What Really Causes Dental Decay In Children?

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What Really Causes Dental Decay In Children?

By Bill Sardi

There is something wrong with what the public is being told about the origin of cavities (caries) in children’s teeth. There is obviously some truth to the fact that the availability of refined sugar resulted in an epidemic of dental caries in children. But a review of scientific studies attempting to make a link between refined sugar and dental caries could only find a strong relationship between sugar consumption and the development of caries in two published papers, 16 papers found a moderate relationship and 18 papers found only a weak-to-no relationship. (1)

There is little question that internal factors govern the development of cavities. Observe older adults with dry mouth who rapidly develop tooth decay. Saliva buffers the strong acids from acid-forming bacteria in the mouth.

In the 1930s dentist Don Chalmers Lyons wrote about tooth decay. (2) The prevailing theory is that acid-forming bacteria in the mouth (Streptococcus), which feed off of sugar, overgrow and the acid attacks the dental enamel. This would make dental caries the most widespread infectious disease of all. But Lyons asked, if acid attacks the teeth, why doesn’t every tooth develop cavities at the same time? Why are cavities confined to a small area on the tooth? Dentists often see perfect teeth in a filthy mouth, said Lyons. “The degree of dental cleanliness does not determine the amount of decay,” said Lyons.

More recent studies bear this out. A survey of dental health among 762 school children found that 42% did not brush their teeth, and 33% of these non-brushers had no cavities compared to 42% of the brushers. While this shows there is some value to brushing, why did 33% of the non-brushers have no dental decay whatsoever? (3)

Tooth brushing at its best only yields marginal results in prevention of caries. For example, a 3-year study of 12-year old adolescents reported a prevalence of dental caries of 9.66 cavities for children who brushed their teeth less than once a day, and 7.63 cavities for children who brushed more than once a day. (4) The kids still got cavities, and a lot of them.

Morning brushing is effective in reducing dental plaque, but only by 11%, said one study. (5)

Another study concluded that teacher-supervised toothbrushing with fluoride has little effect on dental caries prevention.(6) Yet another study claims five-stroke brushing of teeth does not effectively remove plaque and called the benefits of home tooth brushing “illusory.” (7)

Lyons said, if bacteria were the sole cause of dental decay in children, then a strong antiseptic mouth wash should vanquish the development of cavities. However, even the use of penicillin did not eradicate cavities. (8) Why do some teeth resist the action of bacteria and others do not?

L:yons noted that certain tribes of “uncivilized people” are free of dental decay. When these people leave their native lands, dental decay appears. It could be related to the amount of sunlight they receive and less clothing primitive that people wear? Lyons cites a study that found 2500 children in Ireland, 83% whom had rickets (softening bones from vitamin D deficiency), and 91% of these kids also had decayed teeth. Of children free of signs of rickets, 73% had mouths free of decay!

Modern dentistry has become so dependent upon treatment to support a living for dentists that it has all but forgotten what true prevention is. Patients are blamed for not brushing or flossing enough. The plaque and the cavities still occur.

And in this modern era, dental decay is treated as if it were a fluoride deficiency. Yet an authoritative report in Nature Magazine over two decades ago showed in recent decades that major reductions in dental caries have occurred in unfluoridated areas with magnitudes of reduction comparable to those attributed to fluoridation.(9) Fluoridation of water, at 1 part per million concentration, is said to reduce dental caries by hardening the teeth in growing children. But it is very difficult to control fluoride concentration and fluorosis (mottled teeth) can develop with overfluoridation. Spotted, yellow, brown stained or pitted teeth are visual signs of fluorosis during childhood.

In fact, some disturbing reports indicate fluorosis increases the risk of caries.m (10)

More disconcerting is a recent report showing that there is a link between dental fluorosis (over-fluoridation) and gum disease. Dental fluorosis now affects from one-third to one-half of US schoolchildren, according to reports from the Centers for Disease Control.More alarming, in a community in India that has the same concentration of fluoride in water as US cities, the introduction of fluoridation actually increased periodontal (gum) disease. (11) So what as yet unidentified factor controls dental caries? Lyons already hinted at vitamin D. The vitamin D-dental caries hypothesis was first aired by Lady May Mellanby, whose husband discovered vitamin D in 1919. Since vitamin D is needed for proper calcification of bones and teeth, her theory made sense. But this idea was drowned under by a deluge of research in the 1940s and 1950s indicting sugar as the cause of dental decay. (12)

In 1929 another researcher suggested dental caries might be regarded as a symptom of a vitamin deficiency. Proper calcification of teeth creates a barrier against invasion of the tooth, said D. A. Entin in 1929. As early as 1932 animal experiments revealed that vitamin D supplementation vanquished dental decay and the lack of vitamin D resulted in one-third of the animals developing cavities. (13)

By 1938 dentists observed that tooth decay was seasonal. Cavities were more likely to occur in winter months than in the sunny months of summer. So Doctors E.C. McBeath and T.F. Zucker of Columbia University, knowing vitamin D levels are higher in summer than winter, began an experiment. They provided 800 international units (IU) of vitamin D to school children for an entire year. The 800 IU dose of vitamin D, and not a lower dose, reduced cavities by over 50%. (14)

The vitamin D hypothesis of dental caries was again tested and results published in 1939. In this instance, researchers at ColumbiaUniversity fed rats a vitamin D-rich diet and reported that “Vitamin D induced a statistically valid decrease in the level of fissure caries as compared with the control group.” (15)

