Assessing the impact of wear on the recordability of linear enamel hypoplasia: a quantitative approach

Objectives This study proposes a standardized, empirically grounded framework for assessing the recordability of linear enamel hypoplasia (LEH) in archeological dental samples. Despite the frequent use of LEH as a skeletal stress indicator, there is no consensus on whether and how to account for dental wear in recording protocols. Materials and Methods We analyzed the permanent right teeth of 497 medieval and early modern individuals to assess how dental wear affects the visibility and diagnostic utility of hypoplastic defects across different crown regions. For a given tooth, we assessed if there is a region that tends to be (1) less (or more) recordable than others, (2) less (or more) frequently affected by LEH than others, and (3) less (or more) informative with respect to the presence or absence of LEH than others. Results The occlusal third was significantly less recordable and rarely provides additional data beyond the middle and cervical thirds. Excluding the occlusal third has minimal effect on overall LEH prevalence, while omitting the middle or cervical thirds leads to marked underestimation. Discussion These results highlight the importance of incorporating wear-based inclusion criteria into LEH recording protocols. We recommend including only teeth with dental wear affecting less than half of the crown. These findings support the development of standardized inclusion criteria based on crown wear to enhance the consistency and comparability of data on enamel hypoplastic defects across studies and populations.