Dental Enamel Hypoplasia Research Articles

A Paediatric Case Study Report of Cholera in an Endemic Area of Cebu Province of Philippines

ZD, 2 years old male child from Cebu city Philippines with chief complaint of loose watery stools was admitted by his mother to a tertiary hospital. Five days prior to the admission, onset of the disease with three episodes (approximately 100 ml each) of non-foul smelling loose watery (yellow) stools was observed with moderately severe dehydration. However, it was observed that the patient was playful and with a good appetite. He was given 1 pack per day Vivalyte rehydration solution hence, the episode reduced to one time. One night prior to admission, an increase in bowel movement frequency was noted. The stool colour changed to yellowish to greenish with mucus. The patient turned anorexic and weak with sunken eyeballs. In the morning of the admission, the patient had another 2 episodes of the stools with formed particles. Patient also had 3 episodes of non-projectile vomiting (approximately 30 ml/ episode) irrelevant to the food intake timings.
 At the Emergency Room, the patient was treated with IV Fluids of Normal Saline Solution (60 cc/ kg/ day); CBC showed thrombocytosis with neutrophilic predominance, serum electrolytes revealed hyponatremia and hypokalaemia. Stool Culture was done. Medications started were Zinc Sulphate at 20 mg per day and Oral rehydration solution. The patient was referred to an infectious specialist care with a primary impression or consideration of Cholera thus Erythromycin was started at 50 mg/kg/day (3 doses/ day).
 Since the patient was under developed or did not match with the normal developmental milestones like no teething, open anterior fontanel, and deviation in the weight height ratio had developed as significant deviation in head circumference, chest circumference and abdominal girth due to the infused fluid volume overload. There might be chances of making wrong clinical diagnosis like viral diarrhoea complicated to give rise meningitis by primary care givers in absence of a confirmed laboratory results, an immediate initiation of an empirical treatment with fluid resuscitation and antibiotics undertaken, hence, the patient was referred to the care of a specialist of the infectious diseases for further evaluation and treatment.
 At ward, the patient was observed awakened, irritable, without respiratory distress and tachycardia, with moderate dehydration and a positive fluid balance of 210 ml. Stool exam results showed 55-65 WBC per high power field. Intra Venous (IV) Fluid to correct the imbalance of electrolytes and medications were continued. Following days, the patient had 4 episodes of loose watery stools amounting to 100 - 200 ml per episode with passage of Ascaris. Patient was slightly irritable, with still sunken eyeballs, otherwise with good turgor, mobility and strong pulses. IV Hydration was continued. Albendazole (400 mg/ tab) single dose was given. Electrolyte imbalance was already corrected. However, the stool culture was positive for Vibrio cholerae. On the fifth hospital day, the patient got normal for all the symptoms and signs. Erythromycin was prescribed for 3 days at the rate of 50 mg/ kg/ day (3 doses/ day). Further, Zinc Sulphate tablets (20 mg/ tab) twice a day was also prescribed and then the Patient was discharged.
 In absence of teething, Doxycycline as the drug of choice for the Cholera treatment might have been prescribed for a fast recovery. However, doxycycline is contraindicated in children less than 8 years of age due to the risk of yellow tooth discolouration and dental enamel hypoplasia. Generally, V. cholerae often becomes drug-resistant against multiple antibiotics through its enzymatic functions (HGT) that modify antibiotics chemically. Hence changing the antibiotic regimen remains the best strategy to get the best prognosis if the previously administered antibiotic doesn’t work properly. Another, before discharging, the condition of the patient might also have confirmed as normal through the required laboratory exams even if the patient was tolerating orally well. Moreover, the patient might have been referred to a paediatrician or called for an early follow up to reassess him and prescribe probiotics and other growth regulatory supplements for complete well-being of the patient.

