A 17th- to 19th-century cemetery sample of 104 slaves from Newton Plantation (Barbados) shows uniquely high hypercementosis prevalence, as well as unexpectedly high and variable skeletal lead content. A variety of biological and archeological factors indicates that individuals with lower amounts of these anomalies (relative to age at death) were probably African-born, first-generation slaves. The hypercementosis is related to the progression of periodontal disease as assessed from alveolar bone. Although the hypercementosis is endemic in the Caribbean black population, it does not as yet have a clear explanation. We suggest the etiology might relate to chronic malnutrition involving periodic, seasonal rehabilitation.