Access to all articles, new health classes, discounts in our store, and more!
Diet and Tooth Decay Are Related
Typed, undated manuscript, no publication information available.
* * *
Introduction:
Our present so-called “balanced diet” is inadequate, for teeth of our American children prove this, for
A. 98% have teeth with decay or caries.
B. Midshipmen’s caries increased although their diet was superior nutritionally according to accepted standards.
What is wrong? What causes this decay? Does diet contribute to it? If so, how?
Held:
1. Tooth decay is one of many manifestations of a certain imbalance in nutrition.
2. Diet is a prime factor in causing, correcting and preventing this particular nutritional disturbance.
3. Bones and teeth (enamel) do not react alike to certain nutritional faults.
History:
I. Discoveries:
A. Earliest discoveries:
1. Galen, 131-210 A.D. noted this, for
a. Held: disturbance in nutrition caused tooth decay.
B. Later nutritional factors discovered, for
1. Protein defined, for
a. Mulden, 1839, coined the word: “Protein”–meaning “first”
2. Calories defined.
3. Amino acid defined.
4. Vitamins defined.
A. Funk, 1900, coined the word, called it “vitamine”, from “vita” (essential to life) and “amine” belonging to class of nitrogenous substances called “amines”
• Found could prevent and cure beriberi and rickets by a “something” in cod liver oil.
• Experiments on rice polishings showed this.
C. Teeth and Bone relationship discovered:
1. Originally held the same (up to 1800), for
A. Claimed caries of teeth and bone the same.
2. Differentiated:
a. Fox, 1800, differentiated, for
• Held bones could be repaired by nature.
• Teeth could not be repaired, had to be extracted.
b. Miller, 1881, held decay externally caused, for
• Enamel affected by food debris, for
• Starches and sugars trapped in pits and fissures converted into lactic acid, for
• Bacteria did this
c. Williams (J. Leon), held tooth decay due to environment: “Clean teeth can not decay” for
• Held enamel does not change once it is formed.
d. Mrs. May Mellanby held tooth decay due to deficiency in “Vitamin D.”
e. Agnew6 held tooth decay due to lack of phosphorous and “D.”
f. Price8 held fat soluble activators and phosphorous play dominant role in control of caries.
g. Bunting,2 Boyd and Drain,9 held acid-base balance not a factor in dental disease.
II. Diet Inadequacy
A. Our present diet is inadequate, for
1. Average diet recommended for children shows this, for
a. 83% of large group of children1 on this diet had progressive tooth decay (caries), for
• Diet consisted of: 1 qt. milk, 1 egg, 1-2 oz. butter, 1-2 pounds fruits and vegetables, other foods.
2. Milk and calcium not the controlling factors, for
a. Good teeth found where no milk taken, for
• Polynesians show this, for: No milk in the diet excepting mother’s milk.
• Chinese orphan children show this.37
b. Long breast feeding does not insure development of good teeth, for
• Hawaiian babies18 shows this, for (1) Almost universally breast fed for a year or much longer; (2) 95% of 64 babies had decayed teeth for 15 months.
• Day and Sedwick14 show this, for found (1) Little difference in caries between breastfed and artificially fed babies, for (a) Complete statistics of 370 children showed this.
• Hess13 showed this, for (1) Each of four breastfed babies controlled had caries in both deciduous and permanent teeth. (2) Diet of each of above included: 1 pt. milk, butter, 3 eggs/week, vegetables; 1 pt. milk, butter, 2 eggs daily, orange juice, no vegetables; 1 pt. milk, butter, 2 eggs daily, no vegetables; 1 qt. milk, 1 egg daily, few vegetables.
c. Cows milk not the answer, for
• Babies fed on it are 3 times as liable to rickets as breastfed.
• Cows milk has 3 times the calcium, 6 times the phosphorous of woman’s milk.
3. Vitamins and phosphorous not the answer, for
a. Honoroff4 diet shows this, for
• High in phosphorous (1.8 gm)
• Rich in vitamins, for: (1) Supplemented base diet with cod liver oil, cream, malt extract and egg.
• Low in calcium (.090 gm).