Morphological Changes in Dental Surfaces Suggest Health Status and Alimentary Habits in the Subjects Belonging to the Copper Age in Sardinia Island (III Millennium BC)

The aim of this multidisciplinary study, which involved a team of archaeologists, odontologists, biologists, is to examine a set of dental health indicators, including caries, tooth wear, and enamel hypoplasia of a III millennium BC sample from the burial site of Scaba ’e Arriu (Siddi, South Sardinia), in order to evaluate the dental health status and the diet. Our purpose is to depict a timeline of dental health in Sardinia from prehistory to the present day, starting with a focus on a Copper Age population. Caries, dental wear, and enamel hypoplasia of 259 permanent teeth were evaluated. It was not possible to assign sex and age of each tooth because of the lack of bony support, lost due to taphonomy factors. 14,7% of Scaba‘e Arriu’s samples were affected by carious lesions, with greater involvement of the posterior teeth (12,7% against 1,9% of anterior ones). Interproximal caries was the most frequent. Dental wear affected 77,8% of the teeth, and its presence is preponderant over caries’ rate. The high percentage of dental wear suggests a diet based on abrasive foods. Further studies are necessary to delineate more accurately the modus vivendi, the nutrition, and, consequently, the health status of this sample.

Dental Enamel Hypoplasias Being Used as Markers to Identify Undocumented Migrants

This paper discusses the implications of using certain skeletal markers when identifying individuals at the United States' southern border. It looks at a broader picture of where migrants are coming from and how these markers form.

Paleoecology of the Rhinocerotidae (Mammalia, Perissodactyla) from Béon 1, Montréal-du-Gers (late early Miocene, SW France): Insights from dental microwear texture analysis, mesowear, and enamel hypoplasia

Paleoecology of the Rhinocerotidae (Mammalia, Perissodactyla) from Béon 1, Montréal-du-Gers (late early Miocene, SW France): Insights from dental microwear texture analysis, mesowear, and enamel hypoplasia

Bone stable isotope data of the Late Roman population (4th–7th centuries CE) from Mondragones (Granada): A dietary reconstruction in a Roman villa context of south-eastern Spain

The aim of this study is to examine the diet, using bone stable isotope analysis (δ13C and δ15N), of a Late Roman population (4th–7th centuries CE) from the Roman villa of Mondragones (Granada, Spain). This archaeological site presents an exceptionally high number (n = 121) of well-preserved skeletal remains (adults and non-adults), giving the opportunity to study for the first time the nutritional and health conditions of a Late Roman population by the analysis of stable isotopes and pathologies in the context of the south-eastern Iberian Peninsula. Stable isotopes ratios of carbon (δ13C) and nitrogen (δ15N) were analysed in 46 individuals (21 adults and 25 non-adults) as well as in 7 faunal samples (2 cows/ox, 2 goats/sheep, and 3 large mammals). Frequencies of cariogenic lesions, dental calculus, dental enamel hypoplasia, porotic hyperostosis, and cribra orbitalia were also explored. The anthropological study revealed a high presence of dental caries and calculus in adults, which are related to a diet rich in starch and carbohydrates, and non-specific stress markers in non-adults, probably pointing to the weaning process or childhood diseases. Collagen isotope ratios suggested that the population of Mondragones had a diet rich in C3 plants, with some meat intake from terrestrial herbivores. There were significant differences between non-adults and adults, but no differences were detected by sex. The youngest non-adults (aged 1 year ± 4 months) showed the δ15N mean value almost 4‰ above the adult female one, which could reflect the breastfeeding period.

Clinical features of non-classical celiac disease in children and adolescents

Introduction/Objective. Nonclassical celiac disease (CD) is characterized by a very heterogeneous and non-specific clinical presentation. The aim of this study was to determine the basic symptoms and clinical signs of this CD subtype in children and adolescents Methods. The study was based on a sample of 58 children and adolescent, 38 female and 20 male, ages 1.75 to 17.75 (10.01?4.62) years with a nonclassical CD diagnosed according to the European Society for Pediatric Gastroenterology, Hepatology and Nutrition criteria from 1990 and 2012. Results. Except four patients who were between the ages of 1.75 to 2.50 years, all others were older than three years. The main clinical symptoms and signs suggestive of non-classical CD were anemia caused by iron deficiency (48.28%), short stature (34.48%), and intermittent abdominal pain (18.97%), anorexia with stagnation or weight loss (13.79%), and chronic constipation (6.9%). Thirty patients had one symptom or sign of the disease, 15 had two and 13 had three. In addition, 12 patients had dental enamel hypoplasia, 18 sideropenia without anemia and five mild isolated hypertransaminasemia. A gluten-free diet, apart from the dental enamel hypoplasia, has resulted in the withdrawal of all indicators of the disease. Conclusion. The main symptoms and clinical signs of nonclassical CD in children and adolescents were iron deficiency anemia, short stature and intermittent abdominal pain, and less frequently anorexia with stagnation or weight loss and chronic constipation. Excluding dental enamel hypoplasia, a gluten-free diet leads to a complete recovery of the patient.

