|Year : 2020 | Volume
| Issue : 4 | Page : 216-224
Pathological signatures of identity in Ajnala skeletal remains: A forensic dentistry investigation
Jagmahender Singh Sehrawat1, Sakshi Aggarwal2
1 Department of Anthropology, Panjab University, Chandigarh, India
2 General Dentistry, H.S. Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
|Date of Submission||29-Mar-2020|
|Date of Decision||10-Jun-2020|
|Date of Acceptance||07-Aug-2020|
|Date of Web Publication||13-Oct-2020|
Jagmahender Singh Sehrawat
Department of Anthropology, Panjab University, Chandigarh
Source of Support: None, Conflict of Interest: None
Background: Teeth can reveal important information about an individual's lifestyle, sex, occupation, ethnicity, pollutant exposures, dietary status and identity. The analysis of skeletal or dental remains can lay emphasis on the social, health and disease/illnesses status of individuals or the community health. Aims and Objectives: In this study, an attempt was made to estimate the pathological status and possible lifestyle of the individuals whose dental remains were excavated from an abandoned well in Ajnala, India. These individuals were subjected to a mass burial in the year 1857 and thereafter a religious structure was built on top of the disused well. Materials and Methods: The excavated teeth were segregated into different tooth types on the basis of their identifying anatomical features and they were further examined for the wear (according to the Smith and Knights wear criteria) as well as caries (into pit and fissure and deep caries) rates. The pathological status of 3533 (1853 maxillary and 1680 mandibular teeth) avulsed teeth of all types was analysed and results were presented in the textual, tabular and graphical forms. Results: Out of total 3533 teeth examined in this study, 97% had undergone wear of some sort; the majority of the teeth were having Grade '0' wear and the Grade III wear were minimal. It was also observed that the prevalence of pit and fissure caries was higher as compared to the deep caries. Discussion and Conclusions: The low frequency of caries in Ajnala teeth can be attributed to the consumption of a diet low in sugars. As the buried individuals were reportedly army recruits who might had sound health and good oral hygiene prior to being eligible for undergoing a rigorous recruitment process; the negligible percentages of wear and caries in Ajnala teeth may be self-explanatory about their military affiliations.
Keywords: Ajnala teeth, dietary status and lifestyle, forensic dentistry, wear and caries
|How to cite this article:|
Sehrawat JS, Aggarwal S. Pathological signatures of identity in Ajnala skeletal remains: A forensic dentistry investigation. Indian J Dent Sci 2020;12:216-24
|How to cite this URL:|
Sehrawat JS, Aggarwal S. Pathological signatures of identity in Ajnala skeletal remains: A forensic dentistry investigation. Indian J Dent Sci [serial online] 2020 [cited 2020 Dec 3];12:216-24. Available from: http://www.ijds.in/text.asp?2020/12/4/216/298033
| Introduction|| |
Forensic dentistry plays an important role in establishing the identity of an individual due to their longest postmortem longevity and survival. Tooth enamel acts as an armor to all sorts of degradations and damages and hence are almost minimally affected by fire, chemical attacks, trauma, and burials. Different types of teeth vary in their shape, size, and inter spaces between the teeth among the individuals of different population groups and between the two sexes. Therefore, the bite marks caused by teeth are of utmost value in forensics due to their uniqueness in each individual as an evidence., Furthermore, dental characteristics such as mandibular taurodauntism, Carrabelle's cusps in maxillary molars, shovel-shaped incisors, and peg-shaped teeth, etc., can provide clues about the ethnicity/race of an individual. Shovel-shaped incisors are common among Asiatic Mongoloids and Amerindians.,, Australian Aborigines, the Melanesians and the American Indians tend to have wide crowns and larger teeth, Lapps and Bushmen races have smaller teeth.
Moreover, teeth can provide important information about an individual's occupation and dietary habits. For instance, the continuous use of anterior teeth to handle threads, nuts, wires, and other instruments by the tailors, carpenters, cobblers, electricians, and musicians make them notched one. Habits such as pipe smoking, cigarette smoking, and tobacco chewing also tend to have their effects on teeth.. Dental pathologies such as caries, calculus, ante-mortem tooth loss, enamel defects such as linear enamel hypoplasia and tooth wear give an insight about the diet, nutrition, and the method of food preparation used by an individual., Thus, the osseous remains of the dental system may reveal details about food habits, illnesses, tools, social stratification, and rituals within the individuals of a community. An attempt to understand the possible lifestyle of individuals from their dental remains (obtained from Ajnala well) has been carried out in this study. Enamel hypoplasia is a deficit in enamel matrix formation, occurring during childhood as a result of survived nutritional shortages, deficiencies or diseases, and thus, it serves as an excellent indicator of developmental stress levels in the past.
