[HN Gopher] School dental program prevents 80% of cavities with ...
       ___________________________________________________________________
        
       School dental program prevents 80% of cavities with non-invasive
       treatment
        
       Author : voisin
       Score  : 173 points
       Date   : 2023-02-12 15:45 UTC (7 hours ago)
        
 (HTM) web link (www.nyu.edu)
 (TXT) w3m dump (www.nyu.edu)
        
       | neilv wrote:
       | > _The study included 2,998 children in kindergarten through
       | third grade at 47 New York City schools. The schools--which serve
       | a racially diverse group of students, most of whom are from low-
       | income families--were randomized to receive either the simple or
       | complex treatment._
       | 
       | Was this selection because some low-income families need this
       | kind of treatment more than affluent ones? Or represent a
       | diversity of racial backgrounds against which the treatment can
       | be better tested?
       | 
       | Was it a factor that they were cheap subjects? Or maybe unlikely
       | to know any lawyers?
       | 
       | As a kid, our (modest, Catholic) grade school participated in a
       | lengthy toothpaste study. The incentive, AFAIK, was you got free
       | toothpaste for your family (and I seem to recall some free
       | toothbrushes).
       | 
       | As an adult now, aware of some history and societal dynamics, if
       | I ever have kids, and they came home with an experiment subject
       | consent form, one of the questions on my mind would be "Are the
       | children of the wealthy and connected also in this subject
       | cohort?"
        
         | jonahbenton wrote:
         | I don't know anything about this study, but am a lifelong NYC
         | resident whose kids have gone through the public school system
         | and who also has been directly involved as a "parent leader" in
         | some DOE programs. With some confidence I posit the answers to
         | the questions are a) very much yes b) yes c) n/a d) no.
         | 
         | NYC DOE is an incredible organization that serves both the
         | extremely wealthy and the extremely needy. There are schools
         | where the majority of families are millionaires and the quality
         | of the education and attention is competitive with $50k/year
         | private schools. But there is much, much more pervasive need.
         | 
         | Some estimates put 1/10 of the total attending population as
         | homeless. 70% of the attending population are on some form of
         | financial assistance.
         | 
         | The range of services the DOE offers are astonishing. For
         | various reasons they do NOT include anything that constitutes
         | medical care, but they will regularly run studies that involve
         | making medical resources available or provide some medical
         | intervention. The needs in some areas are so great. As an
         | efficient deliverer of in person services, there is no better
         | organization than the DOE.
         | 
         | It is very likely that most of the students in this study have
         | never been- and never would otherwise be- to a dentist. They
         | very likely get 1-2 meals a day from their school year round.
         | They in many cases spend more waking hours in their school than
         | at home. High poverty classrooms can be chaotic, but they often
         | are much less chaotic than whatever home is.
         | 
         | Consent was collected, to be sure- DOE is extremely careful
         | about this. DOE legal is extremely aggressive because they are
         | often sued- mostly by students of means but also by advocacy
         | organizations, of which there are many.
         | 
         | Very likely NYU was offered the option of where to do the
         | study. They could have picked the Upper East Side or Tribeca-
         | wealthy neighborhoods where kids will regularly attend boutique
         | dental practices- but then what would they learn? The kids
         | there are already getting sealants and so forth.
        
           | throwayyy479087 wrote:
           | Second us. One of the most amazing things about New York is
           | that it has a functioning school system unlike places on the
           | West Coast.
           | 
           | Stuy, ps101, bx science are some of the best schools in the
           | country
        
         | hn_throwaway_99 wrote:
         | This is a bit of a silly take in my opinion. This bit, "The
         | schools--which serve a racially diverse group of students, most
         | of whom are from low-income families", sounds just like
         | editorializing to me.
         | 
         | That is, it was just a test in NY public schools, not like they
         | specifically sought out low income or underperforming schools,
         | it's just that public schools in NYC have a much higher rate of
         | low income families.
        
