Dental health indicators of the Chernyakhov population

Nataliia Valentinovna Yanko, Andrij Vladislavovich Artemyev, Lyudmyla Fedorivna Kaskova

Anthropological Review • Vol. 84(1), 17–28 (2021)

Dental health indicators of the Chernyakhov population from Shyshaki ()

Nataliia Valentinovna Yanko1, Andrij Vladislavovich Artemyev1,2, Lyudmyla Fedorivna Kaskova1

1Department of Paediatric Dentistry with Dental Diseases Prevention, Faculty of Dentistry, Ukrainian Medical Stomatological Academy, Poltava, Ukraine 2Archaeological Site Preservation and Studying Centre, Poltava, Ukraine

Abstract: Odontological studies of ancient populations represent different indicators related to health state, lifestyle and human diet. The aim of this paper is to determine the dental health indicators in the Chernyakhov population (the end of the IVth c. AD) from Ukraine. The paper also attempts to identify the relationship between sex and these indicators in the studied population. The sample analysed consisted of the dental remains of 25 adult individuals (11 males and 14 females) and 8 children individuals excavated from the cemetery at the archaeological site of Shyshaki (Poltava of Ukraine). A total of 760 teeth were examined for caries, tooth wear and calculus clinically, and 647 teeth of adults were observed radio- graphically. The studied population presents frequency of caries in individuals of 12.5%. This indicator in adult male and female dentition is 42.86% and 14.0% respectively, and 25% in children. The presented population frequency of caries teeth was 0.88%. Females presented higher caries rate than males (2.72 % females vs. 0.36 % males) (p<0.05). The most frequent were caries lesions of cementum-enamel junction (40%) and combined lesions of crown and root (40%) with no difference in terms of sex. Frequency of dental wear in adult individuals and 8-10 year-old individuals was 100%. The studied population repre- sented TWI (tooth wear index) in adults (2.26), which increased with aging, but the difference in terms of sex is insignificant. Calculus was observed in 64.28% of the females and 63.33% of the males, showing no statistical difference (p>0.5). These findings confirm a very low rate of caries teeth in the territory of Shyshaki during the Late Roman period, which could be related to regional diet and concentration of fluorine in drinking water. The Chernyakhov population presents high dental wear and similar frequency of dental calculus when compared to the population from Roman Britain. Females presented significantly higher frequency of caries than males, whereas no significant sex differences were found regarding dental wear, calculus, and localisation of caries lesions. The authors presume that dental health indicators in the Chernyakhov culture need to be studied more with bigger sample size and data of the populations from other of Ukraine.

Key words: dental anthropology, caries, toot wear, calculus, Chernyakhov culture

Original Research Article Received: September 15, 2020; Revised: December 10, 2020; Accepted: January 28, 2021 DOI: 10.2478/anre-2021-0002 © 2021 Polish Anthropological Society 18 Nataliia Valentinovna Yanko, Andrij Vladislavovich Artemyev, Lyudmyla Fedorivna Kaskova

