Second, it changes the health consequences.

The modern betel quid, processed with lime, is strongly associated with oral cancer and precancerous changes.

The ancient practice of sucking whole nuts would have had different chemical exposure patterns.

The dental destruction it caused — the distinctive rounded grooves — is a different pathology from what modern users develop.

Neither is good for the teeth, but the specific mechanisms and the specific health consequences differ.

Third, it suggests that the ancient use predates the development of the specific preparation method — the quid with lime — that characterizes the historical and modern tradition.