LITTLE BLUE BOOK NO. 688
Edited by E. Haldeman-Julius
Teeth and Mouth
Hygiene
Louis Reiss, D. D. S.
and
William J. Fielding
HALDEMAN-JULIUS COMPANY
GIRARD, KANSAS
Copyright, 1924,
Haldeman-Julius Company.
PRINTED IN THE UNITED STATES OF AMERICA
CONTENTS
Chapter Page
1. Teeth and General Health 5
Dental “Caries” or Tooth Decay 6
Antiquity of Dental Diseases 9
Dead Teeth and Their Results 10
Focal Infection 12
Teeth and Facial Development 13
2. Mouth Hygiene 15
Results of Oral Hygiene 16
How to Clean the Teeth 18
The Tongue 21
Mouth Washes 22
Bleeding Gums 24
Stomatitis 24
3. Teeth in Infancy and Childhood 26
Mother Builds Her Baby’s Teeth 27
Teeth in Infancy (with Chronology of
the Deciduous Teeth) 29
Dietary Hints for Infancy 31
The Permanent Teeth (with Chronology of
Their Usual Appearance) 35
Infant Mortality From Tooth Troubles 37
Normal Signs of Teething 38
4. Pyorrhea and Other Dental Diseases 40
Treat It Early 42
Ravages of Pyorrhea 43
Abscesses--Acute and Blind 45
Impacted and Unerupted Teeth 48
Cancer of the Mouth 49
5. Teeth and Diet 50
Proteins--Carbohydrates--Sugar--Cellulose--Fats--Mineral
Salts--Vitamines 51
Table of Principal Nutritional Elements of
Common Foods 54
Diet for Expectant Mothers 55
6. Importance of Dental Attention 57
Periodical Examinations 57
Dental Care for Expectant Mothers 58
X-Ray Examinations 59
Bridgework and Crowns 61
Prophylactic Dentistry 63
TEETH AND MOUTH HYGIENE
CHAPTER 1.
TEETH AND GENERAL HEALTH
It is only in very recent years that the true relation of the teeth to
the general health has been adequately realized, either by the dental
or medical professions.
As late as 1910, Dr. W. Hunter, a famous English physician, in an
address on “_The Role of Sepsis and Antisepsis in Medicine_,” was the
first to definitely stress the harm done by what he termed “septic
dentistry.” He had observed the serious results in many cases from the
attempt to treat teeth as if they bore no relation to the body as a
whole.
With the best of intentions, there was a tendency before that time
to save the tooth, regardless of its diseased condition, if it could
be patched up in such a way that it would look presentable and
contribute its share to mastication. It was a case of cosmetics and
utilitarianism. The pathology behind the diseased tooth was not taken
into consideration.
While Dr. Hunter’s criticism was at first bitterly resented by the
dental profession, subsequent investigations disclosed in the main the
soundness of his position. As a result dental procedure, since that
time, with respect to the treatment of diseased and infected teeth, has
been very largely revolutionized.
The up-to-date dentist no longer merely considers his patient’s tooth.
Instead, he considers the patient as an organic entity, fully knowing
that one diseased tooth may cause trouble in any organ, nerve or
muscle of the body. Also, it may affect the mind, causing various sorts
of mental aberrations, and in extreme cases has been known to cause
death.
Of course, preventive dentistry, which is and has always been the great
constructive goal of the profession, has not been essentially changed
by the present knowledge of the constitutional character of dental
sepsis. After all, the great field of dental and mouth hygiene lies in
keeping the teeth sound and healthy from infancy, throughout life, and
this is the premise which will be stressed in the present treatise.
It is infinitely more desirable to build a sound structure in the first
place and keep it in a healthy condition, than it is, by neglect or
ignorance, to build an imperfect one and allow it to run a quick course
of deterioration and ruin. And as we shall show, a good, sound set of
teeth can be built up in the individual, if we begin soon enough, and
the teeth can be kept healthy and intact during a long lifetime.
Fortunately, by proper attention to diet, mouth hygiene and the
precaution of periodical dental examinations, there is no reason
why every individual, if correctly started out in infancy--or, more
strictly, in the embryonic life--should not have sound, healthy teeth.
DENTAL “CARIES” OR TOOTH DECAY
Teeth as a factor in health and well-being, or in morbidity and
disease, exert a profound influence in every individual’s life.
Often this influence, whether for good or ill, is concealed and
unsuspected. At the high-tide of health and vigor, we do not realize
how tremendously indebted we are to our teeth.
On the other hand, in ill health and disease, we do not begin to
suspect the role which the teeth play either as the principal or
contributing cause of many of our maladies and miseries.
The most common of all the ills to which the human body is heir is
decayed teeth. It is a disease to which all races and tribes are
subject, and yet it is a disease preeminently of higher civilization.
While it is true, according to the data we have at hand, that no class
of people in the past, whether savage, barbarian or semi-civilized,
has escaped wholly from dental maladies, yet it is certain that, under
existing conditions and with modern dietary habits, civilized people
are particularly susceptible to diseased teeth.