• Result: (1) 92.5% of children had active caries to unusual degree during the 2 yr. Control. (a) Number of new cavities higher than average child under ordinary diet and hygiene, for 37 of 40 children developed average of 3.6 new cavities per child.
b. Mellanby7 diet shows this, for
• Shows Vit. D. not the determining factor, for (1) Diet #7, highest in “D” (12.9 times daily requirement) produced 4 times number of new cavities as Diet #8 with only ⅓ as much “D.” (2) Diet #6 and #8, with comparable amounts of “D” show this: (a) Diet #6 has 5 times increase in caries as #8. (3) Increase in cavities almost as high as average American child, for (a) American child increase in cavities, in six Mos: .75; (b) Mellanby child increase in cavities, in six Mos: .63.
c. Hanke1 shows this, for
• Caries reduced 50% in child with low “D.”
d. Day and Sedwich14 show this, for
• Gave 147 children 6000 A, 1400 D, for 1 yr. found “no appreciable effect.”
e. Mooseheart1 experiments show this, for 3 yr. control does, for
• Shows Vitamin C not a contributing factor, for (1) Orange-lemon juice proven not controlling factor, for (a) 16 oz. orange juice, plus 1 lemon daily (1 oz is all that is necessary); plus 1 qt. milk, almost one egg, 1½ oz. butter, plus other food, show this for: 33.7% of children had active caries; 83.4% of children had active caries–orange juice reduced; Less caries when no orange juice, than when 3 oz. (3 times requirement) taken.
f. Hawaii shows this, for
• Shows Vit “D” not the controlling factor, for (1) Tooth decay almost universal and rampant amongst islanders of the laboring population, for (a) Teeth of their babies erupt defective with little or no enamel. (2) Bone quality poor, for (a) Flat, broad, flexible chests of child show this. (b) Histologic studies of bone show this.
3. Carbohydrates not controlling factor, for
a. Caries immunity found in diets low in carbohydrates, for
• Boyd and Drain9 show this.
b. Caries immunity found in diets excessive in carbohydrates, for
• Original Polynesian diet shows this, for (1) 80% of calories were in form of sugar and starch, for (a) Taro, sweet potato and sugar cane, and taro leaf tops principal foods. No milk.
• Plantation negro diet show this, for (1) Carbohydrates from corn, sweet potato, sugar cane and sorghum. Little milk. Turnip tops used in large quantities.
• Chinese children37 74-78% of diet in form of carbohydrates.
II. Diet Definitely Affects Teeth, for
A. Bones and teeth respond differently to diet, for
1. Experiments prove enamel and bone (including dentin and cementum) respond differently, for
a. Enamel on dogs’ teeth proved this, for
• Jones16 experiment 1920-1928 proved this, for (1) Enamel and bone responded differently, for (a) Alkaline excess diet shows this, for
• Enamel showed this, for: Enamel excellent, for: (a) Never had disintegration of enamel (odontoclasia) on highly alkaline diet. (b) No caries seen in 300 dogs studied.
• Bones, dentin and cementum showed this, for (1) Retrograded, for (a) Long bones and alveolar process resorbed. (b) Cementum, dentin showed this, for: Roots of teeth resorbed leaving only enamel intact, for (1) Enamel caps, only, left in one case. Dentin as well as entire root end missing. Carnivorous animal more susceptible to metabolic disturbance from alkaline diet than man.
b. Alkaline, if neutralized, showed this, for
• Enamel showed this; for (1) Enamel disintegrated.
• Bones; dentin, cementum showed this, for (1) Conditions improved.
b. Experiments on babies and children proved this, for
• Jones4,33 experiments 1929-1933, showed this, for
(1) Enamel showed this, for (a) Excellent if good balance of excess alkaline maintained, for: Old Hawaiian balance of alkaline and acid foods showed this, for (1) Enamel, bones excellent.
• Samoan alkaline diet showed this, for (1) Enamel excellent.
• Microscopic study of autopsy showed this, for (1) Hawaiian cases showed this, for (a) Dentin found comparable to bone tissue, not necessarily like enamel.
• Case 1: Baby 5 days old showed this.
• Case 2: Dentin and bone good; enamel poor. Mother had acute nephritis.
• Case 3: Dentine, bones abnormal; enamel excellent. Baby had 100 fractures.
• Case 4: Dentin mass of loosely put together globules; bones poor; enamel good, well calcified. (1) Baby had rickets.
• Case 5: Dentine, bones relatively good; enamel completely disorganized. Baby died of starvation.
• Adult rickets showed this, for (1) Retrograde changes in bone; no change in enamel.
C. Comparative Diets show this, for
1. Average American diet37 shows this, for
a. Tooth decay found in 98% of children, for
• Diet neutral in reaction, for
(1) Bureau of Human Nutrition and Home Economics shows this,
(a) Diet consists of: milk, meat, eggs, cereals, potato, citrus and other fruits, mixed vegetables, dried peas, bean, peanuts, butter, lard, sugar, jam.