Dental caries and intentional dental modification in a skeletal sample of enslaved Africans from Lagos, Portugal (15th–17th centuries)

AbstractIn 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.

Sex diff erences in Late Iron Age Northeast Estonia as indicated in dental pathologies and enamel hypoplasia

Study of dental pathologies is important in investigating the health and diets of past populations. Dental pathologies of adult peoples show nutritional and hygienic habits in adulthood, but childhood metabolic stresses can be observed in the occurrence of linear enamel hypoplasia (LEH). Dental hard tissue pathologies (caries, pre mortem tooth loss, abscesses, calculus, reduction of alveolar bone, molar attrition) and LEH were observed over 15 years in individuals from Jõuga cemetery (11th–16th cc. Northeast Estonia). The aim of the study was to trace sexual differences in diet and subsistence patterns through an analysis of dental pathology.

The intersections of industrialization: Variation in skeletal indicators of frailty by age, sex, and socioeconomic status in 18th- and 19th-century England.

Intersectionality theory argues that various categories of identity and forms of systemic oppression interact and produce inequalities in resource access, economic opportunities, and health outcomes. However, there has been little explicit engagement with this theory by bioarchaeologists examining disparate health outcomes in the past. This study examines the associations among frailty, age at death, sex, and socioeconomic status (SES) in 18th- and 19th-century England. The sample for this study comes from four industrial-era cemeteries from England, ca. 1711-1857. The associations among adult age (18+ years), SES, sex, and three skeletal indicators of stress (dental enamel hypoplasia [DEH, n = 293], cribra orbitalia [CO, n = 457], periosteal lesions [PNB, n = 436]) are examined using hierarchical log-linear analysis. Significant interactions existed among the variables examined for two skeletal indicators: high SES females had lower frequencies of CO relative to other groups and males between ages 30-45 years exhibited higher frequencies of PNB compared to females or males of older or younger ages, regardless of SES. Additionally, sex and SES were consistently associated with age at death. These results suggest that patterns of stress indicators cannot be examined solely across unilateral axes of age, SES, or sex. Intersecting axes of privilege, marginalization, and structural oppression may have buffered high SES females from some negative health outcomes (CO) while predisposing them to others (risk of maternal mortality). Likewise, the hazardous working conditions relegated to adult males may have heightened the risk of injury, infection, and death for middle-aged men in industrial-era England.

Enamel hypoplasia and dental wear of North American late Pleistocene horses and bison: an assessment of nutritionally based extinction models

AbstractApproximately 50,000–11,000 years ago many species around the world became extinct or were extirpated at a continental scale. The causes of the late Pleistocene extinctions have been extensively debated and continue to be poorly understood. Several extinction models have been proposed, including two nutritionally based extinction models: the coevolutionary disequilibrium and mosaic-nutrient models. These models draw upon the individualistic response of plant species to climate change to present a plausible scenario in which nutritional stress is considered one of the primary causes for the late Pleistocene extinctions.In this study, we tested predictions of the coevolutionary disequilibrium and mosaic-nutrient extinction models through the study of dental wear and enamel hypoplasia ofEquusandBisonfrom various North American localities. The analysis of the dental wear (microwear and mesowear) of the samples yielded results that are consistent with predictions established for the coevolutionary disequilibrium model, but not for the mosaic-nutrient model. These ungulate species show statistically different dental wear patterns (suggesting dietary resource partitioning) during preglacial and full-glacial time intervals, but not during the postglacial in accordance with predictions of the coevolutionary disequilibrium model. In addition to changes in diet, these ungulates, specifically the equid species, show increased levels of enamel hypoplasia during the postglacial, indicating higher levels of systemic stress, a result that is consistent with the models tested and with other climate-based extinction models. The extent to which the increase in systemic stress was detrimental to equid populations remains to be further investigated, but suggests that environmental changes during the late Pleistocene significantly impacted North American equids.

