Fertility and Agriculture Accentuate Sex Differences in Dental Caries Rates

The transition from foraging to farming is associated with a widespread and well‐documented decline in oral health, wherein women experience a more rapid and dramatic decline than men. Historically, anthropologists have attributed this difference to behavioral factors such as sexual division of labor and gender‐based dietary preferences. However, the clinical and epidemiological literature on caries prevalence reveals a ubiquitous pattern of worse oral heath among women than men. Research on cariogenesis shows that women's higher caries rates are influenced by changes in female sex hormones, the biochemical composition and flow rate of saliva, and food cravings and aversions during pregnancy. Significantly, the adoption of agriculture is associated with increased sedentism and fertility. I argue that the impact of dietary change on women's oral health was intensified by the increased demands on women's reproductive systems, including the increase in fertility, that accompanied the rise of agriculture and that these factors contribute to the observed gender differential in dental caries.