DENTAL SEPSIS
Authors: J. G. Turner
Journal: BMJ (1914)

III. PROPHYLAXIS.THE answer to the third question is best sought for by an inquiry as to causation, and every tooth-bearing animal may be studied with advantage.The mouth is obviously fouled from without.The infant's mouth is as early infected as any other of its outward openings, but, in general, the capacity for injury depends on stagnation.The germs then have time to establish themselves.If sticky food be added they are provided with unlimited culture media.Such haphazard conditions may not suit all germs, but in fact do suit many, and experience tells us that the net result is unfavourable to human happiness.FOOD.What food, then, is sticky?Above all, fine-ground flour.Our inquiry may run on these broad lines: What is the relation of deintal sepsis to the occurrence of microorganisms ill the mouth and to the eating of fine-ground flour?Shortly, we o.ma.k, the relation of dental sepsis to germ-carbohydat a I have examined fish, and have never yet found any evidence of dental sepsis among them.I made films of scrapings from the mouth of a large number of deep-sea fish very shortly after capture, and could demonstrate no micro-organisms.There was also not even a shred of seaweed in their mouths.',In the absence of all stagnation there was no dental,sepsis.',In the large collection of skulls of wild carnivora (tigers, etc.) at the South.Kensington Museum I found nopost-mortem evidence of dental sepsis other than abscess follQwing f-ractured tooth, except in the.case of an old hyena from Somaliland, presented by Dr. Drake-.Brockman.The sepsis in this case probably followed some gross injury to the gum by coarse food.Among domesticated carrilvora (dogs) evidences of dental sepsis, especially foul teeth' and alveolar disease are common.Bread, cake, and biscuits' are part of the daily food of the domestic dog.,xamination of skulls of wild monkeys at the South Kensington Museum showed 0.53 per cent. of teeth carious, and 5.31 per cent. of skulls containing carious teeth.The total of skulls was 433, containing 12,249 teeth; 58 teeth had been lost ante mortem.-The skulls of 72 monkeys ,which had died at the London Zoological Society's Gardens gave 16.66 per .cert.,containing canious teeth, and 2.001 per cent. of teeth carious.I do not know much of the feeding habits of wild monkeys, but it seems pio'bable that nuts or plantains may be responsible for the occur- rence of dental caries.. Domesticated monkeys are largely fed on bread.Pyorrhoea alveolaris occurs among wild monkeys, but only in its localized form.The bone is found destroyed between two teeth, the rest of the mouth being sound.In this pocket coarse spikes of vegetable origin are found, and the conclusion is irresistible that the disease was'the res'ult of gross trauma while eating.The skulls of captive monkeys, on the other hand, show,widespread alveolar changes comparable to what is found in human beings.Among wild monkeys, again, tartar occurs in small amounts, but among the captive monkeys in very considerable quantity.In skulls of wild grass-eating animals I have seen no post-nmortem evidence of dental sepsis.Films from the mouths of domesticated cattle show large numbers of .bacteria,but, except mycotic infections, I know of no resulting disease condition.This mycotic infection is of 'the same nature as the localized pyorrhoea alveolaris of wild monkeys.To this category belongs also the alveolar disease of the domestic horse; in these animals spikes of chaffed hay get speared into the gum in mastication, causing localized but not generalized disease.Among humankind we of to-day are the most notable consumers of sticky carbohydrates, and in the matter of dental sepsis we hold an unenviable pre-eminence.Practically 100 per cent. of the population of Great Britain suffer from dchtal caries.P'ractically 100 pier eent.are affected by mnarginal gingivitis or its later developmenIb.