A new study has found that oral hygiene in Britain was better during the times of the Roman empire compared to the present era despite the advent of toothbrushes and dentists.
A study of 303 skulls held at the Natural History Museum, dating from the years 200 to 400 AD, found that only five percent showed signs of moderate to severe gum disease (periodontitis), compared to around 15 to 30 percent of adults nowadays.
The eight-page study, led by a periodontist from King's College London (KCL) university, was published in the British Dental Journal on Friday.
While much of the population nowadays lives with mild gum disease, factors such as tobacco smoking or medical conditions like diabetes can trigger more severe chronic periodontitis, which can lead to the loss of teeth, the study said.
Professor Francis Hughes, from the KCL Dental Institute, was the study's lead author.
"We were very struck by the finding that severe gum disease appeared to be much less common in the Roman British population than in modern humans, despite the fact that they did not use toothbrushes or visit dentists as we do today," he said.
"Gum disease has been found in our ancestors, including in mummified remains in Egypt, and was alluded to in writings by the Babylonians, Assyrians and Sumerians as well as the early Chinese."
The skulls came from a Romano-British burial ground in Poundbury, southwest England.
The Dorset suburb is the site of Prince Charles' model new town, built on the heir to the throne's land, to his architectural principles.
Despite the low rate of gum disease, many of the skulls showed signs of infections and abscesses, and half had tooth decay.
The skulls also showed extensive tooth wear from a young age, as would be expected from a diet rich in coarse grains and cereals at the time.
Among those who survived into adulthood, the peak age at death appears to have been in their 40s.
"This study shows a major deterioration in oral health between Roman times and modern England," said Theya Molleson from the Natural History Museum, the study's co-author.
"By underlining the probable role of smoking, especially in determining the susceptibility to progressive periodontitis in modern populations, there is a real sign that the disease can be avoided".
"As smoking declines in the population we should see a decline in the prevalence of the disease."