           | Spivak wrote:
           | I don't think it's editorializing, there are _plenty_ of
           | school systems, public and private, that don't fit this mold.
           | My HS class had maybe 20 of 250 students whose families'
           | weren't firmly middle class or above with a good 50 who came
           | from the rich feeder school who were "new Mercedes for 16th
           | birthday rich." Realizing my family was lower-middle class
           | was a bit of a shell shock for 13 year old me.
        
         | PaulHoule wrote:
         | I am sure there is some study somewhere that samples rich
         | people rather than others.
        
       | Spooky23 wrote:
       | [flagged]
        
         | dang wrote:
         | " _Eschew flamebait. Avoid generic tangents._ "
         | 
         | https://news.ycombinator.com/newsguidelines.html
        
         | loeg wrote:
         | We do fluoridate drinking water, but it does not (fully)
         | prevent cavities.
        
       | sitkack wrote:
       | This has been "known" for 30 years. It needs to be mandatory.
        
       | umvi wrote:
       | My brother is a dentist and he says the main drawback of SDF is
       | that it looks bad. It indeed stops the decay but turns the tooth
       | (or part of the tooth) black.
        
         | dwheeler wrote:
         | It doesn't stain healthy enamel, but it does permanently stain
         | parts with cavitation:
         | https://www.sproutpediatricdentistry.com/blog/pediatric-
         | dent....
        
         | kranke155 wrote:
         | !! I wouldn't mind
        
       | hgsgm wrote:
       | Titlegore
       | 
       | > Silver diamine fluoride, as well as sealants, protected against
       | cavities
        
       | derwiki wrote:
       | My (dental hygienist) mother insisted that I get a sealant on my
       | teeth when my permanent teeth came in, and to this day I've never
       | had a cavity. Definitely doing the same for my kids.
        
         | 4gotunameagain wrote:
         | Some sealants contain BPA derivatives though. I'd rather have
         | cavities than xenoestrogens messing up my hormonal system, so
         | any non resin sealant is a great step forward
        
           | CipherThrowaway wrote:
           | Surely exposure from composite resin falls off quickly over
           | time and pales in comparison to our constant environmental
           | exposure to plasticizers. Any data on this?
        
             | nickff wrote:
             | "Surely" seems a bit over-confident unless you've seen some
             | research, but it does seem likely.
        
             | 4gotunameagain wrote:
             | Surely it is worth it minimising every single source
             | identified
        
           | kranke155 wrote:
           | So what sealants are good/best ?
        
             | 4gotunameagain wrote:
             | I am not qualified to say what is best, but glass ionomer
             | cements (the ones without resin) do not contain
             | plasticisers.
        
           | throwboatyface wrote:
           | [flagged]
        
         | cvccvroomvroom wrote:
         | Yep. I've had maybe 2 cavities in all of my life, from teeth
         | where sealant dislodged. Didn't need teeth alignment until well
         | into middle age.
        
         | hummus_bae wrote:
         | I never got sealants but did get fluoride treatment and
         | brushing twice a day as a kid. I never had a cavity either and
         | even as an adult I can maybe count the number of cavities I had
         | on one hand. (And I brushed my teeth maybe once a day, don't
         | judge me.) Honestly my diet played a huge role here, but the
         | sealants, fluoride, and twice daily brushing just give you so
         | much more protection than you could expect from brushing alone.
        
         | dmarlow wrote:
         | I stopped getting cavities when I stopped rinsing all of the
         | fluoride away after brushing my teeth. If you wish to rinse, do
         | so after a few minutes. I told this to my dentist and he said
         | he wished that was more common knowledge, yet he's never
         | mentioned it to me. Go figure.
        
           | colordrops wrote:
           | I stopped getting cavities when I started using fluoride-free
           | toothpaste and filtered my water with reverse osmosis. But
           | correlation is not causation and all, so it was probably due
           | more to not eating sweets so much anymore, brushing and
           | flossing properly and without fail twice a day, and
           | maintaining a healthy immune system through sleep, exercise,
           | and a good diet.
        
             | azinman2 wrote:
             | Fluoride is effective at remineralizing your enamel.
             | Fluoride isn't just for cavities.
        
