Teeth and mouth hygiene

By Louis Reiss and William J. Fielding

The Project Gutenberg eBook of Teeth and mouth hygiene

This ebook is for the use of anyone anywhere in the United States and
most other parts of the world at no cost and with almost no restrictions
whatsoever. You may copy it, give it away or re-use it under the terms
of the Project Gutenberg License included with this ebook or online
at www.gutenberg.org. If you are not located in the United States,
you will have to check the laws of the country where you are located
before using this eBook.

Title: Teeth and mouth hygiene

Author: Louis Reiss
William J. Fielding

Editor: E. Haldeman-Julius

Release date: December 15, 2025 [eBook #77467]

Language: English

Original publication: Girard: Haldeman-Julius Company, 1924

Credits: Tim Miller, chenzw and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)

*** START OF THE PROJECT GUTENBERG EBOOK TEETH AND MOUTH HYGIENE ***

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

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.

CHAPTER 2.

MOUTH HYGIENE

The late Dr. Osler, one of the great physicians of the present age, in
an address delivered before the students of the Royal Dental Hospital
of London, said:

“You have just one gospel to preach, and you have got to preach it
early, and you have got to preach it late, in season and out of season.
It is the gospel of the cleanliness of the mouth; cleanliness of the
teeth; cleanliness of the throat. These three things must be your text
through life.”

“Oral hygiene--the hygiene of the mouth--there is not one single thing
more important to the public in the whole range of hygiene; and it is
with that which you, as practitioners, will have to deal.”

The emphatic statement of this great teacher and physician to a class
of dental students is repeated here because it clearly emphasizes the
supreme importance of oral hygiene--mouth cleanliness.

Unfortunately, it is not widely recognized how close is the
relationship between an unhealthy and unclean mouth and many serious
general diseases of the body, both of the infectious and non-infectious
types.

Of the former, children, in particular are highly susceptible, because
of their common practice of carelessly putting into the mouth objects
without much regard to their nature, or possible germ-carrying
properties. As a result, germs are conveyed to the mouth, where, if the
utmost cleanliness does not prevail, they find a favorable field for
incubation, and only too often visiting disease upon the child.

A knowledge of the principle of hygiene, which is acquired by children
who are taught to keep their mouth clean and wholesome, makes them more
careful not to put casual objects into the mouth.

RESULTS OF ORAL HYGIENE

By many it may seem trite to stress the importance of oral cleanliness,
when mouth hygiene is now considered a routine matter in the daily
lives of millions of people. But, strange as it may seem, there are
more millions by far in this country who are strangers to the tooth
brush than there are patrons of this agency of cleanliness.

A statistician some time ago estimated that less than twenty-five
million people in America are habitual users of the tooth brush. Simple
arithmetic tells us, therefore, that over eighty-five millions of
Americans are still to be converted to the merits of elementary mouth
hygiene.

Dr. Alfred C. Fones, a pioneer in oral hygiene, initiated a system of
mouth hygiene in the public schools of Bridgeport, Conn., in 1914, from
which was traced a marked decrease not only in dental diseases, but in
the contagious diseases common to childhood.

Dental hygienists were placed in the various schools, and their number
was increased until, in 1919, twenty-six were appointed. These women,
who received intensive training, both scientific and practical, in a
special school for dental hygienists, supervised the care of the mouths
of nearly twenty thousand children.

All possible emphasis was laid on cleanliness, and the _prevention_ of
dental decay. After decay has once set in, all work is of necessity
palliative, and has to be more or less continuous, with results that
cannot be foreseen.

Dr. Fones began the first year with the first and second grades.
A careful system of four distinct parts was arranged. First, the
hygienist would clean the teeth of every child in the school.

Secondly, tooth brush drills were practiced to teach a method of
brushing the teeth at home.

Thirdly, class-room talks relating to food and cleanliness were given,
supplemented by stereopticon pictures.

Fourthly, the parents’ interest and co-operation were obtained through
special educational literature.

As a result of this systematic work, in 1921, the reduction in dental
decay in thirty schools where the children were under treatment
averaged 69.3 per cent. One of the remarkable results was that out
of 1,161 children in the fifth grade, only 65 had cavities in their
permanent teeth.

Furthermore, the reduction in decay was accompanied by a reduction in
the percentage of retarded pupils, from an average of forty to twenty.

Communicable diseases as we have already observed, are highly prevalent
among children with unhygienic mouths. The greatest harm is often done
before the child starts to school because of the neglect on the part of
the parents in caring for their children’s mouths.

After the mouth hygiene system had been in effect in Bridgeport for
four years, there was a marked decline in the death rate of three
common diseases among children. The following figures give the death
rate per 100,000 population in 1914, before introducing the system,
and four years later:

1914 1918
Diphtheria 36.6 18.7
Measles 20. 4.1
Scarlet fever 14.1 0.5

This represents a reduction in these three diseases from 24.6 to 7.8
per 100,000 population.

Of course, it is impossible to prove that the entire results were due
to the mouth hygiene campaign. Perhaps other factors entered into the
situation. But there is no doubt in the minds of those who witnessed
and studied the remarkable accomplishments in Bridgeport, that by far
the greatest single factor in reducing diseases among children was oral
hygiene--a well-taught lesson in cleanliness.

HOW TO CLEAN THE TEETH

Every one should be on intimate terms with a tooth brush and a good
dentifrice (powder or paste) recommended by a dentist. It is desirable
that the teeth be carefully brushed after each meal. While the brush
is looked upon by some members of the dental profession as a bacteria
carrier, nevertheless, with proper care of the brush by the user,
and until some more hygienic agency is devised, we must continue our
allegiance to the tooth brush.

Some authorities advocate the rotary or circular movement of the brush
upon the teeth and gums, while others prefer the rolling of the brush
from the neck of the gum toward the biting edges of the teeth.

The former claim that when the gums are not in a healthy state, injury
from the bristles of the brush might result and cause irritations,
opening up avenues of infection. The latter maintain that no harm can
result from such procedure.

A middle course may be suggested. First, ascertain whether the gums are
firm and in a perfectly healthy state. If so, carefully brush the teeth
with a suitable powder or paste, in front and in the back. Care must be
taken that the brush reaches surfaces of the grooves of the posterior
teeth, where particles of food are apt to lodge.

The gums should be brushed when cleaning the teeth, but with the utmost
care and without using pressure on the brush.

Of the three grades in which tooth brushes are usually made--“soft”,
“medium” and “hard”, the “medium” brush is to be recommended for
general use. The soft brush is usually too soft to be effective in
removing particles of food from crevices and spaces between the teeth;
while the “hard” brush, because of the stiff, wiry bristles, may injure
the delicate gum tissue.

Some authorities contend that when the gums are irritated constantly
in this way and made to bleed, the abrasions invite infection, and is
often the cause of acute stomatitis, and is also conducive to pyorrhea.
On the other hand, Dr. Paul R. Stillman, in a recent article on the
care of the gums, said one of the chief problems in managing cases
of gum tissue with a low tone is to arouse the regenerative forces
of nature and maintain a constantly high tone in the gum tissue. To
realize this end, stimulation and massaging of the gums by careful
brushing is advocated, and an occasional bleeding is not considered
injurious.

It is evident, from the foregoing statements, that until there is more
unanimity of opinion, a moderate course and the avoidance of extremes
are advisable.

The tooth brush alone should not be depended upon, and no cleansing
outfit is complete without a spool of silk dental floss. Food debris
will stick between the teeth, and the danger resulting from such germ
incubators as tend to propagate dental decay is best removed with silk
floss drawn between the teeth. Care must be taken that the gums are not
irritated by this procedure.

A little lime-water is excellent to rinse out the mouth after cleaning.
While the lime-water is in the mouth, force it back and forth between
the teeth with the tongue and cheeks. Continue this until the water
foams, which indicates that it has been in the mouth long enough to
have had a beneficial action on the teeth.

Lime-water has a very pronounced influence in preventing the decay of
the teeth, and when used in conjunction with a general regimen of mouth
hygiene, it is a valuable supplementary agent.

Milk of magnesia may be used as a mouth wash for children, particularly
in case of over acidity, such as when the teeth are sensitive and set
on edge when eating grape-fruit, grapes, lemons, etc.

When tooth picks are used--although it would be better to use silk
floss instead at all times--great care should be taken to avoid
injuring the gums. Wooden tooth picks are unsafe for this purpose,
as they are too thick and clumsy to enter the dental interspaces.
They have been known to break and leave slivers in the gums, causing
inflammation, suppuration and sometimes sepsis.