(b) Diet produces 1.2 alkali excess (see chart in Appendix)
2. Southern Plantation negro37 diet shows this, for
a. Teeth excellent, for
• Diet strongly alkaline in reaction, for
(1) Consists, essentially, of: corn, turnip tops and other greens and vegetables, sweet potato, molasses, small amount meat, mostly pork, little, if any, milk or egg.
(2) Diet calcium and vitamins found in greens, molasses and sweet potato.
3. Samoan diet (Ferguson24) shows this, for
Teeth excellent, for
• Diet strongly alkaline in reaction, for
(1) Diet consists essentially of: taro, root and leaves; bananas, coconuts, breadfruit, papayas; sugar cane–chewed; luxuries: limes, oranges, fish, pig, chicken; no milk or egg.
• Check of 1365 children showed this, for (1) 4.9% had a total of 85 carious teeth.
• Paradontoclasia in 98% of adults.
4. Samoan-Hawaiian diet shows this, for
a. Change in diet shows this, for
• Native (old custom) diet produced good teeth, for
(1) Record of 22 children18 1 to 15 yrs. old showed this.
(a) Native food produced: 96.4% had excellent teeth; 72.7% had no decay; 22.7% had 1 or 2 small cavities.
(b) Changed diet showed this (diet: rice, bread, refined sugar substituted)—40% (8 out of 20) had no decayed teeth; 12 (60%) had 89 decayed or extracted.
(2) Record of family of 837 showed this, for
(a) Only 1 carious tooth in all 8: 2 grandparents, four grown children, 2 grandchildren, for
• Family ate native food only, cooked in native fashion (on hot rocks in pit dug out in ground): taro roots; sweet potato; breadfruit; bananas, papayas; leaf package containing young taro leaves and grated coconut; 2½ feet sugar cane chewed for dessert.
5. Chinese diet showed this (McCollum,22 quoting Wang)
a. Teeth excellent, for
• Diet strongly alkaline in reaction, for
(1) Eggs, bean sprouts, blood, liberal quantities of leafy vegetables, some corn; sorghum syrup.
b. 96 Chinese boys’ diet showed this.
c. “Millions of people in Asia learned the unique nutritive value of green plants which we in America have never learned to appreciate” (McCollum)
6. Japanese diet shows this (Marimoto23)
a. Largest consumers of vegetables in world.
b. Effect of sweet potato, principal food in many sections, shows this
• White rice a luxury, assoc. with wealth and office.
• Sweet potato “poor man’s” food.
c. When sweet potato substituted for rice
• Better teeth produced, for (1) Japanese babies born in Hawaii and taken to Japan sweet-potato-district shows this37 for
(a) Had no decay until returned to Hawaii
(b) Brothers and sisters reared in Hawaii, with rice, had teeth full of decay.
7. Mooseheart1 diet shows this, for
a. Tooth decay decreased as alkalinity of diet increased.
• 83% of children had caries on 22 cc alkali excess in diet.
• 34% of children had caries on 55 cc alkali excess in diet.
b. Too much alkali excess bad, for
• Probably should not exceed 80 cc for 3200 calories diet37
1) Findings in Samoa, Tristan da Cunha, show this
a) 98% adults in Samoa have paradontoclasia (excellent teeth but they loosen and fall out)
• Diet is 134 cc excess alkali ash.
• Accumulation of calculus, for (1) due to long continued use of vegetable-fruit diet, rich in mineral and alkali.
• Betel nut forms deposit of lime over teeth.
8. Sherman5 and Honoroff4 shows this, for
a.Teeth poor, for
• Almost 100% had caries (Av. American child now over 98%)
(1) Sherman–average American diet.
(2) Honoroff–average American diet plus (over two yr. period): egg, cod liver oil, malt.
9. Navy38,39 diet showed this.
a. 202 of 212 enlisted men (1935 Pearl Harbor) showed this, for
• Had active tooth decay, average number defects per man: 14.78%
• Dental defects parallelled time served in Hawaii, for
(a) Percentage: 1 yr., 23.50%; 1-2 yr., 30.06%; 2-5 yr., 39.97%.
(1) Age no factor in increase.
(2) Diet low in alkali excess: 18.86 cc, for: 17.20 oz. meat; 1 egg; 9 oz. whole milk; 1⅓ oz butter; 11 oz. bread and grain prod.; 2 lb. potato and vegetables; 1 lb. fruit; 4 oz. sugar and syrup.
b. Midshipmen diet: 1937 class, Pearl Harbor, showed this (328 men)
• Caries: 96.0% on admission; 98.5% on graduation, for
(1) Average number defects increased from 12.46 to 22.42
(a) Increase 3 times that found in comparable civilian life.
