An examination of the permanent dentition of 304 individuals from the Averbuch (40DV60) skeletal series from Tennessee was undertaken to establish a profile of oral pathology in this Mississippian period population. The variables chosen for study include caries, enamel hypoplasia, alveolar resorption, and periapical and periodontal abscesses. These markers were chosen as a measure of adaptive efficiency because they are indicative of overall levels of health and disease. The results of the study revealed caries rates at Averbuch at high percentages, showing 77% of the individuals from this skeletal sample had one or more carious lesions, surpassing the 17% average frequency rate for Mississippian groups. Results of the analysis of hypoplasias in the permanent adult dentition of the Averbuch sample also reveal high frequencies for this defect, with a total of 87% of the individuals possessing one or more hypoplasias. Alveolar resorption is in evidence in 39% of the individuals, while periapical and periodontal abscesses are present in 19% of the sample. These results show that the population from Averbuch was adaptively disadvantaged, and the heavy biological stress loads are recorded on the dental and oral hard tissues