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Dental wear, caries, and antemortem loss

Teeth can be categorized according to the following conditions: (1) present, (2) lost antemortem, (3) lost postmortem, (4) unerupted, (5) agenesized (congenital absence), and (6) unknown (due to missing alveolar bone; Hillson 1996). The distinction between antemortem and postmortem loss is made based on the presence of bone remodeling in the root socket. Although this is a standard technique, it may slightly under-enumerate the number of teeth lost before death. For our purposes here, the most important category involves the frequency of antemortem loss versus the frequency of combined present teeth and those lost after death.

Several dental pathologies are of interest in reconstructing past lived experience. These are dental wear (attrition), carious lesions (cavities), and antemortem tooth loss, in addition to LEHs (discussed earlier). Dental wear is a general term referring to the loss of the occlusal or chewing surface of teeth and to the interproximal surface between teeth. Wear may be divided into two components, dental attrition, due to direct tooth-on-tooth contact, and dental abrasion, due to the introduction of foreign matter.

Antemortem tooth loss is also of interest both because it reflects dental health and because it may entail functional impairment. Antemortem loss is frequently associated with the above noted dental conditions: dental abscessing, extreme alveolar resorption, excess attrition, and caries. Antemortem loss may, in fact, be due to any one or a combination of these factors. Antemortem tooth loss represents the ultimate diminution of functional, masticatory capacity. Rampant tooth loss may have a strong effect on the health and nutritional status of the individual. With endemic tooth loss, foods become increasingly more difficult to chew, thus limiting the range of dietary options. Based on the assumption that most dental pathologies increase with agriculture, one might hypothesize that tooth loss will also increase as a secondary effect of dietary shifts.

Identification of carious lesions (cavities) provides insight into both diet and individual oral health. Severe occlusal carious lesions are common and, in combination with fissure and cuspal caries, provide a measure of the total amount of occlusal surface caries. Like the other pathologies, data concerning carious lesions should be examined with respect to biological data such as age at death and sex.

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