By Alfred Aslander
Summary: “A tooth is a living tissue, not a dead mineral structure,” writes Swedish researcher Alfred Aslander in this compelling 1964 report. “And a tooth is an independent individual that grows out of the mandible in somewhat the same way as a plant grows out of the soil. The plant receives nutrients from the soil solution, the tooth from the blood stream. The growth of [each is] governed by the same laws of nutrition.” The author proposes, based on animal studies and his own experimentation, that supplementing the diet with bone meal will supply all the nutrients required by a tooth and even outlines a study that would settle the debate about nutrition and dental disease. Too bad no one took him up on it. Report from the Division of Agriculture, The Royal Institute of Technology, Sweden, 1964. Lee Foundation for Nutritional Research reprint 134B.
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A Plan for Testing the Theory of Complete Tooth Nutrition
The Swedish Medical Research Council has assigned to the writer the task of drawing up a plan for testing the writer’s theory that a complete tooth nutrition acts as a sure dental caries prophylaxis (Aslander, 1963(d)). Such a plan must be founded on experiments carried on over many years. For that reason it would be of great value if somewhat identical experiments could be started simultaneously in several places around the world, so that without unnecessary delay the influence of varying living conditions could be ascertained. Accordingly, this general plan is put forward.
The Theory of Complete Tooth Nutrition
A tooth is a living tissue, not a dead mineral structure. And a tooth is an independent individual that grows out of the mandible in somewhat the same way a plant grows out of the soil. The plant receives nutrients from the soil solution, the tooth from the bloodstream. The growth of both is governed by the same laws of nutrition.
One of these is that any living and growing individual needs a complete set of nutrients in order to attain a normal development. If one or more of the essential nutrients are lacking or present in too small quantities, then severe deficiency diseases will arise. Thus, for the development of a normal tooth, a complete supply of tooth nutrients is necessary. If a tooth does not receive complete nutrition, deficiency diseases will set in. In other words, dental caries is a deficiency disease. Only starved teeth are attacked by dental caries.
A complete tooth nutrition, especially during tooth formation, will produce teeth that are highly resistant to or immune against dental caries. Thus our battle against dental caries should be waged, in order to promote the growth of normal teeth, just as our wild animals grow normal teeth free from dental caries. The difference between wild animals and man with reference to dental caries is that the animals grow up in a natural habitat, where the feed is sufficiently rich in tooth nutrients, whereas man, especially in industrialized countries, is living in a highly artificial habitat and on processed foods that are very deficient in tooth nutrients. In order to grow healthy teeth, man must supplement the daily fare with tooth nutrients.
A. The Birth of the New Theory
As a small boy, the writer suffered badly from toothache. At that time, more than sixty years ago, official dental care was nonexistent. Dental caries in children was regarded as something akin to mumps and measles—something quite natural for children. But for the writer this toothache was something horrible and unforgettable. When at a mature age I was to become a father—in 1938—I was determined to try to protect my children from dental caries.
According to my view of the matter, this could be achieved in two ways. The children could be brought up on a daily fare completely free from cariogenic foods, or the resistance of the teeth to dental caries could be strengthened. The first way appeared almost impossible to follow, especially since for private reasons it was necessary to base the daily fare on inexpensive foods such as carbohydrates. The other method, to improve the quality of the teeth by better tooth nutrition, seemed to be far more interesting and promising.
The writer had at that time, in 1938, a long experience of research in plant nutrition, where the effects of a deficient mineral nutrition were often noted. Deficiency disease in farm animals caused by an insufficient supply of minerals had also been observed. For these reasons it was quite natural to regard dental caries as a deficiency disease caused by an insufficient supply of tooth nutrients. And the most likely tooth nutrients appeared to be the minerals that form the tooth structure. I at least had good reasons to believe that my poor deciduous teeth, which gave me such painful toothache, were the result of phosphate starvation.
The writer grew up on a dairy farm in northern Sweden. Some years prior to my marriage, I had the opportunity to examine the soil types on the parental farm. They were found to be very poor in plant-available phosphates (Aslander, 1932). And the phosphate deficiency must have been even more pronounced in my babyhood, since phosphate fertilizers were used very sparingly then. Crops grown on soils poor in phosphate are likely to contain a low percentage of phosphorus. Thus the foods for the family and the feeds for the cattle on the parental farm were low in phosphorus. Moreover, in those days the daily fare at my home consisted almost entirely of homemade products. I grew up on a diet poor in phosphates—and got poor teeth.
