Practical Procedures For Nutritional Control of Dental Caries Based Upon Studies of Primitive Districts Providing Immunity

These boys are brothers and eat at the same table. The younger, to the left, has rampant tooth decay; he lives on modern foods. The other, on the right, has excellent teeth; he lives on the native diet.

 

Dental caries (tooth decay), civilization’s most universal disease, now seems destined early to join the ranks of the controlled diseases since the evidence seems clearly to indicate that the chief contributing factors are nutritional deficiencies which can be supplied. It is particularly significant that the most important sources of enlightenment have come from a study of some primitive races of the world whose immunity has long been known to be exceedingly high. The important new truths learned from their food and habits of life have been obtained by a critical analysis of the articles of their nutrition and by making comparisons with the foods of people suffering from dental caries and thus locating some factors that are constantly present when teeth do not decay and are absent when teeth do decay. Many studies have been made of the change in nutrition just at the point of contact with modern civilization since it has been demonstrated that practically all races and groups who have high immunity to tooth decay when living in primitive conditions have lost that immunity with the establishment of contact with modern civilization.

This latter phase has been found to be true whether civilization has slowly invaded the borders of primitive communities having high immunity or whether individuals have passed from that zone to sojourn in a region of modern civilization.

These studies have been carried on by personal field investigations among groups of people whose physical isolation has protected them from using any other foods than those naturally provided locally.

Among the groups reported are inhabitants of the Islands of the Outer Hebrides, in some districts of which very primitive conditions still exist, and with them exceedingly high immunity to tooth decay when comparison is made with those parts of these islands where the foods of modern civilizations have arrived. With this immunity to dental caries a wonderfully fine physical development and freedom from degenerative diseases is also disclosed. Strangely, many of the supposed essentials for immunity as modernly thought of are found in these places. For example, much emphasis has been placed on the need that food should be hard and require much exercise in mastication.

Many are teaching that the alkalinity-producing or basic foods must predominate over the acid-producing. Much emphasis has also been placed in modern programs (though abundantly demonstrated to be inadequate) on oral prophylaxis.

These individuals had their splendid immunity without knowledge of modern oral hygiene and the widely advertised mouth washes and dentifrices, or even of toothbrushes. Not that these articles are not desirable, but these primitive folk had their immunity in spite of the absence of them. It would be difficult to find a more acid-producing diet or a more mushy one than was provided by their simple menus. About the only grain that they produce in any quantity locally is oats. These, with sea foods, constitute an exceedingly high percentage of the total foods of the individuals living under primitive conditions in the Outer Hebrides.

Their physical development is very fine so long as they remain on their natural foods, and less than two teeth per hundred examined were found to have been attacked by tooth decay. However, within a short time after contact was made with modern foods by the establishment of a port of call for boats or the building of roads to transport the modern foods inland, this immunity was universally lost. It was often lost so very rapidly that tooth decay was found to be present in the children of the same age groups to the extent that twenty-five out of every hundred teeth examined had already been attacked with tooth decay.

Among the special studies made was the application of a new approach to the problem as developed by the author by chemical analysis of the saliva to determine the presence or absence in the saliva of chemicals which, by their presence, indicate a high immunity, and by their absence a low immunity to tooth decay. This phase of the study not only checked with the clinical investigations with regard to the levels of immunity but also tended to verify the author’s new interpretation of the nature of tooth decay and the physical and chemical processes involved.

Reports of similar studies of people in isolated districts in the Alps of Switzerland revealed that a very high immunity was provided by an entirely different diet; namely, entire rye products and daily products. It was similarly found that as soon as the physical isolation was destroyed by building of roads, or tunnels for railroads, dental caries became as rampant as it is in modern civilizations in all parts of the world. The percentage of teeth involved where the food was limited to that of the isolated districts in the Alps was 4.6 of each hundred teeth examined for growing children; whereas, in the groups sufficiently modernized to receive modern foods, 25.6 per cent of each hundred teeth examined had already been attacked by dental caries.

A chemical analysis of the foods in the two groups; namely, those with high immunity and those with high susceptibility to tooth decay, reveals very striking differences which may be briefly expressed as follows: where the people had high immunity the predominating foods were relatively high in minerals in proportion to energy-producing factors or calories. In the foods of modern civilizations this is largely reversed. In addition, the foods of the individuals with high immunity to tooth decay were high in fat-soluble activators, including known fat-soluble vitamins, while the foods which failed to establish and maintain immunity were low in these fat-soluble activators.

As a check on the practical application of these new principles, large numbers of individual children, as well as special groups, have had their diets reinforced to make them, in principal, like those found associated with immunity. Included in this study are three groups of children in two missions–one of which is running for the second year. The children in one mission have been receiving one meal a day, six days a week; in the other, five days a week. In no case has dental caries extended as new cavities; nor have cavities already established extended or enlarged. On the contrary, decalcified dentine has been remineralized–not revitalized–and in a large number of cases tooth pulps have been induced to build in protective walls beneath approaching tooth decay. In no case, whether in the clinic groups or in experimental groups, has dental caries continued to be active where satisfactory cooperation has been provided in the carrying out of the nutritional program.

