The practice was continuing, in the same region, in a culturally distinct but geographically and temporally adjacent tradition.

This continuity — across the transition from the Pleistocene to the Holocene, across more than 10,000 years of time, in different cultural contexts — is one of the strongest arguments for the study’s central claim about habitual use.

If the betel nut habit had been a one-off individual peculiarity, we would not expect to find the same distinctive dental pathology in two individuals from different sites and different time periods.

The recurrence is evidence of a persistent cultural practice, transmitted across time and across the social and cultural changes that separate the Late Pleistocene foragers from the Toalean tradition.