These considerations induced me to give my firstborn baby small daily doses of a soluble phosphate, CaHPO4, as soon as the mother’s milk was supplemented by other foods. The first doses were almost microscopic, but they were slowly increased, so that at the age of two the child received a daily dose of about 2 grams. Both the child and the teeth grew splendidly.
B. The Bonemeal Period
The phosphate treatment apparently gave excellent results—perhaps too good. The results could in part also have been due to a very careful nutrition given to my firstborn. For the more common upbringing of children, a more comprehensive tooth nutrition [seemed] necessary. Bonemeal appeared to be the answer. It contains, in addition to calcium and phosphorus, as in CaHPO4, a number of trace elements, some of which could be of importance as tooth nutrients.
The choosing of bonemeal was quite natural. In my babyhood bonemeal had been used as a mineral feed, especially for pigs, and bone-eating was an old practice. The writer’s parents, born about 100 years ago, grew up with perfect teeth on a daily fare not very different from the one the writer was brought up on forty years later, but a significant difference was that the parents were bone-eaters. The small Baltic herring was roasted over the open fire and eaten—daily—with head and tail, bones and everything. Apparently this bone-eating gave children perfect teeth. When the writer grew up, this bone-eating had been discarded for more “proper” table manners. And thus the writer got very poor teeth indeed.
Bone-eating could not be resumed, but bone-meal eating could. Thus we decided to feed our children bonemeal. This changeover from phosphate to bonemeal took place in the autumn of 1940.
C. The Publication of the New Theory
In 1948, when tooth nutrition had been practiced for ten years with the writer’s children as guinea pigs, the results were so outstanding that it appeared imperative to publish them. At that time three of my children were free from dental caries, in a community where otherwise all the children suffered from tooth decay, often very severely, as could be ascertained by looking into the mouths of our children’s playmates. A small daily dose of bonemeal given to the children had apparently made all the difference (Aslander, 1948).
During the period 1940 to 1948, the writer’s attention was brought to an experiment with bonemeal in the U.S.A. In the Swedish edition of Reader’s Digest, Det Basta, there appeared in 1944 an article describing an experiment by Harootian (1943). He gave bonemeal to some of his mature patients who had had especially severe attacks of dental caries. After a period of nine months, he was able to record very good results from the bonemeal treatment. However, the writer did not pay very great attention to his experiment. In the first place, the results appeared to be too good. Fully grown teeth could hardly be so easily affected. And the results had no bearing on the writer’s interest in the nutrition of growing teeth.
Particularly, one sentence in the article appeared to be too dogmatic. It ran: “To use bonemeal without the careful advice of a physician is very dangerous.” Bonemeal contains fluorine—a common constituent in rat poison! If the dramatic sentence had been accepted, then I should at once have stopped my children’s bonemeal diet. Fortunately, the sentence was obviously exaggerated. My experience was that bonemeal had been given to farm animals in comparatively large doses for a long time, with only beneficial results. The small doses that I was giving my children—about 2 grams a day—had to be harmless. I disregarded the article.
Some years later (1952), the Royal Medical Board of Sweden published the results of a comprehensive investigation into the cariogenic effects of carbohydrates. In this investigation bonemeal was given to mature persons. No significant caries-protective effect was recorded, which is in full accordance with the writer’s theory of complete tooth nutrition. The caries-protective effect of bonemeal is produced in growing teeth, not in full-grown teeth.
D. Further Investigations
When the nutritional theory had been published (Aslander, 1948), the writer had no intention of performing any more experiments outside the family. In the first place, the new theory appeared to be so well founded that it ought to have been taken up at once by experts on nutrition so that comprehensive investigations could be started immediately. And secondly, the writer had no time for experiments on a large scale. Other research work took up more than the time available.
Unfortunately, the writer’s expectations did not materialize. The theory of complete tooth nutrition met with a compact negativism. It became shockingly evident that if any further investigations were to be made, the writer had to undertake them himself. A plan for testing the theory with 1,000 pregnant mothers and their ensuing children until all the teeth were formed was drawn up in the autumn of 1948 and submitted to the board of a foundation that, according to the founders’ rules, was trying to prevent human suffering. No answer has been received as yet!
