There's evidence that plant root fiber toothbrushes are at least as good as nylon bristle toothbrushes (keywords for search "miswak", "chewing stick"), eg:
https://www.ncbi.nlm.nih.gov/pubmed/15643758
(in my personal experience they work just fine, but they are more hassle than nylon toothbrushes because the bristles point in the same direction as the handle instead of to the side)
Of course, medical research is notoriously unreliable, but it's at least plausible that ancient humans had all the technology needed to keep their teeth in good condition.
While it is true that plaque can be removed with or without toothpaste, that fact is a little misleading in isolation.
The benefit of toothpaste is the topical application of fluoride. When applied topically in concentrations greater than 1000ppm, fluoride replaces a molecule in hydroxyapatite and creates fluorapatite. Fluorapatite is much more resistant to dissolution by acid. That is important because cavity-causing-bacteria in plaque gain entry into a tooth by bathing the tooth in lactic acid.
My driving instructor grew up on a farm in Portugal and claimed that he didn't brush his teeth until he was an adult. Shocked, I asked if he had many dental issues and he claimed that he had none because everything he ate came from the farm.
They are relevant for cavities, but the article is talking about all the other issues with our teeth, like not being aligned properly. Sugar has nothing to do with those problems, according to the article.
Pre-industrial skeletal remains are often seen with more teeth than we might expect.
Here are the ways you lose a tooth:
1. Trauma, like a hit to the face, that knocks a tooth out.
2. Abrasion on the biting surfaces that wears teeth down to a stub over a lifetime.
3. An infectious disease that destroys the teeth (cavities).
4. An infectious disease that destroys the supporting bone around the teeth (periodontal disease).
What we are doing wrong:
1. Not wearing mouthguards to play sports/drive cars (think about hockey players who are missing teeth).
2. Living longer means more wear (also the position of the teeth changed in a softer, post-industrial diet).
3. Fermentable carbohydrates are eaten more frequently throughout the day. Bacteria that cause cavities, like streptococcus mutans, ferment carbohydrates into lactic acid, dissolve the underlying surface of the tooth, and invade deeper into the tooth.
4. Periodontal disease typically starts to take its toll in the third decade of life. We live longer than our ancestors.
You're going to say "ewwwwww gross!", but: I do not brush my teeth. Haven't since I was 10 years old, I'm 34 now. The most I ever do is chew sugar free gum, or pick at my gum line with a fingernail in idle moments alone. You know, like humans did for a few million years. I have very little sugar in my diet.
When I go to the dentist every five or so years, they say "gosh you take good care of your teeth" and I smirk. Never had a filling, never had gum disease.
If I didn't chainsmoke and drink coffee like a gutter they'd not be slightly ivory coloured, as they are, rather white.
I view the dental hygiene industry rather like the anti-spot creme industry - once you start screwing with something, you have to keep screwing with it.
A final aside: I have 28 teeth, including wisdom teeth. Never had first molars, nor my mother or grandfather. Means the wisdom teeth fit just fine, and many a dentist who's not only convinced that I brush thrice daily but also had dental surgery. Apparently this isn't a common mutation.
Enamel can erode for years and still protect your teeth until suddenly it's worn away and doesn't protect your tooth anymore. I got similar feedback from dentists while not having great hygiene and suddenly in one visit after years and years of "doing great" I had four cavities.
My girlfriend has been bragging in a similar way and I've been trying to warn her to be more careful, and she knows exactly what all I went though (fillings kept falling out, eventually lost the teeth and needed a bridge).
The only reason I can see you being down voted is because you're not providing a constructive argument in HN standards against carbs. But you do make an excellent point. I'd like to add that in addition to the dental antropologist listed in the article [0], Weston A. Price [1] is also very well known for the role of agriculture (more carbs) in human dental change.
