CHAPTER 6.

IMPORTANCE OF DENTAL ATTENTION

_Periodical Examinations._ Mouth hygiene is a regular daily routine, as much so as washing the face and hands, and faithful attention to this requirement is not only an index of personal cleanliness, but a means of prolonging the health and usefulness of the teeth, and contributing to the physical well-being generally.

This daily practice, however, should be supplemented by regular, periodical dental examinations, at least every six months with the average person. If the teeth are below par, and contain many fillings, or much other dental work, it may be advisable to have the teeth inspected oftener.

The advantages of keeping the teeth intact, or preventing further damage when inroads have already been made upon the dental economy, and the dangers involved in infected teeth and gums, have been so fully covered already that it is unnecessary to elaborate upon the subject here.

It is decidedly to every individual’s advantage to adhere religiously to the policy of regular, periodical examinations. Do not for a moment deceive yourself into thinking that you are saving money by neglecting this requirement.

If the examination shows that no fillings or other operative treatment are needed, then you have the keen satisfaction of knowing that your teeth are in good condition. If some slight specks or small cavities are detected, they can be filled without much trouble, pain or expense, and you have forestalled a bigger and more painful job, and perhaps saved the tooth many more years of service by timely attention.

In any event, the expense is always minimized by having the teeth examined regularly, and receiving prompt treatment when they show the first signs of decay, or when a piece of tooth breaks off, or any other dental problem presents itself.

To reiterate, save your health, your teeth, and your money by _periodical dental examinations_.

DENTAL CARE FOR EXPECTANT MOTHERS

The expectant mother, in particular, should be careful of her teeth from the very beginning of pregnancy. We have already emphasized the importance of diet, and made various recommendations in this respect.

However, tooth decay and acute abscesses are especially liable to occur at this time, if there is the least deficiency in the normal tooth structure or inadequacy in the diet.

Because of the demands upon the expectant mother’s physical resources and vitality--a latent infection or other predisposition to dental trouble only too often results in quick decay, tooth-aches, abscesses and a general undermining of the health of the teeth.

Infected teeth should be extracted, cavities filled, and the mouth and gums kept in a healthy state.

X-RAY EXAMINATIONS

While we have spoken of the normal, clinical examinations of the teeth, it is always important to mention the possible desirability of X-ray examinations. Teeth should be X-rayed by a dentist, or sent to an X-ray laboratory only upon his advice. It is a mistake to go to commercial X-ray laboratories for diagnoses.

No matter how placid the gums and teeth may look, or how free from pain, there is no way of discovering the condition beneath the surface except by an X-ray picture. If the teeth contain any large fillings, pulpless teeth, crowns, bridgework, etc., even if there is no inflammation or unpleasant sensation, one should have the teeth X-rayed. This is especially true if there are any general physical disabilities which may come from a focal infection.

The X-ray picture will show a great amount of detail of the subsurface structure, and the condition of the various parts. It will show whether there is any infection at the root end of the tooth, and whether or not there are pus pockets at the side. It will also disclose whether a tooth has a root-canal filling, and whether or not this filling is perfect. Leaky fillings, overhanging gold crowns and other defects can likewise be detected.

The X-ray exposes faulty dental work, as well as pathological conditions of the mouth and jaw.

It is particularly important to have a thorough X-ray examination if one has any “dead” or pulpless teeth (from which the nerve has been removed). In the light of modern, antiseptic dentistry, these members are suspicious characters, and should be closely watched, even if apparently giving no trouble. The disadvantages of pulpless teeth as a hidden menace to health may far outweigh their advantages for mastication.

Another advantage of the X-ray is that, if dental trouble cannot definitely be located, so that the source of the disturbance may be in either one of two or more teeth, it can be traced by this method. This enables the dentist to make an accurate diagnosis. Many mistakes in treatment can be avoided by the use of the X-ray at a great saving to the patient of both trouble and expense.

There is no question that many sound, or comparatively good teeth, have been pulled in the case of vague, indefinite tooth-aches, and swellings--often at the insistence of the patient himself--only to be found that the trouble remained undiminished.