               | colordrops wrote:
               | Perhaps, but how much of a difference does it really
               | make? Your saliva remineralizes your enamel naturally.
               | I've gone over 10 years without fluoride in my toothpaste
               | or water and my teeth are in perfect condition, at least
               | according to the dentist. So is the toxicity of fluoride
               | worth some clearly minor and perhaps not even necessary
               | improvement? I used large quantities of fluoride as a
               | child, both in toothpaste and mouth washes, and still got
               | 10 cavities.
        
               | azinman2 wrote:
               | Most people benefit significantly. That has been proven
               | in study after study. The toxicity has not been, or it
               | wouldn't be widespread world wide. I'm glad your genetic
               | makeup, diet, microbiome, etc is working out for you.
               | That may or may not change with time.
               | 
               | The CDC says there's a 25% reduction in cavities for
               | children due to fluoride [1]. So it's not like fluoride
               | is only for cavity prevention, and perhaps your teeth
               | would have been even worse without it.
               | 
               | [1] https://www.cdc.gov/fluoridation/index.html
        
               | wingworks wrote:
               | Everyones teeth, diet etc are different. What works for
               | you may not work for others.
        
               | MathMonkeyMan wrote:
               | What other uses does mineralized enamel have, aside from
               | resisting attack by plaques? Honest question.
        
               | azinman2 wrote:
               | Plaque and tartar eat away at your enamel causing caries.
               | Remineralizing is important to restore what has been
               | taken away. So it's not so much about resisting attack (I
               | don't believe fluoride fights bacteria) as much as
               | reversing the attack.
        
               | saurik wrote:
               | You are much better off using nanohydroxyapatite for
               | that, though; you can easily import such toothpastes from
               | Japan via Amazon.
        
               | azinman2 wrote:
               | Interesting. Hadn't heard it it before, but at least
               | according to this and it's linked paper it's roughly
               | equivalent. What makes you say that you're better off?
               | 
               | https://www.rdhmag.com/patient-
               | care/article/14276225/nanohyd...
        
               | quotz wrote:
               | Source?
        
               | wingworks wrote:
               | Not really a source, but this Dental Hygienist talks a
               | bit about hydroxyapatite. Sounds like it could be of at
               | least equal effectiveness. Though further studies are
               | needed. https://youtu.be/kQAPEZaqwfY?t=63
        
               | alexsereno wrote:
               | Not OP but I have a family member who's a specialized
               | dentist who's well regarded in the field and constantly
               | harps on this kind of toothpaste over fluoride. I think
               | fluoride is basically cheap and that's all
        
           | jghn wrote:
           | All of these posts have me wondering how commonplace cavities
           | actually are. I stopped getting cavities in my preteen years,
           | about 35 years ago. The only change I made was actually
           | brushing my teeth regularly, which very young me always tried
           | to avoid despite my parents' best efforts.
           | 
           | I'm sure my consumption of things like refined sugars has
           | gone steadily down in that time, but not as part of a
           | conscious effort. Being a kid in the 80s meant you ate a ton
           | of crap :)
        
             | wingworks wrote:
             | They're still pretty common, at least in the people I hang
             | out in. You're very lucky you've not had any cavities since
             | preteen. I've done allot to change my diet to strip out all
             | sugars, refined carbs, acidic foods / drinks etc. But still
             | get cavities.
             | 
             | It's a journey, sometimes a long one, to get to a spot with
             | good oral heath. In my case, I had poor heath education. I
             | didn't know what I didn't know. Like visiting the dentist
             | is not equal to visiting a dental hygienist. Up until a few
             | weeks ago, I had no clue what a dental hygienist was or if
             | I should visit one. My dentist never recommended one, so I
             | thought it wasn't needed. But I recently booked an apt with
             | a dental hygienist at another practice, it was 100% needed.
             | 
             | From my understanding, a dental hygienist is more
             | preventative work (and cleaning), while dentist is more the
             | surgeon who does the fixing after an issue has occurred.
             | 
             | I learnt a tonne in my first ever dental hygienist visit.
             | Basic things I wasn't doing for my oral heath. Like
             | flossing... I never done it for years cos I thought it
             | wasn't that big of a deal and cos I thought my teeth were
             | to crammed together, but I learnt (and she showed me) that
             | you can 100% floss my teeth and you defo should!
             | 
             | I wish some basic oral heath was taught in school, and that
             | dental (at least 6 months/yearly checkups were free/govt
             | funded), it's so important, and so expensive these days,
             | even for a checkup.
             | 
             | It's especially tricky when you want to learn so much while
             | at the dentist/hygienist, but know it's costing you $$$ so
             | don't maybe ask everything. Personally the Teeth Talk Girl
             | YouTube channel has helped me so much and gave me the
             | courage to go back to the dentist (after not going for ~5
             | years).
             | 
             | I highly recommend the channel if you want to learn more on
             | what good oral heath is. https://www.youtube.com/@TeethTalk
        
