< return to index of papers
A RADIOGRAPHIC STUDY OF THE HEAD OF A CHILD
FROM GRECO-ROMAN EGYPT
Dr Pamela J.G. Craig
Unit of Oral Anatomy, Medicine & Surgery
School of Dental Science, The University of Melbourne
In the area of forensic odontology, a routine request occasionally reveals
some unexpected and interesting information. In the case described below a request
to ascertain the age of the mummified head by dental radiographic means revealed
evidence of possible interceptive orthodontic treatment having been carried
out on the child prior to death, and also some evidence which may suggest a
possible cause of death.
The mummified head of the Greco-Roman child belonging to the Australian Institute
of Archaeology was being prepared for exhibition purposes. The provenance of
the specimen was unknown but it is thought to have been purchased in Alexandria
at the turn of the 19th/20th century by London dealer who then sold it to an
Australian representative of the Australian Institute of Archaeology.
An examination of the features of the head reveals the hairstyle to be that
of a Greco-Roman with curly hair cut short. The features are in a remarkably
well preserved state. There are traces of gold leaf remaining around the eyes
suggesting that the face may well have been painted subsequent to the mummification
process. The upper lip has been damaged as has an area on the left cheek. The
vertebrae of the neck are angled forwards indicating that the odontoid peg had
been fractured perimortem or postmortem prior to mummification.
The curators wanted a facial reconstruction made to show the visitors what
the child may have looked like during life. This was to be done by the Forensic
Odontology Unit at the University of Melbourne, Victoria, Australia, but before
beginning, we needed to know the age of the child at death. The easiest way
of determining age of death is to x-ray the skull and examine the developmental
stages of the teeth.
Three plain skull films, an orthopantomogram (OPT) and a computerised tomograph
(CT) scan were taken.
The orthopantomogram (OPT) was the best source of information as to the age
of the child. The stages of development of the first permanent molars, the lower
permanent canines and the lower second permanent molar teeth are at a stage
consistent with that of a child of 8 to 9 years of age when compared with a
contemporary population of children. Several teeth are missing from the dentition
the lower left lateral incisor tooth is missing, as are the first upper
deciduous molars and their permanent counterparts, the first premolars. It would
not be unreasonable to assume that the lower incisor tooth was knocked out perimortem
or during the mummification process. Although this was not an uncommon occurrence,
it is more difficult to explain the loss of the two upper first deciduous molars
given the fact that the first permanent premolars are also missing. There did
not appear to be any bone in the area, indicating that something had been removed
at or close to the time of death.
A lateral cephalogram radiograph provides information about the degree of
crowding of the dentition and enables predictions of growth patterns to be made.
It revealed that the child had an extremely crowded dentition set back somewhat
from the base of the skull. A growth analysis was done which indicated that
had the child grown to adulthood, the facial complex could not have accommodated
all the teeth and the child would not only have looked ugly but the teeth would
not have functioned correctly.
The child suffered from dental decay in the 4 first permanent molars and several
deciduous teeth. The condition of the upper second deciduous molars would indicate
that the teeth were extremely decayed and only fragments remained. There does
not appear to be any wear either on the first permanent molars or the deciduous
Although the stages of dental development were such that one could assume that
the child had been 8 to 9 years of age, data gleaned from a contemporary population
does not necessarily reflect that of an individual growing up in a different
climate and society some 2000 years ago. In fact the various stages of dental
development of the individual teeth does not fit securely into any particular
time frame. However for the purposes of our investigation, i.e. that of providing
information prior to a facial reconstruction, it was sufficient to give a general
The most unusual aspect of the childs dentition is the lack of the upper
first deciduous molars and their successors. Teeth may be congenitally missing
from the dentition and it is not unusual to find missing incisors, premolars
or molars in any given population. It is usual though, that the tooth missing
will be the last member of that family of teeth, i.e. the second incisors, the
second premolars and third molars. In addition one would expect bone to be present
in the area indicating that no tooth buds had developed. The lack of bone indicates
that something had been there prior to death and that no infill of bone had
occurred subsequent to its presumed removal. The antero-posterior skull view
revealed the position of the upper anterior teeth, i.e. the central and lateral
incisors and the unerupted upper permanent canines. The position of the canines
was well forward of their normal erupted position and the angulation suggests
that when eruption occurred some 4 years later they would have been in an anterior
position, giving the child a vampire appearance. All four upper
incisor teeth were crooked and the erupting lateral incisors were rotated.
