Weston Andrew Valleau Price[1] (September 6, 1870 – January 23, 1948) was a prominent dentist known primarily for his theories on the relationship between nutrition, dental health, and physical health. He founded the Research Institute of the National Dental Association, which later became the Research Section of the American Dental Association, and served as its chair from 1914-1928.[2][3][4]
Initially Price did dental research regarding the then broad consensus in the dental and medical community of the late 19th and early 20th centuries on the relationship between endodontic therapy and pulpless teeth and broader systemic disease which by that time was known as focal infection theory which resulted in what would be later called an orgy of extractions of tonsils and teeth.[5] The quality of this and similar research began to be questioned in the 1930s, resulting in focal infection theory falling out of favor and pushed to the margins of dentistry by the 1950s.[6]
By 1930 Price had shifted his interest from focal infection to nutrition. In 1939 he published Nutrition and Physical Degeneration,[7] detailing his global travels studying the diets and nutrition of various cultures. The book concludes that aspects of a modern Western diet (particularly flour and sugar) caused nutritional deficiencies that were a root cause of many dental issues and health problems. The dental issues he observed include the proper development of the facial structure (to avoid over-crowding of the teeth) in addition to dental caries. This work received mixed reviews, and continues to be cited today by proponents of many different theories, including controversial dentistry and nutritional theories.
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Born in Newburgh, Ontario, Canada on September 6, 1870 Price graduated from the dental college of the University of Michigan in 1893 and began to practice in Grand Forks, North Dakota but later moved to Cleveland, Ohio that same year.[8]
Price conducted various research efforts to develop technological solutions to dental diseases. He invented and improved the pyrometer dental furnace for the manufacture of porcelain inlays that included the fusion of metal and porcelain. Price also researched improvements in producing dental skiagraphs in the early 1900s and developed special instruments for studying the effect of x-rays on cancer. Much of this work was presented at various professional societies in which he had membership.[1][9] His work with radiographs include pioneering a new radiological technique for studying teeth as well as using radiographs to analyze endodontically treated teeth [10] though his 1904 paralleling and bisecting angle techniques would not be become popular until the work of Dr. Gordon Fitzgerald of the University of California in the late 1940s.[11][12] The initial practice of using radiographs in dentistry is regarded as part of the beginning of a new era of dentistry, as dentists could finally see evidence of past dental treatments.[10]
Beginning in 1894 Price started to consider diet as the primary cause factor of tooth decay and in 1925 was attracted to calcium metabolism when he became an active student of nutrition.[8][13] In the early 1930s, Price's research suggested "vitamin B" and mineral salts were important dietary components to prevent caries.[14]
In 1939 Price published Nutrition and Physical Degeneration,[7] a book that details a series of ethnographic nutritional studies performed by him across diverse cultures, including the Lötschental in Switzerland, Native Americans, Polynesians, Pygmies, and Aborigines, among many others.[15] The photographic material and notes collection in this research "included over 15000 original photographs, 4000 lantern slides (about half of which are hand colored) and a library of strip film lectures."[8]
In the book, Price claimed that various diseases endemic to Western cultures of the 1920s and 1930s - from dental caries to tuberculosis - were rarely present in non-Western cultures. He argued that as non-Western groups abandoned indigenous diets and adopted Western patterns of living they also showed increases in typically Western diseases, and concluded that Western methods of commercially preparing and storing foods stripped away vitamins and minerals necessary to prevent these diseases. His claims extended from physical degradation to moral degradation as well.[16]
The 1939 foreword to the book, written by physical anthropologist Earnest A. Hooton, lauded Price's work for confirming previous research that dental caries were less prevalent in "savages" and attempting to establish the etiology for this difference. In 1940, a review in the Canadian Medical Association Journal called the book "a masterpiece of research", comparing Price's impact on nutrition to that of Ivan Pavlov in digestion. In 1950, a review in the journal The Laryngoscope went as far as to say that "Dr. Price might well be called "The Charles Darwin of Nutrition" while describing Price's documentation of his global travel and research in a book.[17] However, other reviews at the time were less sympathetic with a review in the Scientific Monthly noting some of his conclusion went "much farther than the observations warrant," criticizing Price's controversial conclusions about morality as "not justified by the evidence presented" and downplaying the significance of his dietary findings.[16] Likewise, a review in the Journal of the American Medical Association also disagreed with the significance of this nutritional research, noting Price was "observant but not wholly unbiased" and that his approach was "evangelistic rather than scientific."[18]
