Nutritional Dental Health

“We can now visualize our universe, its light, gravity and heat, its seasons, tides, and harvest, which prepare a habitation for the universe of vital forms, microscopic and majestic, which fill the oceans and the forests. We have a common denominator for universes within and around each other, our world, our food and our life have potentials so vast that we can only observe directions, not goals. We sense human achievements or ignominious race self-destruction. Every creed today vaguely seeks a utopia; all have visualized a common controlling force or deity as the most potent force in all human affairs. Yes, man’s place is most exalted when he obeys Mother Nature’s laws.”
Weston A. Price.

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Have you ever heard of name the Weston A. Price in relation to your dental training or current practice? In all of my 30 plus years in dentistry I must confess, until recently, I hadn’t. My first exposure to him occurred during a visit to a highly recommended Chiropractor. He was fairly alternative, as was Price’s reputation, but respected highly by the person who recommended me to him, my Principal Dentist. Talking to and researching their website brought my attention to Price and the practitioners mistrust of fluoride. The warning bells were ringing loudly but in conversation with him I began to reappraise my position and reconcile the biases and controversy related to his work, and reflection on them. If you claim to be a holistic practitioner you, I hope, would be well versed with Weston A. Price’s work, just as, if you were a nutritionalist, you’d be aware, as well, of the controversial academic and scientific work of Ansel Keyes.

If you carefully delve into the dental literature and research you will find it very difficult, if not almost impossible, to uncover anything related to Price. Ironically, the research and publications he undertook in the early decades of the 20th Century, a revolutionary and controversial book published in 1939 revealing his theories on subjects from root canal treatment, soil health, sacred foods to the development of the face and jaw can be found elsewhere. His work is seen by some as the forefather of the popular Palaeolithic dietary and Low Carb nutritional movements with echoes extending to progressive oral health approaches in the treatment and preventing dental diseases like caries and periodontal diseases. Much, if not all of this work hasn’t been in the curricula of dental schools but now appears to be in the headspace of alternative medical, nutritional and some dental practitioners. Interestingly, the New Zealand Dental Council includes the phrase “holistic” in approaching treatment in its guidance for professionals and encourages collaborative engage with fellow healthcare professionals as part of our practice standards. It appears that the times are changing so let’s dig a little deeper into this subject.

“Life in all its fullness is Mother Nature”. Weston A. Price.

Weston A. Price ( 1870 -1948 ) was born in Ontario, trained and graduated at the University of Michigan as a dentist in 1894. He set up his first practice in the same year but feel ill with Typhoid shortly after. His health was severely affected and a period of convalescence brought him to the realisation of his future higher cause. He decided to direct his attention to the study of the “healthy traditional cultures all over the world”. This was further and tragically enforced by the death of his only son, 9 years of age, from heart related issues, after Price root treated a tooth. This may have also brought the birth pains of the focal theory of infection to his attention. This theory proposed that infected teeth should be treated by dental extraction rather than root canals, to limit the risk of more general illness. He spent 25 years working and researching with endontically treated teeth which lead to the publication in 1925 of Dental Infections and related Degenerative Diseases. Price’s next publication Dental Infections, Oral and Systemic was used as a reference in textbooks and diagnosis guides published in the mid-1930s. Both contributed to the widespread acceptance of the practice of extracting, rather than endodontically treating, infected teeth. By the mid-thirties his work was widely challenged and fell out of favour. Needless dental extractions were seen as too extreme when infected and diseased teeth could be restored and masticatory units maintained. Ironically, as we know now, the foods we eat need molars and other teeth to break down and allow not only passage through the digestive tract but also to gain maximum nutritional value from it. Without teeth, be they unrestored or not, we don’t fully, nutritionally benefit from what we eat. Efficient digestion requires the food be well masticated. His focus soon aligned to the subject of traditional nutrition of communities uninfluenced by modernity by began a global learning journey to ascertain whether the “health of the body is reflected in the health of the teeth.”

“Tooth decay is a symptom, not a disease… it is evidence of faulty nutrition”. Weston A. Price.