(b) Due to:
• Diet low in alkali excess, for (1) rich in protein, calories, phosphorous, iron and vitamins. (a) Field Ration A–.54 cc normal acid. (b) Midshipmen: alkali excess 7.2 cc. (c) Enlisted men: alkali excess 5.2 cc.
• Nervous tension
• Physical activity lowers blood’s base reserve.
c. Army Field Ration A–1942–compared to Navy diet:
D. Balanced Acid-Alkali Diet shows this, for
1. Jones’ Balance shows this, for
a. Hawaiian Health Project,40 (Ewa Plantation 1929-1933) shows this
• Results show this, for
(1) Conditions found in 1929, amongst babies and preschool children show this, for
(a) Incidence high in: colds, impetigo, pink eye, ear infections, rampant tooth decay, for (1) of 50 babies, 40 had decayed teeth at 1; (2) 49 out of 50 had decayed teeth at 2 yr.
(b) Mortality high, for
• 25 out of the 75 Filipino babies born, 1929
• 12 preschool children died in 1929
(2) Conditions found in 1933, show this.
(a) Incidence low in: colds, pneumonia, impetigo, pink eye, ear infections, tooth decay, for: (1) cleared or arrested in Health Center babies on Jones’ Balanced Diet, for taro and sweet potato substituted for grain food.
(b) Mortality low, for
• Charts show this (see Appendix)
• 225 babies enrolled in Health Center in 1933 with 85% in daily attendance.
• Death rate remains high in sections where Jones’ Balanced Diet not used.
b. Food factors37 show this, for
• Natural foods balance each other, for
(1) Leaves are rich in: Minerals, Vitamins, Alkali excess
(2) Grains are rich in: Carbohydrates, Acid in reaction
(3) Flesh foods: Blood–alkaline in reaction; Muscle–acid in reaction
• Food reactions show this, for
(1) Vegetables show this, for
a) Leafy vegetables show this, for
• Rich in vitamins, minerals, iron: (1) Thinner, greener leaves best, as spinach, dandelion greens, turnip tops, mustard greens, etc.; (2)Thicker leaves less valuable, such as cabbage, chard, head lettuce
• Low in starch, calories
• Alkaline in reaction, for: High in excess alkali cc.
b) Root vegetables show this, for
• Rich in starch (calories)
• Poor in minerals
• Vitamins: Yellower–higher in “A” vitamin; Carrot rich in “A.”
(2) Fruits show this, for
(a) Good in minerals, vitamins
(b) Yellow fruits highest in “A” vitamin
(c) Alkaline in reaction: Inferior to leafy vegetables. Do not insure sound teeth.
(3) Flesh foods show this, for
(a) Good in proteins, calories
(b) Nutritive value depends on tissue:
• Blood highest nutritive value. Greatest source of minerals, vitamins. Alkaline in reaction: (a) Excess alkali in 1 pt. blood neutralizes acid in 500 calories of muscle meat.
• Liver and organs.
• Fat
• Marrow and cartilaginous bone
• Muscle: Low in minerals. Acid in reaction.
(c) Protein of muscle is broken down into urea, which in turn is split into ammonia (alkali) and carbon dioxide (acid).
(4) Grains show this, for
(a) Rich in calories, proteins
(b) Acid in reaction
(c) When polished, loss of vitamins
• Beriberi (lack of “B” results from eating too much polished rice.
(5) Eggs show this for
(a) Rich in phosphorous; protein and vitamin (“D”)
(b) Acid in reaction.
• x)Too many eggs can create an imbalance toward acid and may result in tooth decay.
(6) Milk shows this, for
(a) Good in minerals, proteins, fat, some vitamins.
(b) Does not insure sound teeth, for
• Not indispensable, for (1) 1 qt. cows milk gives 22 cc n. alkali but does not prevent tooth decay. (2) Orientals, Polynesians and others do not have milk in diet (other than mothers milk) but had sound teeth.
• Other food factors show this, for
(1) Calcium and phosphorous show this.
(2) Vitamins show this, for
(a) “A” Vitamin shows this.
• Source: fish liver oils, yellow, green vegetables, apricots, tomatoes, liver, butter, egg yolks.
• Value: (1) To prevent: Respiratory infections of mucous membranes or eyes, ears, nose, sinuses, throat, intestines, lungs; Night blindness. (2) To build: bones, skin, teeth, nerves, tooth enamel.
(b) “B” Vitamin shows this
• Source: wheat germ, yeast, soy bean, ham, pork, liver, kidneys, heart.
• Value: (1) To prevent: indigestion, constipation; nerves; beriberi; cold sores, cracked lips, quick lip bleeding. (2) To build: (a) Normal functioning digestive, nerves. (b) Aids in metabolism of carbohydrates and fats.