In the fall of 1950, The Royal Board of Health announced that a great campaign was to start against dental caries. The writer then in a letter suggested that the board should include in the plan a test of the bonemeal method. No answer has been received, and no test was ever made.
In 1952 an article [about the theory] was printed in the American journal Prevention, and it established good contacts (Aslander, 1952). In 1956 a popular booklet in Swedish was published and spread within Scandinavia (Aslander, 1956). Zimmermann (1956) spread the new theory to Germany.
As a preliminary to a determination to write a scientific paper on the subject, I studied some odontological literature in 1957. I was then shocked to find that not only was the acid fermentation theory suggested by Miller (1890) declared to be the cause of dental caries, but the Miller theory was so insistently emphasized that the study of the textbooks came close to brainwashing. No wonder so many dental people have found it impossible to grasp the theory of complete tooth nutrition! It must be admitted that the writer has subsequently received many reprints from various parts of the world in which dental caries has been discussed far better than in the textbooks.
As a result of studies and some laboratory work, several reports have been printed (Aslander, 1958, 1960, 1963(b), 1963(c)). During the period 1948 to 1963, the writer submitted to the government, the Medical Research Council, and a number of other boards at least a dozen applications for funds for testing the theory of complete tooth nutrition but to no avail. However, a good many parents both in Sweden and abroad have been willing to test the bonemeal method on their children. When the writer’s instructions have been followed, the results have been excellent. Caries-free children have been reported.
Mention must be made in this connection of the great part played by the writer’s wife. She became of course very concerned when the writer proposed the mineral feeding of the newborn baby, but she had full confidence in the father’s reasoning and gave day after day, week after week, month after month, year after year, a daily dose of tooth nutrients. And when the children grew up with perfect teeth, the mother became the cornerstone of the new theory. She convinced many mothers of the usefulness of the bone-meal method, and she made out recipes for bonemeal bread, bonemeal buns, bonemeal cookies, bonemeal candies etc., all of them very delicious and without any “bonemeal” taste.
And, not least, my wife always supported the work, which mostly had to be done in the writer’s spare time, so that home life was impaired, and she never complained when household money had to go to the printing and distribution of reports. It is this unselfish support that has made possible the work on the theory of complete tooth nutrition.
A special brand of improved Swedish bonemeal, which has been used by the writer for more than twenty years, has produced caries-free teeth in children when taken daily from the earliest possible date until all the teeth were formed. This fact is taken as proof that this brand of bonemeal contains all the nutrients that the teeth need under prevailing conditions.
The main part of the bonemeal is made up of various minerals. Thus it seems safe to assume that it is the minerals in the bonemeal that in the first place are to be considered essential tooth nutrients. They form the mineral structure of the teeth, and some of them may also act as catalysts.
In addition bonemeal contains some organic matter that is probably of some importance; at the least it seems to prevent fluorine poisoning. Roholm (1939) found that bone ash in which the organic matter had been burned off caused fluorine poisoning in cattle. Normal bonemeal has never had any harmful effect, so we must assume that the organic matter in bonemeal acts as an antidote. It may also have other important actions. For that reason bonemeal is preferable with a somewhat high content of organic matter. The more processed the bones are, the less the content of organic matter.
To date, the following minerals have been found to be essential tooth nutrients: calcium (Ca), phosphorus (P), strontium (Sr), fluorine (F), vanadium (V), and molybdenum (Mo). All of these minerals are found in bonemeal, which explains how it is that the bonemeal has produced perfect teeth, free from dental caries (Aslander, 1960). In addition bonemeal contains a number of other minerals, some of which may eventually be found to be essential tooth nutrients. Bonemeal may be regarded as a horn of plenty as far as tooth nutrients are concerned.
The Swedish bonemeal used by the writer is made of all the bone of all the animals slaughtered, including bone marrow, horns, and hoofs. In this way this bonemeal will be of a rich composition, which may explain the good results obtained. In order to make the bonemeal still more comprehensive, the manufacturer adds small amounts of iron (Fe), iodine (I), and cobalt (Co). These additions have been found to improve the feeding value of the bonemeal for small pigs. (And the metabolism in small children is probably very close to the metabolism in small pigs.)
Bonemeal has met with several objections, none of them to be taken seriously, with the exception that vegetarians will find it repulsive. For them a special form of tooth nutrient has been composed. Bonemeal has a somewhat varying content of fluorine, a fact that has caused unnecessary discussion. Fluorine in household water has been found to be harmful. In bonemeal the organic matter present seems to make the fluorine harmless. The small variations of fluorine in bonemeal are without any significance.
