Case Studies in Nutritional Dentistry—Joan and Nancy

By Fred D. Miller, DDS

Summary: A pioneering holistic dentist uses the case history of two patients to illustrate the clear relationship between nutrition in the body and dental decay in the mouth. Photos included. From the magazine TIC, 1948 and 1949. Lee Foundation for Nutritional Research reprint 49.

The following is a transcription of the original Archives document. To view or download the original document, click here.

Case Studies in Nutritional Dentistry—Joan and Nancy

Excerpted from February 1948 issue of TIC magazine:


Today I had a real thrill that made me feel good all over. A beautiful young lady, seventeen years old, came into my office to have her teeth cleaned by my dental hygienist and have bitewing X-rays (the kind that show cavities) taken.

It has been a year since this young lady moved away from Altoona. She has been my patient since she was three years old. She was always a very difficult child to handle in a dental chair. She always cried, and we had to use novocaine for every dental preparation. She dreaded to come and was very apprehensive about every phase of dental operative procedure.

A Case History

Her very lovely mother tried so hard to do the right things regarding her food, but the child had many dislikes for the kinds of food that would build her a healthy body. She was [also] a sufferer of intestinal conditions and stomach disturbances that upset the program.

Her physician told me recently of her early troubles and that she was a difficult child to raise. She was a bottle-fed infant, had great difficulty with her formulas, was fed too much refined cereal, and got off to a very bad start, as so many children do. Then, when such children develop a finicky stomach and an upset in intestinal function, they become pampered and are frequently given foods that satisfy their hunger or their acquired tastes but do not prevent hidden hunger, foods that fail to supply the body with the necessary protective food factors so essential in building and maintaining a healthy body.

But today Joan is a changed young lady. For a year she has been on a very sane dietary, and her mother said to me, “If Joan has any new cavities in her teeth, we are going to be disappointed.”

Well, the point is she hasn’t any new cavities. Her teeth are beautiful, and they have that very healthy look, [with] beautiful enamel—clean, hard, and dense. You can tell just to look at them that they are highly resistant to decay. This is in contrast to the “chalky” looking enamel, with no glaze or sheen, that looks like the soft, susceptible-to-decay tooth structure that Joan had had for so many years and which was held in check only by rigid prophylaxis, many cavities filled, and good home care.

There were several fissures in her teeth that needed filling—they had been there for some time—so they were prepared, and here is the thrill: no novocaine was used, and the teeth were not sensitive, as they had always been before. Joan did not once complain, and she was not apprehensive; she was perfectly calm and composed. She did not mind at all my grinding out these cavities, and the tooth structure was hard, dense, and sclerotic—in contrast to the soft, malacotic, highly sensitive tooth structure she had always had. Her gum tissue is firm, pink, healthy, and resilient, with fine tissue tone, and, of course, underlying this splendid gum tissue is sound, healthy bone—a firm foundation for this splendid grinding mechanism.

A Year of Good Habits

Now, let me tell you—just as she and her mother told me—about Joan’s daily good habits for the past year. For breakfast she eats three whole oranges, an egg, a slice of whole wheat toast, and a glass of milk. For lunch she eats an apple, an orange, a banana, carrot strips, a sandwich of whole wheat bread with meat or cheese and lots of lettuce, and a glass of milk. For dinner she has meat, a baked potato (skin and all with butter), two vegetables—broccoli and carrots or green beans, a fruit salad or a banana and an apple, and a glass of milk—and no dessert. At bedtime she eats an orange.

Wherein does this dietary differ from the average? First, it contains no white flour or white flour products—no cookies, pies, cakes, or pastries—no refined or processed cereals, no white sugar or products made from it, no candy, and no soft drinks. Fruit and milk replace candy and cake.

Of course, another factor is that Joan has been in the ocean or on the beach for two or three hours a day since she moved to the seashore, so she has had plenty of natural vitamin D, the sunshine vitamin (all other essential vitamins come from natural sources, too).

No doctor bills, no dental bills. Joan is thrilled, her mother is thrilled, and I, her dentist, am thrilled [for this] healthy, vital, active, charming, beautiful young lady who got off to a very bad start.

A Dentist’s Philosophy

Every once in a while some kid comes through as Joan did, and [reversing his or her course] is the thing I get the most kick out of in my dental practice, for I know it can be done. We have seen it happen many, many times. Yet I become discouraged at times because we see so many dental cripples, and I think maybe it isn’t worth all the talking and harping I do on right daily habits of eating and that maybe I should just keep my big mouth shut and put in inlays and bridges and extract teeth and make dentures and make a lot of money. But heck, I wouldn’t get any fun out of just that.

