Wednesday, April 15, 2009

Images of Tooth Decay Healing due to an Improved Diet

This one's for the skeptics out there. As I mentioned in my previous post, Drs. Edward and May Mellanby and Dr. Weston Price reported that under the right circumstances, tooth decay can be reversed by proper nutrition. Here are images taken from the book Nutrition and Disease, by Dr. Mellanby, showing the re-calcification of decayed human teeth due to the growth of tertiary dentin (formerly known as secondary dentin). These are sections (slices) of teeth that have been treated with a chemical that darkens decayed areas. They represent four different teeth at different stages of decay reversal. Click on the image for a larger view:

Here's the text that accompanies the figure:
The hardening of carious areas that takes place in the teeth of children fed on diets of high calcifying value indicates the arrest of the active process and may result in “healing” of the infected area. As might be surmised, this phenomenon is accompanied by a laying down of a thick barrier of well-formed secondary denture. Illustrations of this healing process can be seen in Figs. 21 (b), (c) and (d). Summing up these results it will be clear that the clinical deductions made on the basis of the animal experiments have been justified, and that it is now known how to diminish the spread of caries and even to stop the active carious process in many affected teeth.
The following reference contains a summary of Dr. May Mellanby's experiments on healing tooth decay in children using diet: Mellanby, M. et al. British Medical Journal. Issue 1, page 507. 1932. The diet they used was typically a combination of some source of vitamin D (cod liver oil or irradiated ergosterol), plus liberal full-fat dairy, meats, eggs, vegetables, potatoes and grains low in phytic acid such as white bread. The most effective version of his diet, however, did not include grains.

In the book Nutrition and Physical Degeneration, Dr. Price provides X-rays showing the re-calcification of a mouth full of cavities using a similar diet.


Aaron Blaisdell said...

It's interesting to see that the secondary (or tertiary?) dentin and arresting of carries took noticeably longer here (notice difference b/t 6 months and 3 years) than as reported by Weston Price in which he reported significant improvement on the order of 6 weeks or so.

Where the pictures you are showing of children or adults? Price usually discussed treatment in children.

Robert Andrew Brown said...

Congratulations Stephan !!

Full marks for perseverance and thank you for all your hard work, I know how many hours it can take to follow ideas through.

Again well done.

The time it took for recognition of Vitamin C as beneficial, and Trans fats and cigarettes as detrimental comes to mind.

It is mind numbing as to why results like this are not subject to further extensive research.

The answer always seems to be there is no financial driver.

If a society organised primarily around profit has no mechanism to recognise simple solutions that improve the prospects of survival of the species, it raises questions as to our long term future in a world where so much of life is organised solely round the concept of profit.

Even the argument that we will just revert to hunter gatherers is less certain as we change the ecology of the planet.

arnoud said...

Great work! It is mind-boggling that society, so far, has ignored these findings. While patients and governments keep talking about reducing health care costs, some answers seem available (but ignored)...

Just wondering: with dietary variation between cultures, it might be possible to look further at dental health vs diet. For example, based on the levels of vitamin consumption (K2), it would be reasonable to expect lower incidence of dental disease in Japan?

StephenB said...

I can verify that, for me, supplementing with K2-MK4 makes my skin noticeably softer and my teeth plaque free. I'm actually looking forward to my next dental visit; I can't wait to see if they notice.

I wonder if K2-MK7 would produce the same effect?


homertobias said...

Complex process here. It would be nice to move into the post flouride era and into adult teeth and differentiate between caries and gum disease. It would be nice to move into enamel remineralization instead of dentin remineralization for true primary prevention. Theres alot of literature linking calcium, phosphorous, and fluoride availability in dental biofilm with caries protection. This is somewhat dependent on D,K2, as we all know but also on hydroxyappetite (back to phytic acid) and also some very interesting work on different strains of lactobacillus (lactobacillus casei count positively associated with caries), Lactobacillus ramsus gg inhibiting the growth of streptococcus mutans, the primary bacterial cause of dental caries. Ferment your yogurt = less caries.

Aaron Blaisdell said...


Could you please provide the references for the different effects of the bacteria strains you mention on dental health?

Drs. Cynthia and David said...

Since going low carb, my dentist raves about how great my teeth and gums are. He says you can tell from my gums that I am in "perfect health." Not that I necessarily believe him, but he pointed out some kind of dimpling in the gum tissue that he says is associated with health (as opposed to inflamed gums, presumably). Ever heard of that? I also notice huge amounts of calcium deposits on the night guard I wear at night- it's precipitating out of the saliva. I never realized there was so much calcium dissolved in saliva.

