CARIES PREVALENCE IN ANCIENT EGYPTIANS AND NUBIANS By Konstantine Triambelas RECOMMENDED: Jost D. Irish Advisory Committee Chair <&.f£A> David C. Koester Chair, Department of Anthropology APPROVED: Date CARIES PREVALENCE IN ANCIENT EGYPTIANS AND NUBIANS A THESIS Presented to the Faculty of the University of Alaska Fairbanks in Partial Fulfillment of the Requirements for the Degree of MASTER OF ARTS By Konstantine Triambelas, B.A. Fairbanks, Alaska August 2014 v Abstract This thesis presents an expanded bioarchaeological perspective to quantitative analyses of dental caries in the remains of 1842 ancient Egyptians and Nubians. The skeletal samples from 17 Egyptian and 15 Nubian cemeteries are represented by both sexes, and span a period from 14000 BCE-1450 CE. Considering that a skeletal population of this size has never been previously evaluated for dental caries, this thesis can make a considerable contribution to a better understanding of the variability encountered in dental caries patterns over time, as these are manifested within the bio/cultural/ecological context of the Nile Valley. Dental caries are the decomposition of tooth enamel resulting from the chemical breakdown of dietary carbohydrates by oral bacteria. In archaeological populations, increasing rates of dental caries have been positively correlated with consumption of agriculturally-based cereals such as wheat and barley. Dental caries rates thus provide a reliable indicator of human biocultural transitions to agriculture, as well as information on diet, general oral health, and social organization of the group. In the context of ancient Egypt and Nubia, dental caries frequencies have been previously used to evaluate regional variability in dietary practices, as well differential access to resources based on sex and social class/status. This thesis reevaluates much of the above information using a larger and more statistically-representative sample. Quantitative analyses based on both non-parametric and parametric statistical techniques were used to assess intra- and inter-sample differences in mean tooth caries, mean individual caries, and mean ante mortem tooth loss (AMTL). These variables were compared across samples by region, time period, economic organization, sex, and social status. Results for Egypt were in agreement with previous research showing overall low caries prevalence increasing through time. Significant regional and inter-cemetery differences existed between Lower Egypt and Upper Egypt, as well as between late Dynastic samples and earlier ones. In Nubia, significant differences according to region and sex were shown to exist in the vi prehistoric/preagricultural component of the study. In contrast with previous findings, Nubian dental caries were higher in the earlier phases and declined during the agriculturally-intensive periods of later Nubian history. The exception to this last finding was the Christian period when both dental caries and AMTL experienced considerable increases. vii Table of Contents Page Signature Page ………………………………………………………………………........i Title Page ………………………………………………………………………………..iii Abstract …………………………………………………………………………………..v Table of Contents ……………………………………………………………………….vii List of Figures ……………………………………………………………………………xi List of Tables …………………………………………………………………………..xiii List of Appendices ………………………………………………………………………xv Acknowledgments …………………………………………………………………......xvii CHAPTER 1 PROLEGOMENON ……………………………………………………….1 Introduction ……………………………………………………………………….1 Research Questions ……………………………………………………………….6 Significance ……………………………………………………………………….9 CHAPTER 2 THE LAND, CLIMATE, AND PEOPLE ………………………………..13 Climate and Cultural Change ……………………………………………............15 Archaeology and Cultural History …………………………………………........18 The Paleolithic …………………………………………………………………..19 The Neolithic ………………………………………………………………........21 The Neolithic in the Western Desert (9000-4700 BCE) ………………………...21 The Neolithic of Lower Egypt …………………………………………………..24 The Neolithic of Badari (Upper Egypt) …………………………………………26 The Naqada Period (or Predynastic, 4200-3200 BCE) …………………….........28 viii Page The Neolithic in Nubia and Sudan …………………………………………….....31 Egypt and Nubia in historical times ……………………………………………. 34 CHAPTER 3 DENTAL CARIES ……………………………………………………… 43 Introduction ……………………………………………………………………...43 Dental caries pathology ………………………………………………………….46 Histology of human teeth ……………………………………………………......49 Dental caries etiology …………………………………………………………...51 Carbohydrates and dental caries ……………………………………………….. 55 Dental caries in archaeological populations …………………………………… 58 Sex and dental caries …………………………………………………………... 60 Dental caries in Egypt and Nubia ……………………………………………… 66 Conclusion ……………………………………………………………………... 