An appraisal of the skulls and dentition of ancient Egyptians, highlighting the pathology and speculating on the influence of diet and environment

  • J. Miller
UK: Archaeopress price £29.00; pp 143 ISBN 9781407302829 | ISBN: 978-1-4073-0282-9

This book is a detailed examination of the oral health of the ancient Egyptians from the period of 5000 BC until the time of Christ. Following this meticulous research, a number of conclusions were drawn from the evidence observed.

This ancient population was assessed by an extensive examination of specimens excavated from tombs and tomb paintings principally from the world famous Duckworth Collection in Cambridge and the Department of Paleopathology in the British Museum. The total number of skulls assessed was in excess of 5,000, which must have been a time consuming and dedicated undertaking.

The conclusions drawn from the evidence are very revealing. The incidence of dental coronal caries appears to be relatively low, presumably due to the absence of refined sugars in the diet. However, the presence of unusual amounts of root caries probably indicates that oral hygiene regimes were ill understood and not practised. The amount of abrasion and wear of the teeth is excessive by current standards, often to the extent of causing pulpal exposure. Many of the specimens exhibited a history of periodontal diseases and periapical lesions which are graphically illustrated by photographic evidence of the skulls. Oral malignancies were seemingly rare, but maybe this reflects short life expectancy of the population or the lack of soft tissues to analyse. Whilst it is apparent that there was extensive and severe oral disease, it is surprising that no evidence exists to suggest any technical dental skills and little dentistry performed, although there is some evidence of a sort of 'bridgework' being attempted by wiring teeth together.

The skull examinations also leads to an insight into the diet experienced by the population which varied according to the climatic conditions experienced during those millenniums. For example, many times the Nile Valley was very productive in fruit and other useful crops, whilst during other periods extensive and prolonged periods of drought rendered crop production very difficult, often resulting in famine. The dietary habits were also, and not unsurprisingly, varied according to the social stratus within the population. The better off had access to wine, beer and joints of beef whilst the less affluent had diets highly dependent on various forms of bread made from varying constituents according to what was available, often contaminated with sand which was a substantial contributor to the excessive tooth abrasion. In later years the diet became more stable as the development of the Nile Valley irrigation systems helped to overcome the effects of droughts.

I was particularly fascinated by the chapter on Medical Papyrus revealing the development of medical matters in Ancient Egypt. From translations of papyri there are few references to only 100 medical practitioners, of whom only six held a title of 'dentist'. The most notable was Khuam who was 'Chief of the Dentists' and 'Chief Physician of Lower and Upper Egypt', maybe an ancient CDO and CMO. The medical men relied on hazardous remedies, the authority of the healer and the mutual balance of mind over body. In other words apart from the well documented pharmacological effects of opium for pain relief and quinine for malaria the majority of other cures relied on a placebo effect. Another curious section deals with the vocabulary of dental terms in the papyri, all being translated by an Egyptologist into English.

This book is very well indexed, including a most comprehensive list of references compiled from 175 sources from archaeologists, anthropologists, pathologists, forensic and dentally qualified experts. Additionally the book is very well illustrated with 91 photographs, sadly all in black and white. These would have been better produced in colour, but maybe additional production costs may have prevented this. Many graphs are included and whilst informative and no doubt scientifically sound, a deeper understanding of statistics would be an advantage to pass an informed opinion, and perhaps this aspect of the book is better directed to the serious specialist researcher.

In conclusion, and not withstanding the above comments, the eight written chapters do provide a most readable narrative and insight into exploring the development of agriculture processes on the variation in oral health of what was considered an advance civilisation in its time. The author must be commended on her diligent and extensive research which culminated in a remarkable extensive review of aspects of these ancient communities.