(c) “C” Vitamin shows this, for
• Source: guavas, honeydew melon, mustard greens, green peppers, citrus fruits.
• Value: (1) To prevent: scurvy; breaking of small blood vessels; infections; fragile bones. (2) To build: strong teeth and bones; healthy gums.
(d) “D” Vitamin shows this, for
• Source: sunshine, fish liver oils.
• Value: (1) To prevent: weak; rigid bones; rickets. (2) To build: strong bones.
• Important effect on mineral metabolism:
1. May, in excess, increase caries, for
a. Violet Ray did this, for
i. “Irradiating blood in vitro increases its acidity–fatal doses always accompanied by acidosis” (Laurens19)
ii. Liecht found an increased local subcutaneous acid lasting several days following ultra violet radiation.(Grayzel and Miller31).
iii. Potassium in blood diminished after 3 or more radiation with mercury vapor quartz lamp (Pincuosen and Makrineos)
iv. Increased acid of intestinal contents of: (1) rachitic babies; (2) dogs,rats.
v. Increased acid condition of skin (Koplansky32).
vi. Carnivorous animals prowl at night to avoid sun and “D” stimulant.
vii. Carnivorous African tribes lethargic, sleep much of the night; said to be due to protein putrefaction in intestines.
viii. May increase liability to respiratory/and blood vessel disease, for diet imbalance has shown [this].
III. Jones’ Balanced Diet:
To insure a good health and sound teeth, on a mixed diet it is necessary to have sufficient amounts of protein, fat, carbohydrates, calcium, phosphorous, iron, vitamins, and all other essential food constituents, plus a certain minimum of alkali ash.
A. Maintain Alkali excess by:
1. Fruits and vegetables.
a. Child:
• Needs more than adult, for needs
(1) 2 servings of fruit or vegetable for every serving of acid ash-food (meat, fish, eggs, cereal, bread, pastry). Serve 1 thin, green leaf vegetable (spinach, turnip tops and beet tops, mustard greens, etc.) for every 4 servings of vegetables (one thin-leaf green vegetable in every five vegetable servings) for
• Thin leaf green vegetable yields more calcium, minerals and alkali excess, for (1) The thinner and greener the leaf, the richer in minerals, vitamins and potent alkalinity.
b. Increase amount of fruits and vegetables in summer and sun exposure.
• Necessary to balance Vitamin “D”,42 for
1. Alkali lowered in blood plasm by sun-exposure5,30,42
2. High degree urine acidity reaction from sun (Blatherwick5)
3. Poor physical development, rampant tooth decay if on a grain and little vegetable diet42,30
4. In tropical climates adults may need 150 cc alkali42
c. Avoid excessive alkali balance, for
• Over 100 cc (unless in hot season of temperate climate, or in tropical climates) may result in (1) Calculus formations;37 (2) Alveolar atrophy (loosening of teeth in adult life).
(a) Samoa showed this for sea food (protein-acid) reduced, increased alkali excess and paradontoclasia resulted almost universally in people over 35.37
B. Jones’ Balanced Diet Applied to:
1. Sherman (Average American Diet)
a.Option One:
• Reduce grains. From 1220 calories to 600 calories (½ loaf of bread.)
• Substitute: (1) 400 calories of potato; (2) 20 calories of thin leaf, green vegetable. (3) 200 calories of molasses (sorghum or cane, be certain no corn syrup in it).
• Result: (1) Same carbohydrates; (2) More minerals, vitamins; (3) Alkali excess.
b. Option Two:
• Reduce meat: From 608 calories to 388 calories.
• Substitute: (1) 20 calories thin-leaf green vegetables (4 oz.cooked); (2) 200 calories of molasses (about 3 Tablespoons)
• Results: (1) Small gain in calcium. (2) Large gain in iron and vitamins; (3) Alkali gain of 77 cc.
2. Hawaii
a. Ewa Plantation–native diet for babies, 1929
• 50-60% calories from milk.
• 30-40% calories from grain, and small amount meat, fruit, veg.
• Example: (1) 22 lb. baby fed: (a) 24-40 oz. cow’s milk. (b) small amounts vegetables and fruit; (c) 30-40% total calories from rice and bread. Gave alkali of 5 cc. Urine reaction of child strongly acid.
• Result: (1) Nearly 100% tooth decay in 12- to 15 mos. babies. (2) High susceptibility to head colds, pneumonia, skin, and other diseases.
b. Jones’ Hawaii diet42,43
• Substitute for babies: Poi and sweet potato for grain. Result: increase of alkali to 45 cc. Urine reaction becomes normal or even alkali.