Dr. Eugene Lyman Fisk, Director of Hygiene of the Life Extension Institute, New York, has given a striking example of the benefits to be derived from an X-ray examination, with proper treatment as shown to be required by the diagnosis, in the following paragraph:

“Perhaps the most essential feature of the periodic examination is the X-ray, without which the discovery of some sources of physical impairment would be impossible. An instance of its value is the story of a man who was suffering from rheumatism and cystitis. He had severe pain and had lost weight very much before coming to the Laboratory. During the examination it was discovered that, although most of his teeth were gone, he had still about half a dozen, all of which were loose, and he wore a plate. An X-ray of his teeth showed that all of them were abscessed, which caused a continuous drainage of poison into the system. He was advised to have his teeth out. A few days afterwards he returned to the institute. His rheumatism and bladder trouble had practically disappeared and he no longer suffered pain. After six months, it had not returned. Infected teeth often cause rheumatism, as almost everyone knows, but the interesting feature of this case was that the bladder trouble apparently also came from the same source.”

BRIDGEWORK AND CROWNS

There are two types of bridges--the _fixed_ and the _removable_. The former is cemented to the teeth on either side of the space for which the missing teeth are supplied. It is undoubtedly the most efficacious form of dental structure, from the mechanical standpoint, as it simulates the more natural teeth more closely than any other form of artificial denture.

Often a single artificial tooth is bridged to an adjoining natural tooth. If a fixed bridge can be contrived, without imperiling the tooth or teeth to which the bridgework is anchored, it is an extremely serviceable arrangement. It may help to carry along a set of inferior teeth for some years, under strict dental supervision, until it finally becomes necessary, because of the deterioration of the teeth, to eliminate the bridgework in favor of a plate.

Objection is often made to fixed bridges on account of the unhygienic conditions which frequently exist under them. This, of course, may be due to careless or indifferent cleansing on the part of the patient. Under modern antiseptic dentistry, fixed bridges are not looked upon with such universal favor as they were at a former period, although, as we have stated, there are cases when they may be recommended. When supplied, they must always be made so that no injury is done to the tissues, and with the least possible tooth destruction; nor must they interfere with the hygienic conditions of the mouth. Bridges with worn out crowns are a menace and endanger the vitality of the pulp. When the crowns become worn through they should be removed immediately, and a new bridge supplied.

Removable bridges are considerably more sanitary, inasmuch as they can be taken out and cleaned, and the anchoring teeth thoroughly brushed. There is always the possibility, however, of the attachments--no matter how carefully made--causing friction on the anchoring teeth, and this may result in erosion. Some owners of the removable bridges make it a habit of leaving the denture out of the mouth for considerable periods at a time, and as the natural teeth change their relation slightly if the bridge is not worn constantly, it is not long before the appliance does not fit well. It is also advisable to wear the bridge at night, after cleaning, to preserve the proper relationship of the teeth.

Gold crowns are not nearly so popular as they once were, and there is no assurance, even when most skilfully made and perfectly fitted, that the gums will not be irritated and pus pockets form. Many defective teeth that were formerly crowned are now reinforced by other more hygienic technique, if it is considered advisable to still retain the tooth. As it is usually pulpless teeth that are crowned, it may seriously be questioned whether it is ever policy to resort to this unhygienic and generally unsatisfactory denture.

PROPHYLACTIC DENTISTRY.

Preventive dentistry is now one of the greatest of modern agencies for improved individual and social health. Its influence is far-reaching and will continue to be greater as the advantages of sound teeth become more widely recognized.

The clinical and mechanical resources of dentistry are now developed to a remarkable degree of efficiency. This science reaches its highest state of perfection in the prophylactic realm. With even an elementary knowledge on the part of the great masses of people of the profound importance of oral hygiene, and constructive dietetics, there will be prevented an immeasurable amount of disease, ill health, pain and the inconveniences that are the inevitable accompaniments of unsound and imperfect teeth.

It is to hasten this thoroughly practical end, and help achieve this enviable goal, that the authors have written the present little book.

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TRANSCRIBER’S NOTES

Typographical errors corrected. However, grammatical errors have been left untouched.

Inconsistencies in hyphenation standardized.

Missing section headers on page 24 and 63 (all caps) added.