Prevalence of Dental Caries in Past European Populations - a Systematic Review

Dental health status of the medieval silver-mining community from Kutná Hora (Czech Republic, 13th-16th c.): Impact of socioeconomic changes and mortality crises

OBJECTIVE

The aim of the study was to evaluate the pathological conditions in teeth from skeletal remains found in the medieval burial ground at Kutná Hora (13th-16th centuries, Czech Republic). We focused on the effect on dental health of socioeconomic changes associated with the boom in silver mining at the site.

DESIGN

In this study, dental caries and antemortem tooth loss were recorded for 469 sexed adults (10,558 permanent teeth). Pathologies were analysed and presented by teeth and alveoli, and the differences between their frequencies were tested in sex-, age-, and burial context-separated groups (mass vs. individual graves).

RESULTS

The oral conditions were characterised by a low frequency of caries and moderate frequency of antemortem tooth loss (AMTL). For caries, males and females showed the same frequencies while AMTL comparisons indicated a higher rate in females. Most differences emerged between age-separated and burial context-separated groups. The age progression of the pathologies was confirmed for both caries and AMTL. Skeletons from mass burials had higher caries and AMTL frequencies than those buried in individual graves.

CONCLUSIONS

The dataset exhibited low caries and below average AMTL rates compared to other medieval European skeletal series. We think that life in this mining centre had a positive effect on the dental health of its inhabitants. The relatively poorer dental health of those buried in mass graves reflected either the specific composition of the population in the first half of the 14th century or the lower resilience of these individuals when facing mortality crises.

Investigation of the presence of Non-carious cervical lesions (NCCLs) in ancient adult skulls: analyzing data from prehistoric and historical samples through a systematic review and meta-analysis

OBJECTIVES

Historically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence.

MATERIALS AND METHODS

The present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines.

RESULTS

After the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits.

CONCLUSIONS

In summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets.

CLINICAL RELEVANCE

Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.

Ancient Genomes From Bronze Age Remains Reveal Deep Diversity and Recent Adaptive Episodes for Human Oral Pathobionts

Ancient microbial genomes can illuminate pathobiont evolution across millenia, with teeth providing a rich substrate. However, the characterization of prehistoric oral pathobiont diversity is limited. In Europe, only preagricultural genomes have been subject to phylogenetic analysis, with none compared to more recent archaeological periods. Here, we report well-preserved microbiomes from two 4,000-year-old teeth from an Irish limestone cave. These contained bacteria implicated in periodontitis, as well as Streptococcus mutans, the major cause of caries and rare in the ancient genomic record. Despite deriving from the same individual, these teeth produced divergent Tannerella forsythia genomes, indicating higher levels of strain diversity in prehistoric populations. We find evidence of microbiome dysbiosis, with a disproportionate quantity of S. mutans sequences relative to other oral streptococci. This high abundance allowed for metagenomic assembly, resulting in its first reported ancient genome. Phylogenetic analysis indicates major postmedieval population expansions for both species, highlighting the inordinate impact of recent dietary changes. In T. forsythia, this expansion is associated with the replacement of older lineages, possibly reflecting a genome-wide selective sweep. Accordingly, we see dramatic changes in T. forsythia's virulence repertoire across this period. S. mutans shows a contrasting pattern, with deeply divergent lineages persisting in modern populations. This may be due to its highly recombining nature, allowing for maintenance of diversity through selective episodes. Nonetheless, an explosion in recent coalescences and significantly shorter branch lengths separating bacteriocin-carrying strains indicate major changes in S. mutans demography and function coinciding with sugar popularization during the industrial period.

Caries prevalence and other dental pathological conditions in Vikings from Varnhem, Sweden

In a late Swedish Viking Age population dating from around 10th-12th century AD, the prevalence, distribution and location of dental caries were studied. Tooth wear, other dental pathology and anatomical variations were identified and recorded clinically and radiographically. A total of 3293 teeth were analyzed from 171 individuals with complete and partial dentitions, of which 133 were permanent and 38 deciduous/mixed dentition. The dentitions were studied clinically, using a dental probe under a strong light source, and radiographs were taken for 18 of the individuals to verify and complement the clinical caries registration. Almost half the population, 83 of 171 individuals (49%), had at least one carious lesion. All individuals with deciduous or mixed dentitions were caries-free. The number of teeth affected by caries among adults was 424 (13%) and the surface most susceptible to caries was the root surface. The tooth most commonly affected by caries was the first mandibular molar. Other findings included apical infections, which were detected clinically in 4% of the teeth, and one case of filed front teeth. The findings gave a unique understanding of life and death in this early Christian Viking community and indicated that it was common to suffer from dental caries, tooth loss, infections of dental origin and tooth pain. These Vikings also manipulated their teeth through filing, tooth picking and other occupational behaviors.

Dental public health: Context, challenges, and perspectives

The discipline of “dental public health” derives its epistemological legitimacy from the unique position of dental surgeons within the realm of health care. It serves as a crucial bridge between the domain of public health and the field of dental science. The development of “dental public health” holds a twofold significance. First, it acknowledges and assesses the evolving landscape of public health, societal changes, determinants of overall health, environmental challenges, and global concerns. Its purpose is to guide policy decisions, education, research, and dental practices toward the greater good, ensuring equitable access to care and fostering technical and social innovation. Second, “dental public health” has the potential to contribute to the broader health care domain by transferring the diverse insights gained from dental surgery and its historical context. The independence of dental surgery, while sometimes posing challenges to interdisciplinary collaboration, also offers opportunities for progress through innovative solutions. In an era of patient partnerships and a growing emphasis on equality, diversity, and inclusion, it is imperative to consider the inclusion of patient representatives within the “dental public health” community. This inclusion can further enhance the discipline’s capacity to address contemporary health care challenges effectively.

Lippia origanoides derivatives in vitro evaluation on polymicrobial biofilms: Streptococcus mutans, Lactobacillus rhamnosus and Candida albicans

OBJECTIVE

This work evaluated the Lippia origanoides derivatives in vitro effect on polymicrobial biofilms of Streptococcus mutans, Lactobacillus rhamnosus and Candida albicans. Additionally, the cytotoxic effect of the oils on human skin keratinocytes (HaCaT) and fibroblasts of the periodontal ligament (FLP) cell lines was evaluated.

DESIGN

The minimum inhibitory concentration, the inhibitory activity on monomicrobial (S. mutans) and polymicrobial biofilm (S. mutans, L. rhamnosus and C. albicans) of L. origanoides four essential oils and terpenes (thymol and carvacrol) were evaluated. The cytotoxic effect of each one of the compounds was measured, and all the tests were compared against chlorhexidine.

RESULTS

All the evaluated compounds reached an inhibition percentage of S. mutans monomicrobial biofilms formation of 100 % at 600 µg/mL (p < 0.0001). The highest concentration (2 MIC) eradicated 100 % of S. mutans-preformed biofilms after 5 min L. origanoides carvacrol + thymol and thymol chemotypes showed marked reductions in topography, the number of microbial cells and extracellular matrix on polymicrobial biofilm. The cytotoxic effect of the compounds was very similar to chlorhexidine.

CONCLUSIONS

L. origanoides essential oils have an inhibitory effect on mono and polymicrobial biofilms. The oils present a similar cytotoxic effect to chlorhexidine on HaCaT and FLP cell lines. However, including these compounds in formulations for clinical use is an exciting proposal yet to be investigated.