Various scholars of prehistory have given us photographs of prehistoric skulls with sets of perfect teeth in place. The degeneration in dental health that has occurred over the many centuries from the hunter-gatherer people to the current American population is truly appalling. Today, an adult with no or few dental problems is a rarity. Are there some dental-care lessons to be found in a study of prehistoric skulls? The following overview of a series of episodes from recent history suggests that the answer is “Yes.”
Weston A. Price
An appropriate beginning for a study of why prehistoric humans had such good dental health is the work of Weston A. Price1. Dr. Price received his dental degree from the University of Michigan in 1893. As a student, he was impressed by the excellent condition of the teeth found in prehistoric skulls, but he was even more interested in their well formed facial features and dental arches, which were not commonly seen in modern societies.
Early in his practice, he became interested in the effect of nutrition on dental health. To that end, in the early 1900s, he embarked on a ten-year global expedition with his wife to compare the health and prevalence of dental disease in isolated ethnic groups who were still living on their primitive diets with matched groups of the same stocks who were routinely consuming “white man’s” food.
Price’s remarkable document Nutrition and Physical Degeneration1 presents in photographic detail many examples of the generational loss of well-formed facial anatomy and healthy, well-placed teeth found in skulls of prehistoric hunter-gatherers.
The isolated descendents who maintained the primitive dietary regimes of their prehistoric ancestors also maintained their ancestors’ excellent dental health. In contrast, descendents who switched to white man’s food not only had malformed dental arches and teeth rampant with dental caries but also had a number of other serious medical and physical problems.
The Primitive Diet:
Price identified fourteen tribal diets that differed widely in composition but all of which conferred almost complete immunity to tooth decay and resistance to illness. Some of the healthful diets were based on sea foods and others on domestic animals or dairy foods; regardless of source, all contained animal products of some kind. Some contained no plant foods while others included a wide variety of fruits and vegetables. Some diets were eaten cooked and others eaten raw. Preservation methods among the primitive groups included drying, salting, and fermenting.
Price analyzed the primitive diets and found that all contained at least four times the water soluble vitamins and minerals than the current modern diets and at least ten times the amount of fat soluble vitamins from animal fats, including vitamins A, D, and Price’s Activator X.
Components of the modern diets that were totally absent from the primitive diets were white sugar and flour, canned foods of all varieties, pasteurized or skimmed milk, and refined or hydrogenated vegetable oils.
Price’s Activator X:
Price was never able to chemically identify his Activator X except to show that it was not vitamins A or D. Analytical chemistry of 100 years ago was quite limited in the kinds of chemical structures it could identify. Price found Activator X did give a positive result in iodometric titration, which he used to quantify Activator X in various foods. He found it in butterfat, marine oils, organ meats, fish, shellfish, eggs, fish eggs, and animal tallows. Price noted that Activator X activity was especially increased in butter from cows who ate rapidly growing grass in spring and fall pasturage.
Regeneration of Teeth Damaged by Modern Diet:
An important discovery made by Price in his studies was that dental caries are reversible if the host changed to a primitive diet and supplemented with Activator X. Such dietary change also stimulated new dentine formation to cover and protect any teeth that had exposed pulp. These data were in accord with the concept that the human body is capable of self healing if given the proper nutrition
Michael and Mary Dan Eades
The second visit in our study of why prehistoric humans had such good dental health is Protein Power2by the Doctors Michael and Mary Dan Eades. In addition to their medical skills, the Eades brought the wisdom from their studies of biochemistry, anthropology, and paleopathology to their weight loss practice. This combination of philosophies provided the Eades with a rare understanding of the relationship of nutrition with insulin and obesity and ultimately with all of the chronic inflammatory diseases associated with the modern American diet.