I do not believe in panaceas. Mother Nature knows best, and when you try to violate her laws, you just can’t get away with it.

Do you think this is the end of this story? Well, I don’t think so. I believe Joan has learned a lesson that will carry her through a healthy life, and her children and her children’s children will profit by her experiences. At least I hope so. I’d bet on it.

[Photo of young girl, with caption:] Joan at age six—a scrawny kid, malnourished.[spacer height=”20px”] (See original for image.)

[Photo of young girl’s set of teeth, with caption:] Joan’s teeth at age six-and-a-half. Her deciduous teeth were all badly decayed but had been kept “patched up.” Joan always had dental care. She started orthodontic treatment at age seven because radiographs taken at age five-and-a-half showed these very large centrals coming and no room for them. (Orthodontia by Dr. Frank E. Evans, Altoona, PA.)[spacer height=”20px”]

Joan was very fortunate to inherit a beautiful tooth form. Get the significance of that. We do not inherit “good teeth.” They are all built and maintained after birth. We do not inherit the shape of the teeth. “The price of good teeth is eternal vigilance”—they are worth all the effort.

By Fred D. Miller, DDS. TIC, February 1948. 

Excerpted from October 1949 issue of TIC:


For some time now, since I wrote the story about Joan, I have been worried. The story of the Joans of the world—the wrecks we can salvage—is important, yes, very important, because these cases are our bread-and-butter dentistry. However, it is unfortunately true that we dentists, just like the surgeon, make more money from the wrecks we salvage, while—and this is what worries me—the very real, valuable service of piloting our patients, a much less spectacular service, is too often minimized.

These are the patients we can start with prenatally and bring through their childhood, through adolescence, and into manhood and womanhood without any dental decay or with a minimum amount. These are the patients we have been able to guide, to steer away from the pitfalls and rocks of dental destruction and ill health because dental health and good general health march along together. Perhaps this should be clarified for those skeptics who cannot see the forest for the trees—dental caries, or dental decay, being only one tree in the whole dental-disease forest.

We who have devoted our lives to the education and enlightenment of our patients have had the satisfaction, over a long period of years, of seeing the physical improvements represented by the children of second and third generations. They are patients who, compared with their grandparents and parents, are superior physical specimens. (“Super-rats,” I call a few of them.) This superiority extends beyond their teeth. It includes their bony skeleton, their musculature, the very tone of the tissues, which are firm, healthy, and resilient, as compared with the soft, flabby, waterlogged tissues characteristic of ill health.

These children—many of them now grown and with children of their own, who, in turn, are improvements over their parents—furnish us with the rewarding drive necessary to carry on the less spectacular and less remunerative work of real prevention, in which we, acting as pilots rather than salvagers of wrecks, perform a fundamental and fruitful service for our patients.

[Photo of patent Joan, with caption:] The story of Joan originally appeared in [the February 1948 issue of] TIC magazine, published by Ticonium, Albany, NY. It is presented to you through the courtesy of your dentist.[spacer height=”20px”]

The Origin of a Case

So, let me tell you the story of Nancy. About nine years ago, a young mother brought her daughter into my office, introducing herself like this: “I am Mrs. Bartholomew. You know my husband, Dick. This is our daughter, Nancy.” In the very next breath, she said to me, “If Nancy has any decayed teeth, it is your fault.”

I replied, “Well, that is a pretty good number. How do you figure that one out?”

She explained, “About the time Nancy was born, Dick and I heard you give a talk at a parent-teachers’ meeting, and we have done everything you told us we should do.” (At least that is one talk that registered!) “So,” she continued, “if Nancy has any decayed teeth, it is your fault.”

Well, believe me, I was on a spot. I certainly was anxious to examine Nancy’s mouth. When I did, I found that Nancy, at six years of age, did not have any decayed teeth. And today, at age fifteen, she still does not have any dental decay. Furthermore, she has healthy, resilient, firm gum tissue, supported by firm, dense bone, and beautiful skin as well. She fairly radiates health. You know just by looking at this young lady that she has that God-given health that is the rightful heritage of every child but which so few children possess, even though it is within the power of every mother to do for her child what Mrs. Bartholomew has done for Nancy.

Incidentally, Nancy did not have any serious childhood diseases. She recovered quickly from such illnesses as she did have. Consequently, she has no “scars”—in contrast to Joan, who had about everything in the book. So you see that dental decay is only a part of the whole syndrome of ill health.

