This study uses the dental and cranial skeletal remains of populations interred in the North Carolina Piedmont, including those from the archaeological sites of Town Creek, Forbush Creek, Early Upper Saratown (Hairston), Wall, Fredricks, and Upper Saratown, to present the frequencies of dental and cranial pathologies in the context of the cultural and biological setting of the North Carolina piedmont in order to assess how agriculture and European contact influenced nutrition and overall health. The collection samples range from A.D. 700-1710, a period that encompasses a series of dietary transformations that include the increased incorporation of maize into the diet, and after the arrival of Europeans into the area, a change in diet associated with increased mobility. The study’s purpose was to look at what dental and skeletal cranial markers can tell us about diet and overall health. Data were collected by observing the presence and number of carious lesions, alveolar infection, premortem tooth loss, and dental calculus. I also recorded frequencies of porotic hyperostosis, cribra orbitalia and scurvy as additional evidence of diet and health deficiencies. The results of this study suggest a decline in health during a period of time when agriculture was the most dominant part of a subsistence economy, the middle period of my sample that contains samples from A.D. 1450 to 1620, and a reduction in nutritional strain for populations with a more mixed economy, especially the late period of my sample (1670-1710).