Occlusal variation in a rural Kentucky community.

Some major theories concerning the etiology of malocclusion and its modern increase in frequency include genetic explanations, such as inbreeding, racial crossing, and accumulation of mutations, as well as such environmental causes as "habits," allergies, and caries causing reduced arch space of premature deciduous tooth loss. Reduction of masticatory stress resulting from modern urbanism is less often considered as an agent. Many examples of acquisition of gross malocclusion in aboriginal peoples immediately following dietary "modernization" contradict the genetic explanations. A rural population from central Kentucky presents several propitious social characteristics for epidemiologic study of occlusion. They have experienced almost no professional dental care, they are highly inbred (but less so during the last 30 years), and their diet included many difficult-to-chew foods until the recent introduction of industry to the area. Occlusion was evaluated according to the criteria of the Treatment Priority Index. The temporal change and correlates of occlusal variation were assessed on wax-bite impressions of thirty-four persons, informant dietary histories, and other information. The older inhabitants raised on more traditional diets show significantly better occlusion. Dietary consistency provides the most powerful explanation for the transition in occlusal variation, through it was not conclusive in these data.