Análisis de prevalencia y criterios diagnósticos de hipomineralización molar-incisiva

To identify the prevalence and diagnostic criteria of Molar-Incisor Hipomineralization (MIH) in the scientific literature. Materials and Methods: This is a bibliographical research conducted through the analysis of indexed articles until October 2017 in the PubMed, Web of Science and Scopus databases. The Medical Subject Headings (MESH) used were "Dental Enamel Hypoplasia" and "Molar Incisor Hypomineralization". The analysis of articles was carried out by two reviewers, who collected information independently. The following information was collected: author, year of publication, place of work (continent and country), sample calculation, sample number, age of participants, type of study, prevalence of molar-incisor hypomineralization and criteria used for diagnosis. Data were tabulated using Microsoft Excel for Windows and presented using descriptive statistics. Results: A total of 484 articles were found and 57 were included in the study. Most of the studies were conducted in Europe (35%), and 31.6% of the studies mentioned using a probability sampling. The number of study participants ranged from 99 for a study in Brazil to 3,591 in Kenya. The most frequent age was 8 years, while the predominant type of study was cross-sectional (91.2%). The prevalence varied from 0.4% to 37.3% and most studies (73.6%) employed the European Academy of Pediatric Dentistry criteria for the diagnosis of MIH. Conclusion: There is great variability in prevalence in different countries, probably due to the use of different diagnostic criteria being used, and due to different age groups and geographical variation.

ORAL HEALTH STATUS OF CHILDREN UNDERGOING RENAL DIALYSIS IN ALEXANDRIA, EGYPT

INTRODUCTION: Advances in pediatric nephrology have resulted in increased survival rates of children on renal dialysis. Renal failure is characterized by multiple organ involvement, including complications in the soft and hard tissues of the oral cavity. Yet, data regarding the oral health status of Egyptian children on renal dialysis is scarce. OBJECTIVES: The aim of this study was to assess the oral health conditions (dental caries, oral hygiene, gingival condition, calculus and enamel hypoplasia) of children undergoing renal dialysis, in Alexandria, Egypt compared to matched healthy controls. MATERIALS AND METHODS: This study was conducted on all available (70) end-stage renal disease children undergoing dialysis, aged 6–18 years recruited from Alexandria University Children’s Hospital (AUCH) and its outpatient-clinics (nephrology medicine) and from Sporting Student’s hospital (Health Insurance). The data were compared with that of a gender and age matched control group. Data were collected using an interview questionnaire and clinical examination. The mean df, DMF, GI, Pl.I and CSI scores were recorded. Enamel hypoplasia recorded according to Alaluusa et al criteria was also assessed. RESULTS: Dialysis children had significantly higher plaque, gingival, CSI and enamel hypoplasia scores whereas mean DMFT was higher among healthy children. No significant differences were observed between groups regarding dft. CONCLUSIONS: Children undergoing renal dialysis showed significantly worse oral health conditions than healthy controls except for dental caries status. The results of the study suggest a need for dental advice and supervision, and indicate that dental and medical care should be closely integrated for children with renal failure

Association of nutritional status and dental health among 3–6-year-old children of a South Indian population

Background: Nutrition promotes healthy development and maintenance of oral health. Chronic malnutrition affects tooth exfoliation and renders the permanent teeth susceptible to caries.Aim: To assess the nutritional status and dental health in 3–6-year-old children.Materials and Methods: A cross-sectional epidemiological study was conducted on a representative sample of 1459 children, aged 3–6 years, and visiting the Integrated Child Development Centers (anganwadi) of T. Narasipura Taluk, Mysore, India. Nutritional status was evaluated by measuring body mass index (BMI) and mid-upper arm circumference (MUAC). Oral examination was carried out using a noninvasive technique with the child sitting in an upright position under good natural light. Dental caries, enamel hypoplasia, and oral mucosal status were recorded according to the WHO criteria. Results: Nutritional status according to BMI showed 41% of children to be underweight and according to MUAC only 0.82% of children were undernourished. A highest (41.7%) number of underweight children were seen in 3–4 years age group, with a higher number of females being affected. The prevalence of dental caries was 61.07% and was highest in 3–4 years age group. More number of females were affected with dental caries than males. The prevalence of enamel hypoplasia was 8.7%. Association of dental health status with BMI was significant with dental caries. Conclusions: Forty-one percent of children were underweight and the prevalence of underweight children increased with age. The prevalence of dental caries and enamel hypoplasia were 61% and 8.7%, respectively.

