The Eskimo and Dental Caries

By Martha Koehne

                I have been asked to comment on Stefansson’s recent observations on the relation of diet to dental caries. Needless to say I have found them interesting and informative. We are already to accept as fact his statement that persons who live on the carnivorous diet, as practiced by the native Eskimo who has never adopted any of the white man’s food customs, are free from tooth decay. Students of nutrition will also agree with him that such a diet is nutritionally adequate, even though several nutritive essentials are supplied in forms to which we are unaccustomed.

Several groups of workers seeking to solve the problems of the etiology of dental caries, can, from the statements presented by Stefansson, gather evidence in support of their widely divergent theories as to the cause of this disease. Others will find little to support their beliefs.

Advocates of the theory that tooth decay is caused by not chewing enough tough, hard fibrous food, will place credence in Stefansson’s argument that the Eskimo really does not chew his food much and that his custom of chewing leather is not the controlling factor in protecting his teeth from decay. Those who believe that diets must be basic if the teeth are to be free from cavities will also have difficulty in fitting the facts about the Eskimoan diet and the Eskimo’s freedom from tooth decay to their own theory.

Boyd and Drain and others who believe with them that it is the nutritional adequacy of the diet which protects the individual from caries could, of course, explain the condition of the teeth of the carnivorous native Eskimo as due to the fact that his diet provides each dietary essential. They could likewise give the reason for this susceptibility to caries on adopting the white man’s diet, as due to nutritional inadequacies in this diet.

Those who believe that environmental factors have a greater controlling influence over the soundness of erupted teeth than do metabolic factors, also have excellent support in Stefansson’s observations. Evidence has been submitted that lactobacilli do not infest mouths of persons eating diets lacking in carbohydrates. Advocates of the bacterial theory of the cause of dental caries can say that the Eskimo is free from tooth decay only as long as he avoids eating food on which aciduric bacteria thrive. The Eskimo apparently has no inherent protection against the growth of such bacteria in his body, for as soon as he begins to eat carbohydrate-rich food his teeth decay rapidly.

A person is truly immune to tooth decay who can eat the white man’s food and still be free of caries. A small percentage of those living around us belong in this favored group. Rarely are lactobacilli found in their mouths. Sometimes, too, such persons are living on diets that are far from meeting the Boyd and Drain standard of nutritional adequacy.

At times the diets may even be almost neutral in reaction and have little hard fibrous material requiring much chewing.

Stefansson’s comments are deserving of very careful thought and analysis by all interested in the relation of diet to bodily health and sound teeth. More than one type of diet is capable of supporting good health. Whenever peoples are found, living on simple diets, whose teeth are free from decay, every possible explanation should be studied. Only in this way will the ultimate truth about the relation of diet to the cause of dental caries be discovered.—Martha Koehne.

Journal of the American Dietetic Association. March 1936.

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