Over succeeding decades there were infrequent but continued reports showing vitamin D deficiency induces dental caries in humans. (16) (17) (18) Another telling study was conducted by researchers at Boston University. Researchers analyzed the amount of gingival (gum) inflammation and vitamin D concentrations in blood serum among subjects 13-90 years of age. Those subjects with the highest vitamin D blood serum concentrations were 20% less likely to bleed when a dental probe was pressed against the gums. (19)

A revealing study was conducted in France. Researchers studied 48 children and adults with rickets, some who had been given vitamin D supplement before puberty. The vitamin D-supplemented subjects had normal healthy dental status while the unsupplemented subjects did not. (20)

In 1998 a report by Canadian researchers questioned the current thinking about baby-bottle tooth decay. The majority of bottle-fed children don’t develop this problem. Baby-bottle tooth decay is very prevalent among aboriginal people who have diets very low in vitamin C and calcium. (21)

Hungarian doctors report that the provision of 500 IU of vitamin D to healthy full-term infants, there were still clinical signs of overt rickets, included dental decay, in these babies. A strong dose of vitamin D, 1200 IU, worked much better. (22)

Vitamin D’s dental health benefits extend to adults as well. In a study of adults over age 65 years, the provision of vitamin D cut the number of lost teeth in half. (23) Post-menopausal women need to be supplementing with vitamin D, not only to preserve their bones, but also their teeth. (24)

Dentistry has been sitting on this information for decades, apparently unwilling to conduct further research, unwilling to prescribe vitamin D. We must be mindful that the public relies upon doctors and dentists to conduct research about disease prevention, but such studies, if successful, may also put these health professionals out of business. It is unlikely the public will ever learn how to really prevent dental decay from dentists, especially for children during the critical growth years. Dentists have little understanding of nutritional factors and disease, electing to concentrate on treatment rather than prevention.

The teeth begin to develop in utero. Pregnant moms need get some sunshine for natural vitamin D and take at least 1000 IU as a supplement to the diet. Young infants need at least 800 IU or more. Vitamin C is also important for proper tooth formation, about 20 milligrams per pound of body weight, consumed from breast milk by mommy taking vitamin C supplements, or added to the baby bottle or other beverages as children grow older. –Copyright 2007 Bill Sardi, Knowledge of Health, Inc.

References

 

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Lyons, DC, Diet and decay of teeth, American Journal of Nursing 33: 203-06, 1933.

Al-Sharbati, Meidan TM, Sudani O, Oral health practices and dental caries among Libyan pupils, Benghazi (1993-94), Eastern Mediterranean Health Journal 6: 997-2004, 2000.

Chestnuff JG, Schafer F, Jacobson APM, Stephen KW, Influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. Community Dental Oral Epidemiology 26: 406-11, 1998.

Renton-Harper P, Addy M, Warren P, Newcombe RG, Home use oral hygiene product trials; timing of the last brushing before scoring; an assessment of variation. Journal Clinical Peridontology 25: 446-50, 1998.

Cunha-Cruz J, Journal Evidence Based Dental Practice 5: 202-04, 2005.

Toth V, Keszthelyl G, The effect of toothbrushing on approximal dental surfaces. Fogorv Sz. 84: 189-92, 1991.

Shaw JH, Caries-inhibiting agents. Pharmacological Reviews 11: 705-41, 1959.

Diesendorf M, The mystery of declining tooth decay. Nature 322: 125-29, 1986.

Cunha-Cruz J, Nadanovsky P, Dental fluorosis increases caries risk. Journal Evidence Based Dental Practice 5: 170-71, 2005.

Vandana KL, Sesha Reddy M, Assessment of periodontal status in dental fluorosis subjects using community periodontal index of treatment needs. Indiana Journal of Dental Research 18(2), June 2007.

Rugg-Gunn A, Preventing the preventable- the enigma of dental caries. British Dental Journal 191: 476-88, Nov. 10, 2001.

Marshall JA, Dental caries. Physiology. Review 19: 389-414, 1939.

McBeath EC, Zucker TF. The role of vitamin D in the control of dental caries in children. Journal Nutrition 15: 547–64, 1938.

Rosbury T, Karshan M, Susceptibility to dental caries in the rat. Journal Dental Research 18: 189-202, 1939.

Gedicke K, Rickets and dental caries; possibilities of dental caries prevention with vitamin D preparations with reference to social hygiene uses. (German) Offentl Gesundheitsdienst 20: 419-32, 1959.

Hofmeier K, Mineral Metabolism and vitamin D: a contribution to rickets and dental caries prevention. (German) Offentl Gesundheitdienst 26: 282-86, 1964.

Aebi H, Vitamin D metabolism in caries (German), Bibl Nutrition Dieta 16: 82-99, 1964.

Dietrich T, et al, Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation. American Journal Clinical Nutrition 82: 575-80, 2005]

Chaussain-Miller C, et al, Dental abnormalities in patients with familial hypophosphatemic vitamin D-resistant rickets; prevention by early treatment with 1-hydroxyvitamin D. Journal Pediatrics 142: 324-31, 2003.

Smith PJ, Moffat ME, Baby-bottle tooth decay: are we on the right track? International Journal Circumpolar Health 57: 155-62S, 1998.

Fabian K, Velkey L, Fodor E, Preventive value of vitamin D in various doses based on a prospective study of healthy infants. Orv Hetil 131: 447-50, 1990.

Krall EA, et al, Calcium and vitamin D supplements reduce tooth loss in the elderly. American Journal Medicine 111: 452-56, 2001.

Kaye EK, Bone health and oral health. Journal American Dental Association 138: 616-19, 2007.

 

 

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