The only tooth picks to be recommended are thin, sterilized quills.
These can be used without injury to the tissue, and, when scraped
thin, will easily pass between the teeth. At the same time they are
sufficiently rigid to remove the ordinary fibrous food debris that
becomes lodged between the teeth.

The tooth brush should be kept in a sterile condition, so as to avoid
danger from infection. This can readily be accomplished. The brush
should be carefully washed with clean water each time after using, and
preferably immersed in ethyl alcohol. A glass holder, fitted with a
screw top, makes an ideal container for the brush.

THE TONGUE

As it is impossible to keep the mouth in an hygienic condition if the
tongue is unsanitary, this organ often requires special attention. The
upper surface of the tongue is equipped with numerous tiny _papillae_
and minute grooves or depressions surrounding them.

This uneven surface offers an attractive breeding ground for
objectionable micro-organisms. To have an hygienic mouth, the
dorsum--upper surface--of the tongue should, therefore, be cleaned
every morning. A simple instrument, known as a tongue-scraper, made of
ivory, celluloid, or bone, may be obtained for this purpose. It is a
bow or loop-shaped device, with a handle about six inches long. A home
devised substitute in the form of a silver butterknife, may be set
aside and used for this purpose.

In using this appliance, it should be placed well back in the mouth, to
the root of the tongue, and then drawn forward upon the surface to the
tip of the organ. This should be repeated a few times.

It is said that the Japanese include a tongue-scraper with every
tooth brush sold. In this respect, we Occidentals might well take
pattern after the scrupulously clean Japanese. In the absence of a
tongue-scraper, the tooth brush may be used for the purpose--drawing it
over the surface of the tongue--but it is not so comfortable or well
adapted.

MOUTH WASHES

Mouth washes, it should be understood, are not by any means a
substitute for thorough and regular brushing of the teeth. Real mouth
cleanliness can be obtained only by mechanical means. Washing the
mouth out with fluids will not remove food deposits left on the teeth,
particularly those lodged in crevices.

However, washes have their place, as an auxiliary measure, in the
regimen of mouth hygiene. They are especially useful in helping
temporarily to overcome an offensive breath--in connection with other
necessary treatment; in removing a “bad taste”; as a cooling agency,
and to allay an inflammatory condition of the mouth as a result of
disease or other cause.

There are mouth washes based upon both alkaline and mildly acid
principles. As most of the destructive germs of the mouth flourish in
an acid reaction, the alkaline solution neutralizes the acidity, thus
making the condition of the mouth less favorable for the propagation of
germs.

Of the alkaline group, the most readily available and one of the most
efficacious, is salt and water--a mixture of a teaspoonful of ordinary
table salt to a glass of water. If more salt is used, however, it will
do no harm. Soda bicarbonate, or common baking soda, in the proportion
of a teaspoonful to a glass of water, is also excellent.

Milk of magnesia, already referred to, is considered by some
authorities to be very good. When worked about the mouth and between
the teeth, it not only neutralizes the acidity, but protects the teeth
by leaving a coat of magnesia over their surface.

Of the mildly acid mouth washes, hydrogen peroxide, mixed one part
to two of water, is germicidal. The regular use of this preparation,
however, has a tendency to produce an unpleasant irritation and “set
the teeth on edge.” In fact, any acid element has this effect, more or
less.

Listerine, properly diluted, is a pleasant, mildly acid mouth wash with
antiseptic properties.

Dakin’s solution is another powerful antiseptic mouth wash, the product
of Dr. H. D. Dakin. It was widely and effectively used for treating
wounds in the World War, having been sponsored by Dr. Alexis Carrel,
the famous surgeon.

Dr. W. H. Dixler, in a paper read before the Pittsburgh Adontological
Society, described its action most interestingly as follows:

“The action of Dakin’s solution is an intensely germicidal one,
having a store of chemically combined chlorine in a form which is
non-irritating and non-toxic. When brought into contact with proteins
and blood serum micro-organisms and pus, it readily parts with its
chlorine to the basic substance, immediately exerting its antiseptic
and germicidal action.”

“We found that it performs this chemical action without irritation,
and that it does not coagulate albumen, nor does it interfere with
the digestive action of trypsin of protein, but it does actively
disintegrate protein, and influence a flow of lymph, thereby cleansing
the wounds, which is one of the most important features in wound
sterilization. We are inclined to believe that necrosed tissue is
dissolved and liquified, so that it may be carried away by drainage
or absorption, and in this way the germs on the clean surface of the
living tissue readily are exposed to its germicidal action.”

Dakin’s solution is also efficacious in combating pus formation in
pyorrhea. In fact, it is valuable in overcoming pus formation under any
conditions, and on this account proved itself so useful in treating the
suppurating wounds of soldiers during the World War. The remarkable
strength, combined with its non-toxicity, is attested, when we realize
that a one in one-thousandth solution of this germicide is more
effective than a five per cent solution of carbolic acid.

As a mouth wash, it is used in one-half to one per cent strength,
morning and night, or when needed. The mouth should be rinsed
thoroughly, retaining the solution for a minute or two in order to have
the antiseptic liquid act upon the germs.

BLEEDING GUMS.

Persons troubled with bleeding or sore gums should consult a dentist,
as this may prove to be a symptom of approaching pyorrhea, or other
deep-seated disorder. However, if home treatment is imperative, Dakin’s
solution may be recommended for temporary use; also sodium perborate
(Merk’s)--one teaspoonful to half a glass of water, used as a mouth
wash every two hours.

_Stomatitis_, or inflammation of the mouth, which generally
takes on the form of blisters or ulcers, is a very distressing
complaint. Attention should be given to diet, as well as to the most
thorough-going hygiene of the mouth, and a physician might well be
consulted to see if there is any general symptomatic trouble, or if the
inflammation is a symptom of any other more serious disease.

CHAPTER 3.

TEETH IN INFANCY AND CHILDHOOD

While the baby comes into the world apparently toothless, the dental
situation of the newborn is not as free from complications as it seems.

At the time of birth the first teeth are _practically completely
formed_, lying beneath the gums. And under the first teeth, the
permanent teeth are already beginning the process of formation.

It should be evident, therefore, that the soundness and strength of the
baby’s teeth depend upon (1) the nutrition which the mother has taken
while carrying the child, and (2) the nutrition which the baby receives
from the time of birth until the teeth make their appearance.

And, of course, the continued health of the teeth after they have all
come through the gums, throughout childhood and later, depends upon the
individual receiving foods containing the proper nutritive and vital
elements in subsequent years as well.

This is in addition to the regimen of oral hygiene already outlined.
Cleanliness preserves the teeth against the attacks of foreign foes
(germs), and prevents their breeding; but a properly balanced diet,
according to the age of the individual, builds good, sound teeth in the
first place, and makes them more resistant to disease and infections.

So we see that by combining oral hygiene with the right diet, we are
taking advantage of every means to establish and maintain sound,
healthy teeth, and this goes a long way toward building up health and
strength in body and mind.

MOTHER BUILDS HER BABY’S TEETH

As we have intimated the quality of our teeth is determined largely
before we are born. This depends upon the process of calcification
which in the deciduous, or temporary, teeth, begins some nineteen weeks
before birth; and in the permanent teeth (the first permanent molar is
the first to calcify) ten weeks before birth.

The calcification of the crowns, which is the part of the tooth exposed
to decay, is complete in the first set six months after birth, and in
the permanent set between the first and ninth years, excepting the
third molars (“wisdom” teeth), the crowns of which are not finished
calcifying until about the 12th year.

From this it will be seen that the quality of the first set of teeth
is largely dependent upon the diet of the mother during pregnancy and
the nursing period, as the food that the mother eats supplies, through
her blood circulation, nutrition for the growth and development of the
child.

Even thirty weeks before it is born, the baby commences to develop its
teeth. At about the sixth week after conception, a tissue forms on what
afterwards develops into the jaws of the embryo. This is termed the
“dental band.”

From this _dental band_, are formed the cells and sacs and tissues
which in due time become bone and pulp and enamel, and all the other
elements of the tooth structure.

During the busy months of the inter-uterine period, as we have noted,
the teeth are being formed, and for several months after birth they
are further developing, preparatory to breaking through the gums. The
second teeth, in fact, continue developing within the jaws for several
years before they finally make their appearance.

Organic mineral salts and vitamines are of the utmost importance for
the development of bone and teeth, and these can only be supplied the
unborn child, and the nursing child, if the mother’s diet is abundantly
supplied with these elements.

Inasmuch as the calcification of the permanent teeth continues, as we
have mentioned for a number of years during the child’s early life, it
is therefore necessary that the young individual be supplied with a
well-balanced diet during all the growing and developing years.

