
Why we have so many problems with our teeth - lelf
https://www.scientificamerican.com/article/why-we-have-so-many-problems-with-our-teeth/
======
bsima
The article posits the "soft foods" explanation for our poor teeth, but there
is another, which starts with the research of Weston A Price:
[https://en.wikipedia.org/wiki/Weston_Price](https://en.wikipedia.org/wiki/Weston_Price)

Price studied traditional cultures and observed that, when traditional diets
were followed, people had perfect teeth. When an industrialized, Western diet
was followed, tooth decay resulted. His book has the evidence, and is an easy
read that you can browse in a few evenings. Edit: I found the whole book free
online:
[http://www.journeytoforever.org/farm_library/price/pricetoc....](http://www.journeytoforever.org/farm_library/price/pricetoc.html)

His research has been taken up by various doctors in the "evolutionary
medicine" subfield, here are some introductory lectures:

\-
[https://www.youtube.com/watch?v=D4L0PzprcRI](https://www.youtube.com/watch?v=D4L0PzprcRI)

\-
[https://www.youtube.com/watch?v=e2ck0A5oKjU](https://www.youtube.com/watch?v=e2ck0A5oKjU)

\-
[https://www.youtube.com/watch?v=yCPwD59sDvg](https://www.youtube.com/watch?v=yCPwD59sDvg)

Those are from the Ancestral Health Symposium, for which I have been a
(volunteer) organizer for the last few years.

~~~
ip26
The article makes two points/claims.

\- Soft foods leads to small dental arches and thus crowding

\- carb-rich (i.e. Western diets) lead to decay

Basically, you're agreeing with the article.

~~~
triyambakam
It's not carb-rich diets, it's processed carbohydrates. Every culture on earth
eats predominately carbohydrates, with a very small few exceptions like Inuit
or some peoples in Africa. Asia has mostly rice, Africa various roots,
South/North America it was corn, etc. Humans are (loosely) starch-ivores

~~~
bsima
Price observed that the great majority of traditional diets were high in
animal fats. He theorized that vitamin K, which is mostly acquired from animal
fat, was the key health-promoting factor. Humans are more likely facultative
carnivores than grain-eaters.

~~~
xyzzyz
Traditional to whom, to hunter gatherers? Early farmers living in tribes? Or
people living under strong states that developed over past few thousands
years?

~~~
chrisco255
I read the book, he travelled to multiple continents and generally this is
pre- industrial diets, or prior to introduction of vegetable and seed oils,
refined sugars, processed carbs, etc. Because he was able to do this research
in the 20s, the industrial diet hadn't quite taken over. He also studied
mummies in South America. They overwhelmingly had perfect teeth, prior to
introduction of modern junk food.

~~~
partyboat1586
I wonder how they survived berries. Because berries are not good for your
teeth due to high (natural) sugar content.

~~~
blaser-waffle
Modern fruits have wayyy more sugar than wild plants, due to years and years
of selective breeding.

Even then you still have a lot of fiber and acid to slow down the release and
absorption of sugars.

~~~
novok
Also berries are fairly seasonal AFAIK

------
ebg13
I have a dream of one day being able to just replace _all_ of my teeth at once
with one solid porcelain+titanium prosthetic without any interstitial cracks
or crevices.

No more painful cavities. No more cracked teeth. No more need for floss or
toothpicks, because there aren't any gaps for food to get stuck in. And it
could be trivially sculpted to still have the same outward appearance of
bullshit normal teeth.

~~~
jedberg
My dream is that someone invents a fleet of nanobots that I can put in my
mouth that will clean up all the plaque and repair any tooth and gum damage.
Just pop them in at night, recall them all back in the morning.

~~~
Reedx
Fun idea. Or going even further, have them also take care of your throat,
stomach, etc. Just constantly roaming around, maintaining things.

~~~
zo1
There's an Outer Limits episode that's exactly as you describe. As with all
it's episodes, it takes an unexpected twist that was not anticipated.

[https://theouterlimits.fandom.com/wiki/The_New_Breed](https://theouterlimits.fandom.com/wiki/The_New_Breed)

------
ip26
This has been popping up in the news periodically for a few years now.
However, as a parent of young children, I'm still trying to figure out the
next step. That is, what to feed them that is nutritious, tasty, and also
works the jaw. Raw carrots and overcooked meat are not tolerated for long.

Even if I don't serve them mush, al dente pasta and tender-cooked meats are
quite soft. Home-made jerky and artisan-style bread (with a really tough
crust) are the best I've come up with so far.

I did have an insatiable desire to chew on gum for a year or so while a
teenager. In retrospect I wonder if it was innate. Didn't save my wisdom teeth
though.