           | ars wrote:
           | The various soaps that toothpaste is made of are not so great
           | to leave on your mouth. If it can cause canker sores and
           | various skin conditions in some people.
           | 
           | Instead just get a fluoride rinse, they're not expensive and
           | considerably better for you than soap.
        
         | [deleted]
        
         | WheatMillington wrote:
         | I don't floss, brush once per day and have never heard of
         | sealant, and I also have zero cavities. n = 1
        
           | btgeekboy wrote:
           | It boils down to your dentist, too. Some will leap to
           | drilling and filling every little speck they can find (and
           | charge you for it), while others will monitor them and see if
           | they progress.
           | 
           | Having been to both types, I'd say I strongly prefer the
           | latter.
        
           | MathMonkeyMan wrote:
           | Some people have harder teeth genetically. Probably also diet
           | matters. And habits that alter salivation.
        
             | wingworks wrote:
             | Yeah this, everyones teeth are different. And we all have
             | different enamel thickness etc. And diet definitely plays a
             | role.
             | 
             | Also, it's not inherently bad to brush once a day, IF
             | you're doing a crazy effective job. It's recommended to
             | brush twice a day because most people don't do a good job,
             | so best to disturb the plaque twice a day before it hardens
             | into tartar (which only the dentist can clear). Plaque
             | usually hardens within 48 hours.
             | 
             | But always best to talk to your dentist / dental hygienist
             | about what's best for you teeth, as everyones teeth (diet
             | etc) is different.
        
         | giantg2 wrote:
         | Eh, I had sealant when my adult teeth came in. I still had a
         | few cavities. My teeth naturally have very deep pits and
         | fissures. Apparently that has some bearing on the likelihood of
         | cavities. I wonder if that also effects the success of sealant
         | application.
        
         | jcomis wrote:
         | Same here. My father was a dentist and insisted on sealant and
         | maintained them until around 20. No cavities and almost 40.
        
           | ben1040 wrote:
           | During my bi-annual dentist visits they always mention the
           | sealants on my teeth (maintained with the last touchup done
           | when I was 16) and I'm sort of surprised they're largely
           | intact. I'm 41 and haven't had a cavity since I was 13, on an
           | adult tooth that I just missed my chance to get sealed before
           | the cavity happened.
        
         | roundandround wrote:
         | I always wondered why the topic of sealants was always related
         | to children and figured it was somehow only appropriate for
         | teeth with an approaching end date. Are there any issues such
         | as needing to reapply it every X years?
        
           | Semaphor wrote:
           | Never heard of dental sealants before this. But from a
           | cursory search, you can only use it on _clean_ teeth, so no
           | fillings or cavities.
        
           | wbl wrote:
           | As you get older your teeth have worn smoother so the pits
           | being filled are less serious. I did have a failed sealant
           | result in a compositing of the surface of one of my teeth.
        
       | jupp0r wrote:
       | "kept 50% of cavities from worsening when children were seen two
       | years later."
       | 
       | Wait, they let kids run around for two years with untreated
       | cavities?
        
       | dzink wrote:
       | Yes it works, but the part they don't mention is that the
       | treatment is black as black gets. You have to be very careful
       | about where it goes, or it can affect the self-confidence or the
       | kids, and possibly exacerbate bullying.
        
