GRETH, HERBERT: University of Leipzig, Leipzig, Germany (Aug. 25, 1938).

 [From translation by Rudolf Kronfeld.]

The ultimate causes of caries reside in refinements of civilization and re­sulting changes of diet. Caries is a problem in nutrition. To prevent caries the diet should be ” natural,” and rich in vitamins and minerals; should contain sufficient raw foods and coarse whole-rye bread having bran and grain germs and all their minerals, vitamins, and proteins. Sticky and fermentable foods that leave soft oral deposits should be avoided. Self-cleansing of teeth, by long and thorough chewing of hard foods, is desirable. For small children the diet should contain abundance of vitamins and minerals. There should be a healthy way of living, including abundance of fresh air and sunshine, and oral care and dental control.

In the western part of Germany, the percentage of carious teeth during the Neolithic Age was 3-4 percent ; the percentage of persons affected was 28.57. During the first centuries A.D., the influence of Roman culture and civilization upon the Germanic race caused rapid increase in caries, which raised the incidence to twice or thrice that of the Neolithic period. During the succeeding period, under the Franks, caries again decreased owing to a more natural nutrition and way of living. During the Middle Ages, the type of nutrition, especially composition of breads, favorably influenced teeth. The end of the Middle Ages was a critical period for further development of caries in western Germany. From the 16th to the 18th centuries, especially after the Thirty-Year War, the mode of living, including excessively refined cooking, caused increase in caries. In subsequent centuries these conditions—at first only among the wealthier groups—prevailed in all classes, accounting for the present incidence of caries in 93 percent of persons on the lower Rhine, at the height of the caries curve in Germany. Caries of occlusal fissures has kept pace with the general increase from about 12 percent in the Middle Ages to 93 percent at present. Caries of incisors has greatly increased over that at the time of the Romans. Up to the 17th century, no caries of de­ciduous teeth was observed at the ages of present pre-school children. Caries in deciduous teeth is a modern condition that certainly has contributed to the spread of caries in permanent teeth. Comparison of the foregoing findings in skulls, with those of Euler in eastern Germany (Silesia), shows that in the west the average percentages for caries are a little higher than in the east. The development and course of caries were similar in both areas. Both in Silesia and along the Rhine there was low incidence of caries during the Middle Ages. In both areas the incidence increased from the 16th century to the 18th. The end of the Middle Ages was a critical period in the east as in the west. At present caries is more marked in the west than in the east. Both in the east and west, caries of fissures, incisors, and deciduous teeth account for the steep ascent of the caries curve.

References: D. Zahniirz. Woch., 1937, 1938; Ein Querschnitt der Deutschen wissenschaf tlichen Zahnheilkunde, 1938 (Meusser, Leipzig).

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