Dental caries and antemortem tooth loss in the Northern Peten area Mexico A biocultural perspective on social status differences among the Classic Maya.код для вставкиСкачать
AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 122:1–10 (2003) Dental Caries and Antemortem Tooth Loss in the Northern Peten Area, Mexico: A Biocultural Perspective on Social Status Differences Among the Classic Maya Andrea Cucina,1* and Vera Tiesler1 Facultad de Ciencias Antropológicas, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico KEY WORDS dental anthropology; subsistence patterns; social strata; Classic Maya ABSTRACT Dental caries and antemortem tooth loss (AMTL) are investigated in a Classic Maya sample obtained from the sites of Calakmul, Dzibanché, and Kohunlich (Mexico). This study aims at assessing the effect that sex and social status had on the prevalence of oral pathologies. The lack of a direct relationship between caries, AMTL, and age-at-death led us to interpret the results in terms of the biological, socioeconomic, and behavioral conditions prevailing in these ancient Maya settlements. Beneﬁts related to sex and social status are evident in the frequency of carious lesions, which appear less frequently in elite males than in low-status individuals of both sexes and in elite females. Individuals from problematic mortuary contexts and isolated bone assemblages, who could not be ascribed to any status group, showed the highest rates of caries. Sex discrimination in dietary preferences appears in the elite sample, while the homogeneity encoun- tered between sexes in the low-status segment suggests a more uniform access to resources. Tooth loss clearly distinguishes elite individuals from commoners, regardless of sex, with the former bearing a much higher rate of loss. In individuals from the undeﬁned mortuary assemblages and sacriﬁcial contexts, it was even more pronounced than in the other groups, although its interpretation is problematic due to a lack of associated funerary data. The overall evidence from oral pathologies is interpreted to be the result of deﬁcient oral hygiene coupled with a softer and more reﬁned diet in the high-status population, particularly males. Whereas elite males’ subsistence was apparently based more on animal proteins and relatively soft and reﬁned foods, a diet relying on carbohydrates may account for the observed rate of oral pathologies in elite females and commoners. Am J Phys Anthropol 122:1–10, 2003. © 2003 Wiley-Liss, Inc. One of the features that characterized Lowland Maya civilization during the Classic period (A.D. 250 –900) was its marked social stratiﬁcation, with a few related families ruling over a large population living in the regional centers and their sustaining hinterland (Chase and Chase, 1992; Sharer, 1994). Power in the apical spheres of ancient Maya society was accompanied by a set of privileges and a characteristic lifestyle enjoyed only by the elite. From this point of view, the imposing palaces and monumental temple structures at Maya sites remain as architectural witnesses not only of culture and wealth, but also of the marked hegemonic social structure and authority of Classic Maya rulers. Likewise, the ever-growing corpus of inscriptions and the iconographic record reinforce the image of an elite exclusive social standing and way of life (Coe, 1992). We argue here that the distinctive lifestyles, which developed within the social structure during the Classic period, were accompanied by differential distribution of resources and access to food supply between and within social strata, similar to what has been observed in other human archaeological settings (Powell, 1988; Larsen, 1997; Goodman, 1998). We propose that the privileges enjoyed at the upper end of Maya society, coupled with general differences in lifestyle, are inevitably mirrored by divergent patterns of manifestations of nutritional and pathological conditions. Like other precontact Mesoamerican areas, the Lowland Maya population was characterized by its strong dependence on maize and other tropical crops, which made up a large portion of the diet (Wright and White, 1996; Saul and Saul, 1997; White, 1997, 1999; Wright, 1997; Whittington, 1999). Nonetheless, studies on caries and stable isotopes indicate a high level of heterogeneity in plant consumption both between and within sites (Sanders and Price, 1968; Gerry and Krueger, 1997; White, 1999; Whittington, 1999), when investigated in terms of sex and social stratiﬁcation. The available evidence provides divergent results on diet and © 2003 WILEY-LISS, INC. *Correspondence to: Andrea Cucina, Ph.D., Facultad de Ciencias Antropológicas, Universidad Autónoma de Yucatán, Calle 76 #455 LL 41 y 43, 97000 Mérida, Yucatán, Mexico. E-mail: email@example.com or firstname.lastname@example.org Received 6 February 2002; accepted 10 January 2003. DOI 10.1002/ajpa.10267 2 A. CUCINA AND V. TIESLER dynastic graves and