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Full text of "Dominion dental journal"

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HARRT R- ABBOTT 
MEMOmAIf) 



BINDING Lrr FEB 15^92B 



DOMINION 

DENTAL JOURNAL 

< Official Organ of all Dental Associations in Canada) 




EDITOR: 
A. E. WEBSTER, M.D., D.D.S., L.D.S. 

TORONTO, CANADA 
ASSOCIATE EDITORS: 



QUEBEC 
EUDORE DUBEAU, L.D.S. , D.D.S. 

396 St. Denis Street, Montreal 
STANLEY BURNS, D.D.S. , L.D.S. 

750 St. Catherine Street, Montreal 

A. W. THORNTON, D.D.S., L.D.S. 

McGill University, Montreal 

ONTARIO 

M. F. CROSS, L.D.S., D.D.S. 

Ottawa 

CARL E. KLOTZ, L.D.S. 

St. Catharines 

ALBERTA 

H. F. WHITTAKER, D.D.S., L.D.S. 

Edmonton 

NEW BRUNSWICK 

JAS. M. MAGEE, L.D.S., D.D.S. 

St. John 



NOVA SCOTIA 

FRANK WOODBURY, L.D.S., D.D.S. 

Halifax 

SASKATCHEWAN 

W. D. COWAN, L.D.S. 

Regina 

PRINCE EDWARD ISLAND 

J. S. BAGNALL, D.D.S., L.D.S. 

Charlottetown 

MANITOBA 

M. H. GARVIN, D.D.S., L.D.S. 

Winnipeg 

BRITISH COLUMBIA 

H. T. MINOGUE, D.D.S., L.D.S. 

Vancouver 



VOLUME XXXI 



DOMINION DENTAL JOURNAL 

RICHMOND AND SHEPPARD STREETS, TORONTO 

1919 



LIST OF CONTRIBUTORS FOR VOL. XXXI 



Page 

ANTE, Irvin H., D.D.S., L.D.S., 
Toronto, Ont 1 

BLACK, W. A., M.A., D.D.S., 
Toronto. Ont 359 

COLLINS, Henry A., M.D., Tren- 
ton, N. J 408 

CROCKER, AKred A., Cincinatti, 
Ohio 233 

DAVY, Will C, Morrisburg, Ont.. 381 

DAY. Arthur, D.D.S., Toronto, 
Ont 46 

DOWNING, Augustus S., Albany, 
N. Y 430 

DUKE, William W., M.D., Ph.D., 
Kansas City, Kans.as 43 

GODWIN. W. O., D.D.S 267 

GREENE, Maj. W. R., Ottawa, 
Ont 115 

HALL, Rupert E., D.D.S., Chicago, 
111 191 

1 



Page 

KINSMAN, H. F., D.D.S., Port 
Huron, Mich 92 

LAUTEHMAN, Maxwell, M.D., 
Montreal, Que 15 

McCLINTOCK, Grey, 204 

NESBETT, Norman Beverley, 
D.M.D., Boston, Mass 402 

NOLIN, Dr. Joseph, Montreal, 
Que 229 

SERVICE, Chas. W., B.A., M.D., 
Chengtu, West China 39, 41 

SIMPSON, R. S., D.D.S., L.D.S., 
Trenton, Ont 94 

THOR.NTON. Prof. R. D., Tor- 
onto, Ont 343 

WALSH, C. H., D.D.S., Winnipeg, 
Man, 153 

WEBSTER, A. E., M.D., D.D.S., 
Toronto, Ont 122, 395 

WELLS, Maj. F. M., D.D S., 
L.D.S., Montreal, Que 77 



CONTENTS OF VOLUME XXXI 



ORIGINAL CONTRIBUTIONS. 

A Few Poin/ts About Syphilis IT) 

Action of the Acids on the Teeth of 
Workers in High Explosives !M 

Address to Freshmen 343 

Answers to Vital Questions About 
the Babies' Teeth 122 

Cases of Focal Infection 359 

Course of Instruction for Dental 
Nurses 206 

Care of I>ental Instruments 267 

Cast Clasp Technique for Removable 
Bridgework 402 

I>ental and MedicaJl Needs in Ohina 39 

Demonistrations aA. the Recent Meet- 
ing of the Ontario Dental Society 159 

Dental Sepsis as a Predisposing 
Cause of Cancer 305 

Diagnosis in Dentistry 395 

Exclusion of Moisture in its Re- 
lationship to Asepsis 230 

Food Deficiencies as a Factor In- 
fluencing the Calcification and 
Fixation of Teeth 77 

Headiache Related to Oral Sepsis... 43 

Hiospital Report of Case of Osteo- 
myelitis (Subacute) of the Super- 
ior Maxillary 231 

Inxportance of Dental Service in the 
Hospital 233 

Interesting Cases in Dental Practice 419 

Medical and Dental Inspection in 
Public Schools 381 

Nervous and Mental Diseases Due 
to Infection 408 

One of China's Great Problems 41 

Oral Hygiene 153 

Porceliain 353 

Preparation of Roots for the Recep- 
tion of Dowel Crowns 1 

I'recautionary Treatment to Prevent 
Teeth Falling Into Trachae 49 

Regarding the Dentist and the Busi- 
ness Assessment Act 46 

Retention of Full Dentures 191 

Six Year Course in Dentistrj' in 
Ohina 50 

Sketch of Lecture on X-Ray in 
Dentistry 92 

Tragedies of the Profession 204 

Teaching of Art Dentistry 229 

Value of Research in Dentistr\ .... 42n 



I'aue 
Work of the Canadian .Arni\- Dental 
Service (^orps 115 

X-Ray as a Diagnostic Aid in De- 
termining the Presence or Absence 
of Infection in the Apical Region 52 

SELECTIONS. 

.\hout TeiniHjrary Dentures 287 

American Army Dental Corps 286 

Cla.ssification of Teeth Requiring 
Extraction 290 

Dentistry in Great Britain as Found 
by a Committee of the House of 
Commons 2CS;. 306. 36(i 

Dentistry as a National Defence.... 246 

Erythropleoum Hydrochloride as an 
.\gent foi- Devitalizing the Dental 
Pulp 127 

Horace Fletcher and His Work .... 289 

Ora-1 Focal Infection — From th^e 
Standpoint of an Oral Surgeon. . . . 235 

Pyorrhea Alveolaris and Arthritis. . 288 

Standard of l>ental Education and 
l*ractice 430 

Traveling Dental Surgeon 250 

Vitamines 242 

DENTAL SOCIETIES. 

.\ New Dental Societ\" 141 

.\nnual Meeting of Board of Direct- 
ors of Roytil College of Dental 
Surgeons of Onta.rio 182 

(^anadiin Oral Prophylactic Associa- 
tion Annual Meeting 56 

Canadian Dental Association 9S 

Canadian Oral Proph\ lactic .\ssocia- 
tion Annual RepoH of Educational 
Committee 1 32 

(Constitution of Ontario Dental .As- 
sociation 21s 

Car for C.A.D.C. District No. 2 292 

Dentists Registered at the Special 
Militar.v Practitioners' Course. 
Toronto. December, 1918 »'>2 

Dentists in Attendance at the Ontar- 
io Dental Society Meeting. May. 
1918 H- 

Dental Council of British Columbia 22 ♦• 

Dominion Dental Council Examina- 
tions 32^ 

Domin'ion Dental Council of Canada 
Professional Examination*;. 1919 . . 367 

Eastern Ontario Dental Society 252 

Financial Statement of the Ontario 
DenUil Society. 1918 «« 



CONTENTS OF VOL. XXXI— Continued. 



Pa^e 

Graduating- Class, Royal Colleg-e of 
Deiutal Surgeons' Session, 1918-19 186 

Joint Meeting of the National Dental 
Association with the Canaxiian 
Dental Association 173 

London and Elgin Dental Society.. 451 

Minutes of Ontario Dental Associa- 
tion 209 

Members in Attendance at the 
Ontario Dental Society Meeting . . 254 

:\rethod followed by Victoria Board 
in Establish ing- School Dental Ser- 
vice 294 

Northern Ohio Dental Asisociation . . 108 

Nova Scotia Dental Association 320 

Officers Ontario Dental Society 181 

Officers Saskatchewan Dental As- 
sociation 296 

Officers New Brunswick Dental As- 
sociation • 296 

Programme of New Orleans Conven- 
tion 223 

Post Graduate Course in Dentistry. . 326 

Report of C.O.P.A. Exhibit at Na- 
tional Dental A.«?.soclation o9 

South Ontario and West Durham 
Dental Assoclatlooi 140 

AVoinen's Auxiliary of the C.A.D.C. 222 
EDITORIAL. 

An International Dental Organiza- 
tion 25 

Advances in Teaching Dentistn' in 
Ontario HO 

A Foolish Optimism or an Insane 
Pessiimism 1^05 

A Special Conference of the Repre- 
Hentatives of the Universities of 
Ontario 1^7 

Assist in Examining the Children's 
Teeth 225 

A Pernicious Amendment to the 
Nova Sootia Amendment Act .... 333 

Anierican Institute of Dental Teach- 
ers ^7 

Britisher and Dentistry 226 

Blocking Anaethesia 415 

Cost of Dentistry- 257 

Caa-e of Soldiers' Teeth lmi)ortant 
in War Time 263 

Capillary Attraction in Root Canals 2!'9 

Canadians Gi-anted T..icensos to Prac- 
tice in Great Britain 234 

Dental Nurse, Dental Hygienist. or 
the Dental Assistant 26 

Dental Nurse is H< re W.) 



' Page 

Dental Clinics for Rural Ontario.,.. 262 

Dentistry Investigated 300 

Large Student Registration at Pro- 
fessional Schools 373 

Management of Infected Givnials . . . 378 

Medical, Dental and Nursing Work 
in West China — A Great Advance 
Planned 378 

Mending Broken Plaster Casts 452 

Modern Prosthetic Dental Practice. , 447 

Vitamines 378 

Editorial Notes 28, 70 

111. 149, 190, 227. 264, 302, 337, 416 

General Medicine in Dental Practice 27 

Government Aid for the Strong- 
minded in preference to Aiding the 
Feeble-minded 411 

Insuirance in its Relation to Dentis- 
try 26 

John R. Caliahan Memorial 151 

^latricuiation for the Returned 
Soldier 27 

Minister of Public Health 109 

Memorial to the Fallen in the War 
(University of Toronto) 151 

New Westminister Dentist Goes in 
for Farming 1 49 

The Professions as Close Cori>ora- 
tions 65 

Public Interest in Comparative 
Anatomy 261 

Respect each Other's Rights 28 

State Dentistry 147 

What is to be Done with the Army 
Dental Equipments 68 

CORRESPONDENCE. 

Dental Survey of the School Child- 
ren of the Province of Ontario . . . 297 

Focal Infection and the Family 
Dentist 31 

Nausea from Wearing a Denture 298 

Nausea f!-om Dentures 341 

OBITUARY. 

Dr. Leonard E. Stanley 36 

Dr. Andrew :\lcl>aren 38 

Dr. Charles Anderson Murray 113 

Dr. William R. P;itton 114 

Dr. Arnold Rea 452 

Dr. C. L. Strickland. Dead 266 

The L:tte Dr. A. H. Weagant 418 

BOOK REVIEWS. 

Book Keviews 33. 36. 265 



Dominion 

Dental Journal 

Vol. XXXI. TOHOXTO, JAXIARV 15, 1919. Xo. 1. 

Original Communications 

THE PREPARATION OF ROOTS FOR THE RECEPTION 

OF DOWEL CROWNS 



Irvin H. Ante, D.D.S., L.D.S. Toronto 

Associate Professor Prosthetic Dentistrij, Roi/al CoUrf/c of 

Dental Surgeons. 

Delivered l)efore the Kastern Ontario Dental So<'iety, Ottawa. September. I'Jls. 

1. Ill the field of crown work a clear conception and a thor- 
()n,s>-]i understanding of the indications and recinirenients of 
such substitutes are essentially necessary. Tt is lar<;'el\' a 
matter of judgment and discrimination as to tlie ])articuhn' 
method applicable to the case at hand. At tirst conclusion 
tliere may be several methods api)arently api)licable, ])ut there 
is Uisually one in i)articular whicli upon close observation will 
best aeet all of the requirements. While orown work is divi- 
de into two general classes, namely the shell, or telescope 
cro\vn and the dowel crown, the variation in the essential dc 
tail of their individual construction recpiires that each class he 
sub-d" ided and considered separately. 

THE DOWEL CROWN 

2. ')iiploij))ir'nf. Extensive loss of tooth structure fiom 
caries, fractured or accidental causes, discoloi'ation, impaired 
function, malformation, and as abntmeii'ts for bridges f)v 
special attachments. 

3.r pfiuiremeuts. There should always be enough tooth 
struc re remaining to secure stable anchorage. The i)re- 
j)arat ns of the roots are governed by the particular style of 
crow indicated, whicli in turn is governed by the stress to 
whicl it is subjected in the arch. These facts demand that 
the r t preparation, the crown construction and application 
shouh be made to afford resistance sufficient to secure the 
i^'reatest integrity of both root and crown. 



2 DOMINION DENTAL JOURNAL 

The crown should never jDa&s under the free margin of the 
gum any further than is absolutely necessary, and then only 
far enough to conceal the seam of union between the crown 
and root on the labial or buccal surfaces. It should be so con- 
structed as to produce a close approximate continuity and 
reproduce a normal appearance, anatomical form, interprox- 
imal space, embrasure, contact point, alignment, occlusion, 
and articulation, thus overcoming any tendency toward gin- 
gival inflammation, peridental and alveolar absorption or trau- 
matic injuries. 

4. Removing Coronial Portion. Undermine the crown of 
the too'th by cutting grooves from mesial to distal about two 
millimeters from the gingival margin on the labial and the 
lingual surfaces. Use a knife-edged carborundum stone, size 
half-inch, five-eighths and three-quarters, in the straight hand 
piece for the anterior teeth and in the contra or right angle 
for the bicuspids and molars. Fig. lA. 

Insert a fissure burr, No. 556 into the groove on the labial 
surface and destroy the continuity between the walls. Fig. 
IB. With the excising forceps and without danger of frac- 
turing the root the remaining portion of the crown may be 
nipped off. Fig. 1. The basal end of the root is trimmed 
down with square edged stones, root facers, small mounted 
stones, and burrs. 

Presuming that the tooth has been X-rayed, the surgical 
and therapeutic treatment of the same has been carried out. 
The root canal has been enlarged, thoroughly sterilized and 
dehydrated and is now ready for the inserting of the favorite 
root canal filling. 

If the root is intended to be used as an attachment for a 
dowel crown, it is necessary to fill only a portion of the canal. 
The root filling is packed tig'htly into the canal and about four 
or five millimeters of the apical end is filled. It is then 
X-rayed to verify conditions. If satisfactory, thin chloride of 
zinc cement is forced into the canal to hermetically seal the 
root canai filling. 

The Dowel. A dowel is a piece of metal fitted into two ad- 
jacent parts (the root and the crown in the direction of their 
longitudinal axis) to fasten them together. In roots which 
are even with or approximately the gingival line, attachment 
must necessarily be made by inserting a dowel. If the dowel 
selected is of a size proportionate with the size of the root and 
requirements of the crown and then attached to the root and 
the crown, such a mechanical fixation distributes the leverage 



ORKiLXAL COMMUNICATION'S 3 

throughout the length of the ix)ot, and thus forms a means of 
anchorage. 

Requirements of a dowel. It shouhl conform to the an- 
atomical form of the root canal. It shoukl fit closely to the 
walls of the canal throughout its entire lengtli. It should ex- 
tend into the canal length equal to the length of the crown to 
be restored. It should be con.strueted of a metal that will 
not corrode or disintegrate from the action of the cementing 
medium or the fluids of the mouth. It should possess enough 
strength to withstand the stress to which it is subjected. It 
should be constructed so as to prevent rotation, and afford a 
mechanical fixation between the connecting medium and the 
walls of the canal. 




FigM\J 1/ Uy VFiq.W 

The Adrautages of a Round Dowel. Elasy to remove from 
the canal after mounting. The canal is prepared with greater 
ease. A much larger gauge may be used in the same size 
round canal that would admit of the square. A ditference of 
two gauges 14 and 16 standard which is ecpuil to thirteen one 
thousandths of an inch. It conforms more favorably to the 
anatomical form of the root canal. It recjuires the least 
amount of tooth destruction. Fig. 2. 

Disadvantages. It does not help to {)revent rotation of 
the crown. The only advantage the square shaped dowel has 
over the round is that it helps to prevent rotation and on ac- 
count of being drawn with square edges it is supposed to pos- 
sess greater rigidity. 

The Disadvamtages of the Square Dowel Compared with 
the Round. Difficulty of canal preparation. If inserted into 
a round canal, it does not fit closely to the walls of the canal, 
also a smaller gauge must be used. 



4 DOMINION DENTAL JOURNAL 

It do^s not conform as favorably to the anatomical form 
of the root canal. If the canal is prepared square, the root 
is weakened in four places. Fig. 2. 

Comparison proves in favor of the round dowel. Tliere 
can be no rotation if the wire used is of adequate size; the 
crown and dowel, well adapted and the mounting secure; 
nevertheless this may be overcome by s(iuarely tapering the 
apical end of the dowel. The a])ical half is tapered for 
tlie canals of the cuspids, lower bicuspids, and the u])per 
centrals. The apical three-(iuarters, or a full tapering for 
the lower incisors, upper laterals, upper bicuspids, and all the 
canals of the molars. The dowel should also be flattened 
somewhat for the canals of the upper laterals, second bicus- 
})ids and mesio buccal of the molars, also the mesial canals 
of the lower molars. By so doing it will conform more favor- 
ably to the anatomical form of the root canal, when fitting the 
dowel to the canal if a porcelain crown is to be employed, cut 
the dowel to a length which will afford about four millimeters 
of surplus; if a facing, two millimeters is sufficient. If the 
dowel is shaped as described the gauge of the wire used is 
fourteen and sixteen round irridio platinum or gold and i)lat- 
inum alloy. 

Preparation of the Canal. The root canal should be en- 
larged sufficiently to receive a dowel proportionate in size with 
the diameter and probable length of the root ; and consistent 
with the requirements of the crown. Any further destraction 
of the tooth tissue is unnecessary. None but safe ended in- 
struments should be used (root reamers, twist drills, gates 
glidden, etc.) as there is danger of perforating the root. Start 
with small reamer and gradually increase in size until one 
approximating the same diameter as the dowel is finally 
used. Fig. 4. CVmals that are constructed mesial-distally are 
enlarged (with small reamers) to conform with their anatom- 
ical form. Fig. 5 A. 

When ready-to-wear, or porcelain crowns are to be used, 
the canal is enlarged at the expense of all the surfaces, so the 
dowel will sit directly in the centre of the root. When facings 
are employed the canal is enlarged at the exi)ense of the lin- 
gual half of the root, thus allowing })lenty of room labial ly for 
the adjusting of the facing to the pro])er relation and also in- 
creased attachment between the dowel and the coping. Fig. 5B. 

The writer will i)resent the following root pre])arations 
and construction of the l)ase foi- dowel crowns. 



ORIGINAL COMMUNICATION ^ 



Ready-to-Wcar. Separable dowel. Iiise))ara))le (iowel. 

Full Bcnul and Doivid. Peri'})ljeral band (Kicimiond). 
Shoulder band (Buttner). Iiiterdeiital band ' (('i<!:raii(l). 

Half hand and Doael. P>urnished lialf band. S\va^-e<l 
half band. 

Plate and Doucl. Angnilar base, Flat base. Half ^lionldcr, 
Lingual shoulder. 

The Separable and Inseparable Doacl CnnDts. The sei)ar- 
able dowel crown has a. removable dowel which is designated 
for the pnrj^ose of facilitating the adaptation of the ci'own to 
the root. Fig-. (>. 

The inseparable (h)wel crown lias an immovable dowd 
which is baked in or otherwise securely attached to the porce- 
lain crown. Fig. 7. 

Indications. For single crowns only. On the nppei* six 
anterior teeth. As a tem})orary crown. Fxpediency. Co!i- 
dition of instability of the root. 

Advantages. Presents good esthetic effect. Ease with 
which the crown may be adapted. The natural condition of 




n<j.vin 

the gingival is preserved. Inexpensive. The oi)eration ma> 
be completed in one sitting. 

Disadrantacjes. Difficulty of obtaining a crown of the 
same shape and diameter as the base end of the root. Fig. 
9 B. Dithculty of securing a perfect continuity and adaptation 
between the base and periphery of the root by grinding. The 
absence of the preventive means against the disintegration 
of the cementing medium. The penetration of the saliva and 
destruction of the root by caries or fracture. The ease with 
which the crown may be ada])ted encourages carelessness. 
They cannot be used as abutnuMits for bridges or special at- 
tachments. 

The permanency and success of such crowns depend to a 
great extent upon the degree of accuracy secured in the 
adaptation to the root. Its base should be so shaped as to 
prevent rotation and render the opportunities for a close 
adaptation most favorable. The basal en<l of the root i- bevel- 



6 DOMINION DENTAL JOURNAL 

ed both labially and lingually from the central point. The 
labial bevel extending under the free gum margin to a depth 
of one and a half to two millimeters, the lingual bevel is car- 
ried just to or a little above the gum margin. Figs. 6 and 7. 

Many of the disadvantages of the ready-to-wear crown 
may be overcome by titting a dowel and adapting a coping of 
pure gold (32 gauge) to the basal end of the root, unite the 
two with solder, replace on root, take impression and bite, 
secure model ; then grind the crown to fit the coping instead 
of the root. Fig. 8. 

The Full Band and Doivel Crown. There are three types 
—the peripheral band and dowel, the shoulder band and 
dowel, and the interdental band and dowel. 




The Peripheral Band and Doivel Crown. This style of 
crown involves the adaptation of a full band to the periphery 
of the root, a pure gold cap to the basal end of the root, the 
fitting of a dowel and attaching thereto, and then the sub- 
sequent attaching of the parts. Fig. 9. 

Indications. On fractured roots, on weak roots requiring 
increased mechanical support to prevent fracture, on roots of 
the bicuspids, molars and lower incisors ; on very short roots, 
in cases of very close occlusion ; for single crowns or as abut- 
ments. 

Advantages. It gives a maximum of strength and stabil- 
ity of attachment. The basal end of the root is more or less 
immune to the penetration of secretions. A safeguard against 
fracture. 



ORIGIXAL COMMUNICATIONS 7 

Disadvantages. The gin^i\'al enamel is destroyed. Diffi- 
culty of removing aTl of the gingival enamel. Difficulty of 
reproducing the natural gingival contour. .A tende:.cy to 
gingival irritation. Difficulty of securing close api)roximity 
and continuity. It lacks esthetic requirements. 

The basal end of the root is prepared to a flat incline from 
buccal to lingual, or the angular sha])ed base of 40 to 45 de- 
grees centigrade. Fig. 9. It also is left projecting out of the 
gum 3 mm. on the lingual side and 2 on the buccal to facili- 
tate in removing the enamel, taking of the measurements fit- 
ting, contouring and festooning the band. 

The root is finally trimmed down to a depth of 1 mm. on 
buccal and 2 mm. on lingual. An impression is taken of the 
end of the root, an amalgam model is secured, and a pure gold 
cap is swaged (3() gauge). The band is fitted over this, and 
the two united with solder; then refitted upon the root in the 
mouth, and burnished at the gingival to close approximity; 
then reinforced at that point with solder. Fig. 9. 

When possible it is advisable to eliminate as far as pos- 
sible the necessity of bands that pass under the free margin 
of the gum. It should extend only far enough to ])rotect the 
seam of union. It should be in such proximity to the root as 
to preserve its continuity, and constructed so as to repro- 
duce the normal anatomical form at that point. 

The Interdental Band and Dowel. For the reception of 
the interdental band, a groove is trephined into the base of 
the root about 2 mm. deep, midway between the canal and 
the periphery. The band of rigid plate is fitted into this 
groove, a plate coping is soldered thereto and burnished to 
the base end of the root; then the dowel is subsequently at- 
tached. Fig. lOA. 

Indications. On large, vStrong roots, free from decay 
where increased mechanical support seems desirable. (Upper 
centrals and cuspids.) 

Advantages. Same as the peripheral band, except that the 
root is not as immunei to penetration of secretions. All of the 
disadvantages of the peripheral band are eliminated by the 
adaptation of the interdental band; but there is a greater 
sacrifice of tooth tissue. 

The Full Shoulder Band and Don: el Crown. In the ap- 
plication of the full shoulder band the gingival enamel is all 
removed and the periphery of the root is cut or trephined so 
as to form a seat for the accommodation of a band and cop- 
ing, or a swaged cap— the latter preferred. The dowel is 



8 DOMINION DENTAL JOURNAL 

subsequently attached thereto. Fig. lOB. The indications, 
advantages and disadvantages are practically the same as for 
the ]jeripheral, except that there is not the same difficulty of 
securing close proximity or continuity, or the tendency to 
gingival irritations. 

The Half Band and Dcnvel Croivn, In a lialf band dowel 
crown the band encircles only the proximal and lingual sur- 
faces of the root. The cap may be constructed by one-piece 
methods, burnishing or swaging, and a dowel attached there- 
to. 

Indications. On any root, except fractured, when it is 
possible to allow the root end to project sliglitly beyond the 
gum on the lingual surface. For single crowns or as abut- 
ments. 

Advantages. It increases the stability of attachment to 
the root. It fortifies the root against stress in the direction 
in which it is usually imposed. The most susceptible surface 
(the lingual) is rendered more or less immune to caries. It 
is necessary to remove only the lingual half of the gingival 
enamel. It conserves tooth tissue. It increases esthetic pos- 
sibilities. 

Disadvantages. Part of the natural gingival contour is 
destroyed, a tendency to gingival irritation on proximal and 
lingual surfaces; the bite will not always permit leaving tire 
root long enough on the lingual surfaces for the adai)tation 
of the half band. 

The shape given the end of the root is an obtuse angle 
of about 40 degrees centigrade. The labial sloj^e extends 
from a point one and a half mm. under the free gum margin 
on the labial to a point lingual of the root canal. The lingual 
slope extends lingual ly, meeting the lingual su-rface of the 
root at about right angles, and one inm. above the gum margin. 

On^e-piece Method Burnishing. A piece of pure gold 
(gauge 34) is adapted to the end of the root. Leave a suri)lus 
of 1 mm. on the proximal surface and 3 mm. on the lingual 
surface to extend beyond the periphery of the j'oot. Burnish 
to end of root (a |)iece of rubber). Insert dowel and 
solder to coping. Burnish coping with orange wood 
in the automatic mallet; trim off surplus gold on tlu- 
labial surface close to ])eripheral line, cut co])ing on lingual 
from outer edge to peri])heral line, which is indicated on gold 
from malleting; burnish gold to root on lingual (plastic in- 
strument) ; cut a V-shay)e(l space where gold overlaps. Draw 
V-shaped space together and solder. (Fig. 11.) Trim, and 



ORIGIXAL COMMUNICATIONS 



then burnish to eloso proximity. Two or more cuts on iIk- 
lingual surface are sometimes necessary. Swai^in.i;- this copiiiii 
will be considered separately. 

The Plate aitfl Done} (' roini. The plate and (h)\vel crown 
diifer from the ]>receding' by the absence of a band, or half 
band. It consists of adai)ting a piece of metal to the basal 
end of the root by burnishing or swaging, and subse(iuently 
attaching a dowel thereto. The different shapes given the 
basal end of the root are the angulai-, the Hat, tlu' half shoul- 
der, and the lingual shoulder. 

The Angular Base. Indications. This foi-m of base ha> 
a w^ide range of api)lication, and is })r()bably tlie most exten- 
sively used in making restoration of the u])per anteiior ten 
teeth, the lower cuspids and bicusj)ids, foi* single ci-owns. 
(Fig. l(i.) / 




Advantages. Tt produces a close proximity and con- 
tinuity between the crown, and both the periphery and basal 
end of the root. The natural condition of the ging-ival enamel 
is preserved, the conservation of tooth tissue, and greater 
esthetic possibilities are afforded. The possibilities of gingi- 
val irritation are reduced to a minimum; it lends itself to the 
adaptation of any form of facing or crown. The angular base 
alYords mechanical resistance to the stress imposed, and over- 
coming any tendency towards rotation. 

Disadrantafies. Tt is not snitable as an abutment for a 
bridge. The shape given to the basal end of the root is i)rac- 
tically the same as for the half band, but the angle is more 
acute, being about 35 degrees centigrade; also the lingual 
slope extends just to or about one-half mm. below the free 
gum margin. (Fig. VI.) The coping is either burnished 



10 DOMINION DENTAL JOURNAL 

direct, as heretofore described (half band) or swaged and 
then burnished. 

The Flat Base. While the flat base has a somewhat limit- 
ed use, it may be employed on second bicuspids and molars 
for single crowns. These teeth usually receive vertical stress ; 
the dowel will take care of any lateral stress that may be 
imposed. It may also be employed on roots so disintegrated 
by caries, thus making it impossible to prepare any other 
form of root preparation. 

Advantages. Greater destruction of tooth tissue, offers 
no aiiechanical resistance to stress, does not prevent rotation, 
and suitable for single crowns only. 

To prevent the crowns from rotating, a groove is cut in 
the basel end of the root, from lingual to labial. It is made 
from 2 to 3 mm. wide and about 2 mm. deep at the central 
point, which is at the canal, and gradually diminishes until 
it reaches within 1 mm. of the periphery. (Fig. 13A.) The 
root may be protected against fracture on upper by inserting 
an interdental pin of 18-gauge irrideo platinum aria into the 
basel end of the root, midway between the root canal and the 
lingual surface. The hole is prepared with a one-half mm. 
or a No. 1 round burr, and is made about 3 mm. deep. The 
pin is attached to the coping with solder. (Fig. 13 B and C.) 

The Half Shoulder (Fig. 24.) The shoulder preparation 
differs somewhat from the preceding forms, and consists of a 
combination of the half band preparation (Fig. 14A), and the 
angular plate and dowel preparation (Flig, 14B),'*with a 
shoulder cut on the lingual half of the root and extending 
from the lingual to the proximal surfaces. (Fig. 14C.) 

Indications. It is used when the employment of a band 
or half band is indicated, but seemingly undesirable on any 
tooth except the lower incisors for single crowns or as abut- 
ments. The advantages are the same as for the angular 
plate and dowel preparation, but it also gives additional me- 
chanical support. 

Disadvantages. Difficult to prepare. The best results 
will be obtained by first swaging the coping, 34-gauge pure 
gold (amalgam die), then burnishing directly to the root. 

The Lingual Shoulder. The lingual shoulder is practical- 
ly the same as the former, except that the root is given the 
half band preparation. (Fig. 15 A.) Then a shoulder is cut 
on the lingual half of the root end from mesial to distal mid- 
way between the canal and the lingual surface of the root. 
(Fig. 15 B and C.) The indications, advantages and disad- 



ORIGINAL COMMUNICATIONS 



11 



vantages are the same as the former, except that it is much 
easier to prepare; also the copiuo- may be burnished directly 
to the root. 

Concaving the Basel End of Boots. It consists o.f cutting 
a concavity on to the labial half of the base! end of the root, 
the greatest depth of the concavity being (about 2 nnn. at the 
root canal then extending to the labial, mesial and distal, grad- 
uall.y diminishing as 'it reaches the perpheral edge of the root. 
Fig. 16. 

'Indications. It may be employed with any of the root 
preparations except flat or decayed, the root of which is to sup- 
port a crown with a facing or artifical crown, it is especially 
useful on roots where the gum on the lingual surface has re- 




ceded to excess, thus producing a long labial and a short 
lingual surface. 

Advantages. Greater opportunities are alTorded for the 
adaptation of a porcelain crown or facing. It eliminates any 
prominence or display of gold on the gingival, it increases 
the mechanical retention to the root, it produces a minimum 
of grinding of the facing of the crown, it gives increased sol- 
dering possibilities, it eliminates the possibility of rotation, 
it increases the attachment of the dowel to the coping. Fig. 17. 
AVhen the gum has receded to excess on the labial, thus pro- 
ducing a long labial surface, the root is prepared with a flat 
ncline from the labial to the lingual even with the gnm 
line. Fig. 18 A. The labial one third of the root surface is 
prepared so as to extend under the free margin of the gum. 
The lino-ual half of the root surface is concaved as described. 



12 DO'MINION DENTAL JOURNAL 

When adapting- the facing, the neck or ridge lap is ground so 
as to form an abbutted joint to the labial bevel. Fig. 18 B. 
When possible, a narrow half band should be employed on the 
lingual as the stress imposed would tend to fracture the root. 
Fig. 19. 

Decayed Roots. With these conditions most of the roots 
have been destroyed from disintegration or fracture, and 
present funnelled concaved basel surface with smooth or ir- 
regular edges. The root end is invariably embedded beneath 
the gum and because of the extreme shortness and close |)rox- 
imity of tlie end of the root to- the border of the alvelolus, no 
opportunity is aft'order for the adaptation of a band. The 
best means of securing a coping will depend much upon the 
conditions presenting. When impossible to adapt a band the 
base should be so constructed as to give increased mechanical 
support and prevent fracture. Grood results may be obtained 
by burnishing, swaging, or casting. Fig. 20 represents con- 
caved funnel shaped roots from destruction of caries. 

'Burnished Coping for Funnelled Roots. Fig. 19 A & B. 
A i)iece of pure gold 34 gauge is trimmed to from a round 
disk, make a cut from the outer edge of the gold to the centre 
overlap the edges of the gold to form a funnel. Fig. 21 A. 
Place up on root and force the dowel through same, remove and 
solder the two together. Replace upon root, burnish or mal- 
lett the gold to close proximity with the irregular edges of 
the root and trim flush with the periphery. Fig. 21 B. 

Cast Coping for Funnelled Roots. A flat coping of pure 
gold 84 gauge slightly larger than the basel end of the root is 
adapted to the end of the root, the dowel is forced through 
and then soldered, flow inlay wax upon the under surface of 
the coping and while warm, force to place u[)on the root, re- 
move and trim away the excess, heat again and refit, insert 
sprue wire, invest, heat, and cast. The root base now consists of 
dowel, coping and cast core, replace upon the root and with 
the automatic mallett, burnish the edges of the coping to the 
l)eriphery of the root, overlapping the peripheral edge where- 
ever possible, trim away excess gold and re])lace ready for im- 
pression. Fig. 20 C. 

Fig. 22 represents a root with the labial surface decayed 
away and extending far up under the gum. The lingual sur- 
face extends just under tlie free gum mai-gin making it im- 
possible to adapt a band, Fig. 20 A. The coping is either 
liurnished or swaged so as to fit the basel end of the root. 
The dowel is inserted and attached to the coping, two small 



ORIGINAL COMMUNICATIONS 



13 



holes are drilled into the basal end of tlie root, one on the 
lingual, and the other on the labial midway between the eanal 
and the lingual or labial surfaces, small pins are inserted into 
these holes and attached to the coping with solder. Fig. 2'2 P). 

(Method '2). Fig. 22 C. Another method is to adjust the 
dowel, attach to it a flat coping parallel with the gingival line, 
insert small pin as described above, flow wax upon the under- 
surface of the coping and press to place npon the i-oot, trim off' 
excess wax. invest and cast in gold. 







(h)[l^'^'^^j(c) 






fa)\ r'9'^^\ \l(h) \ /(c) Kiy ^^9-^^\V^^> 







Fiq.M 



Fig. 2:> is a condition where the labial half of the root has 
broken away (fractured) leaving the lingnal half of which ex- 
tends out of the gum margin sufficient to ada])t a partial band. 
(Method 1). Adapt a band to the lingual half of the root, 
to the band solder a flat coping the same size as the basal end 
of the root, adapt a dowel to canal and then attach it to tlie 
cojung, flow inlay wax upon undersurface and reproduce in 
gold by casting Fig. 23 B. (Method 2). Construct a band of 
:U gauge pure gold the shape of Fig. 23 1), and the same size 



14 DOMIXIOX DENTAL JOURNAL 

as the circumference of the lingual half of the root, the band 
is adapted with the lug extending toward the labial, which is 
burnished to the labial half of the root, a top is soldered to the 
band and then the dowel to the coping. Fig. 23 C. 

Fig. 24, A. B. C. represent the direct casting method, the 
dowel is adjusted to place, the crowns are selected and ground 
to proper form, then pure gold 34 gauge is burnished to their 
base, the dowel is forced through the gold base into the crown 
and then attached with solder, flow inlay wax upon the under- 
surface of the crown around the dowel and while warm press 
to place upon the root, remove, trim away excess wax and refit 
upon the root, remove porcelain crown, invest and cast. 

Fig. 24 C is a bicuspid with the labial half of the root 
broken away leaving the lingual cusp intact. Grind olf about 
one third of the lingual half of the root, adjust dowel, keep- 
ing it close to the lingual surface and extending out of the 
canal about 5mms. select a facing and grind to proper anatom- 
ical form, (replacable facings may also be used) back the fac- 
ing with 34 gauge pure gold. Fasten the backing and dowel 
together with sticky wax and adjust to the proper position 
upon the root, remove from the mouth, remove facing and sol- 
der the dowel and backing together, replace facing and flow 
inlay wax upon the lingual, occlusal and around the dowel and 
neck of the facing, while the wax is warm force to place upon 
the root, then have patient close the teeth together and give 
occluding and articulating movements, remove, trim off excess 
wax, carve to correct anatomical form, replace upon root to 
verify conditions, remove facing, invest and cast. 

Sivaging. Impression of the root end in compound re- 
tained in small copper band (Blue Island), or Ransome and 
Randolph. 

Copper amalgam model made from impression. 

Pure gold swaged upon model (34 gauge). 

Cap or Coping fitted upon root in mouth and the peripher- 
al margin are malleted with a boot plugger and light blow 
from the automatic mallet. 

Casting produces a tight fit and inaccurate adaptation. 

Burnishing produces a loose fit, but accurate adaptation. 

Swaging produces a loose fit and a more accurate adap- 
tation. 

Swaging and burnishing produce a loose fit but most ac- 
curate adaptation. 

In conclusion it may not be amiss to point out the all im- 
portance of the X-ray (radiographs) in verifying or censur- 



ORIGINAL COMMUNICATIONS 15 

ing the condition of the root. The therapeutic or surgical 
treatment of the root or root canal fillings, the accuracy of the 
adaptation of bands, co[)ing caps, dowels, etc., in fact all the 
factors that constitute scientific crown work. 



A FEW POINTS ABOUT SYPHILIS OF INTEREST 

TO DENTISTS 



Maxwell Lautehmax, M.D., Montreal, Que. 

Read before Montreal Dental Olub, April, 1912. 

The importance of this subject is- such that I do not feel 
any apology needed for bringing it before a class of men who 
are brought into more intimate contact with the sufferers from 
this affection, and who at the same time are themselves 
exposed to greater danger from infection than are any other 
class of men that I know of, to say nothing of the dangers 
to others with whom the dentist comes in contact in the exer- 
cise of his calling. 