Like many other diseases, decayed teeth and abnormal conditions of the
mouth, play the greatest havoc with the poor.
There are many factors involved in the healthy upkeep of the teeth, and
in their disintegration and destruction, which are not generally known
to the layman.
As an instance, it is conceded by the dental profession that the
prevalence of decayed teeth among females is decidedly more pronounced
than among males, some authorities placing the ratio at three to one.
The periods immediately preceding motherhood and during nursing are
particularly favorable to dental troubles, for reasons which will be
set forth in a subsequent chapter.
Dental _caries_, or tooth decay, is but the beginning of a long series
of maladies which may finally undermine the general health.
The accumulation of tartar deposits, and of particles of food
between the teeth and in the crevices of the gums are the principal
cause of tooth decay. Bacteria in colonies, called “plaques,” form
on tartar-laden and unclean tooth surfaces, and especially in the
interspaces.
The bacteria are nourished by food, especially the easily fermentable
carbohydrates, of which the most prominent are sweets. As the colonies
of bacteria are protected by a gelatine-like membrane from the
neutralizing effect of the saliva, the sugar and other carbohydrates
ferment underneath.
Lactic acid is thus produced which comes into direct contact with the
tooth, dissolving the inorganic enamel. This is the beginning of the
formation of a cavity.
It is true there is a great difference in the resisting powers of
teeth. Hard and well-formed teeth resist decay, while teeth of poor
quality readily fall prey to disease.
Tartar is a rough substance, dark brownish or greenish in appearance,
and is usually the result of local causes, but general conditions may
also be a factor.
The saliva contains a certain quantity of salts. These salts, mixed
with food debris, cause the particles to adhere in deposits around
the teeth. The quick formation of tartar is the product of organic
decomposition. This, in turn, becomes a powerful irritant to the gum
and induces inflammation.
A foul-smelling mouth and breath of objectionable odor are the usual
accompaniments of tartar deposits. This may be followed by chronic
spongy gums and perhaps pyorrhea--a discharge of pus from the gum
pockets, often associated with complicated disturbances throughout the
whole system.
It is perfectly evident that a filthy condition of the mouth which an
accumulation of tartar produces, is a seat of active incubation for the
germs of many diseases. Some characteristic cases of this kind will be
taken up under the appropriate heading.
ANTIQUITY OF DENTAL DISEASES
There are very conclusive records of dental infections, and of
elaborate, systematic attempts made to relieve these maladies, dating
far back into human history. Anthropology and archæology contribute,
with history, their testimony to mankind’s ancient dental disabilities.
Many Egyptian mummies, and even skulls of prehistoric periods, show
very definite evidences of caries, or decayed teeth, and other diseases
of the teeth. One of the oldest of these specimens, an Egyptian mummy
of the period about 2800 B. C.--more than four thousand, seven hundred
years ago--may be seen in the British Museum.
Herodotus, the Greek historian (born 484 B. C.), who visited the
valley of the Nile to study the religion and sciences of the early
Greeks, gives an interesting account of the customs and habits of these
ancient people, who enjoyed a relatively high degree of civilization.
He found in those early days that medicine and surgery were divided
into distinct professions, and each of these branches had its trained
specialists. There were specialists of the ears, eyes, teeth and
internal organs. So we learn that dentistry had reached the dignity of
a specialized profession more than two thousand, five hundred years ago.
Not only of the old world is there evidence of ancient dental
pathology. There are in the National Museum in Washington collections
of skulls of prehistoric inhabitants of North and South America, which
betray the existence of dental caries, and even more so of alveolar
abscesses, caused by death of the tooth pulp from wearing down of the
teeth.
“DEAD” TEETH AND THEIR RESULTS
The living, organic part of the tooth is the pulp, which is supplied
with nerves and blood vessels. The function of this important tissue
is to give sensation and supply nourishment to the tooth, which means
_life_. Like any other tissue that is nourished by blood, a tooth has
little chance of surviving if it is deprived of its chief source of
blood supply.
That is why it is so necessary, as soon as a small cavity appears in
the tooth, to check it by means of a filling. If the small cavity is
not attended to at once, the tooth is doomed to a troublesome career.
The decay gradually saps the vitality of the pulp, endangering the very
life of the tooth.
Many persons, probably under the influence of an older and now obsolete
school of dentistry, are too anxious to have the “nerve” (pulp)
removed, thinking that by so doing the pain will disappear forever.
But this is only the beginning of more serious trouble. The tooth so
deprived remains an easy prey to various changes that occur in the
system and is very susceptible to blood derangements, making it a
target of attack for ulcers, or abscesses.
Generally speaking, a “dead” tooth is a hazard one can ill afford to
carry around in one’s mouth, and it may become a very real danger. When
the nerve and blood supply to the tooth structure have been removed,
there is bound to be a process of putrefaction going on. If the system
is in perfect condition, it may be able to eliminate the putrid
secretions from this source without _apparent_ ill effects.
On the other hand, if the vitality becomes low and the bodily
resistance weakens, there is no telling what effect a “dead” tooth
carried around in the mouth will have.
