Using morphological and radiographic methods, we analysed the dentitions of 24 individuals from Ingombe Ilede and Isamu Pati Zambian Iron Age archaeological sites. In this study, we determined the frequency and distribution of attrition, pathological conditions and dental trauma. This research also presents the first view of dental health for an Iron Age population in southern Africa. In total, 482 teeth were available for this study with 287 teeth missing, where 50 of these were lost antemortem and one individual had an erupted supernumerary first mandibular incisor. With the use of radiography and morphology, 21.5% (104/482) of the analysed teeth had at least one pathological condition or evidence of dental trauma. Some interesting dental aspects found and discussed in this paper are linear enamel hypoplastic lesions, radicular resorption, periapical lesions, fractures, dental modification and carious lesions. Many of these features were diagnosed with radiography, and this was especially important for those found below the cemento‐enamel junction (p = 0.0202) that are less obvious with macroscopic investigation alone. Additionally, the quantity and direction of dental attrition was studied. There were observed sex differences with the direction of wear, likely representing a sex‐specific cultural practice of using teeth as tools. Overall, the results show that this sample suffered relatively little from dental problems, and many of those observed features were associated with the traumatic procedure of dental modification, whereas others were age and diet‐related. Additionally, with the use of radiography, rare dental fractures and other features were diagnosed; these results demonstrate the requirement for its application in dental studies on archaeological assemblages. Copyright © 2012 John Wiley & Sons, Ltd.