commoners’ residential and burial compounds, thus providing a sample likely to reﬂect the social heterogeneity that characterized Classic Maya society. The skeletal remains and the archaeological information from these sites establish an interesting context for addressing research questions about sex discrimination, social status, and differential access to resources. In this investigation, we evaluate caries and antemortem tooth loss (AMTL) from the three abovementioned sites in relation to social factors. Unfortunately, abscesses and periodontoclasia could not be taken into consideration due to the samples’ poor state of preservation. The results of this investigation are intended to provide new regional, socioecological, and epidemiological insights into the Classic Maya patterns of food access and preferences in relation to social status as well as within the domestic sphere. CARIES AND ANTEMORTEM TOOTH LOSS Fig. 1. Location of three sites. Northern Peten area corresponds to southern part of states of Campeche and Quintana Roo. Southern Peten encompasses northern part of Belize and Guatemala. health between the elite and commoners. For example, in the city of Copán, Honduras, adults from privileged contexts were less affected by caries than were low-status people (Hodges, 1985), indicating a reliance on the less cariogenic animal proteins in the wealthier group. Evidence from Belize site of Lamanai, where reliance on maize was inversely related to social status, supports this pattern (White, 1997). Interestingly, White (1997) found an opposite pattern in the individuals from Pacbitun (Belize). Besides the unquestionable reliance on maize, the somewhat contradictory evidence has not provided conclusive answers about the role played by sex and social status in precontact Lowland Maya populations with regard to preferential access to resources, as mirrored by oral pathologies and health. The present study addresses the issue of social and sex differences in dietary intake in northern Peten. A multisite approach was required due to the limited number of burials from each site, coupled with their poor state of preservation. We investigated the human dental remains from Calakmul, one of the largest regional capitals of the Classic period, and Dzibanché and Kohunlich, two neighboring centers to its northeast (Fig. 1).This area has so far only been marginally explored in terms of paleodiet, especially when compared to Belize, Honduras, and Guatemala, as can be inferred from Buikstra (1997) and Danforth et al. (1997). During the last 20 years, the excavations of these settlements brought to light ceremonial centers with noble and The pathogenic process of caries results from an acid demineralization of enamel and dentine caused by fermentation of carbohydrates by bacteria from the genus Streptococcus (White, 1975; James, 1975; Kamp et al., 1983), a process initiated particularly in the presence of sugars. Many intrinsic and extrinsic conditions such as mouth pH, dental hygiene, and food preparation techniques are important causative factors in the etiology of caries (Silverstone et al., 1981). Likewise, changes in dietary patterns, with the shift to agriculture as a primary subsistence source in past societies, are associated with an increase in the rate of dental caries. In his study on the Jomon people, Turner (1979) ranked the rate of cavities by tooth according to population subsistence economy, and found low rates in foragers (1–2%), medium rates in mixed economies (around 5%), and high rates in agricultural economies (8 –9%). However, much variability occurs between populations that share the same kind of subsistence pattern (Larsen, 1997). Once caries penetrates the pulpal chamber, bacteria enter the systemic circulation, causing inﬂammatory responses that may eventually result in the loss of the tooth during the individual’s lifetime. AMTL can also occur after a chronic, severe case of gingival inﬂammation that extends to the alveolar bone underneath the gum (periodontal disease), causing its retraction and eventual loss of the tooth (Hillson, 1996). In addition, tooth loss can be produced as a consequence of continuous eruption, a natural physiological process related to the need for the maintenance of biting capacity in heavily worn teeth. Its differential etiology in archaeological samples has yet to be fully understood (Larsen, 1997). In anthropological studies, tooth loss, caries, abscesses, and periodontoclasia have been recognized as useful tools in the assessment of general oral health (Costa, 1980; Keene, 1981; Lukacs et al., 1985; Lukacs, 1989; Larsen et al., 1991; Hillson, 3 ORAL PATHOLOGIES IN NORTHERN PETEN CLASSIC MAYA TABLE 1. Sample composition by site, age at death, sex, and social status Low High Uncertain context M F n.d.1 M F n.d. M F Calakmul 18–20 25–30 35–45 40–50 40–50 45–55 18–20 35–45 50⫹ Adult Adult Adult 30–35 30–40 30–40 30–40 35–45 35–40 40–45 50–55 50–60 Adult 20–25 45–55 50–55 Adult 25–35 40–50 Adult 18–20 18–20 20–25 20–30 30–35 35–45 40–50 Adult Dzibanché 35–45 50–60 Adult 30–40 50–60 35–45 35–45 Kohunlich 20–25 25–30 30–40 30–40 45–55 Adult 1 25–35 25–30 30–40 35–45 45–55 45–55 45–55 Adult Adult 18–20 n.d. 25–30 Adult n.d., not determined. 