If you listen to some advocates of the paleo diet and similar fad diets, they’ll tell you that tooth decay is a modern development, that people didn’t used to get tooth decay until the agricultural period or even the industrial era when people began eating a lost more carbs. There’s some truth to this, but our first records of gum disease in the human population come from as far back as 1.8 million years ago, and are related to meat getting stuck in our teeth, not carbs.

And we have evidence that whenever people found a high-quality food source, they were likely to experience tooth decay, independent of modern agriculture and processing techniques.

Hunter-Gatherers Had a Sweet Tooth for Acorns

Researchers looked at a settlement that had been in use for more than a thousand years, from about 15,000 years ago to about about 13,700 years ago. Located in the Grotte des Pigeons in Morocco, this settlement had evidence that locals systematically collected sweet acorns and pine nuts. Researchers speculate that the acorns became very sugary, sticky food when cooked.

As a result of this rich food source, the more than 50 skeletons looked at in this site had extensive oral decay, comparable in some ways to modern populations, but without the benefit of modern treatments to stop their progress. About half of all teeth had cavities in them. Numerous teeth had progressed to having internal infections, including abscesses in the jaw, which we would normally treat with a root canal.

Decay before Dentistry?

Part of what made this population so unlucky is that their oral health problems came before anyone was able to treat them.

There was no evidence of oral hygiene at the site, which likely contributed to accelerated decay. These people lived before the Egyptians invented the first profession of what might be called dentistry (perhaps 5000 years ago), and even before primitive experiments with the earliest filling (perhaps 6500 years ago), and earlier than the earliest drilled teeth (perhaps 9000 years ago).

Without the root canal treatment, many of the abscesses burst, leaving holes in the jaws of these people. It was likely that these people experienced significant pain as a result of their dental decay.

We don’t know why, but it seems like these people practiced ritual tooth extraction. They removed the upper central incisors in about 90% of people. This likely isn’t a health treatment, as in medieval dentistry, because they left in so many very damaged teeth. Perhaps, though it was a form of sacrifice to primitive deities they might have imagined were responsible for their suffering.

Although there are definitely some modern foods that are bad for your teeth (we’re looking at you, coke), it’s clear that whenever people had access to high-calorie food, they were likely to suffer tooth decay.