Introduction (Poltava region) which belongs to the Chernyakhov culture living in the terri- Odontological studies of ancient pop- tory of the Eastern in the Late ulations represent different indicators Roman period. related to health state, lifestyle and diet The Chernyakhov (Santa-de-Mures) of humans, and dental caries is the most culture subsisted in a wide area of visible from them (Lanfranco and Eggers Ukraine, Poland, and 2012). The social and cultural environ- for a short historical period between the ment has an impact on human health IIId and Vth cc. and strongly influenced diet and activity, and differences in oral the development of the Slavs. The health between the sexes in different an- migrated to in the IId–IIId cc. cient populations could been interpreted AD after the fall of and with reference to diet (Klaus and Tim nearly became a dominant force in the 2010; Miliauskienė and Jankauskas 2015; Chernyakhov culture (Gwinn 2017). The Michael et al. 2017). aboriginal population from the Ukrainian Carbohydrates and bad oral hygiene area represented by the , Sar- facilitate plaque accumulation on teeth, matians, and late (Magome- but caries demineralization develops dov 2001) accepted the achievements of only with decrease in enamel resistance. Roman material culture – glass, pottery, Enamel resistance falls due to low fluo- jewellery production, metallurgy of fer- rine content in drinking water, and diet rous metals, burning charcoal and lime, misbalanced with minerals (Fejerskov et and others (Liubychev 2019; Petrauskas al. 2008). Therefore, caries rate increases et al 2019); but archaeological and palae- in regions with low fluorine content in oenvironmental evidence did not docu- drinking water (Ramezani et al. 2015). ment changes in the dietary habits after Moreover, dental indicators such as tooth the Goths appearance. The time of the wear is related to caries development. Chernyakhov culture was characterized Tooth wear does not only reflect ageing by flourishing agriculture in its territory and food durability, but also changes when land farming was simplified by the the character of plaque accumulation on use of a plug with a steel tip (Zynkivska- teeth (Esclassan et al. 2009). Calculus as ya 2013). Gorbanenko (2014) claims that a dental indicator is interpreted in terms a 1/4 of grains found in the soil were bar- of oral hygiene and diet; high calculus/ ley; rye and emmer wheat each made up low caries rate as evidence for a high pro- approximately 1/5 of grains; common tein diet (Lillie 1996), while elevated cal- wheat was nearly a 1/6; and millet was culus and caries rates have been linked less than a 1/7. During that period the to carbohydrate-rich diets (Humphrey et Chernyakhov people applied mill stones al. 2014). for grain grinding, which were borrowed There is limited research on dental from the Roman Empire, and produced health indicators of ancient populations more refined food than previously used living in the territory of present-day stone mortar and pestle. Animal hus- Ukraine (Lillie 1996; Arnold et al. 2007; bandry, as revealed by survival of bone Karsten et al. 2015; Yanko et al. 2017). remains, seemed to favour cattle, sheep, The authors were interested in the lo- goat and pig breeding (Shyshkyn 1999). cal ancient population from Shyshaki Dental health indicators of the Chernyakhov population 19

The Chernyakhov culture used both only small fragments of the maxilla or cremation and inhumation. Moreover, mandible were preserved as defined by ritual cremations of destroyed burials Vodanovic et al. (2005). Sex in adults was with skeletal fragments was described in diagnosed by AAV on the basis of cranial a few populations including the present and pelvic morphological features (Buik- one (Kokowski 1997; Heiko 2010; Pe- stra and Ubelaker 1994). Adult skeletal trauskas 2014). In addition, destruction age at death was diagnosed by AAV on of skeletons from the studied population the basis pubic symphysis morphology, relates to grave robberies and economic the auricular surface of the ileum, and activity of modern inhabitants. In spite of the sternal end of the ribs (Byers 2005), the fact that the number of skulls could which was from 18 to 70 years old. Fi- be limited, analysis of dental health indi- nally, each adult skeleton was assigned cators allowed the researchers to obtain to one of four age categories: 18–25 years data not only regarding biological con- old (young adult), 26–35 years old (early dition, but also the diet of the present middle adult); 36–45 years old (late mid- population. dle adult) ≥ 46 years old (mature adult) The aim of this paper is to deter- (Powers 2012). Age of a dead child mine the dental health indicators in the was determined by dental development Chernyakhov population (the end of the (Nelson and Ash 2009) and was from 6 IVth c. AD) from Ukraine. The paper also months to 10 years old. Examined chil- attempts to identify the relationship be- dren were divided into two subgroups: tween sex and these indicators in the primary dentition (6 month–2 years old) studied population. and mixed dentition (8–10 years old). AVA and NVY performed the dental Materials and methods examinations. Next categories of missing teeth are recorded as being ante-mortem, Analysed skeletons of the Chernyakhov post-mortem, and unerupted, Unerupted culture were collected at excavations teeth included impacted and congenital- nearby the town of Shyshaki (Poltava ly missing teeth. Caries was diagnosed region) in 2012–2016, which were con- macroscopically under a bright light, ducted by the staff of the Archaeological with the help of a dental probe; only pres- Site Preservation and Research Centre ence of cavity was estimated as caries. (Poltava). The chronological period was The location of carious lesions (root, CEJ defined by archaeologists as the end of (cementum-enamel junction), crown), as the IVth c. AD by the observing the na- well as their location on the crown (prox- ture of the burials and material culture imal, labial/buccal, lingual, occlusal sur- remains. All the individuals were exca- faces), were analysed. Combined lesions vated from the cemetery. included involvement of root and crown. The Chernyakhov culture was pre- Frequency of dental caries was calculat- sented by 25 skeletons of adults and 8 ed for teeth and individuals in %. The children skeletons. The general preserva- authors numbered the teeth according tion state of the bones and dental pieces to the Fédération Dentaire International was highly variable across individuals, (FDI 1971). Additionally, dental radio- from completely preserved skulls with graphic examinations were performed complete mandibles, to cases where in adult individuals after the clinical ex- 20 Nataliia Valentinovna Yanko, Andrij Vladislavovich Artemyev, Lyudmyla Fedorivna Kaskova amination using retroalveolar X-ray films Results for maxilla and panoramic X-ray films for mandible. All upper teeth were radio- From the 760 teeth examined, 280 be- graphed by groups of three anterior or longed to males, 367 to females, and two posterior teeth. 113 to children. The minimum number Dental wear was recorded in adults of teeth presented for one adult individ- according to Smith and Knight tooth ual was 12 and the maximum 29. Ante- wear index (TWI) (1984), which includes mortem loss included 50 teeth in adults 5 scores. Score 0 represented no wear, (6.33%) (28 female teeth and 22 male score 1 represented slight loss of enam- teeth). Four impacted and two congen- el surface, score 2 represented exposing itally missed teeth third molars were dentine for less than one third of surface, confirmed by X-ray radiographs. - Post score 3 represented exposing dentine for mortem tooth loss was 49 female teeth, more than one third of surface, and score 52 male teeth and 10 children teeth 4 represented complete dentine loss– (12.07%). The information on sex, age, pulp exposure. Dental calculus accumu- number of individuals and present teeth, lation was evaluated macroscopically and and frequency of caries in the Chernyak- calculated for individuals in %. hov population is shown in Table 1. The Chi-square test was used to ex- Adults showed caries frequency in plain the significant differences in caries teeth at 1.7% vs children – at 0.88% frequencies and dental calculus. Tooth (χ2 = 0.41, df = 1, p = 0.5). This indica- wear was expressed as the mean±stan- tor was in individuals 28% and 12.5% ac- dard deviation where p values were cordingly (χ2 = 8.76, df = 1, p = 0.003). based on a one-sided Student`s t test of Females showed caries frequency in in- statistical significance. The results were dividuals at 42.86% vs males – at 9.09% classified as statistically significant ifp < (χ2 = 97.4, df = 1, p< 0.0001). Caries 0.05. frequency in teeth is 2.72% in females