Bonemeal has also been declared an unclean product. That is an out-of-date objection, at least regarding the bon meal used by the writer. (Bone meal manufactured as an artificial fertilizer is of course unsuitable for human beings.) And it must be pointed out that bonemeal for human consumption should be sterilized, in order to make it safe and more appetizing.
The content of radioactive strontium, Sr90, in bonemeal has been stressed in some discussions, especially in the USA. It has been pointed out that the radioactivity makes bonemeal dangerous as a food supplement. However, the danger seems to be vastly exaggerated. In the first place, the content of Sr90 in bonemeal is—according to analyses made here in Sweden—so low that it is far below the harmful level. Secondly, bonemeal is taken in very small amounts compared with the large amounts of some foods, such as vegetables, fruit, and milk, that are other sources of Sr90. And finally, it has been shown that only small traces of the Sr that we obtain in foods are retained in the body. Around 99 percent is excreted in the urine and feces (Underwood, 1962). Apparently, bonemeal is harmless.
In view of the highly exaggerated fear of bonemeal as a carrier of Sr90, it has been stated that it would be possible to use rock phosphate instead of bonemeal, since rock phosphate is free, or very nearly free, of Sr90. However, rock phosphate is absolutely unsuitable for another reason. Rock phosphate is very rich in fluorine. Samples that have been analyzed here have shown a content of 2–4 percent fluorine. A daily dose of 2 grams of rock phosphate would contain from 40 to 80 milligrams of fluorine. Fluorine poisoning would be an inevitable result.
For vegetarians a pure mineral composition has to be made that is as far as possible identical with an improved brand of bonemeal. But it must be admitted we cannot guarantee that such a mineral composition is as effective against dental caries as improved bonemeal has proved to be. The organic matter in bone meal may be of some importance. However, a mineral composition resembling bonemeal ought to be tested. And it may be possible to add some organic matter that improves the effect without being objectionable to vegetarians.
It must be pointed out that all samples of calcium phosphate, Ca3(PO4)2—a salt very suitable for composing the main mineral part of a mineral composition resembling bon meal—contain fluorine, often in considerable amounts. The phosphate used should be analyzed; a suitable amount of fluorine is not more than 500 milligrams per kilogram of phosphate.
Bonemeal, at least the improved brand used by the writer, has been shown to produce caries-free teeth when used according to the rules that have been worked out. However, the aim must be to compose such a mixture of tooth nutrients as will produce perfect teeth. That may take some time and a good deal of cooperation; until this goal is reached, however, improved bonemeal should be used in order to test the theory of complete tooth nutrition.
It must also be emphasized that in an experiment in which tooth nutrition is to be tested, the general nutritional conditions must be adequate if good results are to be obtained. If the main foods are tea or coffee and white bread, no marked effect of special tooth nutrients is to be expected. The daily fare must be more substantial. In some places the need for vitamins must be controlled.
Here in Sweden such a requirement seems to be of but little importance. The daily fare is in most cases adequate—some staple foods are vitaminized—and vitamin pills or vitamin solutions are sold in great quantities, during the winter at any rate. Yet it must be admitted that, especially in Norway, a good effect has been obtained in diminishing dental decay by giving a daily dose of cod liver oil to children. The writer’s children received vitamins on the advice of the official local infant-care institution.
The investigation is primarily a nutritional one. As experimental objects, animals or children can be used.
A. Experiments with Animals
Nutritional experiments with animals have many advantages. It is possible to use very severe conditions. If an experimental animal expires, it does not mean more than a step beyond its power of resistance. And the results are gained rapidly—a very important point in a hectic world. However, when it is a question of the influence of the nutrition on the development of the teeth, experiments with animals have some disadvantages.
In 1956 the writer had an opportunity to use the Syrian hamster in some experiments to show the influence of bonemeal on tooth formation. Among the conditions of the grant from the Medical Research Council, it was stated that the plan was to be approved by experts. To a very artificial feed mixture, bonemeal was added in increasing amounts. The result was that the addition of bonemeal had very little influence on the caries frequency. This result had to be investigated.