The results of investigation by scientific students of 
medicine during the last ten years have so altered our views 
with reference to this disease that many of the ideas then 
held are now known to be erroneous, and I think you will 
agree with me that much misery has resulted from these 
erroneous views. 

The history of syphilis offers one of the most interesting 
pages in the annals of medicine. The period o-f its origin 
is not definitely known, but it is more than likelj^ that some 
of the so^'alled leprosy of the Bible were cases of syphilis. 
It was certainly recognized in Italy as a distinct disease 
late in the fifteenth century, when Naples was besieged by 
Charles VIII. In America it is supposed to have originally 
come over with Columbus and Amerigo Vespucci in 1492, 
although Prof. Jones, in 1878, described unmistakable 
evidences of syphilis found in the bones of aborigines that 
had been dug up in the Southern States, so that there are 
those who believe it was originally carried from America to 
Europe by the sailors who discovered America. Be this 
as it may, syphilis was certainly known in both China and 
Japan several thousand years ago, as is amply proven by 
documents that have come to us. 

During the earlier periods of its existence in Europe 
syphilis is S'aid to have been so malignant and widely dissem- 



16 DOMINION DENTAL JOURNAL 

iiiated as to constitute a plague that nearly destroyed the 
armies of the afflicted countries. The disease lias gradually 
irrown milder in t\"pe, so that very severe cases are spoken 
of as being malignant. The reasons for this diminution in 
virulence are: P^irst, improvements in sanitation and p'er- 
sonal hygiene, as well as more rational methods of treatment, 
and the fact that diseases occuring in individuals in one 
generation seem to impart a degree of immunit\ to their 
dcvscendants. 

Dr. Lyman, of Chicago, wrote a very interesting article 
a few years ago which throws some light on this subject. He 
cites as an example the extraordinary malignancy of measles 
among the natives of the Sand^^ich Islands. These natives 
had never suffered from measles until it was imported by 
the whites, consequently they had not acquired any tolerance 
to the disease. Although the population of the islands was 
almost decimated at the time, the disease has steadily declined 
in severity ever since. 

Applying this theory to syphilis, it may be easily seen 
that the disease has probably destroyed those least able to 
resist it, and that the immunity acciuired in the case of the 
survivors by exposure to its influence has been transmitted 
to successive generations and has tended to render syphilis at 
the present day a much milder affection. 

The importance of hereditary modifications of constitu- 
tion as produced by syphilis has not, in my opinion, received 
the attention it deserves from the medical profession, and 
I am satisfied that many of the hereditary perversions of 
growth, nutrition and development are due to its influence 
somewhere along the ancestral line. 

Malformations. 
Such as talij)es, epispadias, s})ina bifuda, cleft palate and 
rickets are undoubtedly, in many cases, hereditary sy})hilis 
pyi masque. 

Cause. 

Ever since the dawn of bacteriology, it has been generally 
lecognized that syphilis was caused by some form of micro- 
organism, so that when Lustgarden described a bacillus in 
1SS4 which he had found in syphilic lesions, it seemed, for 
a time at least, that the cause of syphilis had been isolated. 
These bacilli had, however, not been successfully cultivated, 
so that the reciuirements formulated by Koch as necessary 
to prove that i)athogenic nature of a specific micro-organism 



ORIGINAL COMMUNICATIONS 17 

ivere never fulfilled. This state of affairs lasted until April, 
1905, when Schaudin and Hoffman described certain spiral 
bodies found in connection with syphilic lesions, and which 
these authorities claimed were the specific cause of syphilis. 
The independent observations of Metchnikoff and Roux, 
who found similar bodies in apes that had been successfully 
inoculated with syphilis, tended to confirm their observations. 
This new organism, now known as the spirochetta palidda, 
is from four to twenty micro-millimetres long-, very mobile, 
thin and spiral, like a corkscrew or wound spring, with 
tapering ends. The spirals are regular, narrow and deep, 
and vary from six to twenty-six in number. It has been 
found in all forms of s^^ohilio lesion, at all stages of the 
disease, in both the acquired and hereditary forms. 

Description. 

Syphilis is a specific constitutional disease, acquired by 
contagion or inheritance, frequently, but not by any means 
always, dtiring sexual intercourse. It is characterized by 
the appearance of a primary lesion at the seat of inoculation, 
followed by periods of eruption, which vary in nature, severity 
and duration. 

Methods of Infection. 

The essential requirements for the transmission of the 
disease are: (1) The specific poison; (2) an inoculable 
situation. 

So that anv combination of circumstances which brings 
this condition to pass is sufficient to procure the disease. 
Sexual intercourse is probably still the means by which it is 
transmitted in the majority of cases, but the records compiled 
by many authors go to show that almost, if not quite as 
man}', become infected in other ways. Bulkley, in his well- 
known book, '^ Syphilis in the Innocent," published in 1894, 
describes almost every conceivable position and action of 
daily life as a possible means of transmitting the disease. 
I shall only refer to a few cases that present points of 
especial interest to us. 

1. A case reported by Dr. Roddick, of this city, in which 
a married woman, age 30, the wife of a physician, developed 
a chancre of the gum, following the extraction of a tooth 
during which the gum had been much lacerated. A careful 
study of every detail led to the conclusion that the forceps 
used had been the means of carrying the disease from a 
patient operated on previous to this case. 



18 DOMINION DENTAL JOURNAL 

2. A case that occurred in my own practice, where two 
young ladies were infected, one on the cheek, the other on 
the angle of the mouth, apparently from the use of a metal 
clip used to hold a piece of rubber dam in place while the 
teeth were being filled. This clip had been previously used 
on another patient suffering from severe mouth syphilis. 

3. A remarkable instance in which nine out of fifteen 
people who had been tatooed within ten days of the same 
individual, using, as far as could be ascertained, the same 
needles, became infected. 

4. Leloir mentions a case of a man with infecting chancre 
of the gum, in which the contagion had been produced by the 
process of filling a decayed tooth. 

Lancereaux, Giovanni, Otis and Dulles report similar 
cases. On the other hand, instances of dentists themselves 
becoming infected are equally common, and I have treated 
at least five such during the last seventeen years. 

The earlier manifestations are superficial; the later ones 
involve the deeper structures, and no organ in the body is 
immune from invasion. The connective tissues are most 
constantly affected, at first in the form of a low, chronic 
inflammation, and later as the seat of small morbid growths, 
known as gummata. 

Course. 

After contact of the poison with a surface capable of 
absorption, a variable period elapses before any signs 
develop. This constitutes the so-called period of incubatioii, 
which is usually about twenty days. Many notable excep- 
tions to this rule have been recorded. Among the most 
notable of these is the case of Dr. Xott, of New York, who 
developed a typical chancre twenty-four hours after wound- 
ing his finger during the course of an operation on an infected 
patient. Taylor reports a case with an incubation of two 
days, and Hammond one of three days. On the other hand, 
Fournier and Geurin report cases of seventy-five days. The 
])ersonal equation maintains in this as in everything else, 
and it is easy to understand that one organism may offer 
more resistance to the invader than another. 

The lesion when it develops is referred to as a chancre, 
and constitutes the first characteristic lesion of the disease. 
It may begin in the form of a dry papule, or a moist tubercle. 



ORIGINAL COMMUNICATIONS \') 

an excavated ulcer, or an eroded surface; it is still a eliauero, 
whatever its appearance or situation. Witliin about two 
weeks of its ai)pearance the lymphatic glands in its nei^li- 
borhood begin to swell and become indurated. As a rule^ 
they are not specially painful and do not tend to suppurate. 
Tliis marks the end of the i)rimary and be^innin«- of the 
so-called secondary stag'e, which, in its turn, has its period 
of incubation, so that in about a month fiom the time the 
i»"lands enlarge a rash makes its aj>pearance; it is scattered 
more or less uniformly over the body. This stage is occa- 
sionally attended by a rise of temperature, Avhich is, as a rule, 
not high, as well as rheumatoid pains, which are worse at 
night. There inay be headache, the hair may fall out, and 
the eyes become involved. These symi)toms in the vast 
majority of cases gradually subside, so tliat at the end of a 
year or so there seems to be a lull in the course of the disease. 
There may be an entire absence of sym])tonis for months, or 
even years. Then, as a rule, new outbreaks appear on the 
skin, in the mouth, on the fauces; periosteal pains in all the 
superficial bones may now assert themselves, and a certain 
amount of failure in general health is the rule. 

Now begins what is described as the tertiary stage, and 
here, let me remark, that if the secondary symptoms have 
been mild the tertiary will usually be severe, and vice versa. 
so that in this stage the manifestations are exceedingly 
variable in extent, intensity and duration. Any tissue or 
organ in the body may becouie involved— the lungs, the liver, 
the kidneys, the brain, the blood vessels, the bones, the 
muscles, the tendons, the joints— and in severe cases a well- 
marked cachexia indicates the involvement more or less of 
every cell in the body. This, briefly, is in a general way the 
course the disease follows. There may be, however, evei-y 
possible form of exception and irregularity imaginable, as 
there is no disease or pathological process that can furnish 
as many surprises as sy})hilis. AVliat T have just stated 
a])plies to accpiired syphilis. Let us now see what we find 
in the hereditary form of the disease. As^ a dentist is not 
called upon to deal with these cases, as a rule, before the first 
dentition has been comi)leted, I shall not refer to the condi- 
tions which medical men are called u])on to deal with in this 
connection, other than to mention that these children present 
certain characteristic signs which show very clearly that they 



20 DOMINION DENTAL JOURNAL 

are sufferers from a systemic disease. These indications 
vary, however, very considerably in both character and 
degree, depending- in great measure npon the intensity and 
stage of the disease in the parent or parents, as the case may 
be, that is responsible for the transmission of the disease to 
the offspring. These children give one the impression of 
being much older than they are, often assuming the appear- 
ance of wizened old men. They may snffer from eye and 
ear affections, and nearly always have mucous patches in 
their mouths, which are highly infectious. The first teeth, 
instead of being cut in the sixth or seventh month, appear 
very early (two or three months), or very late (fourteen to 
fifteen months, or even later). They are especially liable to 
decay, but there is nothing sufficiently characteristic about 
them to be of diagnostic value. ' But when they are replaced 
by the permanent teeth, one sees the characteristic notched 
teeth with which Hutchinson's name is associated. Another 
defect not so often recognized is described by Hutchinson 
himself as a deficiency of enamel in the milk canines. A 
central, discolored, blunt peg projects from and is separated 
by a narrow groove from a base or collar of normal-looking 
tooth tissue. A second, described by Fournier and Darier, 
is a similar condition affecting the first permanent molars. 
The enamel on the crown of these teeth is imperfectly formed. 
The soft dentine grows on to irregular projections, which fall 
an easy prey to caries. Consequently, these teeth nearly 
always become decayed at an early period. Peridontitis is 
frequently caused by syphilis, and is only a localized expres- 
sion of the change that takes place in the periostium and 
bones throughout the body. Exostosis, due to syphilitic 
irritation of the peridental membrane, is another such mani- 
festation, as is pyorrhoea alveolaris in certain cases. The 
same is true of dental neuralgias and antrum disease, due 
to the inflammation of its lining membrane and gummata. 
Irregularities in the size and shape of the palate and teeth 
may be due to the same cause. 

The study of s>7)hilis as seen in the mouth, and its diag- 
nosis, from the other conditions with which it may be con- 
founded, is, of course, of more importance to us to-day than 
its other features. An idea of their importance may be found 
from Bulkley's ^^ Statistics of Extra-Genital Syphilis, '^ of 
which over 50 per cent, were acquired from mouth lesions. 



ORIGINAL COMMUNICATIONS 21 

The diseased conditions most frequently seen in the mouth, 
and which must be differentiated, are: 

1. The primary chancre ; 

2. Mucous patches ; 

3. Gummata; 

4. Epithelioma; 

5. Tubercular ulcers ; 

6. Leucoplakia; 

7. Stomatitis. 

1. Chancre of the lip or tongue are usually single, and in 
these situations have no distinctive characters. They are 
elevated, raw erasions, with a shiny and red or abraided 
surface, which may or may not be covered by a membraneous 
film, and the submaxillary glands are always enlarged. 
There is also induration and deep involvement of the anterior 
segment of the tongue and circumscribed sclerosis, with 
much tumefaction of the inside of the cheek or gum. 

2. Mucous patches are by far the more frequent and 
important lesions we have to consider. They are full}^ as 
infectious as the full-blown initial chancre. They may be 
macular or papular, each type being modified by its situation 
in the mouth and being exposed to friction of contiguous 
surfaces and of ingested food and drink, heat and cold. 
They vary in size from a split pea to a ten-cent piece, or even 
larger. They may be round, oval or irregular, often raised 
above the level of the surrounding tissue, usually painful, 
and most frequently oppose each other where the mucous 
membrane comes in contact, such as the angles of the mouth, 
the cheek and gum, the two halves of the angular crevice 
behind the last molar teeth. A common development in these 
lesions is a superficial ulceration, due to the removal by 
friction of the already damaged epithelium, so that they bleed 
easily when touched, are very sensitive, and have a tendency 
to extend along the lines formed by the folds and angles of 
the mucous membranes. 

3. Gummata occur in all the regions of the mouth, as 
infiltrations, diffuse or circumscribed, usually single, rarely 
multiple, breaking easily into ragged ulcers, with irregular 
edges. The substance of the tongue and of the hard palate 
are conmion sites for these lesions, which do not as a rule 
occur before at least a year after the time of infection. 

4. Epitheliomata are often difficult to distinguish from 
syphilis lesions. Here the process is much slower than in 



21 DOMINION DENTAL JOURNAL 

syphilis. The patient is older— usually over forty-years of 
age. The pain is usually greater, and the mass may present 
a warty appearance. The lesion, as a whole, is larger and 
bulkier, and if ulceration takes place the edges are everted 
and the base of the ulcer more florid. 

6. Leucoplakia, often spoken of as smoker's patches, are 
lesions that are now regarded as being of syphilitic origin 
and aggravated by smoking. They may appear as patches, 
spots, or bands of dull opaline, smooth or rough areas, in the 
mouths of syphilitic patients who had previously had mucous 
patches. Frequent situations are along the lines of the jaws, 
the tongue, the inner side of the cheeks, the angles of the 
mouth, the gums, and they are supposed to tend to the devel- 
opment of epithelioma, which is certainly often seen asso- 
ciated with these lesions. 

7. Stomatitis is a condition that sometimes becomes so 
severe as to simulate some of the lesions described here. The 
multiplicity of the lesions, their rapid development, the foetid 
breath, are, as a rule,- sufficient to establish the diagnosis. 

Neisser, as a result of three years' work on syphilis, has 
come to tbe following conclusions: The spirichetta of 
Schaudin are the cause of syphilis ; wherever they are found 
syphilis is surely present. Negative results must be carefully 
interpreted, as the organism is not easily demonstrated. 

In apes the typical chancre develops in from twenty to 
fifty days after inoculation, thus corresponding to the period 
in man. Apes are subject, also, to the constitutional symp- 
toms of the disease. Inoculation of matter from tertiary 
lesions proved successful, and produced the same symptoms 
and lesions as inoculations from primary lesions. Outside 
the animal body the virus soon loses its virulence, probably 
within a few hours. It can also be destroyed by physical and 
chemical methods. 

That syphilis can be cured is demonstrated by the fact 
that animals inoculated with the disease and subjected to treat- 
ment have later again been successfully inoculated. Neisser 
denies the fact of imnnmity, and lays down that only s\i)hilis- 
free subjects can contract syphilis. Persons refractory to 
syphilitic infection are themselves actually syphilitic. The 
serum diagiiosis of syphilis introduced by Wasserman is 
strongly supported by I^eisser, who says, dognuitically and 
categorically: ''Only with the serum of a syphilitic i)erson 



ORIGINAL COMMUNICATIONS 25 

do we get a positive reaction. A negative result is, however, 
not of equal value." 

Noguchi, of the l-voekefeller hisiitutc of Research, has 
just given the world a new test, whieh is known as tiie Leutin 
reaction, which is even more reliable than the Wasseiinan 
reaction, and has the additional advantage of being applicable 
in cases that do not react to the Wasserman test. These two 
tests, in addition to tlie well-known clinical signs of the 
disease, should make a diagnosis ])ossiblc in an>' doubtful 
case. 

I^EEVENTIOX. 

The medicine of to-da}' is teaching more than ever before 
in the world's history "that prevention is better than cure," 
and 1 know of no disease in which this case applies better 
than in the case of syphilis. The State assumes the respon- 
sibility of safeguarding us against smallpox, scarlet fever, 
diphtheria, and other contagious diseases, but does not pay 
any attention to syphilis, which, we have seen, is (juite as 
s.^rious as any of the other diseases mentioned and further- 
reaching in its effect. Such time-honored institutions as the 
public drinking cup, for example, should be done away with. 

Education of our patients to a sense of their duty towards 
their fellow-beings, with a view to preventing the dissemin- 
ation of the disease among those with whom they come in 
contact with is, to my mind, the duty of every physician or 
dentist who has to do with such a case. 

Greater care on the part of the dentist as regards the 
sterilization of instruments, either by boiling or immersing 
them in antiseptic solutions, such as carbolic (1-100) or 
lysol; protecting their fingers during operations on infected 
patients, either by the use of rubber finger-cots or coating the 
fingers with collodion, or the thorough innunction of the 
fingers with a 33 i)er cent, ointment of calomel in lanoline, 
which will, in most cases, destroy the spirrochetta, and even 
prevent infection from developing, if it has already taken 
place. 

Treatment. 

It should be thoroughly appreciated that the lesions seen 
in the mouth of the syphilitic are but the local manifestations 
or expressions of a constitutional disorder, whicli is (piite 
impossible to eradicate by the treatment of these lesions 
alone. Mercury, the iodides and arsenic, in some form, are 
the remedies most commonly employed for this purpose. 



24 DOMINION DENTAL JOURNAL 

Theodoric, a Dominican monk, used mercury by innunc- 
tion as early as 1250 A.D., while Ricord used arsenic in the 
form of Donovan's solution. Later, Hallopean used atoxyl, 
another preparation of arsenic; and more recently still, 
Erlich and Hatta introduced Salvarsan, or '^606," which is 
also a preparation of arsenic. Erlich claimed for this prepar- 
ation the power of destroying and eradicating the disease 
with one single dose of this remedy. Unfortunately, time, 
which is the test of all remedial measures, has proven this 
statement to have been a sad disappointment, and while the 
preparation has an undoubted sphere of usefulness, it has 
fallen very far short of the claims and hopes that heralded 
its advent. The consensus of opinion at the present time 
among those best qualified to speak is that several doses of 
Salvarsan should be given intravenously at regular intervals^ 
and that mercury should be given during these intervals, 
preferably by the hypodermic method. 

Personally, I make it a rule to keep these patients under 
observation, and, if necessary, treatment of a period of five 
years ; and even after this period I advise the patient to take 
a six weeks' treatment each spring and fall for the rest of 
his life, to ensure against any return of symptoms. I have 
never had cause to regret this stand, which in my hands has 
secured me better results in the treatment of this disease 
than has attended the use of any other method that I know 
of. I try to get my patients to look upon this annual treat- 
ment in Ihe light of an accident insurance policy against any- 
syphilitic contingency or relapse. 



EDITOR: 
A. E. Webster. M.D., D.I). 8., L.D.S., Toronto. Canada. 

ASSOCIATE EDITORS: 
Ontario — M. F. Cross, L..D.S., D.D.S., Ottawa; Carl E. Klotz, L.D.S.. St. 

Catharines. 
Quebec. — Eudore Debeau, L.D.S., D.D.S., 396 St. Dends Street. Montreal; Stanley 

Burns, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton. 

D.D.S., L..D.S., McGill University, Montreal. 
Alberta. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — ^Jas. M. Magee, L.D.S., D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S. , D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Re&ina. 

Prince Edward Island. — J. S. Ba.gTiall, D.D.S., L.D.S., Charlottetown. 
Manitoba. — M. H. Garvin, D.D.S., L.D.S., Winnipeg-. 
British Columbia. — H. T. Minogue, D.D.S., L.D.S., Vancouver. 

Vol. XXXI. TOKONTO, JANUARY 15, 1919. No. 1. 
AN INTERNATIONAL DENTAL ORGANIZATION 



The preparedness league of American Dentists was or- 
ganized by Dr. Beach of Buffalo to prepare soldiers for the 
army. It was quite clear long before the United States de- 
clared war that thousands of men otherwise fit would be re- 
jected because of their teeth. It was to make these men fit 
that the league was formed. Since then, however many other 
duties have fallen to the organization. 

It seems to be the intention to continue the large and 
powerful organization, directing its attention to educating the 
civilian dentist to care for the returned soldier and to care 
for the dependants of dead and wounded soldiers. Besides 
this there is a hope that the general public may be reached by 
the league in a manner that will help them to appreciate the 
value of a dentist's services. 

While the post graduate course was in session in Toronto 
the latter part of December, Dr. Beach and Dr. Tracy were 
present, and called a meeting at which the idea was expressed 
that the Preparedness League and a similar organization in 
Canada should join together for the general good. 



2b DOMlXIOiN DENTAL JOURNAL 

THE DENTAL NURSE, DENTAL HYGIENIST OR 
THE DENTAL ASSISTANT 



At the present time there is a live discussion of tlie status 
of the dental nurse as she is called in Great Britain. It would 
appear from the discussion that the dental nurse has examined 
the mouths of school children for years and now it is proposed 
iliat she make restorations of lost tissue in the form of filling's 
and also perform prophylaxis. It is understood that she 
should always be under the advice of a regular practitioner. 

The dental hygienist in the United States is allowed to 
perform prophylaxis only. All the mechanical operations are 
to be done by a qualified dentist. In other words the opera- 
tions for preventing dental caries, gingival infection and oral 
sepsis are of less importance and require less skill than the 
performance of some mechanical operation which has the 
same object in view. It is quite true that there are many 
parts of oral proplnnlaxis that can be performed by persons 
with little general knowledge but they must be guided at all 
times, it is also true that there are many minor operations in 
filling teeth which might be performed without danger to the 
patient. 

The dental assistant as she is known in Canada has no as- 
])i rations, nor any right to operate for a jjatient at all. There 
are a hundred ways in which she can assist the dentist without 
attempting even dressings for patients. 

It has been stated again and again that it is poor economics 
for any person to do anything which can be done more cheaply 
l)y another. Upon this basis a dental assistant, if properly 
trained, can increase a dentist's service to the public more than 
the equal of a hygienist or nurse who sees patients. 



INSURANCE IN ITS RELATION TO DENTISTRY 



At a meeting of the presidents of the life insurance com- 
l)anies of the United States, 11. J. Burkhart, D.D.S., Ro- 
chester, N. Y., presented an address on the interest insurance 
companies have in ])ublic and private care of the teeth. It is 
l)eculiar that no move has been made in Canada along these 
lines. If every insurance solicitor and agent would make it 
j)art of his business to direct attention to the advantage of 
carmg for the teeth, there would be an interest awakened that 
would be more far reaching than many of the methods of pub- 
lic dental education inauguarated by dentists. 



EDITORIAL 27 

GENERAL MEDICINE IN DENTAL PRACTICE 



A (lontist ill lieiieral ])ractiee lias a (loiuaiid for a kiiow- 
lodge of g'oneral iiRnlieine and i)atliolo<>y far beyond a di'iiiaiid 
for i^eiieral siiri>'ery. Almost every ])atieiit eoiisidtiiii^ a den- 
tist lias within his mouth the actual disease or its potential 
which will some time cause him sufferiii<>' and shorten his days. 
If a dentist has a comprehensive kiiowledi::e of patholoii:y and 
gemM-al medicine he can prevent disease and oftentimes cure 
many ueneral affections. A dentist who does not know the 
causes and symptoms of diseases is not likely to recognize the 
teeth or mouth as a factor in general diseases and will p()()-i)oo 
the i-elation of a diseased tooth to epilepsy, insanity, total 
blindness, appendicitis, exophthalmic goiter, loco motor ataxia, 
paralysis or hammertoe. Within a few days the following- 
cases have come under the writer's notice. A woman of fifty 
complaining- of comi)lete paralysis of the left arm completely 
relieved within a few hours after the extraction of an im- 
pacted molar. 

A nurse complaining of dizziness, frontal headache, in- 
ability to concentrate, extreme pain following reading, loss of 
weight, anamiia. A constant sense of pressure in the head. 

The dizziness, headache, the eye symptoms and the pres- 
sure in tlie head were completely relieved within fifteen min- 
utes after the extraction of a diseased root of a tooth. 

A dentist must know dental surgery but he must also know 
general medicine or he will be in a poor position to consult 
v'th the physician who has asked him to help in the interests 
of the ))atient. The dentist who does not wish the physician 
to dictate to him what should be done for a patient must know 
himself, what should be done. A recent book on focal in- 
fection by Duke, and Osier's ''General Medicine" might help 
some. 



MATRICULATION FOR THE RETURNED SOLDIER 



The annual conference of the representatives of the Tni- 
versities of Ontario was held in Toronto, December 19th. The 
problem of compulsory French and ()])tional S])anish and Ital- 
ian was discussed at length. There were ])resent representativs 
of such |)rofessioiial colleges as, law, medicine, pharmacy and 
dentistry to discuss with the universities what was to be done 
with the 7-eturned soldier who has not the matriculation stand- 



28 DOMINION DENTAL JOURNAL 

ard but wants to attend a professional college. The tendency 
is to be very lenient with such applicants. 

The Universities are prepared to take returned soldiers as 
soon as they return and give them such training in matricula- 
tion work as will fit them for professional schools and give 
them a certificate stating the standing they have attained. 

There is no difficulty so far as dentistry is concerned be- 
cause the college accepts the standing of the university. 



RESPECT EACH OTHERS RIGHTS 



When dentists and physicians meet to discuss what is of 
common interest to both, the physician says that it is the den- 
tists' duty to say what teeth are to be extracted and what 
teeth are to be saved, and to make the interpretations of the 
X-rays. But these self-same physicians in practice direct the 
patient to have X-rays made usually by a man who knows but 
little about dentistry, and then proceeds to make an interpre- 
tation of the pictures and a diagnosis. A much more accept- 
able procedure to the dentist would be for the physician to 
send the patient to the dentist for examination, oral diagnosis 
and later consultation with the physician. When a dentist 
suspects a patient of having tuberculosis he would not have the 
nerve to collect some sputum, have it examined and send the 
patient to a physician with a diagnosis of tuberculosis. It 
would be more respectful to allow the physician to proceed in 
whatever manner he pleased; so with the dentist. 



Editorial Notes 



Dr. L. S. Stanley, Ottawa, died of anemia, Dec. 10th, 1918. 

A study class in Bacteriology has been organized in St. 
John, N.B. 

Dr. Douglas, a graduate of Chicago, has begun practice at 
Wilkie, Sask. 

The Dental office of Dr. Mclntyre, Charlottetown, was des- 
troyed by fire. 



EDITORIAL NOTES 29 

Dr. John M. Campbell, R.C.D.S., 1912, is the curator of the 
dental museum in Glasgow Dental Hospital and School. 

Dr. Mcl^hee, after ])raetisin.ii' in Toronto, has decided to 
move to Midland, Ont. 

The Journal of the National Dental Association and the 
Dental Ee\ iew, are to be joined after Jan. 1st, 1919. 

Dr. Ealph Davis, R.C.D.S., 1910, has begun the practice of 
Orthodontia as a specialty at 2 Bloor St., East, Toronto. 

Medical, dental and veterinary students who were called up 
under the Military Service Act are receiving their discharge. 

Recent investigation has shown that cocaine is excreted 
by the kidneys. The former idea was that cocaine was ab- 
sorbed bv the tissues and destroved. 



At a recent meeting of the Toronto Dental Society, Dr. 
Pull en of Buffalo gave a paper well illustrated on the early 
treatment of irregularities of the teeth. 



There is a large registration of graduates from both Can- 
ada and the United States at the special course of instruction 
given on war dental surgery at the Royal College of Dental 
Surgeons, Toronto. 

During the special practitioners' course held in Toronto, 
Dr. W. M. McGuire, the president of the Board of Directors, 
and Dr. H. R. Abbott, of London, were present to give assist- 
ance and participate in its benefits. 



A clinic of the Canadian Army Dental Corps has been es- 
tablished at the armories in Saskatoon. Captain Ernest 
Holmes and Lieutenant Gardner are in charge. The intention 
is to care for the soldiers discharged through the Saskatoon 
demobilization centre. 



30 DOMINION DENTAL JOURXAI. 

The oral liygiene committee of the Ontario Dental Society 
interviewed the Hon. Dr. Cody on the question of rural school 
dental inspection and treatment. The minister is very sym- 
pathetic and is willing- to assist in every ])ossible way, but 
directs attention to the additional cost. 

Dr. Service, who is on furlough from the mission field of 
China is directing the attention of the medical and dental pro- 
fession to the necessity of establishing a dental and medical 
college in west China. Di-s. Lindsay, Thompson and Mullett 
are prepared to take charge of dental teaching. 

Captain William Ernest Boyce, of C.A.D.C, died in Eng- 
land on November 8th. He was born at Rawdon, and was 
educated at Rawdon Xormal School, Lachute Academy and 
McGill University, graduating in dentistry from the universi- 
ty in 1912. He practised his profession in Montreal, and was 
associated with Dr. T. D'Arcy Tansey. He was a member 
of Kilwinning Lodge, (No. 20) of Freemasons. 

vi 

Recently the following question occurred and was answer- 
ed in the House of Commons. Colonel Burn (Torquay) asked 
the president of the Board of Education : if he would consider 
the desirability of further powers being granted to the Edu- 
cation Committees to enable them to compel parents to obtain 
dental treatment for children who are attending elementary 
schools, either at their own or at the expense of the County 
Council. Mr. Herbert Fisher: '^I should hesitate very 
much to adopt the suggestions which involve the creation of a 
new offence, at all events until further evidence is available 

as to the necessity of such a step.'' 

in 
The department dental officers work in all parts of the 
State said the Minister, Mr. James. ''The work in Sydney 
is performed at a fixed clinic, while the work in the country 
is performed by six travelling clinics and a travelling hospital. 
Each child treated by the clinics is given a printed leaflet, ex- 
plaining the necessity for proper care of the teeth, and how 
this should be done. These leaflets are taken home, and it is 
expected to prove educative to the parents, while in every 
case the dentist instructs the child in the dental chair about 
the care of the teeth. I am in hopes that one of the results of 
the school dental work will be reflected in the improved phy- 
si(iue of our boys and girls." 



CORRESPONDENCE. M 

FOCAL INFECTION AND THE FAMILY DENTIST 



Editor Dominion Dental Journal : 

Sir:— In the Journal for November 1918 there is an edi 
torial entitled ''What has the treatment of war wounds re- 
vealed to the dentist?" the concluding- sentence of which is 
*' Chemicals never cure." Alliterations arc* easily reniemi)i'r 
ed and are therefore very useful if true. ''Chemicals never 
Cure" challenges our attention because it seems to contradict 
the results we have been obtaining- in actual |)ractice. The 
writer of the editorial will not deny that the intelligent use of 
chemicals in war surgery has had very beneficial results in 
saving wounded tissue. It is therefore ^'up to him" to ex- 
plain what he means by "Chemicals never Cure." 

While it is important that we should know the methods of 
treatment and the results obtained by War Surgery, the fact 
must not be lost sight of, that treatment in private practice, 
both Surgical and Dental, will diifer from that which is pos- 
sible in war hospitals. The great number of cases, and tlic 
fact that the patient should be returned to the front line with 
the least possible delay, both result in a limitation of time in 
the treatment which does not apply to x^rivate practice. 1 f 
war treatment means the abandonment of the use of chem- 
icals, and we api)ly that treatment to dental cases in private 
])ractice, "dead teeth" and those likely to become inflamed 
would all be extracted. 

The chief aim of the family dentist for the last twenty-ti\ c 
or thirty years has been to save the natural teeth, so long a- 
they can be kept in a healthy condition. Our great erroi- in 
treatment has been due to the fact that, until recently we iVnl 
not realize that a tooth which gave no pain might be a source 
of chronic infection. Laboratory experiments have shown 
that it is very doubtful whether a tooth in the jaw, which has 
been the seat of infection, can be rendered permanently im- 
mune, with the means at oui* disi)osal at present. We must 
therefore regard all teeth which have been subjected to any of 
the various forms of intiannnation, as possible sources of in- 
fection, and watch them accordingly. 

The proposition we have to face may be stated briefly a> 
follows: Because many diseased teeth which have been "treat- 
ed" may ultimately again become the source of infection, are 
we to abandon the practice and extract them? The position 
we are in, seems to me to resemble the situation caused by the 



32 DOMINION DENTAL JOURNAL 

fact that light, heat, and power produced from coal and elec- 
tricity are annually responsible for the loss of thousands of 
valuable lives. No one can deny the fatalities but the general 
consensus of opinion is that the great good of humanity result- 
ing from the production of light, heat, and power from coal 
and electricity far out-weighs the incidental deaths. 

So by taking a broad view of the dental field we shall find 
that careful and conscientious work in saving infected teeth 
(by the use of chemicals) has resulted in so much good that it 
would be folly to give up our practice because at present, we 
cannot guarantee a -permanent cure. In our daily work most 
of us like to carry out a fixed routine, it saves thinking. Un- 
fortunately the most difficult work for us to perform is to use 
our brains, we therefore shirk it ; with the result that our use- 
fulness to our patients is greatly limited. The chemicals at 
our disposal range all the way from arsenious acid to distilled 
water. Their various effects have been carefully tabulated, 
but because some men are too lazy or too stupid to use them 
with intelligence we are urged to throw them overboard. 

That, I suppose, is what the editor of the Journal meant 
when he said '^Chemicals never Cure." 

F. A. Stevenson, D.M.D., 
154 Metcalfe St., Montreal, Dec. 27th, 1918. 



AMERICAN INSTITUTE OF DENTAL TEACHERS 



The next annual meeting of the American Institute of Den- 
tal Teachers will be held at Hotel Piedmont, Atlanta, Georgia, 
January 28, 29, and 30, 1919. 

Papers on the teaching of war dentistry and an exhibit of 
war appliances will be the main features and along with these 
will ba the usual papers on teaching methods. 

All persons interested are cordially invited. 

Abram Hoffman, Secretary. 
381 Linwood Avenue, Buffalo, N.Y. 



DEWEY SCHOOL OF ORTHODONTIA 



The Alumni Society of the Dewey School of Orthodontia 
will hold their next annual meeting in St. Louis, Mar. 6, 7, and 
8, 1919. The usual high standard of the meetings of this so- 
ciety will be maintained. All interested in Orthodontia are 
welcome. Address communications to Dr. George F. Burke, 
7-1-1-3 David Whitney Bldg. Detroit, Michigan. 



REVIEWS 33 



THE DENTIST'S LIBRARY 

Oral Sepsis in Its R(dationsliip to Systemic Diseases. Bv 
William W. Duke, M.D., Pli. B., Kansas City, Mo. Pro- 
fessor of Experimental Medicine in the Ilniv^ersity of Kan- 
sas School of Medicine, Professor in the Department of 
Medicine in Western Dental College; Visiting Physician to 
Christian Church Hospital ; Consulting Physician to Kansas 
City General Hospital, and to St. Margaret's Kansas City, 
Kansas. 

A book of less than a hundred and fifty pages which de- 
serves more than passing notice. What many writers and ob- 
servers have recorded in a hapliazard and disconnected way 
the author of this work has collected, classified, arranged and 
expressed a conclusion upon. 

The introduction quotes from the works of Benjamin Rush 
to show that diseases of the teeth were known to cause general 
disease over a hundred years ago. The chapter on pyorrhoea 
is interesting from the physician's standpoint, but lacks 
in exactness of expression. in the first i)lace there is 
no definition of the disease discussed, nor is there any attempt 
to differentiate the several varieties recognized by dentists, 
fie says ^^decay, tartar, and dental work are the most frequent 
causes of pyorrhoea." These are not certainly the chief 
causes of some varieties of diseases of the gums observed. 
The author [)oints out the very intimate relations existing be- 
tween the cause of gum infections and general disease. Many 
gum infections clear up at once when the diabetes is cured and 
conversely many cases of diabetes, syphilis, and locomotor 
ataxia clear up more promptly when the gums are treated. 
General disease may hinder a rapid clearing up of mouth in- 
fections, and mouth infections may hinder the cure of general 
disease. 

On page fifty the author says '^the diagnosis of alveolar 
abscesses is made by the use of dental radiograms," very 
little can be determined concerning their extent or existence 
by this means. This statement is far from the truth. It is 
just such statements that are causing many mistakes in diag- 
nosis and treatment. Physicians who have no other know- 
ledge of dental disease than that which may be seen in an X- 
ray picture of the teeth often get into conflict with the dentist 
who has far more reliable means of diagnosis than this. An 
X-ray has its place, but it may not tell half the s^tory, nor even 



34 DOMINION DENTAL JOURNAL 

be relied upon for what it appears to tell. The history, the 
physical appearance,, the results of examination are far more 
to be relied upon than an X-ray picture. The X-ray is an ad- 
junct in diagnosis or part of the examination. The final de- 
cision must rest with the dentist. 

There are a great number of illustrations of diseased teeth 
cured by treatment without extraction, yet in nearly all the 
clinical cases reported as examples, were cured by extraction. 
There is a prevalent notion among physicians and some den- 
tists that if an X-ray shows the canal with a filling to the end 
then there can be no infection. While such is generally true, 
it is not to be relied upon. 

It is in the section on metastatic infection and the chapters 
following that show with the greatest clearness the responsi- 
bilities of the physician and dentist in regard to local in- 
fection. 

The reviewer can do no better than quote some few para- 
graphs to illustrate the value of the book. 

Page 74 Sz 75. The following diseases, often streptococcic 
in origin may originate as a metastatic infection from chronic 
foci of infection such as pyorrhea alveolaris and alveolar ab- 
scesses, rheumatic fever, acute and chronic infections : arthri- 
tis, myositis, bursitis, neuritis, iritis and other inflammatory 
diseases, of the eye including neuroretinitis, vegetative endo- 
carditis, ulcerative endocarditis, myocarditis, pericarditis, 
phlebitis, peritonitis, chorea, spinal myelitis, meningitis, acute 
and chronic nephritis, acute and chronic appendicitis, chole- 
cystitis, gastric and duodenal ulcer, pancreatitis, thyroiditis, 
erythema nodosum, herpes zoster, osteomyelitis, periostitis, 
pneumonia, pleurisy, empyema, septicema, erysipelas, cellu- 
litis, lymphadenitis, etc. 

Possibly the liver of a normal individual can tolerate an 
amount of abuse by alcohol and other poisons which might 
lead to chronic inflammatory changes ending in liver cirrhosis 
in individuals suffering from chronic infection such as oral 
sepsis, tuberculosis, syphilis, etc. 

