ABSTRACT The origin and dispersion of the first Americans have been extensively investigated from morphological and genetic perspectives, but few studies have focused on their health and lifestyle. The archaeological site of Lapa do Santo, central-eastern Brazil, has exceptionally preserved Early Holocene human skeletons, providing 19 individuals with 327 permanent and 122 deciduous teeth dated to 9,250 to 7,500 years BP. In this study, we test whether the inhabitants of Lapa do Santo had high prevalence of dental caries as previous studies of Lagoa Santa collection have indicated, using individual and tooth as units of analyses. The results show a high prevalence of dental caries in the permanent dentition (5.50%, n=327 teeth; 69.23%, n=13 individuals) compared to other samples of hunter-gatherers worldwide. In addition, dental caries in deciduous teeth start occurring as early as 3 to 4 years old, suggesting an early start to caries. Compared with other samples from Lagoa Santa, Lapa do Santo shows statistically similar prevalence of overall caries but different caries location pattern. We believe that a subsistence adaptation to a tropical environment rich in sources of carbohydrates, such as fruits, is the best explanation for the overall caries prevalence.