Objectives The dentition of Olduvai Hominid 1 (OH1) exhibits an anomalous pattern of dental wear that was originally attributed to either intentional cultural modification (filing) or plant processing behaviors. A differential diagnosis of the wear and assessment of the biological affinity of OH1 is presented. Materials and Methods Macroscopic and microscopic observations of all labial and buccal tooth surfaces were undertaken to assess wear patterns. A multivariate analysis of mandibular morphology of OH1 compared to other Late Pleistocene, Holocene, and recent modern humans was used to ascertain biological affinity. Results The morphological variation of the OH1 mandible is closely aligned with variation in penecontemporaneous fossils from Africa and outside that of recent humans. The concave wear facets exposing dentin on the labial surfaces of all three preserved mandibular incisors is confirmed. Substantial loss of labial/buccal surfaces was documented on the surfaces of all in situ maxillary and mandibular canines, premolars, and molars ranging from distinct facets with well-defined edges, to blunting or "polishing" around areas of maximum buccal curvature. The wear on both the anterior and postcanine teeth closely resemble that caused by adornments ("labrets") worn in lower-lip and buccal facial piercings known from bioarchaeological and ethnographic contexts. The wear pattern suggests that the OH1 wore three facial piercings-two buccal/lateral and a medial one in the lower lip. Discussion Our findings suggest that the expression of social identities through intentional body modification is more diverse than previously documented elsewhere in Africa during the Late Pleistocene (i.e., ablation) and Early Holocene (i.e., ablation, chipping, and filing).