This paper discusses dental diseases during the Kofun period as a part of my research spanning from the Jōmon period to the Kamakura period (1185–1333). I had the opportunity to conduct research on 134 human samples of ancient teeth from the Shimauchi site in Miyazaki Prefecture in the possession of the Saitobaru Archaeological Museum. The human tooth samples buried in graves with underground corridor-style chamber with horizontal side entrance (chikashiki yokoana-bo) in Southern Kyūshū, which have a unique feature and are part of the burial customs of this region, were not directly buried in soil and on the contrary, exposed to air and have been therefore preserved in good condition. Moreover, many objects were unearthed along with them. I have examined dental features, dental caries, periodontal diseases, attrition and dental diseases based on the rate of caries, average number of caries per person, approximate estimate of caries’ frequency per person (ACFP; Sakura B formula, 1964) and the rate of antemortem teeth loss (AMTL). For the examination of caries, the clinical classification C1, C2, C3, and C4 is used. For the examination of periodontal diseases, the distance between the cement enamel junction and alveolar crest of teeth is measured using the vernier caliper. The horizontal and vertical absorption of the alveolar bone are confirmed. Besides, the samples are classified into two groups based on the type of objects unearthed with them. The finds from the Shimauchi site can be divided into different categories according to the grave goods: beginning with body armor designated as National Important Cultural Property; weapons like a single-edged long sword with silver inlay composed of a dragon, iron single-edged swords, iron double-edged swords, tortuous swords; horse trappings, including bridle bits, crupper bosses and flat pendant horse harness ornaments. Thereafter, the relationship between dental diseases and different social classes is analyzed. The results of these studies reveal that the rate of caries, periodontal diseases, and missing teeth is different between the two social classes. It can be assumed that these problems are related to differences in diet between the classes.