Varrela J, Varrela T M
Institute of Dentistry, University of Turku, Finland.
Tandlaegebladet. 1991 May;96(7):283-90.
This paper reviews a series of paleo-pathologic studies made to investigate associations between dietary factors and development of occlusion, periodontal diseases and caries. The findings indicate that the change from hard to soft food, which has taken place during the last few hundred years, influences occlusion, craniofacial structures and oral health in several ways. Comparative studies show that the frequency of malocclusion has increased substantially. In the same time, a number of alterations have taken place in the morphology of the craniofacial skeleton. The results support the hypothesis that masticatory stress is a regulative factor in craniofacial growth and occlusal development. With soft food and low masticatory activity, jaw growth is not adequate for optimal occlusal development. Approximal wear itself, caused by the attritive diet, seems to be only a minor adjustive factor. Because of the occlusal wear, the crown height decreased with age and the teeth continued to erupt. As a result, root surfaces were exposed. This process has been equated with bone loss but the lack of inflammatory changes on the bone surface indicates that the alveolar bone was not affected by periodontal diseases. This suggests that the alveolar height was maintained at a constant level throughout life and no growth nor resorption took normally place at the crest. Only the exposure of the furcations increased the occurrence of periodontitis. The caries frequency was decreased by mechanical cleaning effect of attritive food but increased by exposure of the root surfaces. Furthermore, the oral microflora may have been modified by factors related to the chemical and physical properties of the diet.
本文回顾了一系列古病理学研究,这些研究旨在探究饮食因素与咬合、牙周疾病及龋齿发展之间的关联。研究结果表明,在过去几百年间发生的从硬质食物到软质食物的转变,在多个方面影响着咬合、颅面结构及口腔健康。对比研究显示,错牙合畸形的发生率大幅上升。与此同时,颅面骨骼的形态发生了一些改变。这些结果支持了这样一种假说,即咀嚼压力是颅面生长和咬合发育的调节因素。由于食用软质食物且咀嚼活动较少,颌骨生长不足以实现最佳的咬合发育。由磨损性饮食导致的邻面磨损本身似乎只是一个次要的调节因素。由于咬合磨损,牙冠高度随年龄增长而降低,牙齿持续萌出。结果,牙根表面暴露。这一过程被等同于骨质流失,但骨表面缺乏炎症变化表明牙槽骨未受牙周疾病影响。这表明牙槽高度在一生中保持恒定水平,牙槽嵴通常不会发生生长或吸收。只有根分叉暴露会增加牙周炎的发生率。磨损性食物的机械清洁作用降低了龋齿发生率,但牙根表面暴露则增加了龋齿发生率。此外,饮食的化学和物理性质相关因素可能改变了口腔微生物群落。