Prevalence of Periodontitis in an ancient Romano-British population

Objectives: The aetiology of periodontitis is multifactorial, and the prevalence of disease cannot be explained by the presence of plaque alone, but may be associated with risk factors including genetic factors and smoking. The aim of this study was to investigate the prevalence of periodontitis in a Romano-British population living between 200 – 400AD. Methods: Periodontitis was assessed in 303 dried skulls from a collection kept at the Natural History Museum, London originally derived from Poundbury, Dorset. A tooth was classified as affected by periodontitis when it was judged to exhibit 5mm of attachment loss which included infrabony defects together with horizontal bone loss adjusted for age-related over eruption of teeth. A subject was classed as affected by periodontitis according to age and number of affected teeth – Under 25 : at least 2 affected teeth, 25 – 35 : teeth in 3 quadrants affected; over 35 : all quadrants affected. Results: Overall, 5.6% of the population were affected by periodontitis. The prevalence of periodontitis in different age groups was : Under 25: 5.5%; 25 – 34 : 5.3% ; 35 – 44: 6.2% : 45 – 54 : 4.0% ; 55 – 64: 5.9% ; over 65: 10.5%. The number of teeth affected by periodontitis increased in a linear relationship with age. In addition, many individuals who were not classified as being affected by periodontitis had a single area of attachment loss, eg. In the 45 – 54 yrs age group a single 5mm infrabony defect was seen in 30% of the population. Conclusions: Overall, the prevalence of periodontitis was nearly half that of that reported in most modern human populations. The prevalence of periodontitis did not increase with age except in the very oldest sub group, although the number of affected teeth did increase.