2000). Thus, the combined analysis of caries rates and AMTL provides insight about diet and dental disease in past populations, and can provide evidence of the series of biological, socioeconomic, and behavioral factors that are involved in oral pathology. MATERIALS AND METHODS The sample evaluated for this analysis comes from the northern Peten urban sites of Calakmul, Dzibanché, and Kohunlich. The ancient city of Calakmul lies in the southern part of what is now the Mexican state of Campeche, at the northern fringes of the central Maya Lowlands (Folan et al., 1995). The neighboring centers of Dzibanché and Kohunlich are located to the northeast, in the state of Quintana Roo. All human remains analyzed for this study are from the Classic period (A.D. 250 –900). Samples were grouped based on cultural, archaeological, and ecological evidence. The three settlements developed in a seasonal tropical rain forest with a moderately high canopy, bajos (seasonal wetlands), and interspersed open spaces, where areas of fertile soil were cultivated. The richness in ﬂora and fauna provided an abundant source of food, clothing, and medicine (Sharer, 1994). The similar ecological conditions indicate that the three sites had access to the same kinds of resources. Kohunlich was an active center, involved in trade activities that forged close relationships with Dzibanché, a tie revealed by architectural similarities (Nalda and Velázquez Morlet, 1994). Martin and Grube (2000) reported that Dzibanché was politically dependent on Calakmul. Notwithstanding all the similarities, the three collections were combined only after a Mann-Whitney test on caries and AMTL between samples was conﬁrmed to be nonsigniﬁcant (P ⬎ 0.1 for both high and low status). Individuals from isolated mortuary assemblages had been previously excluded from the test because of uncertain provenience and their low sample size at Dzibanché and Kohunlich (one individual each). Forty-nine adult individuals form the sample (Table 1). Nineteen individuals were ascribed to the elite category, and the other 30 were identiﬁed as low-status individuals. Social status was inferred from funerary architecture, along with the placing, quantity, and quality of grave goods, following the status markers proposed for the lowland Maya burials by Krejci and Culbert (1994) and adapted by Tiesler (1999). Final scores ranged from 0 (no status markers, no grave goods) to 5 (more than six status markers and likely to be dynastic burials), and were broadly grouped into two main categories: one considered “nondistinctive” or “commoners” (0 and 1), and the other being “privileged” (2–5). The ratio between commoners and privileged individuals is consistent with the data from other regional samples (Tiesler, 1999). Thirteen additional individuals (for a total of 62 individuals) were retrieved from a wide range of contexts (caches, problematic deposits, or isolated assemblages) that were not assignable in terms of status. Unfortunately, the geography of origin and the social level of these often incomplete skeletons are uncertain, which precludes their assignment to any speciﬁc category. Sex was identiﬁed on macroscopic skeletal determination, which relied on gross morphological parameters of dimorphism from the pelvis, femur, cranium, and mandible (Buikstra and Ubelaker, 1994), complemented by metric discrimination of single and multiple variables adapted from a regional Maya sample (Tiesler, 1999). The assessment of ageat-death in the adult segment of the population was 4 A. CUCINA AND V. TIESLER TABLE 2A. Number of teeth affected by caries, number of caries-free teeth, and frequency of caries by dental arcade, according to sex and social status Maxilla Total Caries-free % N1 Caries Caries-free % N Caries Caries-free % N 6 10 0 44 111 96 12.0 8.3 0.0 5 13 13 5 8 3 51 156 115 8.9 4.9 2.5 5 15 12 11 18 3 95 267 211 10.4 6.3 1.4 5 15 13 3 5 4 49 88 42 5.8 5.4 8.7 8 11 4 4 7 4 55 75 41 6.8 8.5 8.9 8 11 5 7 12 8 104 163 83 6.3 6.9 8.8 8 11 5 9 15 5 93 220 148 8.8 6.4 3.3 13 28 18 9 13 8 106 252 167 7.8 4.9 4.6 13 29 18 18 30 13 199 472 315 8.3 6.0 4.0 13 30 19 Males Uncertain context Low High Females Uncertain context Low High Sexes pooled Uncertain context Low High 1 Mandible Caries N, number of individuals analyzed. TABLE 2B. Number of teeth affected by caries, number of caries-free teeth, and frequency of caries by tooth type, according to sex and social status High Males Incisors Canines Premolars Molars Females Incisors Canines Premolars Molars Sexes pooled Incisors Canines Premolars Molars Low Uncertain context Caries Caries-free % Caries Caries-free % Caries