         | [deleted]
        
         | technocratius wrote:
         | There's a case report [0] where they were able to reverse the
         | staining with a potassium idiode treatment, might be a
         | potential solution in the future.
         | 
         | [0] https://meridian.allenpress.com/operative-
         | dentistry/article-...
        
       | zackees wrote:
       | [dead]
        
       | AgentOrange1234 wrote:
       | Sounds awesome. I've never heard of this before, but from some
       | quick googling it looks like there are some pediatric dentists
       | around who already offer it.
       | 
       | Are there other important new preventive measures to know about?
        
       | oifjsidjf wrote:
       | If you read Weston Price's Nutrition and Physical Degeneration
       | you will see that many tribes have PERFECT teeth without even
       | flossing.
       | 
       | Tooth decay is purely caused by diet.
       | 
       | Certain grains also cause it, not only sugar.
       | 
       | Rice for example is very bad for teeth (90% of people damaged
       | teeth, acidic starch is what they assume), while potatoes are
       | much less harmful (~10% if I remember correctly, since potato
       | starch is alkaline).
       | 
       | Sodas (anything with low ph) is terrible for the teeths as it
       | seems.
       | 
       | So it's also not "just carbs", but there are other factors.
       | 
       | So "painting teeth" with dubious chemicals is moronic since the
       | problem is the food. If the food destroys your teeth so much,
       | think what it does on the inside of you which you cannot see.
       | 
       | Eg check out this study: TOOTH DECAY IN RELATION TO DIET AND
       | GENERAL HEALTH NILS P. LARSEN, M.D
        
         | delecti wrote:
         | > If the food destroys your teeth so much, think what it does
         | on the inside of you which you cannot see.
         | 
         | I was with you until this point. The stomach is highly acidic.
         | The natural next step food takes in our bodies is into an
         | environment that would destroy our teeth. It does not
         | necessarily follow that food which damages our teeth is bad for
         | the rest of us. If anything, your potato/rice examples would
         | suggest that the opposite is true.
         | 
         | I agree tooth decay is largely a result of our diet, but that
         | doesn't mean we _have_ to change our diet to reverse /prevent
         | tooth decay. I have a garbage diet and still manage to keep my
         | teeth okay. I'm not in a rush to overhaul how I interact with
         | food.
        
           | jononomo wrote:
           | Once I switched to an all meat diet I just couldn't believe
           | how many minor health issues it cleared up, how great I felt,
           | and how good I looked naked.
        
             | delecti wrote:
             | People say basically the same thing while on
             | vegan/keto/paleo/raw diets. The real trick is being mindful
             | about what you eat and minimizing processed junk. Based
             | purely on the externalities, you probably picked the worst
             | arbitrary set of rules to remove junk from your diet.
        
             | nerdbert wrote:
             | An all-meat diet, like many other diets, is a non-
             | processed-sugars diet. I suspect that's more important than
             | meat vs vegetables.
        
         | __float wrote:
         | > So "painting teeth" with dubious chemicals is moronic since
         | the problem is the food.
         | 
         | This is a pretty bold claim to make -- given the _reality_ of
         | American diets, do you think there 's a better option?
         | Especially in healthcare (and especially with $$$ American
         | healthcare) you have to balance the perfect solution with
         | meeting people where they are.
        
           | zackees wrote:
           | [dead]
        
         | Broken_Hippo wrote:
         | You still need this stuff while people's diets change, though -
         | diets generally have a good amount of cultural, religious, and
         | family ties and it takes time.
         | 
         | Then there is the entire issue of trying to change the diets of
         | poor people at a time when places (like the US) aren't even
         | making sure the folks at the bottom can get enough calories and
         | nutrients nor are we making sure diabetics and others have a
         | diet fit for them, let alone trying to make sure folks aren't
         | eating badly for their teeth.
         | 
         | And I'm sure I'm not considering things like changing the crops
         | being planted and things like that.
         | 
         | But we have this stuff, perhaps. It isn't moronic considering
         | we probably aren't going to change diets suddenly.
        