It was found that a Syrian hamster that has reached a weight of 50 grams—enough that it can be put on the experimental diet—has already a complete or almost complete set of teeth. And the teeth are permanent. Thus, the nutritional experiment was carried out on full-grown teeth! No wonder the influence [of the bonemeal] on the frequency of dental caries was slight. A bonemeal diet designed to establish a complete tooth nutrition can materially influence the caries resistance of the teeth only when applied to growing teeth. For that reason conventional experiments with animals of the Syrian hamster type cannot be used in determining the caries-protective properties in bonemeal.
Another observation was made. If a mother hamster with a litter did not receive a plentiful ration very rich in proteins, the mother turned cannibal and devoured her young. That means it would be very hard to try to start the experiment with hamsters during the time the teeth are being formed—that is, during suckling time.
On the whole, nutritional experiments with small rodents with a view to studying the influence of the nutrition on the development of teeth are very difficult to arrange. The writer has no desire to venture on such a precarious path.
B. Experiments with Children
Children are, from the nutritional point of view, ideal guinea pigs. The experiment can begin with the pregnant mother. The child is born without teeth, and the teeth are formed very slowly, so that the daily dose of tooth nutrients can be very small, i.e., no danger of overdosing is to be feared. And a child produces both deciduous teeth and permanent teeth. It is possible to study the effect of tooth nutrition on both sets of teeth. The only drawback with nutritional experiments with children is that one has to wait several years before the result is obtained. But in these times of stress, such a slow-motion experiment ought to be soothing to the nerves!
Experimental Technique with Children
A. Pregnant Mothers
According to the theory of complete tooth nutrition, the administering of tooth nutrients must begin well in advance of tooth formation. For that reason it is advisable to start with the pregnant mother. Tooth nutrients should be taken at least during the second half of the pregnancy. Of bonemeal, 2–3 grams a day ought to be a suitable dose. It is advisable to start with a much smaller daily dose and increase it gradually.
B. Newborn Babies
The writer began to give his own babies bonemeal as soon as the mother’s milk was supplemented with other foods. A few drops of freshly squeezed orange juice were given when the babies were a few weeks old. An extremely small amount of bonemeal was added to the juice. The amount was increased slowly and later on mixed in solid foods, so that at the age of two, the daily dose was about 2 grams. Since this method gave perfect teeth, it seems that it can be recommended.
C. Older Children
According to the theory of complete tooth nutrition, tooth nutrients should be given until all the teeth are fully grown—and preferably throughout life. At the age of two and upwards, a daily dose of 2 grams has been found suitable. During periods of rapid growth, a daily dose of 3 grams may prove necessary, depending on the quality of the daily fare. The more fruit and raw vegetables in the daily fare, the less the need for special tooth nutrients. On the other hand, the more processed the foods, the more white sugar and white flour, the greater the need for tooth nutrients. The mineral content of the water supply is also important.
If for some reason it is difficult to start tooth nutrition with the pregnant mother or even with the newborn baby, it is possible to start with children at the age of two. But it must be borne in mind that if a start is made at that age, it will show but little or no influence on the deciduous teeth, only on the permanent teeth.
It must also be pointed out that if the permanent teeth are to be free from dental caries, it is imperative to start by the age of about two. To start at an age of four or five is too late. The results will then be very unsatisfactory. One must start well in advance of tooth formation. And tooth formation starts very early—on the permanent teeth, already at the age of two.
Misconceptions Concerning the Nutritional Theory
In the Journal of the Dental Association of South Africa, Cohen (1963) states that experiments with bonemeal “consistently failed to demonstrate caries-preventive properties in bonemeal.” This statement seems to be based on experiments that have nothing to do with the writer’s theory of complete tooth nutrition or the writer’s bonemeal method. It has thus no foundation in fact.*
The rules governing the practical application of the theory of complete tooth nutrition bonemeal method are as follows:
1. Start early, preferably with the pregnant mother.
2. Start early with the baby, preferably during the first month of life.
3. Feed bonemeal continuously until all the teeth have been formed.
4. A bonemeal of known quality must be used.
5. Use a suitable daily dose of bonemeal, not too small and not too large.
6. Ensure suitable dental care. If brushing is done, a soft toothbrush must be used. The dental plaques must not be destroyed. According to the writer’s view, the dental plaque is a natural protection for the teeth. Toothpastes should not be used. They are considered harmful. The aim of dental care should be only to remove food residues on and between the teeth. If left, such residues are apt to putrefy and produce foul breath.
