A 2026 bioarchaeological study of 40 skeletal remains from Milan spanning 2,000 years found that tooth buildup and wear decreased significantly over time, reflecting improved hygiene practices. However, cavities increased dramatically in the Modern Era despite better cleaning habits, suggesting that modern diets high in sugar and processed foods create more dental problems than ancient diets did, even with superior hygiene tools available today.
Researchers in Italy studied ancient skeletal remains from four different time periods spanning 2,000 years to understand how dental health has changed over time. By examining teeth from the Roman Era through the Modern Era, they discovered that people’s teeth have gotten cleaner (less buildup), but cavities have actually become more common in recent times. The study shows how diet, hygiene habits, and lifestyle changes throughout history have shaped our oral health. According to Gram Research analysis, this archaeological evidence provides surprising insights into how modern life affects our teeth compared to ancient civilizations.
Key Statistics
A 2026 bioarchaeological study examining 40 individuals across four historical periods in Milan found that dental calculus (buildup) and tooth wear progressively declined from the Roman Era to modern times, indicating improved hygiene practices over 2,000 years.
According to research reviewed by Gram, cavity prevalence peaked in the Modern Era despite better dental hygiene practices, suggesting that modern processed foods and sugars pose greater cavity risks than ancient diets, even with superior oral care tools.
A 2026 analysis of skeletal remains found that sex-based differences in tooth buildup were notable in Roman and Medieval periods but diminished by the Modern Era, indicating that modern lifestyles have equalized dental health outcomes between men and women.
The study showed that bone resorption (gum disease indicator) remained relatively consistent across all 2,000 years examined, demonstrating that gum disease has been a persistent human health challenge regardless of era or hygiene practices.
The Quick Take
- What they studied: How people’s dental health and hygiene habits changed over 2,000 years by examining ancient skeletons from different time periods in Milan, Italy.
- Who participated: Forty individuals from four historical periods: Roman Era, Early Middle Ages, Late Middle Ages, and Modern Era. The group was balanced equally between males and females and different ages.
- Key finding: Tooth buildup and wear decreased over time (showing better hygiene), but cavities increased dramatically in the Modern Era, suggesting that modern diets and lifestyles create new dental challenges despite better cleaning habits.
- What it means for you: Even though we have better tools and knowledge for keeping teeth clean today, modern foods and habits may be creating more cavities than in ancient times. This suggests that good brushing alone isn’t enough—what we eat matters just as much.
The Research Details
Researchers examined skeletal remains (bones and teeth) from 40 people who lived in Milan during four different historical periods spanning 2,000 years. They carefully studied each person’s teeth using the same measurement tools that dentists use today, looking for four main things: buildup on teeth (calculus), tooth wear, cavities, and bone loss around the teeth. They recorded all their findings in a standardized way so they could compare teeth from different time periods fairly. Then they used statistics to see if patterns changed over time and if men’s and women’s teeth were different.
This approach is powerful because it shows us the real, long-term effects of how people lived. Instead of just guessing about ancient dental health from written records, researchers can actually examine the physical evidence. This helps us understand whether modern improvements in dental care are truly making our teeth healthier, or if other factors like diet are working against us.
The study used standardized dental measurement tools that dentists use in real clinics, which makes the findings reliable. The sample was carefully balanced between males and females and different ages, reducing bias. However, the sample size of 40 people is relatively small, and all participants were from one city (Milan), so results may not apply everywhere. Archaeological samples can also be damaged or incomplete, which might affect accuracy.
What the Results Show
The most striking finding was a clear trend over 2,000 years: tooth buildup (calculus) and wear steadily decreased from the Roman Era to modern times. This makes sense because people developed better hygiene practices and their diets changed—less hard, rough foods that naturally cleaned teeth through chewing. However, cavities told a different story. Cavity rates were relatively low in ancient times but jumped significantly in the Modern Era, suggesting that modern processed foods and sugars are creating dental problems that ancient people didn’t face. Bone loss around teeth (a sign of gum disease) stayed fairly consistent across all time periods, indicating that gum disease has been a persistent human problem for at least 2,000 years.