• Substitute for older children: fruits–generous amount; vegetables–generous amount; taro (root and top); sweet potato; milk; meat and egg; cane syrup for sugar (refined sugar is acid in reaction).
• Substitute for adults: above diet. Results: (a) Improved health; (b) arrest of tooth decay; (c) greater resistance to colds.
• Substitute for pregnant woman: above diet. Result: (a) babies born with better bones and teeth; (b) better start in life.
3. Shol’s and Sato’s diet, vs Jones’ diet.
a. Diet: (Shol’s and Sato’s) Milk, vegetable, small amounts meat, egg.
b. Result:
• If leaf vegetables and fruit used in excess, could exceed 68 cc alkali excess.
• If too high in alkali excess, bad for bone if used for weeks or months, unless generous supply of “D.” Hawaii has 7½ hours tropical sunshine daily.
4. Mellanby diet vs. Jones’ diet.
a. Mellanby diets conducted at different times, conditions, on different children and of different composition.
• In the one experiment in which the incidence of caries was the least recorded, the potential alkali of the diet was the greatest.
• African sun held nec. by Mellanby, for Vit. “D.” No reference made by Mellanby to diet, to type of vegetable or fruit eaten by natives.
• When native children placed in school and clothed, 50% of children developed tooth decay. Therefore Mrs. Mellanby concluded that “even the African sun may not be of great calcifying or protective value when it strikes well-clothed children.”
• She makes no mention of the introduction of civilized food: cereals and grains as well as clothes.
5. Navy vs Jones’ diet.
a. Reduce:
• Meat—300 calories (⅓ pound)
• Bread—100 calories (1 slice)
• Sugar—100 calories (1¾ T.)
b. Increase:
• Milk—300 calories (14 oz) (to replace meat)
c. Substitute:
• Raw vegetables—100 calories (for bread)
• Molasses—100 calories (for sugar) 1 ½ T.
d. Result:
6. Average American Diet (Red Cross Nutrition Diet) vs Jones
a. Jones:
• Reduce: 220 calories meat.
• Substitute: (1) 20 calories spinach; (2) 200 calories molasses (3 T)
• Result:
7. Comparative diets vs Jones.
a. See chart in Appendix.
IV. Conclusion:
The dietary principle involved in the Ewa Plantation feeding experiment is universal in its application. It may be that there is some unknown factor in fruits and vegetables which is specific for dental caries and that the leafy vegetables are particularly potent in this respect. However, until that factor is discovered, the potential alkalinity of an otherwise adequate diet seems to furnish a dependable guide for the control of dental disease. In the words of Aristotle: “If there is one way better than another it is the way of Nature.”
Report on Teeth
from
Plantation Health Bulletin, July, 1937
Editor: Nils P. Larsen, M.D., Charles L. Wilbar, Jr. M.D.
Published Ewa, Oahu, T.H. Vol. 11, No. 1
During the last two years various members of the Ewa Health Center have been asked whether our optimism about correcting tooth decay has continued. One of the bi-products of the Ewa Health Center has been the observation and the attempted finding of the cause of the rampant tooth decay in the children of the Islands.The first survey made in Honolulu showed that practically all the Oriental children in the Islands had tooth decay and many of them had very rampant decay. The common type is a form of enamel decay called “odontoclasia” and occurs principally in the deciduous teeth. Some of our previous publications have shown mouths of four and five year olds with every tooth decayed.
As to the causative factor, our working theory for a long time has been that the acid-base values of the food was the primary cause. This brought forth a great deal of discussion since there is considerable literature indicating that the acid-base values of diet have no demonstrable influence on health. However, there is also considerable evidence that under certain circumstances, and especially if continued for a long period of time, it may have definite effects. Whether the theory is the answer or not is of no importance. The observation, we feel, is the really important thing, and the observation is this, that children on high carbohydrate diet in which the carbohydrate is a cereal (rice) all have bad teeth; whereas children eating a high carbohydrate diet in which the carbohydrate is a tuber (taro or potato) have close to perfect teeth. Perhaps it is incidental that the starch of the cereal leaves an acid-residue, and the starch of the tubers leaves an alkaline residue after it has burned in the body. Nevertheless, this is a known definite factor. We are willing to grant, however, that someday some, as yet unknown vitamin or other factor may be found. If this is found it does not change the observation that children whose starch comes largely from the alkaline foods (fruit, vegetables, tubers) do have good teeth, and children whose starch comes from the cereals have bad teeth.