Only when these rules have been followed can we speak of the effectiveness of the bonemeal method. Abuses of the rules can only produce poor results.
In Switzerland Berner, Held, and Piquet (1959) started with children five to seven years old in groups of 500 and for three years gave one group bonemeal and another group fluorine tablets and used a third group for control. They found that both bonemeal and fluorine tablets reduced dental decay significantly—fluorine tablets more so. Unfortunately, the experiment started about five to seven years too late to be of any significance as far as the bonemeal method is concerned.
That fluorine tablets gave better results than bonemeal at ages five to seven is easily explained. The tablets contain water-soluble fluorine, and it is well known that fluorine shows a certain activity on the surface of the teeth, and in this way to some extent it diminishes dental decay. Bonemeal, on the other hand, is not soluble in water. It has no apparent surface activity; it is a food. Bonemeal has to be swallowed in order to act as a nutrient. It must be dissolved in the hydrochloric acid produced in the stomach and transported by the bloodstream to the growing teeth in order to build up a tooth that, from the core to the surface, will be of such a good structure that the agents of dental caries cannot attack.
If we are going to start experiments on tooth nutrition, we must be able to distinguish between surface action and nutritive action. Why this experiment started five to seven years too late and thus on lines quite contrary to the bonemeal method ought to be explained. Even before the start, it must have been obvious that the result was bound to be poor.
Cohen (1963) bases his very wrong statement especially on an experiment in Falkenberg, Sweden, by Hall, Lind, and Nystrom (1962). In this experiment 200 schoolchildren ages of 9 to 12 were used as guinea pigs. The duration of the experiment was only two years, with a summer holiday in between. Bonemeal was given in a bonemeal bread. The daily dose of bonemeal was about half the normal one. As bonemeal a brand of unknown quality was used. The degree of dental care is not stated, but it is known that for schoolchildren in Sweden vigorous brushing with toothpaste is recommended.
The result of the experiment was that no influence on dental-caries prevention could be detected. No wonder! All the rules of the true bonemeal method had been grossly violated. It is difficult to understand that such an experiment was ever started, and it is still more difficult to understand how Cohen (1963) in this result has been able to find any foundation for his denunciation of the true bonemeal method.
These two experiments have been mentioned in order to prevent anything like them ever being tried again. What we badly need is well-planned experiments of sufficient duration, not wrongly planned, short-term activities, which only cause confusion.
Control of Dental Caries Frequency
The result of the experiments in complete tooth nutrition must in some way be controlled. The dental status in a group of children given tooth nutrients must be compared with the dental status in a group of children who do not receive special tooth nutrients. In order to obtain reliable results, two conditions may exist:
a. The groups are as identical as possible in every aspect, including social standard and food habits. Then even a limited effect of the tooth nutrients would give a reliable result.
b. The effect of the tooth nutrients is expected to be so great as to produce teeth that are 100 percent free (or very near) from caries. In that case the result would be so overwhelming that comparison with a selected group of children who had not been given special tooth nutrients would be superfluous or almost so.
If two groups as similar as possible were to be selected, the best way would be to start with identical twins, one of which receives tooth nutrients, while the other does not. The difficulty would then be to find mothers who would consent to be partial to their children. At any rate it is the writer’s experience that such mothers do not exist. If the mother believes that one kind of treatment is beneficial, then both the twins shall have the benefit of it, and should the mother not believe in the treatment, then neither of her children shall be a guinea pig. Groups of identical twins are theoretically ideal; in practice they are very difficult to obtain.
In areas where dental caries are common among children, it may be unnecessary to start with different groups. If the experiment starts at an early period of the children’s life, with the pregnant mother, and continues with daily doses of suitable tooth nutrients until all the teeth are formed, then—to judge from long experience—the children will be entirely or almost entirely free from dental caries. Then the experimental group will stand out so conspicuously that the result of the experiment will be very reliable indeed.
In Sweden, where practically 100 percent of the children suffer from dental caries, the writer has proposed such one-group experiments. The results would then have to be compared with the general frequency of dental caries. As far as my experience for more than twenty years goes, the results would be as follows:
a. The children in the experimental group [would have] practically 100 percent caries-free teeth.
b. The children outside the experimental group [would have] practically 100 percent caries-affected teeth.
In areas where dental caries are less frequent, it may be necessary to carry out the experiment with groups of children being given tooth nutrients and groups not being given tooth nutrients, with the selection of the groups being done in such a way that they are [otherwise] as similar as possible.
