The relationship of the teeth to general health and efficiency was appreciated in a general way long before vitamins or focal infections had been heard of. Toothaches used to be as inevitable as colds, and slave buyers and horse traders inspected the teeth of their prospective purchases before buying. But only in recent times has attention been given to the care and preservation of the teeth.
Early studies of the cause and prevention of dental caries suggested that there might be a single causative factor but further results show that the problem is a complex one, with diet, heredity, internal secretions, mechanical factors, and oral hygiene of greatest importance.
Diet and Dental Caries
There is now general agreement that diet probably is the most important single factor in the maintenance of sound, healthy teeth, and that an adequate diet is most essential during the period of most rapid growth. McCullum and Simmonds conclude from an experimental study that rats which are kept on a deficient diet during a part of their growing period have inferior teeth and early decay, even though a decent diet is provided later. In the days before viosterol had been developed and before cod-liver oil was widely used, McCullum also reported that at the age of entering school 9 per cent of children who were breastfed for at least 6 months had dental caries, 22 percent of children who were fed on cow’s milk or on milk mixtures, and 27 per cent who had been fed oatmeal water and other prepared foods. This would indicate that the foundation of dental health is laid very early in life, but it now appears that the prenatal period is also of great importance in this regard. Consequently, the emphasis is now being placed upon a proper diet during pregnancy. Visit New Minas Dental Centre.
Important though diet admittedly is, there does not seem to be any single dietary factor which is responsible for dental caries. Calcium and phosphorus, the two minerals found in bones and teeth, and vitamin D, which regulates the utilization of these minerals by the body, are clearly crucial. Of these, calcium and Vitamin D were first thought to be of greatest significance: but the more recent work seems to indicate that phosphorus is of as great if not greater importance than calcium. Milk, certain vegetables, and fish foods are rich sources of both calcium and phosphorus. Vitamin D is quite likely to be deficient in natural foods during the winter months but is easily administered in the form of cod-liver oil, vitamin D milk, or viosterol.
Children have long been denied candy because of the belief that sugar is related to dental decay, and certain studies carried out in institutions for orphans where the diet is strictly controlled suggest that the prevalence of dental caries is directly related to the amount of carbohydrate in the diet. Cereals from which the hull of this grain has been removed appear to have an unfavorable influence upon the development of the teeth, and several investigators believe that oatmeal contributes directly to the formation of caries.
Divergent opinions concerning the relation of diet to dental health leave one rather confused. Apparently, no one dietary element is responsible for resistance to caries, but various elements are necessary for the proper development and continuing soundness of the teeth. For practical purposes, a well-rounded diet, containing liberal amounts of milk, orange juice, fresh fruits, vegetables, and for children cod-liver oil or some other kind of vitamin D, may be depended upon to supply the nutritional requirements of tooth.
It is frequently said that “a clean tooth never decays. ” Whether or not this is true depends upon the definition of cleanliness. If cleanliness implies freedom from bacteria, the statement probably is correct. However, with germs constantly present in the mouth and in the food we eat, it is impossible to have the teeth bacteriologically clean.
The mechanism of decay is through the action of acids produced by bacterial decomposition of food, first on the enamel and then upon the softer dentine of the tooth. The activity of this acid on the tooth structure may begin in any crevice, irregularity, or break in the enamel. The amount of decomposition and acid formation is greatest when there are gross accumulations of food substances. In fact, it’s between the teeth, in which it is difficult to prevent accumulations of meals that decay most often begins. Hence, although cleanliness of the teeth is hot the only factor in the prevention of dental decay, or even the most important one it’s not without significance.
Some clarification of the aspect of the problem was given by recent studies of these bacteria found in the mouth. If a particular germ called Lactobacillus acidophilus occurs in quantity caries develop with great rapidity. This is because those bacteria act upon carbohydrates, particularly sugars, on and around the teeth to form acids that dissolve the enamel and the dentine. These studies have also shown that if persons have an excessive number of lactobacilli in their mouths, the number of caries can be reduced from the elimination of sugars and other readily fermentable carbohydrates in the diet.
It now seems that specific chemicals applied to the teeth will neutralize the acids formed by the action of bacteria upon carbs and therefore reduce caries. Some of these chemicals are currently being included in so-called “ammoniated” toothpaste.
Fluorine and Dental Caries
During the past many years investigations have taken another turn. It had been determined that the only chemical difference between carious and non-carious teeth is that carious teeth contain less fluorine, a chemical element that’s present in minute quantities in the teeth and bones. This was followed by an investigation, of their fluorine content of the drinking water in areas in which dental caries are rare and regions in which they are prevalent. Here again, a difference in fluorine content was found. From these studies, it has been concluded that the presence of approximately 1 part of fluorine per 1,000,000 parts of drinking water results in a decreased prevalence of caries. Incidentally, fluorine in this amount causes some mottling of the teeth.
Proceeding on the basis of this information, several researchers have experimented with the application of fluorine into the surface of the teeth of children. In this study, Knutson and Armstrong reported the use of 2 percent sodium fluoride solution to the teeth resulted in 40 percent fewer caries over a period of a year at 289 kids than developed in 326 untreated controls. No healing effect was noted on teeth where caries existed. This use of fluorine for the prevention of dental caries is a promising line of investigation but it is still in the experimental stage.
Other exceedingly important studies are those in which sodium fluoride in minute amounts is being added into the water supplies of several cities which have low fluoride content. If this should prove effective in preventing caries, it will be a fantastic forward step in the control of the most widespread of human diseases.