Table 1. Sex, number of individuals and teeth examined in this study, and caries frequency Age of Number of Caries frequency Teeth Caries frequency Sex individuals individuals in individuals, % present in teeth, % Female 18–25 years 5 1 (20.00) 136 2 (1.41) 26–35 years 3 1 (20.00) 89 1 (1.05) 36–45 years 2 2 (40.00) 49 5 (9.43) 46–65 years 4 2 (40.00) 93 2 (2.02) In total 14 6 (42.86) 367 10 (2.72) Male 18–25 years 3 0 82 0 26–35 years 1 0 24 0 36–45 years 3 0 89 0 46–69 years 4 1 (25.00) 85 1 (1.10) In total 11 1 (9.09) 280 1 (0.36) Both sexes 25 7 (28.00) 647 11 (1.70) Children 6 months–2 years 4 0 29 0 8–10 years 4 1 (25.0) 84 1 (1.19) In total 8 1 (12.5) 113 1 (0.88) Dental health indicators of the Chernyakhov population 21 and 0.36% in males, showed significant dren) was 100%. 6-month-old to 2-year- statistical difference (χ2 = 5.29, df = 1, old children (primary dentition) did not p = 0.02). There was no statistical signif- have tooth wear. The studied population icance between age groups in frequency represented a high TWI in adults (2.26). of caries teeth. The information on sex, χ2 test showed that the mature females age, number of individuals, location of had statistically significant dental wear caries on individual tooth surfaces in the (χ2 = 47.65, df = 1, p< 0.0001) than Chernyakhov people is shown in Table 2. The Chernyakhov population rep- resents two crown caries, therefore, proximal, labial/buccal, lingual, occlu- sal localisations of caries were united into location on the crown. Female teeth present CEJ caries lesions (40%), as well as crown lesions (10%), root lesions (10%), and combined lesions (40%), were spread from enamel to cement of root (Fig. 1). Only one male presented a combine caries lesion, also one child had lesion on proximal surface. The information on sex, age, num- ber of presented teeth, dental wear in adults in the Chernyakhov population is shown in Table 3. Frequency of tooth Fig. 1. Fragment of maxilla of 40–45-year-old wom- wear in the permanent dentition (adults) an from burial 150: 1 – combined caries lesion and mixed dentition (8–10-year-old chil- in the 16 tooth, 2 – CEJ lesion in the 17 tooth

