Author's School

Graduate School of Arts & Sciences

Author's Department/Program



English (en)

Date of Award

Spring 4-28-2014

Degree Type


Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Erik Trinkaus


Systematic paleopathology research on the Late Pleistocene can provide a new perspective on the health, demographics and lifestyle of Paleolithic peoples; however oral pathologies, which can reveal both health and diet, have rarely been discussed beyond individual diagnoses. This project sampled Late Pleistocene humans from across Western Eurasia and collected data on dental and alveolar health, focusing on caries, periapical lesions, periodontal disease, and antemortem tooth loss. This research presents a number of new findings as well as reaffirming temporal patterns identified through other research lines (e.g., developmental stress and trauma), suggesting Early Upper Paleolithic peoples were healthier than the preceding Neandertals, but health declined around the Last Glacial Maximum in response to environmental degradation.

Caries prevalences are higher than any previous publication had estimated and reached an individual prevalence of over a quarter of the sample by the Late Upper Paleolithic; however, severe carious lesions and multiple affected teeth in one individual remain rare. Caries also pattern latitudinally with more caries along the Mediterranean, though this cline eases over time. This suggests that subsistence patterns varied regionally, but also shifted over time with the introduction of increased dietary carbohydrates well in advance of agriculture. Periapical lesions increased with age, but did not pattern over time or geography.

Periodontal disease was extensive in the Late Pleistocene. Early Upper Paleolithic modern humans have a slight decrease in disease severity relative to Neandertals, but the overall pattern of the Late Pleistocene is one of high morbidity. Periodontal disease also increases through the aging process, with all elderly individuals exhibiting at least mild alveolar resorption.

Neandertals have more tooth loss than Early Upper Paleolithic humans, suggesting comparisons between Neandertals and recent humans for this trait have produced dichotomies unrepresentative of the Upper Paleolithic transition. Tooth loss then increased again in the Late Upper Paleolithic, though this may represent a relaxing of tooth-loss related mortality.

All the pathologies except caries are correlated with one another suggesting age as approximated by dental wear and periodontal disease produce more tooth loss than caries. Subsistence shifts that occurred in response to cultural and environmental change produced differential health for Late Pleistocene groups, and oral disease was more common than previously thought.


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