At present we are stating our observations a little differently, and rather than postulating that the acid-residue diet is associated with bad teeth, we state that an acid-residue diet in which the acid-residue comes largely from cereal (especially polished rice) is associated with bad teeth. The acid-residue diet coming from meat and fish, consumed by the Eskimo, for instance, has been reported as being associated with good teeth. Even on the acid~base theory this can still conceivably be correct since the body, being fed a great excess of meat, can turn much of this protein into ammonia and in this way neutralize other acid radicals.
The flat statement that an excess of acid radicals are always cared for by the body without any damage should be questioned. Aub and Retznikoff showed definitely, in the work on lead poisoning, that an excess of acid radicals causes an out-pouring of calcium from the bones. Hawley, in Rochester, has also recently shown that when vitamin C is ingested with a meat diet, there is considerable out-pouring of vitamin C. The concept we are stressing at the present time is that an excess of aid radicals may cause a non-utilization of necessary factors, even though these are ingested in the diet. We would like to stress the fact that we do not consider the theory as a proven one but an excellent one as a working hypothesis. We would like to again comment (and this has been proven repeatedly by observations made by doctors on the plantations) that poi-fed babies have infinitely better teeth than the rice-fed babies.
To make a gross check on Ewa Plantation as to whether the teaching program had been effective, Dr. Pritchard recently surveyed carefully the teeth of 173 children on the plantation in the same age group as those surveyed in 1931 at the start of the teaching program. The accompanying chart indicates definitely that there has been a marked improvement. You will note that there is about 50% less tooth decay than there was in 1931 at the same age level. But more than this. Dr. Pritchard reports it is the condition of the mouth–the hardness of the enamel and the general improvement–that is striking. This the actual numbers of decayed teeth hardly indicate. A very small cavity in 1936 on the chart receives the same value as a large cavity on a soft tooth in 1931. Hence, he reports, although the table itself is striking, the examination of the teeth is much more striking.
References Cited:
- Hanke, M. T. and the Chicago Dental Research Club: “Nutritional Studies on Children.” Dental Cosmos, 75: 933. Oct. 1933.
- Bunting, R. W., Jay, Philip, and Hard, Dorothy: “A report of the successful Control of Dental Caries in Three Public Institutions.” Journ. A.D.A. 18; 672. April, 1931.
- Koehne, Martha, Bunting, R. W. and Morrell, Elsie: Amer. Journ. Dis. Child. 48.6
- Honoroff, H. A.: “Prevention through Systematized Treatment of Children’s Teeth.” Journ. A.D.A. 21. 33 Jan. 1934.
- Sherman, H. C.: Chemistry of Food and Nutrition. Macmillan. 1932.
- Agnew, M. C. and R. G., and Tisdall, F. F.: “Production and Prevention of Dental Caries.” Journ. Pediat. 2:190. Feb. 1933.
- Mellanby, May: “Diet and Teeth,” Medical Research Council Special Report, Series No. 191.
- Price, Weston A.: “The Experimental Basis for a New Theory of Dental Caries.” Dental Cosmos, 74: 1139. Dec. 1932.
- Boyd, J. D., Drain, C. L. and Stearns, Genevieve: Journ. Biol. Chem. 103:327. 1933.
- Kugelmass, I. N., King; T. B. and Bodecker, C. F.: “Raw Basis Feeding in Prevention and Treatment of Dental Caries.” Journ. A.D.A. 21: 110. Jan. 1931.
- Hawkins, H. F.: “Relation of Diet to Dental Caries.” Journ. A.D.A. 21:630. April. 1934.
- Jones, Martha, Larsen, Nils P. and Pritchard, George P.: “Dental Disease in Hawaii.” Dental Cosmos 72: 797. August 1930.
- Hess, Alfred and Lewis, J. M.: “Appraisal of Antirachitics in Terms of Rat and Clinical Units.” Journ. A.M.A. 101; 181. July 1933.
- Day, C. D. M. and Sedwick, H. J.: “Studies of Incidence of Dental Caries in Children at Puberty.” Journ. Dental Research 14; 214. June 1934.
- Price, Weston A.: “Relation of Nutrition to Dental Caries among Eskimos and Indians in Alaska and Northern Canada.” Journ. Dental Research 14:227. June, 1934.
- Jones, Martha R. and Simonton, F. V.: Amer. Journ. Physiol. 79:694,1927. Journ. A.D.A. 15:881, May 1928. Journ. A.D.A. 14:984, June 1927; Proc. Soc. Exp. Biol. and Med. 23:734, May 1926.
- Morgan, Agnes Fay. University Cal. Pub. in Physiol. 8:61, 1934.
