Blue Bridge Lane
&
Fishergate House
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The presence of calculus deposits in 63% of the population probably contributed to the development of periodontal disease (49% of individuals with jaws). Periodontal disease is the second stage of gum disease and is one of the few dental diseases which shows a similar prevalence today as in the medieval period (Kerr 1990). Poor dental hygiene, a soft carbohydrate-rich diet, psychological stress, impairment of the immune system, severe attrition, dental trauma and accumulation of bacterial plaque can lead to aggravation of the gums (Hillson 1986, 310-311, Lavigne and Molto 1995, 266) and inflammation of the soft tissues surrounding the teeth (gingivitis). Acute ulcerative gingivitis was particularly common during World War II, and was attributed to poor oral hygiene and high levels of anxiety (Cawson 1991, 114).
Gingivitis may progress eventually to the bone surrounding the teeth (alveolar bone), leading to perpetual low-grade inflammation, the formation of pockets in the bone around the teeth, resorption of the bone, and destruction of the ligaments holding the teeth in place. The effects of periodontitis are largely irreversible (Cawson 1991, 111) and can be observed in skeletons in the form of pitting and loss of bone around the teeth, with exposure of parts of the tooth roots. Eventually, teeth are lost, and according to Shafer et al (1983, 760), periodontitis is responsible for greater ante-mortem tooth loss than cavities with advancing age. Additionally, abscesses may form in the pockets and cause further tooth loss (Cawson 1991). This trend was observed at Fishergate House, where most abscesses (91.7%) were associated with periodontal disease (see below). Once the tooth is lost, the source of irritation, in the form of plaque, is lost with it. This allows remodelling and healing of the socket, which often leaves a smooth area of bone, with no trace of the socket. The largest bone loss tends to occur around the first and second molars (Sagne and Olsson 1977, 50), which was the case at Fishergate House, where 24% of first and 19% of second molars were lost ante-mortem.
Periodontitis was slight in 20% of jaws, moderate in 22% of cases and considerable in 8% of jaws. In the majority of individuals, both jaws were affected to a similar extent. The prevalence of periodontitis rose with advancing age, with the most frequent and severe resorption affecting the mature adults. Periodontitis was observed in three adolescents, who showed slight jaw bone resorption. Pre-pubertal periodontitis is rare and as a general rule, periodontal disease rarely affects people under the age of thirty (Hillson 1986, 308-309). Males and females were affected to the same extent. In this case, calculus was probably the most likely cause of periodontal disease, as 81% of teeth with calculus were associated with periodontitis.
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