Tooth diseases in the medieval population of Gracanica near Valjevo

The analyses of the pattern of dental disease in the Late Medieval Serbian population from cemetery excavations in the archaeological site Grachanica were based on the study of tooth wear, ante-mortem tooth loss, caries, hypoplasia, alveolar resorption, abscesses and calculus. The total sample of all available skeletons with almost complete permanent dentition numbers 45 individuals. Dental sample comprises 178 maxillary teeth and 337 mandibular teeth. The presence of dental caries was scored taking into consideration the size of the lesion (four degrees) and its position on the tooth. The degree of tooth wear was graded into one of four categories: atrition of enamel only; atrition involving dentin; atrition up to the level of fissure at the occlusal surface of the molar teeth, and exposure of the pulp chamber. The cystic defects within the alveolar bone were recorded according to their aetiology, size and position. Radiographic study had not been done in order to detect periapical destruction, so the presence of such destruction was recognizable in advanced stages associated with the appearance of fistula penetrating the compact alveolar bone usually at the buccal side. The condition of the alveolar crest resorption, as the evidence of periodontal disease, was graded into three categories, and the distance from the cemento-enamel junction to the alveolar crest was measured. The analysis of dental pathology profile consisted of the two reporting methods: individual count method (prevalence of disease based on the number of individuals affected) and tooth count method (distribution of lesions frequency on tooth type and class). The Grachanica dentition exhibits a dental pathology profile typical of agricultural medieval populations in this region. Tooth wear was the most frequent, affecting 95% of individuals. Dental caries and ante-mortem teeth loss exhibit also high frequency (51% and 69%). Dental pains of low prevalence include abscesses (13%) and enamel hypoplasia (20%). In the material examined, the carious process was responsible for pulp exposure to infection in all cases of abscess formation. The results obtained suggest that food processing technology and nature of diet allowed use of abrasive in the food and that oral hygiene was at the low level. On the other hand, there were not a lot of people who were subjected to stress-induced growth disruptures. The findings reported here contribute to understand how dietary change and life conditions are related to the changing patterns of dental diseases in medieval populations.