Study links tooth growth patterns to smoking history

Dental Tribune International

Tue. 29. July 2025

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NEWCASTLE UPON TYNE, England: The systematic and oral health effects of smoking are well established, including reduced calcium absorption, altered vitamin D metabolism and disruptions to multiple endocrine pathways. Building on this body of evidence, researchers from Northumbria University and the University of Leicester have investigated whether smoking alters the dental cementum. Their study shows that tobacco use leaves a lasting biological imprint on teeth, offering a promising tool for forensic and archaeological analysis.

In the study, the researchers examined modern and archaeological teeth to determine whether smoking behaviour could be detected in acellular extrinsic fibre cementum (AEFC). In the modern sample, the researchers analysed 70 teeth from 46 living individuals whose age, sex and smoking history were known. They found that current smokers had significantly thinner AEFC layers than did former smokers, suggesting that smoking alters the rate or pattern of cementum deposition. Specifically, distinctive disruptions in the cementum growth lines—referred to as “smoking damage”—were observed in 33% of current smokers and 70% of former smokers, compared with just 3% of non-smokers.

“We found that the regular annual deposition of rings was disrupted for some individuals and realised that these disruptions were associated with current or ex-smokers, but were very rare in non-smokers,” study co-author Dr Ed Schwalbe, associate professor in Northumbria University’s Department of Applied Sciences, explained in a press release.

The presence of such cementum damage indicated an 85%–92% probability that an individual had smoked, whereas its absence corresponded with a 96% likelihood of never having smoked. According to the authors, this suggests that AEFC analysis could be a valuable non-invasive tool for detecting behavioural and environmental influences on cementum formation such as tobacco use.

The study also included 18 teeth from 18 individuals buried between 1776–1890 in Coventry in England. Smoking habits in this archaeological sample were inferred from tooth alterations known to be associated with tobacco consumption, including pipe wear notches and tobacco staining. Similar patterns of cementum disruption were observed in individuals identified as likely smokers.

“Our research shows that it’s possible to tell if someone was a smoker just by examining their teeth,” Dr Schwalbe said. “Together, this information could help identify unknown individuals—such as disaster victims or those buried in mass graves—and offer new tools for forensic and historical investigations,” he continued.

The findings could have important applications beyond the dental field. “The identification of smoking damage in archaeological teeth opens up further avenues to understand how the long-term consumption of tobacco in populations has affected our health through time,” noted co-author Dr Sarah Inskip, UK Research and Innovation Future Leaders Fellow at the University of Leicester’s School of Archaeology and Ancient History.

Lead author Dr Valentina Perrone, who is a research assistant at the same institution, added: “Smoking is known to have a systemic impact on the body, and numerous studies have highlighted the correlation between smoking, periodontitis and tooth loss. This study shows, for the first time, the biological record of smoking-related oral health damage within the dental structure.”

The researchers concluded that AEFC does not merely reflect chronological age, but also offers a record of individual life events and behaviours.

The study, titled “Reconstructing smoking history through dental cementum analysis—a preliminary investigation on modern and archaeological teeth”, was published online on 27 May 2025 in PLOS One.