Nutrition – and Your Dental Practice

By H. F. HAWKINS, D. D. S.Los Angeles, California

As a dentist have you ever asked yourself- Am I primarily “mechanically minded” or do I fall in to the classification of those who could be called “medically minded”? Strange to say, your answer to this question will determine to a large degree your likelihood of making a success in the field of nutrition. It is true that there is a small percentage of persons who seem to possess both characteristics to a high degree, but the great majority have a quality of mind that causes them to lean strongly in one direction or the other as to our question.

As a teacher for fifteen years in one of our dental colleges, I have always been interested in this inborn difference in dental students. It is important for every dentist who contemplates doing nutritional work to evaluate himself and to ask himself the following questions. Am I primarily mechanically minded? Do I derive my greatest pleasure in my mechanical skill or am I medically minded and prefer to treat pyorrhea and Vincent’s infection cases? If you fall in the latter classification and are willing to make it a real study you can probably make a success with nutrition. The strictly mechanically minded dentist does not as a rule succeed in this latter field. I have given nutritional courses for a number of years to graduate dentists and find the most outstandingly successful men in this work are those whose chief interests are in biology, chemistry, physiology and pathology.

In emphasizing the above, I am actuated by the motive of trying to encourage those who might make good in the field of nutrition if they are willing to make a real study of the subject and discourage those who probably would fail.

Do you believe you should charge a fee for nutritional advice? The fact that a dentist has spent considerable time talking “diet” with his patient is not a sufficient reason for expecting a fee unless the professional man knows from experience that his advice and direction is worth something to the patient.

Introduce nutrition into your practice and carry on for six months of a year until you have convinced yourself that your nutritional efforts are of value. Then and only then should you attempt to make a charge. I find the public willing and glad to pay for nutritional services if they have reason to believe the dentist can help them.

Nutrition can be taken up as a specialty like exodontia or orthodontia, or it can be a valuable adjunct to a general dental practice. The author was in charge of a nutritional clinic for five years and has been practicing nutrition as a specialty in private practice (without a dental chair or instruments) for about six years.

There is a group of thirty or thirty-five dentists in Southern California who are practicing nutrition in conjunction with their dental practice. Some are doing general practice, others are in one of the dental specialties. Many of these men are doing outstanding work in the field of Dental Nutrition. They know from their own experience that they are stopping dental decay or are checking or arresting pyorrhea cases. These dentists meet once a month as a study group and discuss nutrition and their problem cases. They are trying to practice preventive dentistry and are succeeding very well indeed.

Diet Analysis

When diet is given simply as an adjunct to dental practice, the necessary data is probably best arrived at on the basis of history. The patient should be asked to furnish the dentist with a list of all food or drink consumed for a three day period or better still for a week. The dentist and his assistant can break down this diet list into its elements- as to the probable protein, carbohydrates, fats, and minerals and vitamins consumed- and make suitable suggestions to the patient for its correction.

If dental nutrition is taken up as a specialty, laboratory tests should be run to establish the degree and character of the dental pathology. A real biochemical study and possibly a bacteriological examination should be made of all cases so a basis can be found for sound nutritional advice.

The dentist specializing in nutrition should be prepared to handle a high degree of problem cases such as faulty assimilation and elimination, while the dentist using nutrition as an adjunct to his practice will probably be concerned more with balancing diets for fairly normal individuals.

Any dentist of physician who attempts to prescribe diets will be subjected to some criticism at times both from his own profession and possibly from one of the other professions. A few concrete cases will illustrate. A physician takes a colitis case that has suffered rampant decay for years. In his effort to control the colitis with diet the decay is completely checked. The patient is delighted and tells the glad news to her dentist who in turn resents the physician’s efforts to enter and practice dentistry. Then we have the dentist who prescribes a diet for dental decay. He is successful in stopping the decay, but also corrects constipation, migraine headaches and insomnia. The patient’s physician hears about the cures and wonders why that dentist does not practice dentistry instead of invading the field of medicine.

There is bound to be some overlapping between medicine and dentistry, particularly is this so in the field of nutrition. Cooperation between medicine and dentistry is the only way that order will be brought out of chaos. Nutrition has been and is a no-man’s-land and it behooves all engaged in this field to cooperate to the end that the public may receive correct information and advice. In time the mass of misinformation that now pervades will be dissipated.

Essential Factors in Nutritional Practice

Basing my conclusions upon more than four thousand diet cases that have been individually regulated with the aid of history and biochemical tests, I would suggest the following factors as essential for success in the nutritional field.