Unfortunately, our modern prepared foods which are so generally used,
are extremely deficient in vitamines and mineral salts. Consequently,
not only are the teeth frequently poor in quality, so that they become
ready prey to dental _caries_, but the whole organism suffers from this
deprivation.

Nor do strong, hard teeth necessarily remain so. The lime salts
which are used in the formation of the teeth may become absorbed by
the system if there is a deficiency of lime salts in the body. This
absorption (robbing the teeth of a vital element) takes place when the
diet is lacking in lime salts.

It is worthy of notice that these mineral salts are contained in
abundance in those parts of our food which are usually thrown
away--such as fruit skins, the hulks of grains, potato peelings, etc.
In the endless assortment of prepared and denatured foods that are
bought so lavishly at the corner grocery, much or all of the mineral
salts have been removed in the process of refining and preserving.

Not only is the question of food important from the standpoint of the
child’s well-being, but it is also very important to the pregnant
woman. Decayed and acutely abscessed teeth are common occurrences
during pregnancy. This is due to the demands upon the woman’s body in
the development of the new being within her.

A complete, new organism is being formed, and the entire material
must be supplied from the mother’s bodily chemistry. If her diet does
not include sufficient mineral salts, then the needs of the evolving
baby are at least partly supplied by drawing upon the salts from the
mother’s bones and teeth, thus predisposing to dental _caries_. This
important question will be further discussed in a subsequent chapter.

TEETH IN INFANCY

As has been stated, the “teething” problem of infancy does not begin
during the middle of the first year, or later, when the teeth usually
begin to erupt. It really begins with the inception of pregnancy, and
when this is understood, the teething problems of infancy will be more
easily and satisfactorily dealt with.

About the end of the sixth month, in the usual course of events, the
first of the deciduous teeth, make their appearance, generally the
lower front ones.

These are followed at more or less regular intervals by the upper
“incisors,” then the “back teeth,” and finally the “cuspids,” popularly
called the “stomach” and “eye” teeth, when the complete first set of
twenty teeth have appeared.

The ages at which the first teeth usually erupt are as follows:

Two lower front teeth (central incisors)--5 to 7 months.

Two upper front teeth (central incisors)--6 to 8 months.

Two more lower front teeth (lateral incisors)--7 to 9 months.

Two more upper front teeth (lateral incisors)--8 to 10 months.

Four back (molar) teeth, one on each side of the jaw--10 to 14 months.

Four more molar teeth, back of the others,--about 2 years.

Four cuspids (“stomach” and “eye” teeth)--2 to 2-1/2 years.

The appearance of each tooth is an important step in the development of
the child. When all the first teeth have come through, coarser foods,
that require a great deal of chewing, should be given to the child, and
it should be taught to masticate the food thoroughly.

Thorough chewing serves a two-fold purpose; first it insures proper
preparation of the food for its entry into the stomach; secondly, it is
necessary in order to properly develop the bones and tissues of the jaw
and head, thereby contributing to the facial appearance.

Proper attention to chewing, together with consideration for a balanced
diet, insuring sufficient organic minerals and phosphorus to supply
the teeth and bones with the necessary elements of their construction,
and mouth cleanliness, are the basic necessities for healthy teeth, a
healthy body and abundant vitality.

This regimen will contribute materially to the upkeep of the first
teeth, until they have served their purpose, which is much more
important than is generally supposed.

The preservation of the first teeth until they have completed their
useful function is of very great importance.

The premature loss of the “temporary” teeth may be followed by a train
of evils--imperfect chewing, poor digestion, irregularities of the
permanent set of teeth, distorted features, and frequently severe
suffering from toothache, which, if long continued, may induce chronic
nervous affections. Children afflicted in this manner make up a great
majority of the “backward” pupils in the public and special schools.

Parents should make it a practice to take the young children to a
dentist at regular intervals--at least every six months, and even every
three or four months in early childhood would be better, because of the
desirability of catching any decaying spots at the very beginning.

This will go far toward preventing decay, and will lead to the
detection of decay before much harm has been done. And not of least
important, it will restrict the dentist’s treatments to easy and
painless operations, so that the child will grow up with no fear of
dentistry.

DIETARY HINTS FOR INFANCY

Whenever possible, the nursing infant should be breast-fed until the
ninth month. There is no substitute which equals the mother’s milk when
it is of good quality and sufficient quantity to feed the infant.

Furthermore, the development of the baby’s jaws, teeth and skull, and
the facial and throat muscles, are promoted by breast feeding. So that
not only is the natural food far more desirable, but the exercise
and stimulation to growth, which are involved with the taking of the
natural food, make a definite contribution to the infant’s welfare,
that is lacking in connection with artificial food and bottle nursing.

The nursing infant should have plenty of cool, boiled water between
feedings.

If artificial feeding is deemed necessary, it is always better to
consult a baby specialist. The advantages of this have been proven over
and over again. Many useful hints, however, will be found in Dr. L.
Emmett Holt’s admirable book, “_The Care and Feeding of Infants_.”

When the baby is three months old, it may be given once a day a
teaspoonful of orange juice, strained and diluted with the same amount
of cool, boiled water. This amount may be increased gradually until at
the age of one year, the child is taking the juice of one-half orange.

Orange juice is wonderfully rich in vitamines and mineral elements, and
there is probably no more valuable article of diet for persons of any
age. If oranges are unavailable, a little ripe tomato juice, strained
and diluted may be used. No sugar should be added.

Solid foods should be introduced very gradually, so as not to cause any
disturbance of the digestive system, or interfere with the development
and growth of the child.

At the sixth month, it is well to add to the diet a well cooked wheat
or oat cereal, preferably with the mid-morning breast feeding. Begin
with a very small amount--a teaspoonful at the start is enough--and
gradually increase the allowance.

At from eight to nine months, a vegetable and some cow’s milk may be
added to supplement the regular feeding. This is best given in the
early afternoon. The vegetables to be preferred are spinach, swiss
chard, asparagus, cauliflower, onions, green string beans, squash,
celery, carrots, peas, white turnips, or potatoes cooked in a little
water, and put through a sieve and served with a little butter or
cream. No sugar should be used. Very small amounts should be fed the
child at first.

At about the same period, stewed and strained fruits may form a part of
the diet. Raisins, apples, pears, prunes, dates, and figs are all good
and more or less obtainable at any time.

When the baby is about eleven or twelve months old, it may be given
zweibach or hard buttered toast with one meal a day. This encourages
mastication.

The thorough mastication of food is indeed of fundamental importance.
It is not only necessary as a preliminary to good digestion, but also
for the proper development of the teeth, gums and jaws, and the facial
muscles. The formation of this habit has a pronounced influence on
facial appearance and on health.

To encourage mastication, as soon as the child is old enough to eat
solids, some hard foods that have to be well chewed should become a
part of the regular diet, as well as the soft foods. Crusts or pieces
of dry bread, bread-sticks, zweibach, with butter, will serve this
purpose. Hard breakfast foods should gradually be introduced from the
time the child is two years old.

At all times encourage the child to eat slowly and chew its food
thoroughly. This is very important. It is a valuable habit that can be
cultivated, and once formed, it becomes “second nature.”

While on the subject of the infant’s diet, it will be well to emphasize
that choice and range of foods for the older, growing child should also
receive adequate attention. This applies to all the developing years
of childhood and adolescence.

There should always, if possible, be two or three vegetables in the
daily diet. They may be selected from any of the following: Spinach,
lettuce, celery, beet tops, or any other greens, tomatoes, carrots,
white turnips, dried beans, string beans, peas, cauliflower, asparagus,
green peas, squash.

Fresh fruits in season, and dried fruits at other times, should
be called upon--oranges, apples, pears, peaches, raisins, prunes,
apricots, dates, figs, cantaloupe, berries, etc.

Milk is a most desirable supplementary food for the growing child,
because it is rich in the mineral elements and the vitamines. The
presence in appreciable quantities of Vitamine C, however, depends upon
the cow receiving plenty of green food. Furthermore, in sterilized,
pasteurized, or cooked milk, the vitamines are to a large extent
destroyed. The liberal use of fresh vegetables, and orange juice, which
are rich in vitamines, is therefore advocated when the milk has been
heated.

There are certain harmful habits, quite common in the long run, which
mothers should guard against in the raising of children. Thumb or
finger sucking is a bad habit, because it produces disfigurement of the
jaws and face, and also causes tooth irregularity.

The use of a so-called pacifier is to be condemned, as it leads to
flattening of the mouth, tooth irregularity, and introduces air into
the baby’s stomach.

