Reference values reflecting the findings of natural concentrations of teeth in a well-defined group of individuals, are indispensable, if one is to interpret results generated for clinical utility. Hence, a comprehensive compilation of literature survey is attempted to make available as a reference guideline for tooth element concentrations. Presently, the reference values are proposed for 19 elements. Several factors that are found influencing element levels, are common to any biosample and are broadly grouped under four categories namely, the factors of teeth, donor, environment and analytical methods. How best the influencing factors to be considered during analysis, are discussed. It is elucidated that standardized method of analysis with quality assurance and precision will reduce the ambiguity of comparison of inter-laboratory measurement. When the merits and demerits of element measurements are evaluated, it is recognized that except a hurdle of difficult specific sampling, many advantages make teeth an attractive material for environmental health monitoring of population and for assessment of element status of deficiency and excess due to differential exposure. The available data of tooth elements are lesser in comparison to data of blood and hair; further studies are required for reference values of others elements and for distribution pattern in different conditions, parts and types of teeth.