Table 2. Location of caries on individual tooth surfaces in the study sample Location on the Root CEJ Combined Gender Age of individuals crown n % n % n % n % Female 18–25 years 0 0 0 0 0 0 2 100 26–35 years 0 0 0 0 0 0 1 100 36–45 years 1 20 0 0 3 60 1 20 46–65 years 0 0 1 50 1 50 0 0 In total 1 10 1 10 4 40 4 40 Male 18–25 years 0 0 0 0 0 0 0 0 26–35 years 0 0 0 0 0 0 0 0 36–45 years 0 0 0 0 0 0 0 0 46–70 years 0 0 0 0 0 0 1 100 In total 0 0 0 0 0 0 5 50 Both sexes 1 9.09 1 9.09 4 36.67 5 45.55 Children 6 months–2 years 0 0 0 0 0 0 0 0 8–10 years 1 100 0 0 0 0 0 0 In total 1 100 0 0 0 0 0 0 22 Nataliia Valentinovna Yanko, Andrij Vladislavovich Artemyev, Lyudmyla Fedorivna Kaskova

Table 3. Sex, number of teeth examined in this study, and tooth wear index (TWI) Sex Age of individuals Teeth present TWI, score (M±m) Female 18–25 years 136 1.29±0.38 26–35 years 89 1.90±0.07 36–45 years 49 2.88±0.39 46–65 years 93 3.18±0.05 In total 367 2.13±0.99 Male 18–25 years 82 1.09±0.36 26–35 years 24 12.0±0.13 36–45 years 89 2.92±0.03 46–70 years 85 3.19±0.05 In total 280 2.39±0.06 Both sexes 647 2,26±0.46 Children 6 months–2 years 29 0 8–10 years 84 0.62±0.06

young females; the same results were Table 4 compares data (frequency of obtained for the males (χ2 = 53.41, caries and calculus) from Shyshaki to df = 1, p< 0.0001). Tooth wear was not data from the Early Iron Age (the 6th–5th different between males and females cc. BC) sites in Ukraine (Kaskova et al (p>0.5). In the 8–10-year-old children 2019), and data collected from the same (mixed dentition) TWI was 0.62. In chil- period (the 3d–5th AD) in England (Bon- dren, the most pronounced tooth wear sall (2005). Data of adult individuals are with dentine exposed was observed in compared. primary molars and canines, and enam- The Scythian population presented el of the first permanent molars which lower frequency of caries teeth (0.15%) showed slight attrition. Caries lesion than the Chernyakhov population was found in dentin exposed by wear in (1.70%) (χ2 = 45.27, df = 1, p<0.0001). 40–45-year-old women. Calculus was ob- Frequency of caries teeth in the sub-Ro- served in 64.28% (9/14) of the females man population (8.98%) was significant- and 63.33% (7/11) of the males, show- ly higher compared to the Chernyak- ing no statistical difference (p>0.5). The hov population (χ2 = 39.87, df = 1, children did not present dental calculus. p<0.0001) and the Scythian population

Table 4. Frequency of dental caries and calculus in adults of the compared populations 4th–5th c. AD, 6th–5th c. BC, 3rd–5th c. AD, Period, place Ukraine* Ukraine1 England2 Females Males Females Males Females Males Frequency of caries teeth, % 2.72 0.36 0.08 0.21 9.4 8.7 Total frequency of caries teeth, % 1.70 0.15 8.98 Frequency of calculus in individuals, % 64.28 63.63 9.0 11.0 39.1 64.3 Total frequency of calculus in individuals, % 64.0 10.0 53.26

* present data, 1 Kaskova et al. 2019, 2 Bonsall 2005. Dental health indicators of the Chernyakhov population 23

