Dental Caries in a Portuguese Identified Skeletal Sample From the Late 19th and Early 20th Centuries Sofia N. Wasterlain, 1 * Simon Hillson, 2 and Euge ´ nia Cunha 1 1 Centro de Investigac ¸a ˜ o em Antropologia e Sau ´ de, Department of Anthropology, University of Coimbra, Coimbra 3000-056, Portugal 2 Institute of Archaeology, University College London, London, UK KEY WORDS paleopathology; epidemiology; Coimbra; diet; antemortem tooth loss ABSTRACT Dental caries was investigated in 600 adult dentitions belonging to the identified osteological collections of the Museum of Anthropology, University of Coimbra, Portugal (late 19th/early 20th centuries). The main advantage of this sample compared to an archaeo- logical source is the presence of known demographic pa- rameters such as age, sex, and occupation. The aim of this study is to investigate the issues involved in com- paring caries data derived from archaeological death assemblages with statistics compiled from clinical stud- ies of the living. When only the upper dentition was con- sidered, higher rates were observed in females than in males. No differences were found between sexes for lower teeth. In both sexes, both the percentage of carious teeth and the severity of lesions were found to increase with age, demonstrating that caries activity continued throughout life. The slight decrease observed for the age group 70–79 years is probably due to the increased ante- mortem tooth loss in the elderly. Caries was most com- mon at contact areas (32.9%) and rarest at smooth crown surfaces (6.5%). Root surface caries was graphed in rela- tion to the exposure of roots, and it was confirmed that the degree of root exposure was not strongly related to the frequency of carious lesions on the exposed root sur- face, although both increased with age. Molars were attacked more frequently by caries as a whole than pre- molars, canines or incisors. The results are similar to studies of recent living populations with a limited access to professional dental care. Am J Phys Anthropol 140:64–79, 2009. V V C 2009 Wiley-Liss, Inc. Dental caries is one of the most widely studied patho- logical conditions in archaeological and anthropological collections. It produces highly characteristic changes that are distinguishable from other causes of tooth destruction, so it is possible to record lesions with a high degree of confidence in archaeological assemblages. It has also been the subject of widespread clinical research, so that the etiology and epidemiology of the disease dur- ing the latter part of the 20th century are well estab- lished. Caries has a multifactorial etiology but of prime importance is the amount and type of carbohydrate in the diet, which makes the disease a particularly useful tool in reconstructing dietary change in the archaeologi- cal record. In interpreting the palaeopathology of dental caries, it is logical to make comparisons with epidemio- logical studies of caries in living people, but there are several important issues that need to be taken into account. The aim of this study is to investigate the issues involved in comparing caries data derived from archaeological death assemblages with statistics com- piled from clinical studies of the living. The first issue concerns the nature of archaeological collections. Recent clinical studies are based upon dental examinations of living people. An archaeological collec- tion of dentitions is fundamentally different—it is a death assemblage. This has a very different age distribu- tion from that of a living population, with much higher proportions of young children and older adults. Further, such assemblages also encompass a particular subset of people—the sick and infirm—who might well have a dif- ferent caries experience from the main bulk of the living. After all, caries in modern times shows a strong relation- ship with general health (Sheiham, 1997). Consequently, one may legitimately query whether the structure of a death assemblage produces a markedly different caries epidemiology from that seen in a living population. The second issue is the patterning of caries between teeth, with different ages and sexes. Epidemiological studies of living people (Thylstrup and Fejerskov, 1994) have concentrated on caries in children. These studies have identified a strong pattern of susceptibility for dif- ferent teeth within the dentition (Batchelor and Shei- ham, 2004) that focuses on the permanent and deciduous molar crowns, so that the caries experience of modern children is clearly related to the sequence of dental erup- tion. These studies also identify sex differences in caries prevalence, usually with higher caries rates in girls, although this is not universal. There are far fewer reports on the epidemiology of caries in living adults (Luan et al., 1989; Manji et al., 1989). All, however, report a strong progression with age and this progres- sion occurs for caries rate, the type of lesion and the spe- cific teeth affected. Although these studies do not always distinguish between men and women, Luan et al. (1989) reported higher caries rates in Chinese women. By con- Additional Supporting Information may be found in the online version of this article. *Correspondence to: Sofia N. Wasterlain, Departamento de Antro- pologia, Universidade de Coimbra, Coimbra 3000-056, Portugal. E-mail: sofiawas@antrop.uc.pt Received 28 April 2008; accepted 23 December 2008 DOI 10.1002/ajpa.21036 Published online 17 March 2009 in Wiley InterScience (www.interscience.wiley.com). V V C 2009 WILEY-LISS, INC. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 140:64–79 (2009)