The publication C&ENews (for ACS members and in your library) has several articles in 2008 about dentin repair, talking about the collagen fibrils and hydroxyapatite crystals embedded in the fibrils, and how an acidic environment erodes the dentin faster than it can be rebuilt. Unfortunatly, once the collagen fibrils collapse, it can't be repaired, and so of course there is still a need for some way to repair the damage for those of us with accumulated damage. But it's clear that tooth decay is not an inevitable process- rather, the state of dentin and enamel is an equilibrium process, and we benefit from shifting the equilibrium toward redeposition of calcium.

Regarding previous post, see this link (found in comments to Eades' post) about the "healthy patient bias".

Thanks for your good work here!


Drs. Cynthia and David said...

oops- forgot the link:

Monica said...

"The answer always seems to be there is no financial driver."

In favor of your argument, Robert, I think if vitamin D3 were invented by a drug company today it would sell like the wonderdrug that it is for $5 a day rather than $5 a month. :)

However, I think this points to the idea that there is something else at work here. First, the beneficial effect of diet on tooth healing was documented before the wonderdrug era (which started in WWII with an application of Fleming's penicillin discovery). Price mentions in his book that he talked to food processors(?) about the need for high vitamin butter. They weren't interested -- I doubt this was because they couldn't have found a niche market or believed that drugs would solve their problems instead. It was most likely because they did not take a long term business view. Also, scientists are not usually business types that know how to pitch ideas.

Another problem is that it is very ingrained in American culture that new and artificial is better. This ties into the Price anecdote above, I think. Honestly, most people today have no understanding of how "primitive" peoples actually lived. They think it is normal that humans should be sick and that even if we are sick, we're much healthier than they were. If you were to show them the pictures in Price's book, they would scarcely believe it. Ex: I was in a restaurant with vintage signs last year and one, probably from the 50s era, read, "Grape drink with artificial flavor! Better than the real thing!"

When you don't view health and diet through the lens of an evolutionary paradigm, you will be prey for any marketing tactic -- or the latest report on why red meat kills you faster -- or the idea that it's all about genetic variation and if we are one of the 60% of people that don't get cancer, we can just thank our genes... or our lucky stars.
Given that a minority of the American population believes in evolution (including doctors) and knows zilch about human history over the longer term, on top of the larger problem that the nutritional science itself is not grounded in evolutionary ideas, it's not difficult to see why we are in the situation we are in.

There's no question that the pharmaceutical industry is very powerful in the way that it influences physicians' behaviors. But the more fundamental problem, I think, is that people (doctors and patients) do not think for themselves and/or take responsibility for themselves. If they did they would not be taken in by slick ads. I hope that will change, and I like what Dr. Davis has had to say about this, here:

By the way, these testing services he talks about are completely capitalist and profit-driven in ways that our current "health"care system is not -- because the consumer base for such products is independently-minded and educated. I think that's all a good thing. Just as Lasik has improved and gotten cheaper due to competition, these tests will get cheaper and better because they are not as subject to the paternalism, over-regulation, hassles and insanities of our current insurance-based "health"care system.

Stephan Guyenet said...


Yeah I noticed that too. I think cavities can begin healing within a matter of weeks, but they may need longer to heal completely.


I don't know what the vitamin K2 consumption is in Japan. I believe natto consumption is regional. I'm not sure if MK-7 would have the same effect on dental health as MK-4. It's possible but it remains to be seen.


I'm asking this question naively, is there evidence that enamel can remineralize? Dentin can be secreted by odontoblasts but they don't make enamel


Are you sure that's calcium depositing on your night guard and not plaque? I used to get hard deposits on my retainer in high school but I always assumed it was plaque. Either way, you're right about the calcifying ability of saliva. Weston Price noted that when he incubated tooth fragments with healthy saliva, minerals passed from the saliva into the teeth. The saliva from people eating a poor diet actually removed minerals from the teeth rather than depositing them.

Thanks for the reference about the equilibrium process in dentin. That makes a lot of sense. Acidic food leaches minerals, but that's not a problem as long as your saliva is calcifying.

Drs. Cynthia and David said...

Well I never analyzed it, but when I asked about it, my dentist told me it was calcium.

