@phdthesis{103389,
  keywords = {Lepra, dental disease, Nerve damage, Leprosarium},
  author = {Gomulak, Robert },
  title = {Lepra Dentes: Dental Disease and Cranial Nerve Damage Among Patients of a 12th Century Leprosarium, Peterborough},
  abstract = {<p>Leprosy is a bacterial infection that causes severe skin lesions and nerve damage in the extremities and face and is able to be identified in archaeological remains through distinct lesions in the bones of the hands, feet, and skull. In both clinical and archaeological studies, leprosy infection is correlated with a high rate of dental pathologies. In the medieval era, England saw a surge in the construction of leprosy hospitals, or leprosaria, quasi-monastic facilities that cared for infected individuals, which included the administration of strict diets that were adherent to both religious and medical standards of the era. Seventy-three individuals recovered from the cemetery associated with the late medieval leprosarium of St. Leonard’s Hospital (comprising 1,091 teeth and 842 alveolar sockets) were assessed for the prevalence of dental pathologies and contributing factors, lesions present in sphenoidal foramina associated with nerves of the jaw and face, and pathognomonic indicators of leprosy in the skull. Porous lesions on the palate were found to be prevalent throughout all groups in this study, while other symptoms of rhinomaxillary syndrome were limited to those with other signs of leprosy. Compared to those without evidence of infection, individuals with skeletal signs of leprosy were observed to have higher prevalence of severe calculus, caries, wear, and periodontal disease scores as well as AMTL. Statistical correlations were made between skeletal signs of leprosy and wear severity, AMTL, and periodontal disease. Lesions associated with sphenoidal foramina were determined to have a higher prevalence in individuals with skeletal signs of leprosy, but not to a statistically significant degree. A tentative correlation was established between porotic lesions in foramina rotunda and the presence of occlusal calculus, which may serve as an indicator of mandibular paralysis. Prevalence of dental pathologies within the subsample was higher than typical medieval contexts, but consistent with other burial grounds associated with leprosaria, which can be attributed to a combination of the prescriptive diets of leprosaria and the pathophysiological mechanisms of bacilli proliferation in individuals infected with lepromatous leprosy.</p>
},
  year = {2025},
  journal = {Department of Archaeology},
  pages = {1-24},
  publisher = {University of Durham },
  address = {United Kingdom},
  url = {https://www.proquest.com/openview/ff503f7b7cdbd66b332ffc758e19d2c6/1?pq-origsite=gscholar&cbl=18750&diss=y},
  language = {ENG},
}