Prevalence of Dental Enamel Hypoplasia in the Neolithic Site of Wadi Shu'eib in Jordan

A study of Neolithic Pre-Pottery B materials from Wado Shu'eib revealed that 38.40% of the examined teeth have dental enamel hypoplasia (DEH). Sixty percent of the anterior teeth exhibit DEH while only 21.40% of the posterior have the defect. The most affected teeth are the maxillary central incisors (72.73%) and the lower canines (62.5%). The most prevalent type of defect is the groove which is present in 68.75% of the teeth with DEH. One notable case is a lateral incisor with a slight deep and sharp groove. The sharpness and the deepness of this groove may indicate a severe stress which caused DEH to occur in a very short period. The most likely casues of DEH were general nutritional stresses. Another cause may have been environmental stresses.

Histological Analysis of Dentition in Rockshelter Burials from Two Sites in Central Belize

Objectives: Investigations of dental health in the Maya region have frequently focused on individualsburied at urban sites rather than in peripheral or intermediary zones. This study presents a dental analysisof a different type of mortuary sample, those persons buried in two non-elite peripheral rockshelters, in CentralBelize using a combined dental micro- and macrodefect approach to interpret health experience. Materials and Methods: A total of 22 teeth (permanent mandibular canines, and mandibular and maxillarythird molars) from the two sites were assessed for dental caries, enamel hypoplasias, and Wilson bands. Themaximum and minimum ages of microdefect formation for each tooth was calculated. Results: Carious lesions were infrequently represented in the sample, while linear enamel hypoplasias wereexpressed in less than half the sample. Wilson bands, conversely, were present in nearly every tooth indicatingthat the rockshelter populations experienced more acute stress. Individuals interred at Caves Branch Rockshelterwere affected earlier in life based on analysis of mandibular canines. Conclusion: Non-elites buried in rockshelters in Central Belize had similar dental health experiences whencompared with individuals buried at elite centers. At least in terms of oral health, peripheral communities in thisarea were not adversely affected by their distance from urban core sites

Tomada de decisão clínica frente ao diagnóstico e tratamento de lesões em esmalte dentário

Introdução: O tecido que recobre a coroa dos dentes é o esmalte dentário, que promove proteção e revestimento. Trata-se de tecido mineralizado e sensível às variações do ambiente em sua formação, sendo que não sofre remodelação ao longo de seu ciclo de vida. Objetivo: Avaliar a escolha mais adequada do diagnóstico e opções de tratamento de lesões de esmalte dentário pelos docentes e discentes do curso de Odontologia. Método: Estudo quantitativo descritivo, cuja amostra foi composta por 98 discentes matriculados nas disciplinas de Clínicas Odontológicas do IV ao VIII nível e por 23 docentes. O instrumento de coleta dos dados foi um questionário composto por fotografias de quatro casos clínicos, cujos dentes apresentavam diferentes lesões em esmalte dentário: hipoplasia do esmalte dentário, fluorose dentária, amelogênese imperfeita e cárie dentária. Resultados: Dos 98 discentes, o acerto predominante foi o da fluorose dentária, onde 93,9% acertaram o diagnóstico. Enquanto o acerto predominante em relação ao tratamento foi o das lesões de cárie, onde 86,7% optaram por restauração direta. Dos 23 docentes, o acerto predominante frente ao diagnóstico foi de lesão de cárie, 100% acertaram o diagnóstico, enquanto o tratamento foi o de restauração direta no caso de hipoplasia, onde 95,7% fizeram essa opção de tratamento.Conclusão: Ambos os grupos apesentaram dificuldade na tomada de decisão de tratamento nos dentes com amelogênese imperfeita e com fluorose dentária leve. Os discentes relataram possuir dificuldade no diagnóstico diferencial na prática clínica frente às diferentes lesões que acometem os tecidos dentários, além de terem pouco conhecimento sobre o diagnóstico das lesões abordadas.

Estrés metabólico y entierros secundarios: nuevas evidencias para el estudio de las poblaciones coloniales del centro-oeste argentino