The Cost to the Patient

Now, let us look at these dental health problems from a monetary standpoint. If you read the story of Joan, you will recall that for years her teeth decayed; she had constant dental care, and she was a problem child, difficult for her parents to bring up because she was always sickly. Joan was a highly nervous and therefore difficult dental patient, with hypersensitive teeth and rampant decay that was held in check only by rigid care and many dental restorations. Sure, she still has good-looking teeth, but her parents paid me a little over five hundred dollars in seventeen years.

Joan is nineteen now. As you may recall, she eventually became health-conscious. Through new, rigid, daily, food habits, she was able to rebuild her health and her teeth—from a soft, malacotic tooth structure that was hypersensitive, to a sound, healthy sclerotic tooth structure that is not the slightest bit sensitive.

Compare this with Nancy, whose total dental bills have been confined to dental prophylaxis—having her teeth cleaned by my dental hygienist—and bitewing X-rays to check up for cavities. Over a period of nine years, Nancy’s total dental bills have been under fifty dollars, excluding orthodontia; both Joan and Nancy had their teeth straightened.

A Note on Orthodontia Bands

Right here I should like to straighten out a prevalent idea—that orthodontia bands on teeth cause the teeth to decay. They do not. Decay occurs in the mouth of a patient only where the environment is favorable for the growth of those organisms that are always present when decay occurs; unless the soil is favorable, these organisms will not remain in the mouth. Of course, children who wear “bands” to have their teeth straightened have more difficulty keeping their teeth clean, and these bands can harbor the wrong kinds of sticky food, thus encouraging decay. But—and this is most significant—if the food is not of the fermentable, carbohydrate, sugary character, then the bands will not cause decay. I hope I have made that clear.

Well, to make a long story short, Nancy has done all her life the things Joan has been doing the last few years. Joan learned the hard, and expensive, way. It never was an effort for Nancy—she always had a good dietary. Simple isn’t it? And it pays off.

Some Suggestions

Here are a few suggestions. You, doctor, keep a record for a week of everything you eat, and check up on yourself. Do that first. Then have the next fifty patients who come to your office keep a record of everything they put into their mouths for a week. Check up on their records. Take a red pencil and underscore everything they are eating that makes no contribution to their dental health. You will be surprised at what you find.

Have your patients always end their meal with fruit, and watch the improvement in the whole mouth.

Nancy’s father was a runner and, later, a track coach. He knows the value of a training-table diet for athletes, and he also knows the value of dietary in rearing a healthy child.

The next time you read about a Baby Beef 4-H contest, note how much the winner gets per pound for his baby beef. It pays to raise a champion. And it is done very largely with good food. This applies to children as well, doctor—yours, mine, and all other children.

A Case History in Pictures

[See original for all photos referenced below.][spacer height=”20px”] [Photo of a young girl’s set of teeth, with caption:] This photograph shows Nancy’s deciduous teeth. She was six years of age when Dr. Miller took this picture.[spacer height=”20px”] [X-ray photo, with caption:] These are bitewing X-rays of Nancy’s permanent teeth.[spacer height=”20px”] [X-ray photo, with caption:] Dr. Miller made these X-rays last November, when Nancy was fourteen years old.[spacer height=”20px”] [Photo of young girl, with caption:] This is a picture of Nancy at eight years of age, before orthodontia.[spacer height=”20px”] [Photo of a set of teeth, with caption:] Here is an excellent picture of the girl’s permanent teeth.[spacer height=”20px”] [Photo of young girl, with caption:] As Dr. Miller says, “Here is Nancy today.”[spacer height=”20px”]

By Fred D. Miller, DDS. TIC, October 1949. This article and previous one published as a single publication, Reprint 49, by the Lee Foundation for Nutritional Research, circa 1950. 

Reprint No. 49
Price – 10 cents
Reprinted by Lee Foundation for Nutritional Research
Milwaukee 3, Wisconsin

Note: Lee Foundation for Nutritional Research is a nonprofit, public-service institution, chartered to investigate and disseminate nutritional information. The attached publication is not literature or labeling for any product, nor shall it be employed as such by anyone. In accordance with the right of freedom of the press guaranteed to the Foundation by the First Amendment of the U.S. Constitution, the attached publication is issued and distributed for informational purposes.


Patrick Earvolino, CN

Patrick Earvolino is a Certified Nutritionist and Special Projects Editor for Selene River Press, Inc.

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