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Oral Health Indicators of Prehistoric Jomon : Temporal, Sex and Environmental Differences

佐宗, 亜衣子 東京大学 DOI:10.15083/0002004578

2022.06.22

概要

齲⻭や⻭周病を含むOral Paleopathologyについては、⼈類の経済段階や社会構造の進展・転化とともに増加すると考えられてきた。すなわち、作物の栽培が開始された新⽯器時代以降（Aufderheide et al. 1998）、さらに、産業⾰命以降の精製した⼩⻨や砂糖を多く含む⾷料の供給量が増えた時期や地域で増加することが報告されている（Ismail et al. 2001)。また、古⼈⾻の⻭⽯内に残る菌DNA分析により、ヨーロッパの中⽯器から現代までの⼝腔内の細菌構成に変化が観測され（Adler et al. 2013）、⻭周病の原因菌の⼀つであるP. gingivitisの構成⽐は新⽯器以降に増加し、齲⻭の主要菌であるS. mutansは現代になって急増することが⽰されてきた。

　縄⽂⼈の⼝腔衛⽣指標に関する研究は、これまで齲⻭を中⼼に⾏われており（Fujita 1995, Temple 2007, Temple 2011, Temple and Larsen 2007）、狩猟採集⺠としては齲⻭率が⾼いこと（平均8.3％, Fujita1995）が指摘されている。しかし、齲⻭以外の指標を含んだ、縄⽂⼈の⼝腔衛⽣状態を総覧する研究はほとんど⾏われていない。本研究では齲⻭（caries）、⽣前喪失⻭（AMTL)、咬耗、⻭冠⽋損（chipping)、セメントーエナメル境と⻭槽縁間の距離による⻭根露出度（CEJ-AC distance)、⻭槽中隔の炎症程度度（morphological assessment of the interdental septum)の６つの指標を⽤い、縄⽂時代における⼝腔衛⽣の時期変化、性差、遺跡の⽴地環境にともなう差異について検討を⾏った。

　１章では、縄⽂⼈⾻における⻭周病を客観的指標により評価した先⾏研究がほとんどないことから（Turner 1979）、まず初めに乾燥⾻における⻭周病の評価法を再検討した。縄⽂時代後期の3集団（内陸部1遺跡、沿岸部2遺跡）について、2つの評価法：CEJ-AC距離時代後期の3集団（内陸部1遺跡、沿岸部2遺跡）について、2つの評価法：CEJ-AC距離と⻭槽中隔の炎症痕より⻭周病の罹患率を調査した。その結果、31.8〜66.0％の個体が中程度以上の⻭周病と評価され、諸外国で報告された狩猟採集集団と同程度の⻭周病率であることが⽰された（Costa 1982, Jurmain 1990, Littleton et al. 2017）。他の⼝腔衛⽣指標を加え、３集団で⽐較した結果、⻭周病率は他の⼝腔衛⽣指標よりも集団差や性差が⼩さかった。⼝腔衛⽣指標6項⽬の全体でみると、遺跡間の差と同程度の男⼥差があり、遺跡間の差は男性よりも⼥性の⽅が⼤きかった。男性はCEJ-AC距離、⻭槽炎症痕、Chippingのスコアが⾼い傾向にあり、⼥性はCariesとAMTLのスコアが⾼い傾向にあった。また、⻭槽中隔の炎症痕による評価法では、咬耗の強い集団ほど⻭周病率が⾼くなる傾向がみられた。全項⽬による多変量解析でも、CEJ-AC距離よりも⻭槽中隔の炎症痕と咬耗とに強い関連性が検出され、咬耗が⻭周組織の炎症と⻭周病の進⾏に影響を及ぼしていることが⽰唆された。

　２章では、46遺跡453個体の資料を⽤いて、⼝腔衛⽣指標の時期変化と遺跡の⽴地環境による違いを検討した。まず、縄⽂時代の５時期（早期、前期、中期、後期、晩期）における齲⻭率、喪失⻭率、⻭周病率の時期変化を明らかにした。また、沿岸部集団と内陸・洞⽳集団とでは、齲⻭率や喪失⻭率、⻭周病率の変化パターンが異なり、両者の植物利⽤の内容や⼿段の違いとの関連が⽰唆された。各時期の特徴は次のとおりである。

　早期：男⼥の⼝腔衛⽣指標における特徴は共通し、齲⻭や喪失⻭の頻度が低く、咬耗や⻭冠損傷を特徴とする。齲⻭率はTurner(1979)に照らすとforagingの⽔準（0〜5.3％)である。内陸部遺跡の齲⻭率が1.2％なのに対し、沿岸部遺跡では6.9％とすでに狩猟採集集団としては⾼い齲⻭率である。

　前期：性差は早期より拡⼤するがそれほど⼤きくなく、男⼥の⼝腔衛⽣指標における特徴には共通性がみられる。やや齲⻭率が⾼くなり、mixed foraging/agricultureの⽔準（0.4〜10.3%, Turner 1979)となる。⼀⽅で、沿岸部と内陸部での差が複数の指標で⾒られるようになる。沿岸部集団では⻭周病率が増し、内陸部では齲⻭率と喪失⻭率が増加する。性差に関しては中期以降とは異なる傾向を⽰し、とくに内陸部集団において、男性の齲⻭率、喪失⻭率が⾼い。

