Sex differentials in caries frequencies in Medieval London

Tooth decay is one of the most common oral infections observed in skeletal assemblages. Sex differentials in caries frequency are commonly examined, with most studies finding that females tend to have a higher frequency of carious lesions (caries) compared to males. Less research has examined differences in caries between males and females with respect to age in past populations. Findings from living populations indicate that caries frequencies are higher in females, at least in part, because of the effects of estrogen and pregnancy. We are interested in the interaction of age, sex, and caries in medieval London, during a period of repeated famines, which might have exacerbated underlying biological causes of caries sex differentials.

We examined caries in adults from two medieval London cemeteries dating to c. 1120-1539 AD: St. Mary Spital (n=291) and St. Mary Graces (n=80) to test the hypothesis that males and females have different caries frequencies irrespective of age. The association between maxillary molar caries and sex was tested using hierarchical log-linear analysis to control for the effects of age on caries frequencies.

The results indicate a higher frequency of maxillary molar caries in females (P<0.00), and that the age distribution of caries differs between the sexes (P=0.01), with a consistent increase in frequency with age for females until late adulthood, but not males.

The difference in caries frequencies is not explained by differences in the age distributions of the sexes. Differences in the age patterns of caries for males and females could be the result of biological factors that present during reproductive age, differences in diet, or differential access to resources during famine.