About the present study dental material
The present study is based on the pathological signatures of dental defects such as caries, wear, hypoplasia, and stains among the teeth retrieved from Ajnala skeletal assemblage. Thousands of badly damaged and commingled human remains belonging to the multiple individuals were excavated from an abandoned well at Ajnala (Amritsar, India) which were handed over to the corresponding author (JS) of this manuscript for their biological profiling purposes. These remains were dug out by the amateur archaeologists after getting textual information from a book and other archive records. The written records mentioned that the retrieved human remains belonged to 282 Indian-origin mutineer soldiers killed by colonial rulers whose dead bodies were thrown and dumped into the said abandoned well., As the entire excavation was carried out nonscientifically, the retrieved human skeletal elements were in a badly fragmented and commingled state. Thousands of dislodged teeth (out of sockets), mandibular and maxillary jaw fragments (having in situ teeth, still fitted in jaw sockets), bones such as clavicle, talus, calcaneus, metacarpals, metatarsals, intact crania, and contextual items were sorted out of the commingled human osseous debris found scattered at the site [Figure 1]. The avulsed teeth were collected from the Ajnala skeletal assemblage to assess the dental health and dietary status of the victims. No articulated skeleton/s could be retrieved from the assemblage as no osteological expert was involved in the said nonscientific excavation.
|Figure 1: Thousands of teeth segregated out of Ajnala skeletal assemblage|
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| Material and Methods|| |
In the present study, the dental pathological status of 3533 (1853 maxillary and 1680 mandibular teeth) avulsed teeth of all types was examined. The collected teeth were first identified on the basis of their identifying features and were classified into the incisors, canines, premolars, or molars. The teeth were further separated into maxillary or mandibular and left or right on the basis of their inter-arch characteristics. A brief summary of the type and number of teeth examined in present study is given in [Table 1]. Each type of tooth was examined for the carious lesions, wear patterns, and hypoplasiac indicators [Figure 2], [Figure 3], [Figure 4]. The teeth were further grouped into four categories on the basis of their degree of wear and following the criteria proposed by Smith and Knight. The carious lesions in the teeth were broadly classified into “pit and fissure” caries and “deep” caries. A lesion was characterized as caries only if it involved a visible cavitation of the tooth surface. The extrinsic or intrinsic stains resembling caries were not classified as caries. The “pit and fissure” caries included the pits and the fissures present on the occlusal, lingual/palatal, or buccal surfaces of teeth while “deep” caries involved significant destruction of the tooth surface. The present study utilized the avulsed teeth only for their pathological analyses than the teeth present in mandibular or maxillary jaw fragments previously published by Sehrawat et al., The null hypothesis was that the Ajnala dental remains belonged to slain army recruits killed by the colonial rulers (Britishers) in 1857, and they enjoyed sound health and dietary status during their life time.
|Table 1: Types and number of avulsed teeth analysed in present study (n=3533)|
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| Results|| |
A total of 3533 teeth, 1853 maxillary and 1680 mandibular teeth, obtained from Ajnala skeletal assemblage were examined for their wear patterns. It was noted that 97% (3432) of the examined teeth had undergone some sort of wear; maxillary teeth exhibited greater percentage of wear compared to the mandibular teeth. The examined teeth were further classified into four categories based on wear patterns (i.e., Grade 0, 1, 2, and 3) following the wear criteria given by Smith and Knight, and it was noticed that 39.6% (n = 734) maxillary and 38.3% (n = 645) mandibular teeth had Grade “0” wear. The maxillary teeth exhibited the highest frequency of the highest degree of wear (i.e., wear of Grade 3), predominantly the right maxillary premolars and; among the mandibular teeth, the left incisors exhibited the highest frequency of wear. Thus, bilateral differences were noticed in the frequency of wear in the same arch i.e., difference in wear on the right and left sides. Maxillary teeth showed greater frequency of wear on the left side, whereas the mandibular teeth showed more wear on the right side. Statistically significant differences were found in the wear patterns between the right and left quadrant mandibular incisors (t = 8.77*), mandibular premolars (t = 24.4**) (*significant at 0.05 level, **highly significant at 0.001 level), maxillary canines (t = 10.5*), and maxillary premolars (t = 18.4**). Furthermore, such differences were quantified between upper and lower right incisors (t = 80.8**), right premolars (t = 19.2**), and left premolars (t = 31.5**) [Table 1].
