoplasia, dental caries, tuberculosis, and rickets. These health variables were chosen for analysis because they are reliable indicators of general health for diachronic comparison (Steckel and Rose: The backbone of history: health and nutrition in the western hemisphere (2002)) and are associated with the introduction of urbanism in Britain during the Roman period (Redfern: J Rom Archaeol Supp Series 64 (2007) 171-194; Redfern: Britannia 39 (2008a) 161-191; Roberts and Cox: Health and disease in Britain: from prehistory to the present day (2003)). The results show that levels of frailty and mortality were lower in the late Iron Age period, and no sex differences in mortality was present. However, post-conquest, mortality risk increased for children and the elderly, and particularly for men. The latter finding challenges received wisdom concerning the benefits of incorporation into the Empire and the higher status of the male body in the Roman world. Therefore, we conclude that the consequences of urbanism, changes in diet, and increased population heterogeneity negatively impacted health, to the extent that the enhanced cultural buffering of men did not outweigh underlying sex differences in biology that advantage women.     

Trends in Oral Disease and Health1

Geriatric dentistry researchers are building a basic knowledge basic pertaining to the oral health status of older adults. Important findings on the prevalence of disease that run counter to “conventional wisdom” surrounding the oral health of older adults are that edentulism is decreasing, that both coronal and root caries are prevalent, that serious periodontal disease is not as prevalent as thought, that chronological age is not strongly associated with disease in older adults, and that oral lesions, especially those related to dentures, are prevalent. An important finding has been that the majority of disease seems to occur in a minority of the population. While the prevalence of oral diseases have been shown to be associated with water fluoridation, systemic diseases, use of medications, social and behavioral factors, and a variety of other oral conditions, there is only preliminary information on the incidence of disease and actual risk factors. The data available on the incidence of disease come from a study of community-dwelling older adults in Iowa, and these data generally confirm the prevalence results. Coronal and root caries are active in this older population with caries being the best predictor of tooth loss. Furthermore, most disease occurs in a high risk group. Multivariate models predicting people at highest risk for root and coronal caries implicate stress and anxiety, use of tobacco, and recent onset of illness as risk factors. In addition, preliminary results indicate that some dental conditions may be predictive of general health status.     

Biomechanical association of dental and temporomandibular pathology in a medieval Nubian population

An analysis of the relationship between oral pathology and degenerative change at the temporomandibular joint (TMJ) was undertaken on an archaeological sample of 122 adult crania from the Medieval site of Kulubnarti in Sudanese Nubia. The crania were sorted into 2 groups: those demonstrating clearly visible bony changes at the joint (TMJ+) and those without visible change (TMJ-). These groups were compared according to 1) age; 2) sex; 3) active dental pathologies (abscesses, caries, partial socket resorption); 4) tooth loss with complete socket resorption; and 5) dental attrition. No statistically significant association was evident between degenerative change at the TMJ and age, active dental pathologies, or dental attrition; however, sex differences and posterior tooth loss with complete socket resorption revealed a significant correspondence to degenerative TMJ changes. Both of these factors agree with the clinical literature and with biomechanical models (most notably that of Hylander) based upon modern populations. Furthermore, the results support the contention that paleopathological conditions can be analyzed from a clinical and functional biomechanical perspective.     

The Epidemiology of Dental Diseases in the Elderly1

This paper summarizes and evaluates epidemiologic evidence on adult dental conditions with a focus on older adults. Information is presented on coronal caries; root caries; loss of teeth, attrition, abrasion, and erosion; periodontal diseases; and oral cancer. The author concludes that the oral health status of the elderly in the United States is essentially unknown. There are no recent, representative population base studies of oral conditions in the elderly. Studies of prevalence or incidence of oral diseases typically include few elderly persons or describe a select group of elderly who are at high risk. Furthermore, it is not really known whether the incidence and prevalence of coronal caries or root caries is actually increasing or is part of a cohort effect. While oral cancers have been shown to increase with age, there is no information as to whether their incidence rates are increasing. While, clinically, there are indications that attrition, abrasion and erosion are characteristics that are more likely to be seen in older adults, there is no information about their distribution in the population. There is evidence that loss of teeth is decreasing but nothing is known about the patterning of that loss. As for periodontal diseases, much work is needed to identify various syndromes that may be distinguished by their distribution in the population as well as determining whether periodontitis is a condition responsible for a majority of tooth loss or just the majority of tooth loss in a small high risk group. In addition, some suggestions are presented for future directions of research in this area.     

Alloxan-induced hyperglycemia causes rapid-onset and progressive dental caries and periodontitis in F344 rats

We have previously shown that diabetes increases dental caries, and periodontitis might be a secondary change resulting from dental caries in spontaneous diabetic rodent models. However, the lesions in these models were slow to manifest, and the intensity and frequency were mild and varied among individuals. The goal of this study was to confirm the reproducibility of caries development in chemically induced diabetic rats and investigate whether alloxan, which induces immediate and severe hyperglycemia in experimental animals, increases the lesions. Female F344 rats were examined 13 and 26 weeks after dosing of alloxan. Alloxan injection induced severe hyperglycemia in two-thirds of the rats. Progressive molar caries and periodontitis were already induced in all diabetic rats 13 weeks after dosing of alloxan, although the lesions were not observed in nondiabetic rats. Histopathologically, dental caries initially developed in the crown, then spread into the dental root, entered the periodontal connective tissue via the apical foramen, and progressed to periodontitis. In conclusion, alloxan-induced severe hyperglycemia is capable of causing rapid-onset and progressive dental caries and periodontitis in rats.