         | anon84873628 wrote:
         | Yeah but maybe unwinding 10,000 years of agriculture isn't very
         | feasible.
        
         | tdeck wrote:
         | > So "painting teeth" with dubious chemicals is moronic since
         | the problem is the food.
         | 
         | Moronic! Why do this simple intervention when we could simply
         | get everyone to completely change their diets, removing every
         | staple food their family has been cooking with for generations?
         | Obviously the latter is much more practical.
        
         | gregwebs wrote:
         | Price didn't believe that carbs or grains caused tooth decay:
         | he prescribed freshly ground grains for the diet.
         | 
         | Price's book is compelling evidence that something in modern
         | societies causes tooth decay, which is unnatural.
         | 
         | Price's hypothesis was that it was caused by the change to the
         | modern diet and its lack of nutrients. So white flour bad,
         | freshly ground whole grain good. Refined sugar, which Americans
         | still eat ~80 pounds of a year creates a nutritional deficit
         | that is hard to over come since the rest of our diet is not
         | nutrient dense.
        
           | jononomo wrote:
           | After I had been on an all meat diet for a year I went to the
           | dentist for a cleaning and the dentist called someone over to
           | show them my gums, which were apparently unusually healthy.
        
           | anvuong wrote:
           | I don't believe in rice causing bad teeth either. I live in
           | Asia and almost all of my grandparents and great-grandparents
           | have good teeth, and we only eat rice here. The ones who have
           | bad teeth are, unsurprisingly, heavy smokers or drinkers.
        
         | hbarka wrote:
         | Potatoes are not alkaline. Potatoes and rice are close in ph
         | and on the acidic to neutral side. The average pH of baked
         | potatoes is around 6.0 to 7.0, while the average pH of cooked
         | rice is around 6.0 to 6.5.
         | 
         | (7 is neutral, and values above 7 move toward alkalinity.)
        
       | dukeofdoom wrote:
       | Poor Dental health has been linked to heart attacks. Also root
       | canal is like pathway for bacteria to enter blood stream and
       | cause life long source of inflammation. Potential benefits to
       | humanity woud be so big. Even if it stained teeth would be worth
       | it.
        
       | jononomo wrote:
       | Eating a diet of only beef is a great way to prevent cavities and
       | gum disease, and also to have excellent health and fitness in
       | every other respect.
        
       | technocratius wrote:
       | Sounds interesting, if you don't have caries in visible parts of
       | your teeth!
       | 
       | I did a quick search and it's apparently also an effective
       | treatment for adults:
       | 
       | "According to an umbrella review, application of 38% SDF
       | prevented root caries in adults with success rates 72% higher
       | than a placebo treatment. The same review reported a prevented
       | fraction for successful root caries arrest, between 100% and 725%
       | higher as compared to a placebo treatment.21 Moreover,
       | application of 38% SDF in combination with oral health education
       | was found to be the most effective method for preventing root
       | caries in adults."[0]
       | 
       | [0] https://www.ada.org/resources/research/science-and-
       | research-...
        
         | petra wrote:
         | Interesting. Thank you!
         | 
         | Btw why aren't dental sealants a good treatment for adults ?
        
           | Loic wrote:
           | I asked my dentist last year. She told me that old teeths
           | have microfisures and to seal she would have to first remove
           | too much of the teeths to clean out these fisures before
           | sealing.
           | 
           | Maybe your dentist can tell you more.
        
             | giantg2 wrote:
             | My teeth naturally have deep pits and fissures. I had
             | sealant and still got some cavities. I wonder if that
             | affected its success.
        
       | cfeduke wrote:
       | In elementary school in the 80s in upstate New York we had some
       | sort of tooth treatment provided in the classroom _, and it
       | seemed like sort of a big deal at the time. Until recently I
       | thought it was just a national program, until my wife told me she
       | never had anything like it growing up in Rhode Island.
       | Anecdotally I 've had pretty good teeth my whole life and as far
       | as I know, my friends from school have as well. Let's just say my
       | wife is presently losing at Redneck Life (where the final score
       | is number of teeth you still have at the conclusion of the game).
       | :)
       | 
       | _ its certainly not this treatment, since my treatment was like
       | 30+ years ago, but it was a treatment
        
       | giardini wrote:
       | And take vitamin K2 for your teeth (and bones and arteries).
        