Caries-free % 0 0 0 3 54 32 53 72 0.0 0.0 0.0 4.0 1 1 7 9 59 38 76 94 1.7 2.6 8.4 8.7 2 1 4 4 23 10 27 35 18.0 9.1 12.9 10.3 2 2 2 2 17 14 26 26 10.5 12.5 7.1 7.1 5 1 2 4 48 21 47 47 9.4 4.5 4.1 7.8 0 2 0 5 30 17 34 23 0.0 10.5 0.0 17.9 2 4 2 5 78 48 85 104 2.5 7.7 2.3 4.6 6 2 9 13 123 66 135 148 4.7 2.9 6.3 8.1 2 3 4 9 53 27 61 58 3.6 10.0 6.2 13.4 based on the macroscopic modiﬁcation of the pubic symphysis, auricular, and rib sternal surfaces (Meindl et al., 1985; Iscan and Loth, 1986; Katz and Suchey, 1986; Brooks and Suchey, 1990), along with the degree of dental wear and the general presence of skeletal degenerative disease. Dental wear was not a factor in evaluating the presence of caries and, as discussed below, was not considered a causative factor in the frequency of AMTL. The overall rate of occlusal surface wear is low, particularly in the high-status group (Tiesler, 1999, 2000), which is expected in populations relying on agriculture and processed food (Molnar, 1972; Larsen, 1997; Rose and Ungar, 1998; Kaifu, 1999). Carious lesions were scored on all permanent teeth and were registered as present when the cavity had invaded the dentine, corresponding to category 2 by Schultz (1988). This level indicates lesions that are at least 2 mm wide and reach the dentine. This way, enamel pits that could possibly be confused with early stages of caries were automatically excluded from the count. In all, 830 permanent teeth were analyzed from the high- and low-status groups, in addition to 217 teeth of unknown context (Table 2). Data on AMTL were collected from alveolar bone. A tooth was considered present when its corresponding tooth socket was present, while it was considered absent (AMTL) when its alveolar bone was clearly resorbed up to complete closure of the socket. Loose teeth that were not represented by their corresponding sockets were not considered in the count of AMTL. The available tooth sockets equaled 344, plus 82 resorbed ones (Table 3a). The problematic group comprised 68 sockets and 45 lost teeth (Table 3a). RESULTS Due to the state of preservation of the samples, caries and AMTL were scored by tooth rather than by individuals. Frequencies are listed correspondingly for both oral pathologies in Tables 2a and 3b. The prevalence of caries by dental arcade, sex, and social status appears in Table 2a, while frequencies by tooth type, sex, and status are reported in Table 2b. Results on AMTL are organized similarly in Table 3a,b. The overall prevalence of caries ranges between 1.4% in high-status males to 8.8% in highstatus females. The prevalence in unknown status individuals is consistently between 6.3–10.4%. The 5 ORAL PATHOLOGIES IN NORTHERN PETEN CLASSIC MAYA TABLE 3A. Composition of sample represented as number of sockets, and frequency of AMTL, according to sex and social status Males Sexes pooled Sockets % N1 AMTL Sockets % N AMTL Sockets % N 21 37 22 41 156 70 33.9 19.2 23.9 4 14 7 24 10 13 27 93 25 47.1 9.7 34.2 3 8 4 45 47 35 68 249 95 39.5 15.9 26.9 7 23 11 Uncertain context Low High 1 Females AMTL N, number of individuals analyzed. TABLE 3B. Number of sockets by tooth type and frequency of AMTL, according to sex and social status High Males Incisors Canines Premolars Molars Females Incisors Canines Premolars Molars Sexes pooled Incisors Canines Premolars Molars Low Sockets % AMTL AMTL Sockets % AMTL AMTL Sockets % AMTL 9 1 4 8 15 9 23 23 37.5 10.0 14.8 25.8 11 2 8 16 42 21 41 52 20.8 8.7 16.3 23.5 8 1 3 9 8 4 13 16 50.0 20.0 18.8 36.0 1 0 2 10 10 5 6 4 9.1 0.0 25.0 71.4 0 0 2 8 26 11 23 33 0.0 0.0 8.0 19.5 7 1 6 10 6 4 8 9 53.8 20.0 42.9 52.6 10 1 6 18 25 14 29 27 28.6 6.7 17.1 40.0 11 2 10 24 69 32 64 85 13.8 5.9 13.5 22.0 15 2 9 19 14 8 21 25 51.7 20.0 30.0 43.2 TABLE 4. Correlation values between age at death and respectively caries and AMTL for each social group, and t-test P values for distribution of individual age at death between social groups* Social Status Caries age AMTL age 0.289 0.312 0.196 0.513 0.210 0.537 Correlation Low High Unknown t-test High-Low Low-Unknown High-Unknown * Unknown AMTL 0.497 0.198 0.094 Level of signiﬁcance: P ⱕ 0.05. percent values of caries in the female samples indicate the highest prevalence in high-status individuals. The opposite tendency is noted among males, whose prevalence of caries rises from high- to lowstatus individuals, and even more to the unknown sample. When sexes are pooled, the low-status group reveals more caries than the high-status group, with individuals from nonassigned contexts constantly surpassing the two others. None of the pairwise Mann-Whitney U tests between males, females, and sex-pooled samples was signiﬁcant in terms of toothtype composition, indicating that frequencies of caries and AMTL are not biased by sampling problems related to differential preservation or recovery of teeth and alveolar bone. Because age-at-death is an indirect factor in oral pathologies, correlation values between