  1. The dentist must be quite medically minded.
  2. He must have a strong course in nutrition and be able to break down a diet into its constituents as protein, carbohydrates, fats, mineral elements and vitamins and be able to suggest the necessary changes for correction.
  3. 3. He must have had a strong course in physiology. He must know how each class of food is digested as well as their ultimate disposition in the body.
  4. He must have some knowledge of medical diagnosis.
  5. He must know how to take a medical and dental history.
  6. He must be methodical in his nutritional work and have a regular routine in which nothing is taken for granted.
  7. He must have the courage to take some cases and reject others. Experience will soon teach what cases he should handle and which cases are essentially medical and should be referred to the physician.
  8. He must have the ability to cooperate with the physicians and medical laboratories to the end that the patient receives the dental relief that he seeks.
  9. He should be willing to give sufficient time to each case he undertakes to treat nutritionally so the patient knows exactly what is expected of him as to food cooperation. Brief suggestions as “Eat more vegetables” and “Drink more milk”

where there has been no real nutritional study of the case is not suitable diet advice.

Preventive Dentistry

Until the day arrives when our dental colleges feel the necessity of building up strong departments of Preventive Dentistry covering Nutrition, Physiology, Medical Diagnosis, Biochemistry and Oral Hygiene, the dentists will have to seek the necessary information from the various departments of our large universities.

The well trained dentist covering the above specialties can do a wonderful piece of work in preventing dental decay and pyorrhea alveolaris. The incidence of caries could easily be halved in a comparatively few years if the dentists of America would only catch the vision and act upon it.

The dentists are the only ones who can legitimately do this work as we alone are charge with the responsibility of the teeth and the supporting tissues. We are proud of our achievements in the restorative field, but not so proud of a national incidence of caries of about ninety six per cent.

During the past twenty years there has been no material lowering of the incidence of decay if we are to accept the various surveys and studies that have been recently made. During that period we encouraged, and rightly too, the use of the tooth brush and mouth cleanliness. We dentists must know by now the hopelessness of materially reducing the incidence of caries by oral hygiene alone. The only encouraging results which have been obtained to date are through adequate nutrition and the elimination of faulty pits and fissures by suitable means.

There is a crying need for dentists who feel that their natural bent fits them for this work to undertake the necessary training so they can qualify to do preventive work in the field of nutrition. There is an increasing number of patients who are demanding to know the cause of tooth decay and what can be done to stop it. The answer and the responsibility is in the hands of the dental profession.

851 Roosevelt Bldg.

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Variant Value and Palatability of Coffee

Prescott, Emerson & Peakes in Food Research conclude that coffee kept in a vacuum is the best preserved. Kept in air, it becomes stale more quickly and in a moist atmosphere the deterioration is exceedingly rapid.

The results of the investigation were as follows:

Method Result
Sample Preservation Taste
No. 1 Unsealed tube Quite brown pale Not much difference
No. 2 Sealed tube under 2.mm. air pressure Pale yellow Not much difference
No. 3 Atmosphere with 75% humidity Dark brown Gone off appreciably

Time length of all was eight weeks

The nature of the chemical changes in staling is not quite completely understood. The chief neutral constituent of the aromatic oils is furfuryl alcohol but the votatile portions is believed to be acetic acid by some, and the valeric acid by other.

The others extracted a mixture of volatile ingredients from the coffee and found that upon standing, it became darker, and finally resinified. Exposed to air this change occurred to a considerable extent even overnight whereas in a sealed evacuated tube it was much retarded. This change in the extract evidently has something to do with the bitter taste of stale coffee for mall portions of a dark portion when dissolved in water and tasted left a very unpleasant bitter taste in the mouth. A freshly distilled sample in an equal amount of water had no such bitter taste.

The volatile ingredients would appear to be part of the cause for staling of coffee but there are possibilities of other groups of compounds also.[i]

______Medical Times.

Salmon as Food Factors

In the Journal of Home Economics are reported the results of experiments on canned salmon. Chinook and Red salmon were found to be richest in vitamin A and the red and pink varieties in vitamin D. Salmon is a food commonly included in all diets, and justly so, for it is one of the richest sources of vitamin D. Salmon also provides inexpensively excellent protein.

Variety International Units of Vitamin A per Gram International Units of Vitamin D per Gram
Chinook

8

4

3.9

2.6

2.1

8

Red

4

2.5

8

Pink

1

1

7.1

7.8

6.2

4.0

Chum

0.5

2.6

1.9

____Medical Times.

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Unpasteurized Milk

More than one-half of the 123,000,000 people in the United States are still consuming potentially dangerous raw, or unpasteurized market milk even thought the public health importance of milk pasteurization has long been established. Dr. James A. Tobey, New York health expert, told the annual convention of the International Association of Milk Dealers at Dallas, Texas, on October 22.

Only about 47 per cent of the fluid milk produced in this country is pasteurized. The risk of epidemics due to contaminated raw milks of low grades is still very great.

Medical times.

October 14, 2017 · jagdish1 · Comments Closed