In 2009, a salvage archaeological excavation in Valle da Gafaria (Lagos, Portugal) brought to light the skeletal remains of 158 African enslaved individuals (15th–17th centuries), from which several presented intentional dental modifications on their anterior dentition. Although this cultural practice may be related to rites of passage, differential status, group identification, mourning, or embellishment, it is not exempt from risk. Among the possible consequences are pulp necrosis, dental caries in the modified surface, loss of masticatory function, and dental enamel hypoplasia in the permanent teeth. A previous study in the Lagos collection already confirmed that anterior modified teeth were significantly more affected by periapical lesions (9.3%) than unmodified teeth (0.4%). Therefore, the aim of this investigation is to analyse the relationship between dental caries and intentional dental modification in the Lagos sample. Eighty‐one individuals were analysed, making a total of 2,285 alveoli and 2,063 teeth (757 anterior and 1,306 posterior). Dental caries was recorded if there was a discernible, even if small, white or brown lesion in the otherwise translucent enamel, or if there was a cavity. Intentional dental modifications were recorded according to their presence and incisal angles removed. Dental caries affected 78 individuals (96.3%) and 1,072 teeth (52.0%). In all, intentional dental modifications were observed in 50 (61.7%) individuals and 203 (27.1%) anterior teeth. Modified teeth were significantly more affected by caries (84.2%) than nonmodified teeth (31.7%). Given that all modifications involved the removal of the mesial and/or distal angles of the teeth, the relationship between these alterations and the presence of caries was investigated. In fact, when modified, mesial and distal contact areas were significantly more affected by caries, although mostly noncavitated, supporting the hypothesis that this cultural practice turns teeth more prone to dental caries.