age-atdeath and caries and AMTL, respectively, are listed in Table 4, as well as the t-test P-values between groups for age distribution. Neither the correlation nor the t-test indicate signiﬁcant differences. TABLE 5. Level of significance (P values) obtained from chisquare intragroup comparison of caries prevalence according to sex1 Maxilla Mandible Whole dentition Low, males vs. females High, males vs. females 0.582 0.397 0.973 0.017 0.089 0.002 1 Statistically signiﬁcant differences are in bold. Level of signiﬁcance: P ⱕ 0.05. TABLE 6. Level of significance (P values) obtained from chisquare intergroup comparison of caries according to and regardless of sex1 Maxilla Mandible Whole dentition Males, low vs. high Females, low vs. high Sexes pooled, low vs. high 0.011 0.277 0.005 0.702 0.793 0.747 0.262 0.842 0.188 1 Statistically signiﬁcant differences are in bold. Level of signiﬁcance: P ⱕ 0.05. Comparison between sexes within each group indicates no substantial differences in the low-status sample; chi-square probability values are never signiﬁcant (Table 5). On the contrary, the higher rate of caries in high-status females is highly signiﬁcant in the maxilla as well as in the whole dentition when compared to their male counterparts (Table 5). The low prevalence in high-status males also holds up in comparison with low-status males. Differences are highly signiﬁcant in the maxilla and in the whole dentition in men, whereas women from the two subsamples do not show signiﬁcant differences (Table 6 A. CUCINA AND V. TIESLER TABLE 7. Level of significance (P values) obtained from chisquare intergroup and intragroup comparison of AMTL1 Intergroup AMTL Whole dentition Males, low vs. high Females, low vs. high Sexes pooled, low vs. high 0.443 0.001 0.011 Intragroup AMTL Males vs. Females Low High 0.054 0.324 1 Statistically signiﬁcant differences are in bold. Level of signiﬁcance: P ⱕ 0.05. 6). When social-status samples are compared regardless of sex, no signiﬁcant differences are noted. Results differ when AMTL is examined, however (Table 3a,b). Ignoring the group of nonassigned provenienced individuals, which consistently surpasses the two other groups, high-status individuals suffered from a higher rate of dental loss than commoners. The rates of 9.7% and 34.2% in females, respectively, from the lower- and higher-status groups discriminate them at P ⫽ 0.001 (Table 7). Males do not show a signiﬁcant difference. However, a sexpooled comparison between social-status segments is still signiﬁcant (Table 7). Intragroup comparison between sexes does not discriminate either sample, although the reduced loss in the low-status females differs from their male counterparts at an almost signiﬁcant level (P ⫽ 0.054, Table 7). DISCUSSION The observed prevalence of caries and AMTL at Calakmul, Dzibanché, and Kohunlich reveals valuable insights about the population that inhabited the northern Peten area during the Classic Maya period. In particular, this information sheds light on the difference between sexes and social classes in relation to nutritional and behavioral patterns. The present results suggest that higher status does not necessarily mean better oral health, as AMTL indicates a higher prevalence of dental decay in the elite segment when compared to the nonelite for each sex and for pooled sexes. On the other hand, lowerstatus individuals suffered from a higher prevalence of caries when sexes are grouped. These results should not contradict each other, for dental loss is very often the natural consequence of caries. Complete tooth loss follows the erosion of the dental structure by caries or the removal of an affected tooth. For this reason, the relationship between caries and tooth loss must be taken into consideration in the analysis of the present results. Moreover, the lack of correlation between oral pathologies and ageat-death suggests that the underlying causes are to be sought in the different nutritional and behavioral patterns that characterized each segment of the society. Evidence from other Classic Maya sites indicates that animal protein consumption was likely not equivalent between elite and nonelite individuals (Hamblin, 1984; White, 1999; Shawn, 1999). A more diversiﬁed and qualitatively better nutritional intake in the upper social segment was noted by Lentz (1991) and Storey (1999) for Late Classic Copán. The settlement’s high-status individuals are thought to have beneﬁted from a more diversiﬁed diet that relied less on carbohydrates and more on meat, a condition that supposedly led to a lower prevalence of caries, similar to the tendencies reported in the literature on caries related to consumption of meat in the shift from hunting to farming (for a review, see Larsen, 1997). Along with daily eating habits, food consumption during ritual events must have inﬂuenced the overall nutritional intake of commoners and so much the more of the male elite in ancient Maya