Category Archives: Teeth

More Evidence That Modern Diets Are Bad For Our Teeth

Australian Aborigine in Swamp Darwin

Australian Aborigine in Swamp Darwin

Phys.org has an article on dental changes associated with the transition from hunter-gatherer cultures to less mobile agricultural ones. The transition occured 10,000 to 12,000 years ago at the end of the Paleolithic period. Some quotes:

“Our findings show that the hunter gatherer populations have an almost “perfect harmony” between their lower jaws and teeth,” he explains. “But this harmony begins to fade when you examine the lower jaws and teeth of the earliest farmers”.

*   *   *

The diet of the hunter-gatherer was based on “hard” foods like wild uncooked vegetables and meat, while the staple diet of the sedentary farmer is based on “soft” cooked or processed foods like cereals and legumes. With soft cooked foods there is less of a requirement for chewing which in turn lessens the size of the jaws but without a corresponding reduction in the dimensions of the teeth, there is no adequate space in the jaws and this often results in malocclusion and dental crowding.

You can read the original research report in PLOS One.

Steve Parker, M.D.

h/t Diet Doctor Eenfeldt

This bedrock metate was used by Indians (aka Native Americans) for grinding maize, acorns, and other foods

This bedrock metate was used by Indians (aka Native Americans) for grinding maize, acorns, and other foods. Rainwater fills this 4-inch deep rounded depression in granite about 10 miles from my house.

Ever Heard “No Carbs, No Cavities”?

I didn’t think so. None of my dentists ever uttered those words. Conflict of interests, maybe? And the worst carbohydrates for your teeth seem to be sugars.

173 Years of U.S. Sugar Consumption

(Thanks to Dr. Stephan Guyenet and Jeremy Landen for this sugar consumption graph.)

MNT on September 16, 2014, published an article about the very prominent role of sugars as a cause of cavities, aka dental caries. This idea deserves much wider dissemination.

I’ve written before about the carbohydrate connection to dental health and chronic systemic disease. Furthermore, sugar-sweetened beverages are linked to 200,000 yearly worldwide deaths

Investigators at University College London and the London School of Hygiene & Tropical Medicine think the World Health Organization’s recommendation of a maximum of 10% total daily calories from “free sugar” should be reduced to 3%, with 5% (25 grams) as a fall-back position.

Six teaspoons of granulated table sugar (sucrose) is 25 grams. That should be enough daily sugar for anyone, right? But it’s incredibly easy to exceed that limit due to subtly hidden sugars in multiple foods, especially commercially prepared foods that you wouldn’t expect contain sugar. Chances are, for instance, that you have in your house store-bought sausage, salad dressings, and various condiments with added sugars such as high fructose corn syrup. Sugar’s a flavor enhancer.

tooth structure, paleo diet, caries, enamel

Cross-section of a tooth

The aforementioned “free sugar” are defined as any monosaccharides and disaccharides that a consumer, cook, or food manufacturer adds to foods. In the U.S., we just call these “added sugars” instead of free sugars. From the MNT article, “Sugars that are naturally present in honey, syrup, and fruit juices are also classed as free sugars.” Sugar in the whole fruit you eat is not counted as free or added sugar.

The London researchers found that—in children at least—moving from consuming almost no sugar to 5% of total daily calories doubled the rate of tooth decay. This rose with every incremental increase in sugar intake.

From the MNT article:

“Tooth decay is a serious problem worldwide and reducing sugar intake makes a huge difference,” says study author Aubrey Sheiham, of the Department of Epidemiology & Public Health at University College London. “Data from Japan were particularly revealing, as the population had no access to sugar during or shortly after the Second World War. We found that decay was hugely reduced during this time, but then increased as they began to import sugar again.”

I’m convinced. How about you?

Steve Parker, M.D.

Jimmy Moore Found a Paleo-Friendly Periodontist, Dr. Alvin Danenberg

Click to listen to the recent podcast interview. Dr. Danenberg favors a Mark Sisson-style “primal” paleo diet. Dr. Danenberg attributes most common periodontal and dental problems to our modern diets with their prominent acellular carbohydrates and associated gut microbiome changes.

To find other dentists and dental hygienists who support a paleo diet approach to dental issues, click on “Teeth” in the subject categories in the far right-hand column.