　中期：齲⻭率はさらに増加し（男⼥混合で12.1%）、agricultureの⽔準（2.3〜29%, Turner 1979)となる。男⼥差が明らかとなり、男性は⻭根露出や⻭冠損傷、咬耗を特徴とし、齲⻭率は8.0％とmixed foraging/agricultureの⽔準にある。⼥性は喪失⻭と齲⻭を特徴とし、齲⻭率は18.9％と明確にagricultureの⽔準である。喪失⻭率においても男⼥差があらわれるが、全体では前期よりやや減少する。⻭周病率は依然として沿岸部と内陸部に差があり、沿岸部が⾼い。

　後期：全体の齲⻭率は13.5%と中期とあまり変わらない。喪失⻭率はやや増加する。⻭周病率に男⼥差はなく、やや少ない。また、齲⻭率と喪失⻭率が沿岸部では⾼くなり、内陸部では低くなる。その結果、沿岸部と内陸部との差が⼤きくなる。

　晩期：齲⻭率が⼥性は27.3％、男性は17.8％となり、男⼥ともにagricultureでも⾼⽔準となる（Turner 1979)。男性も喪失⻭や齲⻭が増加し、男⼥差がさらに⼩さくなる。⻭周病率は全体にやや増加する。喪失⻭率は内陸部では男⼥差が⼤きくなり、沿岸部では男⼥差がなくなる。

　齲⻭の発⽣は糖質（炭⽔化物）の摂取と強く関連することから、齲⻭率の上昇は農耕や栽培社会への移⾏を⽰すシグナルの⼀つとされている（Turner 1979, Larsen 1983）。縄⽂⼈の齲⻭や喪失⻭の頻度にみられる時期変化は縄⽂時代の植物利⽤の発展経過との関連が⽰唆される。

　また、沿岸部の遺跡では、喪失⻭の原因が主に齲⻭にあるが、内陸部では咬耗などと関連し、外的要因に起因することが⽰唆された。⼀⽅で、⻭周病の頻度には⼀定の変化傾向はみられず、前期と中期に沿岸部と内陸部といった遺跡⽴地による差が⾒られた。齲⻭や喪失⻭の頻度変化とは異なる何らかの要因が⽰唆される。沿岸部と内陸部の⽴地差が拡⼤した早期から前期にかけての時期、あるいは差が減少した中期から後期にかけての時期には、内陸部と沿岸部の植物利⽤あるいは集団の移動などの点で、何らかの変化があったのかもしれない。

　最後に３章では、⼈⾻資料による炭素・窒素安定同位体の時期変化を性差、遺跡⽴地差とともに分析し、安定同位体⽐と⼝腔衛⽣指標データとの個体レベルでの相関関係を分析した。安定同位体⽐の時期変化は、早期から前期に増加した後、晩期になるにつれδ13C値とδ15N値ともに低くなる傾向を⽰し、時期が新しくなるとともに海洋資源への依存が減少し、陸⽣資源への依存が増すことが⽰唆された。安定同位体⽐での性差は検出されなかった。ただ、分析対象のサンプル数および遺跡数が⼗分でないことから、ここでみられた時期差や性差は地域差や各遺跡のごとの環境差を反映している可能性もある。

　安定同位体⽐と⼝腔衛⽣指標データの相関分析では、齲⻭率や咬耗度が⾼い個体はδ13Cの値が低くなり、⻭槽壁の炎症スコアが⾼い個体はδ15Nの値が⾼くなる傾向が⽰された。この相関関係は性差や時期差を導⼊しても不変であり、縄⽂時代を通じて安定的な関連を保持していた可能性がある。あるいは遺跡⽴地など、他の要素の影響が強いために性差や時期差としては現れなかったのかもしれない。δ13C値に関しては、陸⽣資源（特にC3植物）の摂取量が多い個体ほど齲⻭率が⾼くなることが予想された。咬耗度とδ13C値の関連は植物加⼯・調理による影響や沿岸部にサンプルが偏っていることを反映していると考えられた。また、δ15N値の変動は、栄養段階の⾼い外洋性⿂類や海獣類の積極的摂取や淡⽔⽣態系の資源の摂取などの影響による可能性があるが、⻭槽壁の炎症との因果関係は不明である。

　本研究の結果を総合すると、⼝腔衛⽣指標からみて縄⽂時代は早期と前期以降の間に⼤きな隔たりがある。前中期を移⾏期と考えると、早期と前中期、後晩期のおよそ３つの時期に⼤別される。前中期には１）齲⻭率の顕著な上昇、２）性差の拡⼤、３）沿岸部と内陸部での差の拡⼤がみられる。⼈⾻の安定同位体⽐でも同じく早期とそれ以降の期間に差が認められ、前中期から後晩期へと徐々に陸⽣資源への依存が⾼くなることが⽰唆された。

　縄⽂前期から中期の⼝腔衛⽣指標に⾒られる変化は、性的分業あるいは⾷料分配における性差が明らかになり、遺跡の周辺資源や植物資源への依存が⾼まった結果と解釈でき、移動性の⾼い狩猟採集集団から定住的な狩猟採集社会への移⾏が想定される。さらに後期から晩期へ向け、さらなる齲⻭率の上昇と性差の縮⼩が観察され、より本格的な栽培経済へと移⾏したと考えられる。

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