En este trabajo se presentan los resultados del análisis de indicadores estrés metabólico en una muestra decráneos, mandíbulas y dientes recuperados en entierros secundarios de las Ruinas Jesuíticas de San Francisco (RSF), ubicadas en el Sitio Área Fundacional (Ciudad de Mendoza). La muestra analizada corresponde a poblaciones coloniales (siglos XVII-XVIII y XIX) y proceden de un sector de laNave Central de las RSF. Se analizaron indicadores de estrés metabólico: hiperostosis porótica (HP), cribra orbitalia (CO) e hipoplasias de esmalte dental lineal (HEDL) en una muestra compuesta por un MNI de 22 individuos. Se calcularon las prevalencias de estos indicadores de estrés por sexo, edad, cronología y sector de entierro. Se identificaron altos porcentajes de HP-CO e HEDL en forma generalizada,aunque con mayores valores en individuos masculinos, entre los juveniles y adultos de edad media, como así también en el periodo Colonial Temprano (siglos XVII-XVIII) y entre los individuos que se infieren con menor estatus socioeconómico. Los resultados se comparan y discuten en relación con las tendencias registradas en entierros primarios y secundarios de otros templos del norte de Mendoza, lo que contribuye a caracterizar el estado de salud y condiciones de vida de las poblaciones coloniales.

Dental enamel hypoplasias in Holocene bighorn sheep (Oviscanadensis) in eastern Washington state, USA

Dental enamel hypoplasias have been documented in extant and fossil mammal species and attributed to several kinds of physiological stress. They have not previously been reported among bighorn sheep (Ovis canadensis Shaw, 1804). Forty-six (36.8%) of 125 mandibular molars (m1, m2, m3) of bighorn recovered from disturbed Holocene archaeological deposits in eastern Washington state display several kinds of hypoplasias. The exact ontogenetic age of the individual animals when hypoplasias formed cannot be determined. The majority of the hypoplasias occur near the root–enamel junction of the m3, suggesting that most individuals were young adults when the defect formed. Physiological stress associated with reproductive costs, winter nutritional deficits, or both seems likely.

Life in the fast lane: Settled pastoralism in the Central Eurasian Steppe during the Middle Bronze Age.

We tested the hypothesis that the purported unstable climate in the South Urals region during the Middle Bronze Age (MBA) resulted in health instability and social stress as evidenced by skeletal response. The skeletal sample (n = 99) derived from Kamennyi Ambar 5 (KA-5), a MBA kurgan cemetery (2040-1730 cal. BCE, 2 sigma) associated with the Sintashta culture. Skeletal stress indicators assessed included cribra orbitalia, porotic hyperostosis, dental enamel hypoplasia, and tibia periosteal new bone growth. Dental disease (caries, abscess, calculus, and periodontitis) and trauma were scored. Results were compared to regional data from the nearby Samara Valley, spanning the Early to Late Bronze Age (EBA, LBA). Lesions were minimal for the KA-5 and MBA-LBA groups except for periodontitis and dental calculus. No unambiguous weapon injuries or injuries associated with violence were observed for the KA-5 group; few injuries occurred at other sites. Subadults (<18 years) formed the majority of each sample. At KA-5, subadults accounted for 75% of the sample with 10% (n = 10) estimated to be 14-18 years of age. Skeletal stress markers and injuries were uncommon among the KA-5 and regional groups, but a MBA-LBA high subadult mortality indicates elevated frailty levels and inability to survive acute illnesses. Following an optimal weaning program, subadults were at risk for physiological insult and many succumbed. Only a small number of individuals attained biological maturity during the MBA, suggesting that a fast life history was an adaptive regional response to a less hospitable and perhaps unstable environment.

A novel approach: combining dental enamel hypoplasia and paleoparasitological analysis in medieval Islamic individuals buried in Santarém (Portugal)

Paleopathological and paleoparasitological studies seek evidences to understand health and disease in past populations. These two approaches are often used independently despite the obvious importance of its complementary. This paper aims to explore the possible relation between a common indicator of childhood stress and infection by intestinal parasites. Thirty adult individuals from the Islamic necropolis of Santarém (9th-12th cent. AD) were macroscopically examined for linear enamel hypoplasia. Sediment from the pelvis and skull of each skeleton were observed under the optical microscope in search of helminth eggs. Hypoplasic defects were identified in 46.67% of the individuals, mostly on canines and incisors. Eggs from Ascaris lumbricoides and Trichuris trichiura were identified respectively in 4 and 2 individuals. The Fisher’s exact test was performed to analyze whether the individuals with evidences of stress in early childhood were more prone to helminth infections or death at younger ages. Although these variables were shown to be independent, this exploratory study highlights the contribution of combining paleopathological and paleoparasitological methods to address the long-term impact of the physiological stress exposure in early life on the immune system. Furthermore, variety of factors that could have influenced these results are discussed and interpreted in a biocultural perspective.