       | bailoon wrote:
       | Is there any company working on "cloning" or growing teeth? That
       | way we don't have to worry about cavities or root canal any
       | longer? When I was a kid, I was sure we'd have this tech by now.
       | How hard is it to grow teeth?
        
         | dazc wrote:
         | Good oral hygiene is all that is needed, and (in the UK, at
         | least) we've been mostly failing at this basic level of common
         | sense prevention for eternity.
         | 
         | I guess it's the same for dieting, people looking for magic
         | solutions when the simple answer is to eat less.
        
           | noodlesUK wrote:
           | I think this is a pretty reductive take, both for dental and
           | dieting.
           | 
           | There are a lot of reasons a person might not be able to take
           | care of themselves very well, and we should certainly try to
           | make it easier for them, rather than just dismissing it as a
           | solved problem and a moral failing of anyone who runs into
           | issues.
        
           | roundandround wrote:
           | Good oral hygiene is only fixing one reason for needing
           | replacement teeth. Artificial replacement remains subpar and
           | causes gradual erosion in the jaw that will catch up with
           | people who have accidents early in life.
        
           | taeric wrote:
           | Between people looking for magic solutions and other people
           | deriding the masses for being lazy... yeah, not much room
           | left in the field for learning and growth.
           | 
           | I do agree there is something to pushing for a bit more
           | hygiene for things. That said, I also think there is
           | something to be said for looking at the items holistically.
           | To wit, I'm not brushing my pet's teeth every night, and I
           | have yet to ever have one that needed intervention due to
           | cavities. Especially not in mid life. I know some folks that
           | have, of course. So, it isn't like it is completely unheard
           | of in the animal kingdom. I'm curious why it is so different
           | for us, though. Would love to see a good treatment of that
           | topic.
        
             | dazc wrote:
             | I'm sure you already know that your pets don't consume much
             | sugar and that's the main reason they don't get cavities?
             | 
             | Maybe humans will, eventually, evolve to a state where our
             | teeth renew themselves naturally, without intervention? Who
             | knows?
        
               | taeric wrote:
               | I mean, you aren't wrong. They also eat a lot of really
               | hard to chew things that scrape at their teeth and gums.
               | And, I'm sure, breeding selected for pets that don't have
               | massive teeth problems.
               | 
               | That is, I get it, very complex topic. You can see other
               | similar "patterns" that are of little help in the animal
               | kingdom. See a "fat" animal, and it is almost certainly
               | one that doesn't eat meat as a primary nutrient source.
               | Similarly, lean animals are typically predators. Would be
               | a fallacy to think you have to be a meat eater to be
               | lean, though.
               | 
               | The topic that has been intriguing to me lately, is the
               | link between mouth breathing and poor oral health. So
               | many topics that we don't know nearly as much about as we
               | want individually. Much less all mixed up together.
        
               | whateveracct wrote:
               | Pets get other stuff though. My understanding for cats at
               | least is there's a heavy genetic component. I have two
               | brother cats and one has bad teeth [1] and one has good
               | teeth. But they eat the same and get their teeth brushed
               | the same.
               | 
               | [1] As in, he lost one and needed his teeth cleaned by
               | age 7 (not old). That said, I didn't get into a habit of
               | brushing their teeth until they were several years old,
               | and both of their teeth are excellent now (vet doesn't
               | see either of them as needing a cleaning in the
               | foreseeable future). So dental hygiene is helpful even
               | for cats!
        
               | taeric wrote:
               | 7 is fairly old for cats, I thought? Not ancient old, but
               | well past early life.
               | 
               | I fully agree on it having a hefty genetic component.
               | Pure breed?
        