The Eades devised a restricted-carbohydrate nutritional plan for weight loss that proved to be highly successful in their practice. This nutritional plan was the antithesis of dietary recommendations for treatment of obesity practiced by the medical profession at the time. The reader may be prompted to ask at this point, “What has the highly successful weight loss practice of the Eades to do with the perfect teeth of prehistoric humans?” The answer is that among its many benefits, the restricted carbohydrate of the Eades’ nutritional plan will eventually be accepted as a prerequisite not only for the development of perfect teeth but also for optimal health
A Natural Law for Optimal Human Health:
The nutritional program designed by the Eades contained the core of a nutritional truth that had been long awaiting recognition. It was the major force in the evolutionary diet; it expressed itself many times in human development throughout the millennia. And, interestingly, it almost became accepted as a natural law for optimal human health at the time of William Banting3. That core of nutritional truth is, very simply, “optimal human health requires restriction of carbohydrate intake” with the additional caveat of “the least amount the better.”
While writing Protein Power, Eades discovered the paleopathology of the early Egyptian agricultural community. The data from the Egyptian studies contrasted hugely with those from hunter-gatherer predecessors. The Egyptian revelations supported the Eades’ conjecture that the benefits of low-carbohydrate nutrition would reach far beyond treatment of obesity. Fortunately for the general public, the discovery was sufficiently timely to permit the Eades to include the expanded group of disorders prevented or healed by Protein Power’s nutritional design in the first edition of Protein Power.
Dr. Mike’s Blog:
The tremendous excitement that accompanied the discovery of the Egyptian data can only be appreciated by reading Dr. Mike’s Blog “Books That Changed My Life”4. A brief excerpt follows:
“Mummy Powder, Mummy Blood” (from Napolean’s Glands) was about early paleopathologists, who autopsied ancient Egyptian mummies, and about their modern counterparts who were continuing those studies with much more sophisticated equipment, including X-ray and CT studies and, believe it or not, even labwork. These mummy autopsies revealed that ancient Egyptians were crawling with parasites, had dental caries and even a fair amount of arthritis. In reading through the roll call of these disorders, the following sentence leaped out at me:
‘Blood-vessel disease was common, contrary to assumptions that it rises from urban stress and a modern high-fat diet.’
As I recall, I was starting to get a little sleepy, but I bolted alert when I read then reread this sentence. I remembered reading somewhere that the ancient Egyptian diet was heavy in carbohydrates, and I started wondering…
Wide awake, I raced through the rest of the chapter and on to the next – “Dry Bones, the Unwritten Past” – about the diagnosis of ancient disease through skeletal remains. I was hooked. I flipped to the back of the book where, to my absolute delight, I discovered a bibliography listing a host of sources and journals that theretofore had been completely unknown to me. I was unable to sleep, so I got up, went down to our library and rummaged through all our books I could find on Ancient Egypt. There were a few, and all seemed to confirm that the early Egyptian people, the ones whose mummies I had just been reading about, did indeed subsist on a diet heavy in carbohydrate, primarily wheat.
A Test of Nutritional Scientific Validity:
The criteria for concluding that a nutritional finding is scientifically valid include: 1) it is not in conflict with known scientific fields of knowledge; 2) it is explainable by known sciences such as biochemistry; and 3) it is highly reproducible and survives the passage of time.
Kris Gunners of authoritynutrition.com recently posted “6 Reasons to Stop Calling Low-Carb a ‘Fad’ Diet”5. In this article, Kris analyzed the data from over 20 studies comparing low-carbohydrate and low-fat diets. All of the studies were randomized controlled trials, the gold standard of science, and all were published in respected, peer-reviewed journals. The low-carbohydrate diet was beneficial in all studies, whereas the low-fat diet was ineffective in all studies.
It is time for nutritional science to accept the nutritional plan of Protein Power as valid science and to start studying the whys and wherefores of individual biochemical responses to dietary carbohydrates. Continued repetition of failed experimental studies in an attempt eventually to get an acceptable answer to justify the high carbohydrate diet is counterproductive.
Modern Dental Health
The book selected as the text for the third stopover in our study of the perfect teeth of prehistoric humans is Kiss Your Dentist Goodbye (KYDG) by Ellie Phillips, DDS6. It was recommended for our study by a friend who said it discussed preventive dental care and included mention of current work on regeneration and remineralization of damaged (carietic) teeth.
