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The focal infection theory and malpractice suits
ABSTRACT OF
CURRENT 1 E =zze =s z Z z z= es
LITERATURE Covering
ORTHODONTIA
-
ORAL
SURGERY -
=Es E
Such Subjects as
SURGICAL
ORTHODONTIA
-
DENTAL
z I E 1 z
RADIOGRAPHY
It is the purpose of this Joun~u to review so far aa possible the most important literature as it Authors are reappears in English and Foreign periodicals and to present it in abstract form. quested to send abstracts or reprints of their papers to the publishers.
The Importance of Early Recognition of Dental Disorders in CWdren. IJpons (Jackson,
Rlich.).
The Dental
D.
c.
Cosmos, May. 1924, lxvi, 5.
Tbc author has examined about 5,000 children of school age and has The average number of permanent teeth reachrd some interesting figurcs. emptrd at the apt of 10 is 16, the extremes being 7 to 28. TJndcr the circumstances it is thcrcfore rery difficult to speak of normal and abnormal. Cnrious drciduous teeth were uni\~-crsally present. But t,hesc wide limits arc not, at all physiological for they depend more than anything else upon precocious loss of deciduous teeth whether spontaneously or from extraction for any c’ausc. Th(l chief pathological consequence of premature loss of the first teeth is malocclusion and two out of every three cases of malocclusion arc clue to this causal factor. Malocclusion in turn is a prominent causal clement in the production of various dental disorders including pyorrhea. Hence the importance, first, of conserving the deciduous teeth as long as possible; and seeand. of correcting the consequences of precocious loss of these teeth at the varlicst possible momrnt .
The Focal Infection Theory and Malpractice Suits. Editorial of Interest,
in Dental
Items
JLU~C,1924. xlvi, 6.
While it is admitted that infection about a tooth. obeying general pathologic laws. can both extend locally and cause disease at a distance, it is by no means proved that dent,al infection is a dominant factor in the causation of T-arious types of chronic discasc. At present the opinions held in explaining the symptoms in a given case must bc regarded as largely personal. 3Ialpracticc suits against dentists arc com’mon enough but only recently has one been brought against the professional man for having failed to remove infected teeth. He was to have pulled certain teeth as a preliminary to fitting a denture, but through some alleged imperfection in the plate the patient, a man, refused to complete the payments. When t,he suit was filed, for $10.000, the dentist was surprised to find that the damage claim was I~ased on failure to extract eight infected t&h, which had “caused cert,ain systemic ailments. ” Since many damage suits are won through the allega511
512
Abstract
of Curmat
Literature
tion and proof of neglect, a good case might be made out for the plaiiltiff, judging from the extensive literature of focal infection. Even disbelievers in focal infection would be slow to admit that infected teeth are of any possible use, that is, in the absence of any conservative attempts to sterilize t,hem. The editor does not know whether radiographs were taken by the doctor or by anyone else. This is not customary in extractions preceding the fitting of artificial dentures. & ui t e aside from the merits and demerits of such a suit the entire principle of the suit is unjust for it would tend to confuse neglect with sober refusal to operate, based on the author’s private judgment.
The Relation of Faulty Diet to Dental Disease. K. Thoma Health,
(Boston).
Oral
May, 1924, xiv, 183.
The author cites various facts of interest from history and anthropology which appear to show a connection between diet, decay of the teeth and infection. Thus while some of the native African tribes are quite free from pyorrhea others show this affection. A careful study of diet showed that the nonimmunes live on cassava which forms a sticky mass that adheres to the teeth. The immunes did not eat cassava at all. It may also be shown that the appearance of pyorrhea among the old Greeks and Romans coincided with the introduction of elaborate cookery and especially of warm cakes and breads which adhere to the teeth intimately, whereas the old dry bread of the ancestors, made of coarse flour, was not adherent but the reverse-it tended to keep the teeth clean. At the present time the effect of a diet rich in sweets tends to lower the appetite for plain and simple foods which are often insipid. The mode of preparing food for the table also eliminates a certain amount of necessary mineral food and vitamin. The area of the beginnings of modern cookery in Greece and Rome was the first century A.D. and the methods of preparing food were imported from Asia Minor by returning soldiers. Not only pyorrhea but caries became common. In discussion of Thoma’s paper MacCallum of Montreal spoke of the excellent retention of sound teeth by the Scotch pioneers of Canada who lived on oatmeal, cheese, milk, fish and mutton. But mere restriction of diet to carbohydrate cannot of itself cause caries, for some of the lower class Chinese subsist almost entirely on millet, yet have no teeth troubles.
The Infiuence of the Nutrition on the Teeth. W. E. Deeks (New York). Dental
Cosmos, April,
The
1924, lxvi, 4.