On page 78 appears the sentence: It (oral sepsis) is a 
less apparent source of disease than the tonsils. Rosenow 
said at the national dental meeting at New York that tonsil in- 
fection is nearly always secondary to oral infection. 

Patients are often under treatment by dentists while suf- 
fering and being treated for some general disease. The fol- 



REVIE;WS 35 

lowing paragraph will throw some light on many of these 
cases. 

Page 84. Removal of focal infections as part of the re- 
gime in the treatment of syphilis is also of value in facilitating 
the use of the mercury and potassium iodide and in rendering 
their use less harmful. Mercury and potassium iodide in 
therapy exert an unfavourable influence upon infection in the 
alveolar process and in the throat and apparently also pyo- 
genic infection in other localities. In many instances they 
cause trivial infections to develop rapidly and give rise to de- 
finite toxemias. It is impossible to push mercury and potas- 
sium iodide to the physiologic limit in the face of severe oral 
sepsis or badly infected tonsils without increasing the local 
trouble and rendering the systematic effect of the infections 
more serious. Many of the untoward effects of mercury and 
potassium iodide are without question due to their action in 
stirring up the latent infection. For this reason the radical 
treatment of oral sepsis with the aid of roentgenograms, the 
removal of infected tonsils, and all other infections is strongly 
indicated as an adjunct to the treatment of oral syphilis. 
AVhen this is done, mercury and potassium iodide pushed to 
the physiologic limit appear to be relatively harmless. 

Toxic effects of oral sepsis are thus set forth: pages 99 
and 100. 

Page 99. General symptoms, such as nervousness, ma- 
laise, dizziness, drowsiness, inability to concentrate, inexplain- 
able weakness, prostration after slight physical exertion, 
headache made worse by eyestrain, or mental or physical ex- 
ertion, slight fever or subnormal temperature, slight brady- 
cardia, instability of the vasomotor centre, etc; are produced 
occasionally in sensitized individuals by the use of vaccines 
made from cultures taken from infected gums and are often 
markedly relieved by the treatment of chronic infections. 

Page 100. The disturbances most commonly observed as a 
result of oral sepsis simulate the vagotonic, and may give rise 
when combined with other contributing factors to such con- 
ditions as asthma, motor and secretary neurosis of the stom- 
ach and intestine, such as gastric hyperacidity, hyperperis- 
talis, and spasticity, mucous colitis, chronic diarrhea, si)astic 
constipation, etc., functional disturbances of the kidney, blad- 
der and sexual organs. Such conditions often clear up rapid- 
Iv after the treatment of chronic infection foci. 



36 DOMINION DENTAL JOURNAL 

There is no book which has come under our observation 
on this subject within the past few years which has as much 
useful information to the dentist as this one. A careful read- 
ing will awaken the dentist to a sense of hia responsibility in 
treating his patients. All dentists must sooner or later real- 
ize that they are treating sick people, though the outward 
s}Tnptoms are not very apparent. 



Technique and Scope of Cast Gold and Porcelain Inlays, with 
a Chapter on Endocrinodontia, or The Ductless Glands — 
—Their Expression in the Human Mouth. By. Herman E. 
S. Chayes, D.D.S., New York City. 

xl work of almost 400 pages publislied by a progressive 
book publishing company. The title gives but a small idea of 
the contents. There are four distinct sections besides several 
short chapters on allied subjects. The book opens with fifty 
pages on '^the sequence of thought in teaching'' next comes 
^^the functions of the teeth'' followed by ^^gold and porcelain 
inlays" closing with a chapter on ^' light and colour" and the 
ductless glands. There is much useful information within 
these pages, in fact information not found except in a mass of 
general literature. As a book for the general practitioner it 
is of great value, but not suitable as a student's book or as a 
text book. Canadian agents : McAinish & Co., Cor. College k 
Yonge, Toronto. 



Obituary 



DR. LEONARD E. STANLEY 



Dr. Leonard S. Stanley died in Ottawa, Ontario, on Tues- 
day, December 10th, 1918, of Anemia. 

Doctor Stanley was born in Greeley, Ont., in 1877. He ob- 
tained his early education in the public schools at Greeley and 
Metcalfe, afterwards attending the Kemptville High School 
where he matriculated for dentistry. In 1900 he entered the 
Royal College of Dental Surgeons, Toronto, and was grad- 
uated in 1904. His preceptor was Dr. Alex. Armstrong of 
Ottawa, now Lieut.-Col. x^rmstrong, head of the Canadian 
Army Dental Corps in England. He was a clever student 
and in his senior year was demonstrator to the freshman class 
in operative dentistry. Immediately after graduation he 



OBITUARY. 37 

began practice for himself in the city of Ottawa. In 1907, Dr. 
Samuel S. Davidson, now the oldest practising dentist in Ot- 
tawa, asked Dr. Stanley to become associated with him. They 
worked as associates until Dr. Stanley's illness last May. In 
the summer of 1915, Dr. Stanley attended the Dewey School 
of Orthodontia and is a graduate of that school. He was a 
member of the Canadian Dental Association and at the Mon- 
treal meeting in 1916 opened the discussion on Dr. W. H. G. 
Logan's paper on conductive anaesthesia. His illness pre- 
vented his attending the C. D. A. and N. D. A. meetings in 
Chicago last August. Up to a short time previous to this 
meeting he expected he would recuperate sufficiently to attend 
and regretted keenly his inability to do so. He was a member 
of the Ontario Dental Society and attended the 1918 meeting 
last April. He was President of the Eastern Ontario Dental 
Society in 1917. Dr. Stanley was a member of the Rivermead 
Golf Club and an enthusiastic golfer. He was also a member 
of the Kiwanis Club of Ottawa. He belonged to Doric Lodge 
A. F. and A. M., and to the Lodge of Perfection and Rose 
Croix Chapter, Scottish Rite, and at the time of his death was 
master of Doric Lodge. Dr. Stanley was an Anglican and at- 
tended St. George's Church. He is survived by his widow and 
two little girls, Kathleen and Lenore. 

Thus are chronicled briefly the principal facts concerning 
the life and death of Dr. Stanley, but to give these conven- 
tional items without paying a tribute to our late lamented 
friend would indeed bo failing to do what was most dominant 
ill the writer's mind. 

Dr. Stanley was a man of strict integrity, honest and truth- 
ful, unselfish, genial; a good friend and a Christian gentle- 
man. He was a successful practitioner and a very pleasant 
relatiouship existed between him and his patients. He was 
still a young man, only forty-one years old and had so much 
of future possibility before him that his taking away was a 
distinct loss. He was one of the most ])rogressive men in the 
dental profession and his ideals could not help but raise the 
status of our profession. He was never neutral on a subject 
for the sake of policy, yet possessed the quality of being able 
to differ from you most emphatically and still hold you as a 
friend. His was a sunny, cheery, optimistic nature, one whose 
cheer helps to relieve the stress and strain of our busy every 
^ day life. The chief loss will fall on his immediate family and 
at this time when the shadow of tlieir bereavement falls so 



38 DOMINION DENTAL JOURNAL 

heavily upon them, their chief solace must come from the fact 
that he was a devoted husband and an affectionate father. 

'^I cannot say, and will not say 

That he is dead— he is just away: 

With a cheery smile, and a wave of the hand, 

He has wandered into an unknown land, 

And left us dreaming how very fair 

It needs must be, since he lingers there. 

Think of him still as the same, I say : 

He is not dead, he is just away." — S.W.B. 



DR. McLaren dies 



Andrew McLaren, a well-known Toronto dentist, died at 
the residence of his son, 142 Wells street, Toronto, in his 79th 
year. Although he was active up till the time of his death, he 
died practically from old age. During his early life he was 
engaged in oil drilling at Lambton. He began his career as 
a dentist in Strathroy. For the last 25 years he practised 
dentistry on Yonge street. The late Andrew McLaren was a 
great theologist and a deep student of Swedenborg. Politi- 
cally, he never cast a vote which was not for the Liberal party. 



ELECTION OF BOARD OF DIRECTORS— ROYAL 
COLLEGE OF DENTAL SURGEONS 



District No. 1. W. E. Greene, Ottawa. 

District No. 2. M. A. Morrison, Peterboro. 

District No. 3. R. Gordon McLean, Toronto, on a close 

vote with several ballots in dispute. 

District No. 4. P. Cowan, Hamilton. 

District No. 5. W. M. McGuire, Simcoe. 

District No. 6. E. W. Binice, Kincardine. 

District No. 7. H. R. Abbot, London. 



Dominion 

Dental Journal 

Vol. XXXI. TORONTO, FEBRUARY 15, 1919. No. 2. 

Original Communications 

DENTAL AND MEDICAL NEEDS IN CHINA 



Chas. AV. Skrvice, B.A., M.l)., Chong-tu, West China. 



The health of a nation is one of its i>Teatest assets. The 
medical and dental professions are an integral part of the 
life of all civilized lands. The Tnembers of these two pro- 
fessions are recognized by all citizens as holding- an honored 
and indispensable place in the national life. P)nt uncivilized 
and non-Christian lands are not thus blessed. 

China^s millions are needy millions. Prom whatever 
point of view one views China, the word needy stands out 
prominently. This is emphatically true from the physical 
standpoint. One cannot over-emp^hasize the tragic side of the 
situation. Here, certainly, is a situation crying aloud for 
succour. During these years of war nothing has stirred us 
so deeply as the thought of the great sum of human suffering 
in Euroi)e. We have read of the countless cases of infected 
wounds, blindness, etc., and we have been stirred to the 
deex>est sympathy; we have poured out our millions for Red 
C^ross work, etc., and have sent our doctors and nurses with- 
out stint to Europe. 

But suffering does not end with the war zone. The Chinese 
have been sufferers for millenniums. Almost every ill that 
human flesh is heir to may be found in China in aggravated 
form. At least 16,000,000 of Chinese die annually, fully two- 
thirds of whom die of preventable causes. At least 80 per 
cent, of wounds in C^hina are infected, due to ignorance, 
neglect, filth, absence of a trained medical profession, lack 
of Christian teaching and moral restraints. AVliile the few 
Western medical practitioners in China annually have about 
3,000,000 treatments and perform thousands of operations, 
most of the cases treated are advanced. Rut the hundreds of 



40 DOMINION DENTAL JOURNAL 

millions are left to suffer without skilled treatment. The 
native practitioners, though numerous, are untrained and can 
relieve only common ailments. In the face of epidemics, 
plagues, surgical conditions and other serious illnesses they 
are powerless. The medical missionary force in China at 
any one time numbers less than 400, or about one for ev^ery 
1,000,000 people. 

Tragic as is the medical situation, the dental situation is 
manifoldly worse. Western dentists in China are very few 
indeed when compared with Western doctors. In all of 
Western and North-Western China, embracing over 100,- 
000,000 people, there are only three Western dentists. In all 
China, with her 400,000,000 people, the Western dentists can 
be numbered on the lingers of both hands. 

All members of both the medical and the dental profes- 
sions know how essential to ihealth is a healthy condition of 
the mouth. During recent years great stress is being laid 
on that point. Hence, wonderful progress has been made in 
dental science in the use of the X-ray, in the treatment of 
pyorrhea. 

Now, every doctor who has practised medicine knows that 
there is not a healthy Chinese mouth in that great land. He 
sees thousands of them every year. How could there possibly 
be a healthy oral condition in any one individual in China? 
The teeth require care both from the individual himself and 
from a dental surgeon. Fortunately, as one result of long 
contact with foreigners, many Chinese are beginning to use 
tooth powders and the tooth brush. This is certainly some 
improvement and holds out promise for the future. The 
(^hinese are willing to learn. 

In the far distant part of China, known as West China, are 
now three dentists, one of whom. Dr. H. J. Mullett, is a recent 
arrival and is still engaged in the study of the Chinese 
language in preparation for future work. Drs. A. W. Lindsay 
and J. E. Thompson are the only two engaged in actual prac- 
tice in that immense region of China. These three men are 
all graduates of the Toronto Dental College, and are, no doubt, 
well known to hundreds of dental surgeons now practising in 
Canada. You may rest assured that they are the *' right men 
in the right place.'' If ever men worked hard, they do; if 
ever men had boundless opportunities, they have; if ever men 
had a great vision, they have ; if ever men had a magnificent 
task, they have. They all feel overwhelmed with the situa 



ORIGINAL COMMUNICATIONS 41 

tion, and feel as we medical practitioners do, that the only 
solution of their problem lies in the line of dental education 
for thousands of Chinese young- men. They therefore propose 
(and we medical men heartily second the proposal) the estab- 
lishment of a Dental Faculty in connection with the medical 
college which is already a department of the West China Union 
University. It is hoped that their confreres in Canada will 
take a keen, a definite and a practical interest in the establish- 
ment and development of this much-needed institution. Such 
provision for dental education in West China will be an in- 
valuable piece of constructive work for that great land. It 
will furnish an opportunity to provide leadersihip for a much 
needed profession in China — a leadership, trained under 
('hristian auspices, and inspired by high ethical ideals. 



ONE OF CHINA'S GREAT PROBLEMS 



Charles W. Service, B.A., M.D., Chengtu, China. 



The backwardness of the Chinese in all questions relating 
to the study of modern scientific methods is deplorable. This 
is especially true of medical science. But as the result of 
nearh^ a century of medical work carried on by western medi- 
cal practitioners China is now accepting western civilization 
in its many phases. But probably nowhere has this change 
effected such a revolution in ideas and customs as in the medi- 
cal field. The stage of pioneering has largely passed and 
gradually an atmosphere of receptiveness has been created. 
This change of mind in China has naturally wrought a change 
in the scope of the medical work done by the western prac- 
titioners. During this period the conditions in which medical 
work had to be done were discouraging. Yet very nmch has 
been done in the medical and surgical treatment of millions 
of patients. Much has also been done in the way of medical 
research. But to treat all the sick and wounded of China under 
present conditions is obviously an impossible ta<k. Xo foreign 
agencies can do more than touch t\lie fringe of the problem. 
Two hundred thousand doctors are needed in China, of whom 
there are less than 2,000 at the present time. With medical 
science much more exact and exacting than formerly, the num- 
ber of cases under one doctor must be greatly reduced. How 
meet the problem of the ever increasing number of patients? 



42 UOMIXIOX DENTAL JOURXAL 

This can only be met in one of two ways, either by sending 
many more foreign doctors or by training thousands of 
Chinese youths in the science of western medicine. A certain 
increase in the number of foreign doctors in Cliina will be 
necessary for years to come, chiefly for the purpose of train- 
ing Chinese leaders^ who will be able to commence the solution 
of China's great physical problem. 

The above is also true of the dental situation in China. 
China has had multitudes of native practitioners who have 
attempted to do something to relieve the ills of her people. 
But who ever heard of a native dentist! Moreover, to meet 
the oral needs of 400,000,000 of Chinese the number of (juali- 
fied dentists from abroad is almost negligible. 

Then there is the formidable problem of public health. 
China can make little substantial progress until she begins 
to solve this fundamental problem. Insanitary China needs 
a revolution of ideas, customs, and life. Ignorance, prejudice 
and superstition have to be removed, and for this purpose 
outside hell) is absolutely essential. 

So important is the medical situation and so great is the 
opportunity for medical education in China that the Rocke- 
feller Foundation has established a China Medical Board, 
with a resident director in Peking. Its purpose is to assist 
in the promotion of scientific medicine, to train a truly Chinese 
medical profession, and especially to prepare medical leaders-. 
It proposes to spare no expense in the establishment of two 
Medical Colleges in China, one in Peking and one in Shanghai, 
in which the teaching will be done in English. In this enter- 
prise it desires to co-operate with already established medical 
work, and indeed to build on the foundations of medical educa- 
tion built by medical missionaries. Indeed, they have recently 
entered this field of medical education b}' taking over the 
Union Medical College in Peking, an institution which had 
been successfully carried on for some years by several mis- 
sionary organizations. The beginning of their other proposed 
medical college scheme, in Shanghai, has Iffben postponed on 
account of the war. 

Obviously, the development of these two' great Rockefeller 
Foundation teaching centres in China, while helping to meet 
the urgent medical needs of Cliina, cannot do all that is re- 
quired. The opinion unanimously prevails among the 450 
members of the China Medical Missionary Association that 
there must also be a few high-grade medical colleges in wihich 



ORIGINAL COMMUNICATIONS 43 

the Chinese langua«"e shall be the teaching- niediinii. A few 
union medical colleges already exist, but these are all under- 
developed and do not measure up to the highest re(|uiremeiits 
of modern medical educational standards, either in plant, 
equipment, staff or endowment. The effort now is to slightly 
reduce the number of the&e teaching institutions and to 
strengthen the remainder by further unions. 

One of these union medical colleges is in West CJiina, in 
the city of Chengtu, the Provincial capital of Sze Chwan, the 
largest and most j)opulous of all the pi'oviuces of China, Avith 
a po])ulation of 6{),0()(),000. With the two other provinces of 
West ('hina and also 1'hibet included, the constituency served 
by this institution is about 1()(),()()(),()()(). Cliengtu is one of 
the several large cities in China officially recognized by the 
China Medical Missionary Association as a most strategic 
centre for the development of medical education in China. 



HEADACHE RELATED TO ORAL SEPSIS 



William W. \)\'kk, M.D., PhD., Kansas (Ity, U.S.A. 



Chronic infections, especially those in the alveolar process, 
are relatively frequent causes of chronic headache. Many 
individuals who have headache after eyestrain may discard 
their glasses after the treatment of chronic infection. This 
is not apparently due to a relationship between infection and 
eyestrain, but rather to the fact that eyestrain, which so fre- 
quently figures in the etiology of headache, is not always a 
primary or sole cause, but is often a contributory cause. Orai 
sepsis, infected tonsils, infected ethnoids, hyperacidity due 
to chronic appendicitis or gallstones are directly or remotely 
the cause of headache more often, perhaps, than eyestrain. 
Defective teeth may be responsible for headache in several 
different ways. 

First, the\^ may be sources of arthritis in the cervical spine, 
of myositis in the muscles of the neck, or of inflammatory pro- 
cesses in the bursae, in the tendon sheaths or at the ))oints 
of attachment of the tendons to the skull and cervical verte- 
brae. All the above may give rise to pain in the back of the 
neck reflected upward over the skull. This type of headache 
is common in individuals with postural defects^ the abnormal 
strain on the muscles, tendons, and ligaments of the neck 



44 DOMINION DENTAL JOURNAL 

being a factor, perhaps, in determining this localization for 
an arthritis. Such headaches may be constant for days, may 
be made worse or brought on by mental or physical exertion, 
fatigue, excitement, worry, eyestrain, indulgence in alcohol; 
in fact, by any condition which may act as an additional strain 
on the individual. The pain may be so severe as to interfere 
with business or pleasure. When headache such as the above 
has its origin in oral sepsis or other infections, relief can be 
secured by their treatment. If the condition is of long stand- 
ing, and a considerable degree of rigidity of the cervical spine 
has resulted, the immediate effect is not so striking. Appar- 
ently, headaches giving symptoms such as those above de- 
scribed may be the result solely of a toxic effect of sepsis, at 
least, it is frequently not possible even in cases of headache 
of years' duration to demonstrate by physical examinations- 
of the X-ray, the usual manifestations of local inflammatory 
processes at the base of the skull or in the cervical vertebrae. 
The following is cited as a typical example of headache due 
primarily to dental sepsis: 

Patient, female, age twenty-five, had for years been sub- 
ject to headache starting in the back of the neck and radiating 
over the skull, lasting usually for several days at a time and 
often so severe as to render patient incapable of mental or 
physical exertion. Such attacks could be brought on by exer- 
tion, eyestrain, fatigue, by the use of alcohol, or by indiges- 
tion. The condition was definitely alleviated by the removal 
of the tonsils. Later several root abscesses were discovered 
and treatment of these was advised. The treatment of each 
abscess was followed by such severe headache as to confine 
the patient to bed (probably a focal reaction). Since com- 
pletion of dental work, however, the patient has been com- 
pletely relieved. 

Second, oral sepsis may be a source of neuralgia or neur- 
itis in man}' or all of the branches of the facial nerve. Tic- 
douloureux is not included here, since this condition occurs 
frequently in individuals whose teeth have all been extracted. 
Third, headache is occasionally a referred toothache. Fre- 
(juently a i)atient not only fails to localize the particular tooth 
which causes pain, but occasionally can state simply that pain 
is localized somewhere in the head. Such a toothache may be 
so severe as to suggest brain tumor. A tooth need not be 
abscessed to cause such pain, and occasionally can be found 



ORIGINAL COMMUNICATIONS 45 

only after a most careful examination by a dentist. Tlio fol- 
lowing is an example of such a case: 

Patient, male, age forty-three, complained of a constant 
and severe headache ol* about three weeks' diuatioii. It 
interfered with sleep and caused h)ss of weight and was at 
times so severe as to make tlie patient cry out. Physical, hdj- 
oratory, and Roentgen examiiiations were negative through- 
out excei^)t for disclosing a pulpstcme in a first upper 
molar tooth. This tooth, on examination by Dr. K. M. Siebel, 
showed the pulp of one root to be diseased. Two of the roots 
were vital. TJie tooth was cocainized and the pain disappeared 
immediately. Following extraction of the tooth, the lieadaclie 
was permanently relieved. 

Fourth, an alveolar abscess may rui)ture into the antrum of 
Highmore and cause headache. The local symptoms may be 
so slight as to escape notice: The following is a typical ex- 
ample : 

Patient, woman, age forty, had been subject to headache 
sinoe the age of eigliteen, at which time a bicuspid tooth had 
been devitalized. Headache resisted all therapeutic measui^es 
except the strongest sedatives. When the tooth had been ex- 
tracted a probe could be introduced into the antiiim. Follow- 
ing the extraction of the tooth, there was a marked exaggera- 
tion of the headache for some time, and a profuse nasal dis- 
charge evidently due to an exacerbation of the antrum in- 
fection. Following this, treatment was directed to the diseased 
antrum, and since then the patient has been ]'ehiti\-ely free 
from headache. 



46 DOMINION DENTAL JOURNAL 

REGARDING THE DENTIST AND THE BUSINESS 

ASSESSMENT ACT 
An Open Letter to the Committee on Taxation, Ontario. 



Arthuk Day, D.D.S., Kent Building, Toronto. 



A dentist occupies a large office space in proportion to the 
amount of work accomplds'hed. This is necessary on account 
of the nature of the work. A patient requires privacy whiHe 
having dental operations, and, after many operations, the pa- 
tient requires a rest-room. This is especially so after a 
tedious session, also with older patients, or where there is 
much bleeding. A great amount of the office space is only oc- 
oasionally used, but when it is- required, it is a necessiity. 

There is a waiting-room, a rest-room, an operating room, 
and a laboratory, all of which are necessary, but the Dentist 
does all of his work in the operating room and the laboratory, 
and in only one of these at a time. Much space is taken up 
by equipment which is used only part of the time. 

The same amount of space used for a business purpose 
would be sufficient to make unlimited profits. Business would 
be done in each room of the office, and the business done in 
each part would be paid for; as example, the stenographers 
in a law office, draug'htsman in an architect's office, etc., while 
in a dental office all the dental work has to be done by the 
dentist himself. A- dentist employes a nurse or assistant, but 
the law does not permit the 'assistant to work on the patient. 

It would be just as fair to business tax any otlier workman 
as a dentist. They are each just paid for work done. There 
are no profits from business transactions. 

A retail merclitrnt in a large city is taxed 25 per cent, busi- 
ness tax. There is no doubt the merchant makes more money 
than a dentist, still his astsessment is only one half of that of 
the dentists'. 

The foregoing is to show the wrong classification of the 
dentist providing that we allow that a business tax on that 
profession is just, but a study of the whole subject leads to a 
more important conclusion. 

This is a Business Tax, but the practice of dentistry is not 
a business, it is a profession. We are not allowed to sell such 
services, good or bad, as wo might choose. ^ On the contrary, 
we are compelled by law to protect the public. 

Irrespective of what the public asks for, we must, by law, 
give them the services which are best for them. Anythmg 



ORIGINAL COMMUNICATIONS 47 

0lse i^mal-practice. If there is a patient who cannot afford 
to pay, we are bound to give them good service whether we 
get paid for it or not. The j^ractice of medicine and den- 
ti'S'try is obviously a necessity for the ])ublic welfare; as i^roof 
The Anny Medical and Dental (.'orps, and medical and 
dental inspection in the public schools. The dentist, when he 
receives his Diploma, is called upon to practice not only for 
financial gain, but also for the benefit and protection of the 
public. If it were not for these points the business fax would 
make no difference to us. We would work for those only 
who could afford to pay huge fees, and then we could easily 
pay the business tax. 

The Koyal College of Dental Surgeons of Ontario, which 
is the governing body of the ]>rofe&sion in thiis Province is ex- 
ercising every effort to induce young men to enter the study 
of dentistry. They recognize that there are none too many 
dentists to do the necessary dental work, and provide 'healthy 
mouths for the public. The probable reason why we cannot 
get more students for the study of dentistry, is because the 
parents of ])rospective students recognize tliat the practice of 
that ])rofession i-s not remunei'ative enough. 

AVhen a student enters the College his lideas are moulded 
by the teaching staff and when he graduates, by the Dental 
Societies, to the end that he may serve in the public welfare 
first, and put financial consideration second. The very na- 
ture of a business tax has a contrary influence. The Govern- 
ment is legislating the practitioner out of the profession and 
into the business atmosphere, and if a dentist is to practice 
along business lines, then the people who could pay highest 
fees, would get the best service, and those of moderate means 
would get service according to their capacity to ])ay. It is 
therefore necessary that the Goverament should encourage 
students to take up dentistry, and also to encourage the prac- 
tice of the profession as a profession and not as a business. 

It is a known fact that the dentist makes only a decent liv- 
ing, though there are a few exceptdons. It is said that the 
physician and the dentist are the last to have their bills paid. 
They are to an extent philanthropists. You may not have 
recognized this because you are the ones that are rich enough 
to help pay for the services we render to the i)oorer people at 
a small fee. The Canadian Oral Pro] )hylactic Association, 
(a dental society) are the proprietors of the Hutaj^ Mouth 
Preparations. This Societies' Government (Ontario) Char- 
ter, stipulates that^ niW profits derived from the Societies' 



4« DOMINION DENTAL JOURNAL 

business must be expend'ed iii Education and Charity. Though 
the saJe of these Hutax Preparations nets thousands of dol- 
lars a year in protits, no member of the profession can derive 
any financial benefit direct or indirect. We claim dentists 
are not business men. 

Dentists make but a deceait living, and still the middle 
class public cannot afford a higher dental bill, and the most 
of the public belong to the middle class, or the poorer class. 
Take stenographers, teachers, government employees, labor- 
ers, etc. Taxation on any line must be paid by the consumer. 
A business tax on the dentist will only increase dental fees 
and so deprive a great many people of proper dental -stei-vice ; 
will therefore impair their efficiency, and impair the public 
health. 

If relieving the dentist and physicians of this tax seems 
to be favoring them, it is no greater a favor than ]>rotecting 
them from unlicensed practitioners. In each case it is for the 
benefit of the public. It might be claimed that there are 
other professions such as engineering, but their work has to 
do with business enterprises. 

As the practice of medicine and dentistr\' provides but an 
ordinary living in the great majority of cases, and as any tax 
on it will have to be paid by that section of the public who 
are at present getting services at a law fee, and who can af- 
ford but a low fee; as these professions feel morally bound 
to provide this class of people witli the best of service, both in 
the interest of the individual patient, and in the interest of 
the public liealth ; and as the professions are carrpng out 
their moral obligations so nobly; we ask you to hel}) them in 
the great work, and to remove the obstacle of the business tax. 
The conditions of i^ractice as they are cannot be improved 
upon as regards the benefits to the public. A change might 
l>e for the worse. 

The practice of medicine and dentistry is a humane pro- 
fession and not a business. 

The profession does not wish to escape taxation as is now 
provided for income tax, and tax on real property. 



ORIGINAL COMMUNICATIONS 49 

PRECAUTIONARY TREATMENT TO PREVENT 
TEETH FALLING INTO TRACHAE 



What line of action should a dental surgeon follow il* iie 
thinks, or even suspects, that a tooth or other foreign body 
had entered the air passages while his jjatient is in the chair? 
Well, the first and most important indication is given us in 
the good old medical principle, primiint uoii nocere. Chevalier 
Jackson has tabulated the following seven ''don'ts'': 

(1) Do not reach for the foreign body with the finger, 
lest the foreign body be thereby pushed into the larynx, or 
the larynx be thus traumatized. 

(2) Do not make any attempt at removal with the patient 
in any other position than recumbent, with the head and 
shoulders lower than the body. 

(3) Do not hold up the patient by the heels, lest the foreign 
body be dislodged and asphyxiate the patient by becoming 
jammed in the glottis. 

(4) Do not fail to have a radiograph made, if possible, 
whether the foreign body in question is of the kind dense to 
the ray or not. 

(5) Do not fail endoscopically to search for a foreign body 
in all cases of dou'bt. 

(6) Do not pass an oesophageal bougie, probang, or other 
instrument blindly. 

(7) Do not tell the patient he has no foreign r)()dy until 
after a radiography, physical examination, indirect examina- 
tion, and endoscopy have all proven negative (op. cit., p. 235) 

Several of the above precautionary measures are advised 
so as to prevent gravitation attracting the foi-eign body, par- 
ticularly if of small size, into a deeper secondary bronchus. 
It is better, if possible, for the patient to rest until he can l)e 
treated, lying flat and face downwards. Tn this position 
there is less likelihood of the foreign body falling into the 
middle or upper lobe secondary bronchi — regions where it is 
particularly inaccessible — and it is into these undesirable 
tubes that it might gravitate if the patient lay on his back 
or on one side. The patient should not be encouraged to cough 
or hawk up. The chances of success are small if the foreign 
body has passed the glottis, and the efforts may only drive 
the point of a sharp substance, like a pin or tack, dee])ly into 
the mucosa. In the case of a loose or largei* body, the cousi-h 
may drive it up into the glottis and so threaten asphyxia. If 



50 DOMINION DENTAL JOURNAL 

one f eft certain that the tooth or other foreign body was in 
the oesophagus, these rules would not apply, but, short of that, 
it is wiser to follow them as nearly as possible until the case 
can' be placed in the hands of a skilled laryngologist. 



SIX YEAR COURSE IN DENTISTRY IN CHINA 



The Committee to report on the proposal to establish a 
Dental Department presented a report to the Senate. 

Resolved, that this report be adopted, as amended, subject 
to the approval of the Board of Governors. 

The Report as adopted is as follows : 

''Whereas there is now one student in the Medical School 
who has completed the third year, who will begin dental train- 
ing this Autumn, and whereas there are now ten odd boys in 
the ]\liddle School who are pledged to Dental training, there- 
fore we recommend 

''1. That a dental course of six years be established in 
connection with the Medical School, three years of which shall 
correspond with three years of the Medical Course and three 
years in dental subjects, technique, and training. 

"2. That upon the completion of this course the University 
grant to the student who has maintained satisfactory stand- 
ards a certificate of graduation in Dentistry. 

"3. That for the present subject to the concurrence of the 
Canadian Methodist Mission, the subjects in dentistry and 
the training in connection therewith be pursued at the Dental 
Department of the Canadian Methodist Mission, and that 
the instruction given there be under the direction of the Uni- 
versity. 

''4. That the dental course be incorporated in the Uni- 
versit.v Catalogue in connection with the IMedical courses, and 
that the instructors recognized be included in the list of the 
University staff, and that the students be enrolled in the 
student body. 

"5. Tliat until such time as the Board of Governors and 
the Senate have ordered otherwise the budget for the strictly 
dental work done at the Dental Department shall not be in- 
cluded in the University Budget to an amount exceeding the 
income from student fees. 

"In making these recommendations we have recognized that 
some of its items ought to be considered as of a temporary 



ORIGIXAL COMMUNICATIONS 31 

nature, and that ultimately the dental instruction should ))e 
done at the University, and that in anticipation thereof we 
further recommend, that in the i)lannin^- of the ^ledical l>uild- 
in^ provision be made for this department. 

'^Further, in recommending- this course, we have assumed 
that the addition of its instructors to the University staff will 
not reduce the number of physicians supplied or to be 8Ui)plied 
by the Canadian Methodist Mission to the Medical School so 
long as the dental instruction is not carried on at tlie Uni- 
versit}^, and that the other Missions are not obligated, until 
fui'ther agreed, to furnish instructors for this de])artm('nt." 



Oral sepsis as a focus of chronic infection may be a source 
of ill hea'lth in many different wa\'s. It may harbour and dis- 
tribute organisms which, under certain conditions, may infect 
other tissues and give rise to acute or elironic inflammatory 
lesions. It may have a toxic effect with ensuing disease in 
both noa'mal and disieased organs. This effect in healthy in- 
dividuals may perhaps be slight. It may be de<?idedly harm- 
ful, however, in individuals who are depleted by disease, in- 
jurious habits, overwork or age. It miay favour the advaiice 
of infectious disease due to org^anisms distributed from the 
alveolar process as- a primary source of infection and may also 
favour the advance and augment the symptoms of other iji- 
fections which are in no wise related to it. It may also cause 
functional disturbance in relatively normal organs by fur- 
nishing an a/lien ])rotein to which an individual may become 
highly seu'sitized. In the same way it may increase functional 
distnrbanceis due primarily to organic disease. Finally it 
may cause local pain, referred pain, and headache. 



'^2 DOMINION DENTAL JOURNAL 

THE X-RAY AS A DIAGNOSTIC AID IN DETER- 
MINING THE PRESENCE OR ABSENCE OF 
INFECTION IN THE APICAL REGION 

It is in this particular that the X-ray has been very valu- 
able and very misleading. When the X-ray first came out 
the conclusion was jumped at immediately that any rarefied 
area showing at the end of a root in X-ray pictures meant in- 
fection, and such teeth were either opened up at once and 
treated or condemned and extracted. That such a proceed- 
ure was premature has been amply demonstrated by the ex- 
traction of many healthy teeth. In fact whole mouths have 
been needlessly mutilated and crippled for life through the 
mistaken zeal of operators going solely by an X-ray evidence. 
No man can tell with certainty by the X-ray whether very 
many of these areas around pulpless teeth are infected or 
whether there has simply been a thinning of the bone from 
absorption at the time the pulp died, and a subsequent filling 
in of reperative tissue, with the s'lighteist trace of infection. 
These areas have been shown around teeth where the canals 
have been filled as perfectly as '^the hand of man'' can fill 
them, and more than this they have been demonstrated in the 
apical region of teeth with living pulp. Any irritation in 
this region seems to cause a rebellion of n'ature coup/led 
with an absorptive process in the bone, but it does not neces- 
sarily follow that there is 'infection.'' Dr. L. E. Custer, of 
Dayton, Ohio, who was the second practitioner to take up the 
X-ray work in Dentistry (Dr. C. Edmund Kells being the 
first) says in this connection: These light areas about the 
root apices, are not all abscesses— not by a long shot. After 
a period of twenty-two years in X-ray work and the study of 
the behaviour of teeth showing light areas about the root 
apices I am prepared to show that ninety per cent, and per- 
haps moire, of all the pulpless teeth show rarefaction about 
the root apices. Why is this, and what does it mean? My 
answer is that nature never intended that a tooth should be 
pulpless, and that no matter how well a pulp canal may be 
])repared and filled, it still is not a normal pulp canal. The 
apical foramen and region thereabouts is the vital point in 
the whole proposition, and unfortunately the apex i^ the most 
difficult to seal in a manner comfortable and non-irritating to 
nature. The unfilled apex or an apex sealed with a foreign 
material, is an irritant, although it may be slight, to the sur- 
rounding tissues. The result is the absorption of the bone in 



ORIGINAL COMMUNICATIONS 53 

the immediate vicinity, and its replacement with new tissue 
which when completed, encysts the end of the root. Now the 
encysting tissue, being devoid of the lime salts shows dark ii) 
the photograph, and unless one has had considerable exper- 
ience in the observation of these cases, he will make the com- 
mon mistake of pronouncing such skiagraph as showing an 
abscess/' 

It is a very difficult matter to decide with our i)resent 
knowledge, just which teeth showing light areas shall be re- 
tained and which extracted. If we remove all these teeth or 
even an appreciable number of them, we will do an irreparable 
injury to our patients — an injury which can never be con- 
doned in the subsequent plea that we did not know better. If 
we are observant of the behaviour of pulpless teeth under all 
sorts of conditions from the first day that pulpless teeth were 
filled till now, we do know better. That pulpless teeth are 
sometimes a menace to the health of the individual, no think- 
ing man will deny, but if they were the grave danger that in 
some quarters they are accounted to be to-day, more than half 
of the people who ai'e now going around comfortably with 
pulpless teeth in their mouths would have been dead long ago. 

On the other hand we have no right to leave in the human 
mouth any teeth which can be demonstrated to be infected. 
Either the infection must be removed by treatment, or the 
tooth must come out. To determine the action, as has been 
said, is sometimes a difficult matter, and yet the X-ray, taken 
with close chemical observation of the case, will aid us in 
clearing up most of the dangerous cases. If the individual 
shows evidence of metastic infection, as indicated by i)ain 
and an abnormal blood count, and in connection with this if 
the X-ray demonstrates an appreciable or well-defined area of 
absorption at the root end, where the case has gone past a 
mere thinning of the bone, then there is no question that the 
tooth should be removed. But this matter should be deter- 
mined not by the physician alone, but by a careful conference 
between the two — to the end that the patient's best interests 
are conserv^ed. 

Too frequently teeth have been taken out under the fol- 
lowing routine : The patient has been ill wntli some infection 
and has consulted a physician. The significance of the teeth 
as causative factors in di-sease 'have been greatly ma«:nified in 
the minds of many medical men. In recent years these organs 
are at once suspected, and the patient sent at once to see an 
X-ray man for a skiagraph. Just here is where an irre]^ar- 



54 DOMINION DExNFTAL JOURNAL 

able harm and a cruel injustice has been done to the patient. 
The X-ray man from the very nature of his calling is prone 
to ''look for something'." Frequently he is a medical man 
who has not studied the teeth in any particular before he be- 
gins to take pictures of them. Frequently he is a dentist who 
has not studied pathological or -physiological processes as he 
should have done. Frequently he is neither physician nor 
dentist, and knows nothing whatever about the teeth, or path- 
ology or physiology. These men may all be conscientious 
and all may be looking for the light, but some of them have 
made most horrible blunders and committed the most cruel 
wrongs in the name of their calling. It is a strange mouth 
in which they cannot find "infection'^ or "abscess" or *' py- 
orrhea." Any little lightened area around a tooth is seized 
upon by them as a sure sign of disease. And the chief wrong 
is done in this way: Not content with telling the physician 
what they think, they write their diagnosis on a slip of paper 
and hand it to the patient. The patient sees the alarming 
words "Abscess," "Infection," etc., and goes away with the 
conviction that the case is desperate. People have died of 
infection so the patient has heard, and an abscess is always 
formidable. When the physician gets the radiographer's re- 
port he naturally thinks that he has found a solution of his 
patient's ailment and immediately sends the patient to an exo- 
dontist to have the teeth removed, and the patient goes gladly 
to be relieved of the horrors of infection. 