There's research on remineralization of enamel and dentin going on at UCSF, by Stefan Habelitz, and Grayson and Sally Marshall, at NYU by Van P. Thompson, and at Johns Hopkins by Timothy P. Weihs. These were just a few of the researchers mentioned in the article I read. A quick search of pubmed shows quite a bit of published research if you want to take a gander. It's still in early stages, but so much better than the drill and fill strategies that I grew up with!


homertobias said...

Thanks Drs C and D

Stephan, go to pubmed and search "dental caries, enamel remineralization" 877 hits. I look forward to how you process this.

Aaron, go to pubmed, look up streptococcus mutans and dental caries and follow the trail.

Robert Andrew Brown said...

Thanks HomerTobias

I did what you suggested and found this.

It identifies the problem but Stephan's blog is not on the reading list. (-:

Thought provoking recommendations include "Avoid blowing on child’s food or prechewing foods."

Anonymous said...

Stephan (and others),

Sorry to be off topic, but I just read an interesting post from Robert M and was curious about your thoughts.

Stephan Guyenet said...


Cool, I guess it was calcium then.


I took a peek around. There's definitely a lot of information about the equilibrium between demineralization and remineralization. What's disappointing is that when you add the word "diet" to the search, the hits plummet. And when you look at the hits, they're all about sugar, fluoride and special mineral salts people are experimenting with. The only exception I saw was a general acknowledgement that dairy improves tooth mineralization.

It seems to me that the knowledge of what factors affect the mineralizing properties of saliva has really regressed over the years.


I read that post as well. There are a few points on which we disagree. I don't think carbohydrate itself is the cause of fatty liver, or overweight.

JohnN said...

Stephan - Try PMID: 19212520 which discusses dietary factors. Remineralization can't occur until saliva's pH>6.0. That won't be easy until grains are removed from diet - Hyperlipid approach to diet works best (IMO). I think Peter should trademark the term.

For better sorting out Pubmed documents I'd recommend

Stephan Guyenet said...


I don't doubt that the OD approach can heal cavities. I see your point about grains and saliva pH. It can't be the whole story though, since a number of cultures have had good teeth on grain-heavy diets, such as the Swiss villagers of the Loetschental valley eating whole rye and dairy. That diet must have been highly acid-forming but it didn't give them cavities. Same for a number of African cultures eating grains and dairy.

Robert M. said...


Hard cheese is quite protective against caries, especially if eaten post-meal. E.g. same is true for many other dairy products although less so.

homertobias said...

Aha! There's the pubmed article that came and went...J Am Dental Assoc, May 2008. Garcia-Godoy F. Interesting.

Stephan Guyenet said...


That's cool. I wonder if that's connected at all to the K2 content? Chewing gum laced with menadione ("vitamin K3") kills oral bacteria. Or maybe cheese is full of antibiotics from being fermented.


Good to know. I'm glad to see that some people are acknowledging the role of dietary minerals in tooth quality.

Aaron Blaisdell said...

Just checked Dr. Mellanby's book out of the library. It's a quick read and very fascinating. The first chapter which is on Rickets is stunning. This guy knew how to translate between basic research and clinical applications! This is largely the objective of the book.

Stephan Guyenet said...


Cool! Yeah I really enjoyed it too. There don't seem to be a lot of copies floating around. I had to special order it from a library in British Columbia. I have a post written about his research on diet and immunity that I'll be putting up soon.

Monica said...

Here's a question for anyone with some insight into it. If a diet high in fat soluble vitamins and low in unsprouted grains increasing mineral deposition, why do so many people on this diet report a lack of calculus? Can only certain types of food be calcified and turned into calculus? (i.e. grains?)

Brian said...

Does anyone know how much vitamin D was used in the treatments that resulted in those photos? I'm currently taking 6,000 IU in cod liver oil capsules daily.

Stephan Guyenet said...


I'm not sure. Calculus probably is a marker of sub-optimal oral health, judging by the fact that it was rare in pre-agricultural times.


6,000 IU of D from cod liver oil, good lord! That must be a lot of pills! The kids were getting large doses of irradiated ergosterol, which is vitamin D2. I haven't seen him say the potency of the irradiated ergosterol he used, so I can't tell you the equivalent IU. But Mellanby was into the high doses, I would guess it was in the 2,000-3,000 IU equivalent range, and remember these were children.

Brian said...


It's two pills daily - the "Solar D Gems" by Carlson Labs, one at 4,000 IU, one at 2,000 IU of Vitamin D3.

R Allen said...