A 1981 editorial by William T. Jarvis published in Nutrition Today, was more critical, identifying Price's work as a classic example of the "myth of the healthy savage," which holds that individuals who live in more technologically primitive conditions lead healthier lives than those who live in more modern societies. The review noted that Price's work was limited by a lack of quantitative analysis of the nutrition of the diets studied and the overlooking of alternative explanations for his observations including malnutrition leading to the lack of caries in primitive societies and overindulgence of the Western diet, rather than the diet itself, as cause for poorer health. The review makes the assertion that Price had a preconceived positive notion about the health of "primitive" people, which led to data of questionable value and conclusions that ignored important problems known to afflict their societies, such as periodontal disease.[19]
Price spent 25 years of his career performing research on pulpless and endodontically treated teeth, which supported the theory of focal infection, which at that time held that systemic conditions including complexion, intestinal disorders, anemia among others could be explained by infections in the mouth. This theory also held that infected teeth should therefore be treated by dental extraction, rather than undergo root canals, to limit the risk of more general illness. His research, based on case reports and animal studies performed on rabbits, claimed to show dramatic improvements after the extraction of teeth with non-vital pulps. Price's research fit into a wider body of testimonials in the dental literature of the 1920s, which contributed to the widespread acceptance of the practice of extracting, rather than endodontically treating, infected teeth.[20] Despite contentions in a 1927 review of Price's work of "faulty bacterial technique" in Price's 1925 publication, Dental Infections and related Degenerative Diseases, [21] Price's publication Dental Infections, Oral and Systemic was used as a reference in textbooks and diagnosis guides published in the mid 1930s.[22][23]
By the 1930s, the theory of focal infection began to be reexamined, and new research shed doubt on the results of previous studies. A 1935 Journal of the Canadian Dental Association article author would call Price radical while citing his comment in Dental Infections, Oral and Systemic of "continually seeing patients suffering more from the inconvenience and difficulties of mastication and nourishment than they did from the lesions from which their physician or dentist had sought to give them relief" as an example of one of 'the authorities that emphasize my contentions for conservatism' with regards to tooth extraction [24] and one researcher in 1940 noted "practically every investigation dealing with the pulpless teeth made prior to 1936 is invalid in the light of recent studies" and that the research of Price and others suffered from technical limitations and questionable interpretations of results.[25]
Three years after Price died in Santa Monica, California, a special review issue of the Journal of the American Dental Association confirmed the shift of standard of care from extraction back to endodontical dentistry.[26] In terms of more modern research, Price's studies lacked proper control groups, used excessive doses of bacteria, and had bacterial contamination during teeth extraction, leading to experimental biases.[20]
In 1994 George E. Meinig published Root Canal Cover-up Exposed which resurrected the outdated studies of Rosenow and Price, raising the concern that patients hearing about these studies might view them as new and reliable.[27] A book review in the Annals of Dentistry critical of Meinig's book noted Meinig based his ideas entirely on Price's 1923 Dental Infections, Oral and Systemic, and that Meinig's book suffers from a lack of professional editing, makes unsubstantiated claims, confuses basic terms (such as infection and inflammation), and expands into areas unrelated to the main topic to the point the reviewer ends the review with the comment "I wonder how the serious researcher Weston Price would have reacted to the way his work has been presented." The review also points out that Price's work has been well discussed and has not been covered-up, and notes that although Price's theories were later supplanted by subsequent research that found endodontic treatment is safe and effective, his focus on the biology of teeth and infection is still relevant in more modern dentistry as some clinicians have placed more emphasis on technology and poorly tested procedures for the treatment of infected teeth.[28]
More recently the Weston A. Price Foundation was co-founded in 1999 by Sally Fallon and nutritionist Mary G. Enig to disseminate the research of Dr. Weston A. Price. This foundation has been criticized by health advocates, such as Stephen Barrett of the Quackwatch website, on grounds that the core assumptions of Price's original work are incorrect and contrary to contemporary medical understanding.[29] The Foundation has written a rebuttal to Barrett's claims.[30] William T. Jarvis' article, "The Myth of the Healthy Savage" noted that his work on primitive diets is still widely sourced by dentists who emphasize nutrition, but argued that it had shortcomings that Price overlooked due to a steadfast ideologically motivated adherence to the notion that the modern diet led to physical degeneration.[19] The foundation has written a rebuttal to the arguments contained within the article, that have also been raised by other critics.[31] Another foundation, originally known as the Weston A. Price Memorial Foundation, the Price-Pottenger Nutrition Foundation (PPNF) was established in 1952 as a non-profit organization that serves as the guardian for the archived material from the research of Weston A. Price and medical doctor Francis M. Pottenger, Jr.
In a statistical overview derived from writings by and about Weston Price, OCLC/WorldCat encompasses roughly 10+ works in 50+ publications in 4 languages and 1,000+ library holdings.[32]