Caries were less prevalent among the examined Ajnala teeth. The anterior teeth were less carious than the posterior ones. The inter-arch prevalence of caries revealed that mandibular teeth had comparatively higher frequency of carious lesions than the maxillary ones. When the observed caries was broadly classified into “pit and fissure” and “deep caries” categories, it was observed that the prevalence of shallow category of caries was higher than the deep caries in both the maxillary and mandibular teeth [Figure 2], [Figure 3], [Figure 4].
| Discussion|| |
Tooth wear can reveal much information about dietary status and lifestyle of a person which is influenced by multiple factors such as abrasives in the diet and nonmasticatory use of the teeth as being the principal factors. Apart from these major contributory factors, the tooth eruption sequence, enamel thickness, cusp morphology, root angulation, occlusion, arch shape, craniofacial shape, and the paramasticatory functions of teeth may contribute toward different grades of tooth wear. The surface and position of the tooth, sex and age of the individual, number of teeth lost, and the nature of diet consumed by the individual (frequency of consumption of sour fruits, alcohol, carbonated drinks, vegetarian or nonvegetarian foods) also determine the wear patterns. The culture, occupation, environment, and geographic conditions may also influence the tooth wear. Different teeth have different grades of wear. Mehta and Evans reported that the teeth of Post-Columbian Indian Arkansas skulls suffered extensive attrition due to the coarser nature of their diet having excessive amount of sand and soil particles. In ancient times, hunter and gatherers had a severe wear in their anterior teeth compared to the agriculturists.,,
Teeth wear is also influenced by their eruption sequence; first molar undergoes maximum wear compared to other permanent teeth as it is the first permanent tooth to erupt into the oral cavity which remain exposed to mastication stresses for longer durations., Similarly, wear of teeth may also be caused in a sequential manner, leading to the development of wear facets at different positions and also at different time periods. During food chewing, some cusps are exposed to masticatory stresses more prominently, and thus, show comparatively more wear than other teeth causing uneven tooth wear patterns. Wear facets can be produced by both the direct and indirect contacts. Tooth to tooth contacts are the direct contacts during functional (masticatory) or parafunctional activities. Indirect contacts occur during mastication through interposed hard particles which further increase the wear surface area.
Tooth wear examinations in the present study teeth showed that posterior teeth (molar and premolar) were more severely affected than the anterior teeth (incisors and canine). On the basis of tooth wear patterns, the dental health status of ancient Ajnala remains can be related with their military affiliations. The anterior teeth were most probably used in the military operations such as holding items, carrying or unloading pork or beef greased cartridges as per the ordeals of the colonial rulers at that period. Attrition wear was the most common dental pathology among Ajnala ancient teeth; maxillary and mandibular 1st molars showing almost the same incidence of wear i.e., 94.1% and 95.9%, respectively [Table 2] and [Figure 5], [Figure 6], [Figure 7], [Figure 8]. More than 75% Ajnala teeth reportedly had a high prevalence of attrition wear and the occlusal surface of different types of teeth was more frequently affected. Only canine teeth showed significant result for level IV wear. Severe dental wear on the posterior teeth implies the ingestion of coarser, abrasives, fibrous, hard-textured foods which requires extreme mastication and thus more extensive use of teeth for nonmasticatory purposes, like for breaking the threads of pork or beef-greasy cartridges during military operations.,
|Table 2: Frequency distribution of dental wear and caries among the studied dislodged Ajnala teeth (n=3533)|
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|Figure 5: The percentage of right maxillary teeth affected by different gradients of wear|
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|Figure 6: The percentage of left maxillary teeth affected by different gradients of wear|
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|Figure 7: The percentage of right mandibular teeth affected by different gradients of wear|
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|Figure 8: The percentage of left mandibular teeth affected by different gradients of wear|
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In the present study, it was observed that the number of teeth affected by Grade III wear was comparatively lesser than other wear levels; probably due to less abrasives in the dietary consumptions. Bonfiglioli et al. noticed very few teeth having suffered heavy wear in a Roman Imperial age population to suggest the consumption of a diet that contained less amounts of fibrous foods and vegetables washed off all abrasives before their consumption. Maxillary teeth showed comparatively frequency of wear than the mandibular ones. Molnar reported that apart from diet and culture, the tooth size variations, age distribution of the sample, enamel and dentin hardness, different occlusal characteristics, and parafunctional habits of an individual also contribute toward differences in wear prevalence among the maxillary and mandibular teeth. Sometimes, the absence of wear signatures in the lower antagonists may suggest that the external object was held between both the upper and lower teeth, though the abrasive contact happened with only the maxillary teeth.
