Nutrition in Practice

_____________

Pyorrhea

Dr. W. M. Cunningham of New Zealand believes that pyorrhea is due to many causes, not the least of which is a deficiency of Vitamins A and C. He states in the New Zealand Dental Journal that Vitamin A in his opinion is a physiological prophylactic against infection by virtue of the fact that it maintain the integrity of the epithelium of the mucous membranes and skin. Edward Mellanby has frequently demonstrated that a deficiency of Vitamin A during the developmental period definitely affected the gingival tissues of dogs. He attributes changes in the intercellular substances of blood vessels and connective tissue to a lack of Vitamin C and calls attention to the hypertrified gingiva and free hemorrhage in scurvey cases. Dr. Cunningham believes that a sufficient amount of these food factors in the diet is an efficient preventive of pyorrhea. Attention is called to the necessity of also treating and caring for the local traumatic factors as well.

_________________

Caries

Two factors are attributed as the cause of dental caries by Dr. Iago Galdston in the Review of Dentistry for Children. First the lack of scrupulous oral hygiene and secondly the lack of good nutrition. Restorations have been ineffective, in his opinion, in the control of dental disease and his only hope of efficient control lies in prevention rather than repair. He calls attention to the fact that childhood is the logical time to institute rigid cleanliness and to provide well balanced and nutritious foods.

______________________

Dental Nutrition

A study of caries immune school children was undertaken in England by Drs. T. Talmage Read and E. M. Knowles in an effort to determine the reasons for the remarkable freedom from dental disease. The report appearing in the British Dental Journal states that the study included 12 school children between the ages of 5 and 14 all of which had complete dentition and absolute freedom from caries. The characteristic feature of the group was the careful and intelligent bringing up, even in the cases of poor children. The general diet was well balanced with adequate protein, fat and green vegetables. Additional milk was taken in all cases. Most of the children consumed fresh fruit in abundance. Cod liver oil was taken in all but three cases. Oral hygiene was rigidly practiced in all cases.

A corresponding study of twelve children of the same ages with extensive caries was made for comparison. In this group the diet was poorly managed. Considerable sweets were consumed between meals. Additional milk was taken in all cases but cod liver oil was used only by a few and spasmodically. Oral hygiene was unsatisfactory or entirely lacking.

Calcium Requirements

Dr. George M. Wishart, writing in the British Dental Journal, emphasizes the necessity of providing sufficient calcium to the child after birth to transform the infant skeletal system to one of an adult.

After birth, the question of the child’s demand for calcium may be approached in a theoretical way by considering how much calcium would be necessary to transform an infant of normal calcium composition to an adult, also of normal calcium content. The average adult contains about 2 per cent of his total body-weight as calcium. Observations on still-born full-term infants show that their average calcium content is just under 1 per cent. Throughout growth, therefore, as 1 per cent content has to be raised to 2 per cent. This is not uniformly done and unfortunately the date on the relative rates of skeletal and body growth are both scanty and uncertain. But, even if, during the first six months of life, we neglect the rising percentage and calculate the theoretical calcium requirement on the basis of normal weight increase with a uniform preservation of 1 per cent of this weight as calcium, some interesting results emerge. Disregarding the first month, which is anomalous owing to the loss of weight immediately after birth, the requirement would be 0.27 grm. per day in the second month, falling to 0.20 grm. at the sixth month and to 0.14 grm. at the end of a year. It must be emphasized that these figures take no account of a possible increase in relative calcium content of the skeleton which is generally thought to take place at this time, and pediatrician’s recommendations are in general higher.

Dr. Evelyn Sprawson believes that all factors concerning nutrition should be considered in a dietary correction for the prevention of dental disease. She states in the March issue of the British Dental Journal that, “It seems right that the present claims for Vitamin D are that it is necessary for the efficient formation of teeth rather than a definite preventer of caries; similarly, Vitamin C has been shown (in guinea-pigs, and almost certainly so in man) to be of paramount importance. Our knowledge of the chemical constituents of teeth makes it obvious that the same must be true of many other substances contained in foods and without which no tooth can been efficiently made. Each seems to have its part –but only a part –to play in efficient growth and development; and of no one item can it be said that it is the King pin, though one knows that complete absence of one ore several may cause death.”