While this routine is in many respects a perfectly natural 
one yet it has some serious flaws. It fails to take into con- 
sideration the possible light that the patient's dentist might 
throw on the case. No physician will claim that he knows 
more about the teeth than does the dentist, in fact he usually 
claims that he knows nothing at all about them, and is merely 
taking the radiographer ''S findings as a basis for ordering 
them extracted. The physician does not wilfully ignore the 
dentist, nor does the X-ray man realize the serious harm he 
has done. Neither of them knows fully the importance of 
saving natural teeth, but both of them must in the future be 
roused to the grave harm they may be doing the patient by 
such a procedure as the one outlined. The radiograjiher 
must positively cease giving a written diagnosis to the ])a- 
tient. Too much harm has been done by this means to toler- 
ate it in the future. His function ceases when he has re- 
ported to the professional man who refers the patient to him, 
what he thinks he has found. Even then he will make mis- 



ORIGINAL COMMUNICATIONS 55 

takes enough in the faulty interpretation wliich seems an in- 
evitable concomitant of the X-ray woi*k. And the physician 
must consult with the dentist before ordering- teeth extracted. 
The dentist will co-operate with him willint>ly in clearing up 
conditions of the moutli, and relieving the patient of any dis- 
ability connected with the teeth. In short it will recjuire the 
united efforts ol* the physiiician, tlie dentist, and the radio- 
grapher to safeguard the patient againsit the danger of me- 
tastic infection caused by pulpless teeth on the one hand, and 
on the other the needless, foolish and criminal mutilation of 
mouths by the extraction of teeth which are in no way at fault, 
and which are sadly needed in the physical economy of the 
individual. — C. A^. Johnson in tirw textbook. 



56 DOMINION DENTAL JOURNAL 

Dental Societies 



THE CANADIAN ORAL PROPHYLACTIC ASSOCI- 
ATION ANNUAL MEETING 

The Annual Meeting of the Canadian Oral Prophylactic 
Association was held Monday evening January 20th at the 
Walker House, Toronto. After partaking of dinner the busi- 
ness of the meeting was proceeded with. The President, Mr. 
McDonagh (who was recovering from a serious illness and at 
a great risk to his health was present) requested that he be 
not asked to take the Chair. So the Vice-President, Dr. J. 
Frank Adams acted as Chairman. 

After reading the minutes of the last Annual Meeting the 
Secretary read a letter from Lieutenant Colonel W. G. Thomp- 
son, A.D.D.S., M.D. No. 2, regretting his inability to be pres- 
ent and expressing his appreciation for the assistance ren- 
dered by the Association to the C.A.D.C., in his district. 

The various reports were presented and adopted. 

The President's report presented by Dr. Adams, being a 
resume of the work of the Board for the past year. 

The report of the Educational Committee presented by 
Dr. H. E. Eaton, giving a full and interesting account of the 
many activities of this Committee. 

The Financial report presented by Dr. Broughton the Sec- 
retary Treasurer, showing a very satisfactory increase in 
business in spite of war conditions. 

The Actual receipts for 1918 from the sale of Hutax 

brushes, paste and powder $5555.64 

Total operating expenses for 1918 ^^^^-^^ 

Leaving a profit for the year of 4065.44 

Out of this amount $2666.43 was expended by the Edu- 
cational Committee for Cliarity and Educational purposes as 

follows: 

Dental Research Committee University of Toronto $1000.00 

Purchase of moving picture films 176.50 

Dr. Gies' lecture and dinner expenses 372.91 

Exhibit at 0. D. A. Convention 41.00 

Exhibit at C. D. A. Convention at Chicago 112.53 

Printing of pamphlets, leaflets, military and school 
charts 



DENTAL SOCIETIES. 57 

Donations to hospitals, colleges, C.A.D.C, auxiliary 56.18 
Snndry expenses 6.87 

$2666.43 

Tn addition to this there was the Christmas donations of 
brushes to various charitable institutions aniountini!' to J|;220, 
which will not show until the 1919 report. 

The Statement of Res*ources and Liabilities showed Soluble 
Assets of $7729.16. 

During the year 1918, then- was sold 2019 gross of ITutax 
])rushes, paste and powder being a gain of 288 gross over 
1917. 

The following amendment to the By-law which had been 
])assed by the Board of Directors was confirmed by the meet- 
ing: "That By-Law Xo. 2, Clause 3, be amended to read, 
"Members may be elected by the Board of Directors from 
among ethical dejitists upon the |)ayment of $10.00, any As- 
sociate Member may be elected Member by the Board of 
Directors upon the payment of $9.00.' " 

Before proceeding with the election of officers, Drs. A. E. 
Webster and J. F. Adams, earnestly requested the meeting 
not to re-elect them as Directors in order tliat new members 
might become acquainted with the work of the Board. 

The ballot resulted in the following being elected : 

Board of Directors : Drs. A. J. McDonagh, W. Cecil Trot- 
ter. A. J. Broughton, Horace E. Eaton, B. F. Nichols. Edu- 
cational Committee: Drs. A. E. Webster, Geo. Vs\ Grieve, 
:\fajor H. A. Semple, W. A. Black, C. G. Scott, E. L. Gausby, 
A. \V. Ellis. 



PRESIDENT'S REPORT 



J. Frrntl' Aflam.^, D.D.S.; Toro}iti 



Great strides have been made in the improved mouth con- 
ditions of the inhabitants of this continent and the C.O.P.A. 
has taken a paii in bringing about the results, and we hope 
to take a still greater part in the years to coane through our 
t products, our research and our educational work. The busi- 
ness of the C.O.P.A. during the past year has been encourag- 
ing both financially and educationally. (See Treasurer's 
Reports.) during the war there have been difficulties in ob- 
taining brushes, supplies of paste and powder and at times, 



58 DOMINION DENTAL JOURNAL 

tubes and tins were impossible to get But with, all these 
liindrances we still have made memorable increase in the sale 
of our products. AVe feel that as this is a co-operative so- 
ciety, a good deal of the success of this year is due to your ef- 
forts, as well as the untiring zeail of the members of your 
directorate. 

I regret with you the absence of the President. The 
C.O.P.A. owes more than any one knows to the fertile brain, 
benevolent heart and persistent etforts of Dr. McDonagh. 
Through his vision, the work began and dfuring all the years of 
its life,it has been on liis mind and heart to a greater or less ex- 
tent, mostly greater. The moi'e real the difficulties the more 
it would arouse his fighting Irish and he was up and ready 
to protect the interests of thi>s philanthropy. Dr. McDonagh 
has overtaxed his energies, and Nature is demanding that he 
take a rest. We sincerely hope that he will soon be back at 
work with his customary health. The profession owes a great 
debt to Dr. McDonagh for his untiring energy in the cause of 
its uplift. Only a profession whose primary object was to 
bring about such an improved condition, that there could be no 
need for its continuecl existence, would appeal to the unselfish 
mind of Dr. McDonagh. And this is the reason why the 
C.O.P.A. has made so strong an appeal to him and to the rest 
of us. The ultimate end is to educate the i)eople in the care 
of their teeth so that tbey will no longer need us as dentists. 
We are striving ito this end through our i^aste, powder and 
brushes ; through our educational committee and through our 
research work. The profession is placed as a sentry to guard 
the entrance to the portal of life, and we desire that ''they 
might have life, and that they might have it more abun- 
dantly. ' ' 

Our educational committee and the research committee 
will report later, and you will hear from Dr. Eaton, cliairman 
of the committee. Some of the actions of the board have been 
brought before you in the form of alteration to by-laws, which 
you will be asked to ratify or annul. 

There is a steady increase in the sale of brushes, paste and 
powder in spite of tlie necessary jump in prices due to war 
conditions. All the dentists were sampled with lingual and 
large brushes so as to keep them in touch with our products. 
We gave Christmas donations of 81 dozen brushes, valued at 
$220. 

We are bringing before you a by-law to chaaige the fee for 
active membership from $25 to $10. This can be discussed 



DENTAL SOCIETIES. 59 

when the resolution comes up. There has been a des-ire on the 
part of some of the members to enlarge the dire<5toratie. We 
have notified you of this by-law in the announcement of the 
meeting, and you can annul or ratify it as you may see fit. 

It has been a pleasure for your directors to do business 
for you diiring the past year. The i)erfect harmony among 
the directors and the unity of feeling in the joint meetings 
with the Educational Committee made it a i>leasiire to serve. 



REPORT OF C. O. P. A. EXHIBIT AT NATIONAL 
DENTAL EXHIBITION 

To the President and Members of the CiDtad'Htu Oral Prophy- 
lactic Association. 

Your represeTitati\'e in charge of the exhibit at the com- 
bined meeting of the National and Canadian Dental Associa- 
tion at Chicago wishes to commend the wisdom of the execu- 
tive of the C.O.P.A. in having an exhibit at this meeting, as 
an intense interest 'has been created among our American 
confreres, espeicially those engaged in oral hygiene and edu- 
cational work. He further wishes to express his sincere 
thanks to the Association for the honour confen-ed upon him 
in being chosen to represent the Association at that meeting. 

A great deal of difficulty was experienced in having the 
shipment passed by the customs officials. The United States 
Customs Officer was interviewed before leaving Toronto, and 
was shown samples of the pamphlets, but he stated that he 
could not pass them as they were dutiable printed matter. He 
further stated that he could not ship them through to Chicago 
in bond, but tih^at tthey would have to be examined by the Cus- 
toms Officer at Port Huron. On account of a block on the 
main line of the G.T.R., the train was des«patched via Detroit. 
Before retiring the bagigageman was interviewed, and he stat- 
ed that he thought there would be no difficulty in having the 
literature passed free, or sent throiigh in bond. However, 
upon arrival in Detroit, the ease was put off the train and 
your representative had to remain tbere over night. The fol- 
lowing morning, he was siiccessful in having the literature 
passed through free, but, on account of tlie high rate of duty 
on the pasites and powders, all of these were returned to To- 
ronto by express, also part of the brushes. Duty was ]>aid on 
three dozen brushes, as it was felt it would be an advantage 
to distribute these gratis to men engaged in prophylactic 
work. 



60 UOMIXIOX DENTAL JOURNAL 

Numerous commendations of the work carried on by your 
As'S'Ociation, als'O of the display, were received ; many men ex- 
pressing the opinion that it was the best exhibit at the meet- 
ing. A large number of men left their names and addresses 
that they might be placed on yofur mailing lists and from time 
to time receive further educational literature. In conver- 
sation with these and others a number of suggestions were 
received, so'me of which will be reported. 

Membership. — Two applications, accompanied by the fees 
for associate membership to the Association, were received. 

Brushes. — The general consensus of opinion, especially 
among those engaged in prophylactic work, was that your 
medium-sized brush was correct in every detail. A few sug- 
gestions however, were received which are submitted for con- 
sideration herewith:— (1) A smaller brush with two rows of 
bristles for the use of children. (2) The use of unbleached 
bristles in all brushes. These are claimed to possess great- 
er rigidity and last longer. 

American Representative.— Many enquiries were received 
regarding the procuring of "Hutax'' products, particularly 
the brushes, in the United States. The reply to these was 
that, in order to save duty on brushes coming from Canada, 
by arrangement with the general secretary, a quantity could 
be sent direct from the manufacturers to some local dental 
dealer or drug store, where p'atients could be instructed to ob- 
tain them. To facilitate distribution, your representative 
would snggest the appointment of an American representative 
who would superintend dis'tribution through the United 
States. When this representative received his appointment, 
notice could be sent members of the dental profession in the 
Staites by obtaining a list of names from the National Dental 
Asisociation. If it were deemed advisable to introduce Hutax 
powder and paste amongst ithe members of the profession in 
the States, Mr. Banks, of the Dental Supply Co., Chicago, 
would undertake to distribute 100 free samples judiciously, 
if the Association would pay the duty on these. 

Charts. — The school and military diarts received the ap- 
proval of every one who saw them. Some suggestions might 
be obtained from charts issued by the Kolynos Co., and the 
Pyorrhocide Clinic, the latter issued in chart or book form. 
A request for a set of charts was received from far-off Tokio 
Dental College, Japan. Men engaged in industrial dentistry- 
suggested that a series of charts adapted to this work be de- 
vised as well as outline lectures for this work. AVhere the 



DENTAL SOCIETIES. 61 

same set of charts is sent to various i)arts of the country, a 
suggestion was received, that these be printed (or chalked) 
on linen and a number mounted on one roller. By using a 
map stand the charts may be turned over as the lecturer pro- 
ceeds. Your representative suggests that lantern slides of 
each chart, now on hand be made and sent out with the out- 
line lectures now being used. These could be thrown upon 
the screen a.t intervals during the lecture. 

Pamphlets.— Three hundred of each of the various pam- 
phlets were taken to the meeting, and only half a dozen or so 
of each were returned. Your representative understands 
that the pamphlet on '^The Care of the Teeth" is nearly out 
of print and suggests that in re-writing it some space be de- 
voted to the results following lack of care of the teeth, such 
as caries, recession of the g-ums, various stages of pyorrhea, 
etc. Also mention might be made of the use of the tooth 
brush with the lips closed, especially the lingual brush, and 
outs made to illustrate this technique. 

Books. — Two books on oral hygiene work were inscribed 
and presented to the Association by the author. Dr. Maude 
Tanner. Quotations on large quantities were received. Dr. 
Fone's work on oral h3'giene was also recommended to be pur- 
chased. It deals with preventive work in schools. 

This report would be incomplete without a word of ap- 
preciation of the courtesy shown the association by the mem- 
bers of the committees, especially Dr. Gallic, who arranged 
space for the exhibit gratis, in the same room as the U. S. and 
Canadian Army Dental Corps Exhibits. One of the out- 
standing features of the meetting was the keen appreciation 
of the medical men who attended, of the value of dental edu- 
cation; a large number of whom asked to have their names 
placed upon your mailing lists, in order that they might keep 
in touch with your Association. Your representative feels 
that much has been accomplished by this exhibit and thinks 
that your work has served as an inspiration to others work- 
ing along similar lines in the United States. 

Respectfully submitted 

G. Vernon Fisk. 



The time for accepting Dominion Dental Council certi- 
ficates has been extended to July the 1st. Correspondence 
should be sent to Dr. W. D. Cowan, M.P., Ottawa, Ont. 



62 DOMINION DENTAL JOURNAL 

DENTISTS REGISTERED AT THE SPECIAL 

MILITARY PRACTITIONERS* COURSE 

TORONTO, DECEMBER, 1918 



Abbott, E.G., 2 Bloor St. East, Toronto; Allen, Capt. H. 
S., Ottawa, Out. ; Araistrong, J. W., 22 College St., Toronto ; 
Arnold, E. F., 2 Bloor St. E., Toronto ; Astle, Capt. W. W., 
Edmonton,Alta. ; Badgley, F. M., 110 Avenue Road, Toronto ; 
Barker, C. R., 753 Fifth Avenue, New York; Bagshaw, Capt. 
D. J., 100 Avenue Road, Toronto; Bailey, Capt. B. S., Winni- 
peg, Man.; Biehn, C. E., Chelsey, Ont. ; Botbwell, J. A., 604 
Spadina Avenue, Toronto; Black, W. A., 2 Bloor St. E., To- 
ronto ; Boyd, Geoffrey, Bloor E., Toronto ; Bray, Capt. G. H., 
Winnipeg,^ Man. ; Bradley, Lt.-Col. F. H., M.D. No. 4, Mon- 
treal, Que. ; Brock, Capt. B. W., St. Anne de Bellevue Military 
Hospital; Brooks, C. E., 2 Bloor St. E., Toronto; Bucknall, 
J. A., 129 K'irby E., Detroit, Mich.; Campbell, D. K., 436 
Gold St., Brooklyn, N.Y. ; Canning, Capt., M.D. No. 2, Ham- 
ilton, Ont.,; Chalmers, W. L., Toronto; Collings, M. F., 6 
West 50th Street, New York ; Crawford, J. C. A., Haileybury, 
Ont.; Coon, W. H., 22 College St., Toronto; Coram, G. H., 
Carlton St., Toronto; Coram, J. W., 26 College St., Toronto ^ 
Cunningham, H., 182 Quebec Ave., Toronto; Daly, C. L., 2 
Bloor St., E., Toronto ; Daman, K., Woodstock, N.B. ; Davies, 
T. A., 578 Sherbourne St., Toronto; Doore, Capt. J. C, St. 
John, N.B. ; Dubeau, Eudore, 308 Sherbrooke E., Montreal, 
Que.; Duff. Capt. J. H., 460 Jarvis St. Toronto; Dunlop, 
Oapt., M. D. No. 2, Toronto; Emmett, G., 1 Maynard Ave., 
Toronto; Everett, G. W., Hamilton, Ont.; Fife, B. 0., 229 
College St., Toronto; Forester, A. M., 300 Doctor's Bldg., 
Nashville, Tenn. ; Fowler, Capt. C. H., Niagara Polish Camp, 
Niagara, Ont.; Franz, H., 22 E. Washington, Chicago, 111.; 
Godsoe, Capt. F. A., St. John, N.B.; Grainger, G. W. Capt, 
Brant House, Burlington, Out.; Hallenberg, Albert, Fargo, 
North Dakota; Hayden, Capt. W. Y., M. D. No. 1, London, 
Ont.; Healey, Capt. P. J., C.A.D.C, Calgary, Alta.; Hillis, W. 
A., 22 Tvafayette Place, Greenwich, Conn.; G. A. Hull, 
123 West 73rd St., New York; Husband, F. C, 2 Bloor 
St., E. Toronto; Johnston, J. E., Hamilton, Ont.; Jones, 
Courtland S., 232 Delaware Ave., Buffalo, N.Y., Kawamura, 
H., 945 Margate Terrace, Chicago, TU.; Kelsey, James 
H., 714 Sassafras St., Erie, Penn.; Kennedy, E., 347 Fifth 
Ave., New York; Kruger, L. F., Queen St., E., Toronto; Le- 
mieux. Capt. E., St. Anne de Bellevue Military Hospital; 



DENTAL SOCIETIES. ^3 

Loucks, Capt., M. D. Xo. 2, Hamilton, Out. Loweiy, P. C, 
1957 Gratiot Ave., Detroit, Midi.; Lucas, R. F., 612 J. M. S. 
Bldg., South Bend, Ind.; Lundy, W. E., Kent BIdg., Toronto j 
Marlatt, H. G., 18 E. Eagle, Buffalo, N.Y. ; Marshall, 0. A., 
Belleville, Ont. ; Mason, A. D. A., 2 College St., Toronto; Mc- 
Lean, Gordon, 2 Bloor St. E., Toronto; Mitchener, Capt. H. 
L., Kentville, N.S.; Mclntire, W. R., 231 Broad St., Provi- 
dence, R.I.; Neil, Ewell, 226 Doctor's Bldg., Nashville, Tenn. ; 
Pearson, C. D., 2 Bloor St. East, Toronto; Purdy, Capt. J. H., 
M. D. No. 1, Ottawa, Ont. ; Reese, R. H., 103 Macon St., Brook- 
lyn, N.Y. ; Robb, J. W., 1336 Widner Bldg., Philadelphia, Pa. ; 
Robert, J. G., 174 E. Ferry St., Buffalo, N.Y. ; Robertson, H. 
A., Hamilton, Ont. ; Royce, Lt.-Col. George C, Toronto ; Ruyl, 
J. P., 40 East 41st St., New York; Santo, A. E., London, Ont.; 
Shantz, U. B., Kitchener, Ont. ; Simpson, J. F., Trenton, Ont. ; 
Simpson, Major S. TL, Kingston, Ont.; Shaw, Col. F. P., M. 
D. No. 1, London, Ont.; Sparks, E. B., Kingston, Ont.; Stan- 
ton, E. P., 2387 Main St., Buffalo, N.Y. ; Strang, R. H. W., Na- 
tional Bank Bldg., Bridgeport, Conn.; Spaulding, W. G. L., 
701 Lumsden Bldg., Toronto; Stratton, Capt. D. P., Winni- 
peg, Man.; Suter, A. B., Elmira, N.Y. ; Stoecklev, J. A., 511 
J. M. S. Bldg., South Bend, Ind. ; Sutton, C. E., 449 Spadina 
Ave., Toronto; Thornton, A. W., McGill University, Montreal ; 
Thornton, Capt. R. D., 240 College St., Toronto. ; Walt, Major, 
M. D., No. 3, Kingston, Ont.; Webster, A. E., 45 Glen Ave., 
Toronto; Willard, W. T., 2863 Dundas St., Toronto; Will- 
mott, W. E., 96 College St., Toronto; Wilson, G. H., 701 Scho- 
field Bldg., Cleveland, Ohio.; Wilson, Capt. D. D., 42nd Wing 
R. A. F., Deseronto, Ont. 

DELEGATES, UNITED STATES: 

Beach, J. W., 131 Allen St., Buffalo, N. Y.,; President 
Preparedness League of American Dentists ; McCarthy, A. J., 
131 Allen S., Buffalo; Rilian, H. Y., 520 Beacon St. Boston, 
Mass.; Tracy, W. D., 46 West 51st St., New York; Director- 
General Preparedness League of American Dentists. 

DELEGATES, DOMINION OF CANADA: 

Clavton, Col. W. B., 128 Queen St., Ottawa; Thompson, 
Lt.-Cof. W. G., M. D. No. 2, Toronto; Magee, Major J. M., M. 
D. No. 7, St. John, X.B.; Levey, Capt. C. H., M. D. Xo. 11, 
Victoria, B. C.,; Mann, Capt. H. E. Halifax, N.S.,; Washhurn, 
Capt. B. L., 46 Grande Allee Apts., Quebec. 

SPECIAL COMMITTEES I 

Box, Harold K., 229 College St., Toronto; Thomson, Capt. 
H. S., M. D. No. 2, Toronto. 



64 DOMINION DENTAL JOURNAL 

FINANCIAL STATEMENT OF THE ONTARIO 
DENTAL SOCIETY, 1918 



October, 3rd, 1918. 
Eeceipts. 

BalaiK^e from last year $ 774.00 

Regist ration Fees, Lundieon Tickets and Exhibits 1658.25 
Bank Interest 8.42 

$2440.67 

Expenditures. 
Printing, Postage, Stationery, Convention Hall 

Rental, Essayists, etc $1100.60 

Oral Hygiene Committee Grant 200.00 

Angus & Stonehouse reportin^g Convention . ' 88.75 

Convention Luncheon Y.M.C.A 84.00 

Balance in Bank 967.32 

$2440.67 

This statement is in accordance with the books of the 
Ontario Dental Society, which we have this day audited. 

(Signed) R. G. McLean ) Auditors 
F. C. Husband ^ ^^^it<^^^- 



ANNUAL MEETING OF MANITOBA DENTAL 

ASSOCIATION 



The amnual meeting of the Manitoba Dental Asisooiatiooi 
was held January the 13th. There were three vacancies on 
the boiard to be filled caused by the automatic retirement of 
three directors. The three new directors who were elected 
unanimousily are Dr. Greenfield and Dr. Christie who were 
retiring directors and Capt. Stratton, a former member of the 
board who has recently returned from overseas. Dr. Manly 
Bowles the third retiring director did not wish to be re-elect- 
ed as he had already iserved on the board for five years, four 
as Secretary and the last as President. He received a hearty 
vote of thanks for his services. The new officers of the board 
are: President, Dr. G. F. Bush, Vice-President, Dr. J. H. 
Greenfield, Secretary, Dr. C. P. Banning, Registrar Treasur- 
er, Dr. H. F. Christie. The other members of the board are 
Dr. Walter Dalzell and Capt. Stratton. 

C. H. Banning, Secretary. 



^ditorzciZ 




EDITOR: 
A. E. Webster. M.D., D.D.S., L.D.S.. Toronto. Caiinda. 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross, L.D.S., D.D.S. , Ottawa; Carl E. Klotz, L.D.S., St. 

Catharines. 
Quebec. — Eudore Debeau, L.D.S., D.D.S., 396 St. Denis Street, Montreal; Stanley 

Burns, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton, 

D.D.S., L.D.S., McGill University, Montreal. 
Alberta. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — Jas. M. Magee, L.D.S., D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S., D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Regina. 

Prince Edward Island. — J. S. Bag-nail, D.D.S., L.D.S., Charlottetown. 
Manitoba. — M. H. Garvin, D.D.S., L.D.S., Winnipeg-. 
British Columbia. — H. T. Minogue, D.D.S., L.D.S., Vancouver. 

Vol. XXXI. TORONTO, FEBRUARY 15, 1919. No. 2. 



THE PROFESSIONS AS CLOSE CORPORATIONS 



In the Bracebridge Gazette of January 16tli appears a 
very well written article on the subject. While we are not 
prepared to agree in full with the writer's view on the sub- 
jeiot we are compelled to admit that mueh of what he says is 
true and might well be adjusted by the leg'islature. 

The Editor introduces the subject by clearing the atmos- 
phere with regard to private rig^hts or vested rights. He 
points out that there were no vested rights acknowledged 
when temperance or prohibition was introduced in Ontario. 
He also points out that there was no recognition of private 
rig'hts when public school education was introduced. At that 
time there were many private institutions running for gain. 
When the government undertook to give free education they 
did not compensate those who were in the private school busi- 
ness. So it should be, in his opinion with regard to medical, 
dental -and pharmacy schools. His claim is that they have 
no private right and that there should be no compensation 
for losses, if the government undertook to teach medicine, 
dentistry and pharmacy in the same manner as they do public 
and private sohools. 



66 DOMINION DENTAL JOURNAL 

The Editor says that these professions are organized for 
the very purpose of raising the standards so that there may 
be but a few enter the profession. 

With these views we are not prepared to agree. What- 
ever the original intentions of those who secured the medicin- 
al, dental and pharmacy Acts was we don't know, but we knew 
that the leaders of these professions are much con'cerned 
about public health in general. The fact is there is much 
more concern about the needs of the public than there is about 
the individual members of the profession. They have long- 
since recognized that which is good for the public is also good 
fo>r the individual. 

We most heartily agree with the editor that the cost of 
professdonal education is altogether too higth. If the fees of 
the student could be reduced until the less financially fortun- 
ate young men and women could enter these professions there 
would undoubtedly be a great advantage to the public. It is 
strongly held by many educators of today that the govern- 
ment should supply the necessary means for professional edu- 
cation and then control the location and financial rewards of 
those so educated. The following paragraphs give a clear 
idea of the author 's contention. ' ' My contention is that these 
three professions or businesises should be under complete con- 
trol of the provincial Department of Education, just as teach- 
ing is ; that the province should set such tests as in the judg- 
ment of that Department seemed wise ; that it should regulate 
the subjects to be studied and the extent of such studies; that 
it should give as much encouragement in the way of free in- 
struction as it does student teachers; that it should use its 
utmost endeavor to train a sufficient number of men to ade- 
quately attend to the needs of the people; that it should to 
whatever extent is necessary guarantee adequate incomes for 
tlhose engaged in it; that it should insist upon a more equit- 
able distribution of these necessai*y helpers through the coun- 
try so that peoplle remote from towns should not tove to die 
because no help is available; that such care should be avail- 
able for the poor as well as the rich. To serve Muskoka and 
all well there should be resiident doctors, and dentists in at 
least the following plaoes. (Here are given names of fifteen 
places in Muskoka where there are neither doctors nor den- 
tists, which should be supplied). In support of this contention 
he says that a young man died at Dorset not because he got his 
limb crushe<l, but because he got his limb crushed at Dorset. 
He died because he was so long unattended. . Why sdiould it 



EDITORIAL 67 

cost a man his life to liave his leg crushed in Dorset, and only 
oanse a little loiss of tlime to have it crushed in Tluntsville i 
Why should the birth of a child at Van Kou^hnet (»ause a fam- 
ily the loss of its mother or a mortgage on tlu^ farm'^ Why 
should the memlier of any outlying district have to gum it 
while the townspeople chew on gold? How can a govern- 
ment expect its people to go back to, or stay on the land when 
it leaves those people sutfering so many disadvantag-es by 
being back on the land! Is there any righteousness in allow- 
ing any body of men to combine to the generHii hurt -of the 
people? 

The author of this article only states what is in the minds 
of most every layman in reference to the professionals being 
close corporations or combines, but, none of these i)eoi)le 
ever think that the teachers are combines because they are 
under government control. We have many times expiressed 
the view given by the late Dean Willmott that the Dental pro- 
fession would be far better off in Ontario if the Government 
took complete control of the profession, setting the standards, 
doing the. teaching and directing and controUinu- the pro- 
fession. With this \'iew we heartily concur. 



THE AMERICAN INSTITUTE OF DENTAL TEACHERS 



The American Institute of Dental Teachers held its an- 
nual meeting in the last week of January at Atlanta, Georgia. 

The attendance was not as liarge as usual nor were there 
as many interesting discussions as in former times, but not- 
withstanding this fact the meeting was one of intense interest 
because there was up for discussion some of the most vital 
problems in Dental education. 

During the days before the regular meeting there was held 
a meeting of the National Faculties Association and also a 
m'eeting of the Universities^ Faculties Assodiation as well as 
one of the Educational Council of America. During the lat- 
ter part of the yeaT 1918 the Educational Council of America 
undertook to ciassify the dental schools of America. They 
set forth some definite headings under which the schools were 
to be classified. To these headings there has been offered 
much objection but at the same time the Council must, have 
some basis upon which to proceed. As might be exi>ected all 
the sdhools were not satisfied with the class in which the> 
were placed. There wei'e sixteen A schools, twenty-six H 



68 DOMINION DENTAL JOURNAL 

schools and a few C school s. All of the B and C sichools were 
advised to chaoge their methods so that they mig-ht qnalify 
as A schools. The C schools were asked not to take students. 
Naturally such i)ositive' regulations raised a storm from those 
who thoug^ht they were improperly classified. After two or 
three days' conference most of the difficulties had been swept 
away, and there is an outlook for demtal education in the 
United States far bej^ond the expeetatitons of the most sian- 
guine. 

pne of the most interesting features of the meeting was 
the introduction of Dr. George Villian of Paris, who had 
come to America to be present at the meeting, and, to present 
the different methods of treating fractures and deformities 
of the face and jaws. At the cloise of the meeting Dr. Villiian 
was made an* honorary member of the Institute of Dental 
Teaohers. 

At a banquet Dr. Villian showed many photographs on the 
screen and. moving pictuires of the conditions in war-«tricken 
Fi'ance. 

The weather was congenial and hearts were warm, to- 
g-ether with true Southern hospitality which made the meet- 
ing one of exceptional interest and va'lue, especially to those 
who had come from the north. 

The next meeting will be held in Detroiit, Mich. Dr. A. W. 
Thornton who wais president for the last yeair is to be oon- 
gratulated on the success of the meeting and the brilliancy 
with whidh it -was carried through. 



WHAT IS TO BE DONE WITH THE ARMY DENTAL 

EQUIPMENTS ? 

The war has done much for dentistry. It has supplied an 
opportunity. When one looks back over the years in Den- 
tistry in Canada to 1904 when the first dentists were appoint- 
ed to the army under the Medical Corps, one marvels at the 
success of the present organization. Dentists then were 
merely tolerated in the army; they were not expected to do 
very much, though there were thousands of recruits being re- 
jected because of the condition of their mouths. As the Armj 
Medical Corps did not call out the dentists under their com- 
mand, it required the civilian dentists to take care of these 
men and point out to the Government what could be done in 
making these men fit for service. Greneral Hughes, then Min- 
ister of Militia was the first person in hig'h authority to ap- 



EDITORIAL 69 

predate the advantages of dentistry to the soldiers. Much 
credit is due to him for placing the dental profession in Can- 
ada on a basis which it may not be ashamed of. The rank 
giveji the dentist in the Army Medical Corps, is a fair ex- 
ample of what the medical men thought the services of the 
dentists were worth. They were given the relative rank of 
lieutenant, but not full rank as in any other department of the 
service. Today there is an independent organization ranked 
as high as full Co'lonel. A great opportunity has opened to 
the dental profession. With that opportunity comes respon- 
sibility. The profession has lived up to the responsibility in 
its relation to the army. The next problem is to live up to its 
responsibility to the public; at the present time there are 
dental equipments in France, England and Canada owned by 
the Canadian Government. What is to be done with these 
equipments?. If they are sold they will bring a mere pit- 
tance; if they are set up in the different localities in the coun- 
try they could be used for caring for the poor people of the 
country. There are approximately six hundred equipments 
which would give fifty or more for each province according to 
population. If these were properly manned, great good might 
come to the public at little cOvSt. 



THE DENTAL REVIEW CEASES PUBLICATION 



The Dental Review, published by H. D. Justi & Sons and 
edited by C. X. Johnston, Chicago, has ceased publication. 
It comes as a shock to the dental profession, to hoar that the 
Dental Review, a magazine of such wide distribution, and 
hig'h ideals should cease publication. There is no statement 
from the publishers or from the editor as to just why publi- 
cation ceases. The only parallel one can think of in this con- 
nection is that of the Indiana Dental Journal published by 
the late George E. Hunt, who said in the closing issue that 
the enterprise had been very successful financially and very 
enjoyable to the Editor, and it had a large circle of readers, 
in fact, it could be looked upon as the most influential maga- 
zine published for the Dental profession in America, but gave 
as liis reason for ceasing publication that both the publishers 
and the editor were tired. The Dental Review has filled a 
place in the literature of the profession second to no other on 
this continent, and if it is tired it does not admit it. It is 
gratifying however, to know that the pen of the editor will not 
bo laid down. 



70 DOMINION DENTAL JOURNAL 

Editorial Notes 

Dr. E. A. Kay has begun practice a.t HisUsboro, N.S. 

Dr. C. F. (xilKes-has resumed his practice at Campbelltou, 
N.B. 

Dr. J. S. Ibbotson, ^loiitreal, has been elected President of 
the Quebec Dental Board. 

Dr. Frank Switzer addressed the Saskatoon Rotary Club 
on Dentistry for the Young. 

Dr. Hutchinsjon who has been on. overseas duty for more 
than two years has just begun practice again in B. 0. 

Dr. H. S. Gilford for more than thirty-five years the Deaji 
of the Philadelphia Dental College died only a week ago. 

It is surprisiug- the amount of publicity that is given any 
dential question in the province of Ontario. Who will produce 
the material? * 

The hospital for insane at Trenton, New Jersey, has re- 
ported that many cases of insanity are due to infected and 
diseased teeth. 

Dr. H. McMillan, returned from overseas has been ap- 
pointed school dentist for Windsor and Walkerville, Ontario, 
at a salary of $3,000. 

Dr. George Villian will visit all of the principal cities of 
the United States and Canada, especially where there are den- 
tal schools to demonstrate the recent methods developed in 
war surgery and wa'r prosthesiis. It is ex|>ected he will 
reach Canada about the first week in March. 

The Swiss Odontological society in its reports says that 
dental caries is "a symptom of a constitutional malady due 
to irrational diet,'' and that war bread is an undeniable step 
in advance towards a rational diet, which should be nu^de up 
of hardstuffs masticated with perfect completeness. 



KDITORIAL NOTES 71 

Dr. Arthur M. Davis, late dentist to the Kaiser of Ger- 
many gave an address on his rela.tions with the German no- 
biility at a banquet in Buffah> given by the Buffalo Dental 
Society and the seventh and eighth districts. The address 
was most entertaining and instructive, giving an inside light 
on the happenings. 

The Hon. Dr. Cody, Minister of Education of Ontario, in 
addressing the general annual meeting of Women's Institutes, 
gave them the assurance that the oliiklren of the province 
would be given one complete examination with a view of de- 
termining the state of their liealth. It is remarkable that 
pigs get more direct public attention if they show signs of 
illn-esis than the children of the province. 

If the i)ubl'ic, as well as the physicians and dentists, wei'e 
aware of the serious influence whidi defective teeth have on 
the development and liealth of the average in<lividual, oral 
prophylaxas would hold the important place in preventive 
medicine that it so richly deserves, and the result would be 
economy in time and expense to the patient, increased phy- 
sical and mental efficiency, a greater average duration of life 
better preservation of the tissues in old age, arid fewer chronic 
diseases. 

At an informal meeting of some Canadian dentists and 
officers of the Preparedness of American Dentists held on 
Jan. lltli in Buffalo a free diseusision of the international 
relations between Canada and the United States along dental 
educational lines for the public was indulged in. There is a 
desire on the part of the preparedness league and some den- 
tists in Canada that they each should join hands, so that &such 
would be stronger in their own country, both in the interests 
of their profession and the ])ublic. 

The Moose Jaw Collegiate Institute sees its duty and sets 
about to cany it out. Duning the winter months it is pro- 
viding a course in agriculture for the farmers' sons of the 
surrooinding count'ry aw well as a course in domestic science 
for the daughters. In addition physical training is provid- 
ed as well as medical and dental in'spection and treatment. 
^If the deintal or medical treatment is too expensive for tJie 
pupils to bear the board will assist. Shouldn't some other 
localitv in Canada awaken to its res]>onsibiility ? 



72 DOMINION DENTAL JOURNAL 

The Board of Eduoatioii of the city of Moose Jaw hais 
employed a nurse at a sallar}- of fouii;eeii hundred dollars a 
3'ear. Duties to 'commence February 2nd, 1919. A dentist 
is to be emplo^-^d half-time service to teach oral hygieaie as 
well as re])air the defects of the children's teeth. 



;t'our or five years ago the department of education in On- 
tario gave the Board of Education the privilege of employing 
medical and dental assistants as well as teachers. Most of 
the cities throughout the ])rovfince have inaugurated this 
system, but througho<ut the rural districts not much has yet 
been dou'C. 

The report of higher education in the State of New York 
has just come to hand for tJie yeair 1915. As cue studies the 
methods of higher education in this report he is driven to the 
condlusion tliat in Ontario there could be a great improve- 
ment. If professional education rs a matter to be in the iai- 
terests of the public then the public should take direct control 
of it throuig-h its legislative as'sembly. After having spent 
thousands of dollars and a great deal of time on its medical 
education during the past two years it is remarkable that the 
report would perpetuate the old system of each profession 
governing itself wholly and entirely independent of the legis- 
lature. 

In another part of this issue appears an outline of the 
establishment of a department of dentistry in the university 
at Chingtu. This is a university in the very heart of Chma 
directed, supported and controlled by a board of governors 
living in America. While the main support of the university 
is from denominational organizations the scientific instruc- 
tion is non-denominational. The establishment of dentistry 
as a part of medical education is significant. There are many 
movements in this direction throughout the world that make 
one pause and wonder what has brought about the change of 
attitude both within the ranks of dentistry as well as medi- 
cine. 

The course in dentistry in the Cliingtu university is to be 
six years— three years in pre-dental studies and three years 
in dentistry proper. The three years of pre-dental studies 
are to be taken with the medical students. 