Bilateral differences were noticed in the tooth wear frequency in this study [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16], [Figure 17] and it supported Molnar study. Such differences may due to the differences in chewing habits of the individuals and or due to the presence of some pathological conditions. The presence of bone pathology or even caries might refrain an individual from chewing on the affected side or unilateral chewing habit and hence may lead to more wear on the contra-lateral/opposite side. The maxillary sinus infection may result in more wear on the contralateral cusps of teeth. Unilateral pain in facial muscles or pain in the temporomandibular joint (TMJ) or other problems associated with TMJ like unilateral joint clicking may also lead to asymmetric wear on the teeth. Asymmetric tooth loss also plays a role in wear asymmetrization. An individual may use one side of the arch more frequently than the other side. Berbesque et al. reported asymmetry in wear among Hazda men (hunter-gatherers of Tanzania), probably due to the use of dentition as tools for working arrows or for tightening of the bow strings. The presence of additional nonuniform stresses in a dental arch may also lead to bilateral asymmetry in wear. The anterior teeth also undergo wear during the process of chewing to guide the jaw into closure. Wear generates a smaller angulation on one side of tooth which is generally preferred for further chewing, thus leading to more wear on that side. The habit of eating with one side creates more wear on that side which viciously deteriorates the tooth conditions.
|Figure 9: A comparison of different grades of wear in the maxillary incisors on the right and left sides|
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|Figure 10: A comparison of different grades of wear in the maxillary canines on the right and left sides|
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|Figure 11: A comparison of different grades of wear in the maxillary premolars on the right and left sides|
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|Figure 12: A comparison of different grades of wear in the maxillary molars on the right and left sides|
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|Figure 13: A comparison of different grades of wear among the mandibular incisors on the right and left sides|
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|Figure 14: A comparison of different grades of wear among the mandibular canines on the right and left sides|
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|Figure 15: A comparison of different grades of wear in the mandibular premolars on the right and left sides|
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|Figure 16: A comparison of different grades of wear in the mandibular molars on the right and left sides|
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|Figure 17: The comparison of different gradients of wear in the maxillary and the mandibular arch|
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In India, most military recruits generally come from the rural areas (even today) who largely depend upon more fibrous and home-made raw food items having calorific values. The consistency and texture of food and the dietary practices greatly influenced the prevalence of dental wear. Agriculture was the major subsistence activity for Indians during the 18th and 19th century also; so a decline in wear frequencies among contemporary individuals compared to ancient populations could be due to the increased consumption of softer food sources which resulted in less angled wear but more caries among them., Caries increased and wear declined with the consumption of softer and more carbohydrate-rich food products in today's world and the present study results has substantiated this generalization.
Dental caries is the localized destruction of susceptible dental hard tissues by the acidic by-products produced from the bacterial fermentation of dietary carbohydrates. Among multi-factorial causes of dental caries, the influences of salivary flow and its composition, intake of dietary sugars, preventive habits like teeth cleansing, exposure to fluoride are the major contributory factors. This process starts with shifts in complex biofilms formed by microbacteria in the oral cavity. Diet plays an important role in the formation of caries. Consumption of a diet rich in meat is associated with the low frequency of dental caries. The adherence of dental plaque on teeth is minimized by the presence of fatty acids in the meat as they have antibacterial properties. Diet which alters the pH of the oral cavity also has an effect on caries. Food products rich in calcium and casein that can help increase urea production alter pH and also inhibit formation of dental caries, thereby reducing plaque formation. Another mechanism responsible for the reduction of dental caries is the increased salivary production which is caused by a diet rich in polyphenols (present in tea and coffee).
The present study results showed comparatively very low incidence of caries [Table 2] that point toward Ajnala subjects' diet consisted of low-cariogenic food intakes. The prevalence and association of dental caries were investigated extensively in various population groups and the frequency of dental pathologies (especially caries) was found to increase with the incorporation of cariogenic food products into modern populations. Palubeeckaite-Miliauskiene et al. examined the skeletal remains of military recruits of Great Army of Napoleon killed during 1812 and found that 11% of 3269 soldiers had dental caries in their dental remains. Miliauskiene and Jankauskas also studied the caries in 6528 teeth of Napoleon's Lithuanian 14 (1812) and German soldiers (1915–1917) skeletons and reported very less caries frequency (11.50%) in overall, and these results were similar to the present study observations. Saunders et al. studied 18th century skeletal remains from St. Thomas' Anglican Church in Belleville, (Ontario) and from an examination of 4605 teeth, it was reported that 31.1% teeth were carious; maxillary teeth had more caries (37.8%) than the mandibular one (25.7%). No sexual differences were found in the prevalence of caries as both sexes had almost similar caries prevalence.. However, Wasterlain et al., found sexual differences in the incidence of caries in the maxillary teeth only.