~~~
_jal
Chew toys.

Seriously - kids often chew on pens and other random household objects.
Something less likely to make a mess/be gross or dangerous would seem
preferable.

~~~
derefr
What's gum but a chew toy?

If you want it to also not rot teeth, don't put sugar in it.

If you want it to still taste like something, just put non-metabolizable
sugars in it, like xylitol.

(There are already xylitol gums. Buy them for your kids today!)

~~~
ravenstine
Probably would have to be really tough gum. Early humans had more aligned
teeth because they were chewing on connective tissue.

~~~
aesh2Xa1
Have you chewed double bubble for any longer than 10s?

------
dTal
I'm surprised that in nearly 200 comments, nobody has pointed out that hominid
jaw evolution has been trending smaller for millions of years. Problems such
as crowding and malformed wisdom teeth are a symptom of an in-progress
adaptation - it is easier for evolution to change the size of the jaw than the
number of teeth. Broadly, the issues with our mouths all fall under the
umbrella of rapid (on an evolutionary timescale) changes to our diet and
lifestyle, far predating the development of agriculture which is merely the
latest brick in the wall. You may be able to mitigate some problems by
adopting an earlier dietary style, but you may also cause other problems.

We are not perfectly adapted to any environment; we are a work in progress.

~~~
usrusr
Oh, we are adapting I think, adapting to an environment where teeth don't to
create much selection pressure.

------
jaggederest
I was fairly disappointed when Oragenics abandoned their modified
streptococcus treatment, designed to replace the most harmful bacteria in the
human mouth with a non-damaging one.

[https://www.oragenics.com/technology-
pipeline/lbp/smart](https://www.oragenics.com/technology-pipeline/lbp/smart)

Last I heard, the few people who had tried the treatment are still completely
free of decay and gum issues, but it's been a long time and there's no follow
up, sadly.

~~~
starpilot
I think there should be a serious look at whether dental industry is
preventing these treatments from seeing the light, or at least quietly and
deliberately ignoring them. Xylitol has almost definite benefits but most
dentists have never heard of it.

~~~
derefr
> Xylitol has almost definite benefits but most dentists have never heard of
> it.

I mean, it's in a lot of toothpastes and mouthwashes. Certainly it could be in
more things, but dentists _do_ recommend those things it's in (without
understanding exactly what makes one better than another, instead going on
dentistry-association studies of the observed effects of various products.
Presumably the scientists doing said studies know what xylitol is.)

It's hard to just put xylitol in regular foods, though, because people feed
random foods to their pets all the time, and xylitol kills dogs. So it only
ends up _marketed_ in the form of things you would never think to allow your
pets to have in the first place. (Like mouthwash, or gum, or mints.)

You can certainly take your consumption into your own hands, though, and just
buy a bag of xylitol to use in place of sucrose for cooking/baking/putting in
your coffee/etc. (That is, if you don't have a dog.)

~~~
starpilot
_A lot_ of toothpastes and mouthwashes? Any that you can find in local stores?
I have to order mine from Amazon.

~~~
ravenstine
I'd buy a toothpaste with xylitol if I could, but I've never seen any in
stores.

It doesn't have xylitol, but I do buy toothpaste with bioactive glass which
helps remineralize teeth without fluoride.

I actually wrote an article about its history and why it disappeared from
shelves in the US:

[https://medium.com/@ravenstine/the-curious-history-of-
novami...](https://medium.com/@ravenstine/the-curious-history-of-novamin-
toothpaste-620c6bef8881)

~~~
alanbernstein
Thanks for sharing this. I've been asking dentists about this stuff for years,
not one had heard of it. When I last read about it, it was just referred to as
45s5, and I didn't realize it was available from a major manufacturer. Now I
have a chance to get some.

Care to share your experience with using it?

------
redka
What about the tongue? After reading something strange in a book about
meditation, where it said I should keep my tongue at the roof of my mouth, I
got curious. Actually I was baffled because I couldn't do it. I literally
could not keep a significant part of my tongue stuck to the roof of my mouth
without significant effort and actually strain. I did a survey between my
friends and only one of them (my brother) actually kept the tongue in the
described position naturally. Surprisingly (this is highly anecdotal, but
still interesting) he's the only person that I know that doesn't have any
teeth issues - only once he'd visited a dentist with a small cavity. This got
me researching and there's actually a British orthodontist (Dr. Mike Mew) who
actively pushes the idea that we should keep our tongue at the roof of our
mouth and that it's actually our natural tongue position that _would_ develop
if we kept our ancestral dietary habits, e.g. chewing hard foods like meat
from since we were little.