- Jones, Martha R., Larsen, Nils P. and Pritchard, G. P.: “Dental Disease in Hawaii.” Dental Cosmos, 72:439, 574. May and June, 1930.
- Laurens, J.: “Physiological effects of radiation.” Physiol. Rev. 8:1, Jan. 1928.
- Van Slyke, D. D.: “Studies of Acidosis: Normal and Abnormal Variations in Acid-Base Balance of Blood.” Journ. Biol. Chem. 48:153, Sept. 1921.
- Card, H. C. and Peters, J. P.: “Concentration of Acid and Base in Serum in Normal Pregnancy.” Journ. Biol. Chem. 81:9. Jun. 1929.
- McCollum, E. V. and Simmonds, Nina: Newer Knowledge of Nutrition. MacMillan 1929. Fourth Ed.
- Morimoto, Kokichi: “Efficiency Standard of Living in Japan.” Japan Council of Inst. of Pacific Relations. Tokyo, Japan.
- Ferguson, H. A.: “Dental Survey of School Children of American Samoa.” Journ. A.D.A. 21:534, March 1934.
- Hammond, J. and Hsia, Sheng: “Development and Diet of Chinese Children.” Amer. Journ. Disc. Child. 29:729. June 1925.
- Miller, Cary: Bernice P. Bishop Museum, Honolulu, Hawaii. Bulletin 62.
- Detlefsen, J. A. Journal Dental Research, 14:216. June 1934.
- Bradley, Alice V.: “Tables of Food Values.” Manual Arts Press 1931. Peoria, Ill.
- Bunting, R.W.: “Bacteriological, Chemical and Nutritional Studies of Dental Caries by the Michigan Research Group.” Journ. Dental Res.15:162. June, 1934.
- Shol, A. T. and Sato, A.: “Acid Base Metabolism, Determination of Base Balance.” Journ. Biol. Chem. 58:235, 1923.
- Grayzel, D. M. and Miller, E. G. Jr.: “The pH of Contents of Gastro Intestinal Tract in Dogs, in Relation to Diet and Rickets.” Journ. Biol. Chem. 76:423. Feb. 1928.
- Kaplansky, S.: Zeitschr. Ges. Exp. Med. 63:102. 1928.
- Jones, Martha R., Larsen, N. P. and Pritchard, G. P.: “Dental Disease in Hawaii: Can Unerupted Teeth Decay?” Journ. A.M.A. 99:1849. Nov. 26,1932.
“Dental Disease in Hawaii, Relationship between Bone and Tooth Development in Infants.” Amer. Journ. Dis. Child. 45:789,1933.
Jones, M. R., Larsen, Nils P. and Pritchard: G. P. Dental Cosmos. 72:797, 1930. - Jones, M. R., Larsen, Nils P. and Pritchard: G. P. Dental Cosmos, 72:685, 1930.
- Jones, M. R., Larsen, Nils P. and Pritchard: A. J. Dis. of Child. April 1933, Vol. 45, 789-798.
- Idem: Dental Cosmos, May, June, July, Aug. 1930. “Dental Disease in Hawaii.”
- Jones, Martha R.: “Our Changing Concept of an Adequate Diet in Relation to Dental Disease.” Dental Cosmos, June, July, Aug. 1935.
- Jones, Martha R. and Crosland, Geo. N.: U. S. N. Naval Medical Bulletin, Vol. 34, No. 2. L936, “A study of the Diet in Relation to Caries Activity in 212 Enlisted men at the Pearl Harbor Submarine Base, Hawaii.”
- Jones, Martha R.: “Dental Caries–the Handwriting in the Mouth.” Journ. of Dental Research, Vol. 22. No. 3. June, 1943.
- Hawaiian P. A. Research Health Project. Bulletin No. 1.
- Nilson, D.: Physiol. Rev. 1923, 3:295. “Muscular Exercise causes an increase in the acidity in the blood.” (quotation from it)
- Jones, Martha R., Larsen, Nils P. and Pritchard, G. P.: “Taro and Sweet Potatoes versus Grain Foods in Relation to Health and Dental Decay in Hawaii.” Dental Cosmos, April, 1934.
- Larsen, Nils P. and Wilbar, Chas. L.: “Report on Teeth.” Plantation Health Bulletin July, 1937. Vol 2. No.1.
Editor’s note: Since the era in which this article was written, society’s understanding of respectful terminology when referring to ethnic and cultural groups has evolved, and some readers may be offended by references to “negro” people and other out-of-date terminology. However, this article has been archived as a historical document, and so we have chosen to use the author’s exact words in the interest of authenticity. No disrespect to any cultural or ethnic group is intended.