In 1939 Price published his now seminal book “Nutrition and Physical Degeneration” and claiming that “eating a nutritional dense diet of whole foods, grown naturally in healthy soil and prepared in a traditional method” producing “nourishing and digestible foods enabling them to build strong and healthy bodies, sustainable over generations.’ His work led him to the conclusion of the power of “sacred foods”, such as “unpasteurised dairy foods, offal, pasture fed animal, seafoods, in particular fish eggs, cod liver oils, fermented foods like sauerkraut, kimchi, kefir and animal fats”. The lack of which, he believed, led to “dental caries and deformed arches, resulting in crowded, crocked teeth was a sign of physical degeneration as a result of suspected nutritional deficiencies”. This was due to his close observation and critical study of isolated communities around the world in that period of time. Price, it is noted, used chemical testing of soil, food quality and the prodigious use of photography in his work. He observed what he described as disease free indigenous populations with “straight teeth”, “stalwart bodies”, “resistance to disease” and “fine” characteristics, associated with their traditional, nutritionally dense diets. Interestingly too, Price also alluded to an unknown but healing component which he defines a “Activator X”, found in butter oil. Price concluded that butter, which was produced from rapidly growing grass in the spring, had higher “Activator X” levels than butter produced during the rest of the year. This “vitamin like activator” was to be better understood, after the Second World War, as Vitamin K1. He also deduced that modern processed foods lacked this and other essential vitamins and minerals due to modern food processing effects.

“For humanity to survive it must eat better – foods must be whole, fresh and unprocessed.” Weston A. Price.

Price’s detractors cite poor observational analysis, a simplistic scientific approach and confirmation bias. They claim, also, that he ignored native people who weren’t healthy, and that those who were in contact with European and modern civilisations were affected by diseases unfamiliar to them historically. They claim, with their own confirmation biases, that modern food is wholesome but native people “overconsumed” and didn’t balance their diets correctly. As a consequence they had higher rates of disease. Sound familiar? Isn’t this the same as what is said of the increasingly obese populations in todays society? This will be discussed in detail in a future post regarding metabolic health, but the burgeoning shoots of its importance begin here.

“The most serious problem confronting the coming generations is the nearly insurmountable handicap of depletion of the quality of the foods because of the

depletion of the minerals of the soil”. Weston A. Price.

Let us look further back than Price’s influence on the nutritional debate, but perhaps something he may contend today is as important, that of our very distant ancestors. Fossil records go back nearly 14 million years with Ramapithicus, found in Africa. Our cave dwelling forefathers evolved over time in different habitats, with different foods, and began to migrate north living and eating seasonally, working in communities to hunt and gather foods, designing tools and weapons, working in teams collaboratively to achieve their nutritional necessities. In the mid 20^th Century different hypotheses examined the changes in nutritional cultures, meat eating, seed eating and, in particular, the Extensive Tissue Hypothesis which related brain and gut size in human evolution. The control of fire, the preparation of starches and meat led to increases in the energy gained from food in comparison to the raw form. The cooking process increased digestion, higher blood glucose, the energy gained through this process increased it by nearly 30%. 1. Interestingly too, the human microbiome, a mass of trillions of bacteria, is also responsible for 6-10% of daily energy supply, creating short chained fatty acids, hormones than regulate hunger and satiety and vitamins, in particular, B6 and B12, passing via the gut lining into the blood supply. The microbiome has now become a subject of scientific research and its presence into oral cavity cannot be under estimated in its role in digestion and oral health. It is observed that the modern human microbiome in comparison to apes, monkeys and chimpanzees is far less diverse.

“Don’t eat anything your great-great grandmother wouldn’t recognise as food”. Michael Pollan.

What we know, as a consequence of the research of many, including the likes of Weston A. Price, is the importance of nutritional behaviour in the prevention and treatment of dental caries and periodontitis. The optimal function of the body’s host defence system is dependant upon an adequate supply of anti-oxidant micro-nutrients. 2. Micro-nutrient anti-oxidants are important for limiting tissue damage but also decreasing prolonged inflammation. Reducing periodontitis is associated with a reduction in HbA1c, a test measuring your average blood glucose over 2-3 months and gives an indication of your longer-term blood glucose control. Reducing blood sugar is also associated with reductions in death related diabetes and myocardial complications. 3.

“An adequate, well balanced diet combined with regular physical activity”. World Health Organisation, Definition of Nutrition.

Oxidative stress or oxidation is a damaging activity caused by attack from free radicals. Nutrients called antioxidants help the body’s natural defence system combat this process. A variety of anti-oxidants including vitamins, A, C, E as well as minerals like Selenium and Zinc are found in fruits, vegetables, nuts, sees, oily fish and whole grains. Vitamins D2, from food sources and D3, from sunlight are vital, along with calcium, for bone health and repair. It is seen to benefit older age groups, beyond 50 years. 4. Other studies indicate a 20% likelihood of less tooth lose with sufficient Vitamin D blood levels and 14% less likely to lose teeth over 5 years. 5, 6.

