Nutritional Notes

Problems in Dental Dietetics

The problem of dietetics in the field of dentistry is one that is forcing itself upon the profession. Pre-natal food influences in the building of strong, disease-resisting teeth and healthy mouth tissue, seems the most logical line of research. The evidence from immune races, and member of families tested in our own practices, points to a definite deficiency in the necessary minerals for bone and strong teeth as, if not the main cause of these defects, at least the principal contributing factor. The study of the races most isolated from our food habits, with mothers on their natural diet, breast feeding the children for long periods, in each and every case shows dental conditions unequalled in civilized countries.

It is certain that the teeth of human beings were intended to function through the whole period of life in equal perfection with all other organs. To doubt this as the original plan of mankind would be to throw our own faults and failings in the face of the Creator, and say that, whilst we admit the general perfection of man’s architecture, He has failed in providing the necessary strength of the teeth and mouth tissue to stand up to the continual work through life, of masticating and preparing the food necessary for strength and health. I cannot imagine any sane person accepting this view; therefore the breakdown of this vital part of our machinery is a product of our civilization, and, as such, must be within our power to repair or prevent.

If we accept this fact, the responsibility is upon us, as dentists, to do our part before it is forced upon us from outside sources. To those who follow these questions in the lay Press, and in the findings of research workers, it is impossible to fail in seeing that into the public mind is creeping a slow but definite understanding that something is wrong with modern food and food preparation. I realize the extent of the problem we have to face, for outside the very few research workers with means and equipment, together with institutions and many fixed inmates under their control, the vast majority of dentists have no such advantages, and can only apply the findings of these writers on the subject to the very limited number of their patients who will be interested enough to do their part in the work.

In general dental practice the field is narrowed again: first the mothers do not present at the time when pre-natal advice should be given, and that is four to six months prior to the birth of the child. Of these, again, many are in the hands of their own medical men, and if we risked giving the advice as to dental requirements, it may conflict with what has been advised, possibly to meet some other systemic weakness outside our work. Something has, therefore, to be done to educate the public mind to the importance of the dental requirements, so that the instruction will be asked for and not forced upon them – two very different aspects.

Another problem in the practice is the few cases of really interested mothers where results can be followed up, for the test of time has to be applied for years, and, owing to change of location on patient’s part, or lack of sustained interest, we are unable, except in few cases, to collect evidence of value to pass on to the profession.

In applying the needed dental dietetic education, consideration must be taken of the patient’s mentality. In the cases of those not gifted with common sense, when certain necessary foods of an anti-scorbutic nature are suggested, in order to raise tissue resistance in the mouth, such people are apt to seize on one or two of these foods and take them in excess of requirements, to the exclusion of other needed foods, thereby defeating our ends. Slimming diets are attracting a large following, particularly among those young people who seem to place the reduction of weight before health.

These things are brought under our notice every day, and we find that So-and-so’s diet, which is to reduce weight, is lacking in many necessary foods from a dental point of view. It is almost impossible to impress upon people so obsessed that the dietetic requirements for dental health will equally well for what they want.

Medical men, in the majority, I feel sure, do not recognize the dentist’s position in this field of health; and one can easily understand their thinking we are moving into a field of public health which is new to them, as they understand old time dentistry, and outside few men of note in our profession we have not yet shown our ability, or justified our rights, to treat patient along these lines. The dental dietetic needs, as outlined in modern dental literature, come less under their notice, or perhaps not at all, so it should be our earnest endeavor to interest them and obtain their co-operation at all times, and together work for the results we feel can be obtained.

Dentists wishing to improve present conditions and do their part along preventive lines, and who may not have the literature of facilities for studying this work, can do much by advocating the need of a fair proportion of fresh foods, green vegetables, vegetable soups and fruits, with milk and its products, together with eggs. Variety in diet along these lines is more likely to include some necessary elements and vitamins than fancying certain things and instituting a saneness n food habits.

Proper mastication, too, of the harder foods, giving exercise to both teeth and gums, is also important in raising resistance against the inroads of micro-organisms.

If dentists only do this amount of educational work, they will have contributed much to the improvement of dental health in the future. – The Dental Journal of Australia.


The Alkaline Reserve in Paradontal Disease

By T. Badeff

The values of the alkaline reserve noted varied between 62.3 and 80 per cent. In one case there was a lower value: 57.27 per cent. These results seem to show that there is no disturbance of equilibrium in the direction of acidosis. There may be considered deviation towards acidosis when the alkaline reserves falls to 40 per cent. On the other hand, in five cases (out of 51) values above 75 per cent were found and in six cases values between 74 and 75 per cent. Therefore a certain number of the patients showed a slight deviation in the direction of alkalosis. If the type of paradentosis studied be considered, we find that 29 cases were of the pure dystrophic type. All these patients had an alkaline reserve above 68.9 per cent and the greater number (23) had values above 70 per cent. From this one may conclude that the patients with the dystrophic type of paradentosis had an alkaline reserve either normal or above normal. 13.79 per cent of these had valued above normal if we use the standards of van Slyke, but all were above normal if we accept Labbe’s upper standard of 65 per cent.

In 17 cases of paradentosis of the mixed type the alkaline reserve varied between 62.8 and 73.5 per cent, with the exception of one case where it was 77.46 per cent. These values are within normal limits according to most authors. In the few cases of inflammatory paradentosis examined (5) the alkaline reserve was below 64.5 per cent and within normal limits. The majority of cases of dystrophic paradentosis examined were men. The ages of the patients were in the most cases between 40 and 55. 8 cases were between 29 and 40 and 8 above 55. The whole group was selected from 900 patients. The author concludes that:

(1)  Acidosis cannot be considered a principal factor in the origin of paradentosis.
(2)  Only the inflammatory type seems to be associated with a tendency to acidosis.
(3)  The dystrophic type seems to be associated with a deviation of the acid base equilibrium in the direction of alkalosis.
(4)  Men seem to be more frequently affected by the dystrophic type than women.

In observation on the metabolism of patients with paradentosis the different types of paradentosis must first be distinguished. – Schweizerische Monatschrift fur Zahnheilkunde per The Dental Record