Dental disease in childhood has the potential to inform about food availability, social status, and feeding practices, in addition to contributing to a child’s overall health status. This paper presents the first comprehensive overview of carious lesion frequencies in 433 nonadults (1-17 years), and 6283 erupted permanent and deciduous teeth from 15 urban and rural Romano-British settlements. Pooled deciduous and permanent caries rates were significantly higher in major urban sites (1.8%) compared to rural settlements (0.4%), with children from urban sites having significantly higher lesion rates in the deciduous dentition (3.0%), and inudyounger age groups with mixed dentitions. The differences in dental caries between urban and rural populations suggest disparities in maternal oral health, early childhood feeding practices, food preparation and access to refined carbohydrates. A richer, perhaps more ‘Roman’, cuisine was eaten in the urban settlements, as opposed to a more modest diet in the countryside. The effect of early childhood stress on caries frequency was explored using evidence for enamel hypoplasia. Co-occurrence of caries and enamel hypoplasia was highest in the major urban cohort (5.8%) and lowest in the rural sample (1.3%), suggesting that environmental stress was a contributing factor to carious lesion development in Romano-British urban children.
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