CORRESPONDENCE. 7i 

A School of i\Ieeliaiiiical Dentistry has been established in 
Victoria undeir the presidency of Albert E. Clarke, a naitive 
of that city. It is claimed in the announcement that Chicago 
and New York are the only cities on this continent that ])ro- 
vide a cours-e in den'tal mechanics for prosthetic dental la- 
boratory as'sistants. He says that tliere is a great demand 
for dental laboratory help, in fact his opinion is that each 
dentist should have a dental laboratory assistant of his own, 
raither than send his work out to a commercial la]>oratory. 
Wliether dental co^Uegcs know it or not the fact is tluit the 
practising- dentist does little or no mechanrcal laboi'atory 
work. Dr. Clarke is now trying to fill a definite want, we 
trust that many of the students attending Dr. Clarke's school 
will be women because it is a kind of work they can do just 
as well or better than men, besiides having the necessary 
adaptation and skill to be an assistant at the chair as well. 



A LETTER FROM A WEST INDIAN DENTIST 



A West hidid)/ detitist in Canada who cannot 
register and irisJies to return to Ids native land. 



To the Editor: Do not think, readers, that you will find 
me dealing with a surgical case or one pertaining to pros- 
thetic Dentistry, but what 1 will lay down in these pages of 
this Journal is merely a case that is to my opinion worth 
considering. 

I was born and educated in the West Indies, City of 
Georgetown, British Guiana, South America, registered by 
the Medical Board of that country as a Dental Practitioner 
and practiced there for 5 years. There was a great boom for 
Canada at the time in the West Indies, and as a young man 
full of aspiration and energy and desire to gain more 
knowledge, I gave u\) my ])ractice and came to (^anada in 
August, 1912. I landed in Toronto and called on the Dean 
of the College of D. S., the late Dr. Willmott, at the time, 
he handed me an annual report of the college and pointed out 
at the same time that there was no piovision made for foreigni 
])raictitioners and the only way to do, was to take the full 
four year course at the College. Now this did not a])])eal to me, 
as I did not intend to go to school again, but asked whether 
advance standing could be given to me. "Xothing doing," 
he said. I thanked him for the information and went huntin'^' 
for a job. 



^-+ DOMINION' DENTAL JOURNAi, 

In the Toronto papers I found an announcement of a 
AVinnipeg Dentist who wanted an expert operator for ethical 
practice, applied and got the position; but the idea of having 
my own practice again was still pushing me ahead, and I 
went to Saskatchewan, and called on the President of the 
University, Dr. Murray at Saskatoon, he explained to me that 
I could be an assistant to an establisilied dentist anywhere in 
the province and so some of my four years bringing me to 
my I'ong* felt ambition. T got Dr. G. J. Hope, President of 
the Saskatchewan Dental Association to help me out and 
stayed with him until the DentaH Corps was organized and 
enlisted as a sergeant in February -tth, 1916. I was fully 
aware that a commission could not be given to me because 
of my not being a "Canadian graduate," but I did expect 
that my superior officer could recommend me for promotion 
with the West Indian forces, and so give me a chance to go 
back and continue to do good work. I 'have since written 
to the Dejnity Director of Dental Services at Ottawa, put- 
ting the matter before him and am anxioinsly waiting his 
reply. Only wish he could see his way of returning me to 
the West Indies and 1 will be moae than thankful. 



IMPORTANT NOTICE— DOMINION DENTAL 
COUNCIL OF CANADA 



CLASS C. APPLICANTS. 

Notice is hereby given that the time has been extended 
untiil June 30th next in which tO' make application for a class 
^'C^' Certificate of Qualification. All applicants must prove 
''Regular, Legal, Ethical," practice in an agreeing province 
for ten years prior to December 31st, 1918, and muist have 
been registered in one of the agreeing provinces pnor to 
January 1st, 1917. 

CLASS D. EXAMINATION. 

All applicants for a class ''D" examination must have 
their applicatioais in the hands of the Secretary on or before 
May 1st, 1919 for the Examination which commences on the 
Second Tuesday in June. All Applicants for this exami- 
nation must prove "Regiilar, Legail, Ethical Practice" for 
five years prior to May 1st, next. 

All the above ay)plicants, accompanied by the required 
fee of One hundred dollars, must be sent to the Secretary, 
Dr. W. D. Cowan, House of Commons, Ottawa, Ont. 



REVIEWS 75 

THE DENTIST'S LIBR ARY 

Principles and Practice of Filling Teeth. By 0. N. Johnson 
M.A., L.D.8., D.D.S. Professor of Operative Dentistry in 
the Chicago College of Dental Surgery. Editor of The 
DoTital Review, Fourth Edition. Revised and Enlarged. 
With 127 Illustrations. P. Blakiston, Son, & Co., 1012 Wal- 
nut St., Philadelphia. 
Although the original of this book ai)peared many years 
ago it is as readable now as it was then. There may be some 
changes an practice not fully dealt with in this book, and yet, 
no dentist can find anywhere a book that will present the 
subject of ''Operative Dentistry'' or ''Filling Teeth" as con- 
cisely and as easily understood as in this book. The chapters 
on "Gold Inlays" and Porcelain Inlays" might have been en- 
larged as well as the work on "Root Canals" but in all tliree 
of these chapters there is sufficient to give the reader a fair 
grasp of the subject from the author's view point. This is a 
personal book and will always have readers when the com- 
pilation 01" referenc(» book is laiid on the back shelf covered 

witli dust. 

* * * 

Fimdanuntals of Patholoqii. For students and general prac- 
titiojiers of medicine and dentistry and for nurses in train- 
ing schools. By Paul G. Wooley, B.S., ^I.D. Professor of 
Pathology, Ihe University of Cincinnati; Director of the 
Pathological Institute of the Cincinn^ati General Hospital, 
Cincinnati, Ohio. Eighty-one Illustrations, including one 
color plate. St. I.ouis, C. V. Mosby, Company, 1916. 
This is a very interesting book for general practitioners 
and dentists who have but little time to wade through a tre- 
mendously large volume of patholog\\ The chapters on 
"The Causes of Disease" and "The Disturbances of Meta- 
bolism" and "Growth and Overgrowth" and "Degenera- 
tion" are of special interest to the dentist. The chapter on 
the "Dustless Glands' and its relation to metabolism will 
have to be carefully studied by the profession in order to ap- 
preciate the relationship between general diseases and the 
manifestations of diseases in the body. No dentist to-day 
can get alo-ng without having a small book of this kind on his 
desk in his librarv for careful study. The Caivadian agents 
are McAinsh & Co., Cor. Yonge and College Sts., Toronto. 



76 DOMINION DENTAL JOURNAL 

Technique and Scope of Cast Gold and Porcelain Inlays, with 
a Chapter on Endocrinodontia, or the Ductless Glands, 
Their Expression in the Human Mouth. By Herman, E. S. 
Chayes, D.D.S., New York City. 

A work of aliiTOS't 400 pages, published by a progressive 
book piiblisiii'iig coiiii^aiiy. The title gives but a small idea 
of the contents. There are four distinct sections besides 
several short chajjters' on allied subjects. The book opens 
with fifty pages on ^'the sequence of thought in teaching'^ 
next comes "the functions of the teeth" followed by '^gold 
and porcelain inlays" closing with a chapter on "light and coil- 
our" and the ductie&s gl-ands. There is much useful informa- 
tioai within these pages, in fact information not found in a 
mass of general literature. As a book for the. general prac- 
titioner it is of great value, but not suitable as a student's 
book, or as a text book. There is no relation between the var- 
ious chapters discussed, and often little relation between the 
sub-headings of the chapters, not to mention the loose use of 
words and bad construction, it is not suitable English to 
set before a student. 



ONTARIO DENTAL SOCIETY 



The Ontario Dental Society will meet in Toronto on April 
i^Hth, 29th and 30th. A division of the Detroit Clinic Club 
will be present and it is expected that Dr. Percy Howe of Bos- 
ton will giYQ an address on the use of nitrate of silver in den- 
tal practice. 

There will be two or three other progressive clinics one on 
the making of crowns, another on the X-ray machine, another 
on filling root canals, and still another on sterilization in den- 
tistry. Besides this there will be tlie regular individual 
clinics. The main portion of the meeting will be given up to 
demonstration, clinics and exhibits. 



WANTED.— A dental inspector for half time service— every 
forenoon. Duties to conmience as sooai ais possible. Salary 
One Hnndred and Twenty-five doMairs per month. Apply, 
stating experience and qualifications. E. B. R. Pragne^ll, 
Secretary, Moose Jaw, Saskatchewan. 



Dominion 

Dental Journal 

Vol. XXXI TORONTO, MARCH 15, 1919. No. 3. 

Original Communications 

FOOD DEFICIENCIES AS A FACTOR INFLUENCING 

THE CALCIFICATION AND FIXAl ION 

OF THE TEETH 



Mx.j. F. M. Wells, D.D.S., J..1).S., .Montreal. 

Read before the Royal Society of Medicine. Dec. 19th, 191 S. 

1 imist, in the first j^laeo, apolo.i>-i8e to the 0(lontolo<iif'al 
Section of tliis Society and to the distin.^nislied visitors wlio 
have honored ns with their presence tliis evenini>-, for having' 
taken npon myself the task of introdneino*. this snbject. I can 
claim no S])ecial knowledge of these food deficiency in'oducts 
or so-called ''vitamines. " In fact I have only a very sn])er- 
ficial and inadequate acquaintance with the vai'ious and \ai-v- 
in.g theories that have been held on this subject. 

The problem of food deficiency factors or so-caUed "vita- 
mines,'' has, of late years, received an increasing consider- 
ation, and there has been brought together from most ditferent 
sources an abundance of facts which seem calculated to enrich 
our conception of the dietetic value of foods. 

The investigations have revealed that satisfactory growth 
of nutrition cannot be maintained upon a diet containing ])ro- 
tein, fat, carbohydrate, salts and water, but that in addition 
certain other essential constituents are necessary, of which, 
as yet, very little is known. These are known as Accessory 
Food Factors or " \^itaniines," and are present in a very small 
amount in most natural foods, and their chemical natuie is 
unknown, but healthy life is impossible in their absence. 

The diseases that are known to be produced by these acces- 
sory factors are beri-beri and scurvy, others which are be- 
lieved to be caused by accessory factors, but of which the proof 
is incomplete, are rickets, sprue and pellagra. 

Before proceeding- with the exi)eriniental i:>art of the work 
done by Dr. Zilva and myself, 1 would like to liive a short re- 



78 DOMINION DENTAL JOURNAL 

view of the work on scurvy and rickets and a few of the many 
theories that have been advanced as to the cause of the rapid 
increase of tooth decay. 

The etiology of beri-beri is well understood to-day, but as 
this disease is not endemic in this country and rarely occurs 
in infants, and as far as I know, it causes no dental disease, 
it is, therefore, not to our interest to discuss it here to-night. 

Thrush or ''s|)rue" is interesting to dentists, but as yet I 
know of no scientific work done on this disease. 

Scurvy is not a new disease, as some people are led to be- 
lieve. A description of scurvy is to be found in the narrative 
of llie campaign of the Christian Army in Egypt under Louis 
IX, about the year 1260. The historian of that crusade was 
not only an eye witness of the disease in others, but was him- 
self attacked by it. He speaks of the debility and tendency to 
swoon, black spots on the legs, bleeding from the nose and the 
livid and spongy condition of the gums, etc. The barbers used 
to go around trimming the gums of the sufferers. 

Scurvy has unquestionably existed in the north of Europe 
from the most remote antiquity. That we have no mention of 
it in the early history of the Northern nations must be im- 
puted to the ignorance of the people, especially as regards 
medicine. 

Well-marked, so-called florid, scurv}^ among infants was 
not an uncommon occurrence about the period 1875-1900, when 
artificial feeding was popular and patent foods were enthusi- 
astically adopted. At the present day it is probable that mild 
incipient scurvy is more common than is usually believed. This 
condition is solely due to the rapid increase of artificial feed- 
ing o'f infants. 

Obscured though the exact etiology of infantile scurvy may 
be, it is probable from clinical facts that this affection arises 
from causes distinct from those that produce rickets. 

It is" due to the investigations of Sir Thomas Barlow and 
Professor Still, of the Great Ormond Street Childrens Hos- 
pital, London, almost all that is known of the pathology of 
scurvy amongst infants. 

Ill adult scurvy we have conclusive proof that the pro 
longed dej)rivation of fresh vegetables, or their equivalent, is 
certain to bring about a scorbutic condition. We are also suffi- 
ciently familiar with the fact that ])roprietary infant foods 
do not contain the accessory factors that are necessaiy to pre- 
vent scurvy. It has been demonstrated experimentally that 
these accessory factors which i)revent scurvy, are contained 



ORIGINAL COMMUNICATIONS 79 

in hmnau milk and in the milk of the cow, but not in laiiie 
quantities, but they are destroyed by the process of heating 
to a de^ee depending on the time and temperature of heat- 
ing. It is clear then, and fair to say, that the further we get 
from a natural food which is consumed in the raw condition, 
like the mother's milk, the more frequent will be the risk of 
the disease. Dried milk contains less of the anti-scorbutic 
factor than raw milk. 

The age at which we should be on the qui vive for the 
initial symptoms of scurvy is about the eighth month of in- 
fantile life. It is exceptional when the symptoms appear ear- 
lier. This point is of considerable impoi*tance in diagnosing. 

Professor Still in his clinical picture of the fully-developed 
disease is striking enough ; an infant who has been fed upon 
one of the patent foods, with or without milk, or on milk which 
has been condensed, sterilized, or otherwise altered, has been 
ailing for some weeks, has taken food badly and probably lost 
weight. Moreover, the mother says it cries whenever it is 
touched, and, as she puts it, "has lost the use of its limbs.'' 
The infant is pale, it lies quiet perhaps until it is approached, 
when it cries, out in obvious dread of being touched; the legs 
lie motionless, usually with the thighs slightly abducted and 
averted and the knee slightly flexed; the arms are less often 
affected. There may be some swelling of part of one or other 
of the limbs, obliterating the natural curves. Any handling 
of the affected limbs causes a piteous cry, evidently of acute 
pain. If teeth are present the gums around them are swollen 
and purple, occasionally projecting like a mass of granulations 
almost completely hiding the teeth, aiid bleeding readily when 
touched. The urine is perhaps smoky, if not red with blood. 
Such in outline is the characteristic picture of infantile scurvy. 

Rickets is believed to be a disorder of nutrition, and as 
such affects the whole system. The bone changes are only 
part of a general disease. The child may suffer severely and 
yet show so slight a degree of rachitic change in the bones 
that the disease might almost pass unnoticed, if oidy the osse- 
aus system was considered. 

The temperature is normal, even during the most active 
stage of the disease. A rise in temperature is almost always 
due to some complication. There is little to be said in favor 
of an infective origin. Rickets amongst children in the Brit- 
ish Isles has grown to a very alarming state. From 50 per 
cent- to 80 ])er cent, in London clinics show signs of rickets to 



80 DOMINION DENTAL JOURNAL 

a more or less marked degree. It is found in the Dominions 
to a less extent, but it is quite common. 

Symptoms— Delayed dentition is one of the most constant 
symptoms. It has been found in 32 out of 42 consecutive cases 
between nine months and three years old that this was present. 
Frequently no teeth have appeared at the end of the first year. 
Rarely their appearance is delayed beyond the period of 
eighteen months. If dentition has begun before the onset of 
rickets, it is often arrested for several months. There is a 
striking tendency to very early caries, even before the tooth 
is fully cut, the enamel at the cutting edge is often completely 
destroyed. Amongst other symptoms is sweating of the head 
during sleep, large protuberant abdomen, reluctance or in 
ability to stand, which makes the child late in learning to walk, 
the softness of the bones and ligaments, which makes the bones 
bend and the joints yield, with resulting bandy-leg, knock-knee 
or other deformity, stooping curve of the spine, large size of 
the head and square shaped, with all the tendency of conviii- 
sive disorders and to catarrh of the respiratory and alimentary 
track, adenoids, chest affections, indigestion, etc. 

The most prominent symptoms, no doubt, are those tliat 
alfect the bones, but in rickets there is a general disturbance 
of metabolism, and its effects are not limited to any one tissue 
of the organism. Until a cure is made the disease prevents 
satisfactory nutrition of the bones and teeth, stunts and de- 
forms the bones of the face and jaws, etc., and the damaging 
results are carried by the patient through the whole of his 
life, even after a cure is etfected. 

This great affliction, which appears to become more com- 
mon every day, if not altogether ])revented, can easily be 
remedied, if the baby is started otf on a proper diet, which is 
the mother's milk and which every baby needs. If the condi- 
tions are such that the baby is prevented from getting its 
proper diet and has to be artificially fed, too much care cannot 
be exercised in watching its progress for the first eighteen 
months, especially in regard to the weight of the infant. 

The early stages of scurvy and rickets are almost impos- 
sible to diagnose, and a baby that has to be fed on an artifi- 
cial diet should never be allowed the use of a teat or '' dummy *' 
as the diseased condition of the bones, caused by the absence 
of the food deficiency products, with constant suction of a 
"dummy," will rapidly cause badly developed jaws and nose, 
followed by adenoids, nasal obstruction, irregular articulation 



ORIGINAL COMMUNICATIONS 81 

of the teeth, mouth breathing and the whole train of evils 
which this condition gives rise to. 

It is important that a baby's weight should be kept normal. 
Rickety babies usually appear to be fat If the disease is to 
be checked before serious harm is done to the child, the early 
signs must be recognized as soon as possible. 

The first symptoms point to ^^air^ fro7n teething. (Painful 
teething in children is just as much a disease as any other 
baby ailment.) 

The second symptom is late dentition. (Every baby should 
have at least two teeth between the sixth and seventh month.) 
If the child shows these signs, rickets should be suspected. 

It is amazing that these evils are known to exist and it has 
been pointed out that they were due solely to improper diet 
and yet medical men will allow mothers, who are quite call- 
able of suckling their infants, to feed them on artificial foods 
and so deprive the infant of its heritage. Perhaps the fault 
lies in not having had direct scientific evidence to show that 
a faulty diet was the direct cause of improper fixation and 
calcification of the hard tissue. 

Now we will take up some of the most important theories 
that have been advanced during the past fifty years, as to what 
is the cause of the rapid increase of tooth decay. Miller's 
"Chemico-Parasitic Theory," which accounts for the phenom- 
ena of caries of the teeth, does not explain the rapid progress 
made in the increase of dental caries accompanying civiliza- 
tion in the past hundred years. In view of the fact that the 
incidence of dental caries has been greatly on the increase, 
especially in the yjast fifty years, it would seem obvious that 
our present mode of treatment of dental caries was radically 
wrong, that tlie judgment of time and experience alike con- 
demned it, and that such measures as are now in vogur have 
proved futile to arrest the progress of what has become the 
most prevalent disease of civilized communities. 

Heredity.— FrofessK)Y Darwin in his address to the British 
Asso'ciation in 1909, set forth some of the difficulties which 
exist in accepting either the theory of pangenesis or that of 
the continuity of the germ-plasma as an explanation of hered- 
ity. I have no intention, for I have not the necessary knowl- 
edge, to express an opinion on heredity. The only informa- 
tion that is at our dis^^^osal in regard to this theory are statis- 
tics of family history, which appear to throw very little light 
on the subject. 



82 DOMINION DENTAL JOURNAL 

Chemical analysis of our teeth has yielded' us so far, little 
or no information, and biochemistry is, as yet, still in its in- 
fancy. 

To what extent do ^'vitamines" affect the enamel? We do 
not, at present, know how far differences in their action may 
modify the rest of the tooth, but the connection wliich appears 
to exist between the enamel and the odontoblastic cells is 
direct, if this is not so I should call it an ^'inborn error of 
metabolism." I know that I am g*oin<>' to be severely criti- 
cized by my friend Dr. Mummery, and very generally by all 
of the leading dental anatomists, who state, as I understand 
it, that when the enamel is once formed it is formed for good, 
but strong reasons have adduced me that this belief is not 
based on such sure grounds as is generally supposed. 

T made a trip to Scotland last October, with a view to 
studying the diet conditions in the Highlands and Lowlands. 
I have always been led to believe that the Highland Scotch 
had better bones than is to be found in any part of the British 
Isles, and I thoroughly believe they have. This is largely 
accounted for by their simple diet of natural foods. Up to a 
few years ago the Highlander's meals were very simple. Their 
breakfast consisted of brose at 6 a.m. Brose is made by pour- 
ing boiling water over oatmeal, stirring all the time and add- 
ing a little salt. It was eaten with milk, syrup ot treacle and 
some had butter with it. The next meal was between 11 and 
12 o'clock, which consisted of potatoes and salt herring. No 
bread was eaten, but for the second course a bowl of milk and 
a piece of oatcake was taken. This was a universal dinner all 
through the North. The next meal was about 6 p.m. Again 
brose, but as a variati'on it was made with boiling milk, instead 
of boiling water. Between the mid-day meal and supper they 
had a glass of milk and in later years tea came in. The only 
variation from this diet was on Sundaj^s. Breakfast was 
usually later and dinner was served after church, which con- 
sisted of boiled cabbage and turnips. For supper on Sunday 
they had boiled potatoes and fresh fish and sometimes pork, 
but the pork was very sparingly used, as one pig had to last 
a family for the whole of the winter. Beef was rarely eaten. 
Rickets is not known by Dr. Bremner of the Department 
of Public Health for the County of Sutherland. He told me 
there has not been a case in his district. He also stated that 
the percentage of artificial feeding of infants was practically 
nil A mother looked upon it as a disgrace if she was unable 
to feed her child, and it is only recently there has been a small 



ORIGINAL COMMUNICATIONS 83 

percentage on the coast towns where the women are compelled 
to hawk their fish and render other duties, which make it im- 
possible for them to breast-feed their children, but away from 
the coast there is practically no artificial feeding. 

A remarkable thing among the old type of fishermen to-day 
is that there is hardly any decay in the teeth of men of 70 to 
80 years of age, but the young generation has quite a consid- 
erable number of decayed teeth. 

The following is a little incident which I would like to re- 
late. I happened to call on a very intelligent did lady, 81 
years of age, and after a short conversation with her relating 
to the subject of my trip, she immediately told me that the 
curse of the Highland Scotch to-day was tea. All the crofters 
or poor farmers keep the teapot going from morning until 
night, and are sipping tea all day long. I remarked that sh-e 
had a very good set of teeth and she told me, in her broad 
Scotch, that she had lost one tooth through an accident and 
that she had never had a tooth brush in the house. 1 might 
state here that a tooth brush was hardly ever known among 
the last generation of the Highland Scotch. However, T will 
refer to the tooth brush and its uses later on. 

Dr. Bremner, of the Department of Public Health for 
Sutherland, gave me a lot of valuable information in regard 
to his examination of the men for the Army and Navy from 
his district. He found that all the men over 20 years of age 
and up to 45 had exceptionally good teeth, as they advanced 
in years their teeth showed wear but no decay, but there was 
a vast difference in the teeth of the men under 20 years of age. 
I asked him what he thought it was due to and he said he 
thought it was due to nothing else except to the rapid change 
in the diet. He also stated that there is an increase in tuber- 
culosis, due to the same cause. The crofters or poor farmers 
are taking to artificial foods and discarding the natural foods. 
The oatmeal and potatoes are being exchanged with the gro- 
cer3 for white bread, jam, syrup and tea. These are all less 
valuable foods as regards content of accessory factors. T was 
told by one Public Health Officer in the Highlands of Scotland 
that there are a great many families at the present time that 
make two meals a day off bread and jam or treacle and their 
mid-day meal consists of potatoes and fish and this class have 
become inveterate tea drinkers. 

What a different condition presents itself in the Lowlands. 
I found in the Clyde district a different type of Scotchman 
altogether. The great reason for this is, to my mind^ the diet 



84 DOMINION DENTAL JOURNAL 

of more refined foods. The people are better housed and sani- 
tary conditions are better than in the North. Rickets and 
scurvy in the infant are as bad in this district as in any part 
of the British Isles and they have left their mark on the ohier 
generation. Nearly ever}^ person is wearing false teeth or pre- 
sents a row of decaj^ed teeth when they open their mouths. 

THE USE OF THE TOOTH BRUSH AND ANTISEPTICS IN THE MOUTH. 

Has oral prophylaxis been a success as a preventive 
against tooth decay? Our great army of dentists and teachers 
all over the civilized world are recommending the diligent use 
of the tooth brush. One dentist that I know, conceived the idea 
that he could prevent his patients' teeth from decaying alto- 
gether by oral prophylactic measures. His method was to have 
his patients come to his office as often as he thought desirable, 
once a week or once in two weeks, etc., and thoroughly cleanse 
all the interproximal spaces. This kind of a practice did not 
last long, as the cavities were multiplying so rapidly that he 
had to either send his patients to another dentist or return to 
his general practice. He decided on taking no chance of los- 
ing his patients, so he went back to general practice. 

No, T do not believe the tooth brush ever prevents tooth de- 
cay. If the enamel will not resist the action of the fluids of the 
mouth, the tooth brush will not prevent the onset of decay on 
the surface of the teeth or in the interproximal spaces. It has 
been found that mouths that are immune to decay have very 
often a greater number of fermentative bacteria than the 
mouths of patients where decay is rampant. The plain fact 
iS; that tlie tooth brush is a dangerous germ-ridden instru- 
ment, which it is impossible to sterilize. It cannot be boiled 
and we have no disinfectant which would render it aseptic and 
not leave it unfit for further use. 

On my way back from Jena to Canada in 1904, I called on 
my old friend, Mr. Grilmour, in Liverpool, and I was telling 
him about some experiments that I had made during the sum- 
mer with ditferent tooth pastes and washes that are in general 
use. I showed him my results and told him how short a period 
the antiseptic properties of these washes would last and the 
increased growth of bacteria over the normal within a few 
hours' time, due to the destructive effect on the delicate mucous 
membrane of the mouth, causing an impaired condition of the 
natural resistance and thereby intensifying the growth of 
bacteria. In no case did the antiseptic action last over fifteen 
minutes. He then told me that he had been watching the re- 
sults of different patients of his, that he could rely on as being 



ORIGINAL COMMUNICATIONS 85 

very careful to cleanse the moutli out regularly, and that fre- 
quently they had an increased amount of work to be done over 
the previous year. On turning up his records I found some 
of his patients he was referring to were using the same pastes 
and washes that I had experimented with. 

For our own comfort we have got to keep the tootli l)rush 
going, but it is not going to prevent tooth decay. Tartar has 
never decayed teeth, but in lots of cases it has, I believe, saved 
them from decay. If you gather records of conditions of the 
teeth extending o\'er a large area, you will find the least decay 
always where the tooth brush is not in use and this has been 
my experience all over. 

We liave, therefore, to look to some other source to find 
the true cause of tooth decay, and I think it can usually be 
traced to the improper diet of the child in infancy. 

Antiseptic luashes. — The conception which prevails gener- 
ally among medical and dental practitioners in regard to the 
use of antiseptic washes in the throat and mouth, is singularly 
confusing and confused. It is credited by them with consis- 
tent and often contradictory attributes, so great is the lack 
of clearness and precision of scientific work on this subject, 
when it approaches this topic, which has so weighty a bearing 
on our daily woi'k. I began to despair of ever being able to 
get an antise|)tic wash that we would be able to use on such a 
delicate structure as the mucous membrance of the mouth and 
throat, but though the work on flavine of Dr. Browning of the 
Bland-Sutton Institute, we have now a wash that will not only 
act as a good antiseptic, without causing irritation, land its re- 
tentive powers are such that it keeps the bacterial flora down 
for hours, instead of a few minutes. 

EXPERIMENTAL. 

This report is based on histological work carried out on 
the teeth and jaws obtained from considerably over 100 ani- 
mals. 

Method of in vestigation. ~¥or the purpose of this enquiry 
the lower incisor and molar teeth of the guinea pig were 
chosen. As in all rodents, these teeth grow from i^ersistent 
pulp and are never shed. The teeth while still in situ in the 
lower jaAv were decalcified and sections made in an antero- 
posterior direction, parallel to the long axis. In advanced 
cases of scurvy the teeth were apparently sound, but useles-s, 
inasmuch as they had been loosened by the gradual absorp- 
tion of the cement membrane of the alveolar sockets, which 
had left ex]:)osed that portion below the neck. As a result 



86 



DOMINION DENTAL JOURNAL 



there must have occurred that peculiar periostitic pain or 
something analog'ous which follows in the case of human 
patients who are suffering from shrunken alveoli. These 
teeth also presented, in addition, all the appearance of the 
chang^es of senility. A great number of longitudinal and 
transverse seetions suitable for microscopic examination were 
obtained. The revelations otfered by these sections are of a 
particularly interesting nature. Note the fine line of the den- 
tine and odontoblastic cells as compared with figures 3 and 4. 
Figures Nos. 1 and 2 are of a normal tooth and give one 
the opportunity of studying the histology and patho-histology 
of the dental pulp in its normal relationship to dentine. The 
enamel is not (juite as heavy as in the natural tooth on account 




Xo. 1 — Normal tooth of a gudnea-pig' (40 magnification). 

of the decalcifying process which has reduced it to about half 
its thickness, but it gives one an excellent example of the typ- 
ical appearance of the relationship to the dentine of the blood 
vessels, the fine cellular tissue and odontoblastic cells when in 
a normal condition. 

Figures Nos. 3 and 4. It is obvious that the term "Fibro- 
sis," or fibroid degeneration, is the only one which can with 
certainty be applied to this particular form under notice. 
There is no doubt that it is a specimen of degeneration, and 
it is equally easy to eliminate those other degenerative vari- 
eties, such as mucous, calcareous or fatty, which animal 
tissues may undergo. 



ORIGINAL COMMUNICATIONS 



87 



The present instance affords an opportunity of examining 
certain structural metamorphoses in the pnlj), which are be- 
iieved not to be dependent on any inflannnatory condition, but 
simply attendant on and ))roduced by altered metabolism or 
constitutional changes, due to the diets. 

Minute descriptions have been published on pulp modules, 
cahareous pulps and elaborate vvoik on ulcers and tumors 
connected therewith, but this at1^"ection seems to have been un- 
known or overlooked by the pathologists both in P^urope and 
America. In no case does one find the condition as depicted 
in Fig. 2 brouglit about by a dietetic experiment. It is evident 
in this ))icture that in comi)lete pul])ai" fibrosis no celluhu- ele- 













No. 2 — Normal tooth of g-uiiiea-i)ig (200 magnilication). 

ments of any description occurred. It is clear at once, and 
it is an imivortant fact, that no trace of cellular organization, 
no trace of cell nucleus, no trace of interstitial cement sub- 
stances can be found anywhere. Nerves, cells, blood vessels 
and odontoblasts have all shared the process of fibri-fication 
and are no longer recognizable. The fine cellular connective 
tissue, which is but a loose mass of network in the normal 
state, has either become grossly hypertroi)hized or (juite 
obliterated and its place taken by a new firm, fibrous struc- 
tuie, devoid of cells, nuclei, or any i-egular ai'rangement of 
constituted parts. 



88 



DOMINION DENTAL JOURNAL 



Figures Xos. 3 and 4 show an advanced state of scurvy. 
The irregular osteroid condition of the dentine is well marked 
and the different refractive appearance of the dentine is prob- 




No. 3 — Tooth of guinea-pig fed on scorbutic diet for 15 days (40 magnification). 




No. 4 — Tooth of guinea-pig fed on scorbutic diet for 15 days (200 magnification). 

ably due to the haemorrhagic condition of the dentinal fibrils. 
In a scurvy tooth the condition persists rights up to the 



ORIGINAL COMMUNICATIONS 



89 



apex of the root. The trouble at first appears to start in the 
odoiitohlastic cells at the top of the pulp, woi'kin^- towards the 
apex, followed by distended blood vessels and haemorrha,a:e, 
then complete fibroid degeneration follows. 

With the object of obtaining some insight into the condi- 
tion of the teeth of pregnant guinea pigs, I placed eight pigs, 
which were in a more or less advanced state of pregnancy, on 
a scorbutic diet, to study the biological relation existing be- 
tween tlie mother and offspring. Two of the guinea pigs that 
weie used for this experiment were in the early stages of preg- 
nancy, the remaining six being in an achanced state. The diet 
given, in each case, consisted of autoclaved milk, oats and 




TSTo. 5 — Tooth ol" monkey after six weeks' feeding- on scorbutic diet, showing 
coagulation and bunching- of odontoblasts. 

bran. The pigs wliich were in the early stages of ])regnancy 
died on the 11th and lotli day respectively, and death from 
intestinal infection was suspected. 

Microscopical sections were made of the embryos (^f both 
])igs, but on account of the haemorrhage condition and the very 
early stage of pregnancy, nothing could be discovered. 

The six pigs that were in an advanced state of ])regnancy 
all dropped their young at various stages of the ex])eriments, 
from 11 to 15 days. 

Microscopical sections were made of the teeth of the mother 
and offspring and in every case an advanced state of scurvy 
could be seen. No. 5 will indicate the condition of mother and 



90 



DOMINION DENTAL JOURNAL 



No. i) the condition of offspring, which are typical of results 
obtained throug-hout the experimental work which was after- 
wards carried on by Dr. Zilva and myself on normal pigs. It 
is not necessary to discuss the remaining cases of this group, 
as they all exhibited similar symptoms. 

This work has to be carried out moi-e extensively, as it is 
a little premature to make a positive statement, but the indi- 
cations lead me to believe that the pigs, during pregnancy, are 
more susceptible to scurvy than when in a normal condition. 

For the past four months I have been working on rickets, 
but my great difficulty has l)een to obtain material for histo- 
logical work. 













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No. »j — Tooth of monkey after eight weeks' feeding on scorbutic diet, showing 
coagulation and bunching of odontoblasts. 

Advanced cases of rickets are not so common now as they 
were from 1890 to 1895, when artificial feeding of infants was 
at its Iveiglit, and when less was known of the contents of arti- 
ficial foods. 

To-day if a child enters a hospital and rickets is diagnosed 
a cure is brought about in a very short time, consequently 
material to be had from infants for histological work is very 
raie indeed. 

Mr. Sidney Spokes kindly gave me some old specimens and 
from tliese I made a great many sections, which lead me to be- 
lieve there is a great change taking place in the enamel organ. 
These sections aie not sufficiently clear for me to exhibit here, 



DOMINION DENTAL JOURNAL 91 

as the material is very old and the sections I made are very 
poor, but the results are sufficient to show that the enamel cells 
are ^-reatJy deranged from the jaw of a child eight to nine 
months old. Mr. Si)okes has kindly lent me his sections which 
he made from the same specimen when he first obtained it a 
few years ago and which is exhibit No. 9. 

This work is to be further developed and I expect within a 
very short time to have a considerable amount of material to 
work with. 

The teeth were all decalcified in a solution containing 40 
per cent, formaldehyde, 30 per cent, formic acid and 20 per 
cent, distilled water. This is rather a slow process, but T 
found it gave better results than the more rapid method. The 
rapid method which T used was to decalcify with ])liloroglucin 
and nitric acid. This process will give very quick results, but 
is not so efficient as the slower method. After the decalcifica- 
tion was complete, sections were cut by freezing in gum and 
then staining with Ehrlich's acid haemotoxylin and eosin. 

Throughout the whole of the experimental work the earliest 
alteration to be noticed first takes place in the odontoblastic 
cells, in the upper part of the pulp, working gradually down 
to the apex, followed by dilation of the blood vessels and 
haemorrhage. 

CONCLUSIONS. 

That scurvy does affect the pulp is indisputable and is not 
a theory but an absolute fact, a doctrine in the true sense. 

The dentists who are working on infant's and children's 
hospitals are the most fortunately placed to get reliable in- 
formation for records that would be of great assistance in 
studying the development of the first dentition from a dietetic 
view. But this work, like all other medical research, has got 
to be carried on in animal life, if scientific results are to be 
obtained and work that is carried on with animals that are 
always kept in cages and carefully watched and given a cer- 
tain diet, is bound to give a definite result, if the experiment 
is repeated often enough. We have used considerably over 
100 animals on this exi>eriment. 

I am obliged to confess that twelve years ago when I pub- 
lished my first article on the effect of artificial light on in- 
fants in regard to the calcification of the teeth, T certainly 
thought that it played a much more important part than the 
diet. It was while I was arranging my w^ork to carry on my 
research still further with the artificial light that T was at- 
tracte<l by the work that was being done in the Lister Institute 



92 DOMINION DENTAL JOURNAL 

on scurvy. After having examined the teeth of several ani- 
mals that had been given a scorbutic diet, I found the pulp 
of the teeth was affected, even before any clinical symptom 
appeared in any other part of the system. This led Dr. Har- 
den, Dr. Zilva and myself to believe that it was more impor- 
tant to go on with the dietetic experimental work than the arti- 
ficial light. 

To Dr. P. P. Laidlaw, of Guy's Hospital, I wish to express 
my gratitude for much useful advice and help in the histolog- 
ical work and to Mr. F. Martin Duncan for the pains and skill 
taken with the photomicrographs. 



SKETCH OF LECTURE ON X-RAY IN DENTISTRY 



H. F. Kinsman, D.D.S. 

Delivered before the 7th District Dental Association, at Port Huron, Michigan, 

February, 1919. 

The time has now come whK?n no dentist can atford to risk 
his reputation by disregarding the necessity of X-rays in 
dentistry, and if a machine is not accessible, steps should be 
taken to gain access to one or one should be bought. To buy 
one is a good iu vestment, and it will pay for itself in about 
one year, and it will advertise your practice better than any 
newspaper advertisement coUld and do so ethically. 

KEASONS FOR BUYING AN X-EAY MACHINE. 

1. The Hadiomounts bear your name and should be kept 
for reference. 

2. The use of the X-ray gives the public confidence in your 
ability to find their trouble and to relieve it. 

3. You cannot expect the confidence of the medical prac- 
titioner if you do not use X-rays to disclose focal infections 
and impactions, for the day has come when the physician must 
have the intelligent co-operation of the dentist. 

4. You cannot protect yourself against accidents in prac- 
tice without the use of X-rays. 

SOME OF THE USES TO PUT X-RAYS TO. 

1. To locate impactions or lesions which are causing neur- 
algia. 

2. To locate focal infections responsible for neuritis aaid 
and rh eum a t i s m . 

3. To show un-errupted teeth in children or the absence of 
the tooth germs, so as to warn you to keep space and tlnis pre- 



ORIGINAL COMMUNICATIONS 93 

vent malocclusion by sending the patient to an intelligent 
orthodontist. 

4. To give intelligence before and to verify operations for 
apiectomy. 

5. To give an intelligent idea of the difficulties to be over- 
come, and the angles to proceed at in pulp extirpation and 
root canal filling. 

6. To protect oneself against false accusation as regards 
fracture. If a patient states that you broke his jaw, come at 
him with an X-ray, and in nine cases out of ten his bluff is 
called. 