society. Ritual feasting was practiced on many different occasions, celebrating family and community affairs, commemorating religious and war events, and providing scenes for political transactions and power displays (McAnany, 1995; LeCount, 2001). Although not conﬁned to the elite, it was in the upper end of the society where feasts took the form of exclusive, lavish banquets, hosted and attended mostly by male rulers, nobles, and heads of lineages. On these occasions, prestige goods were exchanged with local and foreign guests, and exquisite meals were offered, including tamales, cacao drinks, and meat (Houston et al., 1989; LeCount, 2001; for references on colonial Yucatan, see de Landa, 1982). Evidence of caries in our samples seems to be consistent with the data reported in the literature, particularly for high-status males. Within the upper class, the lower frequency of caries encountered in males in comparison with females indicates that the former had access to less cariogenic food. This is indicative of the fact that preferential access to food and resources was a factor, not just between classes, but also between sexes within the elite itself. Highstatus males seem to be the ones who enjoyed better attention and care in terms of food and resources, in particular in the Maya society based on warfare against surrounding states and on the expression of political power and strength (Roys, 1972; Schele and Miller, 1986). As in other highly ranked societies with clearly deﬁned gender roles, the males’ position was predominant, while the females’ role was publicly less important and more restricted within household boundaries (Harris, 1993; Crown and Fish, 1996; McAnany and Plank, 2001). In terms of food, sex discrimination in animal protein consumption within the high-status group may have resulted in the tendency toward oral pathologies we encountered. Interestingly, the difference between elite males and females is highly signiﬁcant, while, on the contrary, no signiﬁcant discrimination between sexes in terms of caries and AMTL is evident in the lowstatus segment. Moreover, females from high and low classes do not reveal signiﬁcant differences in ORAL PATHOLOGIES IN NORTHERN PETEN CLASSIC MAYA terms of caries frequency, which could be interpreted as the result of a more similar exposure to cariogenic foods. The higher frequency of caries in the high-class females from the northern Peten sites, compared to high-status males, could reﬂect their higher consumption of carbohydrates. On the contrary, low-status females do not differ signiﬁcantly from their male counterparts, which would indicate that the extent of carbohydrate consumption in the low class was not particularly different between sexes. Similarly to our ﬁndings, sex, as well as status differences, was associated with different food intake also at Copán, where elite males were signiﬁcantly taller than their low-status counterparts, and were likely better nourished than elite females (Storey, 1999). Whittington (1999) encountered a more carbohydrate-dependent diet in lowstatus females than in low-status males at Copán, which explained the signiﬁcantly higher rate of caries in the former, although his studies did not consider high-status individuals or compare social strata (Whittington and Reed, 1997; Whittington, 1999). A potential explanation for our observations can be drawn from Larsen et al. (1991), who discussed the high frequency of caries in females as due to behavioral and cultural patterns not directly related to the kinds of food consumed. According to those authors, women who are restricted to household activities tend to eat more frequently during the day, while preparing the food for the family or performing their daily household activities. In turn, males, who leave the house to engage in ﬁeld labor, eat the same kind of food in more restricted schedules than their spouses, thus reducing the possibility for food residuals to remain in the mouth, and consequently shortening the time of exposure to bacterial reactions (Larsen et al., 1991; Hillson, 1996). Following the above tendencies, the frequency of caries scored in the sample from the northern Peten reveals two different scenarios. One involves highstatus females, who were likely discriminated in access to food or food choice and were probably restricted to more sedentary activities. The scheme seemingly ﬁts the discussion by Larsen et al. (1991) and conforms to nutritional models already introduced by previous studies on ancient Maya populations (White, 1997, 1999; Whittington, 1999). The second scenario concerns low-status individuals. The homogeneity in oral pathologies seen between sexes is suggestive of the limited ranking within this segment of the society. It is possible that in the sample of commoners from northern Peten, the intake of carbohydrates was high enough to take over different daily habits between sexes and produce a rate of oral pathologies