Mouth breathing, a sign of obstruction in the breathing passages--often
adenoids, is a distressing habit, and should receive special surgical
attention. Among the ill results of this unnatural method of breathing
are irregularity of the teeth; disfigurement of the face, air
starvation, and increased susceptibility to infectious diseases.
Everything should be done to enable the child to breathe through its
nose.

THE PERMANENT TEETH

The first of the permanent teeth to make their appearance are the “six
year” molars. Not only are these the first of the permanent teeth, but
the largest. They differ from the teeth that have thus far appeared in
that they are not replaced by others. As they have no predecessor, they
are often mistaken for deciduous (“milk”) teeth and are neglected by
those who consider the deciduous teeth of little importance.

These teeth play an extremely important part in the architecture of
the mouth. They sustain the stress of chewing during the period in
which the temporary teeth are being replaced by permanent teeth, and
they also largely determine the position of the permanent teeth which
follow. Consequently, the very shape of the jaw and the contour of the
face are in part dependent upon the proper development and preservation
of the “six year” molars. This name has been applied to them because
they usually make their appearance about the sixth year. There is one
in each side of both jaws. It is the sixth tooth back, from the front
center, and should receive scrupulous care.

There are thirty-two teeth in the complete permanent set; sixteen in
the lower and sixteen in the upper jaw.

They take their places in the dental arches, roughly speaking, between
the ages of 6 and 18 years. The last to appear are the third molars
(“wisdom teeth”), which may come considerably later than this limit.
For all practical purposes, however, the years during which the
temporary teeth are shed and the permanent teeth erupted, may be put
between the age of 6 and 18.

The teeth are the advance agents of the digestive system. They are the
grinding mills and through the process of chewing they help to reduce
the food (supplemented by the salivary fluids) to a form suitable for
the digestive action of the stomach. The principal divisions of the
functions of chewing are to cut the food into pieces and to grind and
mix it with the secretions of the mouth.

There are several distinct types of teeth, each class designed by
nature for a specific kind of service. In a full set there are twelve
chisel teeth, 8 sharp tools with two points each, and 12 solid molars
with large surfaces for grinding purposes.

The “chisels” are the _incisors_, and the _canine_ or _cuspid_ teeth.
The double pointed teeth are the _bicuspids_; and the grinders are the
molars in the back of the mouth. We cut our food with the _incisors_,
_canines_ and _bicuspids_. The tongue turns the food around in the
mouth, and as a part of the process the molars grind the food into fine
bits.

The following table gives an approximate idea of the time and the order
in which the permanent teeth erupt, the figures, of course, being
subject to slight variations in different individuals:

Four first molars, one on each side of each jaw--5 to 7 years.

Two lower front (central incisors)--5 to 7 years.

Two upper front teeth (central incisors)--6 to 8 years.

Two more upper front teeth and two more lower front teeth (lateral
incisors)--6 to 8 years.

Two “eye” and two “stomach” teeth (cuspids)--9 to 12 years.

Eight bicuspids, four upper and four lower--10 to 12 years.

Two upper and two lower second molars--12 to 14 years.

Two upper and two lower third molars--17 to 25 years.

It is not uncommon for the third molars (“wisdom teeth”) not to appear
at all, in which case they are usually more or less developed, but
remain in their crypts in the jaws for lack of space in the dental
arch to accommodate them, or are malposed (turned out of their normal
position), so their eruption is difficult or impossible.

About the time of this writing, Dr. Reiss had occasion to remove
two impacted, unerupted, incompletely developed third molars from a
man about sixty years of age. There was no clinical evidence of the
presence of these teeth in the jaws, and they were only revealed by
an X-ray picture. After their removal, the patient reported general
improvement in health, as well as the passing or local agitation in his
jaws which had hitherto greatly inconvenienced him.

INFANT MORTALITY FROM TOOTH TROUBLES

Dr. Harvey W. Wiley, the pure food expert, is responsible for the
following astounding statement, which should cause every parent to
pause and consider the dental question with respect to the child: “One
thousand children die daily in this country; their deaths due more to
defective teeth than to any other trouble.”

The high rate of mortality during the first year of life is too well
known to need emphasizing. However, the notable reduction in this
death rate in some of the more progressive communities, indicates that
very great strides can be made in saving the lives of infants during
the first year. And it is not unreasonable to suppose the increased
knowledge of mouth hygiene among educated people is an important factor
in bringing about this desirable result.

The influence of clean teeth and clean mouths on older children, in
preventing contagious diseases common to childhood, such as scarlet
fever, measles, and diphtheria, has already been noted.

John Sayre Marshall, M.D., a well known dental authority, in “_Mouth
Hygiene and Mouth Sepsis_,” states that nearly all forms of stomatitis
that affect infants and small children may be traced to an unclean
condition of the mouth.

NORMAL SIGNS OF TEETHING

The usual signs of teething in healthy children are an increased flow
of saliva; a tendency to put the fingers or some hard article in
the mouth and bite on; swollen and congested gums; fretfulness and
disturbed sleep; loss of usual appetite; sometimes slight diarrhea; and
often a slight fever.

These symptoms, however, usually last only three or four days, while
the teeth are coming through the gums.

Most of the digestive disturbances of babyhood, generally attributed to
teething, are due to improper feeding, and to chilling of the body.

The right kind of food and plenty of cool boiled water are the best
aids to teething. A hard dry crust of bread may be given, or a freshly
cooked chicken leg, without any meat on it, to bite on.

If it should be deemed necessary to have the gums lanced to relieve
difficult teething, extreme care should be taken to keep the wound
clean, so as to avoid infection. The lancing, of course, should be done
by a physician or dentist.

The first few teeth that have erupted may be kept clean by the use of a
piece of clean gauze, or cotton wrapped around the mother’s or nurse’s
finger and dipped in a normal salt solution (1/2 level teaspoonful of
salt to a glass of cool boiled water). The cleaning should include,
besides the teeth, the gums, roof of the mouth, tongue, and inside of
lips and cheek.

During the nursing period, the mother’s breast should be cleansed with
cool boiled water.

CHAPTER 4.

PYORRHEA AND OTHER DENTAL DISEASES

Pyorrhea, or Riggs disease--more technically known as
_pericementoclasia_--is a very pernicious malady, about the pathology
of which there is still a great deal to be learned. Enough is already
known, however, of the characteristics of pyorrhea to prevent it in the
average person, if proper precautions are observed; and to treat it
effectively if the patient will heartily cooperate with the dentist,
should there be an indication of pyorrhea presenting itself.

This disease is a chronic inflammation located in the membrane covering
the roots of the teeth, and in the alveolar process or sockets of
the teeth, which produces a gradual and painful dissolution of these
structures. It is accompanied by a flow of pus from the alveolus, or
socket, resulting, unless the progress of the disease is checked, in
the ultimate loss of the teeth.

It is believed to be sometimes due to constitutional causes, such as
rheumatism, diabetes, Bright’s disease, gout, mercureal poisoning,
anemia, and blood disorders.

A contributing cause is uncleanliness of the mouth, which permits
deposits of tartar to accumulate where the teeth join the gums. As a
result the gums become irritated and infected by disease--producing
germs; the tissues are broken down and pus forms.

A predisposing factor in pyorrhea is believed to be irregular teeth,
or malocclusion or improper closing of the teeth. This tends to a
mild form of rotation in the process of mastication, and the continued
rocking of the teeth contribute to their loosening, which permits the
invasion of the gum attachments by destructive micro-organisms.

There is no doubt that hereditary factors are paramount in determining
the _character_ of tissue and its susceptibility to, or tendency to
resist, certain diseases. This is especially true of the membranes
and tissue of the gums and mouth. However, there is equally positive
evidence, in the opinion of prominent authorities, that local
irritation is a specific cause of pyorrhea.

In this connection, Dr. John Deans Patterson sums up the etiology of
the condition as follows: “_Any irritant, of whatever nature, which
impairs the integrity and continuity of the gingival gum margin, may
cause pyorrhea and without this impairment the condition will not be
established._”

Pyorrhea is not restricted to the gums of human beings, but affects as
well the teeth of certain domestic animals, notably dogs and cats which
share our human habitations.

Dr. Theobold Smith, in his dietetic experiments, while endeavoring to
prove that scurvy could be produced by a faulty diet, was the first to
produce pyorrhea artificially. He discovered that guinea-pigs fed on
a diet of oats, would in three weeks show all the symptoms of scurvy.
The dental symptoms were pronounced; the teeth loosened, and the gums
became red and swollen, quite as in the case of the pyorrhea patient.
Other medical experimenters have also shown the relationship of faulty
diet and pyorrhea in animals. It is worthy of note that very few of the
animals which received the same diet, but with the addition of orange
juice--which is extremely rich in vitamines--displayed the symptoms of
scurvy and pyorrhea.

