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Question & Answer - Dental

What is contributing to non-communicable diseases, and what are the dire consequences on health?

Commentary by Dr. Barry Raphael, DMD, orthodontist in Clifton, NY, USA

September 2017


Gary Taubes, the medical journalist and author of The Case Against Sugar (Alfred A. Knopf, 2016), wrote a column for the New York Times in July, 2017 called Are You a Carboholic? Why Cutting Carbs is So Tough. He summarizes what we have come to understand about our food source: It is not only addicting but a chronic stressor, too. It is just one of many examples of how our modern environment, while easy and wonderful in so many ways, has fostered a host of unintended consequences that now plague us.  

These consequences are the Chronic Non-Communicable Diseases (NCD) of civilization. The World Health Organization now recognizes these NCD's as "one of the major challenges for development in the 21st century, undermining social and economic progress throughout the world." (Dr. Chan, Director General, 2017).  

The underpinnings of NCDs, according to Dr. Chan, are tobacco abuse, alcohol abuse, sugar abuse, and physical inactivity. The symptoms of NCDs (a list too long to print) include obesity, heart disease, diabetes, digestive disorders, autoimmune diseases, and so forth. We know these diseases are not only occurring with greater frequency and intensity but appearing at younger and younger ages.

While sometimes the diseases don't become a pathology until the symptoms hit a certain threshold (often determined by medical orthodoxy or insurance reimbursements), the astute clinician can often spot the precursors to NCDs well before they become clinical. The more focused our assessment skills of pre-clinical signs become and the sooner we can pick up on these precursors, the easier it will become to prevent the full expression of the NCD pathology. 

For instance, in my field of orthodontics, the typical approach to the NCD of crooked teeth is to wait for the permanent teeth to grow in before declaring it to be time for braces, usually in the teenage years.  But, we know the precursors to malocclusion begin at birth when cultural compensations like bottle-feeding, pacifiers, processed pre-chewed foods (such as chicken nuggets containing ground meat), and sippy cups are used and when physiologic adaptations like mouth-breathing, forward head posture, finger sucking, and over-breathing are used to deal with the chronic stressors of the modern environment. 

If a 4-year old's baby teeth don't have spaces between each of the front teeth, I already know there is trouble brewing. If a toddler’s chin doesn't come forward, if the upper teeth begin to sag in the face, or if the upper jaw is narrow in shape, I already know there will be problems not just with the teeth but with the breathing spaces behind the jaws that so affect nighttime breathing and sleep. And, fragmented sleep has its own set of physical and mental consequences, as we all know.

So the question is: Why would I even WANT to wait for the teenage years to straighten the teeth when they are just symptoms of other, more important health issues? Fortunately, new approaches to mitigating these early signs are available, and practitioners in many areas are beginning to pick up on methods of prevention. In my field, I can help the jaws return to their proper shape, re-establish good function, and teach the good health habits that will keep the child on a pathway to lifelong health. In medicine, the movement toward Functional Medicine does the same for the entire list of NCDs, if given the chance.

I'm sure readers of this blog have been listening to Diane Bahr talk about the necessity of early intervention. She is spot on, not just in terms of setting up the conditions for better articulation and communication but for bigger areas of health as well. The sooner we come to grips with the precursors of these chronic, non-communicable diseases, the better the life-long prognosis for health.

If our government could take its head out of the “Insurance Provider sand” and wake up to the "An ounce of prevention is worth a pound of cure," addressing the possibility of treating NCDs at their beginnings, we could turn around the health of our people for generations to come.  And, we need to.

About Dr. Barry Raphael, DMD

Dr. Raphael has been a specialist in orthodontics for nearly 30 years. Prior to that, he was a General Dentist for 3 years. He has the following affiliations:

  • Member American Association of Orthodontists
  • President New Jersey Association of Orthodontists 2016-2018
  • Board of the AAO Donated Orthodontic Services
  • Member American Dental Association
  • Past-President Passaic County Dental Society
  • American College of Dentists
  • American Academy of Physiologic Medicine and Dentistry - Chairman Orthodontic Section

Dr. Raphael’s integrative practice is located in Clifton, New Jersey where he also invites presenters from a variety of fields to teach at The Raphael Center for Integrative Education. Contact Barry Raphael at


Chan, M., Director General of the World Health Organization (2006-2017).

Taubes, G. (2016). The case against sugar. Canada: Alfred A. Knopf Publishing.