I love this post! I recently purchased the book "Cure Tooth Decay" by Ramiel Nagel which utilizes the Weston Price protocol. I am overjoyed to have found an alternative as my dentist advised me that my three children need 8 (!) root canals and tons of fillings and I cannot see myself paying for it unless I sell my car (or possibly my house)!
My search for a remineralization procedure came about for financial reasons but I believe my whole family will benefit in overall health if we continue to eschew "modern" living practices and look to nature for solutions.

Stephan Guyenet said...


OK, they must be fortified then. Sounds good.

R Max,

Good luck. Let us know how that works!

Stan Bleszynski said...

R Max,

You don't have to mortgage your house! A diet rich in animal produce and low in plants will work wonders, sooner and better than you probably think.

Our 4 children (girls), age now 11 to 17, have been fed Optimal Diet by their "cruel" parents since 1999, except the oldest one who stopped eating our food 2 years ago, ever since she started earning some pocket money. In spite of their frequent transgressions and (forbidden) sweet snacks at school, the 3 youngest have zero cavities! Except, our oldest girl who opted out - has developed one and had a small filling done!

Stan (Heretic)

I have seen the future and it works!

Aaron Blaisdell said...

Stan (Heretic),

From your italicized closing line, I take it you're a Prince fan.

My funk is multilayered

Dr. David Cheng said...

It has been known by many dentists that dental decay can be arrested or even reversed in the early stages, but I have never seen microscopic evidence of this until now. Thanks for sharing!

Emergency dental

derridian said...

Really interesting to see the work on Dr. Mellanby. It's something of a co-incidence to find that both Dr Price and Dr. Mellanby came up with almost the same results at the same time. Both books were published in the 1930, almost with the same titles.
It's also amazing to me that the whole debate about tooth remineralization has been hijacked into a discussion about Fluoride.
Readers may want to find out other ways of increasing re-mineralization here:

Brad said...

What is the hyperlipid diet?

Anonymous said...

Two years late to the party and I imagine no one will ever read this, but here goes:

I have stopped the cavities in four of my children. The oldest three were 8, 5, & 2 at the time, and the only changes we made then were switching from skim to whole milk, from processed cereals to oatmeal, and a slight reduction in the number of grains. The youngest was an infant, and his cavities started, like the others, at 18mo and rapidly completely removed his four front teeth. Nearly every tooth he had was so badly decayed it "needed" capping, pulpotomy, or extraction. That was when I removed sugar & grains from *my* diet (some 80% of his calories were still from nursing) - and his cavities stopped.

Stephen, I think the problem with grains in the problem of dental caries is largely one of substitution. The processed dry cereal grains were binding the precious minerals with phytates and removing them from the body, and the entire diet was devoid of D, A, and K2 until we added the whole milk. That was enough for them, possibly b/c they hadn't already spent decades on a nutrient-deficient diet.

All the decayed teeth have since fallen out and been replaced by beautiful adult teeth in the older two. Four active (but contained and pain-free) abscesses continued for 2-4 years in the two middle children until the teeth involved fell out. No harm done.

The youngest has a mouth full of hideous gutted teeth, but they have been perfectly stable for two years since his dietary change. They only hurt after Christmas or a few days at Grandma's, at which time we crank up the butter, raw yolks, fCLO, and vit C again and all returns to normal.

Monica - I'm Catholic, and whether human history is reliant on evolution of not, I believe that the habits that our bodies have been evolved/designed to expect over our hundreds of thousands of years of existence are the ones most likely to lead to vibrant health. If our society focused on the implications of either evolution or the natural law - or both - we'd be far better off.

My impression was that calculus was created by the Ca in the saliva. What I'm not sure of is why the Ca goes there instead of *into* the teeth. That would be interesting to know, or perhaps I'm completely wrong about what calculus is (other than three years of fun math).

Eden said...


I'm reading your post and I'm so encouraged by it. My two-year old has some signficant decay in her front teeth, and my copy of Ramiel Nagel's book arrived today. I'm heading to your blog now to see how to contact you directly and/or to read more about your experience with arresting the decay of your children's teeth. :)

Frank said...

I wonder if it's possible to heal a chipped tooth. I broke off a small part of my front tooth a while ago due to biting on a nutshell. It does not hurt, but it would be great to "re-grow" that instead of having it fixed. Does anyone have experience with such a problem? How exactly could this be accomplished?

bizbroker said...

Does anyone know if this image from Mellanby's book is a drawing? Or an X-ray? Or what? How does one obtain pictures of "slices" of teeth?

Unknown said...

I saw images like this at my friend's office. He is a dentist in Burlington so he sees a lot of things like this.