Fillings found in the skull of a 7th Cavalry trooper killed 118 years ago in the Battle of Little Bighorn show sophisticated, well-executed dentistry. Some fillings are examples of early preventive dentistry, using a variety of materials and techniques typical of 19th-century cavity preparation. Dental care most likely was delivered by a private dentist or performed in part at a dental school in the East or Midwest, in a large city or at West Point. The logical, deductive process suggests an identification: Cpl. George Lell. Without additional corroborative documentation, however, this is speculation. Whoever he was, the cavalryman was older and shorter and had better oral care and health than most of the comrades who died with him in 1876. He used tobacco, most likely by chewing it. His remains provide a glimpse into the reality of life and death, dental care and hygiene of the mid-19th century.