The study found interesting differences between men and women in earlier time periods. In Roman and Medieval times, men had more tooth buildup than women, possibly because of different diets or hygiene practices. However, this gap narrowed significantly by the Modern Era, suggesting that modern life has made dental health more similar between sexes. The researchers also noted that the types of cavities changed over time, reflecting shifts in what people ate.
This research adds important context to what we know about modern dental health. While previous studies have shown that modern populations have more cavities than historical populations, this study provides direct physical evidence from the same geographic location over centuries. It confirms that despite our superior brushing techniques and dental care access, we’re actually experiencing more tooth decay than our ancestors—a paradox that points to diet as the primary culprit rather than hygiene alone.
The study examined only 40 people from one Italian city, so findings may not represent all of Europe or the world. Archaeological remains can be damaged or incomplete, potentially affecting accuracy of measurements. The study couldn’t directly measure diet or hygiene practices—researchers had to infer them from tooth conditions. Additionally, people who were healthier or wealthier in ancient times may have been more likely to be preserved in the archaeological record, creating a bias toward certain populations.
The Bottom Line
This research suggests that modern dental care should focus equally on diet and hygiene. While brushing and flossing remain important (and have clearly reduced tooth buildup), reducing sugar and processed foods may be equally or more important for preventing cavities. The evidence is strong that diet plays a major role in cavity formation, based on the clear increase in cavities in the Modern Era despite better hygiene practices.
Everyone should care about these findings, especially parents concerned about children’s dental health and people struggling with cavities despite good brushing habits. If you’re doing everything right with oral hygiene but still getting cavities, this research suggests examining your diet. People with gum disease should know that this is a persistent human problem, not a modern invention, but it’s still preventable.
Changes in tooth buildup and wear took centuries to develop, reflecting gradual shifts in diet and hygiene. However, cavity prevention can happen much faster—reducing sugar intake can show results in months to a year. Gum disease prevention requires consistent daily habits and may take weeks to months to show improvement.
Frequently Asked Questions
Did ancient people have better teeth than we do today?
Ancient people had less tooth buildup and wear, showing better natural cleaning. However, they had fewer cavities because their diets lacked processed sugars. Modern teeth are cleaner but more cavity-prone due to diet, not hygiene differences.
Why do I get cavities even though I brush twice a day?
This 2026 study suggests diet matters more than brushing alone. Ancient people with minimal hygiene had fewer cavities because they ate less sugar. Modern processed foods and sugars create cavity risk that brushing can’t fully prevent.
Has gum disease always been a problem for humans?
Yes. The study found bone resorption (gum disease indicator) remained consistent across 2,000 years, showing gum disease is a persistent human problem. However, it’s preventable through consistent daily oral care and healthy habits.
What changed the most about teeth over 2,000 years?
Cavity rates increased dramatically in modern times, while tooth buildup decreased. This shift reflects dietary changes toward processed foods and sugars, combined with improved hygiene practices that reduced natural tooth cleaning.
Can I reduce my cavity risk by changing my diet?
This research strongly suggests yes. Since ancient people with poor hygiene had fewer cavities due to lower sugar diets, reducing processed foods and sugars may be as important as brushing for cavity prevention in modern life.
Want to Apply This Research?
- Track daily sugar intake and correlate it with cavity development over 3-6 months. Log all sugary foods and drinks, then monitor cavity formation at dental checkups to see if reducing sugar improves your results.
- Use the app to set a daily sugar limit and log all foods and drinks consumed. Create reminders for brushing (twice daily) and flossing (daily), then add a weekly reflection noting any changes in gum health or tooth sensitivity.
- Establish a baseline at your next dental checkup (note cavity count and gum health status). Then track monthly using app logs of diet and hygiene habits. Compare results at your next dental visit in 6 months to see if dietary changes improved your oral health outcomes.
This article summarizes research findings from a bioarchaeological study and should not replace professional dental advice. Individual dental health depends on many factors including genetics, diet, hygiene practices, and access to dental care. If you have concerns about cavities, gum disease, or other dental issues, consult a qualified dentist. This research provides historical context but does not constitute medical diagnosis or treatment recommendations. Always follow your dentist’s personalized advice for your oral health.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.