The frequency of dental caries gives us an insight about the diet consumed by the individual as well as their oral hygiene practices. As the dental procedures like restorations were less frequent or did not exist at all in ancient times, the epidemiology of dental caries can be better studied in its original form from the ancient skeletal remains. Association between the age of an individual and the incidence of dental caries has been widely studied in the literature which mentioned that younger individuals have comparatively lesser incidences of dental caries than the older ones. Low levels of dental caries in the Ajnala dental remains implied that the inhabitants were young and healthy at the time of death, thus probably the victims had military affiliations. In the 19th and 20th centuries, with the introduction of refined sugars, caries shifted from a preferentially cervical location to the occlusal location. However, no such observations were noticed for Ajnala dental remains, since these remains reportedly belonged to the young adult army recruits who died around the middle of the 19th century.
The present study results show that posterior teeth are more frequently affected by dental caries as compared to the anterior teeth, and these observations have been supported by several previous studies. The plaque in the posterior teeth can easily get accommodated in the pits and fissures of teeth, making them more retentive as they are less affected by cleansing actions of the tongue, cheeks, and the salivary flow. First molars are usually more frequently affected by the caries than other molars, possibly due to its early eruption, its broad occlusal surfaces, and also the high masticatory pressures it is subjected to., Previous studies have reported that the frequency of caries increases as one move posteriorly in the arch, i.e., molars have the highest frequency of caries (25.3%) as compared to anterior teeth which have a frequency of 1.1% only.,, Corbett and Moore stated that the intake of sugar and other processed carbohydrates rose at the end of the 19th century that might have exaggerated the caries prevalence and distribution. Low dental caries in the present study mid-19th century teeth indicate that the victims might had fibrous diet, consumed less sugary food, and had good dental hygiene practices relative to present day populations. The occurrence of dental caries has been reported to be lower in ancient teeth than the contemporary populations.,
In the present study sample, the occlusal and interproximal surfaces were mostly affected by caries and 70% of caries had affected the enamel tissues. Equally affected mesial and distal surfaces were having caries. In the 19th and 20th centuries, with the introduction of refined sugars, caries shifted from a preferentially cervical location to the occlusal location. However, no such observations were noticed for Ajnala dental remains, since these remains were relatively modern and belonged to the young adult army recruits who died around the middle of the 19th century. The dental health of the present study samples indicated toward their simple dietary status having no complex carbohydrates. Extrinsic stains on certain tooth surfaces were mostly nonmetallic in character and such stains often found in individuals who chew betel nuts or “guttaka.” Low levels of dental caries in Ajnala dental remain reflected that the inhabitants might had been young and healthy at the time of their death.
In this study, we observed that the prevalence of caries is quite low. This fact can be attributed to various reasons. First, the diet consumed by the individuals was fibrous and low in carbohydrate content. The low content of sugars in the diet is directly related to the low incidence of carious lesions. Another conclusion which can be drawn is that, as the individuals who were buried were army professionals, there was a strict recruitment criteria and oral hygiene was an important factor which was considered in the recruitment process. Even after recruitment the individuals laid emphasis on oral hygiene on a daily basis. Good oral hygiene decreases the amount of plaque in the pit and fissures and other retentive sites, thereby decreasing the overall bacterial load in the oral cavity.
The authors are highly thankful to Ms. Deeksha Sankhyan and Ms. Monika, the PhD Scholars with the 1st author (JS), for helping in segregation, cleaning and identification of the studied teeth and jaw fragments from the Ajnala skeletal assemblage. Dr. Manjit Talwar, Associate Professor, Oral Health Centre, GMCH-32, Chandigarh, helped us in classification of the segregated teeth to upper and lower and right and left jaws. Authors are deeply indebted to the anonymous reviewers for helping us in improvement of the scientific quality of this manuscript.
Financial support and sponsorship
The financial support provided by Science and Engineering Research Board (SERB), Department of Science and Technology (DST), Govt. of India, New Delhi, in the form of 'Core Research Grant' (Animal Sciences) vide Grant No SERB/F/4790/2018-2019, helped in conceptualization, experimentation and designing of present study.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16], [Figure 17]
[Table 1], [Table 2]