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KEY WORDS: dental caries, human, history, Vipeholm.
BACKGROUND
In the 1930s, it had been clearly documented that dental health in Scandinavia was extremely poor. In three-year-old children, dental caries occurred in 83% of the deciduous teeth (Roos, 1944), and only one out of 1000 conscripts was caries-free (Westin and Wold, 1943). Furthermore, a comprehensive socio-medical study in the northern part of the country indicated a causal relationship between poor diet and some diseases. This led to some important decisions. One of these was the resolution in the Swedish Parliament that a Public Dental Service should be organized. When the service was planned, it was found that the cost would be very great, since the need for dental care was tremendous. This finding resulted in a proposal to the Parliament about the need for research in prevention, and the Swedish Government asked the Medical Board "to perform in collaboration with the Dental Institute a general investigation concerning what measures should be taken to decrease the frequency of the most common dental diseases in Sweden". [The Dental Institute in Stockholm, associated with the Karolinska Institute, was the only dental school in Sweden at that time.] Comprehensive committee work began, and it gradually resulted in a decision to perform a clinical study on diet and dental caries at the Vipeholm Hospital, a hospital for individuals with mental handicaps, situated outside the university city of Lund. It was thought that an institution of this type, with a large number of virtually permanent patients, would provide an opportunity for long-term nutritional studies to be performed in well-controlled conditions.
In the introduction to the study (Hojer and Maunsbach, 1954), it was stated: "Studies hitherto available have not provided a definite answer to such basic questions as to whether dental caries should be regarded as the expression of a disturbance of the general condition...