The 82nd Annual Meeting of the American Association of Physical Anthropologists (2013)

A comparison of visual and radiographic methods for detecting oral pathology in a skeletal sample from Ban Non Wat, Thailand


Department of Anatomy, University of Otago

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Traditionally, the diagnosis of oral diseases in bioarchaeology has relied solely on visual examination. This may result in an underestimation of dental disease occurrence because some oral lesions are undetectable macroscopically. Radiography is commonly used in clinical and epidemiological studies of oral disease, particularly dental caries, but few bioarchaeological studies employ this method, even though it has the potential to improve detection rates. The purpose of the study is to assess the value of radiography to the study of oral health in archaeological remains by comparing visual and radiographic methods for detecting oral pathology. The dental remains of adults (n=80) from the prehistoric site of Ban Non Wat, Thailand, were examined both visually and radiographically. The permanent teeth and supporting structures were radiographed using a portable dental X-ray system equipped with a digital sensor. Dental caries and periapical cavities were evaluated using standardised radiographic diagnostic criteria and compared with evidence from visual observations. The results show that radiographic examination significantly increased the detection of oral lesions. Specifically, radiographic examination (1) detected dental caries that were either invisible or obscured upon visual inspection, in particular interproximal lesions; (2) showed dental caries lesions may be more extensive than what is observed visually; and, (3) identified periapical lesions, indicative of conditions such as abscesses and granulomata, that would otherwise remain undetected. These results indicate that supplementing visual assessment of oral pathologies with radiography provides a more precise and accurate representation of oral health.

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