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Dental caries: diet and wealth

Dental caries is widespread throughout the world. However it is rare in some groups of people. In some parts of the world caries used to be rare or unknown, but it is now common. Consider the following facts:

  1. When Captain Cook visited Tahiti, a remote Pacific Island, 200 years ago he was greatly impressed by the beautiful white teeth of the local people.
  2. In 1965, one visitor to Tahiti described the teeth of the Tahitians as ‘catastrophic’. There was very widespread dental caries. Many of the teenagers had no teeth at all.
  3. Until about 70 years ago, dental caries was unknown among the Eskimos. It is now increasing among them.
  4. Today dental caries is increasing among the people in many of the world’s poorer countries. In earlier times, caries was rare or unknown in these places. However, differences within some countries are still seen. For example, dental caries is often more widespread among the richer people (especially those living in towns), than among the poorer people living in rural areas.
  5. The traditional diet of Eskimos was bear and seal meat.
  6. Traditional diets in Tahiti, among the Eskimos, and in most poorer developing countries do not include sugar or sweets.
  7. Sugar and sweets are now readily available in developing countries, especially in the towns, but they are expensive.

And now imagine that you are a dental health expert who has been called in by the government of a developing country to report on the people’s teeth. You discover that dental caries is widespread in the towns, but almost absent in the rural areas, especially among the poorer people. You are asked to write a report for the Minister of Health. The Minister is particularly puzzled by the fact that the wealthiest people in his country appear to have more decayed teeth than the poorer people.

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