that is statistically equivalent between the sexes. Maya society was ranked, and two diverging schools of thought debate the internal stratiﬁcation of elite and nonelite. One states that both classes were internally ranked, and the second contends 7 that ranking occurred in the elite only (Sharer, 1994). The evidence encountered from the analysis of oral pathologies would suggest that ranking occurred in the elite group in the form of sexual discrimination, while the commoners’ group was not structured in a ranked system, thereby supporting the second argument. Notwithstanding other possible explanations, several factors contribute to these results, among which is the relatively small sample size that induces us to interpret the results with caution. The subsistence economy of the low-status group that is seemingly higher in carbohydrates, as likely reﬂected by the higher rate of caries, should also be supported by subsequent tooth loss. Instead, AMTL does not seem to be consistent with what was expected. Male and female members of the elite segment show a greater prevalence of tooth loss when compared to nonelites. If intake of cariogenic food can be claimed to be a plausible direct causative factor in the prevalence of tooth loss, at least in some groups, a simple linear association between caries and tooth loss cannot be equally applied to all groups. Given that the interaction among all factors involved in the expression of oral disease is very complex (Hillson, 2000), and that inter- and intragroup variability cannot be assessed in detail on the basis of oral pathologies only, the similarities and differences encountered between and within status groups in the rate of cavities and tooth loss in northern Peten seem to be due to a wide array of synergistic pathological, behavioral, nutritional, socioeconomic, and cultural factors. Age, calculus, gingival inﬂammation, and periodontitis play important roles in dental decay (Hillson, 1996; Larsen, 1997). The analysis of demographic proﬁles of whole populations or subgroups can shed light on the extent of caries and AMTL afﬂiction in a population. Whittington (1999) noted that tooth loss in low-status individuals in Copán was not equivalent to caries, and argued that dental loss was related to dental decay in younger individuals and to age in older ones. When the age factor is correlated with tooth loss in Calakmul, Dzibanché, and Kohunlich, it does not seem to signiﬁcantly discriminate between social segments and account for the differences encountered between them. Caries and AMTL never show signiﬁcant correlations with age-at-death, as Table 4 indicates. The fragmentary state of the remains should not bias the evidence of caries and AMTL, for every subsample underwent the same extent of taphonomic alteration. But when a between-groups t-test was performed on the demographic proﬁle of each subsample, no signiﬁcant difference was encountered (Table 4), further indicating that age-atdeath in this sample was not a major causative factor in the rate of dental disease. Dental wear does not seem to provide a possible explanation for the rate of AMTL encountered in the sample, particularly in the elite group. Tiesler (1999, 2000) noted that nobles from the three sites 8 A. CUCINA AND V. TIESLER from northern Peten, as from other Classic sites, averaged an even lower attritional rate than the already low rate observed in the commoners’ group. In particular, she noted that the four high-status individuals unearthed from Structure II at Calakmul, all falling into the 35–50-year age class, were characterized by a wear barely reaching the dentine. This is indeed consistent with a very soft, reﬁned diet where animal proteins represented a major constituent along with soft tamale maize cakes, chocolate beverages, and atole soups (Houston et al., 1989). The overall low rate of occlusal wear also indicates that the commoners’ diet was not highly abrasive, despite the grinding and consumption of maize. A soft diet could have reduced the effects that bite forces and grinding have on the alveolar bone, possibly leading to periodontal disease and eventual tooth loss (Corruccini and Whitley, 1981; Corruccini, 1991; Strohm and Alt, 1998). In turn, other factors such as malocclusion do not produce periodontitis, but rather accelerate a process already in progress (Strohm and Alt, 1998). The fragmentary state of the remains in this study does not allow us to assess to what extent malocclusion and bite forces can be related to AMTL. Even though we cannot rule out masticatory forces as possible causative factors determining the rate of AMTL in high-status individuals, it seems plausible that they were not the main factor involved. Since the high rate of AMTL in the elites does not seem to be explained in terms of economy (food diversiﬁcation) and culture (food preparing) alone, it might relate to behavioral and hygiene conditions, the more so since