7. To give a pleasant diversion to the monotony of a purely 
technical practice. 

8. To ascertain the extent of alveolar support left in cases 
of advanced pyorrhoea. 

HINTS IN READING X-RAYS. 

The study of the film must not be hurried or perfunctoiy, 
I believe that it is possible to look at a single film many minutes 
and put it away and referring to it, find something that you 
entirely missed. The study of X-ra^^s is only accomplished, I 
may say, by a Sherlock Holmes method in which some rules to 
be applied are : 

1. Notice the position of the filling in rayed teeth, and by 
so doing satisfy yourself as to Which teeth are devitalized, 
either with or without canals filled (a live tooth is veiy seldom 
responsible for any trouble). 

2. Give all your attention to the thus segregated suspects. 
Look carefully for broken nerve broaches, Grates Glidden or 
Beutelrock drills. 

3. Examine carefully by good light the apex of all roots 
with canals not filled to the apex. 

4. Look for the bulbous appearance and rarefied area in- 
dicating focal infections and granuloma. 

5. Look for improperly fitted crowns, and improi)erly 
trimmed margins of fillings and improper contact. Do not 
fear that the patient will hesitate to allow the use of X-rays 
or begrudge the cost. You will find them all as willing to sub- 
mit to it as you are anxious to employ it. The jjei'iodicals have 
long been educating the public to look for the source of many 
discomforts and diseases in their teeth, and there is no com- 
modity which has so ready a market as personal comfoi-t and 
freedom from the clutches of disease. Always be sure that 
external symptoms and conditions have been utilized to their 



94 ORIGINAL COMMUXICATIONS 

fullest in diagnosis before the X-ray is called in and you will 
still find a surprisingly large number of cases requiring it, 
and you may take my word for it that if you put a machine in 
your office you will never decide to do without it again. 



ACTION OF THE ACIDS ON THE TEETH OF 

WORKERS IN HIGH EXPLOSIVE 

FACTORIES 



E. S. Simpson, D.D.S., L.D.S., Trenton, Out. 

Delivered before the Ontario Dental Society. 

Mr. Chairman and Members of the Ontario Dental Society, 
— ^It was a great surprise to the writer when he opened a letter 
from the Programme Committee of the Ontario Dental Society 
bearing date of March 25, asking him in a most flattering man- 
ner to give what is to the writer an entirely new field of work, 
and what he feels sure of is that it is the same to most of the 




Model Al. 



profession, as it was to him twelve mouths ago— that is, the 
action on the mouth and teeth of the operators in munition 
plants from the fnmes of the acids used in the manufacture of 
hig1i explosives. The first thing that attracts a stranger's at- 
tention is the bleached and straw-cok)red hair and bad color 
of the skin, especially of the wringer men. They are dubbed 
by the other men '^canaries." Some of the men's hands are all 



ORiraXAL COMMCXICATIOXS 95 

stained, and if the hands be thin and fingers long they would 
suggest the appearance of a bronze turkey's feet. These last 
are the T.N.T. men. The nitraters are the men that get the 
most fumes. Dr. \V. J. Johnston of the plant hospital, told 
the writer that the fumes seemed to be bad on the heart. The 
fumes are nitric acid and seem to irritate the throat, but do not 
seem to bother asthmatic patients; in fact, Dr. Johnston has 
been watching |:hree tubercular patients that the analysis of 
sputum showed tubercular bacilli. Those three men are work- 
ing up in the plant as nitraters, and one has gained 30 pounds, 
another 18 and the other 12 in six months, although these 
three are not enough to give positive proof of the fumes as 
being beneficial to a tubercular patient. Some men seem to 
have an idiosyncracy to the fumes, and it upsets their stom- 
achs, the mouths become very inflamed, as there is so much 
ether used in the manufacture of smokeless powder that when 




Model A2. 

you meet one of the smokeless men on the street you can smell 
ether, and the writer has had his office scented up by one of 
them being in nearly as badly as though there had been an 
ether case in the office. Some of the new men in the smokeless 
are more than one-half drunk the first few days from the 
effects of the ether; and tlie nurse of the plant hospital told 
the writer that they always use chloroform on what they call 
the ether men to put them under an anaesthetic for an opera- 
tion. It looks as though they become habituated to the effects 
of ether; or, in other words, immune to the anaesthetic effects 
of the ether. The wringer men, nitraters, acid blowers and 
men working acid jmmps use masks, and wear rubber gloves 
and rubber boots. They are the ones that the fumes attack 
the teeth and skin. You often see one of these men with 
the skin coming off the ears or nose, and very often with face 



96 DOMINION DENTAL JOURNAL 

or neck bound up with cotton, where they have been burned. 

Then to the dentist when these men present themselves, 
he notices the reddened gums, and often almost sunburned 
lips and the labial surfaces of the anterior teeth eroded off. 
Note models A.I., how the left upper lateral is eroded, that is 
labial surface, and also left inferior cuspid and the lower in- 
cisors ; the left inferior cuspid you can see the leatheiy dentine 
standing up in the centre of tooth, and very soft. 

Now models A.II., the lower ones have gold crowns on; 
i.e., four incisors and left inferior cuspid; but note the distal 
cutting edge at central, and mesial cutting point at lateral 
base. They have gone in two or three months since the rest 




Model B. 

of the teeth were worked at. The left central is a gold crown 
tbat the patient had put on to replace left central, which had 
got broken four or five years ago ; had it done in Nova Scotia 
or New Brunswick. 

Now model B. Note how the labial surfaces of incisors 
are concaved at cutting edges. That patient never saw a 
munition plant until last July. He is a well built man, and 
has very strong looking teeth. Dates are on models. 

Model C, lower incisors. Note how the cutting edge is 
thinned. Those teeth were very sensitive, and patient could 
not eat an apple, or allow you to draw finger across labial 
surfaces, and also sensitive to cold air. Five or six months' 
work at nitrating. 

Model D. This man had very poor teeth. Man about 
35 or 40. Inferior central gold crown. Some one had put 



ORIGINAL COMMUNICATIONS 



97 



on before the writer saw the patient. Note how left central 
and left cuspid are cut out, i.e., the labial surface. Patient 
has worked about six months. 

Model E. Note the two centrals. These two centrals 
had four inlays. Writer does not know how long, as he had 
never seen mouth until two weeks ago ; but mesial fillings were 



Model E. 



Model D. 



Model C. 




out ; and note how labial surfaces are eroded off and the distal 
inlays stand up beyond the surface of enamel on labial sur- 
face. The acid men whose teeth are most attacked by the 
fumes are generally mouth-breathers. They are warned at 
the plant to keep their teeth clean and use their tooth brushes, 
and masks are supplied them. 



98 nOMINIOX DEXTAL JOURNAL 

Dental Societies 



CANADIAN DENTAL ASSOCIATION 



CONSTITUTION. 

Note. — The committee appointed to draft a constitution and by-laws for the 
Canadian Dental Association reported the constitution at the last general meeting, 
which was agreed to by the Association. It now reports the bv-laws for criticism 
and suggestion before sending them on to the executive committee of the Canadian 
Dental Association for approval (address editor). 

ARTICLE I. 

Title. This society shall be known as the Canadian Dental 
Association. 

ARTICLE II. 

Objects. The objects for which the Association is estab- 
lished are the promotion of dentistry and allied sciences, and 
the maintenance of the honor and the interests of the dental 
profession. 

To be attained:— 

(a) By x)eriodical meetings of the Association. 

(b) By promotion of public health. 

(c) By the publication of such information as may be 
thouo'ht desirable in the form of pamphlets or of periodical 
journal. 

(d) By grants of sums of money out of the funds of the 
Association for the promotion of dental surgery, allied 
Sciences and research work. 

(e) By promoting the enactment of just dental laws. 

(f) By promoting and safeguarding the interests of the 
profession. 

(g) And by such other lawful means as are conducive 
to the attainment of the above objects. 

ARTICLE III. 

Membership. The Association shall be composed of active, 
honorary and associate members : 1. Active members mu/st 
be regularh" qualified dentists in Canada, those engaged in 
teaching or research work in dentistry,- or in the allied sciences 
in Canada. 

2. Honorary members must be persons who have dis- 
tinguished themselves and risen to pre-eminence in dentistry, 
the allied sciences, literature or statesmanship. 

3. Associate members must be regularly qualified prac- 
titioners of dentistry or of the allied sciences, not resident in 
Canada. 



DENTAL SOCIETIES. 99 

4. Honorary and Associate members shall have all the 
privileges of the Association except tlie exercises of the fran- 
chise and they shall not be eligible for election as officers or 
members of any committee. 

ARTICLE IV. 

Affiliated Societies and Associations. All provincial or in- 
ter-provincial (where there are no provincial) dental asso- 
ciation or societies, at present existing, in Canada, or which 
hereafter may be organized in Canada, may by special reso- 
lution of said dental society or association, become affiliated 
with the Canadian Dental Association, by subscribing to its 
Constitution, By-Laws, and Code of Ethics, and by securing 
the approval of the Executive Council. 

AETICLE V. 

Officers. J. The officers of the Association shall consist 
of a President, 1st Vice-President and 2nd Vice-President, 
and General Secretary-Treasurer, all of whom shall be elected 
as hereinafter provided. 

(2) No one shall be eligible for any office or any committee 
who is not an active member. 

ARTICLE VI. 

Executive Council. The Executive Council shall be the 
business body of the Association. It shall consist of delegates 
elected by the affiliated societies or associations and by the 
Canadian Dental Association, as hereinafter provided in the 
By-Laws. It shall nominate two members for President, Vice- 
Presidents, and all other general officers for the Associa- 
tion, and shall transact all the general business of the Associa- 
tion between meetings. The President, Vice-Presidents, 
General Secretary and Treasurer, shall be members of the 
Executive Council. 

ARTICLE VII. 

Elections. The Presidents and Vice-Presidents shall be 
nominated by the Executive Council a.nd elected by ballot by 
the Association. 

The Secretary-Treasurer shall be elected biennially by bal- 
lot by the Executive Council. 

Any five members of the Association may nominate any 
member for any office in writing to the General Secretary. 

ARTICLE vin. 

The Treasurer shall give a bond for the amount of monej 
in his possession. 



100 , DOMINION DENTAL JOURNAL 

ARTICLE IX. 

Finance Committee. The Executive Council shall Bien- 
nially appoint five of its members, (two of whom shall be the 
President and the Secretary-Treasiurer,) as a Finance Com- 
mittee whose duties shall be as hereinafter provided and who 
shall also be a publishing Committee. 

ARTICLE X. 

Meetings. The meetings of the Association shall be held 
at leasit once every two years at such time and place as shall 
be determined by the Executive Council. 

ARTICLE XI. 

Funds. Funds for the purposes of the Association shall be 
raised by an equal assessment upon each active member ; from 
the Association's publications, and in any other manner ap- 
proved of by the Finance Committee. These funds, from what- 
ever source derived, are to be transferred to the Treasurer, 
by him deposited in some responsible institution selected by 
the Finance Committee, and x^aid out by him only on the order 
of the Finance Committee, through its chairman. 

ARTICLE XII. 

Amendments. No amendmenits to any of the foregoing 
articles or sections thereof shall be made, unless due notice 
has been given in writing to the General Secretary at least 
two months before the annual meeting. Any isuch notice of mo- 
tion must be laid by that officer before the Executive Council 
and iSanidtioned by three-fourths of that body present and 
voting, before it is submitted to the Association. 

PROPOSED BY-LAWS. 

ARTICLE I. 

Membership. At each meeting of the Association every 
(me attending ishall fill in a registration card of the following 
form: 

Name 

Address 

Present credentials from what Affiliated Society 

Note. — From those who do not present credentials this card will be accepted 
as an application for membership in the Association and shall be reviewed by the 
Executive Committee, and if the application be not accepted, the applicant shall 
be eo notified and the fee returned. 

80 long as a member conforms to the By-laws and Code of 
Ethics of the Canadian Dental Association, and pays his fee, 
he shall retain his membership therein. 



DENTAL SOCIETIES. 101 

ARTICLE II. 

Registration of Members. No active member shall take 
part in the proceedings of the Association, nor in the pro- 
ceedings of any of the sections, nor appear before any Com- 
mittee thereof, until he has properly registered his name and 
paid his fee. 

ARTICLE HI. 

Guests and Visitors. Dental practitioners residing out- 
side of Canada and other men of science of good standing may 
be received by invitation of the Association, the Executive 
Council, the President, or any one of the sections, on a letter of 
introduction from an absent member of the Association, or at 
the discretion of any of these. They may, after proper intro- 
duction, be allowed to participate in the discussions of a 
purely scientific nature. 

Dental students may be admitted to either the general 
meetings or to the meetings of any of the sections thereof— 
but shall not be allowed to take part in any of the proceedings. 
They shall be vouched for as being students by some member 
of the Association to either the President or General Secre- 
tary- Treasurer. ^ 

ARTICLE IV. 

Honorary Members. Honorary members shall be elected 
by the Executive Council by a unanimous vote. 

Associate Members shall be elected in the same manner as 
honorary members, by a majority vote. 

ARTICLE v. 

Association Year. The Association year shall be from one 
meeting to the next. 

ARTICLE VI. 

Section I.— Executive Council. 

Qualifications for Membership on Executive Council. 
No one shall serve as a member of the Executive Council who 
is not an active member of the Canadian Dental Association. 

Members of the Executive Council shall hold office until 
the next meeting. 

Every affiliated Society sliall be entitled to elect in ad- 
dition to its President, and Secretary, who become ex-officio 
members, one delegate to serve on the Executive Council for 
its membership from fifteen to fifty; and one for every ad- 
ditional hundred members. 

At the first general session of each and every meeting of the 
Association ten members thereof, who shall be present at that 



102 DOMINION DENTAL JOURNAL 

meeting, shall be elected bj' ballot, to act on the Executive 
Council, provided that any one already a member 
from an affiliated society or association shall not be at that 
meeting- elected a member of the Executive Council. The 
President of the Association shall name three tellers, to con- 
duct this ballot. The ten having the greatest number of votes 
shall be declared elected. 

Every delegate from an affiliated society or association 
shall be required, before acting on the Executive Council, to 
have entered his name on the Register of the Association, paid 
his fee to the Association, and deposited a certificate with the 
General Secretary of the Association, duly signed by the 
President and Secretary of the affiliated society or association 
from which he has been elected a delegate. 

Section II. 
Order of Business. The following shall be the order of 
business in the Executive Council, which can only be changed 
or departed from by a three-fourths vote of that body : 

1. Calling the meeting to order by the President. 

2. Eeading the minutes of the previous session. 

3. Reports of officers. 

4. Reports of Committees. 

5. Unfinished Business. 

6. New Business. 

The rules of Order which govern the proceedings of the 
House of Commons of Canada shall be the gTiide for con- 
ducting the sessions of the Executive Council. 

Seven members of the Executive Council shall constitute 
a quorum for the transaction of business. 

It shall be the duty of the chairmen of Committees and 
members of the Executive Council to report to the Executive 
Council, and they shall have the right to discuss their own re- 
ports. 

Section III. 

Meetings of the Executive Council. The meetings of the 
Executive Council shall be held previous to and during the 
regular meeting of the Canadian Dental Association— 
but not at the time of any general session of the Association— 
and shall report at each business session thereafter. 

The Executive Council shall elect its own Chairman bienn- 
ially, from amongst its members. He shall be eligible for re- 
election. 



DENTAL SOCIETIES. 103 

Special iiieetiugs of the Executive CouiumI shall be called 
by the Chairman of Council, upon a written requisition, stat- 
ing the objects of such meetings and signed by fifteen members 
of the Executive Council. 

A member of the Executive l^)niicil who has not alU'iided 
half of the sessions of the council shall not be eligible to vote 
for the nomination of officers or committees. 

Section iV. 

Nominations, Elections and Installation of General 
Officers. The general officers of the Association sliall be a 
President, Vice-Presidents, and a General Secretary-Treas- 
urer. The President and Vice-Presidents shall be nominated 
by the Council and elected by the Association in General Ses- 
sion. 

Nominations. Any five members of the Association may 
hand to the General Secretary, in writing, the name of any 
member of the Association whom they may wish to nominate 
for any office, except in the case of the Finance Committee, 
which shall in all cases, be elected by and from the members of 
the Executive Council. 

The Executive Council shall elect biennially the General 
Secretary-Treasurer. 

These Officers shall serve until such time as their succes- 
sors are elected and installed in office. 

All elections sliall be by ballot and a majority of the votes 
cast shall be necessary to elect a candidate. Should there be 
more than two nominees for any position, the one having the 
lowest number of votes shall be dropped and a new ballot pro- 
ceeded with. This procedure shall be continued until one of 
the nominees receives a majority of all votes cast, when he 
shall be declared elected. 

The election of officers may take place at any session. The 
Executive Council shall fix the exact time for same to take 
place. 

The President shall appoint three tellers to conduct the bal- 
lot. 

The Executive Council shall decide on the arrangement of 
the programme for the meetings of the Association. 

ARTICLE VII. 

Section I. — Duties of Officers. 

President. The President shall preside at general 
meetings of the Association. lie shall deliver the Presi- 
dential Address at either the first or second general session of 



104 DOMINION DENTAL JOURNAL 

the General Meeting, held under his presidency, as he may de- 
cide. In the absence of the President, the Vice-Presidents in 
order shall preside, or, in their absence, the meeting shall 
select a Chairman. The President shall appoint Itwo members 
of the Committee of Arrangements, these shall select three 
others, all of whom shall reside in the place at which the As- 
sociation is to hold its next meeting. The President shall be 
an ex-officio member of all the Committees and the Executive 
Council. 

In case of the death or resignation of the President, the 
First Vice-President shall become the President. 

Section II. 

Vice-Presidents. The Vice-Presidents shall assist the 
President in the discharge of his duties at his request. 

Section III. 

General Secretary-Treasurer. The General Secretary 
shall also be the Secretary of the Executive Council of the 
Association. He shall give due notice of the time and place 
of all general and special meetings, by publishing the same in 
the official journal of the Association, or if necessary, in the 
opinion of the Finance Committee, by postal card to each 
member. He shall keep the minutes of the General Sessions 
of the Association, and the minutes of each meeting of the 
Executive Council, in separate books, and shall provide min- 
ute books for the secretaries of the diif erent sections which he 
shall see are properly attested by both chairman and secre- 
tary thereof. He shall notify members of the committees 
of their duties in connection therewith. Where necessary or 
deemed advisable by the President he shall conduct corres- 
pondence with other organized Dental associations or so- 
cieties, domestic o-r foreign. He shall preserve the archives, 
the public transactions, essays, papers, and addresses of the 
Association. He shall see that the official programme of each 
meeting is properly published, and shall perform such other 
duties as may be required of him by the President or Finance 
Committee. 

The General Secretary-Treasurer shall be ex-officio a mem- 
ber of all committees. 

For his services the General Secretary shall receive such 
remuneration as shall be fixed by the Finance Conmiittee. 
All his legitimate travelling expenses to and from the 
general and executive meetings and other places ordered by 



DENTAL SOCIETIES 105 

the Finiance Committee shall be paid out of the fmidis of the 
Association. 

The Secretary-Treasurer shall receive and collect the an- 
nual fees and demands of the Association from the members 
and any others owing the Association. He shall be the cus- 
todian of all moneys, securities and deeds belon*i:ing to the 
Association, and shall pay out moneys only on the approval of 
the Finance Committee, whose chairman shall also oounter- 
sign all cheques. 

The Secretary-Treasurer shall give to the Finance Com- 
mittee a suitable bond for the faithful discharge of his duties. 

Section IV. 

Local Secretaries. The Local Secretaries shall assist the 
General Secretary at the general and special meetings and 
shall perform the duties of corresponding Secretaries for the 
respective provinces they are elected to represent; these duties 
shall be performed under the direction of the General Sec- 
retary. 

Section V. 

All the officers shall discharge the duties of their respective 
position until the completion of the business and scientific pro- 
ceedings of each meeting. 

COMMITTEES. 

ARTICLE VIIT. 

Classification of Committees. There shall be (a) Stand- 
ing, (b) Special and (c) Reference Committees. 

All committees when not otherwise specified shall be ap- 
pointed by the executive council and consist of not more than 
five members and shall report to the President or Executive 
Council when required. 

(a) Standing Committees. The Standing Committees shall 
be the following: 

(1) A Committee on Finance. 

(2) A Committee on Arrangements. 

(3) A Connnittee on Dental Legislation. 

(4) A Connnittee on Oral Hygiene. 

(5) A (/oniinitteo on Eesearch. 

(6) A Committee on Foreii»Ti Relations. 

(7) A Committee on Programme. 

(8) A Committee on Dental Education. 
Appointment and Duties of the Finance Committee. The 

Finance Committee, as set forth in the constitution, shall con- 
sist of five members biennially appointed from the members of 



106 DO'MlNiON DENTAL JOURNAL 

the Executive Council. This Finance Committee shall have 
charge of all the properties of the Association and of all the 
financial affairs of the Association. It shall elect its own 
chairman. The chairman may then appoint any sub-com- 
mittees that may be necessary or desirable in connection with 
the finances of the Association. This Committee shall have 
charge of the publication of all published proceedings, trans- 
actions, memoirs, addresses, essays, papers, programmes, etc., 
of the Association. It shall have power to omit, in part, or in 
whole any paper or address that may be referred to it for 
publication by the general meeting, the Executive Council or 
any of the sections. It shall have the accounts of the Treas- 
urer audited biennially, or oftener if desirable, and shall make 
a biennial report of the same to the Executive Council. It 
shall meet when and whore it may determine, and the chair- 
man shaU call a meeting on the request of three members in 
writing and three members of the Finance Committee shall 
constitute a quorum for the transaction of the business of the 
Committee. 

The General Secretary shall act as the Secretary of the 
Committee. 

Any donations recommended by the Executive Council 
shall be paid only with the approval of the Committee. It 
shall take charge of all publicity in connection with the general 
meetings, and shall fix the biennial fee. 

The Committee on Arrangements shall consist of five mem- 
bers, who shall be residents of the place in which the meeting 
is to be held. The President shall select two who shall select 
the other three. The committee shall elect its own chairman. 

The Oommittee shall be required to provide for transporta- 
tion and the necessary accommodations for the meeting. 

The General Secretary shall act in an ad\nsory capacity to 
the Committee. 

The Committee shall have power to add to its members. 

Committee on Legislation. To the Committee on Legis- 
lation shall be referred all matters pertaining to local and 
federal Dental Acts. 

Committee on Oral Hygiene. The Committee on Oral 
Hygiene shall take charge of all matters relating to oral hy- 
giene, public health, public dental education, etc., and have 
power to add to its numbers. 

(■oniniittee on Bcscarch. The Committee on Research will 
take charge of all research work under the general direction 
of the Association and will report to the president or the 



DENTAL SOCIETIES. 10'. 

executive council whoii required. This committee shall have 
power to add to its numbers and to name its own executive. 

The Committee on Foreign Relations. To the Committee 
on Foreign Relations will be referred all matters dealing;- with 
dental relations with forei^i countries. 

The Committee on Programme. It shall be the duty of 
the Committee on Projo'ramme to secure speakei's, essayists, 
clinics, and exhibits for the o:eneral meeting and report from 
time to time to the g-eneral secretary who will have the pro- 
gramme arranged, published and distributed to the profes- 
sion. 

Committee on Dental Education. To the Committee oai 
Dental Education shall be referred all matters pertaining to 
Dental Colleges and Dental education. 

(b) Special Committees. Special Committees may from time 
to time be appointed by the Executive Council; they may be 
named by the President on the authority of the Executive 
Council. They shall perform the duties for which they are 
called into existence, and shall in all cases report direct to the 
Executive Council as hereinbefore provided. 

(c) Reference Committees. The Executive Council shall at 
its first meeting appoint all the Reference Committees and 
name the chairman thereof. Their titles shall be as follows: 

^1) A Conmiittee on Repo-rts of Officers. 

(2) A Committee on Credentials. 

(3) A Committee on Necrology. 

The General Secretary shall notify each member of these 
committees so appointed, of his duties. 

Committee on Reports of Officers. To the Committee on 
Reports of Officers shall be referred the President's address, 
the report of the General Secretary and the report of the Fi- 
nance Committee before submission to the Executive Council. 

Committee on Credentials. To the Committee on Creden- 
tials shall be referred all questions regarding the registration 
and credentials of delegates or members before submission to 
the Executive Council. 

Committee on Necrology. To the Committee on Necrology 
shall be assigned the duty of collecting, as far as possible, the 
obituaries of members who have died since the last meeting. 
These shall be duly filed by the General Secretary. The Com- 
mittee shall report on the call of the President at the last gen- 
eral session of each biennial meeting. 

Three members shall constitute a quorum of any Reference 



108 DOMINION DENTAL JOURNAL 

Committee, and all reports shall be made as hereinbefore pro- 
vided. 

ARTICLE IX. 

General Meetings. Date of Meetings. The date of each 
general meeting shall be fixed by the President on the advice of 
the Committee of Arrangements. 

The order of business of the first general sessio-n of each 
meeting shall be as follows : 

(1) Calling the meeting to order by the President. 

(2) Prayer; by some one designated by the President. 

(3) Addresses of welcome and response. 

(4) The report of the Committee of Arrangements. 

(5) Reading the minutes of the last general Session. 

(6) The report of the General Secretary of the last general 
meeting. 

(7) Election of the Association's members to the Exe- 
cutive Council. 

(8) Presidental or other addresses, if decided on by the 
President and Committee of Arrangements. 

The order of business for all subsequent general sessio-ns 
shall be the same as that for the Executive Council. 

. All addresses delivered at any general meeting shall im- 
mediately become the property of the Association to be pub- 
lished or not— in whole or part, as deemed advisable. They 
must, as soon as the}' have been delivered, be handed to the 
General Secretary, who shall refer them to the Finance Com- 
mittee. Any other arrangement for their publication must 
have the consent of the author or of the reader of same and of 
the Committee. 



NORTHERN OHIO DENTAL ASSOCIATION 



The Northern Ohio Dental Association will meet in Cleve- 
land, Ohio, June 2nd, 3rd, and 4th, at Hotel Statler. In con- 
nection a post graduate course will be held from the 2nd to 
6th inclusive, consisting of the following: ''Nerve Blocking 
Anaesthesia," Dr. Arthur E. Smith of Ch' ago; "Attachments 
to Vital Teeth," Dr. Edward T. Tinker qf Minneapolis; 
''Prosthesis," Dr. M. M. House of Indianapolis. Geo. B. 
Smith, Secretary. 



EDITOR: 
A. E. Webster, M.D.. D.D.S., I^.D.S.. Toionio. (jiiiMd;! 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross, L..D.S., D.D.S. , Ottawa; Carl E. Klotz, L.D.S.. St. 

Catharines. 
Quebec. — Eudore Debeau. L.D.S., D.D.S.. 396 St. Denis Street, Montreal; Stanley 

Burns, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton, 

D.D.S., L.D.S., McGill University. Montreal. 
Alberta. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — Jas. M. Magee, L.D.S.. D.D.S., St. John. 
Nova Scotia. — Frank Woodbur>', L.D.S., D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Reg-ina. 

Prince Edward Island. — J. S. Bag-nall. D.D.S., L.D.S., Charlottetown. 
Manitoba. — M. H. Garvin, D.D.S., L.D.S., Winnii>eg. 
British Columbia. — H. T. Minogue, D.D.S., L.D.S.^ Vancouver. 



Vol. XXXI 



TORONTO, MARCH 15, 1919. 



No. 3. 



MINISTER OF PUBLIC HEALTH 



Every person interested in public health problems was 
pleased to see in the speech from the throne in the Dominion 
House of Commons reference made to the establishment of 
a Department of Public Health. The time was when the keep- 
ing of the health of the nation was in the hands of the in- 
dividual. Not so to-day. ''AVe are our brothers' keepers.'' 
More and more this principle is being recognized. No indi- 
vidual, no municipality, no province or country can live alone. 
Health, education, ethics and social conditions are world-wide 
problems. 

A Department of Public Health has had but one public 
function recognized in the past. Its police power was in 
evidence and notMng more. In many of the provincial de- 
partments the educational factor has come into proiniiieiice. 

It will be interesting to note what aspect of the subject 
of public health wiW be undertaken by the departuionl at 
Ottawa. The dental profession is interested in a full icco.,^- 
nition of the value of a clean mouth with teeth ca|)able of 
masticating food in promoting the health of the natioiL The 
Army recognized the value, so surely the civil authorities will. 



110 DOMINION DENTAL JOURNAL 

The Canadian Dental Association should watch the legisla- 
tion in this department with alertness and active assistance. 



ADVANCES IN TEACHING DENTISTRY IN ONTARIO 



A special meeting of the Board of Directors of the Royal 
College of Dental Surgeons of Ontario was held on February 
26th and 27th for the purpose of discussing the means of get- 
ting more accommodation for teaching the large number of 
students in the College at the present time. 

The present building and equipment are not nearly large 
enough nor of the proper character for teaching dental stu- 
dents of to-day. After discussing the problem in all its as- 
pects it was finally decided that an attempt would be made to 
erect a building or an addition to the present building which 
would be capable of occupation by the first of October. The 
cost of the building would be about $100,000. The equipment 
in ;he neighborhood of $50,000. 

It was generally agreed that the present building was not 
well located because it is in a business section of the city or 
OTi a business street, therefore any additions that are made 
should be made with the idea of using the building finally for 
commercial purposes. Having this idea in view, the additions 
were to be made to the north and east. It not being an easy 
matter to finance $150,000 at the present time it was agreed 
that the board should interview the Legislature and ask them 
for a loan or a gift of $100,000 to put into the building. 

The Board was received by the Premier, the Minister of 
Education and the Attorney-General. After a conference of 
about an hour lit was agreed that in a few days the Govern- 
ment would give its answer on the question. In the meantime 
the board is getting out plans of specification for the erection 
of the new building. 

A committee of the Board of Directors of the Royal Col- 
lege of Dental Surgeons and the Board of Governors of the 
University of Toronto had an infoimal conference in refer- 
ence to the University taking over the School of Dentistry 
as a faculty of the University. It was learned at the confer- 
ence that the Board of Governors were very willing to take 
the teaching of dentisty and place it on the same basis as other 
faculties of the University. 

Committees have been api>ointed from the two bodies to 
further negotiate and make out a basis upon which the trans- 
fer mis'ht be made. 



EDITORIAL NOTEb 111 

Editorial Notes 

Major F. M. Wells, of the Canadian Army Dental Corps, 
working- in the Lister Institute of London, has made some 
discoveries in connection with the teeth. 

The research committee of the Canadian Dental Associa- 
tion is endeavouring to accumulate a fund of $50,000, the pro- 
ceeds of which may be used in original research in Canada. 

im 

We are publishing in this issue a report on the work done 
by Dr. Simpson in the high explosive factory at Trenton. This 
is a most interesting report, inasmuch as it covers the new 
malady among munition workers. 

The School }>oard of Carleton Place, Ontario, has aj)- 
pointed a committee to look into the advisability of inaugur- 
ating medical and dental inspection in the public and high 
schools of that town. This committee is to report at the next 
meeting of the Board. 

In the past the practice of dentistry has been directed 
towards the preservation of the teeth almost solely for me- 
chanical and cosmetic pur|)oses. In the future it appears it 
is destined to have as one of its chief aims the preservation 
of health and the cure of disease. 

»^ 

The Quaker employers of Great Britain made this state- 
ment a few month-s ago concerning their relations with their 
employees: ^^We asked all the employees to consider very 
carefully whether their style of living and personal expendi- 
ture are restricted to what is needed in order to insure the 
efficient perfonnance of their functions in society. More tlian 
this is waste, and is, moreover, a great cause of class divi- 
sions. '' 

Medical practitioners in the missionary field are always 
given a furlough after five years' service. In the British ser- 
vice, a similar plan is allowed, and the practitioner is expected 
to spend six months out of eighteen months' furlough in hos- 
pital work. There is not much better opportunity in some 
parts of Canada for a medical or dental practitioner to keep 
up to date than the missionary in South Africa or China. 



112 DOMINION DENTAL JOURNAL 

If it has been fcuiid necessary in military service to require 
dental and medical practitioners to take post-graduate work 
every five years in order to keep up even with the times, what 
is to be done for the civil practitioner who oftentimes prac- 
tices the same kind of dentistry or medicine that was taught 
him forty or fifty years previous? Surely what is good for 
the soldier is good for the civilian. The civil population's 
health is of as much value as the soldier's, and should be 
properly cared for. 

U 

The profession has to be shown every few years that drugs 
do not destroy the bacteria in the tissues of a tooth. Nor do 
they very often destroy the bacteria in the tissues beyond the 
teeth. The most recent investigation by Price has shown that 
there are very few drugs that can be depended upon to ade- 
quately sterilize the teeth. Formaldehyde, iodine, and nitrate 
of silver are about the only drugs that may be depended upon. 
Experiments have shown that if these drugs are not used fre- 
quently, or not allowed to remain in the teeth for more than 
twenty-four hours, they will be efficient. All of the drugs 
mentioned are highly irritating to the soft tissues, and should 
not be allowed to pass through the apex of a tooth. Besides 
this, nitrate of silver will discolor the roots of the teeth. 



At a banquet recently given in New York in honor of Dr. 
Van Wort, Ool. H. G. Logan, Director of Dental Services 
in the United States army, gave an outline of the possible 
future of dental sei^ice in the army. He told those at the 
banquet that plans have been formulated for a post-graduate 
school to be conducted with the Army Medical School. There 
will be an adequately equipped dental school and infirmary 
with a faculty of seven teachers. There would be two sessions 
annually of four and a half months each. Every candidate for 
admission to the Dental Corps would enter only probationally^ 
then attend one of these courses. Upon passing a satisfactory 
examination, and only under such conditions he would receive 
the commission. Another feature of the scholastic plan would 
be keeping up the efficiency of the corps. To do this every 
dental officer would be required to return to the school once 
in every five years for post-graduate instruction, and his re- 
tention in active service would depend upon his passing all 
examinations at the end of the course. 



OBITUARY. 113 

ONTARIO DENTAL SOCIETY CONVENTION 



The annual convention of Ontario Dental Society, to be 
held from April 29th to May 1st, 1919, will be favored in hav- 
ing Progressive Clinics given by the Detroit Clinic Club, the 
Dental Educational Association of Toronto, the School of 
Dentistrv R.C.D.S., ajid also numerous individual clinics and 
prominent speakers on dental and other subjects. 



Obituary 

CHARLES ANDERSON MURRAY, D. D. S. 



On Tuesday, February 4th, 1919, at No. 7 Alma street, 
Moncton, N.B., the grim reaper cut down one more prominent 
member of the dental profession. 

Doctor Murray was born at Long Creek, Queen's County, 
N.B., October 10th, 1856. His father was Charles Murray and 
his mother Mary Secord Murray — and there survive him, one 
sister and three brothers, one of whom is Dr. Harley W. Mur- 
ray of Shediac, N.B. 

He graduated in 1885 from the University of Michigan, 
Ami Arbor, and began practice in Moncton, N.B., during the 
summer of that year. His experience covers therefore a period 
of nearly thirty-four years, at the end of which time, in strong 
contrast with the financial posiition of the great majority of 
dental surgeons whose lives close with small credit of cash, 
and in testimony of his financial astuteness, it is estimated 
that Dr. Murray left his wife at least comfortably ])rovidod 
for. 

In June, 1889, he married Bessie Temple MacGowan, who 
survives him. Two children were bom to them, but both died 
in early childhood. 

Of a most genial disposition. Dr. Murray had a large circle 
of friends. 

In politics he has been described as '^an enthusiastic and 
energetic Liberal, ' ' but these words do not adequately describe 
him in action during a political contest. Notwithstanding his 
political views, however, he had hosts of friends outside the 
fold, for whom he would, if necessity demanded it, give the 
shirt off his back. 

In addition to his political afl&liation, he was identified 
with the Independent Order of Oddfellows, holding at the time 



114 DOMINION DENTAL JOURNAL 

of his death the office of Deputy Grand Master of the Grand 
Lodge of the Maritime Provinces, and had he lived until 
August, would have been Grand Master. 

Dr. Murray had been pleased, among other things, to eon- 
template the fact that he came of old Loyalist stock, and 
looked back with considerable pride to his relationship witli 
Laura Secord, a Canadian heroine, whose name is familiar 
to many Ontario readers. 

His activities in connection with bringing the New Bruns- 
wick Dental Act of 1890 into existence are elsewhere recorded. 

His attendance at the meetings of the New Brunswick 
Dental Society, of which he was a secretary, and was after- 
ward a president, was almost unbroken, and he always took a 
prominent part in the debates. Li token of his membership, 
the Society sent a beautiful floral tribute. • 

The funeral was conducted by the Oddfellows, and was 
attended by a very large number of his fellow-citizens. The 
procession was led by the members of the Moncton Dental 
Society, with whom Dr. A. F. McAvenery and Dr. J. M. Magee, 
from St. John, representing the New Brunswick Dental So- 
ciety, were accorded the post of honor. 

Interment took place in Elmwood Cemetery, the services 
being conducted by Rev. T. Potter DiTimm, of St. John's Pres- 
byterian Church, of which the deceased was a staunch mem- 
ber. 



WILLIAM R. PATTON, D. D. S. 



William E. Patton, D.D.S., died in London, February 26, 
1919, of pneumonia. Dr. Patton had been dentist to the 
HohenzoUern court for over thirty years. 

He was born in Quebec City 72 years ago, and was edu- 
cated at Laval and Lennoxville Universities in Quebec, later 
taking a course in the New York College of Dentistry. He 
was always a great sportsman, and at one time took a trip 
from Toronto to Bermuda in his own yacht. When he returned 
to Canada ten years ago he retired from active professional 
life and resided in Toronto. He was a member of the R.C.Y.C. 
and the Rod and Gun Club of Canada. Besides his brother 
and sister, of Toronto, he is survived by George C. Patton, of 
New York City. His sister, Mrs. James Oarlyle, with her two 
daughters, Annie and Josephine, are at present in Bermuda. 



Dominion 

Dental Journal 

Vol. XXXI. TORONTO, APRIL 15, 1919. No. 4. 

Original Communications 

WORK OF THE CANADIAN ARMY DENTAL CORPS 

OVERSEAS 



Major W. R. Greene, Ottawa. 

Delivered before the Ontario Dental Society, 1918. 

It is very gratifjmg to look back and see the improvement 
in the standing of the C.A.D.C. since the First Contingent 
landed in England Jnly 4th, 1915. 

We were received with an air of cooil indifference, and in 
some quarters with surprise that there should be such a corps. 
It at once became evident that this baby corps must win its 
way by service rendered, and prove that such an organization 
was essential to the army. 

At first we had difficulty in securing adequate quarters for 
clinics and stores and difficulty in securing proper authority 
to purchase supplies. EveTything was new, and precedents 
had to be established and customs formed. In the army one 
must quote one's authority for every move. And without 
authority one does not get far before being halted. 