Steve Parker, M.D.

Steven Novella on Oil Pulling (or oil swishing)

paleobetic diet

Good source of omega-3 fatty acids

I mentioned oil pulling before, without much cogent comment. It involves swishing edible oil around in your mouth for 10—20 minutes, for oral and systemic health benefits. Steven Novella over at Science-Based Medicine gave it more consideration. His conclusion:

Oil pulling is a suggestive misnomer, implying that something bad is being pulled from the mouth (toxins and bacteria). What little scientific evidence exists shows that it is probably not as effective as standard mouth wash, and what benefit it has is likely entirely due to the mechanical act of swishing to remove particles and bacteria from teeth and gums.

There is no reason either theoretically or based upon any evidence to recommend oil pulling (which should be renamed “oil-swishing”) instead of standard modern health care with flossing, tooth-brushing, and mouth rinse. However, it does appear to be better than nothing, and might have a role in developing countries without access to modern oral care. The one caveat is that extended periods of swishing that are commonly recommended (10–20 minutes) are likely not necessary and further present a risk of lipoid pneumonia from accidentally breathing in small amounts of oil.

Read the rest.

What’s Pure, White, and Deadly?

Sugar, according to John Yudkin and Robert Lustig, among others. The Age has the details. A quote:

[Robert] Lustig is one of a growing number of scientists who don’t just believe sugar makes you fat and rots teeth. They’re convinced it’s the cause of several chronic and very common illnesses, including heart disease, cancer, Alzheimer’s and diabetes. It’s also addictive, since it interferes with our appetites and creates an irresistible urge to eat.

This year, Lustig’s message has gone mainstream; many of the New Year diet books focused not on fat or carbohydrates, but on cutting out sugar and the everyday foods (soups, fruit juices, bread) that contain high levels of sucrose. The anti-sugar camp is not celebrating yet, however. They know what happened to Yudkin and what a ruthless and unscrupulous adversary the sugar industry proved to be.

In 1822, we in the U.S. ate 6.2 pounds of sugar per person per year. By 1999, we were up to 108 pounds.

An occasional teaspoon of sugar probably won't hurt you

An occasional teaspoon of sugar probably won’t hurt you

The U.S. Department of Agriculture estimates that added sugars provide 17% of the total calories in the average American diet.  A typical carbonated soda contain the equivalent of 10 tsp (50 ml) of sugar.  The average U.S. adult eats 30 tsp  (150 ml) daily of added sweeteners and sugars.

On the other hand, Fanatic Cook Bix found a study linking higher sugar consumption with lower body weight, which you might think would protect against type 2 diabetes, heart disease, and some cancers.

Read the rest at The Age. It’s mostly about John Yudkin.

Steve Parker, M.D.

h/t Jamie Scott

Was It the Paleo Diet or Acorns or ? That Rotted These Teeth?

“Basically, nearly everybody in the population had caries,” or tooth decay, says Louise Humphrey, a paleo-anthropologist with the Natural History Museum in London.

Humphrey says 94 percent of the more than 50 people from the cave she studied had serious tooth decay. “I was quite surprised by that,” says Humphrey. “I haven’t seen that extent of caries in other ancient populations.”

Certainly, life was brutal and short for Stone Age folks, what with saber tooth cats, parasites, and not an aspirin to be found anywhere. But at least the paleo diet — meat, tubers, berries, maybe some primitive vegetables and very few carbs— was supposed to be good for the teeth. Carbohydrates can turn sugary in your mouth, then bacteria turn that into enamel-eating acid.

But apparently, these ancient people had a thing for acorns.

“Acorns,” says Humphrey, “are high in carbohydrates. They also have quite a sticky texture. So they would have adhered easily to the teeth.”

Read the whole thing.

Click to see the study abstract.

h/t Melissa McEwen

Mouth Bacteria May Be an Important Cause of Heart Disease

…according to an article at University Herald.

paleo diet, Steve Parker MD,calcium, osteoporosis

That milk mustache is a tell-tale sign she’s not eating pure paleo

The idea is that nasty bacteria around your gums somehow cause arterial inflammation in your heart arteries, which could lead to heart attacks. I’ve written about this before.