The early symptoms manifest themselves in a tendency of the gums to
bleed upon slight provocation, usually while brushing the teeth, or
while removing impacted particles of food from between them with a
tooth pick.

When the attachments of the soft tissues of the gums to the teeth are
destroyed, the teeth become loose and when the disease reaches this
stage, there is little that can be done beyond removing them.

TREAT IT EARLY

At the first suspicion of pyorrhea, one should at once put his case in
the hands of a dentist, otherwise the disease is apt to become rapidly
progressive, and make treatment difficult or ineffective.

At the outset in a case of this kind, the dentist’s treatment lies in
thoroughly removing all irritating substances of whatever nature, and
polishing the exposed teeth surfaces. The patient, on his part, should
give more care and attention than ever to the hygiene of his teeth and
mouth, cleaning them several times daily.

It is of paramount importance to keep the teeth and gums clean, and
free from all irritating substances.

As there is a definite relation between pyorrhea and the general
health, in some cases more noticeable than others, the patient should
make every effort to put and keep himself in first-class physical
condition. Every endeavor devoted to this end, will be amply repaid,
because it will afford the best possible assistance to the specific
treatment that the dentist is giving.

There is no dental disease, in fact, in the treatment of which it is so
important that the dentist receive the hearty co-operation and support
of the patient.

More recent research indicates that malnutrition is a predisposing
factor in pyorrhea. Faulty diet, especially in preparing foods so that
an insufficient content of mineral salts and vitamines is obtained,
seems to play an important role in the genesis of this disease. The
experiments with animals, already referred to, lend confirmation to
this theory.

Faulty elimination, and toxic absorption from food decomposition in the
intestines--a result of chronic constipation--are also believed to be
conducive to pyorrhea.

No medicine has ever been suggested which will cure pyorrhea. Medical
treatment, if taken, can only be for some other specific disease, or
for the general health. There is no medical specific for pyorrhea
alveolaris.

RAVAGES OF PYORRHEA

After pyorrhea has definitely manifested itself, the gums recede and
shrink, and the tissues surrounding the roots of the teeth deteriorate.
Consequently, the attachments of the teeth to the socket in the jaw are
loosened.

When the gradual destruction of tissue has reached this point, and the
membranes covering the roots of the teeth are gone, there is no chance
of ever replacing the tissue destroyed.

As there is always a pus secretion from pyorrhea, this adds to the evil
results of the disease, because in masticating food the pus is squeezed
from the gums and mixes with the food. Thus, there is a constant
supply of poison being swallowed by the pyorrhea patient. This is
absorbed into the circulation--or at least carried into the digestive
system, ready to assert itself malevolently in the event of low bodily
resistance.

Dr. Hunter, the famous English authority already quoted, maintains that
pus from the teeth, when swallowed with the food, is a cause of ulcers
and other diseases of the stomach and intestines.

Pyorrhea may also cause disturbances in the local regions of the mouth,
head and neck. The glands of these parts are particularly susceptible
to inflammation. Infections of the nose and throat, diseases of the
internal ear, suppuration of the tonsils, and other disorders, are also
among the possibilities.

Dr. William H. Porter, Professor Emeritus of Pathology and Clinical
Medicine of the New York Post-Graduate Medical School and Hospital,
has summed up the treatment of pyorrhea in these words: “Keep the pus
flowing, keep the surfaces clean, so that Nature will be enabled,
by the germ-resisting action of the white corpuscles, to throw up a
barrier, behind which the germs cannot thrive.”

Certain rules with regard to eating, as well as conscientious oral
hygiene, will aid in the prevention of pyorrhea. Soft, starchy foods,
such as cakes and sweets, and gelatinous concoctions, should not
be eaten between meals, nor late at night. When they are eaten at
meal-times, they should be followed by foods which act as a cleansor,
such as foods of a fibrous nature, and uncooked fruits, the juices of
which have a beneficial influence on the teeth and mouth.

When one has a suspicion that the teeth are showing symptoms of
pyorrhea, no time should be lost in consulting a dentist. If anything
can be done at all, it must be done at the start. After the disease
has definitely established itself, the conditions are infinitely more
difficult to treat.

Dr. Kurt H. Thoma, of the Harvard University Dental School, mentions
the incident of a prominent dentist in the Western part of the country
who, when giving a clinic at a dental convention to show the method
which made his treatment of pyorrhea so successful, was reproached
with the statement that his cases did not present pyorrhea at all. He
replied that this criticism was a proof that most dentists either did
not recognize the early stages of pyorrhea or else paid no attention to
it until the disease was virtually incurable.

It cannot be too strongly emphasized that pyorrhea must be attacked in
its incipient stages, if a cure is to be effected. When the gums begin
to bleed and show signs of inflammation, then is the time to seek the
best professional treatment.

ABSCESSES

There are different types of alveolar abscesses--of which the acute
kind, with swelling and pain is best known to the layman.

The most intense pain accompanies the acute alveolar abscess. For this
reason, treatment of some kind is usually given. The abscess begins
as soon as the infection from the diseased or dead tooth penetrates
through the opening at the end of the root.

With the inflammation of the tooth membranes, pus forms and gradually
the surrounding bone is destroyed. In a few days the pus burrows a hole
toward the surface, accumulating under the gum, and finally obtains
an outlet, usually in the mouth, forming a sinus, but sometimes on the
outside of the face.

As the early inflammation forces the tooth outward in its socket,
whenever the jaws close, the infected tooth is first to come in contact
with its opposite tooth, with painful results. Later, the accumulated
pus causes a constant pressure, with unremitting deep and throbbing
pain. There is an extensive swelling of the face. When a tooth in the
upper jaw is abscessed, the swelling extends over the upper part of the
face, often partly closing the eye. When in the lower jaw, the swelling
may extend down into the neck.

At the peak of the inflammation, there is usually a high fever,
preceded by chills. Also, among the usual symptoms are flushing of the
face, headache, constipation and highly colored urine. In extremely
serious cases, delirium may occur, and in the event of extensive pus
absorption, blood-poisoning (_septicemia_) may occur.

Shortly before the abscess breaks the swollen gum takes on a whitish
appearance, which is known as the “pointing” of the abscess. With the
breaking of the abscess and the discharge of most of the pus, there is
a cessation of pain.

The disappearance of the pain and swelling does not imply that the
trouble has been eliminated. It means that after a past accumulation
of infection an upheaval has taken place, and conditions become
temporarily quiet--very similar to the state of a volcano, in its
periods of apparent latency--but as long as the seat of the disease
remains, there is always the possibility of a recurrence of the acute
abscess.

If relief from the more extreme symptoms is afforded by a discharge
of pus through the sinus, this may prove detrimental to the general
health. It is always a liability to carry around an infection of this
kind, and the sooner the case is given thorough-going attention the
better.

Never wait for an abscess to run its course, or quiet down on its own
account, but at the first hint, seek relief from the dentist, and
arrange for prompt removal of the cause of this disturbance. It may be
necessary to have an X-Ray taken to obtain a satisfactory diagnosis.

_Blind Abscesses._--The blind abscess--or _dental granuloma_--as it is
technically known--is an insidious foe. It causes practically no local
disturbances, and this absence of definite symptoms sometimes results
in a more unfortunate series of troubles than the intense pain of the
acute abscess. The latter gives a warning which is usually headed,
while the blind abscess works its mischief painlessly and unobtrusively.

The presence of the blind abscess is often suspected by some
constitutional ailment or certain physical or mental symptoms for which
no organic basis seem to be in evidence. In any vague disorder of this
kind, it is always advisable to have an X-Ray examination of the teeth.

The seat of the infection may be a tooth from which the pulp has been
removed. Instead of dissolving a considerable amount of tissue into
pus, however,--as in an acute abscess--a blind sac, or _granuloma_, is
formed.

A certain amount of bone is eaten away, leaving the sac, and it is this
defect in the bone structure which shows as a dark area in the X-Ray
picture.

The consequences of blind abscesses, in general disabilities and
specific diseases, are many and far-reaching. Some of these results
have been referred to in Chapter I, under the caption of Focal
Infections.

It may impress one more with the seriousness of alveolar
abscesses--both blind and acute--to state that they are in reality
infections of the jawbone. If neglected, they may cause serious
involvement of the bone structure of the jaw, as well as disease in any
part of the body.

IMPACTED AND UNERUPTED TEETH

Civilization hits us pretty hard at times--with all its
compensations--and the dental structure is undoubtedly the hardest
hit of all. The biologists tell us that one of the penalties of
evolutionary progress is a shortening of the jaws. Consequently, there
is becoming less room for the teeth and some of them are extremely
crowded and are getting smaller, particularly the third molars and
lateral incisors.

