The role of religious faith in dental pathological lesion patterning and approaches to care in a medieval Portuguese assemblage

The European middle ages (c.500–1500 CE) is often seen as a period of poor oral health and hygiene, as evidenced through artistic, textual, or popular media portrayals. Anthropological analyses have the unique potential to illuminate what medieval mouths were actually like through direct examination of dental and skeletal tissues themselves. In doing so, we can not only document the variability of dental diseases, but also how medieval communities responded to them. This study examines dental pathological lesions (caries, antemortem tooth loss, periodontal disease, periapical lesions, and calculus) and tooth wear from skeletal remains recovered from municipal excavations in Santarém, central Portugal. These assemblages comprise multiple faith communities (Muslims and Christians) from the medieval period (7th−13th c. CE), as based on their distinct funerary treatment. As such, the presence of distinct faith communities buried in adjacent graves offers us the opportunity to furnish a comparative approach to see how health and disease (in this case, of the oral cavity) vary by faith community. Results demonstrated that Islamic females exhibited higher frequencies of antemortem tooth loss, caries, and calculus compared to their Islamic male counterparts, while Christian males exhibited higher caries and calculus frequencies compared to Islamic males. Results and patterns of dental pathological lesions are discussed in terms of religious and temporal differences in diet as well as religious differences in oral healthcare and hygiene as evidenced by ethnohistoric documents, with a particular focus on how keeping a clean mouth was both a physical and spiritual act.