THE EFFECTIVENESS OF AN ADEQUATE DIET IN THE CONTROL OF DENTAL CARIES

¹ RESEARCH PROFESSOR OF PEDIATRICS, UNIVERSITY OF IOWA COLLEGE OF MEDICINE, IOWA CITY, IOWA

To summarize, if the incidence of caries is related to the state of nutrition, we should expect the greatest incidence of caries during or shortly after periods of nutritional stress. Such periods occur at any age during illness, especially during chronic illnesses, though they be low-grade infections. Other known periods of stresses are: (1) the periods of rapid growth preceding puberty, (2) lactation, and (3) menopause. The incidence of dental caries is usually considered to be increased at about puberty. The incidence at the other periods of stress could well be studied.

In evaluating nutritional studies in relation to dental caries it is important to know the nutritional history of the subjects. Improvement of the diet in one respect only cannot be expected to bring improvement if the diet as a whole remains hopelessly below standard, or if the chief deficiency is other than the material supplied. The effectiveness of vitamin D, in particular, cannot be determined unless it is proved that the calcium and phosphorus intake is sufficiently high to permit an increase in retention through the action of the vitamin.

When several factors of the dietary regimen have been altered, results cannot be ascribed to only one factor. That seems so obvious as to be trite, but still it is the most common error in research reports.

At the State University of Iowa, keeping children under strictly controlled dietary regimens, we have observed complete arrest of caries with diets high in sugar, and with diets low in sugar but always nutritionally adequate and well-absorbed. From our nutritional studies on normal children, we have concluded that the longer a child remains in a state of poor nutrition, the longer it takes for him to utilize a good diet when he eats it. Often many months must elapse before the child becomes well nourished. Under these conditions, it is slight wonder that many investigators feel that diet is not a major factor in the prevention of dental caries. It is not diet, but the state of nutrition which we believe to be an important factor in the incidence of dental caries.