Worse still, in many instances, certain teeth are sometimes missing
altogether. That is, they are not visible. However, in these cases,
they are usually lying more or less undeveloped, below the surface of
the gums.

These are known as unerupted teeth. The reason they do not erupt is,
as aforesaid, because there is not space enough in the jaw for them to
take their place alongside their more fortunate fellow teeth. In this
submerged state, they become locked or impacted--jammed or crammed
down by the adjoining teeth. Often in the case of the third molar, or
“wisdom” tooth, it is forced into a horizontal position, instead of
the normal upright one, which makes the situation more difficult.
Sometimes the bicuspids become impacted.

Residing in this unnatural position in the jaw, impacted teeth are very
susceptible to infection, and as their very presence in most instances
is not suspected, the trouble caused by the infection remains more or
less a mystery.

The presence and position of unerupted, impacted teeth can be
determined by an X-Ray picture of the jaw. They cause distressing local
symptoms (from pressure on a nerve), such as sharp, throbbing or dull
pains, or, in other cases, a vague, obscure sensation of pressure. The
trouble is relieved by removing the unwelcome, unaccommodated teeth.

_Cancer of the Month._--Buccal cancer, or cancer of the mouth cavity,
is a serious affliction that may result from any sort of chronic
irritation or friction in that locality. While the most frequent cause
is undoubtedly irritation from excessive smoking, dental causes are
also a factor. Of the latter, a broken tooth, hook, diseased root or
an ill-fitting plate, may be the seat of the irritation. If one is
bothered by any of these irritating stimuli, no time should be lost in
going to a dentist to have the offending object eliminated.

According to data obtained by the Metropolitan Life Insurance Company,
as a result of a comprehensive survey of the mortality from cancer
among its millions of policyholders covering the twelve-year period
from 1911 to 1922 inclusive, cancer was the fifth cause of death in
numerical importance. Buccal cancer was responsible for 8.9 per cent
of all cancer among white males, and 6.9 per cent among colored males.
Only one per cent of deaths from cancer among females was due to buccal
cavity growths.

CHAPTER 5.

TEETH AND DIET

The question of diet is so frequently stressed that, superficially,
it seems almost like carrying coals to Newcastle to be injecting the
subject continually into a treatise dealing with the teeth.

There is no question, however, more important in its relation to
the teeth than diet. It is this fact which makes it so necessary to
emphasize the eternal food problem in this connection.

There are today perhaps millions of people who have been converted to
the necessity of mouth hygiene, who clean their teeth daily, visit the
dentist regularly, and otherwise observe a commendable degree of oral
hygienic precautions, but who, nevertheless, have yet to learn of the
equally fundamental requirement of safeguarding the teeth by dietetic
measures.

In one sense at least diet is even more fundamental than mouth
hygiene--if this may be said without implying that the latter is not
absolutely essential. What we mean is that proper diet, in the first
place--in the prenatal stage--builds good sound teeth that are an asset
throughout infancy and childhood, and, with reasonable care, adulthood.

On the other hand, if the mother, for any reason, lives on a faulty
diet during the period of pregnancy, the teeth of the baby are bound to
be defective, particularly if the infant’s diet is not what it ought to
be during the time the teeth are further developing in the gums, in
the stage preceding eruption.

So if the teeth are not sound to begin with, because of improper diet,
the most perfect mouth hygiene subsequently will not bring about good,
sound teeth. Even then, of course, oral hygiene is most desirable,
as it lengthens the period of usefulness of even inferior teeth, and
postpones the day when they will have to be replaced by artificial ones.

Food is divided into the following classifications: Proteins,
carbohydrates, fats, mineral salts and vitamines.

_Proteins_ are nitrogen-containing elements, which make up the greater
part of our bodies. This substance is necessary to build up and repair
tissue, and to replace waste in the somatic cells. Much more protein
is required by manual workers and persons doing hard physical labor
than those following a sedentary life. Most adults would be healthier
if they cut down on the proteins, and used more of the mineral salts
and vitamine foods. Protein is obtained from both vegetable and animal
food. (See table on subsequent page.)

_Carbohydrate foods_, the principal ones being sugar, starch and
cellulose, generate heat and energy. Starch is a staple food. In the
process of digestion it is transformed into sugar, in which form it is
absorbed and utilized in the organism. Its chief sources are certain
vegetables, but not in greens or the leaves of vegetables, nor in fruit
or animal foods.

_Sugar._ The system normally obtains its greatest supply of sugar from
starchy food, by the process above mentioned. There is an additional
supply of natural sugar obtained from sweet fruits, in a form known as
levulose and grapesugar. Commercial, refined sugar is unnecessary for
the well-being of the organism, because it is deprived of its mineral
salts. It is therefore detrimental to health, and a prolific source of
teeth infections. If sweetening is demanded, the natural sugar should
be used--genuine brown sugar (which contains the mineral elements),
molasses, maple-syrup and honey. And, of course, the sweet fruits are
recommended.

_Cellulose_ and vegetable fibres are not assimilated in the body.
Strictly speaking, therefore, they are not food products, but are
valuable constituents of the diet, because they help digestion in a
mechanical way and give consistency to the bowel contents. They are the
_roughage_. A sufficient quantity of this substance is the best natural
preventive of constipation. Cellulose is contained only in vegetables,
fruits and the husks of grains. It is absent from refined wheat flour.

_Fats_ produce heat and energy, and in moderation have a particular
value as a reserve food, for use by the body in case of deficiency.
Thus, a person who is taken severely ill for an extended period,
and unable to assimilate or digest sufficient food for the bodily
requirements, lives in part on the reserve fat that is tucked away
throughout the tissues of the body.

_Mineral salts_ are vitally important, as much so as protein foods.
While the necessity of the latter is appreciated by practically
everyone, the importance of mineral salts have been overlooked by
the great mass of people. All the tissues of the body require these
elements, and particularly the bone and teeth, more especially during
the period of development. A well-balanced diet, therefore, should
always contain a liberal quantity of food having potassium, calcium,
sodium, iron, and chlorine. They are contained in varying proportions
in green and leafy vegetables, fruits, the outer coatings of grains,
and vegetables, also in milk and eggs. Lean meats contain some of the
mineral salts, but are deficient in others.

The _Vitamines_, of which there are now four identified, are like
the mineral salts, vital to health. They are obtained chiefly in
the following foods: Vitamine A in milk (unskimmed), butter, young
sprouting vegetables, and most animal fats, except lard, the yolks
of eggs, and cod-liver oil. Vitamine B in whole grain cereals and
practically all vegetables. Vitamine C in fresh fruits and vegetables,
also in milk from cows that are grazing in green pasture. Fresh
tomatoes are rich in Vitamines A, B and C. Vitamine D is found in egg
yolks and cod-liver oil.

The following table is appended for the guidance of readers who are
desirous of studying the food problem with the intent of availing
themselves of a properly balanced diet. It is a fact that people living
in the country, especially those who have gardens and farms, could
make their diet much more healthful and vitalizing without adding
to the expense; in some cases at less expense. To a certain extent,
this applies to city and town people too. It is less expensive, for
instance, to buy brown sugar, than refined sugar; whole wheat and rye
breads cost no more than white: molasses is more desirable and costs
less than refined syrups. Honey can be obtained for about the same
price as many highly sugared preserves and jams.

PRINCIPAL NUTRITIONAL ELEMENTS OF COMMON FOODS

[A] Some mineral salts only.

DIET FOR EXPECTANT MOTHERS

As the pregnant woman is destined, for a period of nine months, to
supply nourishment for an embryonic being, as well as for herself, the
question of diet is to her one of double importance. The well-being of
the prospective infant is equally involved with that of her own welfare.

At this time, while a sufficient quantity of food is necessary, the
quality and right selection are really of more importance. The appetite
ordinarily governs the matter of quantity (barring poverty or other
hardship), but the right selection requires a knowledge of dietetic
facts which is often lamentably lacking where there is ample means to
obtain the best.

When we take into consideration that the baby’s first, or deciduous,
teeth begin to form about the third month, we better realize how
necessary it is that the mother receive the proper nutritional elements
to take care of the new dental construction, as well as the building of
the whole little, but complicated, body.

The materials needed for the developing embryo can come from only two
sources: from the food which the mother eats, or from her own body
tissues. If she does not eat the proper kind and amount of food, and
assimilate it, then Nature draws upon the substance of her own body to
nourish the baby. As we have already indicated, the embryo requires
mineral salts and vitamines to grow good, sound teeth and strong bones,
and if these elements are not contained in sufficient quantity in the
mother’s food, they are taken from her own teeth and bones. During the
last four months of pregnancy, the mother requires about one-fifth more
food than normally.