The actual check for the occurrence of dental caries should be kept at least once a year or, better, at shorter intervals.
Here a little parenthesis must be inserted. Proell (1962) has tried to make a great affair of the fact that he was able to discover microscopic signs of dental caries on lost deciduous teeth from the writer’s children. To the naked eye, the teeth appeared to be completely free from dental caries. As the writer has pointed out (Aslander, 1963(a)), such microscopic attacks of dental caries during the last few weeks of the existence of the deciduous teeth—when the roots of the teeth are reabsorbed, and thus the connection between teeth and mandibles is gradually broken, and the teeth are cast off—should not be taken seriously. They are more or less attacks on dead teeth, not on living teeth. At any rate they are of no practical consequence. The aim of an experiment with complete tooth nutrition should be to ascertain whether real caries—especially in the permanent teeth—can be prevented. That is the real problem.
The frequency of dental caries is influenced by environmental factors. In 1938, as discussed, the writer presumed that a correlation existed between phosphate deficiency in the food-producing soil on the parental farm and the writer’s early dental caries. This presumption was the first idea that suggested to him the theory of complete tooth nutrition (Aslander, 1948).
Later on, a good many workers found a correlation between soil conditions and the prevalence of dental caries. Albrecht (1948) considered the contents of calcium and phosphates in the soil to be important factors influencing the health of teeth. In the New England states, where the soil is leached and poor in plant nutrients as a result of a humid climate, dental caries are very prevalent, while in an area west of the Mississippi River where, owing to an arid climate, the soils are nonleached and thus rich in plant nutrients, dental caries are very much less prevalent. The correlation is simple: A rich soil (especially a soil rich in Ca and P) equals good teeth; a poor, leached, soil equals poor teeth.
In Australia and New Zealand, Hewat and Eastcott (1953), Cadell (1962), and Ludwig, Healy, and Malthus (1962) all found a correlation between soil types and the occurrence of dental caries. Losee (1962) summarizes the results of several workers who have come to the conclusion that there exists a correlation between soil conditions and the occurrence of dental caries.
And not only the soil but also the quality of the household water influences dental caries. Lodrup (1953) explained the good dental health in Bonn, West Germany, and the poor dental health in Oslo, Norway, as being caused by the rich mineral content in the Bonn water (although the fluorine content is very low) and the very low mineral content in the Oslo water. Irving (1963) has studied the saline waters of Essex, England, and points out that the quality of the drinking water undoubtedly has a great influence on the occurrence of dental caries in children.
Several American investigators—East (1939), Blackerby (1943), Dunning (1953), and Hadjimarkos (1956)—have found an inverse ratio between caries prevalence and the amount of available sunshine. One explanation is that in regions with plenty of sunshine, the ultraviolet radiation stimulates the production of vitamin D, which directly influences the calcification of the growing bones. But the findings may also be interpreted in another way. A sunny climate is generally an arid climate, where the soils are nonleached and thus rich in soluble minerals, i.e., rich in tooth nutrients, which by way of food plants and drinking water find their way to the growing teeth.
The existence of environmental factors influencing the prevalence of dental caries makes it obvious that their influence must be studied in experiments on tooth nutrition. The household water should always be analyzed, especially within rural districts, where mineral-rich ground water may be used, and the soil types should be examined. The plants grown in the districts as well as the vegetables marketed in the cities should be analyzed. By this means it would be possible to determine whether vegetables from a certain area are more valuable than those from other areas.
It may also be possible to find out whether any particular mineral is lacking in certain areas, and as a remedy to add a mineral or several minerals to the tooth nutrients to be used. The writer has found that a special brand of improved bonemeal, to which have been added small amounts of Fe, I, and Co, has produced perfect teeth in children when it has been given from earliest babyhood until all the teeth are full-grown. That must mean that this bonemeal contains all the tooth nutrients needed under the conditions prevailing within Scandinavia.
Yet in other parts of the world, some other composition of the tooth nutrients may prove necessary. Thus it is necessary to investigate the environmental factors everywhere when experiments on tooth nutrition are started.
1. A tooth is a living, growing structure that needs a complete nutrition in order to develop normally. And a normal tooth is highly resistant to or immune against dental caries. Only starved teeth are attacked by dental caries.
2. Essential tooth nutrients are in the first place the minerals that form and catalyze the formation of the tooth structure.