What Makes Imperfect Teeth?
The question of why prehistoric humans had perfect teeth begs the question of what makes imperfect teeth. Whatever the circumstances are that trigger dental diseases, they must have been absent or inhibited in prehistoric humans. Modern dentistry has had ample time and ample material to determine the many requisites for caries formation. Consideration of what causes dental disease may shed light on circumstances not existing for prehistoric humans.
Acid Oral Environment:
There seems to be a general consensus that the direct cause of dental disease is acidic saliva that softens the enamel and encourages growth of harmful bacteria that produce dental caries. Conditions that favor acidic saliva include poor dental hygiene, illness and medications, chronic or acutely stressful personal situations, and aging.
In a normal, healthy mouth, the saliva that bathes the teeth is released from salivary glands by typical mouth movements and by chewing action. This saliva is non-acidic or slightly alkaline. Periodic excursions of saliva into the acidic range are normally returned to alkalinity by normal saliva flow within a short period.
The role of diet:
There seem to be no strong opinions about the influence of diet on dental health other than that the diet should include herbs, vegetables, and, fruits to create an alkaline environment in the body and presumably in the saliva. There seems to be no concern about dietary carbohydrate intake except for a few low-carbohydrate advocates who see other benefits of low-carbohydrate dieting. Any dental problem from consumption of sugars and starches is considered to be due to topical fermentation of residues left in the mouth after eating.
The position of modern dentistry is that dental caries are caused by specific (harmful) bacteria in numbers that exceed the numbers of friendly (protective) bacteria. Growth of harmful bacteria is stimulated by acidic mouth and by sugar and starches if they are permitted to ferment in the mouth. Harmful bacteria produce their own acid environment in the mouth and are the cause of various dental diseases.
With regard to the study of why prehistoric humans had perfect teeth, the chapter entitled Plaque6 is the most rewarding. It tells of the discovery in 1890 of a film that covers the teeth and surfaces in the mouth. This film, a complex organization of many kinds of bacteria, protein strands, and a variety of other substances, fluids, and cells, was named dental plaque. By 1900, dental plaque became associated with the harmful bacteria that caused caries. The visible sign of plaque was a hard white deposit on teeth along the gum line made by a film infected with harmful bacteria.
It was ultimately decided that plaque was the cause of caries; thus, began a war on plaque that exists to this day. Patients were instructed to brush vigorously daily to prevent plaque buildup and to have the teeth cleaned at least every six months to scrape away any plaque buildup under the gum line. This attack on plaque damaged the biofilm and unknowingly created oral environments that promoted dental disease.
During the 1970s, dental research began to consider that if dental plaque infected with pathogenic bacteria caused dental disease, perhaps a healthy, non-infected plaque might protect against disease. Throughout the decades, microbiologists had studied the thousands of microorganisms that inhabited plaque and found that the majority, by far, were beneficial organisms that protected against dental disease. In this period, the concept of a healthy, protective oral biofilm was born. In 1994, P.D. Marsh proposed:
…in order for a mouth to be truly healthy, the bacteria in it need to be healthy…harmful germs exist only when a shift in mouth chemistry encourages acid-producing bacteria to grow… in a healthy mouth, bacteria do not need to be removed because they are, in fact, healthy and protective6, p73.
Concurrently and independently, research by biochemists into the causes and treatment of dental diseases was motivated by the fact that in modern society periodontal diseases are among the most prevalent of human diseases. In 20017, an investigation of inflammatory processes found that mucosal epithelial cells provide a first line of defense against bacterial invasion and infection. The details of “a previously unappreciated ‘molecular shield’ for protection of mucosal surfaces against pathogenic organisms and endotoxins” seem to describe the “oral biofilm” of dental practice.
It is important to note here that, although oral biofilms are specific to periodontal diseases, it appears that all mucous membranes throughout the body harbor a number of antimicrobial factors that form protective barriers or films.