The pains are not by any means limited to the jaws and adjacent parts
of the face, although these are common enough, such as neuralgia, which
may attack the eye or ear in a most excruciating manner.
There are countless numbers of cases of bodily ailments, rheumatism,
diseases of the blood, liver, kidneys, heart, eyes, swellings in the
legs and finger joints, even nervous exhaustion and insanity, that are
due to chronically infected teeth.
Dr. Henry A. Cotton, medical director of the New Jersey State Hospital,
has proven with many cases under his care, that physical disorders,
such as infected teeth and tonsils and infections of the stomach and
intestines, _cause more insanity than heredity_.
One of the first things Dr. Cotton does when a so-called insane patient
is brought to his institution is to examine and X-ray his teeth, and
provide radical treatment when the result of the examination shows it
to be necessary. Other physical disorders are, of course, searched for
and treated when present.
Either mental aberrations, or physical ailments which result from
infected teeth, are due to the accumulation of toxins (poisons) in
the system, which lower the resistance of the organism, and assert
themselves where the resistance is weakest. If one has a weakness in
any part of the body, it may soon become the seat of serious trouble.
If there is a predisposition to mental disturbances, these disorders
may ensue.
FOCAL INFECTIONS
If an infection starts in one part of the body and is transported to
another part, the process is termed a focal infection. The original
site of the disease is called the focus, and the germs and toxic
material (poisons) are absorbed by the blood and cause the secondary
infection in the new location.
The most frequent dental focal infections (for there may be _foci_ in
other parts of the body, as well) are the diseased pulp of a decayed
tooth, an infection at the end of a root, and severe cases of pyorrhea.
It is important to remember that pain is not necessarily present in a
focal infection--although it may be strongly in evidence. Nor is good
general health a certain sign of the absence of a focal infection.
Good health may mean that the vitality is so great and the resistance
to disease toxins so strong that the poisons emanating from the
infected tissue are for the time being successfully eliminated from the
system.
This process, however, is a constant, abnormal strain on the organism,
and in a crisis, or when the vitality or bodily resistance is lowered
from whatever cause, a serious reaction may occur. This will assert
itself, probably not in the focal seat, but in some other part of the
body, selecting some particular organ that is not quite as strong as
the others, or it may become constitutional in character, and strike at
the whole organism.
When there is a doubt or some question of the probability of a dental
focal infection, even in the case of teeth of thoroughly sound
appearance, it is desirable to have an X-ray taken of the teeth. If
there is a latent infection or blind abscess, the X-ray will reveal
the fact, and drastic action should be taken to rid the body of this
liability to health, this menace to the welfare of the organism.
Besides specific organic disturbances that may result from focal
infections, other troubles of a more general character sometimes
occur--so-called constitutional defects. Among the symptoms of these
are fever, rapid pulse and respiration, dry, hot skin, constipation,
highly colored urine, later sweating, sometimes accompanied by delirium
at night. Where the absorbed bacteria grow in the blood, the condition,
which is a serious one, is known as _septicemia_, popularly called
“blood-poisoning.”
As the process of chronic pus absorption takes place rather slowly,
there are usually no sudden and acute symptoms. This gives the victim
a sense of false security, which permits ever-present dangers to be
underestimated or ignored, with results that are sometimes ruinous to
the general health.
TEETH AND FACIAL DEVELOPMENT
The teeth influence our health and lives in many ways, as we have
already shown, and which will further be elaborated upon in the
chapters that follow.
It is worthy of mention, however, that the teeth have a definite
influence in the formation of the jaws and face, and in facial
expression, determining whether the expression shall be pleasing and
attractive, or ugly and repellent.
There is no mistaking the fact that sound, symmetrical and healthy
teeth beautify the face. This is not only a fact of cosmetic interest,
but it implies that we should make the most of our natural resources,
physical and mental. Besides the purely physical reflection of good
dental economy, there are also mental influences that are worthy of
mention.
The presence of a set of sound teeth in childhood, for instance,
tends to the development of the jaw, which improves the contour and
appearance of the face. If a child loses his deciduous (milk) teeth
too soon, or if the first of the permanent teeth decay quickly,
there is apt to be a shortening of the jawbone in the course of its
growth, which will be anything but desirable for the appearance of
the individual. Furthermore, a condition of this kind leaves its
deleterious imprint in other ways.
The human teeth were meant to use (not for non-use or abuse), and
use implies plenty of work on foods that have to be well chewed and
masticated before they should be swallowed.
There is a grain of truth in the witticism “one can be what one chews
to be.” If adequate teeth are lacking, or if, for other reasons, a
person--particularly a young, growing person, does not chew his food
sufficiently, or is in the habit of eating soft foods which require
little chewing, this fact may have a pronounced influence on the shape
of his face, his expression, his health and mental development.
If a child is backward physically, he is almost invariably backward
mentally. After all, the organism--body and mind--is a unit, and one
part of the organism cannot be neglected or abused without detriment to
the rest of it.