Many illustrations are presented indicating a relation of general physical development to the same nutritional deficiencies. For example, there were 110 cases of marked irregularity of the teeth such as would indicate the need for orthodontic or tooth straightening processes among the children with low incidence of tooth decay. On the other hand, a very general tendency was found both to deformity in the arrangement of the teeth and the shape of the arches and, indeed, in imperfect facial development of the individuals who are on the diet that permitted tooth decay.

Not a single case of mouth breathing was found in the group with natural immunity to tooth decay, but in several groups on deficient modern diets, many cases of mouth breathing and inadequate development of the air spaces of the nose were found.

Another symptom or expression of the nutritional disturbance was the difference in the position and development of the third molar. These were always in normal position in the group with high immunity, and very frequently and, indeed, generally in abnormal position and direction of development, leading to impaction in individuals in the middle and early teen age, on the more deficient diets.

One of the most universal differences in the diet was in the levels of calcium and phosphorus that were provided in the average daily ration. For the gram factor of the foods this practically always meant the difference between an entire grain product and the white flour products. The chemical analysis of the grains and flours used indicated that a large proportion of the phosphorus had been removed in the process of milling, sometimes as much as eighty per cent.

Accordingly, in the light of our newer knowledge, dental caries or tooth decay is not a disease at all but really only a symptom. Sometimes it is only one of several symptoms of nutritional stress produced by an inability of the food to supply the body with all the factors necessary for life.

Another important development in these investigations has revealed that these deficiencies in mineral and activator content of food are often due to mineral deficiencies in the soil that reduce the mineral content of plants, and in the fodders that are provided for dairy animals. Therefore, the problem very often has geographic expression of increased severity. This phase is one of extreme importance to the people of New England because of the evidence of increase in some degenerative processes which have also been shown to be directly and indirectly related to similar nutritional deficiencies. This is particularly true of arthritis. A recent official health report for the state of Massachusetts indicated that there are approximately one hundred and fifty thousand cases of arthritis in this one state alone, causing probably ten times as much incapacity for work as heart disease, and for which medicine has not found a means of prevention or control.

This provides an important new approach to this and a number of other degenerative processes, including degenerative processes of the heart, and even the lowering of defense which makes heart involvements more easily possible not only in childhood, but also at all ages. It is not accidental that seventy-five per cent of all cases of organic heart disease begin before ten years of age and that of these nearly all suffered from active tooth decay in that period.

It is of particular interest and apparent significance that, in those sections of the country where farms are abandoned because they have run out, the chief chemical that they have run out of: namely, phosphorus, is one that is practically always found to be deficient in the nutrition of individuals with tooth decay. Further, that the development of the vitalizing activators in the growing plants is shown by these investigations to be directly related to an inadequacy of phosphorus in the soil in which the plant was growing as one of the contributing factors. Practical cases are shown of many degenerative processes which have greatly improved by reinforcing the diet with the high mineral-carrying foods, particularly those rich in phosphorus, together with fat-soluble activators. These have included, in addition to the complete control of dental caries, a marked improvement of many cases of arthritis and several other conditions. Unfortunately, the number of foods that are specially high in phosphorus while low in energy-producing factors or calories are quite limited, as are also the foods that provide the fat-soluble activators; also artificial substitutes have not been found that can satisfactorily replace the natural foods. An important advance is being made in providing the latter by furnishing dairy cattle with fodder that is high in vitalizing factors, which are created in the plants by sunshine when the plants contain the proper chemicals. The feeding of cattle with rapidly growing young wheat has produced a milk and butter-fat of very greatly enhanced value for making the minerals available when they are present in foods.

Tooth decay can now be prevented and can also be checked when it is active by the simple procedure of giving the individuals foods as high in minerals and fat-soluble activators as those of our primitive ancestors. At the same time many other degenerative processes will be prevented from developing, or their severity relieved if already established.

As this is being published the writer is extending these field studies by an investigation of the American Eskimos and American Indians in various stages of civilization. These include primitive districts in both Alaska and northern Canada. Considerable data have already been secured by a study of groups of modernized Indians living on typical foods of civilizations with the same striking dental results that so regularly attend the use of modern dietaries. A review of these North American studies will be presented to the readers of The Dental Digest during the autumn. The entire series may be reproduced in book form for general distribution if a sufficient number of individuals indicate to the publishers of Oral Hygiene and The Dental Digest their interest in having this done.

In addition to this, material for a textbook has been prepared by the writer, which will give critical interpretation of the various data and which will include chemical procedures for analysis of foods to determine their mineral and activator content and procedures for analyzing saliva for determining the level of immunity of an individual with regard to dental caries. General procedures are given in detail for the making of diagnoses, the establishment of nutritional programs for individual cases with rampant caries, and an outline for nutritional program that will be protective. This will be a volume of a little over a hundred thousand words, about three hundred pages, and the publishers will proceed with its publication immediately after sufficient evidence is available to justify their doing so.

 

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 “primitive” people and other out-of-date terminology. However, this article has been archived as a historical document, and so we have chosen to use Price’s exact words in the interest of authenticity.  No disrespect to any cultural or ethnic group is intended.