Essential Fatty Acids and Their Eicosanoids-Docosanoids
The recognition of the protective role of the oral biofilm in dental health brings the study of the teeth of prehistoric humans to a relatively unexplored section of nutritional biochemistry, namely, the metabolism of essential fatty acids (EFAs) and their end-product eicosanoids and docosanoids (20- and, 22-carbons respectively)8.
The EFAs consist of two families, the omega-6 family and the omega-3 family. The omega-6 family has its first double bond between carbons six and seven from the terminal carbon of the carbon chain. The omega-3 family has it first double bond between carbons three and four. These are termed essential fatty acids because the human body is incapable of biosynthesizing them.
The total daily consumption of EFAs varies widely worldwide. However, the total daily consumption is of lesser importance than the ratio of omega-6 to omega-3 in the diet. The ideal ratio is considered to be about 1:1. A ratio greater than about 4:1 is a serious risk factor for essentially all chronic inflammatory diseases. The ratio in the average American diet is between 10:1 and 20:1.
Although the metabolism of the essential fatty acids and their eicosanoid end products have been of little general interest in the nutrition community, certain lipid mediators from the eicosanoid family, notably the prostaglandins, have been the subject of intensive investigation for many decades. In 1982, the Nobel Prize in Physiology of Medicine was granted to Sune Bergstrom, Sir John Vane, and Bengt Samuelson of the Karolinska Institute for elucidation of the very complex structures of the prostaglandins (so named because they were first found in prostate tissue).
During the past few decades, study of the very complex structures, functions, actions, and interrelationships among lipid mediators in the numerous subgroups of eicosanoid and docosanoid biochemicals has progressed actively with little notice from nutritional science. With this research, a new field of biochemical science labeled lipidomics has emerged – virtually unnoticed.
From the EFAs of nutritional science, we turn to the EFAs of lipodomics for the final contribution to our study of why prehistoric humans had such good dental health. Lipidomics explains the very complex biochemistry and functions of EFAs and their eicosanoids-docosanoids system.
Eicosanoids and docosanoids, also called lipid mediators, constantly monitor and adjust internal functions to maintain normal bodily stability (homeostasis). They also maintain physiological stability by controlling a large number of body functions. Some examples are regulation of blood pressure, gastric mucosal secretion, and gestation and parturition in pregnancy. The eicosanoid control system governs the biochemistry by which health or disease is determined. Lipid mediator imbalance caused by dietary excesses of omega-6 EFAs is involved in the development of essentially all chronic inflammatory diseases.
Lipidomics tells us that prehistoric humans evolved with this very elaborate control system that constantly monitored the body for any sign of anything abnormal. This was a self-healing system that was constantly working on maintenance and repair. It was responsible for protecting not only the health of his mouth and teeth but also his whole body. This splendid self-healing system, like prehistoric man himself, was the product of the restricted-carbohydrate and bountiful omega-3 EFAs nutrition of the hunter-gather life.
Lipidomics discovered the marvelous self-healing system with which man evolved from research on chronic inflammatory diseases. Lipidomic study of inflammatory processes revealed countless very complex and never-before-known biochemicals synthesized from EFAs that eventually could only be explained by the prehistoric self-healing system.
The degeneration of the remarkable prehistoric self-healing system apparently occurred with the change from hunter-gatherer nutrition to that of plant-based agriculture exemplified by the early Egyptian civilization. The self-healing system is generally unrecognized today because it does not function in people who have flawed nutrition.
With proper and dedicated nutritional treatment, lipidomics is proving that the system can be revitalized.
An Overview of the Eicosanoid-Docosanoid System:
Charles Serhan, who began his postdoctoral career with Dr. Samuelson prior to the 1982 Nobel award, has been the principal investigator during the long journey through very complex lipid biochemistry to final acceptance of the new science of lipidomics, a branch of the larger discipline of metabolomics.