high-status individuals in northern Peten did show very extensive calculus (Cucina and Tiesler, 2003). This indicates that oral hygiene was not likely a major concern within the elite segment. Hillson (1996) reported that gingival inﬂammation, when observed in more advanced and acute stages (periodontal disease), leads to bone resorption and eventually to tooth loss. Inﬂammation results from bacterial plaque that proliferates in exposed areas on the crown and root. When bacterial plaque mineralizes, it leads to the formation of dental calculus (Scheie, 1989). The etiology of periodontal disease is very problematic and multifactorial, but insufﬁcient oral hygiene that removes dental plaque is the basis of future dental loss (Hillson, 1996). Extensive calculus might have caused gingival inﬂammation and periodontal disease of the underlying bone tissues, causing a progressive deterioration of the alveolar region and subsequent loss of the tooth (Hillson, 1996; Larsen, 1997). It is probably the lack of basic oral hygiene habits, along with a softer, less abrasive diet, that accounted for the high rate of AMTL among the elites. CONCLUSIONS In light of the many direct and indirect factors contributing to the formation of caries and AMTL, we infer lifestyle and life conditions according to sex and status in the northern Peten area during the Maya Classic period. Social status is closely associated with differential access to food and other resources. A more reﬁned diet likely characterized the elite individuals, as well as sexual discrimination in the choices and access to food. Males were the ones who mostly beneﬁted from their social position. In contrast, high-status females were seemingly more restricted in access to food, and tended to closely resemble low-status individuals, at least in terms of caries frequencies. The reduced amount of caries in elite males, as a consequence of a ﬁner, more sophisticated, and diversiﬁed diet, is consistent with what was reported by Lentz (1991) and Storey (1999). Regarding the female elite segment, the small sample and the lack of chemical evidence imply a need for further investigations. On the contrary, the nonelite group is very homogeneous in the frequency of oral pathologies. Interestingly, no signiﬁcant sex differences are noted. This, along with the very high frequency of caries, may be suggestive of a diet in which maize strongly predominated to such an extent that possible differences between sexes due to normal daily activities are not noted (Larsen et al., 1991). It may also indicate a more even distribution of resources and less ranking within this group. The higher frequency of AMTL in the elite segment could be attributed to periodontal inﬂammation and gingivitis, as witnessed by the extensive tartar observed. Dental calculus could be interpreted as the combined consequence of behavioral habits, such as lack of oral hygiene, and a less abrasive diet. Finally, the group of individuals recovered from uncertain funerary or extrafunerary contexts warrants a separate discussion. Their identity and provenance are still unknown, which makes it impossible to place them in either of the two groups. Moreover, they were recovered in public areas not related to any residential compound, thus limiting any inference on their living spaces. Their mean age at death is signiﬁcantly younger than that of the two other segments, but their rate of caries and tooth loss always exceeds the others. Such high levels of oral pathologies, along with their younger age, may trigger the question of whether they represented less healthy, foreign, or fringe society members who did not deserve to receive common funerary treatments. Until a clear archaeological and anthropological definition of their status is available, any assessment of their identity, more than suggesting that they did not seem to belong to the local elite group, is impossible. Our general conclusions on nutrition and food choice, as evidenced by oral pathologies, conﬁrm the recent statement of White (1999). As that author contends, diet furnishes an important source of complementary information, helping us to understand the complexity of ancient populations. More than the differences in food intake, it is the large and ORAL PATHOLOGIES IN NORTHERN PETEN CLASSIC MAYA entangled array of features and pathological manifestations that denotes differential access to food and divergent lifestyles and privileges. ACKNOWLEDGMENTS The skeletal materials were studied originally by V.T. as part of a doctoral dissertation in anthropology. We thank William Folan (Proyecto Calakmul, UAC), Enrique Nalda, Luz Evelia Campaña, Adriana Velázquez (Proyecto Sureste de Quintana Roo, INAH), and Ramón Carrasco (Proyecto Arqueológico Calakmul, INAH) for their kind collaboration during the evaluation of skeletal collections from their respective ﬁeld sites. We thank D.L. 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