3. Our modern daily fare is poor in tooth nutrients because the food plants are grown on deficient soils and foods are processed or handled so that tooth nutrients are lost.
4. In order to obtain a complete tooth nutrition, our deficient daily fare must be supplemented by a suitable mixture of tooth nutrients. The writer has found that a special brand of improved bonemeal has produced the results required, i.e., caries-free children. For vegetarians a special mixture of minerals must be used.
5. Tooth nutrition must be studied on growing teeth, not on full-grown teeth. For this reason experiments with small rodents, such as the Syrian hamster, give misleading results. By the time a hamster can be subjected to a feeding experiment, its dentation is already complete or nearly so. The result of such an experiment will thus only elucidate the influence of the feed on full-grown teeth, not on growing teeth. On the other hand, children are ideal guinea pigs, especially if identical twins can be used.
6. The addition of tooth nutrients to the daily fare must begin well in advance of tooth development; preferably it should begin with the pregnant mother and continue throughout the period of breastfeeding. The child should be given tooth nutrients as soon as the mother’s milk is supplemented by other foods, and this should continue with small daily doses until all the teeth are full-grown and thereafter preferably throughout life. Full-grown teeth also need nutrients in order to retain caries resistance. And a daily fare sufficiently rich in healthy minerals is probably beneficial for body and soul.
7. The environmental factors influencing dental caries should be studied, including the daily fare given to the children.
8. The result of experiments with complete tooth nutrition, that is, the effect on the teeth, should be controlled [sic] at least once a year, preferably at shorter intervals.
9. It must be the aim of future investigations to work out suitable mixtures of tooth nutrients for varying environmental conditions prevailing around the world.
10. Finally, it must be pointed out that this plan does not claim to solve the problem of dental caries. It is only intended to be a very modest start for investigations into the vast problem of tooth nutrition. But a start is always necessary, if only a modest one, if results are to be obtained. Our present knowledge of tooth nutrition is very scanty. We need extensive and profound investigations. We need the interest and skill of our foremost scientists in the field of nutrition. Dental caries are a worldwide malady; we need worldwide investigations. Dental caries can be prevented by a complete tooth nutrition, but what is included in the term complete tooth nutrition? And how do we find a practical solution to the problem of complete tooth nutrition?
*[Footnote:] Laetherman (1963) writes: “Bonemeal as a caries preventive: The Commission on Dental Research, in response to a request from the Dental Association of South Africa, recently conducted a survey of current research into the use of bonemeal for the prevention of dental caries. After studying the replies received from the commission members and other authorities consulted, the commission is of the opinion that there are no major investigations in this field at the present time, and expert opinion does not favor a repetition of experiments that have consistently failed to show caries-preventive properties for humans.” This notice seems to have been reprinted in dental journals all over the world and has thus given a very wrong view of the writer’s bonemeal method.^
By Alfred Aslander. Report from The Division of Agriculture, The Royal Institute of Technology, Stockholm 70, Sweden, No. 6, 1964. Reprinted by the Lee Foundation of Nutritional Research.
Albrecht, Wm. A., 1948. Our Teeth and Our Soils. Circular 333. Agr. Exp. Sta. University of Missouri, 15 pp.
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— 1963 (d). “En plan for provande av tandernas fullnaring som kariesprofylax.” (Swedish only.) “A Plan for Testing Complete Tooth Nutrition as a Caries Prophylaxis.” Manuscript distributed in 500 copies within Scandinavia, 15 pp.
Berner, L., Fernes, E., Held, A.J., et Piquet, R.1959. “Profylaxie de la cane dentaire par les comprimes fluores.” Schweiz. Monatschr. Zahnhk. 69: 798.
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East, B.R. 1939. “Mean Annual Hours of Sunshine and the Incidence of Dental Caries.” Am. Journ. Publ. Health 29: 277.
— 1956. “Geographic Variations of Dental Caries in Oregon.” Journ. Ped. 48: 195–201.
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Hall, B., Lind, V., och Nystrom, S. 1962. “Benmjol i skolbespisningens matbrod. Ett praktiskt kariesforsok.” “Summary: A Clinical Caries Experiment with Bonemeal-enriched Bread.” Svensk Tandlikar-Tidskr. 55: 21–27.
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Reprint No. 134B
Reprinted by Lee Foundation For Nutritional Research
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.