~~~
dorkwood
This sounds like an interesting theory. I'm not really sure where my tongue
could rest that wasn't on the roof of my mouth. The vacuum kind of naturally
sticks it up there. I'd have to force it down otherwise.

------
sneak
There is ample evidence supporting the theory that the standard western diet
high in refined carbohydrates is the root cause or at least primary
contributing factor of many of our society’s most common health disorders.

I heartily encourage everyone to try radically different (but nutritionally
complete) diets for a month or two, if for no other reason than to see how
your body and brain responds. Go vegan, try keto/lchf, try carnivore, try
soylent, try sated. See what, if anything, it gets you.

I like spending 80% or so of my life in ketosis (usually for 2-8 weeks at a
time), due to the many small changes it causes in my body and mind.

One of the interesting side effects (for me) is a significant reduction in
dental buildup, and after a few weeks of not eating sugar, much of the
existing buildup (if I haven’t had a professional cleaning recently) will
spontaneously crumble and detach.

It surprised me when it happened.

~~~
Simulacra
Not to mention sugar. Societies that are not as heavily ....invested as
western diets are in sugar seem to have much better teeth.

~~~
themdonuts
I've recently realized how Indians in general have such perfect teeth. Some of
my Indian colleagues even say they've never been to a dentist in their life.
It seems like anecdotal evidence supporting how diets are that important to
teeth health.

~~~
sumedh
Indians love sweets, most Indian sweets are loaded with sugar. Some sweets are
literally served with sugar syrup which is just sugar and water.

Since we are talking about anecdotes, most of my Indian friends have had
dental issues didn't matter if they were veg or non vegetarians.

------
eastbayjake
The Hacker News community spends a _lot_ of time discussing the surprising
importance of our gut biome -- this article does an amazing job bringing that
biome all the way to the start of the line. Unsurprisingly, the biome in our
mouths has enormous importance as well.

~~~
UnbugMe
For anyone interested in microbiomes of the human body, gut or otherwise,
'Bacteriology of Humans - An Ecological Perspective' is a great book.

------
akersten
Part of it is genetics too - I've been cursed with deeply-pitted chewing
surfaces that are prone to cavities. A sibling with the same diet was not, and
has never needed a filling.

One of my biggest regrets in life is getting amalgam fillings as a kid. Not
that I would have known any better, or been able to protest it (they were the
cheap and affordable option, after all). But knowing that a mercury compound
is in my mouth 24/7 is not comforting.

I am reassured by studies indicating there are no toxic effects[0], but it's
still one of those backburner things that one thinks about every once in a
while. This fear alone has done more to motivate me to floss and brush
properly than anything else. Luckily, I haven't needed a filling in almost a
decade - but if I do, it will not be an amalgam one.

[0]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388771/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388771/)

~~~
jasonpeacock
There's also mercury in vaccines. But thanks to the miracle of chemistry,
you're safe. Just like the chlorine in salt doesn't kill you.

~~~
pmiller2
You're using a bad argument. Dental amalgam literally contains elemental
mercury:
[https://en.wikipedia.org/wiki/Amalgam_(dentistry)#Compositio...](https://en.wikipedia.org/wiki/Amalgam_\(dentistry\)#Composition)
That alone is cause for concern, although it does not mean it's necessarily
dangerous:
[https://en.wikipedia.org/wiki/Dental_amalgam_controversy](https://en.wikipedia.org/wiki/Dental_amalgam_controversy)

------
leafmeal
Recently I was wondering why we have so many mouth problems. Teeth are often
misaligned, wisdom teeth need to be removed, TMJ (clicking / popping jaw) is
extremely common. After researching, I came to the same conclusion that this
article mentions at the end. Essentially we need to eat harder foods while
developing in order to increase jaw size and strength.

The article touches on sleep apnoea as well. Apparently this can become a huge
problem for developing children if their pallet is under-formed.

I think this is a big public health issue, and I think it makes sense to start
some kind of large scale public health campaign to inform the public and avoid
all of these dental issues.

There's a book about this, the introduction is online here
[https://www.sup.org/books/extra/?id=29626&i=Introduction.htm...](https://www.sup.org/books/extra/?id=29626&i=Introduction.html)

------
bradlys
Interesting. So, it seems to be beneficial to have children chew on hard
things when small to develop a larger jaw so that their teeth don't crowd. I
guess chewing on ice would be beneficial in this sense. As long as they're
chewing on it with teeth that will fall out as to not worry about damaging
them...