In 2005, Serhan published a seminal paper discussing a decade of progress in eicosanoid research and announcing discovery of lipid mediators of endogenous anti-inflammation and resolution9. Once thought to be merely a passive process, resolution (healing) of inflammation was shown by the work of Serhan and colleagues to be an active biochemical process that does not occur automatically but must be initiated in order to proceed.
The lipid mediators reported by Serhan were anti-inflammatory, pain-moderating, and pro-healing eicosanoids that began to be discovered and described in the 1990s. They were new pro-resolving lipid mediators. As a group, they are referred to as lipid autacoids or lipid mediators, and are individually identified as lipoxins (LXs), derived from arachidonic acid (AA), and resolvins (RvEs and RvDs), protectins (PDs), and maresins (MaRs), derived from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
The biochemical mechanisms for prevention and treatment of chronic inflammatory diseases are extremely complex and difficult for all but scientists working in the field to comprehend. However, in layman’s words, it is known that the major cause of chronic inflammation that leads to chronic disease is primarily nutritional. In simplest terms, inflammation is the result of a dietary imbalance of EFAs and their lipid mediators.
An existing chronic inflammatory disease will progress unabated until the contributory nutritional failing is remedied. Until that time, the body makes every effort to make repairs with what materials it has available. It is in this period that scar tissue or the equivalent, depending on the tissue involved, is formed in an attempt to stop damage. It is not until the body is provided with ample dietary EPA and DHA, the lipid mediators described above, inflammation will begin to diminish and healing will commence.
These discoveries are tremendously important because they describe the nutritional need for these essential fatty acids and explain the biochemical processes that end inflammation, initiate healing, protect involved tissues, control pain, and return damaged tissues to homeostasis8.
Dental Disease as an Inflammatory Disease10:
Periodontal diseases are chronic inflammatory diseases initiated by bacterial infection of the oral protective film and mucosa of the mouth. Dental disease, as with all inflammatory diseases, is a failure of pathways of resolution to heal the infected biofilm and mucosa and return them to homeostasis. Healing cannot occur if the body does not have available in the diet the lipid mediators described by Serhan. Anti-inflammatory and proresolving mechanisms are the only successful approach to prevention or elimination of dental diseases.
Re-Emergence of Activator X:
As biochemical science became more acquainted with the emerging science of lipidomics, the obvious similarity between omega-3 essential fatty acids and Activator X became obvious to scientists versed in organic chemistry. However, in 2008, in an exhaustively researched paper11, Masterjohn rejected an EFA as Activator X because
…neither the distribution of unsaturated fatty acids in foods nor their chemical behavior corresponds to that of Activator X…Moreover, Price tested Activator X by quantifying the ability of a food to oxidize iodide to iodine; essential fatty acids, however, do not possess this chemical ability.
The first part of the statement does not appear to be in accord with a careful reading of Nutrition and Physical Degeneration1; however, that the second part is obviously wrong is explained by organic chemistry. Polyunsaturated fatty acids are notoriously subject to oxidation. An iodometric titration, as employed by Price, is used currently to quantitate oxidized polyunsaturated fatty acids in lipid emulsions12.
Interestingly, despite the remarkable and convincing data developed by lipidomics, a survey of Paleo-fitness blogs reveals that it is still generally accepted in the Paleo community that Price’s Activator X is indeed vitamin K2. A discussion of why vitamin K2 does not qualify for consideration as Price’s Activator X is beyond the scope of this paper other than to mention that vitamin K2 quite logically can serve along with other nutrients as an element in tooth remineralization, but it cannot function as a lipid mediator to initiate and govern the healing process as Price’s Activator X appeared to do.
It is unfortunate that once erroneous information is disseminated to an accepting public, it is difficult to correct. Vitamin K2 is important in calcium metabolism and can help prevent or reverse tissue deposition of calcium, but it is deceptive to credit it with the power of Activator X to heal inflammatory diseases.
