Elsevier

HOMO

Volume 61, Issue 6, December 2010, Pages 421-439
HOMO

Dental health and lifestyle in four early mediaeval juvenile populations: Comparisons between urban and rural individuals, and between coastal and inland settlements

https://doi.org/10.1016/j.jchb.2010.06.004Get rights and content

Abstract

Dental stress markers such as enamel hypoplasia and caries are suitable indicators of population health and lifestyle, although they must be recorded and interpreted carefully. To date, they have been predominantly studied in adult samples, whereas juvenile remains are also affected by these lesions. In this study, dental enamel hypoplasia and caries were both evaluated on 613 non-adult individuals from four early mediaeval Moravian and Frankish skeletal series, who had experienced contrasting environments and lifestyles. The aim of this study is to assess the relationship between these biological traits and living conditions, and how this is manifested in the juvenile dental remains.

Significant differences between populations were found in stress markers, dental lesions and the way these were manifested. Exposure to stressful conditions varies between urban and rural populations and is related to age groups. Although the children under investigation seem to have had different diets, it is difficult to distinguish the biological contribution (different enamel susceptibility) from the lifestyle contribution (different food, environment) in the formation of caries. Moreover, such studies must be interpreted carefully due to the possibility of intra- and inter-observer errors and the subjectivity of the scoring techniques.

Nevertheless, this study also demonstrates that results of an investigation of juvenile skeletal remains can be as informative as a study of adults and that juvenile skeletons can be included in large bioarchaeological population studies.

Résumé

Les marqueurs de stress non spécifique et les lésions carieuses apportent des informations pertinentes sur la santé et le mode de vie des populations du passé, même s’ils doivent être enregistrés et interprétés avec précaution. Les études préexistantes combinant ces caractères concernent essentiellement les adultes bien que les enfants soient également touchés. Cette étude repose sur 613 individus immatures provenant de quatre populations du haut Moyen Âge au mode de vie contrasté, sur lesquels nous avons enregistré à la fois les hypoplasies de l’émail dentaire et les lésions carieuses. Son but est d’évaluer la relation entre ces expressions biologiques et le mode de vie des enfants.

Des différences significatives ont été mises en évidence entre les populations ainsi qu’une certaine influence de l’âge au décès. Les interprétations environnementales restent néanmoins complexes car les facteurs de biais sont nombreux tant par les techniques de cotation qui souffrent d’une forte erreur intra- et inter-observateurs que par notre connaissance limitée des véritables conditions de vie au haut Moyen Âge. Toutefois, cette étude démontre aussi l’intérêt d’intégrer les enfants dans les larges études de populations en bioarchéologie.

Introduction

Davis and McCormick stated in their book, The Long Morning of Medieval Europe: New Directions in Early Medieval Studies (2008:1) that “Not even a generation ago, scholars located around the year 1000 a series of crucial new directions in the development of European civilization: the demographic upturn after the late Roman decline, the spread of new agricultural techniques and productivity, the beginning of mediaeval trading centers and circuits, to name only a few of them.” In the absence of written sources, archaeobotanical and archaeozoological research can provide information about crops and other aspects of agriculture in early mediaeval Europe (Bakels, 2005, Rösch, 2008). However, a more detailed and accurate knowledge and understanding of the state of health conditions at the population level can be acquired by analysing dental material.

Dental stress markers and carious lesions are widely believed to reflect the environment within which individuals grow and live (Cook and Buikstra, 1979, Goodman et al., 1988, Goodman and Rose, 1991, Lewis, 2000). They are also a valuable source of information on the nutrition and, in a broader sense, the lifestyle and environment of a population. However, most studies on past and historic populations evaluating both dental enamel hypoplasia and caries, are based on adult remains only (Barthelemy et al., 1999, Belcastro et al., 2007, Cucina et al., 2006, Esclassan et al., 2009, Palubeckaitë et al., 2002, Wright, 1997), while it is well accepted that juveniles, and thus their skeletons, are the most sensitive to social and environmental conditions (Bennike et al., 2005, Humphrey and King, 2000, Lewis, 2007, Pinhasi et al., 2005). Linear enamel hypoplasia (LEH) is often scored in the whole sample, regardless of the age at death, and some specific sections are dedicated to juveniles (such as in Blakey and Armelagos, 1985, Cook and Buikstra, 1979, Skinner, 1986). However, due to the habitual under-representation of subadult remains (Guy et al., 1997) and the influence of age-at-death on caries formation, these lesions on juvenile dentition are seldom included in studies of populations. In response to the need for more studies on juvenile remains, and because skeletal samples in our study include a considerably large proportion of juveniles, we have chosen to assess both LEH and caries in order to evaluate their expression in non-adult dental remains.