I wonder what the aesthetic differences would be though. In a western beauty
sense, I can imagine having a larger jaw being somewhat preferential for men
but for women - isn't it not? Would it be enough to notice?

Wish I had known this growing up. Ironically, I felt like I did eat some hard
foods but I wonder how much you have to eat in order for it to have a real
effect.

~~~
centimeter
It's not about chewing on something hard, but about pulling on something
strong (away from your face). E.g. ripping chunks off a piece of meat. This
will have the desired effect on their jaw, making them both healthier and more
attractive.

~~~
bradlys
> and more attractive.

I guess that'll vary on your definition of what's more attractive.

------
themdonuts
Reading this made me stand back up from bed and go floss.

~~~
Simulacra
Interesting that every so often there will be a news report about the
ineffectiveness of flossing. i.e. from 2016:
[https://www.nytimes.com/2016/08/03/health/flossing-teeth-
cav...](https://www.nytimes.com/2016/08/03/health/flossing-teeth-
cavities.html)

~~~
ebg13
Flossing doesn't need to be "effective" to be worthwhile. All you have to do
is not floss for a long time and then floss and sniff the floss.

~~~
Etheryte
This is actually what got me into flossing daily. I also think dentists doing
this to patients, that is flossing their teeth and then having them sniff the
floss, would be a lot more effective than simply telling people they should
floss.

~~~
ebg13
> _dentists doing this to patients_

I'm dying. "SNIFF IT! SNIIFFFFFFF IIIIIIITTTTTT!" TBH, that sounds like
assault.

------
crazygringo
Is there any actual evidence, though, that soft foods have led to smaller jaws
(and therefore crowded teeth)?

When you look at traditional cooking all around the world, I just don't see
any evidence that diets today are overwhelmingly "softer".

When you think of traditional diets, you think of boiled vegetables, milled
grains made into porridge or bread, grilled fish and meat, and so on. I don't
see any evidence that traditional diets were harder to chew in any way. People
have been cooking and boiling foods to make them soft for many thousands of
years.

And plenty of people today are raised on crusty chewy bread, chewy steak
sandwiches, salads with chewy greens (kale), and so on. Not everybody, sure --
but those people (like me) still need to get braces terribly often.

So while there certainly appears to be evidence that teeth crowding has gotten
worse, it's not clear that the hypothesis that small jaws are caused by soft
food has been proven at all, or is even plausible.

------
lenkite
Human Teeth are terrible. The fact that we cannot regrow enamel, considering
our life-span is a ridiculous, evolutionary design mistake. So wish we were
Polyphyodont.
[https://en.wikipedia.org/wiki/Polyphyodont](https://en.wikipedia.org/wiki/Polyphyodont)

~~~
decebalus1
Why is it an evolutionary design mistake? It's perfect from an evolutionary
standpoint. They get you through sexual maturity, reproduction and plenty of
time to see after your offspring. What happens afterwards is bonus time on the
planet, it's free-for-all everything goes wrt to your body. Evolution didn't
'design' us to last that long..

------
blendo
I will recommend the book "The Story of the Human Body" by Daniel E.
Lieberman. In his section "Unwise Wisdom Teeth", he writes:

"Just as your limbs and spine will not grow strong enough if you don't
sufficiently stress your bones by walking, running, and doing other
activities, your jaws won't grow large enough for your teeth and your teeth
won't fit properly if you don't stress your face sufficiently from chewing
food."

A fascinating book. One observation: modern human hunter-gatherer mothers
typically wean their children at age three, while a mother who is a
subsistence farmer can wean her children between one and two years. Thus,
humanity underwent a population explosion once we started farming instead of
hunting and gathering.

------
eth0up
Tired, so I'll skip my own interpretation - but I've become convinced that
hydroxyapatite is overlooked. I subscribe to the importance of vitamin K too,
although my experience with hydroxyapatite has been tangibly beneficial. I
find it odd that it's as uncommon as it is, eg I've never seen it on a store
shelf. Again, I'm tired, so I'm dropping an unvetted lazily found link on the
topic below:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252862/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252862/)

------
mc32
Somewhat related was something on NPR the other day[1]. Diet has affected
mouth morphology such that about 90% of people are affected by it and it’s
expressed in crooked teeth, poor sleep and other things.

Looks like diets over the last 400 years have had dramatic impact on human
health mouth shape.

[1] [https://www.npr.org/sections/health-
shots/2020/05/27/8629631...](https://www.npr.org/sections/health-
shots/2020/05/27/862963172/how-the-lost-art-of-breathing-can-impact-sleep-and-
resilience)

------
kaybe
Everyone, please be aware that if you brush too hard/wrong you can wear down
your gums which will be very troublesome from middle age up! Get a softer
toothbrush if you are sensitive!

------
maerF0x0
A couple of other reading:

* [https://elemental.medium.com/why-is-the-internet-obsessed-wi...](https://elemental.medium.com/why-is-the-internet-obsessed-with-this-cult-toothpaste-963dda060501)

* [https://www.nytimes.com/2016/07/26/upshot/you-probably-dont-...](https://www.nytimes.com/2016/07/26/upshot/you-probably-dont-need-dental-x-rays-every-year.html)

------
kyle_morris_
I read somewhere that people in recent history have begun to mouth breath
heavily compared to folks living before the industrial revolution.

A drier mouth has to impact the biome in your mouth I would presume, for
better or worse.

Mouth breathing could have a lot of other disadvantages, such as sleep apnea,
as mentioned in the article.

Mouth breathing obviously doesn’t cause teeth crowding but I’m wondering how
significant factor it is in overall dental health.