It would appear, based on the work of Serhan and Van Dyke, that AA, EPA, DHA comprise Price’s Activator X. It is evident that Activator X was actually this small class of EFAs, each designed to respond to a specific manifestation of inflammation. EPA and DHA are often considered as a biochemical pair because of their cyclic relationship in Sprecher’s Shunt8, p.183.
Prehistoric Human’s Dental Hygiene
The perfect teeth of prehistoric humans are illustrative of a miracle of life about which the average person of today is totally unaware, namely our inborn, steady-state, self-healing system. It is not just responsible for maintaining a healthy mouth but also for healing any and all chronic inflammatory diseases that afflict the body. The main reason that self healing is not recognized in modern society is that it seldom seen because it requires optimal nutrition to work. Neither the Food Guide Pyramid nor the Eat-What-Makes-You-Happy nutritional philosophies provide optimal nutrition.
Prehistoric humans also were not aware of the wonderful self-healing system within themselves, but they benefited from its existence because they had no choice. Their nutrition, like themselves, was prescribed by their environment. The evolutionary diet was the diet that described the optimum nutrition for humans.
The development of perfect prehistoric teeth, however, had its beginning much earlier in life – actually at birth. In the prehistoric setting, the original transfer of oral microflora to the sterile infant mouth must have occurred almost immediately after birth because of the role of the mother’s mouth in infant cleaning and feeding.
The quality of dental health in the prehistoric neonate depended, as it does in modern babies, on the kinds of oral microorganisms, protective or harmful, transferred to them. The oral biofilms of prehistoric neonates were formed with a predominance of friendly, protective microorganisms that were representative of the average of the tribe. They were kept in healthful microbial composition in the newborn by daily transfer of premasticated food from mother’s mouth.
Finally, perfect prehistoric teeth would not have been achievable without the existence of the anti-inflammatory, pro-resolution, lipid mediator system that constantly monitored and mended occasional insults. “Disease is the Failure to Heal,” and it is nutrition that controls the human healing process.
Shortly after completion of this article, the following conclusion appeared in a research abstract in the June 26 issue of the Journal of Dental Research13:
In this randomized controlled trial, aspirin-triggered DHA supplementation significantly improved periodontal outcomes in people with periodontitis, indicating its potential therapeutic efficacy.
- Price WA. Nutrition and Physical Degeneration. Los Angeles, CA: Keats Publishing, 1998.
- Eades MR, Eades MD. Protein Power, Paperback Edition. New York, NY: Bantam Books, 1999.
- Banting, W. Letter on Corpulance.
- Eades MR. Books That Changed My Life.
- Gunners K. 6 Reasons to Stop Calling Low-Carb a ‘Fad’ Diet.
- Phillips E. Kiss Your Dentist Goodbye. Austin TX: Greenleaf Book Group Press, 2010.
- Canny G, et al. Lipid mediator-induced expression of bactericidal/permeability-increasing protein (BPI) in human mucosal epithelia.PNAS, 2002; 99(6):3902–7.
- Ottoboni A, Ottoboni F. The Modern Nutritional Diseases and How to Prevent Them. Fernley, NV: Vincente Books, 2013.
- Serhan CN. Lipoxins and aspirin-triggered 15-epi-lipoxins are the first mediators of endogenous anti-inflammation and resolution. Prostaglandins, Leukotrienes, and Essential Fatty Acids. 2005; 73:141-162.
- Fredman G. Impaired phagocytosis in localized aggressive Peridontitis: rescue by resolvin E1. PLoS ONE, 2011; 6(9):e24422.
- Masterjohn C. On the Trail of the Elusive X-Factor: A Sixty-Two-Year-Old Mystery Finally Solved. Spring, 2008; Wise Traditions.
- Steger PJ, Mühlebach SF. In vitro oxidation of i.v.lipid emulsions in different all-in-one admixture bags assessed by an iodometric assay and gas-liquid chromatography. Nutrition. 1997; 13(2):133-40.
- Naqvi AZ, et al. Docosahexaenoic Acid and Periodontitis in Adults: A Randomized Controlled Trial. J Dent Res. 2014;93(8):767-773.