“Fermentable carbohydrates are the most relevant common dietary risk factor for caries and periodontal diseases” state Moynihan and Petersen (2004).7. Vitamin C depletion can lead to profuse gingival bleeding, known historically as Scurvy. Periodontal diseases demonstrate lower serum Magnesium and Calcium levels as well as lower antioxidant micronutrient levels. 8, 9. Using Vitamin D supplementation combined with Calcium has been shown to reduce risk in the elderly. 10, 11. The concentration and bioavailability of carbohydrates and starchy foods and the lack of Vitamin D, K and Calcium in the developmental growth of teeth increase the risk of dental caries. 12.

“Let food be thy medicine.” Hypocrates.

Upon reflection of this it is advisable to create a guide for my clients regarding what will benefit healing and repair of dental diseases nutritionally. This I did in the light of an authentic learning project undertaken in 2017 but does it require updating? I would consider a deeper dental orientated nutritional discussion with all clients who have active periodontal disease, including bleeding on probing over 10% with no attachment loss. This would include supplementation of Vitamin D and Calcium with an additional emphasis on an anti-oxidant rich diet and a significant reduction in fermentable carbohydrates. I’d consider, in severe cases, advising them to test for serum Vitamin D levels and advise exposure to a recommended level of sunlight too, depending upon the season. In the case of dental caries in the light of no new knowledge, I would continue with a reduction, cessation where possible, and regulation of fermentable carbohydrates. The onus on oral health improvement measures with both diseases are multifactorial, not just purely nutritional, but it does, however, play a significant role in both.

“Going against the principles of nature does nothing but harm for us, the animals and the environment”. Weston A. Price

Weston A. Price, I believe, was a principled and holistically minded individual worthy of study and attention. The mantle for his ancestrally linked nutritional improvement for better health has been handed over to many others, books written, careers changed, lifestyles altered for the better and his legacy continues. I have learned to put his cannon of work into the context of time and his life experiences. I won’t judge him too harshly on what we know where he was incorrect but will maintain and protect the best intentions and knowledge gained from his work. He attracts and continues to influence those who associate good nutritional behaviour with better environmental practice and those who hold the values of our ancestral nutritional legacy in line with their belief in nature.

References

Carmody N, Weinstraub G, & Wrangham R. (2011) Nat Academy of Science, USA.Energetic consequences of thermal and nonthermal food processing. Nat Academy of Science, USA.

Schmidt K. (1997) Interaction of antioxidative micronutrients with the host defence mechanisms. A critical review. Int J Vit Nutr Res.

Simpsom T, Needleman I, Wild S, Moles D, & Mills E. (2010) Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database.

Dietrich T, Joshipura K, Dawson-Hughes B, & Bischoff H. (2004) Association between serum concentrations of 25(OH)D3 and periodontal diseases in the US population. Am J Clin Nutr.

Jimenez M, Giovannucci E, Krall Kaye E, Joshipura J, Dietrich T. (2014) Predicted vitamin D status and incidence of tooth loss and periodontitis. Public Health Nutr.

Zahn Y, Samietz S, Holtfreter B et al. (2014) Prospective study of serum 25-hydroxy Vitamin D and tooth loss. J Dent Res.

Moynihan P, & Petersen P. (2004) Diet, nutrition and the prevention of dental diseases. Pub Med.

Leggott P, Robetson P, Rothman D, Murray P, & Jacob R. (1986) The effect of controlled ascorbic acid depletion and supplementation on periodontal health. Journal of Perio.

Van der Velden U, Kuzmanova D, & Chapple I. (2011) Micronutritional approaches to periodontal therapy. Journal of Clinical Perio.

Krall E, Wehler C, Garcia R, Harris S, & Dawson-Hughes B. (2001) Calcium and vitamin D supplements reduce bone loss in the elderly. Am Journal of Medicine.

Miley D, et al. (2009) Cross-sectional study of vitamin D and calcium supplementation effects on chronic periodontitis. Journal of Perio.

Chapple et al. (2017) Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases. Concensus report EFP/ORCA.

Resources

Weston A. Price – Overview – https://youtu.be/OH1HSG9AOS8