Unlocking the past: Dental calculus as key to understanding ancient health and disease through a One Health framework

Objective: Ancient dental calculus (DC) serves as a critical biomolecular repository, preserving dietary and extradietary residues related to past health and disease. This review examines DC as a potential ‘One Paleopathology’ resource, highlighting the interconnectedness of past human-animal-environmental health. Through a One Health lens, it critically assesses current research and opportunities for the next 50 years of study. Results: By synthesizing the available literature and the current state of the art, we critically evaluate how DC research bridges paleopathology, bioarchaeology, and modern health sciences, providing a unique lens for assessing health and disease within ecological and evolutionary contexts. We highlight methodological advances and limitations, while identifying critical gaps and opportunities for interdisciplinary integration, standardization, and forward-looking research to expand the field over the next 50 years. Conclusions: DC research effectively integrates paleopathology, bioarchaeology, and modern health sciences enabling the reconstruction of health and disease within ecological and evolutionary contexts and highlights the interdependence of humans, animals, and the environment. Significance: From a One Health perspective, dental calculus analysis provides a long-term perspective on interactions among humans, animals, microbes, and environments, informing past and contemporary health research. Limitations: Interpretation is constrained by preservation biases, variability in analytical methods, and the destructive nature of sampling dental calculus. Further Research: Future investigations should prioritize sustainable sampling, methodological standardization, and interdisciplinary collaboration. Emerging technologies and integrative approaches will place DC research at the forefront of ‘One Paleopathology’.