The daily menu of the expectant mother should include the following:
Vegetables--two or more a day, including a leafy vegetable.
Fruit--preferably fresh, twice or more times a day. Graham or
whole wheat bread, with meals, and a coarse cereal. Meat, fish or
poultry--not more than once a day. Milk or buttermilk--a quart daily,
used in cooking or as a drink. Eggs (not fried), occasionally instead
of meat. Not more than one cup of coffee daily. Tea also in moderation.
Water, drunk liberally between meals--a great deal of water is required
in the biological process of baby-building. No fried foods, rich
pastries, highly seasoned foods or strong stimulants. A glass of milk
may be taken between meals in mid-morning and mid-afternoon, and before
going to bed. Some coarse cereal also may be taken before retiring if
the appetite calls for it.

The selection of food should be varied from day to day to avoid
monotony, and to assure a supply of all the substances needed for both
mother and the developing baby.

As Drs. Ryan and Bowers state in their excellent manual, _Teeth and
Health_: “But it would be much better if dentists everywhere would
teach the people that the great cause of tooth destruction lies
principally in lime and phosphorus starvation, brought about by
eating--from the time the mother first conceives the child, until the
individual dies of old age--a diet robbed of its minerals, totally
deficient in the lime and phosphorus necessary, not only to make teeth
and bones, but also to make nervous systems and brains, and to keep
the numerous functions of nutrition--regulated by the activities of
the ductless glands--from going awry, and making a mess of the whole
organic structure--mental, physical and moral.”

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.

HEALTH AND SELF-MASTERY

Through Psycho-Analysis and Autosuggestion

BY WILLIAM J. FIELDING

“_A book that makes it easy to learn what everyone wants to know_”

In this fascinating book, Mr. Fielding, whose standing as an authority
on the most-talked-of subject of the day: personal benefit by
autosuggestion, is so well recognized, explains with great clearness
the psychic and physical processes which govern the human organism and
make our personality what it is, whether for good or ill.

Coué has demonstrated that it is the Unconscious Mind, through
autosuggestion, which cures and which vastly increases our
potentialities. Mr. Fielding, with his deep scientific knowledge,
takes us behind the scenes of personality (as is done in no other
book dealing with autosuggestion), and shows us the mechanism of the
Unconscious Mind, and of our whole automatic organism at work--a most
interesting revelation.

The hidden processes of our innermost being, of our vital, elemental
personality, are laid bare. A true understanding of Self implies
a working knowledge of these factors, and gives us Self-mastery,
Self-expression and Health.

Price, $2.10 postpaid
HALDEMAN-JULIUS COMPANY
Girard, Kansas

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.

*** END OF THE PROJECT GUTENBERG EBOOK TEETH AND MOUTH HYGIENE ***

Updated editions will replace the previous one—the old editions will
be renamed.

Creating the works from print editions not protected by U.S. copyright
law means that no one owns a United States copyright in these works,
so the Foundation (and you!) can copy and distribute it in the United
States without permission and without paying copyright
royalties. Special rules, set forth in the General Terms of Use part
of this license, apply to copying and distributing Project
Gutenberg™ electronic works to protect the PROJECT GUTENBERG™
concept and trademark. Project Gutenberg is a registered trademark,
and may not be used if you charge for an eBook, except by following
the terms of the trademark license, including paying royalties for use
of the Project Gutenberg trademark. If you do not charge anything for
copies of this eBook, complying with the trademark license is very
easy. You may use this eBook for nearly any purpose such as creation
of derivative works, reports, performances and research. Project
Gutenberg eBooks may be modified and printed and given away—you may
do practically ANYTHING in the United States with eBooks not protected
by U.S. copyright law. Redistribution is subject to the trademark
license, especially commercial redistribution.

START: FULL LICENSE

THE FULL PROJECT GUTENBERG LICENSE

PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK

To protect the Project Gutenberg™ mission of promoting the free
distribution of electronic works, by using or distributing this work
(or any other work associated in any way with the phrase “Project
Gutenberg”), you agree to comply with all the terms of the Full
Project Gutenberg™ License available with this file or online at
www.gutenberg.org/license.

Section 1. General Terms of Use and Redistributing Project Gutenberg™
electronic works

1.A. By reading or using any part of this Project Gutenberg™
electronic work, you indicate that you have read, understand, agree to
and accept all the terms of this license and intellectual property
(trademark/copyright) agreement. If you do not agree to abide by all
the terms of this agreement, you must cease using and return or
destroy all copies of Project Gutenberg™ electronic works in your
possession. If you paid a fee for obtaining a copy of or access to a
Project Gutenberg™ electronic work and you do not agree to be bound
by the terms of this agreement, you may obtain a refund from the person
or entity to whom you paid the fee as set forth in paragraph 1.E.8.

1.B. “Project Gutenberg” is a registered trademark. It may only be
used on or associated in any way with an electronic work by people who
agree to be bound by the terms of this agreement. There are a few
things that you can do with most Project Gutenberg™ electronic works
even without complying with the full terms of this agreement. See
paragraph 1.C below. There are a lot of things you can do with Project
Gutenberg™ electronic works if you follow the terms of this
agreement and help preserve free future access to Project Gutenberg™
electronic works. See paragraph 1.E below.

1.C. The Project Gutenberg Literary Archive Foundation (“the
Foundation” or PGLAF), owns a compilation copyright in the collection
of Project Gutenberg™ electronic works. Nearly all the individual
works in the collection are in the public domain in the United
States. If an individual work is unprotected by copyright law in the
United States and you are located in the United States, we do not
claim a right to prevent you from copying, distributing, performing,
displaying or creating derivative works based on the work as long as
all references to Project Gutenberg are removed. Of course, we hope
that you will support the Project Gutenberg™ mission of promoting
free access to electronic works by freely sharing Project Gutenberg™
works in compliance with the terms of this agreement for keeping the
Project Gutenberg™ name associated with the work. You can easily
comply with the terms of this agreement by keeping this work in the
same format with its attached full Project Gutenberg™ License when
you share it without charge with others.

1.D. The copyright laws of the place where you are located also govern
what you can do with this work. Copyright laws in most countries are
in a constant state of change. If you are outside the United States,
check the laws of your country in addition to the terms of this
agreement before downloading, copying, displaying, performing,
distributing or creating derivative works based on this work or any
other Project Gutenberg™ work. The Foundation makes no
representations concerning the copyright status of any work in any
country other than the United States.

1.E. Unless you have removed all references to Project Gutenberg:

1.E.1. The following sentence, with active links to, or other
immediate access to, the full Project Gutenberg™ License must appear
prominently whenever any copy of a Project Gutenberg™ work (any work
on which the phrase “Project Gutenberg” appears, or with which the
phrase “Project Gutenberg” is associated) is accessed, displayed,
performed, viewed, copied or distributed:

This eBook is for the use of anyone anywhere in the United States and most
other parts of the world at no cost and with almost no restrictions
whatsoever. You may copy it, give it away or re-use it under the terms
of the Project Gutenberg License included with this eBook or online
at www.gutenberg.org. If you
are not located in the United States, you will have to check the laws
of the country where you are located before using this eBook.

1.E.2. If an individual Project Gutenberg™ electronic work is
derived from texts not protected by U.S. copyright law (does not
contain a notice indicating that it is posted with permission of the
copyright holder), the work can be copied and distributed to anyone in
the United States without paying any fees or charges. If you are
redistributing or providing access to a work with the phrase “Project
Gutenberg” associated with or appearing on the work, you must comply
either with the requirements of paragraphs 1.E.1 through 1.E.7 or
obtain permission for the use of the work and the Project Gutenberg™
trademark as set forth in paragraphs 1.E.8 or 1.E.9.

1.E.3. If an individual Project Gutenberg™ electronic work is posted
with the permission of the copyright holder, your use and distribution
must comply with both paragraphs 1.E.1 through 1.E.7 and any
additional terms imposed by the copyright holder. Additional terms
will be linked to the Project Gutenberg™ License for all works
posted with the permission of the copyright holder found at the
beginning of this work.

1.E.4. Do not unlink or detach or remove the full Project Gutenberg™
License terms from this work, or any files containing a part of this
work or any other work associated with Project Gutenberg™.

1.E.5. Do not copy, display, perform, distribute or redistribute this
electronic work, or any part of this electronic work, without
prominently displaying the sentence set forth in paragraph 1.E.1 with
active links or immediate access to the full terms of the Project
Gutenberg™ License.

