College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA.
College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Nutrients. 2024 May 13;16(10):1463. doi: 10.3390/nu16101463.
Current conceptualizations of dental caries etiology center primarily on the local role of sugar, starch, or other fermentable carbohydrates on tooth enamel demineralization-a well-established and empirically supported mechanism. However, in addition to this mechanism, studies dating back to the early 1900s point to an important systemic role of diet and nutrition, particularly from pasture-raised animal-source foods (ASF), in dental caries etiology and arrest. Findings from animal and human studies suggest that adherence to a diet high in calcium, phosphorus, fat-soluble vitamins A and D, and antioxidant vitamin C, as well as low in phytates, may contribute to arrest and reversal of dental caries, particularly among children. Furthermore, findings from observational and experimental studies of humans across the life-course suggest that fat-soluble vitamins A, D, and K2 may interact to protect against dental caries progression, even within a diet that regularly contains sugar. While these historic studies have not been revisited in decades, we emphasize the need for them to be reinvestigated and contextualized in the 21st century. Specifically, methodologically rigorous studies are needed to reinvestigate whether historical knowledge of systemic impacts of nutrition on dental health can help to inform current conceptualizations of dental caries etiology, prevention, and arrest.
目前的龋齿病因概念主要集中在糖、淀粉或其他可发酵碳水化合物对牙釉质脱矿的局部作用上——这是一个经过充分证实和经验支持的机制。然而，除了这种机制之外，早在 20 世纪初的研究就指出了饮食和营养的重要系统性作用，特别是来自草饲动物源性食物（ASF）在龋齿病因和抑制方面的作用。动物和人体研究的结果表明，高钙、磷、脂溶性维生素 A 和 D、抗氧化维生素 C 的饮食，以及低植酸盐的饮食，可能有助于抑制和逆转龋齿，特别是在儿童中。此外，对整个人生阶段的人群进行的观察性和实验性研究结果表明，脂溶性维生素 A、D 和 K2 可能相互作用以预防龋齿的进展，即使在经常含有糖的饮食中也是如此。虽然这些历史研究已经有几十年没有被重新研究了，但我们强调需要在 21 世纪重新研究它们，并将其置于背景之中。具体来说，需要进行方法严谨的研究，重新研究营养对口腔健康的系统性影响的历史知识是否有助于为当前的龋齿病因、预防和抑制概念提供信息。
