Periodontal disease in ancient populations

Abstract

Recent clinical and anthropological findings indicate that the conventional concept of the pathogenesis of periodontal disease requires review. The periodontal lesion has been defined as a generalised horizontal loss of crestal bone resulting from host immune and inflammatory responses triggered by the action of commensal bacteria, and the extension of gingivitis into the deeper periodontium to become periodontitis has been assumed to occur slowly but steadily over many years. Anthropological and clinical investigations reveal that the widespread loss of crestal tissue is relatively unusual and that lesions of the alveolus are commonly localised and severe. Longitudinal studies have shown that the disease progresses in bursts and is stable in both the gingivitis and periodontal modes in between the burst activity. The findings of the present study demonstrate that generalized horizontal periodontitis has been unusual and has not been responsible for tooth loss. Other factors responsible for deficient alveolar margins in dry bones have been overlooked in most studies, leading to overassessment of the incidence of periodontal disease in postmortem materials; the same assumptions have led to overassessment of periodontal disease in clinical studies and practice.

Dental health and disease in ancient Egypt

“…7 Periodontal disease in archaeological specimens has to be identifi ed with care, as the increase in the distance between the cemento-enamel junction and the alveolar crest, which has erroneously been used as an indicator of periodontal disease in the past, has been shown to be due to continuing eruption as a result of tooth wear. 15 A more positive indicator is the appearance of pitting on the alveolar bone caused by the resorption of the outer cortical plate, which then reveals the underlying porous cancellous structure. 16 The primary cause of periodontal disease today is bacterial irritation brought about by the accumulation of plaque at the dentogingival junction, and this may well have been the case in ancient Egypt.…”

“…Clarke et al 15 examined over 1,000 skulls from antiquity, a study which included a number of ancient Egyptian specimens, and found numerous examples of severe localised periodontitis, but by and large a low incidence of generalised horizontal bone loss. This latter case they suggested may have been due to a greater level of effi ciency of the host defence systems operating in the gingival crevice as compared to modern populations.…”

Trends in oral pathology of hunter-gatherers from Western Pampas, Argentina

“…Here, it is considered that the trait is present when a distance of at least 2 mm between the cement-enamel junction and the alveolar ridge is observed. Bone rarefaction, such as irregular tissue reaction and osteoporosis, may also be present (Tal, 1985;Clarke et al, 1986;Hillson, 2005).…”

Caries and Periodontal Disease in Rice-Cultivating Yayoi People of Ancient Japan

“…There have been few reports regarding periodontal disease in ancient skeletal remains. Notable exceptions include the studies of Clarke et al (Clarke et al, 1986), Sakashita et al, (Sakashita et al, 1997) and Kerr, (Kerr, 1998) which assessed the prevalence of periodontal disease in ancient populations. Clark et al (Clarke et al, 1986) investigated ancient human bones stored in 20 museums in 10 countries and reported that the prevalence of periodontal disease was 10% in ancient people.…”

“…Notable exceptions include the studies of Clarke et al (Clarke et al, 1986), Sakashita et al, (Sakashita et al, 1997) and Kerr, (Kerr, 1998) which assessed the prevalence of periodontal disease in ancient populations. Clark et al (Clarke et al, 1986) investigated ancient human bones stored in 20 museums in 10 countries and reported that the prevalence of periodontal disease was 10% in ancient people. Further, Sakashita et al (Sakashita et al, 1997) examined bones from the Yin-Shang period in China and reported that periodontal disease prevalence ranged from 20% to 30%.…”