Linear enamel hypoplasia and historical change in a central Australian community

The future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past: Re-framing oral health discourse

OBJECTIVE

The history of oral health research and dental care provision for Aboriginal and Torres Strait Islander Peoples has been framed by oppressive colonial values and wrought with maltreatment and unethical behavior. This commentary aims to collate evidence regarding the healthy history of Aboriginal and Torres Strait Islander oral health, the implications of colonization on oral health, and the current portrayal of oral health.

CONCLUSION

We argue the need to reframe deficit focused discussions of Aboriginal and Torres Strait Islander oral health to strengths-based narratives by critically engaging with the ways in which the future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past.

Dental enamel defects and dental caries of primary teeth among Indigenous children in Western Australia

BACKGROUND

Teeth affected with enamel defects (EDs) are at an increased risk of dental caries. In spite of improving oral health status overall in Australia, Indigenous Australians still experience higher rates of dental caries than non-Indigenous Australians. This study reports on the prevalence of EDs and dental caries experience among Indigenous children in the Kimberley region of Western Australia.

METHODS

Health status of all the primary teeth (ICDAS II criteria) and the presence of EDs on index teeth (modified Dental Defects of Enamel index; DDE) of young Indigenous children who participated in a 2-arm intervention trial was recorded. Generalized estimating equations were used to estimate the association between EDs and dental caries and effect estimates were presented as odds ratios and associated 95% confidence intervals.

RESULTS

Person-level prevalence, from 237 children (mean age 3.6 years, standard deviation 1.7) assessed for EDs, was 58% and tooth-level prevalence was 24%. Teeth affected with demarcated or diffuse defects were associated with a twofold higher odds of having caries experience, odds ratio (OR) 2.5, 95% confidence interval (CI) 1.7-3.7 and OR 2.7, 95% CI 1.7-4.0 respectively.

CONCLUSIONS

The presence of EDs among young Indigenous children was associated with a higher odds of caries experience among affected teeth.

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.

Was molar incisor hypomineralisation (MIH) present in archaeological case series?

OBJECTIVE

With respect to the unknown aetiology of molar incisor hypomineralisation (MIH), it is unclear whether this phenomenon was overlooked in the last century as a result of a high number of caries in children or if this developmental disorder was not present until then. Therefore, this study determined the presence of MIH in historical dentitions and teeth.

MATERIALS AND METHODS

Dental remains from late medieval (n = 191, twelfth-sixteenth century, Regensburg, Germany), post-medieval (n = 33, sixteenth-eighteenth century, Passau, Germany) and modern age archaeological skeletal series (n = 99, nineteenth-twentieth century, Altdorf, Germany) were examined for MIH. In addition, linear enamel hypoplasia (LEH), diffuse opacities, hypoplasia and Turner's teeth were documented.

RESULTS

MIH-related demarcated opacities or enamel breakdowns were found in only 15 (0.4 %) of the 3891 examined permanent teeth. Ten cases (3.1 %) from a total of 323 dentitions were classified as having MIH. In contrast, 98 individuals (30.3 %) showed LEH. Other enamel disorders were recorded in 64 individuals (19.8 %).

CONCLUSION

With respect to the low number of affected dentitions and teeth, MIH most likely did not exist or was at least rarely present in the investigated archaeological case series.

CLINICAL RELEVANCE

This study supports the hypothesis that MIH may be linked to contemporary living conditions or other health-related factors.

Linear enamel hypoplasia and growth in an Australian Aboriginal community: Not so small, but not so healthy either

BACKGROUND

While much is strongly suspected about synergisms linking courses of growth and development with nutrient intakes, immune function, disease exposures, and energy expenditures, debates remain regarding the probability of permanent impairments to growth and function under various circumstances.

AIM

This study tests a series of related hypotheses in an attempt to reconcile evidence of increasing physiological stress among Warlpiri and Pintubi infants and young children following settlement in the 1940s with their frequently rapid and undelayed longitudinal growth in stature during adolescence.

SUBJECTS AND METHODS

The study used archived cross-sectional and longitudinal records of stature, weight, and dental casts collected by the Dental School at the University of Adelaide beginning in 1951 at the then recently settled community of Yuendumu. Longitudinal modelling of height data and all statistical tests were accomplished using SYSTAT 10. Height, weight, and BMI (kg m-2) for age z-scores were calculated using NCHS reference data. Dental casts were scored for linear enamel hypoplasia (LEH) with each defect assigned to an enamel developmental unit. The extent of height catch-up was estimated using conditional height gain.

RESULTS

Cross-sectional analyses indicate significant associations between birth year and women's heights (n = 105, p = 0.02) or height for age z-scores (p = 0.003), but no similar associations among men. Final height for age z-score was significantly associated with sex (p < 0.0005), onset (p = 0.031), and an onset by number of enamel defects interaction (p = 0.033). Late adolescent height z-scores were only significantly negatively associated with increasing numbers of defects among individuals with enamel defects appearing prior to about 18 months of age (n = 60, p = 0.019). With longitudinally estimated age at peak height velocity (APHV) statistically controlled, peak height velocity (PHV) was similarly significantly positively associated with conditional height gain in males (n = 50, p = 0.01) and females (n = 31, p = 0.05). Exploratory analyses suggest that with timing and intensity of PHV controlled, childhood body mass was only significantly positively associated with catch-up in height among those who experienced defect onset relatively early (n = 80, p = 0.005).

CONCLUSION

Results help explain previously documented, and apparently contradictory, outcomes of settlement processes. Rapid and relatively undelayed late childhood and adolescent growth associated with catch-up in height occurred through a confluence of increasing early childhood systemic stress followed by increases in net energy consumption that probably increased as children aged.