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Teeth, being the most highly mineralized body structures, are uniquely well-preserved remains relating to past individuals, their life history, the diseases they suffered from and the societies to which they belonged. This chapter reports on changes in our understanding of a few key aspects of dental palaeopathology. It suggests a new rare, but highly important category of enamel hypoplasia, cuspal enamel hypoplasia, where the cuspal pattern and enamel formation of permanent molars are severely disrupted in the early stages of tooth formation. It presents new and simple systems for the detection of periodontal disease, and for the categorization and understanding of voids in dental alveoli. It is suggested that unexpected patterns of tooth destruction by wear or caries might be explained by incomplete occlusal surfaces due to cuspal enamel hypoplasia, or be due to acid erosion from the diet or from gastric reflux. Suggestions are made for future lines of research, particularly on the relationship between periodontal disease and systemic conditions. All too often archaeological teeth are only examined once in any detail. The ability to do more than simply record, e.g. by spotting unusual patterns of wear or disease, is essential if we are to make progress in our understanding of all that teeth can tell us about earlier peoples.
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