A quote from the article:

The researchers followed 420 adults as part of the Oral Infections and Vascular Disease Epidemiology Study (INVEST), a randomly sampled prospective cohort of Northern Manhattan residents. Participants were examined for periodontal infection. Overall, 5,008 plaque samples were taken from several teeth, beneath the gum, and analyzed for 11 bacterial strains linked to periodontal disease and seven control bacteria. Fluid around the gums was sampled to assess levels of Interleukin-1β, a marker of inflammation. Atherosclerosis in both carotid arteries was measured using high-resolution ultrasound.

Over a median follow-up period of three years, the researchers found that improvement in periodontal health-health of the gums-and a reduction in the proportion of specific bacteria linked to periodontal disease correlated to a slower intima-medial thickness (IMT) progression, and worsening periodontal infections paralleled the progression of IMT. Results were adjusted for potential confounders such as body mass index, cholesterol levels, diabetes, and smoking status.

Thickening of the arterial lining is linked to higher rates of heart attack and stroke.

It remains to be seen whether alteration of gum bacteria and periodontal disease via oral self-care and dental care will reduce cardiovascular risk going forward. Stay tuned.

Read more at http://www.universityherald.com/articles/5322/20131101/brushing-your-teeth-could-prevent-heart-disease.htm#rvx294vC7VKJ6Qu3.99

Carb-Craving Olympians Have the Teeth To Prove It

BBC has the story:

The beaming smiles of gold-medal winners Usain Bolt, Jessica Ennis-Hill and Mo Farah are some of the defining memories of London 2012.

But a team at University College London says many competitors had dental problems.

“Our data and other studies suggest that, for a similar age profile, the oral health of athletes is poor. It’s quite striking,” said lead researcher Prof Ian Needleman.

He said eating large amounts of carbohydrates regularly, including sugary energy drinks, was damaging teeth.

Impaired immune system function associated with hard training may also play a role.

Many, if not most, high-level athletes think high carbohydrate consumption is necessary for optimal performance. They should know better than I. For their sake, I hope meticulous oral care—brushing, flossing, professional cleaning—helps preserve dental health.

tooth structure, paleo diet, caries, enamel

Cross-section of a tooth

Think Twice Before You Get Those Wisdom Teeth Removed

Yahoo News covered the story earlier this year. Dentist Jay Friedman says far too many third molars are extracted prophylactically. He got his ideas published in American Journal of Public Health way back in 2007. A snippet:

The British National Institute for Clinical Excellence is unequivocal in its recommendation, adopted by the National Health Service: “The practice of prophylactic removal of pathology-free impacted third molars should be discontinued. . . . There is no reliable evidence to support a health benefit to patients from the prophylactic removal of pathology-free impacted teeth.”9(p1–2)The conditions for which extraction is justified include nonrestorable dental caries, pulpal infection, cellulitis, recurrent pericoronitis, abscesses, cysts, and fractures.

Dr. Friedman says the risks of extraction outweigh the benefits in most cases.

Another Dentist Blames Neolithic Diet For Cavities

I found another dentist who believes cavities (dental caries) are a neolithic disease caused by a mismatch between the standard Western diet and human evolutionary biology. Meet Dr. Mark Burhenne:

It is generally well accepted that tooth decay, in the modern sense, is a relatively new phenomena. Until the rise of agriculture roughly 10,000 years ago, there was nearly no tooth decay in the human race. Cavities became endemic in the 17th century but became an epidemic in the middle of the 20th century (1950).

If we understand that tooth decay started when people started farming, rather than hunting and gathering, it’s clear that tooth decay is the result of a mismatch between what we’re eating and what our bodies are expecting us to eat based on how they evolved.

***

The recent changes in our lifestyle create a “mismatch” for the mouth, which evolved under vastly different environments than what our mouths are exposed to these days. Our mouths evolved to be chewing tough meats and fibrous vegetables. Sugar laden fruit was a rare and special treat for our paleolithic ancestors. Now, our diets are filled with heavily processed foods that take hardly any energy to chew — smoothies, coffees, and sodas high in sugar, white bread, and crackers to name just a few.

Read the whole thing.

It’s disconcerting that Dr. Burhenne says Streptococcus mutans (a germ linked to cavities) is the same germ that causes strep throat. That’s not right. Strep throat is usually caused by Streptococcus pyogenes, aka Group A Strep.

Steve Parker, M.D.