We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.
