One mild malnutrition episode occurring in the first year of life is associated with increased caries in both the baby and permanent teeth many years later. Dr J. Alvarez, 1995
Mineralization of primary (or baby) and permanent teeth begins before birth and continues with throughout the child’s life. Unlike bones, the structure and texture of teeth is determined by the health and nutritional status at the time of tooth formation. Like growth rings in a tree, the quality of the enamel and dentin form a permanent record of conditions during formation. If nutrition is deficient at anytime during tooth formation, the enamel and dentin developing at that time may be poorly or underdeveloped, a condition referred to as hypoplastic.
During the 1920’s, Lady Mellanby and colleagues in England examined over 1200 baby teeth from British children. The teeth were classified either as normal, with well developed enamel and dentin, through to very hypoplastic, with irregular and incomplete enamel and defects in the dentin. About 21% were considered normal, and 35% very hypoplastic, with the remainder being slightly to moderately hypoplastic.
The development of cavities varied drastically with the structure of the teeth. Normal teeth with well developed enamel and dentin are highly resistant to dental decay. Almost 80% of the normal teeth examined were cavity-free.
In contrast, the very hypoplastic teeth, with incomplete and poorly formed enamel and irregular dentin, were highly susceptible to decay, with 75% having advanced decay (Category III).
The well mineralized teeth had 10 times fewer cavities than the poorly mineralized, hypoplastic teeth.
Nutrition and Development of Perfect Teeth
Lady Mellanby also undertook extensive animal studies to determine the important dietary conditions that resulted in either normal, well mineralized teeth, or hypoplastic and poorly mineralized. Her experiments with dogs paralleled those of her husband, Dr Edward Mellanby, who was studying the childhood bone disease, rickets.
When growing puppies or their pregnant mothers were fed a poor diet with limited amount of skim milk, together with cereals and lean meat, defectively formed, poorly mineralized teeth resulted. If a source of vitamin D was added, such as cod liver oil or egg yolk, the structure of the teeth greatly improved. The addition of extra calcium resulted in perfectly developed teeth. Cereals have an anticalcifying action. When vitamin D or calcium intake was inadequate, and the cereal content of the diet was increased, the teeth tended to be worse in structure and poorly mineralized.
Natural development of well-mineralized, decay resistant teeth require optimal nutrition and a mineralizing diet beginning as early as the second trimester of pregnancy and continuing throughout childhood. Once formed, well mineralized teeth remain highly resistant to decay. A marked deficiency in mineralizing agents, particularly calcium and vitamin D, any time during tooth formation can result in poorly-developed or hypoplastic tooth enamel and dentin, which can lead to a lifetime of susceptibility to tooth decay.