1.E.6. You may convert to and distribute this work in any binary,
compressed, marked up, nonproprietary or proprietary form, including
any word processing or hypertext form. However, if you provide access
to or distribute copies of a Project Gutenberg™ work in a format
other than “Plain Vanilla ASCII” or other format used in the official
version posted on the official Project Gutenberg™ website
(www.gutenberg.org), you must, at no additional cost, fee or expense
to the user, provide a copy, a means of exporting a copy, or a means
of obtaining a copy upon request, of the work in its original “Plain
Vanilla ASCII” or other form. Any alternate format must include the
full Project Gutenberg™ License as specified in paragraph 1.E.1.

1.E.7. Do not charge a fee for access to, viewing, displaying,
performing, copying or distributing any Project Gutenberg™ works
unless you comply with paragraph 1.E.8 or 1.E.9.

1.E.8. You may charge a reasonable fee for copies of or providing
access to or distributing Project Gutenberg™ electronic works
provided that:

• You pay a royalty fee of 20% of the gross profits you derive from
the use of Project Gutenberg™ works calculated using the method
you already use to calculate your applicable taxes. The fee is owed
to the owner of the Project Gutenberg™ trademark, but he has
agreed to donate royalties under this paragraph to the Project
Gutenberg Literary Archive Foundation. Royalty payments must be paid
within 60 days following each date on which you prepare (or are
legally required to prepare) your periodic tax returns. Royalty
payments should be clearly marked as such and sent to the Project
Gutenberg Literary Archive Foundation at the address specified in
Section 4, “Information about donations to the Project Gutenberg
Literary Archive Foundation.”

• You provide a full refund of any money paid by a user who notifies
you in writing (or by e-mail) within 30 days of receipt that s/he
does not agree to the terms of the full Project Gutenberg™
License. You must require such a user to return or destroy all
copies of the works possessed in a physical medium and discontinue
all use of and all access to other copies of Project Gutenberg™
works.

• You provide, in accordance with paragraph 1.F.3, a full refund of
any money paid for a work or a replacement copy, if a defect in the
electronic work is discovered and reported to you within 90 days of
receipt of the work.

• You comply with all other terms of this agreement for free
distribution of Project Gutenberg™ works.

1.E.9. If you wish to charge a fee or distribute a Project
Gutenberg™ electronic work or group of works on different terms than
are set forth in this agreement, you must obtain permission in writing
from the Project Gutenberg Literary Archive Foundation, the manager of
the Project Gutenberg™ trademark. Contact the Foundation as set
forth in Section 3 below.

1.F.

1.F.1. Project Gutenberg volunteers and employees expend considerable
effort to identify, do copyright research on, transcribe and proofread
works not protected by U.S. copyright law in creating the Project
Gutenberg™ collection. Despite these efforts, Project Gutenberg™
electronic works, and the medium on which they may be stored, may
contain “Defects,” such as, but not limited to, incomplete, inaccurate
or corrupt data, transcription errors, a copyright or other
intellectual property infringement, a defective or damaged disk or
other medium, a computer virus, or computer codes that damage or
cannot be read by your equipment.

1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the “Right
of Replacement or Refund” described in paragraph 1.F.3, the Project
Gutenberg Literary Archive Foundation, the owner of the Project
Gutenberg™ trademark, and any other party distributing a Project
Gutenberg™ electronic work under this agreement, disclaim all
liability to you for damages, costs and expenses, including legal
fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
PROVIDED IN PARAGRAPH 1.F.3. YOU AGREE THAT THE FOUNDATION, THE
TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
DAMAGE.

1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
defect in this electronic work within 90 days of receiving it, you can
receive a refund of the money (if any) you paid for it by sending a
written explanation to the person you received the work from. If you
received the work on a physical medium, you must return the medium
with your written explanation. The person or entity that provided you
with the defective work may elect to provide a replacement copy in
lieu of a refund. If you received the work electronically, the person
or entity providing it to you may choose to give you a second
opportunity to receive the work electronically in lieu of a refund. If
the second copy is also defective, you may demand a refund in writing
without further opportunities to fix the problem.

1.F.4. Except for the limited right of replacement or refund set forth
in paragraph 1.F.3, this work is provided to you ‘AS-IS’, WITH NO
OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT
LIMITED TO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PURPOSE.

1.F.5. Some states do not allow disclaimers of certain implied
warranties or the exclusion or limitation of certain types of
damages. If any disclaimer or limitation set forth in this agreement
violates the law of the state applicable to this agreement, the
agreement shall be interpreted to make the maximum disclaimer or
limitation permitted by the applicable state law. The invalidity or
unenforceability of any provision of this agreement shall not void the
remaining provisions.

1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation, the
trademark owner, any agent or employee of the Foundation, anyone
providing copies of Project Gutenberg™ electronic works in
accordance with this agreement, and any volunteers associated with the
production, promotion and distribution of Project Gutenberg™
electronic works, harmless from all liability, costs and expenses,
including legal fees, that arise directly or indirectly from any of
the following which you do or cause to occur: (a) distribution of this
or any Project Gutenberg™ work, (b) alteration, modification, or
additions or deletions to any Project Gutenberg™ work, and (c) any
Defect you cause.

Section 2. Information about the Mission of Project Gutenberg™

Project Gutenberg™ is synonymous with the free distribution of
electronic works in formats readable by the widest variety of
computers including obsolete, old, middle-aged and new computers. It
exists because of the efforts of hundreds of volunteers and donations
from people in all walks of life.

Volunteers and financial support to provide volunteers with the
assistance they need are critical to reaching Project Gutenberg™’s
goals and ensuring that the Project Gutenberg™ collection will
remain freely available for generations to come. In 2001, the Project
Gutenberg Literary Archive Foundation was created to provide a secure
and permanent future for Project Gutenberg™ and future
generations. To learn more about the Project Gutenberg Literary
Archive Foundation and how your efforts and donations can help, see
Sections 3 and 4 and the Foundation information page at www.gutenberg.org.

Section 3. Information about the Project Gutenberg Literary Archive Foundation

The Project Gutenberg Literary Archive Foundation is a non-profit
501(c)(3) educational corporation organized under the laws of the
state of Mississippi and granted tax exempt status by the Internal
Revenue Service. The Foundation’s EIN or federal tax identification
number is 64-6221541. Contributions to the Project Gutenberg Literary
Archive Foundation are tax deductible to the full extent permitted by
U.S. federal laws and your state’s laws.

The Foundation’s business office is located at 809 North 1500 West,
Salt Lake City, UT 84116, (801) 596-1887. Email contact links and up
to date contact information can be found at the Foundation’s website
and official page at www.gutenberg.org/contact

Section 4. Information about Donations to the Project Gutenberg
Literary Archive Foundation

Project Gutenberg™ depends upon and cannot survive without widespread
public support and donations to carry out its mission of
increasing the number of public domain and licensed works that can be
freely distributed in machine-readable form accessible by the widest
array of equipment including outdated equipment. Many small donations
($1 to $5,000) are particularly important to maintaining tax exempt
status with the IRS.

The Foundation is committed to complying with the laws regulating
charities and charitable donations in all 50 states of the United
States. Compliance requirements are not uniform and it takes a
considerable effort, much paperwork and many fees to meet and keep up
with these requirements. We do not solicit donations in locations
where we have not received written confirmation of compliance. To SEND
DONATIONS or determine the status of compliance for any particular state
visit www.gutenberg.org/donate.

While we cannot and do not solicit contributions from states where we
have not met the solicitation requirements, we know of no prohibition
against accepting unsolicited donations from donors in such states who
approach us with offers to donate.

International donations are gratefully accepted, but we cannot make
any statements concerning tax treatment of donations received from
outside the United States. U.S. laws alone swamp our small staff.

Please check the Project Gutenberg web pages for current donation
methods and addresses. Donations are accepted in a number of other
ways including checks, online payments and credit card donations. To
donate, please visit: www.gutenberg.org/donate.

Section 5. General Information About Project Gutenberg™ electronic works

Professor Michael S. Hart was the originator of the Project
Gutenberg™ concept of a library of electronic works that could be
freely shared with anyone. For forty years, he produced and
distributed Project Gutenberg™ eBooks with only a loose network of
volunteer support.

Project Gutenberg™ eBooks are often created from several printed
editions, all of which are confirmed as not protected by copyright in
the U.S. unless a copyright notice is included. Thus, we do not
necessarily keep eBooks in compliance with any particular paper
edition.

Most people start at our website which has the main PG search
facility: www.gutenberg.org.

This website includes information about Project Gutenberg™,
including how to make donations to the Project Gutenberg Literary
Archive Foundation, how to help produce our new eBooks, and how to
subscribe to our email newsletter to hear about new eBooks.