The Miller concept of the etiology of caries appears to be untenable. L. acidophilus, or the amount of lactic acid produced by fermentation, in the mouth, can be destructive only if the protein network of enamel and dentin has already been charged with hydrochloric acid primarily or lactic acid secondarily above the isoelectric point of this protein network. The organisms and their acid therefore necessarily play secondary roles in active caries. Molecular destruction of mineral parts of tooth structure by the surcharge of hydrochloric acid or lactic acid, or both, on the protein network, plus molecular destruction of the protein network through proteolytic enzymatic action, constitute caries (enamel, dentin and cementum). Seen from the enlarged concept presented below, caries is a result of malnutrition—individual corrected diets and elimination of errors adjust mineral levels to normal.
There is no proof that enamel arises from the ectoderm. It can be considered a specialized form of bone derived from mesoderm and influenced by ectodermal secretions of ameloblasts (possibly globulin). Correlation between certain minerals in body fluids and active caries (also active paradentosis) depends upon (a) proper dietary intake, (b) normal amount of hydrochloric acid in the stomach, (c) proper assimilation, (d) glandular balance, (e) vitamin balance, and (f) solubility factors as produced psychically and physico-chemically, and as influenced by changes in climate, altitude, etc. (colloid-peptizing factors). The importance of these inherent tendencies diminishes when individual surroundings are changed from abnormal to normal. Calcium and phosphorus levels, and the behavior of these minerals through solubility factors in body fluids (deposition or demineralization), express functional activities of thyroid and parathyroid glands. Refined carbohydrates—refined sugar, refined white flour and such derivatives as pie,
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pastry, candy, chewing gum, spaghetti, noodle, etc.—play important roles in the disturbance of metabolic mineral-levels, and bring about changes detrimental to health. They seem to be related to nasal-septum color and to the process of active caries (increased oxidation-levels).
Immunity to active caries seems to depend upon the charge of hydrochloric acid or lactic acid, or both, on the protein network of the body with which the protein fibers of enamel, dentin, cementum and bone are in continuum. The amount of hydrochloric acid or lactic acid, or both, on the protein network is expressed in degrees of acidosis or alkalosis of tissue. Demineralizations expressed after comparing Ca and P, levels in body fluids—before and after shaking with powdered beef bone, Ca X P2 balance below 30 or Ca++ X P, balance below 10, with low mineral levels—are related to active caries. The reactions—pH—of saliva and urine can be definitely correlated with the state of dynamia or adynamia of the individual as an end-result governing the biochemical changes in the body. When polysaccharides are consumed, low oxidation-level and lack of vitamin-B complex favor carbohydrate block. Lactic acid is not reoxidized to glucose or broken down to carbon dioxide and water. The accumulation of lactic acid favors surcharge on the protein network and intermittent demineralization of the hard tooth-tissue (first step in caries). Relationships of sugar metabolism and lack of vitamin-B complex to the caries problem are hereby clarified.
References: Den. Digest, 1933; Nutr. Den. Health, 1936, 1937; Trans. IXth Int. Den. Cong. (F.D.I.), 1936.