An ‘Index of Oro-dental Disease’: A holistic method for understanding the impacts of different risk factors on oral health in archaeological populations

Objective: To gain a more holistic understanding of oral health in the past by producing an ‘Index of Oro-dental Disease’ (IOD), incorporating multiple oro-dental diseases and accounting for differences in antemortem/postmortem alveolar bone and tooth loss. Materials: UK Adult Dental Health Survey, 2009 anonymised dataset (N = 6206). Archaeological dental data from skeletal individuals from medieval and post-medieval Barton-upon-Humber, North Lincolnshire (N = 214, 1150–1855) and St James's Gardens Burial Ground, London (N = 281, 1789–1853). Methods: Creation of a formula for the production of index values. Application of the formula to clinical, ‘mock archaeological’, and archaeological datasets. Results: Patterns in mean IOD values within different groups were identifiable regardless of preservation. It was possible to identify potential differences between IOD scores related to aging, tobacco consumption, geographical location, and time period. Conclusions: Innovative use of modern clinical data and the production of ‘mock archaeological’ datasets provides validation of the IOD method. The approach may be useful for understanding the impact of different risk factors on oral health in the past, whilst also accounting for missing data and increasing comparability between groups. Significance: Allows for the investigation of risk factors that affect overall oral health but manifest in different ways in different individuals, whilst also producing larger sample sizes. Limitations: Impacts of age and posterior/anterior site positioning within the mouth suggest a careful consideration of age distribution and preservation of samples is required. Future research: Future adaption and testing of the method on a greater range of population groups and different variables/risk factors for oro-dental disease.