Dental cavities and what we eat: Together through history
YOKOTA AIR BASE, Japan -- Anthropologists believe approximately 10,000 years ago humans stopped following the herd and began growing plants to eat. Able to feed more people in a more predictable manner, our diet became less diverse. We went from eating anything we could find or kill to eating a few domesticated items. While we were able to support large populations with a new stable food source, overall health declined.
According to scientists at the Smithsonian, diseases associated with modern life began to appear. One of the worst of these, in my opinion as a dentist, was the increase in dental caries (cavities).
Many researchers tie the increase in dental caries to the introduction of cariogenic, or cavity causing foods into the diet. The appearance of grains, such as wheat in North Africa and the Near East; corn in the Americas; and rice in Asia, exposed early farmers to two new dental insults: bits of stone introduced into the grain through the grain grinding process and new sources of carbohydrates that had previously not been available.
According to an article published in the December 2002 European Journal of Clinical Nutrition, these new carbohydrates led to the appearance of dental cavities which were almost nonexistent in pre-farming societies.
Not long after the domestication of grains around the world, sugar cane was domesticated in Southeast Asia. However, it did not come into world-wide use until it was crystallized in about 600 A.D. Sugar crystallization created a portable and storable food which was spread throughout the Old World by Muslim traders and eventually arrived in the New World, becoming a staple of the early American Colonies. Over the next 400 years, sugar production intensified and new forms such as beat sugar and high-fructose corn syrup came into common use.
In July 2013, an article was published in The European Journal of Epidemiology reporting a connection between the introduction of sugar into societies and an increase of teeth with caries. In Europe and the Americas, where sugar consumption is high, the caries rate is also high. Meanwhile, in countries where sugar consumption is lower (i.e. countries in Africa and East and South Asia) the caries rate is low. Sugar also appears to be linked to a decrease in the diversity of oral bacteria leading to a prevalence of a cavity causing bacteria in most Western mouths.
Thankfully there have been great improvements in oral health since public health measures have started. Water fluoridation programs, fluoridated toothpastes, community education about oral hygiene, and better knowledge of caries prevention have led to decreases in overall caries rates in first-world countries. This trend continues with some minor deviation in poorer communities.
Thus, the next time your dentist discusses your diet and its link to oral health, know that there is more than a casual relationship between the two. Many studies, using both archeological and epidemiological data, point to the importance of a healthy diet in cavity prevention. So, next time you reach for a sugary snack, think about grabbing a piece of fruit or a vegetable and, instead of that soda, wash it down with a glass of water. Keep brushing and flossing and take a moment to ponder how what you eat will affect your oral health. You are in the driver seat to keep those cavities away.