Dental Hygiene And Care
( Originally Published 1936 )
It is important that even the first teeth be carefully watched, kept clean, and decay and cavities be attended to. These teeth are necessary for mastication during the years of most rapid growth, and so may influence the general health of the child. Proper brushing and washing of the mouth is important from early years. Careless habits of babyhood may have lifelong effects. Persistent thumb-sucking tends to pull the upper front teeth for-ward, and misshape the upper jaw. Misplacement of the teeth prevents proper action in biting into foods, and a changed shape of the jaw is likely to lead to poor occlusion of the teeth and consequent poor results in chewing. Incomplete mastication is followed by poorly digested food and disturbed nutrition. Good mastication exercises the teeth and their supporting tissues. Children should be given some food requiring biting and chewing just as soon as they have teeth. Brushing the teeth and keeping the gums clean and the mouth free from decaying or fermenting food are hygienic habits to be encouraged at all ages.
Where teeth are misplaced the services of an orthodontist at an early age will result in correcting the alignment and restoring symmetry to the jaws, thus aiding the function of the teeth. Regular inspection of the teeth, preferably by a dentist, should be provided for all. Frequently, a defect observed early may be cared. for so as to avoid permanent damage.
SOME DISEASES AFFECTING THE TEETH
Pyorrhea. This is a disease seen frequently in adults. It is characterized by bleeding from the gums following the most gentle brushing. It is generally believed that pyorrhea begins as a soft tissue infection with a slight swelling of the gum tissue, and later the small blood vessels become engorged, this being the reason for the continuous bleeding when pressure is applied. Secondly, the alveolar bone, or the bone in which the teeth are placed, is affected, a degeneration of the bone resulting in the presence of pus about the teeth and a loosening of the teeth themselves.
Certain research work 'shows that blood vessel diseases and injury to the odontoblasts (teeth-building cells) and pulp are early manifestations of scurvy. Extensive clinical work supports the idea that one of the factors in the production of pyorrhea is the scurvy-like state of the gums due to a deficiency of vitamin C. In giving large amounts of orange juice flavored with lemon juice together with raw vegetables, such as lettuce and cabbage, favorable results were obtained in the treatment of this condition. These foods are rich in vitamin C and contain fairly large amounts of available calcium. Since most adult diets contain too little calcium, these may very well have brought about a better calcium-phosphorus balance in addition to supplying an adequate amount of vitamin C.
Caries or Dental Decay. The problem of decay is one which has confronted civilized man ever since he was able to leave decipherable records. Some of the earliest medical literature dwells at length upon this subject. Hippocrates, usually referred to as the father of modern medicine, advanced a very interesting theory as to the cause of decay—that it was caused by stagnation of depraved juices in the tooth. Since that time man has endeavored to unravel the mystery regarding this unfortunate phenomenon.
There are two prevalent modern theories regarding this problem. While there has been much research work done in the past and considerable is being carried on at the present time with reference to dental caries, it has been approached usually from the bacterial or the metabolic points of view.
The points of interest in the bacterial theory are: first, that it is really an infectious process beginning and ending within the mouth. In a very broad sense the followers of the bacterial theory believe that the decay of teeth is due to the formation of an organic acid by micro-organisms in the mouth which break down the residual carbohydrates which are constantly present about the teeth. Second, that this product of carbohydrate fermentation has the power or the property to destroy the enamel rods which mark the beginning of decay.
The metabolic theory embraces any factors which might influence this condition, exclusive of those included in the bacterial theory. In planned experiments it has been possible to regulate the progress of caries almost at will. The various studies have included the effects of diets deficient in vitamin C, in vitamins A and D and in calcium and phosphorus. Diets have been used that include an excessive amount of sugar or oatmeal which apparently contains an ingredient not found in other cereals. In other instances the alkaline reserve of the body has been lowered, some particular chemical condition has prevailed in the mouth or glandular irregularities have been present. The fact that many findings appear to influence the integrity of the teeth, suggests that the cause of caries is not fully understood but that dietary deficiencies undoubtedly contribute to the presence of the disease.
The endocrine system or the influence of the ductless glands in the minds of many investigators is of paramount significance. They show us that the endocrine glands regulate many physiological processes such as the mineral balance of the body, which when disturbed may play a destructive role with reference to the teeth. Also the fact that decay is more prevalent during certain periods of life would tend to support this belief. As stated above, the ages when decay seems to be most active are between 4 and 6, 12 and 15, 22 and 25 years. The first period (4 to 6) affects the baby teeth and often the first permanent molars. The next period in which the incidence of caries increases is during puberty—roughly between 12 and 15 years. Certain endocrinologists postulate that the sex hormones play a decided role during this period. This, however, is theoretical. The last period of decay, based on a review of thousands of mouths by various clinicians, appears to be from 22 to 25 years. During this time young adults are subjected to severe emotional strain—starting life careers, establishing homes, and planning their futures.
Teeth Infections. The teeth have been intimately associated with the results of focal infection from our earliest understanding of the condition. Inflamed or injured gums may permit infection to develop about the roots of teeth; continued activity leads to destruction of the supporting tissues, and there is an absorption of toxic substances and bacteria from the pus pockets. De-vitalized teeth often have infection about their roots. Lack of aching or soreness is not proof of freedom from infection, because the nerve is lifeless or absent. At times cysts are found in the bone of the jaws. The cause of these is not always clear. Occasionally new growths of tissue appear about the teeth and in the jaws. These demand careful diagnosis and treatment by the oral surgeon.