Intentional dental modifications are alterations of teeth usually performed as a ritual for aesthetic or identity purposes. However, the execution of the technique is not exempt from risk and can be related to a higher prevalence of dental pathology, more specifically through the exposure of the dental pulp and consequent periapical inflammation. With the aim of analysing the relationship between intentional dental modifications and periapical inflammation, the current study evaluated 81 skeletons (49 women, 19 men, and 13 individuals of unknown sex) of enslaved Africans from Lagos, Portugal (15th-17th centuries), of which 50 (61.7%) had intentionally modified teeth. In all, 2285 sockets and 2063 teeth were observed. Two hundred and three intentionally modified anterior teeth (27.2%) were identified. Twenty five individuals (30.9%) and 54 teeth (25 anterior and 29 posterior) showed macroscopic evidences of periapical lesions. In the anterior dentition, intentional modification was identified as the probable aetiology of 17 (68.0%) periapical lesions, mostly granulomata or cysts, but also abscesses. The association between intentional modifications of the dentition and the presence of periapical lesions was found in both the maxilla and mandible. These results suggest that this cultural practice can predispose teeth to periapical inflammation, which may cause pain and sensitivity to cold, heat, and pressure, and probably had a negative impact on the quality of life of these individuals. Copyright

Dental enamel hypoplasia, a defect of enamel formation, has been widely used for the investigation of growth disruptions in past populations, as it provides a permanent record of disturbances occurring during an individual's development. With the aim of recording changes in health status during development of the African enslaved individuals recovered from Valle da Gafaria, Lagos, Portugal (15th-17th centuries), linear enamel hypoplastic defects were investigated in a sample of 78 individuals aged 12-40+ years old. Of the 744 anterior teeth present, 13.0% were not observable due to dental calculus, tooth wear or intentional modifications. In all, 647 teeth were macroscopically observed for the presence of dental enamel defects. The position of each defect on the crown was scored by measuring its distance to the cemento-enamel junction on the labial surface of the crown, being the age of occurrence of the physiological stress thereafter calculated. Of the 78 individuals, 89.7% had at least one defect. Of the 647 teeth, 63.5% presented at least one defect. The age of occurrence of the physiological stress ranged between 1.5 and 5.2 years of age, and the mean peak age was between 3.3 and 3.7 years. A previous study has found that the non-adult individuals of this skeletal assemblage died more frequently between 7 and 9 years. Although these two age ranges may represent distinct sets of adverse factors, such as weaning and workload, respectively, they reinforce the idea that the Lagos's individuals experienced harsh living conditions during childhood.

This paper discusses the atypical wear observed on the anterior teeth of an enslaved African adult female (age-at-death: 47.62 ± 3.36 years), exhumed from Valle da Gafaria, Lagos, Portugal (15th-17th centuries). All teeth of this individual (n = 31) were macroscopically observed to score dental wear and caries. A more accentuated wear was observed on the lingual surface of the maxillary anterior teeth, with dentine exposure until the cement-enamel junction. Although many individuals of this osteoarchaeological assemblage present intentional dental modifications, the location and characteristics of these wear facets are not compatible with such cultural practices. Interdental attrition caused by overbite was also excluded due to the inexistence of corresponding lingual or labial wear on any lower teeth. Also, the relatively unpolished appearance of the wear facets does not favor the hypothesis of perimolysis due to regurgitation. Instead, the observed wear pattern is consistent with lingual surface attrition of the maxillary anterior teeth (LSAMAT). Regarding the aetiology, in this particular case, two possible causes are suggested: extra-masticatory behaviors and/or consumption of abrasive carbohydrates, namely, a starchy plant. Although this individual presents several carious lesions, which favor the hypothesis of a carbohydrate-rich diet, these processes can act simultaneously. Therefore, it would be unwise to favor one aetiological factor over the other.

In 2009, a salvage archaeological excavation in Valle da Gafaria (Lagos, Portugal) brought to light the skeletal remains of 158 African enslaved individuals (15th-17th centuries), from which several presented intentional dental modifications on their anterior dentition. Although this cultural practice may be related to rites of passage, differential status, group identification, mourning, or embellishment, it is not exempt from risk. Among the possible consequences are pulp necrosis, dental caries in the modified surface, loss of masticatory function, and dental enamel hypoplasia in the permanent teeth. A previous study in the Lagos collection already confirmed that anterior modified teeth were significantly more affected by periapical lesions (9.3%) than unmodified teeth (0.4%). Therefore, the aim of this investigation is to analyse the relationship between dental caries and intentional dental modification in the Lagos sample. Eighty-one individuals were analysed, making a total of 2,285 alveoli and 2,063 teeth (757 anterior and 1,306 posterior). Dental caries was recorded if there was a discernible, even if small, white or brown lesion in the otherwise translucent enamel, or if there was a cavity. Intentional dental modifications were recorded according to their presence and incisal angles removed. Dental caries affected 78 individuals (96.3%) and 1,072 teeth (52.0%). In all, intentional dental modifications were observed in 50 (61.7%) individuals and 203 (27.1%) anterior teeth. Modified teeth were significantly more affected by caries (84.2%) than nonmodified teeth (31.7%). Given that all modifications involved the removal of the mesial and/or distal angles of the teeth, the relationship between these alterations and the presence of caries was investigated. In fact, when modified, mesial and distal contact areas were significantly more affected by caries, although mostly noncavitated, supporting the hypothesis that this cultural practice turns teeth more prone to dental caries.