(χ2 = 458, df = 1, p<0.0001). Difference teeth were found in children from the in frequency of calculus in individuals Chernjakhov (1.26%) and the Scythian between the Chernyakhov population population (0.26%) (Yanko et al 2017). (64.0%) and the population from Roman Consequently, the authors suggested Britain (53.26%) was not statistically that caries rates in the compared popu- significant (p = 0.3). The frequency of lations were not only attributed to the calculus in the Scythian population was consumption of carbohydrates, but also lower (10%) than in the sub-Roman pop- to the fluorine concentration in drinking ulation (p<0.0001) and the Chernyak- water and dental wear. hov population (p<0.0001). The Scyth- Poltava region has areas with dif- ian population had similar caries and ferent level of fluorine in aquifer, and calculus rates in terms of sex (p>0.2). In present-day concentration of fluorine in Roman Britain the males had higher cal- drinking water in Shyshaki reaches up 3 culus rate than the females (χ2 = 12.43, mg/l (high level) (Toronchenko 2013). df = 1, p = 0.0004), but similar caries In addition, Kaskova et al (2011) found rate (p>0.5). that frequency of caries in modern ad- olescents from areas with high fluorine Discussion concentration of 54% was lower than in adolescents from areas with low fluorine The study of dental health in ancient pop- concentration in drinking water (74.5%). ulations can provide important informa- That concentration of fluorine in aquifer tion on past dietary habits and environ- has not changed since ancient times. ment impact, especially if the teeth keep Mentioned Scythian population inhab- relatively well in archaeological contexts. ited areas with high and normal con- There have been numerous bioarchaeo- centration of fluorine in drinking water. logical studies of caries as an indicator Frequency of caries teeth in the British of past diet (Hillson et al. 2013; Bonsall population (8.98%) in same late Roman 2014; Forshaw 2014; Tosso et al. 2019). period (Bonsall 2015) was higher com- We have suggested that agricultural pared to the Chernyakhov population intensification recorded in the area of (p<0.0001).Present-day drinking water the Chernyakhov culture (Zinkovskaya in Ancaster and Winchester (England) 2015; Gwinn 2017) might have provoked has a low level of fluorine (drinking water increase in caries rate as happened in the quality information). Thus, the authors Late Medieval population from Poland suggest that very low caries frequency in during intensification of agricultural the studied Chernjakhov population was production (Tomczyk et al. 2020). Diet attributed with high concentration of flu- of the Chernyakhov people mostly con- orine in drinking water in Shyshaki. In sisted of cereals and meat of domestic addition, caries frequency of the present animals. However, despite the fact that population may have been smaller than frequency of caries teeth in the adult this indicator in other populations from Chernyakhov population (1.7%) was big- the same culture from the territory of ger compared to the Scythian population, Ukraine. which lived earlier in same area (0.15%) Frequency of caries teeth in the (p<0.0001), these indices were very Chernyakhov females was significantly low. Same very low frequencies of caries higher than in males (p<0.05) (Table 24 Nataliia Valentinovna Yanko, Andrij Vladislavovich Artemyev, Lyudmyla Fedorivna Kaskova