Up till the time of the formiation of the Canadian Army 
Dental Corps the need of dental services in the army was not 
so urgent as it became soon after. The first contingents were 
chosen more carefully as regards physical fitness. Men with 
defective teeth were not admitted to the army. After this 
time, however, the condition of the teeth was no barrier to a 
man being enlisted as a soldier. If he was dentally unfit he 
was handed over to the dental officer to be transformed into 
the fit category. 

I proceeded to France on August 23rd, 1915, in charge of 
the first detachment of C.A.D.C. to cross the Channel. We 
were six officers and nine ''other ranks.'' We arrived at the 
camp at Harfleoirs. on August 24th, and found a virgin field 



116 DOMINION DENTAL JOURNAL 

for our activities, as no dental services had been rendered in 
that important base. I say important base because in connec- 
tion with this camp there were altogether aboiit sixty thousand 
men, about one-tenth of whom were Canadians. 

We found ourselves entirely under tlie Eoyal Army Medi- 
cal Corps, as the C.A.D.C. has never been able to secure any 
authority in France. The senior medical officers and the 
Assistant Director of Medical Services received us most 
cordially and showed a deep interest in getting a hut properly 
fitted up for our clinic, and did everything possible to make 
things comfortable. The heartiness of their welcome might 
be accounted for, in part, by the fact that there were already 
about four homdred men in the camp waiting for artificial teeth 
before they would be fit to be sent up the line, and their num- 
bers were rapidly increasing. 

We were soon at work— and hard at work— working on a 
task that was ever increasing. We had no time for any work 
that was not absolutely essential. No time to treat infected 
root canals; no time for replacing missing anterior teeth for 
purely aesthetic purposes. If a man had a reasonably good 
masticating surface he was considered fit. We had to do what 
was most urgent, and leave much undone. The greatest good 
to the greatest number was the rule we had to go by. 

During the winter of '15- '16 we received reinforcements, 
bringing the total personnel up to two English and nine Cana- 
dian dental officers and about thirty-seven ''other ranks,'' 
aibout two-thirds of whom were English mechanics. Before 
the spring of 1916 we had overtaken the waiting list, and had 
the work of the Base well in hand. The largest number of 
oases we vulcanized in one day was one hundred and four. 
Our average day's vulcanizing ran from sixty to seventy cases. 

We found that we could almost invariably tell by looking 
into the soldier's moutb whether he was a Canadian or if he 
belonged to the Imperial Army. The Canadian soldier's teeth 
always showed some indication of an attempt having been 
made to save the natural teeth. The Imperial Tommy usually 
presented a mouth showing absolute neglect. His only idea of 
having teeth treated is to have them out and artificial ones in, 
while the Caaiadian soldier, on the other hand, was always 
anxious to save his natural teeth; he wanted gold fillings, 
crowns and bridges, and was willing to pay for them. We 
had to tell him that gold we had none, but such as we had he 



ORIGINAL COMMUNICATIONS 117 

was welcome to without money. Anrl the Cannrlinns always 
Teceived special attention. 

The Imperial Tommy liad a tendrney lo i)ut little value on 
anythiii^i>' he ^'ot for notliin.i;' in the army. For instance: a 
soldier presented himself at our clinic for an upper plate. 
The dental officer noticed certain tell-tale marks in the mouth 
and the following conversation took place: 

D. 0.— '' You have worn a plate before, have you notT' 

Tommy— ''Yes, sir.'' 

D. O.— ''Where is it now:'' 

Tommy— "At 'ome, sir." 

D. 0. — "Do you mean in yonr tent or in Flngland?" 

Tommy— "At 'ome in England, sir." 

D. 0.— "What is the matter with it? Is it no good; does it 
not fit!" 

Tommy— "Oh, it's perfect. It fits perfect, sir." 

D. 0. — "AYell, why have you not got it in your mouth?'* 

Tommy— "Oh, sir, it is much too good to wear on active 



service. ' ' 



You will suppose that we saw and treated many cases of 
wounds of the face involving fracture of the jaw and mandible 
while doing service in France. One might recite many in- 
stances of treatment and correction of such cases, but such 
stories might not be true. This class of work is all done in 
special hospitals, where the patient can be kept from six to 
ten or more weeks and receive special treatment by men who 
devote all their time to that particular work. 

Lieutenant-Colonel Guy Hume, of Toronto, has charge of 
the work at Orpington Hospital and, with his assistants, is 
having some excellent results. Records, photos, models and 
nmch other useful data are being kept. And T am sure that 
after the war Lieutenant-Colonel TTume will be able to give 
this society a very interesting account of the work done at 
that hospital. 

The rule in France is to keep the hospitals clear. As soon 
as a wounded soldier is able to travel he is sent to England; 
so, while at field ambulance or hospital the dental officer might 
see many cases he might like to treat, still he knows that in a 
day or two the wounded soldier will be in Blighty. So in that 
case usually the best thing to do is to leave him alone. 

The greatest work done by the C.A.D.C. is not this more 
spectacular work on facial restorations, but the ordinary 
every-day work of the dental officers in the various clinics 



118 DOMINION DENTAL JOURNAL 

scattered up and down through Canada, England and France, 
where the masses of the soldiers receive treatment and are 
made fit, and kept fit, to perform their duties as soldiers. Here 
much sutfering is relieved, and more prevented. Tt is this 
class of work, too, that taxes the nerve, endurance and patience 
of the dental officer. This constant grind is calculated to 
make a man restless and long for a change. 

Our clinic at Harfleur was likened to the resurrection day, 
when men from the four corners of the earth meet together. 
We had men from India, South Africa, Australia, New Zea- 
land, France, Belgium and Canada, and English, Irish and 
Scotch who had been in many lands, but who returned at the 
bugle call to help the mother country in this desperate fight 
for freedom. We even had sullen German prisoners, and I 
may tell you that I had the satisfaction of doing a little Ger- 
man blood-letting myself. 

That clinic is the only place I know of where the Tommy 
took precedence over the officers. If an officer came for dental 
treatment some morning when we had a parade of a hundred 
and fifty or more to attend to, he was told that we would be 
pleased to attend to him after we had finished with this parade. 

While at Harfieur we made and fitted over fifteen thousand 
artificial dentures, besides fillings, extractions, prophylaxis 
and other treatments. Our clinic always showed the largest 
nuTTlber of fillings of any in France. The English dental 
officer believed more in extracting, and often even inserted 
his partial plate against decayed teeth without filling them. 

Yes, w^e saw a great deal of ' ' trench mouth, ' ' as it is quite 
prevalent in the army, and fully a'S prevalent among the officers 
as among the men. The treatment w^e found to best clear up 
this ulceratic condition of the gums was as follows: Wheii 
the patient first presented himself we usually syringed the 
gums with warm water and wiped away all debris, and then 
swabbed the gums and interstices with the following solution : 

R. Vinium ipicac ii. dr. 

Glycerin i. dr. 

Liquor arsinicalis ad ii. oz. 

On the next visit the calcarious deposits may be removed 
and the gums again swabbed with the above solution. Usually 
two or three treatments suffice to clear up the trouble. We 
frequently gave the patient a little bottle of the solution, with 
instructions to use a few drops on his tooth-brush. 



ORIGINAL COMMUNICATIONS 119 

We made quite a few lueehaiiical restorations for cleft 
palate. The majority of the cases were the result of syphilis. 

On December the 10th, 1916, the work at Harfleur was taken 
over by English dentists, and the Canadian dental officers 
returned to En^'land. I remained for two weeks at the request 
of the D.G.M.S. to install the new dental officers. We left with 
the work well in hand, and with the best wishes of our superior 
officers. 

On December 23rd I landed back in England, with twenty- 
nine cases of dental equipment belonging to C.A.D.C. officers 
who had been recalled from France. I was immediately 
detailed as Acting-A.D.D.S., Bramshot Camp. Here I foimd 
the work somewhat behind, as there was not a sufficient uum- 
ber of D. O.'s to cope with the work. Reinforcements from 
Canada arrived almost at the same time, but they brought no 
equipment with them, so it was necessary to work the D. O.'s 
in pairs, with one set of forceps and one engine for the two. 
The Engineers made us some chairs, and we secured extra 
mirrors, excavators, jjliaors, and a few other operating instru- 
ments, and in this way carried on until proper equipments 
were secured. 

Before this time, owing to the scarcity of dental officers, 
whenever a draft was warned for France it was necessary to 
concentrate all our efforts to get all those men warned den- 
tally fit. After this, however, it was possible to attach two 
D. O.'s to each reserve battalion. These D. O.'s were held 
responsible to see that the men in that battalion were kept 
dentally fit. This arrangement worked out well, and before 
the spring we had all available men in the camp in the dentally 
fit class. 

The clinic accommodation in Bramshot was very poor. 
The Royal Engineers considered a hut given over for dental 
purposes a misappropriation, and called it so. However, 
three good huts were secured close to bath-houses, where hot 
and cold water could be secured. These huts w^ere each fitted 
to accommodate eight dental officers. A nine-inch porcelain 
bowl was placed beside each chair, with running water and 
drainage connection. There were also two enamel hand 
basins, with hot and cold water, besides tables, shelves and 
brackets. The interior was ]iainted white. When I left last 
June, I think the clinics at Bramshott were shaping to be the 
best in any camp area in England. 

A\Tien the drafts from Canada arrive in England the men 



120 DOMINION DENTAL JOURNAL 

are kept in a detention camp under obser\^ation to see that no 
infectious disease develops among them. During the two or 
three weeks they are in this camp is our best time to ascertain 
their dental condition. Consequently we made arrangements 
to have a nominal roll prepared for us on a special fonn, and 
every man is examined and his dental recjuirements noted for 
fit or unfit, number of extractions required, number of fillings 
required, number of plates required. During this time, also, 
all extractions were done, impressions taken, where possible, 
and the work gotten under way as far as possible before they 
were placed in one of the reserve battalions to commence their 
training. Some of those drafts were in very good dental 
condition, while some required considerable attention. 

There is a duty which rests upon the shoulders of the 
C.A.D.C. administration in the matter of giving the N.C.O.'s 
and men sufficiently good wholesome recreation. Their work 
is sedentary and confining, and young men require plenty of 
good, vigorous exercise to keep them fit. Besides, too, in 
England and France there are attractions for young men 
which are far from being wholesome, and I fancy conditions 
are not different in Canada, only in degree. 

At Bramshott our football team struggled into the final 
game, and were only beaten by one goal, after a hard game, 
by the 17th Reserve Battalion. 

Good sports give the necessary exercise to keep the men in 
good health. They develop a corps spirit; they give occupation 
for the leisure time and keep the mind from less worthy 
desires. It is the leisure hours that give the opportunity for 
the men to apply themselves to self-development or to get into 
mischief. 

If there are any funds for overseas boys they could not be 
spent to better advantage than by providing games, such as 
baseball or football outfits. 

I had the privilege of attending the British Dental Associa- 
tion in June, 1916, where I met some of the leading men in 
the profession in England, and also Dr. Villain, who is at the 
head of the Dental School in Paris. In November of the same 
year I had the good fortune to be able to attend the Inter- 
Allies' Dental Congress in Paris. At both of these meetings 
the papers and discussions were almost entirely on wounds of 
the face and fractures. There was a splendid display of 
charts, models, casts and appliances, photographs and coloured 
photographs. Some of these wax models and coloured photos 



ORIGINAL COMMUNICATIONS 121 

were real works of art. The meetings were very interesting 
and highly instructive. Many of the methods and devices 
used showed much originality. 

While in Paris I visited the American Ambulance, which 
is a large, well-equipped hospital. It possesses a splendid 
dental department, where special attention is given to "jaw 
cases. '^ Here we saw many very interesting cases under 
treatment and -many splendid results nearing completion. 

I spent a very jjleasant afternoon with Dr. Price, of Lon- 
don, who is Secretary of the British Dental Association, and 
discussed with him the possibility of securing for the Dental 
Officers of the C.A.D.C. who served overseas a license to prac- 
tice in England. With this end in view, I arranged a meeting 
between Dr. Price, along with other officers of the British 
Dental Association, and the Director and the Deputy-Director 
of Canadian Dental Services. I have not heard what results, 
if any, came from this meeting. 

Dr. Villain, in reply to a letter on this subject, said, while 
he would be quite sympathetic to such an arrangement, he 
thought, however, it must wait until after the war for further 
consideration. 

Gradually the C.A.D.C. has been settling down into its 
place, and it is getting acknowledged rights. A General Order 
giving the C.A.D.C. an establishment in March of 1917 has 
greatly strengthened our position in England. An A.D.D.S. 
or a Senior Dental officer is not now in an area by permission 
of someone higher up. He is there to complete establishment. 
There is no questioning; he has his rights and must be accom- 
modated. 

It is to be regretted that after three years' service in the 
Army the C.A.D.C. cannot, as such, go with the Army into 
France and organize the work there according to the need of 
the men who are bearing the brunt of this terrible struggle. 
I believe there is still much to be desired at that point, and the 
requirements of our soldiers demand that every effort should 
be put forward to secure the necessary authority to give them 
proper dental services at the front. 



122 DOMINION DENTAL JOURNAL 

ANSWERS TO VITAL QUESTIONS ABOUT 
THE BABIES' TEETH 



A. E. Webster, M.D., D.D.S., Toronto. 



In the city of Toronto there are schools known as the 
'^Little Mothers' " schools or classes, in connection with the 
Public Health Department. These classes are held on Satur- 
day morning for girls between the ages of twelve and sixteen, 
where they have the opportunity of caring for small babies. 

The teachers or nurses in charge of this department are 
asked a great nunlber of questions by the children, many of 
which are of vital importance in the care of babies. The fol- 
lowing questions w^ere gathered over a period of some months 
by the teachers. They show exactly the trend of mind of a 
young girl : 

1. Why don't young babies have teeth? 

2. Why do they come in one at a time 1 

3. Why do the front teeth come first? 

4. What makes them grow? 

5. Why are babies sick when cutting teeth? 

6. Why do second teeth look so large? 

7. Why are human's teeth different from other animals? 

8. Why care for the sixth-year molars ? 

9. How do you know them? 

10. Why do teeth ache? 

11. Why clean the teeth? 

12. How do you clean a baby's mouth? 

The Dean of the Dental College was asked to give an 
address to the teachers of the city, using these questions as a 
basis for the lecture, or, in other words, to answer the chil- 
dren's questions. 

Address. 

In the first place, the general principle may be enunciated 
that all creatures have the kind of teeth that is best suited for 
their conditions. Thus it is that the baby when born does not 
have teeth because it does not need them; in fact, they would 
be a distinct disadvantage to a baby. In the first place, the 
teeth would tend to wound the nipple of the mother's breast, 
and in the next place, these teeth would tend to collect the milk 
about them and fermentation start up. Some of the crowned 
heads of Europe have been very proud to say that their 
children had teeth when they were born. If they had known 



ORIGINAL COMMUNICATIONS 123 

more about pathology they would have told no one about it, 
because the presence of teeth at the time of birth is almost a 
sure indication of syphilis. 

As a matter of fact, the teeth do not come through one at 
a time ; they come through in pairs, two in the lower and two 
in the upper; usually the lower teeth precede the upper by a 
few weeks. In most all the processes of life nature works and 
rests; thus it is two or four teeth come through at once, and 
then there is a period of rest until the next pair begin. All 
animals have the number of teeth and the kind of teeth suitable 
for the preparation of food for the stomach, so the child ^s 
front teeth come first. They are wedge-shaped, and of a char- 
acter such as will cut things. The number of teeth and the 
kinds of teeth that a baby has is a very good indication as to 
the kind of food that it should have. The baby which has only 
wedge-shaped or cutting teeth should not be given food which 
requires grinding, such as the cereals or starches. The front 
teeth are for cutting off things or tearing them ; thus a baby 
might work away at crusts or sugarcane or something of that 
kind, but should not be fed starches until the teeth farther 
back in the mouth come through which are intended for 
grinding. 

There are a great number of theories as to the cause of 
making the teeth grow, but as a matter of fact nobody knows 
just w^hy they do grow no more than they know why vegetables 
grow. The seed is planted and the vegetable grows, but just 
what that process is, or why it begins, is quite unknown. 
Sometimes babies are quite sick during the eruption of their 
teeth. As a matter of fact, this should not be, because the 
development of the teeth is a perfectly normal physiological 
act, but for some reason or other babies often suffer extreme 
nervous symptoms during the period of eruption. It w^ould 
seem as if the teeth in the process of coming through make 
pressure upon the nerves at the base of the root, and this 
reflects throughout the nervous system, making the patient 
highly irritable during the process. If the irritation is very 
severe, the child may be disturbed in its sleep and often is 
disturbed in its digestion, but more often the mother, noticing 
the child somewhat disturbed, finds that it eats more at that 
time than it is able to digest, and hence may have an attack of 
diarrhoea. Mothers and nurses are often in the habit of 
attributing all kinds of ailments to the child's oncoming teeth, 
even when the teeth are not nearly due for eruption. Every 



124 DOMINION DENTAL JOURNAL 

dig-estive disturbance in childhood is not necessarily caused 
by the eruption of teeth. One authority making a number of 
investigations discovered the fact that children suffer from 
so-called diseases of dentition during the months of July and 
August more than at any other period of the year. These 
months correspond very closely to the time in which milk may 
be infected or when the mothers often give green fruit and 
vegetables to their children. 

The first teeth do not stay permanently in the mouth 
because they are too small and are so much worn by the time 
they are lost that they would not be useful over a long period 
of time; they would be out of proportion in both size and 
colour for the mature person. When the permanent teeth 
come in they are the full size that they require to be. They 
look large because they are out of proportion to the size of a 
child's face, but in a very few years, as the bones of the face 
increase in size and the tissues fill out, they then seem to be 
in proper proportion as to size and form. 

As we said before, the animal has the kind of teeth suitable 
for its environment. There are two general classes of teeth, 
or classes of animals, viz., the herbivourous and the cami- 
vourous. The herbivourous animals have large, flat top teeth, 
vith very few high emanances or cusps, and these teeth grind 
together as millstones, the lower jaw swinging in every direc- 
tion, while the carnivourous animals have high cusped teeth 
with sharp emanences, and do not swing back and forth, they 
only open and close their jaws as a hinge. Starchy and fiber- 
ous foods need to be ground, while the carnivourous animals 
do not grind meat at all. You have often noticed a dog eating 
meat; there is no grinding as we see in the herbivourous 
animal. The human teeth are a combination of both forms ; 
there are the cutting teeth in the front and at the sides ; there 
are the tearing teeth, much like the carnivourous animals, and 
at the back are the flat, square teeth with rough surfaces for 
grinding starches. We are a highly specialized form of 
animal; that is why we need both types of teeth. 

The first molar, or the sixth-year molar, comes at about six 
years of age, and is the largest, strongest, most firmly-set 
tooth in the dental arch of the human being. It is 
the guide to all the other teeth; it sets the position of 
the jaws, while the temporary teeth in front of it are 
lost and replaced by permanent ones and arranged in accord- 
ance with the space and room in front of these grinders. 



ORIGINAL COMMUNICATIONS 125 

Behind them are developed two more grinders, the last ones 
being the wisdom teeth. If this first permanent molar should 
be in its wrong phice, then all the other teeth which come in 
after it would be wrongly placed also. It is the guide to those 
that are yet to come. If it should be lost by decay, then the 
other teeth coming in behind it would droop forward and those; 
in front would drift backwards and destroy the alignment ol' 
the arch of the teeth and cause deformities of the face, as well 
as the loss of power to masticate food. Sooner or later an 
arch of teeth which has lost its keystone will decay and be lost 
also. It is the most important tooth for mastication at an 
important period of the child's life between the ages of six and 
twelve. Any nurse or teacher or parent should be able to 
locate this tooth. It is the last tooth in the arch when the 
child is about six to twelve years of age. It is larger than any 
of the others and the third one back from the eye-tooth, which 
is generally easily recognized. 

Teeth ache because there has been some interference with 
the normal processes of development. They may ache because 
of a blow upon them, or some irritation from acid, such as 
strong fruit acid or strong sugar. They may ache because of 
extremes of heat and cold, as in eating ice cream or taking 
very hot drinks ; but the most common reason for toothache is 
decay of the teeth. In the centre of the tooth there is what is 
knowni as the pulp, which contains nerves and blood vessels 
and connective tissues. These nerves become irritated by 
extremes of cold or heat or because of acids which form in 
the process of dental caries which irritate the nerves, and if 
the pulp becomes exposed to the fluids of the mouth bacteria 
gets into the pulp and causes pain from the poison of the bac- 
teria. Sooner or later a tooth which has a pulp exposed in 
this way will become infected and die. Later on the tooth may 
become abscessed and very sore, the face swelling, and later 
the tooth become unserviceable. 

It is very commonly said that teeth will not decay if they 
are kept clean, which is perfectly true, but it is quite impos- 
sible to keep all of the surfaces of the teeth so clean by the 
ordinary methods of brushing that they will not decay. 
Shortly after Dr. W. D. ^liller discovered the cause of dental 
caries to be bacterial in origin, it was suddenly concluded that 
if the bacteria in the mouth could be destroyed that decay 
would not take place. Consequently, a great number of the 
profession began making a number of mouth washes contain- 



126 DOMINION DENTAL JOURNAL 

ing disinfectants, such as carbolic acid, which was represented 
to the public to stop their teeth from decay. Notwithstanding 
all the drugs which w^ere put on the market for this purpose 
at that time teeth still continue to decay. Since then the idea 
was introduced that if the teeth were kept clean by an abrasive 
that they would not decay. These abrasives, in the form of 
tooth powders and tooth pastes, have been on the market for 
years, and everybody knows that there is more tooth decay 
now than there was when these were first introduced, so that 
they have not stopped dental decay. The fact of the matter is 
that these methods of cleaning the teeth do not reach the points 
where decay begins. Decay of the teeth always begins in 
some little defect in the surface of the tooth or between the 
teeth where the micro-organisms may lodge until they have 
developed an acid w^hich dissolves the tooth substance. It is 
true that the methods suggested will hinder the teeth from 
decay on the exposed surfaces. Though teeth may decay 
which are very carefully cleaned and brushed, the practice is 
recommended so that micro-organisms may not develop in the 
mouth and cause general systemic diseases. Among the prim- 
itive races the teeth are kept clean by the mastication of hard 
foods, but among more civilized races the foods are made so 
mushy and tenacious that they stick around the teeth and are 
the source of the development of micro-organisms that may 
cause a good number of general diseases; so that for these 
reasons, though decay cannot be stopped, the teeth ought to 
be brushed and kept clean most carefully. 

How should we clean a baby's teeth? A baby developing 
and growing and nursing at its mother's breast in a normal 
way needs no mouth cleaning or attention. Nature has pro- 
vided no place for lodgement of foul things in the mouth of a 
baby. There are no teeth with little crevices in which micro- 
organisms may grow. If, however, a baby should become ill 
and its lips and mouth and tongue become sore, then the mouth 
might well be wiped out very carefully and cautiously with a 
piece of cheese cloth wound upon the first finger. Even the 
young child after the teeth have erupted needs very little 
attention, because if the child is normal at all its mouth will be 
kept clean from the ordinary exercises of masticating its food. 
Children up to the age of three or four, or even six or seven, 
who have not been fed a lot of slimy, starchy, sugary food, will 
have clean red or pink mucous membrane and tongue and 
white teeth quite the equal of a young puppy or a wolf. In 



SELECTIONS. 127 

closing, 1 should wnni you not to instruct the girls to brush 
the gums of a baby or wipe the mucous membrane heavily \vith 
any wipe. The mucus membranes of a baby's mouth are very 
tendei-, and nurses are in the hahit of forcibly wiping out 
the mouth, and abrasions are made on the surface which after- 
wards ])eeomo infected, causing the patient to suffer severely. 

ERYTHROPHLCEUM HYDROCHLORIDE AS AN 

AGENT FOR DEVITALIZING THE 

DENTAL PULP 



Norman Black, L.D.S. (Eng.), 
Lecturer in Dental Surgery j University of St. Andreivs. 



I am under the impression that no previous w^riter has 
described the property of erythrophloin, with which this article 
deals. The drug is one which, for some strange reason, is little 
used. Text-books on dental surgery make little or no refer- 
ence to it, and Martindale and Westcott, in one of the recent 
editions of the Extra Pharmacopoeia ^ directly state that ''The 
drug has no central direct action on the dental puip.^' This 
is far from being correct, as for a good many years I have 
been using erythrophlein as a wonderfully speedy and painless 
pulp devitalizer. 

Since Mummery has demonstrated the direct connection 
between the dentinal fibril and the pulp, it would now be 
fatuous to imagine that any drug which had a real, deep, 
obtundent effect on sensitive dentine could be employed with- 
out danger to the pulp. It w^as indeed due to reasoning of that 
s/ort that the devitalizing action of the drug was discovered 
and used. A case of sensitive dentine had been treated with 
throphleol for a few hours, and on the removal of the dressing 
the desensitization was so very marked that death of the pulp 
was suspected. With a sharp spear-head bur the pulp was 
exposed and removed without sensation. 

Erythrophloeum, sassy bark, casca bark, or ordeal bark, 
is the bark of Erythrophloeum guineense. The hydrochloride 
occurs in yellowish-white granular crystals, easily soluble in 
water. The drug has a powerful effect on the heart, similar 
to the combined action of digitalis and picrotoxin. It is used 
in doses of from l/40th to l/20th of a grain in valvular diseases 
and dropsy. Erythrophlein is described as an almost ideal 
drug for the treatment of sensitive dentine. For this purpose 



128 DOMINION DENTAL JOURNAL 

it is used in tlie form of a preparation known as tlirophleol, 
consisting of a 50 per cent, solution of erythrophlein in 
eugenol. This is the preparation of which I have made use 
for pulp devitalization. Its actio-n is startling in its rapidity, 
and usually free from anything more than the merest sugges- 
tion of pain. Whatever the future may bring in the matter 
of increased use of erythrophlein as a devitalizing agent, one 
thing is certain, it is an addition to the armamentarium of the 
conservative operator. From some five years' personal expe- 
rience of its usefulness, I am bold enough to say it is an 
addition not to be despised. Whatever the favourite method 
of devitalization of the individual operator may be, there are 
four classes of cases in which the use of erythrophlein may be 
justified, indeed, I think, indicated. They are: 

(a) Shallow cavities which have produced considerable 

pain, and therefore call for devitalization. 

(b) Pulps requiring destruction in mouths of patients so 

sensitive that they will permit no operative 
measures till the tooth is free of sensation. 

(c) Where drug devitalization must be accomplished 

speedily. 

(d) Devitalization in mouths where other methods have 

proved unfortunate. 

The technique of the employment of erythrophlein for the 
devitalization of pulps is similar to that carried out when 
arsenic is the drug used. 

With a w^eak, warm alkaline antiseptic wash away all 
debris. With sharp instruments cut away as much carious 
dentine as can be removed without causing pain. Do not 
specially seek to expose the pulp. Isolate the tooth, and 
dehydrate with chloroform. With warm air evaporate all 
moisture, and the cavity is ready for the application. 

Take an extremely tiny pellet of cotton wool (as small as 
can be conveniently handled in dressing tweezers), dip it in 
tlirophleol and apply to the centre of floor of the cavity. A 
mere smear of the drug on the floor will act quite efficiently 
and is best in very shallow cavities. 

Do not apply the dressing direct to the exposure if it is an 
old one, but rather to the dentine at a little distance from the 
exposed spot. Seal in the dressing carefully with a watertight 
temporary filling such as temporary gutta-percha or calxine. 
Leave the dressing in situ for 48 hours, and then proceed 
as after devitalization by any other method. 



SELECTIONS. 129 

ill c'lKleavouriiig to understand the action of this drug', I 
have for comparison studied what modern authorities say as 
to the action of the other drugs used to devitalize dental pulps 
by means of their ijoisonous action on them. Bennett, in his 
''Science and Practice of Dental Suroery/' says: "The jjulp 
may be devitalized by or with the aid of (a) surgery, (b) poi- 
sons, (c) anaesthetics," and hiter under poisons, "Arsenic 
devitalizes the pulp by congestion or strangulation. It has 
been held in many long and cleverly written articles that 
arsenic caused the death of the pulp by creating an irritation 
which stopped or hindered the circuhition in the veins. It has 
been as vehemently held that arsenic causes pulps to die by 
irritating tissues until so much blood is forced into the pulp 
cavity through the fine foramen that the return circulation is 
cut off and the pulp is thus strangulated. ' ' 

In shorter terms, the arsenic is presumed to act by passive 
congestion and stasis in the first case, and by active hyper- 
aemia followed by strangulation in the other. In order to 
find out the action of erythrophlein on the pulp, comparison 
of the condition of the organ when under its influence was 
made w4th pulps acted on by arsenic. 

Whatever the actual process by which arsenic devitalizes, 
examination of a pulp during the action of the drug certainly 
shows the pulp to be engorged with blood. 

If one drills into a pulp only partly devitalized by arsenic 
it is amazing how much blood so small an organ can contain. 
On the contrary, whatever stage of the process of devitaliza- 
tion by erythrophlein hydrochloride is taken, the pulp will be 
found more anaemic than normal. Twenty-four to forty- 
eight hours after its exhibition in a favourable case the pulp 
is usually a white bloodless thread. 

Later it is noticeable that the pulp is softer, more friable 
and more shrunken than in arsenical devitalization; indeed, 
in many cases it seems almost to be partially dissolved. 

Obviously, here is a very different action from that of 
arsenic, and with all humility and willingness for my theory 
to be disproved, I suggest a possible explanation. 

The poisonous action of erythrophlein hydrochloride on 
the pulp appears to me to be the opposite to that of arsenic. 
The latter determines an excessive flow to or congestion of the 
pulp, while erythrophlein hydrochloride works out the destruc- 
tion of the pulp by denying it its blood supply. If asked for 
any analogous pathological state, I would suggest the starving 



130 DOMINION DENTAL JOURNAL 

of the peripheral tissues in Rajaiaiid's disease, in which spasm 
of the arterioles due to morbid action of vaso-motor nerves 
causes death of the parts affected. 

I find that it is said that the drugs in general use internally 
have an action comparable to the combined effects of digitalis 
and picrotoxin. As digitalis is a depressant and picrotoxin 
checks nervous action by preventing the stimulation of nervous 
mechanism, it might be feasible to suggest in support of my 
theory that the drug which is said to act like a combination of 
the two above mentioned, in topical application may depress 
the vitality of the pulp, and interfere with the nervous 
mechanism which determines the flow of blood to that organ. 

Bearing in mind that the action is as satisfactory when the 
application is made far away from the pulp as when the drug 
is placed near to it, the further suggestion is that it has a 
special and rapid action on nerve and nerve-like tissues. If, 
then, Mr. Mummery's description of the passage of nerve 
filaments from the plexus of Raschkow in the pulp into the 
tubules of the dentine be accepted as proved, the rapidity of 
action of our drug (through the dentinal fibril to the pulp) is 
explained. 

In all these suggestions I beg to be considered rather as a 
blind seeker after facts than as one advancing a didactic state- 
ment. I have for a couple of sessions in my lectures to dental 
students of St. Andrew's University included erythrophlein 
hydrochloride in the list of drugs used to devitalize the 
dental pulp. 

In speaking of it, I compare the speed of action to that of 
an express train, while that of arsenic to a horse omnibus. 
I have hoped b}^ so doing to interest students in its use and 
so have the knowledge of its action increased by their 
experiences. Such increase is but slow, so I am emboldened 
to approach the great field of forward dental thought with 
this new idea in the hope that it may be of much use and that 
fuller understanding of it may be arrived at. 

The two outstanding features of the use of this drug for 
devitalization are: 

(a) The speed of its action, and 

(h) The minuteness of the dosage. 

All speed is comparative, and so I should state that in my 
experience the average time required for complete action of 
an arsenical dressing is seven days. To bring about the same 



SELECTIONS. 131 

result eiythrophlein hydrochloride requires about thirty- 
six hours. 

As regards minuteness of dosage, on one occasion to a 
superficial cavity I applied a tiny smear of throphleol. In 
order not to affect adhesion of my temporary filling, I removed 
with cotton wool all of the throphleol that could be rubbed off. 
Complete devitalization resulted in the usual time. 

I do not wish to suggest that I have not had failures or 
met with painful action with this drug. 

We all know that there are conditions of the pulp and 
idiosyncracies of patients which nullify successful arsenical 
action. I should say, roughly, that the action of throphleol 
shadows that of arsenic in these cases. T have a patient who 
has always suffered intense pain with arsenical dressinG:s, and 
in his case devitalization is slow. The action of throphleol in 
his case is slower than usual and accompanied by neuralcria. 
and T now^ invariably extirpate pulps for him under an injected 
local anaesthetic. Similarly, chronically inflamed pulps react 
less satisfactorily to throphleol than those unaffected by 
degenerative changes. Still, over all, T am impressed by the 
wonderful, speedy painless action of the drus:, and strongly 
recommend all operators to test its worth for themselves, 
remembering that it is a very powerful drug, and so to be 
handled with caution and respect. 

The only warning I have heard sounded is that contained 
in Martindale; that after forty-eight hours' exhibition slight 
pericemental inflammation may occur. This T have noticed 
but verv rarelv and in verv slight degree. 



132 DOMINION DENTAL JOURNAL 

Dental Societies 



CANADIAN ORAL PROPHYLACTIC ASSOCIATION 

ANNUAL REPORT OF EDUCATIONAL 

COMMITTEE 



Mr. Chairman and Members of the Canadian Oral Prophy- 
lactic Association, 

Your Committee on Education begs leave to submit the 
following report: — 

Before going into the report, your committee desires to 
express its regret that the father and president of this As- 
sociation has for the past couple of months been unable, as a 
result of illness, to carry on his usual activities, both in his 
private pra<3tice and in the affairs of this Association. Only 
those who have been in close touch with Dr. McDonagh in 
C.O.P.A. matters realize how much time he has given to the 
work of this Association, and your committee cannot but feel 
that this extra labour has been more or less responsible for 
our esteemed President's illness. It is gratifying to know, 
however, that Dr. McDonagh is constantly getting stronger, 
even to the extent of his possible presence at this meeting to- 
niglit. This result of overwork which has been brought to 
our attention by tlie illness of our president should stimulate 
every member of this Association, and more particularly 
those on committees, to put forth every effort to relieve the 
load which sometimes ^'breaks the back of the willing horse." 
This committee hopes for a speedy return of full health and 
the old-time vigor to Dr. McDonagh. 

Since the last annual meeting of the Association the first 
and most important step of one of the greatest educational 
campaigns in the history of the world has been taken. The 
**Huns" have been tausrht the fallacy of the statement that 
''might is right," and the people of the universe have reason 
to thank Almi^ty God that the anns of the Allies and the 
United States have been successful, after over four years of 
struggle, in establishino: for them the freedom which should 
be, has been and will continue to be theirs. 

The sons of Canada (grandsons of the great mother coun- 
try) have played a stellar par^t in this stniorgle in the interests 
of edu<^ation and right. The bulk of the people, from the 
f^h^Mren up to those who will naturally soon pass to tbe 
* 'groat beyond" to rocoflve fheir final reward, did their part 



HEXTAL SOCIKTIES. 133 

in tbe many activities nece^ssary to e(iuip and maintain a large 
army in the theatre of war. To those families that have been 
bereaved is due the greatest credit, but truly great things are 
never accomplished without sacrifice, and to those parents 
who have reared sons and given them freely for the benefit of 
bumianity will come the greatest reward. 

The Canadian Army Dental Corps has done a wonderful 
work for the men in the army, and to those members of the 
profession who gave u|) theiir practices and placed their ser- 
vices at the disposal of the government, too much credit can- 
not be given. Your connmittee would respectfully suggest 
that as these men retui-n to re])uil(l their practices they 
have the support and help in every way possible of the mem- 
bers of the profession. It is hoped that the work of your 
committee on education was of some assistance to the C.A. 
D.C. in its educational canii>aign in the anterests of the men 
in the army. Display cards of an educational nature were 
printed and supplied to the dental surgeries in the different 
military districts of which it was possible to obtain know- 
ledge. These cards were noticed in some of the militaiy den- 
tal surgeries by a committee on vocational education, whidh 
came here from Washington, and a request for a set came 
from Mr. C. A. Prosser, Director of the Federal Board for 
Vocational Training at Washington. Your committee was 
pleased to send a set to Mr. Prosser. A second lot of these 
cards had to be printed to supply the demand for them. 

Thousands of copies of the military leaflet were also sent 
to the various isurgeries, and all the requests for more could 
not be met without printing a further supply. 

Before getting away from military matters your com- 
mittee desires to note with pleasure the return to our midst 
of one of its before-t)he-war members. Lt.-Col. Hume gave 
over three years' service, and, as promotion in military life 
in these days is indicative of ability. Col. Hume's rank 
would indicate that his services to the army were of the high- 
est type. The work he has done since his return along the 
line of teaching war dental prosthesis is not less im]>ortaiit 
than his duties as head of the Dental Department of the On- 
tario Hospital at Or[)ington. The re-election of Col. Hume 
to this committee would ]>e a factoi- in the advancement of the 
educational work of this Association. 

A set of school cards, which were completed about the 
time of the last annual meeting, has been sent to a number of 
committees in different parts of the Dominion for use in their 



134 DOMINION DENTAL JOURNAL 

district. Your committee would be pleased to supply a set of 
these cards to any society or committee doing oral hygiene 
work. Any ethical practitioner, also, may have the loan of 
these at any time upon application to the Secretary. These 
cards, as well as all material of the Association, are for the 
use of the profession, free of all cost. Your committee has 
always been pleased to render assistance in any way possible 
to any propaganda for educational work in oral hygiene. It 
migtht be mentioned here as a reminder to the den'tal societies 
and oral hygiene committees lali over the Dominion that the 
''assistance'' spoken of means in a financial: way, as well as 
educational material, such as moving picture films, lantern 
slides, etc. In rendering financial assistance, however, to any 
society or committee, information is required as to what use 
is intended to be made of any funds Which the Canadian Oral 
Prophylactic Association is asked to donate. 

As reported at the last annual meeting of this Association, 
there is now established in the University of Toronto a special 
dental research organization, with the president of the Uni- 
versity as dhairman of the committee in charge. This com- 
mittee experienced a good deal of difficulty in getting a pro- 
perly qualified assistant. It was not until the first of June 
that an assistant was obtained who had the necessary training 
to begin the work. The committee was fortunate in securing 
the services of Miss Fraser, a graduate in Household Science, 
who had spent one year in loriginal research work in that de- 
partmeiiit. Since June she has spent her time in the study of 
laboratory, bacteriological and physiological technique, 
spending a good deal of time in the fundamental subject of 
pathology. Some work has been done on oral infection, un- 
der the direction of Prof. McKenzie and Dr. Box. The 
special laboratory equipped for this purpose is located in the 
Pathological Building, University Avenue. What is requir- 
ed niow is a good working dental library and the employment 
of an! efficient research worker to direct and carry on the work. 