The author, who is physician to the United Fruit Co., gives his experience in the following summary: The causes of dental anomalies are bound up in heredity, the diet and nutrition and other factors which may be summed up under environment. Nutrition counts double here because it plays a role in heredity. Protein should be of animal origin, fats may be of either animal or vegetable origin, carbohydrates from tubers, cereals, green vegetables and fruits. (Cereals should be from whole grains of wheat, oats and maize and a diet of these is superior to one of bread, biscuit, cake, macaroni, etc. In
CURRENT 1 E =zze =s z Z z z= es
LITERATURE Covering
ORTHODONTIA
-
ORAL
SURGERY -
=Es E
Such Subjects as
SURGICAL
ORTHODONTIA
-
DENTAL
z I E 1 z
RADIOGRAPHY
It is the purpose of this Joun~u to review so far aa possible the most important literature as it Authors are reappears in English and Foreign periodicals and to present it in abstract form. quested to send abstracts or reprints of their papers to the publishers.
The Importance of Early Recognition of Dental Disorders in CWdren. IJpons (Jackson,
Rlich.).
The Dental
D.
c.
Cosmos, May. 1924, lxvi, 5.
Tbc author has examined about 5,000 children of school age and has The average number of permanent teeth reachrd some interesting figurcs. emptrd at the apt of 10 is 16, the extremes being 7 to 28. TJndcr the circumstances it is thcrcfore rery difficult to speak of normal and abnormal. Cnrious drciduous teeth were uni\~-crsally present. But t,hesc wide limits arc not, at all physiological for they depend more than anything else upon precocious loss of deciduous teeth whether spontaneously or from extraction for any c’ausc. Th(l chief pathological consequence of premature loss of the first teeth is malocclusion and two out of every three cases of malocclusion arc clue to this causal factor. Malocclusion in turn is a prominent causal clement in the production of various dental disorders including pyorrhea. Hence the importance, first, of conserving the deciduous teeth as long as possible; and seeand. of correcting the consequences of precocious loss of these teeth at the varlicst possible momrnt .
The Focal Infection Theory and Malpractice Suits. Editorial of Interest,
in Dental
Items
JLU~C,1924. xlvi, 6.
While it is admitted that infection about a tooth. obeying general pathologic laws. can both extend locally and cause disease at a distance, it is by no means proved that dent,al infection is a dominant factor in the causation of T-arious types of chronic discasc. At present the opinions held in explaining the symptoms in a given case must bc regarded as largely personal. 3Ialpracticc suits against dentists arc com’mon enough but only recently has one been brought against the professional man for having failed to remove infected teeth. He was to have pulled certain teeth as a preliminary to fitting a denture, but through some alleged imperfection in the plate the patient, a man, refused to complete the payments. When t,he suit was filed, for $10.000, the dentist was surprised to find that the damage claim was I~ased on failure to extract eight infected t&h, which had “caused cert,ain systemic ailments. ” Since many damage suits are won through the allega511
512
Abstract
of Curmat
Literature
tion and proof of neglect, a good case might be made out for the plaiiltiff, judging from the extensive literature of focal infection. Even disbelievers in focal infection would be slow to admit that infected teeth are of any possible use, that is, in the absence of any conservative attempts to sterilize t,hem. The editor does not know whether radiographs were taken by the doctor or by anyone else. This is not customary in extractions preceding the fitting of artificial dentures. & ui t e aside from the merits and demerits of such a suit the entire principle of the suit is unjust for it would tend to confuse neglect with sober refusal to operate, based on the author’s private judgment.
The Relation of Faulty Diet to Dental Disease. K. Thoma Health,
(Boston).
Oral
May, 1924, xiv, 183.
The author cites various facts of interest from history and anthropology which appear to show a connection between diet, decay of the teeth and infection. Thus while some of the native African tribes are quite free from pyorrhea others show this affection. A careful study of diet showed that the nonimmunes live on cassava which forms a sticky mass that adheres to the teeth. The immunes did not eat cassava at all. It may also be shown that the appearance of pyorrhea among the old Greeks and Romans coincided with the introduction of elaborate cookery and especially of warm cakes and breads which adhere to the teeth intimately, whereas the old dry bread of the ancestors, made of coarse flour, was not adherent but the reverse-it tended to keep the teeth clean. At the present time the effect of a diet rich in sweets tends to lower the appetite for plain and simple foods which are often insipid. The mode of preparing food for the table also eliminates a certain amount of necessary mineral food and vitamin. The area of the beginnings of modern cookery in Greece and Rome was the first century A.D. and the methods of preparing food were imported from Asia Minor by returning soldiers. Not only pyorrhea but caries became common. In discussion of Thoma’s paper MacCallum of Montreal spoke of the excellent retention of sound teeth by the Scotch pioneers of Canada who lived on oatmeal, cheese, milk, fish and mutton. But mere restriction of diet to carbohydrate cannot of itself cause caries, for some of the lower class Chinese subsist almost entirely on millet, yet have no teeth troubles.
The Infiuence of the Nutrition on the Teeth. W. E. Deeks (New York). Dental
Cosmos, April,
The
1924, lxvi, 4.
The author, who is physician to the United Fruit Co., gives his experience in the following summary: The causes of dental anomalies are bound up in heredity, the diet and nutrition and other factors which may be summed up under environment. Nutrition counts double here because it plays a role in heredity. Protein should be of animal origin, fats may be of either animal or vegetable origin, carbohydrates from tubers, cereals, green vegetables and fruits. (Cereals should be from whole grains of wheat, oats and maize and a diet of these is superior to one of bread, biscuit, cake, macaroni, etc. In