69 CHAPTER 4 MATERIALS ………………………………………………….................73 Preagricultural/Prehistoric cemeteries …………………………………………..78 Predynastic cemeteries …………………………………………………………..84 Dynastic cemeteries ……………………………………………………………..88 Late Dynastic and Greco-Roman cemeteries ………………………………........94 Nubian cemeteries …………………………………………………………….....98 Early Nubian cemeteries (3400-1450 BCE) …………………………………….99 Classic Nubian cemeteries (1750 BCE-550 CE) ………………………………101 Late Nubian cemeteries (100 BCE-1350 CE) ………………………………….106 ix Page CHAPTER 5 METHODS ……………………………………………………………...109 Economy, Period, Region, Country, Sex, Age, Status …………………………110 Dental representation and prevalence in the archaeological record ……………115 Dental caries methods ………………………………………………………….123 Statistical methods ……………………………………………………………..127 The independent variables ……………………………………………………..129 Statistical tests ………………………………………………………………….131 Parametric assumptions ………………………………………………………..133 CHAPTER 6 RESULTS ……………………………………………………………….141 Dental caries per Country ……………………………………………………...142 Dental caries per Region ……………………………………………………….144 Dental caries per Economy …………………………………………………….145 Dental caries per Period ………………………………………………………..146 Dental caries and Sex ………...………………………………………………...149 Dental caries and (Social) Status ………..……………………………………..150 CHAPTER 7 DISCUSSION …………………………………………………………...153 Egypt and Nubia ……………………………………………………………….154 Egypt …………………………………………………………………………..156 The relationship between dental caries and dental wear ………………………157 Regional and temporal dental caries comparisons in Egypt …………………...164 AMTL in Egypt ………………………………………………………………..175 Nubia …………………………………………………………………………..176 x Page CHAPTER 8 SUMMARY AND CONCLUSIONS ………...........................................187 Future research ………………………………………………………………....194 References ……………………………………………………………………………...197 Appendices ……………………………………………………………………………..227 xi List of Figures Page Figure 1: Location of most cemeteries ………………………………………………….77 Figure 2: Tooth caries histogram ………………………………………………………135 Figure 3: Histogram of caries per individual …………………………………………..135 Figure 4: Mean AMTL histogram ……………………………………………………..136 Figure 5: Mean tooth caries per cemetery ……………………………………………..169 Figure 6: Mean individual caries per cemetery ………………………………………..170 Figure 7: Mean tooth caries in prehistoric Nubians …………………………………...180 Figure 8: Mean tooth caries for Period excluding HCG …………………………….....183 xiii List of Tables Page Table 1: Location and chronology of samples …………………………………………..10 Table 2: Nubian chronology …………………………………………………………….33 Table 3: Sex, age, and social status of the skeletal population ……………………….....74 Table 4: Sample abbreviation and curation ……………………………………………..75 Table 5: Descriptive statistics for the three variables ………………………………….133 Table 6: Caries per tooth and jaw ……………………………………………………...141 Table 7: Carious teeth frequencies ……………………………………………………..142 Table 8: Mann-Whitney results for Country …………………………………………...143 Table 9: Kruskal-Wallis results for Region…………………………………………….144 Table 10: Kruskal-Wallis results for Economy ………………………………………..146 Table 11: Kruskal-Wallis results for Period …………………………………………...147 Table 12: Overall sex caries comparisons ………………………………………..........149 Table 13: Kruskal-Wallis results for Status ……………………………………………151 Table 14: Results for Region without HAW …………………………………………...171 Table 15: Results for Period without HAW ……………………………………………172 xv List of Appendices Page Appendix A …………………………………………………………………………….227 Appendix B …………………………………………………………………………….233 Appendix C …………………………………………………………………………….239 xvii Acknowledgements This work represents the cumulative influence, effort, and contribution of several individuals without whose assistance completion of this thesis would be impossible. First among them are the members of my master’s committee Dr’s. Joel D. Irish, Kara C. Hoover, and Jamie Clark. Dr. Irish’s decades-long dedication and involvement in dental anthropology on the African continent provided the large set of data that allowed this thesis to materialize. Additionally, his guidance and deep knowledge has galvanized, hopefully, a future dental anthropologist in me. Dr. Hoover provided valuable input on the epidemiology of disease in past and present human populations, and Dr. Clark provided a much-needed archaeological perspective in the writing of this thesis. Thank you both for your comments, suggestions, and corrections. Also, many thanks to other UAF anthropology graduate students in my cohort: Gerard, Laura, Clarissa, Fawn, Mike, David, Sarah, Meagan, you are already missed. I am also forever obliged to Charu and Brian at the UAF Anthropology Department’s office for helping me successfully navigate the uncharted waters of departmental bureaucracy. Also, a big thank