               | wingworks wrote:
               | Allot of what most people consume isn't great for teeth.
               | Like coffee (and some teas).
        
             | wizofaus wrote:
             | Other animals don't eat nearly as much sugary food, or food
             | of a sort that tends to get stuck in your mouth (non-
             | processed food like corn on the cob can do so, but even
             | that's a product of domestication and not so widely eaten
             | by other animals - our dog loves it, but canine teeth are
             | spaced further apart and shaped in such a way it's less
             | likely for bits to get lodged between them. Also I gather
             | dogs at least have much more powerful anti-bacterial agents
             | in their saliva.)
        
               | giantg2 wrote:
               | "Other animals"
               | 
               | Most other animals (at least mammals with teeth) don't
               | live as long. Many do suffer from dental issues if
               | untreated. For example, horses may live into their 30s in
               | domestic settings, which include dental care. Wild horses
               | typically live 15-20 years. If they survive other perils,
               | one of the causes of their earlier death can be
               | starvation or malnourishment due to not being able to
               | chew their food.
        
               | taeric wrote:
               | Yeah. I tried hinting at that in my first post. Pets will
               | have teeth issues as they get older. Much of that comes
               | from nutrition learning, though.
               | 
               | Humans seem particularly prone to midlife tooth issues.
               | With the obvious caveat that humans also are prone to
               | ignorance dominating the things we believe. :)
        
               | wizofaus wrote:
               | Sure, but humans often have issues with cavities well
               | before even reaching adulthood.
        
               | taeric wrote:
               | The food that gets the most stuck in my teeth is meat.
               | Pretty much period. Close second will be stringy
               | vegetables.
               | 
               | Which is to say, you aren't really wrong. But it is
               | clearly more nuanced. I put a longer response to another
               | post. I am not trying to find a single answer here. If we
               | are lucky and there is one, I'm all for it. But, in
               | general, I am very skeptical of many of these simplistic
               | answers.
        
               | xhkkffbf wrote:
               | Celery in my case.
        
               | viraptor wrote:
               | Meat and stringy stuff gets stuck _between teeth_ , not
               | _to teeth_. It 's the stuff that sticks to the teeth,
               | provides cover and environment for bacteria to grow is (a
               | big part of) the problem. The things that are actually
               | stringy are usually easy to remove. Things that stick to
               | the surface - less so.
        
               | giantg2 wrote:
               | The thing that typically gets stuck _to_ teeth even with
               | a good diet are minerals found in saliva.
        
               | taeric wrote:
               | As someone that doesn't have any cavities, I'm well aware
               | of many of the subtle points. I also am well aware of
               | just how scatter shot so much advice is... And how
               | dominant genetics can be in this.
        
               | wizofaus wrote:
               | I'd hazard that cooked meat is more likely to have that
               | issue than raw meat. And as another poster pointed out,
               | it's possibly more relevant what food sticks to the outer
               | surface of your teeth, though I'm pretty sure any source
               | of food around your teeth that bacteria can grow on is
               | likely to lead to cavities.
        
         | bilsbie wrote:
         | Even if it was invented it would be super expensive.
        
         | interestica wrote:
         | I've always half-wondered if wisdom teeth could be saved.
         | Either for re-insertion. Or as the source for the required stem
         | cells for regrowth.
         | 
         | I mean, evolutionarily, the late appearance of those teeth were
         | probably to replace broken molars?
        
           | jononomo wrote:
           | If you get 95% of your calories from hunting you will spend a
           | lot of time chewing tough pieces of meat. Kids who grow up
           | chewing meat and gnawing on bones develop larger and wider
           | jaws (and more attractive faces) and they have space for
           | wisdom teeth.
        
         | nerdbert wrote:
         | It seems like I've been hearing for the last 40 years that
         | tooth-re-growing tech was just around the corner, and in five
         | years none of us would have to worry about dental problems
         | anymore.
         | 
         | Still waiting.
         | 
         | Soon I'm going to have to break down and buy a toothbrush.
        
         | oneoff786 wrote:
         | Can't just clone them. Gotta grow them in your mouth with stem
         | cells.
        
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