In life the unerupted upper permanent canines in their crypts would have been
readily palpable beneath the tissues below the nostrils. It would therefore
be obvious to an observer that their projected path of eruption would force
them anteriorly from their ideal position. Early removal of the first deciduous
molars and their permanent successors would allow sufficient space for the unerupted
canines to drop back into the space and therefore provide enough room for the
incisors to align themselves and for the canine to position itself in line with
the rest of the arch. This procedure is commonly undertaken in modern times.
A study of the literature would indicate that tooth removal as a preventative
measure against the development of malocclusion was not practiced in Greece
or in Egypt at any time. This may be due to lack of affirmative evidence rather
than negative, as there are various surgical instruments known to have existed
for the extraction of teeth in the Grecian world during the Ptolemaic period
in which the child lived.
The absence of evidence of bony healing on the radiographs would indicate that
this procedure had taken place close to the time of death. Any surgical procedure
in the absence of aseptic conditions would be likely to cause infection. As
there was little knowledge of aseptic technique, blood poisoning and subsequent
death would have to have been a common complication.
Although dental decay was somewhat of a rarity in ancient Egypt, it increased
markedly during the time of the Greek Diaspora due to greater affluence and
trade. Although the boy appears to have been Egyptian, most expatriate Greeks
adopted Egyptian customs and practices, including mummification.
The diet changed among the upper classes to include large amounts of dried
fruit, honey and sugar. Other dental diseases were also prevalent. Among these
were dental abscesses that occurred subsequent to the rapid wear of the teeth
down to the pulp chamber. This has been attributed to two factors: firstly the
habit of grinding grain in stone quern thus incorporating particles of stone
in the flour, and also to the general sandy environment which would have permeated
the food eaten by the community.
The fact that this child exhibits no wear on the erupted permanent molars may
not be an unusual occurrence given the fact that the teeth had been erupted
for only two to three years. However, one would have expected a great deal more
wear on the biting surfaces of the deciduous molars. Wear on the deciduous molars
is not an uncommon occurrence among modern children, due to the relative thinness
of the enamel coating and the habit of many children of grinding their teeth.
Therefore this child can be assumed to have consumed a diet that was somewhat
out of the ordinary for the time. It was a diet that was low in abrasive qualities
and high in fermentable carbohydrates. One explanation for this may have been
the prolonged practice of breast-feeding, which occurred among the upper classes
of the time. The period of weaning was, and still is in some communities, regarded
as a period of great danger for the child due to the fact that many childhood
ailments occur soon after weaning. It is known now that this is due to cessation
of the maternal antibodies that protect the child during the breast-feeding
period. In addition to breast milk the child would have needed another source
of nutrient as it grew larger. It may have been consuming large quantities of
soft fermentable carbohydrates in the form of fruit either fresh or possibly
dried, dates, and honey.
The examination of the head of this eight-year-old child may have thrown some
light on the oral health practices of the upper class Egyptian and Greek inhabitants
of the Ptolemaic period. It also throws some light on the dietary habits of
the upper classes, which were very different from those of the bulk of the population.
Due to the obvious failure of the surgical procedure in this case, it may be
a one off experiment, which although fine in theory, failed to take into account
the risks of infection. The answer to this question will be the discovery of
more remains of the period, in particular adults, who have beautifully aligned
teeth and two missing premolars!
< return to index of papers