Nutritional stress is considered a correlating factor in dental caries etiology in children (O'Sullivan et al., 1992). More information is available about diachronic changes in dental health in various countries (Oyamada et al., 2008, Vodanović et al., 2005, Watt et al., 1997) than in population variability in the same geographical latitude of the continent. Moreover, assessment of the relation between dental health, lifestyle and environment is a central topic in bioarchaeology especially on children (Lewis, 2007:97). This study aims to emphasise the significant role of children in such studies by recording both dental enamel hypoplasia and dental caries.

Enamel hypoplasia is a macroscopically observable quantitative dental defect where enamel thickness has locally decreased on the surfaces of tooth crowns (Clarkson, 1989). As enamel is not remodeled during one's lifetime once it had been formed, hypoplasia provides significant information about stress during development of the dentition (Ubelaker, 1978). Alongside enamel defects, dental caries are the oral health indicators frequently used to reconstruct the dietary patterns and lifestyles of skeletal populations (Erdal and Duyar, 1999). “Dental caries is a disease process characterized by the focal demineralization of dental hard tissues by organic acids produced by bacterial fermentation of dietary carbohydrates, especially sugars” as stated by Larsen et al. (1991:179). These defects and lesions are studied together in order to estimate the relationship and possible correlation between them.

The major aim of this study is to compare four contrasting populations (rural vs. urban; coastal vs. inland settlements), in order to understand how these biological traits are linked to environmental conditions. Bearing in mind the limitations of such studies, such as the osteological paradox effect (Wood et al., 1992) and some methodological biases (Hillson, 2001), special care has been taken in order to ensure the reproducibility of the results and reliable interpretations.

Section snippets

Samples under study

The skeletal sample comprises 613 individuals ranging from the perinatal period to late adolescence, dating to the European Early Middle Age, and belonging to four different populations. The first two sites where the skeletons were uncovered are Mikulčice (9th–10th centuries C.E.), a Czech municipality situated 7 km south of Hodonín near the border of Slovakia, and Prušánky (9th–10th centuries C.E.), a rural settlement located only a few kilometers from Mikulčice (Fig. 1). The sites belong to

Intra- and inter-observer errors

As mentioned in Section 2, intra- and inter-observer errors cannot be avoided. Percentage of agreement, results of Spearman rank order correlation and the Kendall coefficient of concordance for each observed feature, are reported in Table 1.

Intra-observer errors vary between the features. The most variable traits are hypoplasia counts and the severity of these defects. Caries features, in contrast, are the least variable (percentage of agreement is always greater than 97%), confirming the value

Discussion

Before discussing the environmental and socioeconomic differences in oral health and stress, the main limitations of using these indicators for inter- and intra-population comparisons should be emphasised.

Both dental characteristics were evaluated only macroscopically and, even if the recording of the data is simplified, errors are not totally avoidable (especially inter-observer errors). In most studies, only the intra-observer error is evaluated, which is generally low for macroscopical and

Acknowledgments

We would like to thank Veijo Honkimaki for his support throughout the preparation of this paper and especially Charles Osborne for improving the language. The comments of anonymous reviewers are much appreciated. This study was supported by a Ph.D. Government grant (Bordeaux 1 University), the ECO-NET Project n° 16368PB and by the Grant Agency of Czech Republic (GACR 206/07/0699).

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