1). However, this sex difference was not plained by dental wear. The authors note attributed to the factors of age or tooth the high degree of dental wear in the loss in mature adult category, where Chernyakhov adult individuals (2.26) males and the females presented almost compared to data of contemporary popu- the same number of tooth loss (46 male lation (Wetselaar et al. 2016). There was teeth vs. 50 female teeth). Higher rates no significant difference between males of caries among females may hint at and females for tooth wear which may some difference in carbohydrates being be related to the diet of the studied pop- consumed. The compared Scythian and ulation. It is clear, that 6-months-old to sub-Roman populations did not demon- 2-year-old children were breast fed and strate sex differences in caries frequen- did not have tooth wear. In 8–10-year- cies (Table 4). old children, this indicator showed both In the Chernyakhov population, a physiological attrition and impact of the male presented a combined caries lesion; diet. Also age-related increase was found 88.88 % of the females presented CEJ in tooth wear among both sexes. Despite and combined lesions, 11.11% of females dental wear, fissure caries may occur in presented crown caries, and 11.11% root young and early middle adults and per- caries. One 9–10-year-old child had prox- sist in the mouth long enough to initiate imal caries localisation that is typical for the development of large cavity. Howev- this age due to physiological spaces be- er, one late middle female in this study tween primary teeth, but the number had caries lesion of dentine exposed by of children was too small (n = 8). Our wear. In addition, fissure caries was not findings are consistent with data of the detected in mature adults (Table 2), Scythian population from the area of when defective fissures and cervical sur- Ukraine where 100% of females and 89% faces could have been worn away due to of males presented combined lesions intense attrition. (Kaskova et al. 2019). The rate of CEJ Adults in the studied population showed the highest prevalence (33.33%) showed calculus frequency (64.0%) com- in the Ancaster and Winchester popula- parable to the population from Roman tions. It should be noted that inhabitants Britain (53.26%) with no difference in of Roman Britain had a predominantly terms of sex (Table 4). However, males cereal-based diet in that period (Britton in the sub-Roman population from Brit- and Huntley 2011). In later ages, con- ain (Bonsall 2015) experienced higher suming food rich in simple sugars usually calculus rates than the females, which accompanied increase in caries rate, and could be explained by possible differenc- occurrence of occlusal and approximal le- es in fluid consumption or greater con- sions (Lanfranco and Eggers 2012). The sumption of silica-rich foods. Frequency authors explain occurrence of CEJ and of calculus among Scythians was lower root lesions by plaque accumulation in (10%) than in the Chernyakhov popula- the cervical part of crown, which causes tion. However, calculus could have been gum recession and caries development in removed during excavation. There were these areas. no sex differences in calculus rate in the The fact that adults in the Chernyak- Scythian population (p>0.1). Thus, the hov population present a few caries le- authors did not identify the relation- sions in the crown (Table 3) could be ex- ship between sex and tooth wear, sex Dental health indicators of the Chernyakhov population 25 and dental calculus in the Chernyakhov a high dental wear, similar frequency of population. In addition, the number of dental calculus when compared to the examined samples was not enough to en- population from Roman Britain. Females sure age-related increase in frequency of presented significantly higher frequency caries and dental calculus. of caries than males, whereas no signifi- Unfortunately, there are no isotope cant sex differences were found regarding evidences about the diet in the Chernyak- dental wear, calculus, and localisation of hov culture. The results originating from caries lesions. The authors presume that Neolithic settlement Çatalhöyük (Agar- dental health indicators in the Chernyak- wal et al 2015), where isotope evidence hov culture need to be studied more with indicated similar diets of males and fe- bigger sample size and data of the pop- males, did not present sex difference in ulations from other regions of Ukraine. the caries. However, researchers, who found that females from different his- Aknowledgements torical populations consumed a small amount of protein (Toso et al. 2019) or We would like to thank the anonymous more millet items (Dotsika et al. (2018) reviewers of this paper for their valuable than males, could not declare sex differ- comments on the manuscript. ence in caries rate due to small sample sizes. Therefore, to understand better The Author’s contribution the relationship between sex and den- tal health indicators it is important to NVY conceived of the paper aim and de- study enough sample sizes and conduct sign, served as principal investigator for isotope analysis of their remains to elu- the research project, wrote the draft and cidate diet. approved the final version; AVA served Studies conducted in skeletal popula- as an investigator for the project and tions in their archaeological and anthro- was involved in grafting the manuscript; pological context can substantially enrich LFK analysed data and grafted the man- our understanding of past human societ- uscript; All authors contributed to ap- ies. If extra data is collected from other proved, final version of the manuscript regions of Ukraine where the Chernyak- hov culture existed, this study could be Conflict of interest used for further investigation of the ef- fect of diet and concentration of fluorine The authors declare no conflict of inter- in drinking water on caries in ancient est. populations. Corresponding author Conclusions Nataliia Valentinovna Yanko, Depart- These findings confirm a very low rate of ment of Paediatric Dentistry with Dental caries teeth in the territory of Shyshaki Diseases Prevention, Ukrainian Medical during Late Roman period, which could Stomatological Academy, Schevchenka, be related to regional diet and concen- 23, Poltava, Ukraine tration of fluorine in drinking water. e-mail: [email protected] The Chernyakhov population presented 26 Nataliia Valentinovna Yanko, Andrij Vladislavovich Artemyev, Lyudmyla Fedorivna Kaskova

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