~~~
vczf
I think there's a link to tooth decay. If you're mouth breathing your teeth
aren't being coated in saliva, so they can't be remineralized.

I read that distance runners can develop dental problems because of mouth
dryness combined with sugary energy gels.

------
rotrux
A)Teeth are sorta like regular ol' bones 'cept they're on the outside of your
body and their purpose is to grind things. B) You don't really need all of
them to survive + evolution. C) Humans live a really long time now and we just
expect our mashy-grinders to keep up? D) Enamel doesn't like sugar which is in
everything.

Bam. Scientific American here I come.

------
TopHand
I can't help thinking that this problem is being looked at backwards. Maybe in
primitive societies good teeth were far more important to survival than they
are today. If that were true, then people/children with bad teeth would not
survive as well, and the record would show that those who did thrive had good
teeth.

~~~
necovek
I think that hypothesis can work for many other things (eg I can imagine high
myopia to be an issue for hunter-gatherers), but not teeth or bones: what we
know of primitive societies and their eating habits is from looking at their
bone remains and tools. Hopefully scientists having access to actual findings
are not overlooking child skeletons with bad teeth when coming up with
conclusions that our primitive ancestors had better teeth.

~~~
TopHand
It is my understanding that only about 6000 ancient human skeletons have been
found. [https://humanorigins.si.edu/evidence/human-
fossils](https://humanorigins.si.edu/evidence/human-fossils) Many of these are
incomplete. So the samples of children with bad teeth could easily not exist
or be very limited. The same could be said for children with good teeth.

------
woodandsteel
The article gives us yet another set of reasons for avoiding the modern
processed diet and sticking with unprocessed foods.

------
phnofive
All that talk of the history of orthodontics and surgery and medical
approaches were left out... too cheap, I guess:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800179/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800179/)

------
senectus1
I was born without wisdom teeth.

According to my dentist its becoming more common and considered and a part of
the evolutionary process.

------
jonplackett
Fascinating - but was I the only one who had to go brush their teeth half way
through reading?

------
sjg007
We have bionators and other tools to correct jaws.. not sure why those
wouldn’t work.

------
xenospn
Am I the only person around without any cavities or painful dentist memories?

~~~
airstrike
Never had a cavity in my life, for some reason, and it's not like I'm OCD
about my teeth. I just brush multiple times a day, floss less often than that

~~~
xenospn
I brush twice a day and never floss.

------
bedhesd
Sugar!

------
Simulacra
Some anecdotal evidence: In my volunteer work with the homeless, and
prisoners, dental care is painfully, ridiculously absent. As much as I am
opposed to the idea of universal health care, I think we can all 100% get
behind universal dental care.

~~~
metabeard
Can you please explain how you're opposed to universal health care but 100%
behind universal dental care? These seem at odds.

~~~
marcell
Not GP but dental care is a lot cheaper than medical

~~~
nightfly
Maybe on average, but dental care can suck when you need a lot done. Root
canals, crowns, and implants are expensive. And dentists often expect payment
in full up-front before doing any work.

~~~
Simulacra
But it's a definitive payment. Medical bills from hospitals and doctors
offices are often padded, or somehow magically they grow in cost. Dental bills
don't. It's generally a one-time thing.

