The Precarious State of Subsistence: Reevaluating Dental Pathological Lesions Associated with Agricultural and Hunter-Gatherer Lifeways

Abstract

Numerous bioarchaeological studies emphasize an increase in dental lesions associated with the transition to agricultural subsistence. Over the years, this diachronic trend has led to the conflation and oversimplification of specific dental indicators of oral health with broad subsistence strategies, emphasizing intergroup variation at the expense of intragroup variation. In order to explore such hidden variation, this metastudy uses published data from 185 archaeological sites to test the hypothesis that the prevalence of dental lesions (carious lesions, antemortem tooth loss, and periapical abscesses) among classified agricultural groups is higher than among hunter-gatherers. As a secondary hypothesis, this study also tests the association between climatic variables (temperature variation, altitude, and precipitation) and dental lesion prevalence. Our results show that, despite significant differences in the average prevalence of carious lesions between agricultural and hunter-gatherer populations, the variation in caries prevalence shows high overlap (170%) between subsistence patterns. Additionally, differences in the prevalence of antemortem tooth loss and periapical abscesses between agricultural and hunter-gatherer populations are not significant, showing even larger overlaps in prevalence ranges. Complementing the lifestyle analyses, climatic factors (mean temperature, annual temperature, and precipitation) are significantly correlated with the prevalence of specific dental pathological lesions and not others. Our results emphasize the need to reevaluate certain dental conditions as direct indicators of broad subsistence patterns, calling attention to the complex multifactorial pathogenesis of dental lesions and the nonlinear relationship between oral indicators of health and subsistence lifeways. It is often-but falsely-said that dental caries is a "disease of civilization." There is no human population that has completely escaped it.

Evolutionary Origins of Toothache

“…Gum diseases became more common as barley and wheat consumption increased [44]. Tooth decay also became more common as wheat and sugar consumption increased [45]. Crooked teeth may be caused by today's widespread consumption of soft foods.…”

Mixed economy and dried foods: Dental indicators reveal Heishuiguo Han Dynasty population's environmental adaptation to the semi‐arid region of northwestern China

“…Tayles et al find the relationship inapplicable to Southeast Asian rice‐based populations (Tayles et al, 2000). One recent study suggested significant differences in average caries prevalence between agricultural and hunter‐gatherer populations alongside a high overlap (>70%) between different subsistence strategies, whereby only 13.6% of variation can be explained by subsistence strategy (Marklein et al, 2019). Given the difficulties of deducing subsistence strategies from dental caries, evidence from multiple disciplines is required to strengthen any claims to the former relationship.…”

Diet and differentiation in the Roman province of Macedonia: A bioarchaeological approach

“…Their simultaneous study has been conducted on the grounds that cariogenic food (mostly of carbohydrate content) promotes caries, leading to periapical cavities, tooth loss, and periodontitis. In that context, dietary shifts from the protein based consumption patterns of foragers to the consumption of carbohydrates or processed food due to the advent of agriculture have been widely studied in past populations showing an increasing trend in the frequency of periodontitis among agriculturalists compared to hunter-gatherers (e.g., Beckett and Lovell, 1994;Frayer, 1984;Klaus and Tam, 2010;Larsen, 1995;Marklein et al, 2019;Munoz, 2017;Sakashita et al, 1997;Scott et al, 1992). The differential access to certain foodstuffs based on sex has been also the focus of bioarchaeological studies, revealing no uniform trends, with some studies showing a higher frequency of periodontitis among men (in agreement with clinical research, see above) (e.g., DeWitte, 2012;Šlaus, 2000;Tomczyk et al, 2018;Wasterlain et al, 2011), others among females (e.g., Tuggle and Watson, 2019;Watson et al, 2010), and others no differences between sexes (e.g., Giuffra et al, 2020).…”

“…Several studies have been conducted in the field of physical anthropology and bioarchaeology, including periapical cavities among the examined variables, attributing them among others to nutritional deficiencies and caries (Giuffra et al, 2020;Figure 5.6: Female young adult left mandibular ramus showing the presence of a periapical cavity (arrow) with associated gross caries (circle); Tomb 15 -skeleton a of the Pontokomi-Vrysi skeletal assemblage, Kozani, Greece, 1 st to 4 th century CE (photo by Vergidou C. with the kind permission of Dr. Karamitrou-Mentessidi). Keenleyside, 2008;Lukacs, 1992;Marklein et al, 2019;Pētersone-Gordina and Gerhards, 2011;Šlaus et al, 2010;. Periapical lesions can be identified on dry bones in the form of focal cavities of various size located at the alveolar bone surrounding the infected tooth.…”

“…In that context, research has been conducted seeking for temporal trends in the caries prevalence. Relevant research has shown a gradual increase in the prevalence of caries mostly related to the transition from hunting-gathering to agriculture and the intensification of farming, which led to a higher consumption of cariogenic processed foodstuffs, primarily carbohydrates (Beckett and Lovell, 1994;Lanfranco and Eggers, 2010;Larsen, 1995;Lillie and Richards, 2000;Lukacs, 1992;Marklein et al, 2019;Oxenham et al, 2006;Temple and Larsen, 2007;Walker and Hewlett, 1990). Research has been also conducted regarding past male and female differences in caries prevalence and its link to gender-based food differentiation, showing a clear female preponderance in different times and settings (Bertilsson et al, 2021;Frayer, 1984;Klaus and Tam, 2010;Kolpan and Bartelink, 2019;Lukacs, 1996;Lukacs and Thompson, 2018;Temple, 2011;Trombley et al, 2019;Walter et al, 2016;Watson et al, 2010), the emergence or maintenance of social stratification using food as a medium (Cucina and Tiesler, 2007;Frayer, 1984;Nagaoka et al, 2021;Sakashita et al, 1997;Swärdstedt, 1966;Walker and Hewlett, 1990), the dietary profile of the people of major past urban centers (e.g., London: Mant and Roberts, 2015;Rome: Prowse, 2011), the effect of local delicacies to specific populations (Nelson et al, 1999), and so on.…”