This Department of Dental Research in the University is 
at the disposal of the dental profession in Canada, and it is 
hoped that every man practising in this country, who from 
time to time has problems which this Research Department 
might be able to solve, will send them to the Secretary of the 
Educational Committee for submission to this department. 

One outstanding feature of an educational charactei- dur 
ing the past year was the address given hy Di*. W. J. Gies, of 
Columbia University, New York, before th(^ ndjoninod nnnunl 



DENTAL SOCIETIES. 135 

meeting- of tiiis iVssociaiioii last yeai'. On this ow.asion a 
large number of dentists and physiiciaiis assembled, upon in- 
vitation, at lihe Board ol' Trade BaiK^uet Halil, to hear Dr. 
Gies, who spoke on the subject of "Afouth Bacteria/' His 
address has since been printed in pamplilct foi-m and a coi)y 
sent to every dentist in Canada. 

During the year the prize essay of Dr. M. H. Grarvin, of 
Winnipeg, was printed and mailed to the members of the pro- 
fession. Dr. Grarvin 's contribution was entitled ''Mouth In- 
fection as it Affects the General Dental Practitioner." The 
pamphlet was splendidly illustrated, and must have been of 
great value to many men in their efforts to solve the root 
canal problem. 

Your committee believes that much good was accomplished 
by 'the Association's exhibit at the combined meeting of the 
Oanadian Dental Association and National Dental Associa- 
tion, held at Chicago last August. The greatest courtesy was 
shown your representatives by the officers in charge of the 
meeting, particularly Dr. Don. M. Gail lie, who secured for the 
C.O.P.A. exhibiit one of the dhoicest locations possible, for 
which there was no charge made, notwithstandinig the fact 
that an immense amount of space was occupied. Dr. Gallic 
was untiring in his eft'orts on behalf of all Canadians present. 
A detailed report, prepared by Dr. G. Vernon Fisk, who had 
charge of the exhibit, is appended herewith. The Black His- 
torical Ex'hibit was an outstanding feature at the Chicago 
meeting, a few pamphlets describing this are on the table to- 
nigiht for your perusal. 

Copies of the Report of the Educational Committee to 
that meeting are also presented herewith. You will also be 
interested in two little books for children, by Maude MuUer 
Tanner, D.M.D., Portland, Oregon, which were kindly pre- 
sented to the Association by their author, whom the writer had 
the pleasure of meeting, a little lady who is very enthusiastic 
and very clever in oral hygiene work, as evidenced by her 
books. 

Another striking feature of the Chicago meeting was the 
fact that the memorial address in the unveiling of the Black 
Memorial Statue in Lincoln Park was delivered by a member 
of this Association — Dr. A. W. Thornton, of Montreal. 

A study club was organized by your Executive and Edu- 
cational Committee early last spring, several meetings were 
held, and it was intended, after the club was gotten well or- 



136 DOMINION DENTAL JOURNAL 

ganized, to endeavour to interesit a large number of the den- 
tists in and around Toronto, and thus form a number of 
groups for special study. In the autumn, however, a cir- 
cular was sent out by Dr. Conboy and others, seeking to form 
the Dental Educational Association. Your committee felt 
that it would be to the greatest advantage if the members of 
this Association wou'ld become members of the Dental Edu<Ja- 
tional Associaition, and a circular letter was sent out to this 
effect, thus dropping, for the time being, at least, the study 
club which had been started. 

In the Province of. Quebec an earnest effort is under way 
now to do some oral hygiene work. The committee down 
there has sought the aid of this Association, and a plan is 
being worked out w'hereby the Quebec Committee can secure 
constant financial assistance, through the sale of Hutax pro- 
ducts in that province. With a desire to help this movement 
the Association's Secretary some time ago, mailed a Hutax 
brush to every dentist in the province of Quebec, and the sug- 
gestion was made to the Quebec Committee that it follow up 
the brush with a circular letter, soiliciting the aid of tlie niem- 
bers of the profession in its efforts to conduct an oral hygiene 
campaign. In Montreal last May, a large Baby Welfare Ex- 
hibit was held, to which the Montreal Women's Club con- 
tributed a booth on Mouth Hygiene. Mrs. A. D. Angus, wife 
of one of Montreal's prominent dentists, was convenor of this 
committee. 

Following are excerpts from the report received of this 
exhibit:— 

*^The idea of the booth was to instruct the public in oral 
hygien'e and to bring abouit an interest on the part of the pub- 
lic in the importance of early dental treatment of the child, 
with the hope of leading eventually to the formation of clinics 
in our schools. 

^^The booth was fitted up as a modem dental office, the 
walls being lined with educationial charts showing the serious 
conditions arising from neglect, giving instructions to parents 
regarding the care of the teeth and demonstrating their im- 
portance to the general health. 

"During the exhibit 3000 pamphlets containing dental in- 
struction were distributed to the public. 

"In conjunction with the booth a series of lectures were 
given in the lecture hall, also a dentist being in attendance at 
the booth to give advice and instruction to mothers. 

"An instructive lecture was also given by Dr. Duncan P. 



DENTAL SOCIETIES. 137 

Anderson on 'The Relation of Mouth Conditions to the Gen- 
eral Health. ' 

''Through the kindness of the Imperial Theatre a dental 
film was shown at the speoial children's performance Satur- 
day morning. 

"The exhibit lasited two weeks and was well attended. 

"The committee is deeply indebted to the Canadian OraJ 
Prophylactic Association for sending wall charts, school 
cards, lantern slides, etc., which were made good use of and 
were a great help. ' ' 

The report of the Nova Scotia Dental Association of its 
meeting, held at Truro last July, contains the following in the 
report of the committee on Dental Education of the public:— 

"Several meetings of the Committee and interviews have 
been held with the Superintendent of Education and repre- 
sentatives of the Normal School. 

' ' The recommendations of your Committee with regard to 
a course of illustrated lectures on Oral Hygiene, to be given to 
the students at the Normal School, were approved by the 
Council of Public Instruction, and a meeting has been ar- 
ranged with Mr. Connolly of the Normal School, for this af- 
ternoon, for the purpose of making definite arrangements. 

"Correspondence has been conducted with the C.O.P.A., 
and a set of display cards for use in school rooms has been re- 
ceived from them with an offer to supply them for tHs pur- 
pose at a very low price. It is hoped that arrangements will 
be made so that a large number of the schools in the province 
will purchase them. 

"The C.O.P.A. has also promised to send us skeleton lec- 
tures and slides for use in lectures on oral hygiene, so that 
any member of this association wishing to obtain them for 
this purpose may do so. 

"The School Dental Surgery in Halifax, in spite of the 
terrible catastrophe of last December, has had a very success- 
ful year, and plans for school dental surgeries in the new 
school buildings have been approved.'' 

A further report of this committee contains the following: 

"Your Committee begs to report that at the conference 
with Mr. Connolly, of the Normal School, definite arrange- 
ments were made for the course of illustrated lectures on 
Oral Hygiene, to be given to the students of the Normal 
School between February and May, 1919, by a member of the 
Feoulty of Dentistry of Dalhousie University." 



138 DOMINION DENTAL JOURNAL 

Dr. George K. Thomson is chairman of this committee 
and Dr. A. G. Ritchie, secretary. 

In a recent letter from Dr. Thomson, he says : ' ' The at- 
tention of the Council of Public Instniction has been directed 
to the school cards, and arrangements will probably be made 
for placing them in a number of schools throughout the prov- 
ince. They will also be used in the Normal School lectures 
in connection with the slides which you recently forwarded. 

* ' The Halifax Dental Surgery is doing excellent work, and 
the prospects for the establishment of a Municipal Dental 
Surgery under the auspices of the Massachusetts-Halifax Re- 
lief Committee are excellent. 

^^Recommendations with regard to State Dentistry have 
also been made to the authorities. With many thanks for the 
slides and suggestions.'* 

Last May a request came to your committee from the 
President of the British Columbia Dental Association, asking 
for films, charts, or anything which this committee could pro- 
vide. Two films, school <3ards, etc., were sent. In a recent 
letter from Dr. Jones, he says :~ 

**The moving picture films you so kindly sent me last May 
were shown and very much appreciated by the members of 
the B. C. Society at our convention last June. The set of 
s<5hool cards were also shown at the meeting and a recom- 
mendation was made to the new Executive to purchase a set 
of the cards for use here. The films were afterwards shown 
in Victoria, B. C. 

Dr. James E. Black, in a letter dated January 15th, says : 

^^The Educational Committee had no definite campaign 
outlined last year, because war conditions prevented oper- 
ating such, but the committee has formed a study club along 
educational linds and are hoping this winter to assist anyone 
giving health talks with outlines of lectures or send material 
loaned by the C.O.P.A. 

^'The Provincial Government is contemplating a scheme 
whereby isolated places (and unfortunately, there are many 
in B.C.) can be supplied with an ethical dentist, who will be 
partially paid by the Government and who will not only do 
dental work, but give lectures on educational subjects. This 
is part of the plan of a Public Health Campaign of the Pro- 
vincial Government and our Committee is offering all possible 
assistance. Lectures have been given in several parts of the 
Province, but the most important feature of our educational 
work was the establishment of four complete dental outfits, 



DENTAL SOCIETIES. 139 

purchased and operated by the Vancouver School Board and 
no part of our school systom is more appreciated than the 
dental clinic. 

"This year, the Board, on the advice of the Chief Dental 
Officer, is purchasing a movable outfit, whereby a dentist will 
be able to go to any school and there examine and do prophy- 
lactic work for all children, with less loss of time from class- 
room than sending them to the central clinic. ' ' 

A copy of the Oral Health Film and the Toothache Film 
have been out West for several months, and in one district in 
Saskatchewan one of them was shown in seven towns. 

Since the last meeting a second copy of the Oral Health 
Film was secured, also a new film on Personal Mouth Hy- 
giene. This latest film and the Oral Health Film have been 
in constant us'e by the Ontario Government. 

The skeleton lectures and slides have been sent to a large 
number of towns all over the Dominion during the year, and 
these as well as the films, seems to be much appreciated. 

Some of the members of your committee attended in- 
formally, a meeting in Buffalo recently, called by the Pre- 
paredness League of American Dentists. It is the desire of 
the League to organize an international association somewhat 
along the lines of this association, and its members desire to 
obtain the co-operation of the Canadian dental organizations, 
with a view to having an international oral hygiene associa- 
tion under the control of the National and Canadian Dental 
Associations. The President of the Canadian Dental As- 
sociation desired your Educational Committee to appoint an 
official representative to attend this meeting at Buffalo. Capt. 
Harry Thompson, of Davisville Hospital, kindly consented 
to accept this appointment, and he will make a more detailed 
report of this meeting. 

Your Committee would like an expression of the opinion 
of this meeting in the matter of the proposed organization. 

One particularly good feature of the work of the League, 
in the opinion of the writer, is the use of the Dental Am- 
bulance in rural districts, which system would be productive 
of much good if taken up seriously by the municipal or pro- 
vincial governments. 

Your committee was able to be of some small service to 
the recently appointed Oral Hygiene Inspector of the State of 
New York. He wrote for information re the conduct of 
school clinics here. Through the kindness of Dr. John A. 
Bothwell, Chief Dental Inspector under the Board of Health, 



140 DOMINION DENTAL JOURNAL 

City of Toronto, a full detail of the working of the clinics was 
sent to Dr. Leak, State Department of Education, Albany, for 
which his sincere thanks have been tendered. 

Dr. Kawamura, the clever young Japanese, who visited 
Toronto a couple of times, taking the recent post-graduate 
course at the R.C.D.S., admired the school cards and desired 
to obtain a set to send to the dental department of the Uni- 
versity in Tokio. Your Committee presented him with a set 
along with the Association's compliments. 

The conclusion of the war and the removal of many duties 
in its behalf will have the effect of a stimulus along other 
lines, and, as a consequence, more opportunities will present 
themselves for those who are interested in the oral hygiene 
movement. 

There are a great many opportunities for this committee, 
the sky only being the limit of its possible activities. It is a 
pleasure to have the opportunity to serve. 

All of which is respectfully submitted. 
Horace E. Eaton, Chairman. George W. Grieve, 

Toronto, Jan. 20th, 1919. Secretary. 



SOUTH ONTARIO AND WEST DURHAM DENTAL 

ASSOCIATION 



The third meeting of the South Ontario and West Dur- 
ham Dental Society was held at Oshawa, on Thursday night, 
Feb. 27th. 

After dinner was served, the meeting was called to order 
by the President, Dr. J. C. Devitt, of Bowmanville. 

Dr. Wallace Secombe, Supt. of the Dental College, was 
the guest of the Society, and gave an able and instructive 
address on Preventive Dentistry. He brought out some 
strong points on the foods required for the proper nourish- 
ment of the child from early life up to maturity, giving a list 
of the foods best suited to the needs of the different ages. It 
is a paper that Dr. Secombe should be asked to publish for 
the benefit of the profession in general. 

Dr. Henry, of Oshawa, moved that Dr. Secombe be ten- 
dered a hearty vote of thanks for the able paper he had given 
and also his kindness in coming to help out the Society. The 
motion was seconded by Dr. Harry Hudson, of Whitby. This 



DEXTAL SOCIETIKS. 141 

Society was organized in May, 1918, every member of the 
dental profession in Whitb}', Oshawa, and Bowmanville are 
active members. The Society meets quarterly. 

Officers: President, Dr. Devitt, Bowmanville; Vice-Presi- 
dent, Dr. Hudson, Whitby; Secretary, Dr. Arnott, Oshawa. 

Slogan — "Good Fellowship and (iood Dentistry.'^ 



* A NEW DENTAL SOCIETY 

February 7th, 1919. 
Editor, The Dominion Dental Journal, 
Royal College of Surgeons, 
Toronto, Canada. 
Dear Sirs,— Permit me to announce, through the medium 
of your journal, the formation of a new Dental Society regis- 
tered under the name of the Society of Dental Science, B.M.A. 
Buildings, Elizabeth Street, Sydney, Australia. 

Mem'bers of the Odontological Society of N.S.W., the 
N. S. W. Dental Graduates Society, and the University of 
Sydney Dental Graduates Association have joined forces and 
will meet together in the interests of Dental Science. Thank- 
ing you in anticipation. 

Yours faithfully, 

Stewart Zill, D.D.S., 

Hon. Secretary. 



OFFICERS OF THE TORONTO DENTAL SOCIETY 



President— R. D. Thornton. 

1st Vice-President— W. H. Coon. 

2nd Vice-President— H. A. McKim. 

Secretary— A. C. Pye. 

Treasurer— H. H. Armstrong. 

Auditors-J. A. Bothwell, W. E. Willmott. 



ONTARIO DENTAL SOCIETY MEETING 



The Ontario Dental Society will hold its annual meeting 
in Toronto, Ontario, Monday, Tuesday, Wednesday and Thurs- 
day, April 28th, 29th, 30th and Mav 1st, 1919. 
J. E. RHIND, President, J. A. BOTmVELL, Secretary, 

Toronto. 604 Spadina Ave., Toronto. 



142 DOMIXIOX DENTAL JOURNAL 

DENTISTS IN ATTENDANCE AT THE ONTARIO 
DENTAL SOCIETY MEETING, MAY, 1918 



E. G. Abbott, 2 Bloor East; J. M. Abbott, Erin; H. Frank 
Adams, 325 College St, City; H. F. Alford, 2 Bloor East; 
A. H. Allen, Paisley; W. B. Armif^, 190 Avenue Road; J. L. 
Anderson, Oakville; eT. W. Armstrong, 22 College St.; H. C. 
Arnott, Oshawa; A. J. Brown, Mitcliell; A. J. Broughton, 305 
Markham St, City; C. E. Brooks, 2 Bloor East, City; M. G. 
Brick, 18-20 La Belle Block, Windsor; M. L. Brereton, Barrie; 
Sydney W. Bradley, Ottawa;' B. M. Bracken, Grand Valley; 
L. F. Bovle, 1348 Queen West; John A. Bothwell, 604 Spadina 
Ave. ; M.^R. Billings, Cayuga, Ont. ; E. R. Bury, 205 Yonge St. ; 
P. N. Berry, Caledonia ; F. E. Bell, Imperial Bank, Queen and 
Yonge; D. H. Beaton, Bathurst and Dundas; Chas. 0. Beam, 
St. Catharines; J. W. Barker, Cannington; E. R. Barker, 
Stouffville; F. Barron, Paris; J. C. Bansley, 325 Church St.: 
Earls S. Ball, 2559 Yonge St. ; 0. Baird, 921 College St. ; J. ^^\ 
E. Brown, Peterboro; W. W. Brown, 2 Gould St.; W. W. 
Burns, St. Thomas; F. F. Campbell, Gait; E. H. Campbell, 
Orangeville; F. J. Capon, 26 College St.; J. M. Cation, 
Toronto; W. L. Chalmers, Alexandria; J. B. Chalmers, 186 
King St. West; Harold Clark, 1104 Temperance Building; 
M. J. Clarke, Belleville; J. W. Coates, Wallaceburg; G. K. 
Collard, 429 College St. ; W. LI. Coon, 23 College St. ; F. J. 
Conboy, 1043 Bloor AVest; R. H. Cowen, Hamilton; N. S. 
Coyne, Toronto; J. J. Craig, Bowmanville; H. A. Crawford, 
Haileybury; P. E. Crysler, Simcoe, Ont.; W. E. Cummer, 
2 Bloor East; Hugh Cunningham, 2881 Dundas St.; 0. S. 
Cunningham, London ; T. A. Currie, 2 College St. ; R. S. Day, 
Harrowsmith; J. A. Drummond, Petrolia; C. B. Dorland, 
Oakville; E. H. Dobson, 105 Dundas St.; J. C. Devitt, Bow- 
manville; Morley A. Day, Belleville; Arthur Day, Toronto; 
T. W. Dawson, 2 Bloor East; R. 0. Davis, St. Catharines; 
W. A. Dalr>Tnple, Toronto; E. M. Eby, Ottawa; Arthur Ellis, 
Toronto; S. Eckert, Waterloo; H. E. Eaton, 631 Sherbourne 
St.; W. A. Fleming, AUiston; E. A. Fuller, 214 Dundas St., 
London; H. G. French, Dresden; Grant Eraser, Madore; 
J. H. Frain, Norwich ; J. A. Flemming, Prescott ; R. E. Fisher, 
338 Pape Ave.; E. M. Fulton, Hamilton; E. L. Gansley, 
Toronto; W. F. Ganton, Uxbridge; W. R. Glover, Kingston; 
E. Goodwin, Welland; R. ^Milton Graham, 206 Laurier Ave., 
Ottawa ; J. F. Grassie, Welland ; J. B. Gray. 1095 Dovercourt 



DENTAL SOCIETIES. 143 

Rd.; W. R. Grieve, Ottawa; J. W. Hutchinson, London; T. II. 
Husband, Hamilton; F. G. Husband, 2 Bloor St. East; Harry 
Holmes, 72 Harbord St. ; R. U. Hoffman, 2046 Queen St. East; 
J. A. Hilliard, Kitchener; W. J. Hill, Alliston; E. A. Hill, 
Sudbury; Arthur W. Hill, Dnndas; George Hicks, Watford; 
Frank C. Harwood, Moose Jaw; H. N. Hartman, Meaford; 
E. Hart, Brantford; George G. Jordan, 535 Queen West; Alex. 
R. Jordan, Toronto; A. Jennison, Millbrook; W. T. Jeffs, 
Dresden; R. I). Jarvis, 213 Dundas St., London; T. S. Jarnian, 
Bancroft; J. W. Ingram, 171 Yonge St.; H. Irvine, Lindsay; 
A. G. R. Kinsman, Exeter; F. Killiner, St. Catharines; C. A. 
Kennedy, 2 College St.; G. T. Kennedy, St. Thomas; W. C. 
Lympburner, Smithville; W. E. Lundy, 801 Kent Bldg.; J. A. 
Locheed, Hamilton; Bradley W. Linscott, Brantford; 11. D. 
Lenty, 724 Queen East; A. V. Lester, Hamilton; W. Cecil 
Ijeggitt, 31 Queen AVest; G. A. Lee, AVliitby; S. Ledernian, 
Kitchener; W. J. Laker, 512 Dovercourt Rd. ; R. E. Laing, 
Dundas, Ont. ; F. G. Law, Toronto ; R. G. McGahey, 435 Jones 
Ave.; S. G. McCaughey, Ottawa; Geo. C. McKinley, 950 St. 
Clair Ave. ; H. A. McKim, 420 Roncesvalles ; A. J. McDonogh, 
2 Blooi- East ; J. P. MacLachlan, 26 College St. ; R. Macf arlane. 
Kitchener; H. G. MacDonell, Goderich; Wm. AV. Macdonald, 
204 Brunswick Ave.; R. G. McLean, 2 Bloor East; R. G. 
McLaughlin; Wm. C. McLachlan, 599 Gerrard East; W. S. 
Madill, 539 Bloor St.; W. A. Maclaren, 199 Yonge St.; W. A. 
Matheson, 339 Danforth Ave.; T. E. Mallory, 2 Bloor East; 
W. M. Monor, Sun Life Bldg.; G. K. Mills, Tilbury; D. M. 
Mitchell, Fort William; M. A. Morrison, Peterboro; G. A. 
Newton, Lucknow; H. A. Nesbitt, Lindsay; C. C. Nash, King- 
ston; J. E. Overholt, 608 Bank of Hamilton Bldg.; E. W. 
Oliver, Almonte; J. O'FIynn, St. Catharines; Philip B. Proud- 
foot, Russel, Ont.; R. F. Price, Ottawa; Chas. E. Pearson, 
2 Bloor East ; Edgar W. Paul, 205 Yonge St. ; R. A. Patterson, 
Kemptville; J. Ryan, 146 Queen We^t; M. Rutherford, 700 
Bathurst St.; D. E. Russell, Brantford; A. E. Rudell, 
Kitchener; G. W. Roulston, Exeter; John F. Ross, 2 College 
St. ; Chas. M. Ross, 403 King East, Hamilton ; H. A. Robert- 
son, Hamilton; Harold K. Richardson, 495 ^Bathurst St.; 
J. E. Rhind, Toronto; *H. AV. Reid, 1560 Queen West, City; 
R. M. Stewart, Markhani; J. X. Stewart, Hamilton; Leonard 
E. Stanley, 185 Sparks St., Ottawa; R. J. Sprott, Barrie; 
W. (J. F. Spence, Listowel ; W. E. Spaulding, 101 Lumsden 
l)l(lg. ; \l. E. Sj)arks, Kingston ; W. U. Sonierville, Haileybury ; 



144 DOMINION DENTAL JOURNAL 

C. A. Snell, 2 Bloor East; L. Gerald Smith, 137 Annette St.; 
W. P. Smith, 2 St. Clair West; Geo. D. Smith, Port Dover; 
Calour J. Smith, London; J. A. Slade, 179 Bathurst St.; Wm. 
M. Sinvirs, 625 Spadina Ave.; J. F. Simpson, Toronto; W. B. 
Shantz, Kitchener; F. W. Sellery, 530 Bloor West; Wallace 
Se€comhe, 269 College St. ; Chas. G. Scott, 20 Charles St. East ; 
W. Cecil Trotter, 326 Bloor West ; J. W. B. Topp, Bracehridge ; 
M. C. Tisdale, 7 John St., Hamilton; R. D. Thornton, 22 Col- 
lege St. ; L. G. Thomson, 301 Eyrie Bldg. ; A. S. Thompson, 
1400 Queen West; W. A. Ross Thomas, London; L. E. Tanner, 
155 Main St., Toronto; B. J. Vance, Waterdown; A. E. Web- 
ster, 45 Glen Ave.; I. H. Wylie, Toronto; G. F. Wriglit, Tren- 
ton; Wm. E. Wray, 126 Geoffrey St.; W. W^oods, Toronto; 
W. E. Willmott, 96 College St.; B. E. Wilson, London; H. N. 
Wilkinson, Newmarket; N. T. Willard, 2863 Dundas St. ; W. C. 
Wickett, Royal Bank Bldg.; A. M. Weldon, Peterboro; R. G. 
Ward, 199 Yonge St.; 0. Watson, Cami)bellford; F. Watson, 
Georgetown; D. Watson, Brantford; R. D. Wallace, 1152 
College St.; E. L Zinken, 26 College St.; 0. H. Zeigler. 
College St. 

PUBLIC HEALTH IN CHINA 



Scheme of Organization.— lsiQ(\iQ,mQ, Dentistr}^ and Nursing 
for the purpose of collecting money in Canada for West China 
University. 

GENERAL OFFICERS. 

President, 1st Vice-President. Vice-President. Corres- 
ponding Secretary. Recording Secretary. Treasurer. 

Provincial Organizations.— K vice-chairman for each pro- 
fession and for each province, making in all a general execu- 
tive of thirty-three members. 

The Central Executive shall consist of the six general offi- 
cers and the local Provincial Executive and the Toronto Ex- 
ecutive, making in all twelve members. 



KENTUCKY STATE DENTAL ASSOCIATION 



**The Fiftieth Anniversary— Jubilee Meeting— of the 
Kentucky State Dental Association will be held at Louisville, 
Ky., June 9-10-11-12, 1919. A Post Graduate Course of un- 
usual interest has been ]jlainied. Address all correspondence 
to W, M. Randall, Sec, Louisvillo, Ky. 



^ditoridZ 



:^5 



EDITOR: 
A. E. Webster, M.D., D.D.S., L.D.S., Toronto. Canada. 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross, L..D.S.. D.D.S., Ottawa; Carl E. Klotz, L.D.S., St. 

Catharines. 
QuBBBC. — Eudore Debeau, L.D.S., D.D.S. . 396 St. Denis Street, Montreal; Stanley 

Bums, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton. 

D.D.S. , L.D.S., McGill University. Montreal. 
ALBERTA.— H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — Jas. M. Magree, L.D.S., D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S., D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Regina. 

Prince Edward Island.— J. S. Ba&nall, D.D.S., L.D.S., Charlottetown. 
Manitoba.— M. H. Garvin, D.D.S., L.D.S., Winnipeg. 
British Columbia.— H. T. Minogue, D.D.S., L.D.S., Vancouver. 



Vol. XXXI. 



TORONTO, APRIL 15, 1919. No. 4. 



A FOOLISH OPTIMISM OR AN INSANE PESSIMISM 



The workings of the human intellect seem to be the same 
whether it is in one of the professions, in businesses or the 
trades. One sees the same human virtues and frailties exem- 
plified on all sides. Some thinkers believe that all human 
actions are begotten in selfishness, thus classifying all human 
motives and actions with those of lower animal life. One 
cannot recognize any motive in the cow, for example, outside 
of self-presei^ation. There is little altruism in her motives 
and actions. Are the fundamental principles guiding the 
human any different from the lower animal? It must be 
conceded that the human has many highly specialized forms of 
desires, while the lower animals' motives are chiefly directed 
to the physical pleasures of satisfying the cravings of hunger 
and procreation; the human enjoys in addition many mental 
exhilarations and pleasures. 

Some men go through life guided by one or other of the 
fundamental principles having their basis in self-preservation. 
During the whole of childhood and up to adolescence or full 
manhood, it is pre])a ration for the struggle of life yet to come. 



146 DOMINION DENTAL JOURNAL 

Among the higher types of civilized races there is much 
preparation so there may be greater satisfaction later in life. 
Their joys and sorrows are in proportion to their mental 
capacity to appreciate them. 

If the foregoing principles are applied to the affairs of life, 
or, to make it more concrete, to the general practice of a 
profession, it makes clear, or often explains, why men at times 
act in certain absurd ways. There is a type of person who 
proudly calls himself an optimist. He says he looks on the 
rosy side of life. He sees no shadows. In fact, he won't allow 
himself to see the dark clouds at all. Everything is lovely. 
^'Whatever was good enough for me is good enough for my 
children.'' ''Let well enough alone." ''Why meddle with 
things established for years." "Don't discuss or think of the 
dark side of the question lest the patient or the public might 
think there was something wrong." This kind of stupid, 
slothful, mental laziness, proudly called optimism, is begotten 
of selfishness, and is to be dreaded more than dishonesty. It 
leads many a young man to dishonesty, early senility and to 
mental and physical decay. 

In every walk of life there are men spending more mental 
energy in schemes to avoid coping with a difficulty than in 
attempts to solve it. They assume an air of wisdom in the face 
of all problems. Their explanations are so ingenious that they 
appear wise to the uninformed. In dental legislation, educa- 
tion and practice their name is legion. Patients are asking 
their dentists to have their teeth X-rayed, and they are told 
that the X-ray will not reveal anything that cannot be seen or 
made out from an external examination, and, anyway, it is 
only a new-fangled notion, instituted by enthusiasts, having no 
real value, and, besides, it is dangerous. Such dentists have a 
confidence in the past and a hope for the recovery of their 
patients not based upon reason, an optimism born of laziness 
which, in turn, is begotten of selfishness. Professional men 
especially go on practising what they learned when they were 
young because they are too lazy or selfish to change. 

On the other hand, there is the dissatisfied, unreasoning 
pessimist, who sees no good in human kind. Everything is 
going to the dogs. All is wrong. Even his best friends are 
not as they once were. If he should hear of a friend being 
accused of a greater or a lesser evil he would believe him to be 
guilty of both. Such Job's comfoi-ters are a nuisance, and 
might be looked upon as jokes except that they get a following. 



EDITORIAL 147 

There is nothing quite ii<>lil except their own views. Their 
patients are hard to get along with; the people in the towns 
where they live are constantly in error as to administration 
and government; they themselves have chosen the wrong pro- 
fession; they are sure they would have made great engnneers, 
surgeons or authors. Anyway, they never had half a chance. 
Others in their professions are all wrong; they do not i)erform 
operations correctly, and by improper means take their 
patients away from them. The whole effect of snch a pes- 
simism is bad for everybody who comes near them. They 
have a bad effect on sick or suffering people; they tend to 
break confidence in other members of their profession. 

Between these two extremes there is surely sane ground 
for the average person. Tf reason is allowed to enter, most 
extreme views vanish. The jx'ssimist is more liable to do him- 
self injury than the optimist. In fact, up to a certain point he 
can be guided, but the other person basnet usually enough 
brains to accept guidance. Elber Hubbard said: '^ Thank 
God we are as others are,'^ or as the great majority are, else 
we would be locked up. Some pride themselves on not being 
like others. Be neither the optimist nor the pessimist in den- 
tistry, and thus enjoy a sane, reasoning existence. 



STATE DENTISTRY 



Ever since the signing of the armistice the dental literature 
of Great Britain has been filled with the conti-oversy of the 
subject of State Dentistry. 

The subject was opened by Major Broderick, a returned 
Army Dental Surgeon. There Are two distinct classes of 
charges again Dr. Broderick. First, he published an article in 
a public health journal; second, he published in a lay journal 
the price of making artificial dentures. Ever since 1911 Great 
Britain has had state medicine, so it becomes quite easy for 
the Britisher to think of state dentistry. There must be a 
distinction made between state dentistry and public dental 
service. State dentistry means dentistry paid for or con- 
ducted by the state, while public dental service means a service 
to all of the public. In the scheme of state medicine in Great 
Britain, or state dentistry, as indicated by the discussion, 
there is no intention of taking care of all of the people, only 
taking care of those who require or are unable to pay for regu- 



148 DOMINION DENTAL JOURNAL 

lar service. The advocates of state dentistry, as indicated by 
the writings of those in favour of it, are often introduced with 
such statements as 'Hhe right of every individual to be pro- 
tected against disease/' ^'I am convinced that there is no 
common-sense in providing a police force for the protection of 
the lives of our citizens, and yet neglecting to protect them 
against the attacks of hostile organism." The work of the 
army has shown that dentures can be made more cheaply in 
large organizations than in private offices. The schemes 
presented are unique, comprehensive and bold. The work is 
divided into two general classes, that in the department of 
educatiojL for the children in the schools, and that for the adult 
population. The schools are now taken care of, so the discus- 
sion is on taking care of the general public. According to 
papers published, there are many large cities, even to 150,000 
inhabitants, with but one dentist, while in other cities there is a 
dentist for every twelve thousand. Jusit why such an unequal 
distribution of available dentists exists is hard for one to 
understand in a country like Canada. 

The general plan suggested by Major Broderick, and con- 
curred in by Dr. Mahoney and also Dr. McMillan, is to do the 
sort of work such as filling and prophylaxis for nothing and 
charge the public $7.50 for dentures. What really made the 
storm in Great Britain about this suggestion is that dentures 
made at even less than $5.00 apiece would give sufficient profit 
to do three fillings for nothing. The last scheme set forth by 
Dr. McMillan is to charge $7.50 for dentures and do all the 
operating and prophylaxis for nothing. This is figured out on 
the basis of 70,000 dentures to 212,000 fillings and prophylaxis. 
This proportion of fillings to dentures is really too low, unless 
there is no intention to devitalize any pulps. The provision 
made for salary and laboratory assistance is most ample. 
Overseers will get $4,500 per year, with two to four weeks' 
holidays, working six hours a day, while the laboratory fore- 
man will get $2,500. The clinical staff will be divided into 
juniors and seniors. The junior's limit of salary will be 
$3,500, while that of the senior will be $4,500. The centralized 
laboratory is the chief reason for cheap dentures. 



Cocaine pressure anesthesia should be limited to non-in- 
fected dental pulps. If there is any doubt about the sterility 
of the pulp use phenol, but care must be exercised lest too 
much of the drug may pass through to apex. 



EDITORIAL NOTES 149 

NEW WESTMINSTER DENTIST GOES IN FOR 

FARMING 



Dr. P. D. McSweeii, a well-known dentist of New Westmin- 
ster, British Columbia, has purchased the 480-acre farm at 
Kamloops formerly owned by Bartlett Bros., one of whom 
was killed in action overseas. It is the purpose of the new 
owner to go in extensively for stock-raising and general 
farming. The deal was put through early in April, and J. 
Kipp, an experienced farm manager, has been placed in 
charge by Dr. McSween, who does not intend to relinquish 
his practice in the Royal City, at least for the present. 

The farm is said to be one of the finest in the Kamloops 
district, in the famed dry belt of the Pacific Province, and 
there is an adjoining property of some 1,200 acres which Dr. 
]\[cBweeii has leased for range purposes. 

Dr. McSween has stocked his new farm with seventy head 
of cattle, mostly Herefords, and his entire investment will 
run close to $50,000. The ranch itself cost about $20,000. 



Editorial Notes 



Convocation, R.C.D.S., Toronto, Friday, May Kith, 1919. 

Victoria Hospital, London, Ontario, has established a 
dental department. 

Two thousand dollars have been placed in the estimates for 
a school clinic in Victoria, B.C., for 1919. 

Ontario Dental Society meets April 28, 29, 30 and March 
1st. Only one address, the balance clinics. 

Tn the district of Quebec a dentist l)y the name of Guillett 
has been accused of selling liquor to soldiers in uniform. 

s^ 

Dr. Howe, of Boston, the introducer of tlie Howe method 
of treating root canals, will be the only essayist at the coming 
Ontario meeting. ^ 

Dr. Xorman Guy, Dentist, Vancouver City, has resumed 
practice. His offices are located in the Orpheum Theatre 
Building, Granville street. 



150 DOMINION DENTAL JOURNAL 

The regular annual meeting of the Board of Directors of 
the Eoyal College of Dental Surgeons of Ontario will be held 
in Toronto the second week in May. 



A dental clinic will be established in connection with the 
Public schools of Owen Sound. 

Dr. Marshall, who is one of the trustees, has brought the 
matter to the attention of the board, and it is likely that this 
will be done forthwith. 



H. Irvin Mahoney, writing in the British Dental Journal, 
says in reference to dental education that the present system 
of training dentists at dental hospitals taught by honorary 
jjart-time officers with the assistance of comparatively inexpe- 
perienced whole-time and inadequately paid house surgeons, 
makes for inefficiency. 

Under a state dental service there would be facilities for 
the training of students in the large clinics, and much of the 
work could be carried out by them under the supervision of 
adequately-trained clinical demonstrators. In any case, the 
competition of state clinics would denude the dental hospitals 
of their patients, and I suggest that the situation be faced 
boldly by the inclusion in a state dental service scheme of 
proposals for efficient training schools. 



Review 



Roentgen Technic, {Diagnostic). By Norman C. Prince, M.D. 

With Seventy-one Original Illustrations. Second Edition. 

St. Louis, C. V. Mosby Company, 1918. 
This book has been published for the general practitioner 
of medicine. There is very little of particular interest to the 
dentist in it. The methods of taking X-rays in this book 
would not be very satisfactory for a dental practitioner, be- 
cause the patients are undressed and laid upon a table for ex- 
amination. It is a very excellent book to show the full 
technic of general X-ray photography. 

The Canadian agents are McAinsh & Co., Cor. Yonge and 
College Sts., Toronto. 



MEMORIALS. 151 

THE JOHN R. CALLAHAN MEMORIAL 



At the December, 1918, nieeting ot* the Ohio State Dental 
Society, a resolution was adopted to perpetuate the memory 
of the late John E. CaUahan in recognition of his contributions 
to the science and art of dentistry and his unselfish devotion 
to its advancement throughout the many years of liis profes- 
sional life. 

The committee to which this memorial was referred has 
decided on the following as the most appropriate, and worthy 
of the aipproval of the profession: 

1st— A Bronze Memorial to be placed in the Cincinnati 
General Hospital grounds. 

2nd— A Callahan Memorial Research Fund, the income 
from which to be awarded from time to time to the person 
making the best contribution to the science and art of root 
canal problems. The fund and award to be under the direction 
of a conmiittee perpetuated by the Ohio State Dental Society. 
The prize to be known as The John R. Callahan Award. 

The sum necessary in the minds of the committee to carry 
out the memorial in its two phases should approximate $8,000, 
an amount that should speedily be raised in these times when 
the spirit of giving is universal. 

Subscriptions to this fund by individuals or societies will 
be duly credited, and should be forwarded to the secretary- 
treasurer of the fund. 

T. Irving AVay, Chairman, 

52 Groton Building, Cincijinati. 
Henry E. Germann, Secy.-Treas., 

719 Gwynne Building, Cincinnati. 
L. L. Barber, Toledo. 
Weston A. Price, Cleveland. 
L. E. Custer, Dayton. 
Edward C. Mills, Columbus. 

Connfiitfpp. 



MEMORIAL TO THE FALLEN IN THE WAR 
(UNIVERSITY OF TORONTO) 



The Sub-Committee on Physical Memorial recommends as 
a memorial a tower with archway and hall connecting arclii- 
tecturally Hart House with the east wing of the main build- 
ing, together with a chime of bells. 



152 DOMINION DENTAL JOURNAL 

Your Committee also recommends that an annual Com- 
memoration Day be established, when at a religious service^ 
the University should commemorate the war service of its 
sons and daughters, and the ideal for which they fought and 
died, to the end that their courage, faith, and constancy may 
be an abiding inspiration. 



DENTAL OPERATIONS 



Performed by Officers of The Canadian Army Dental Corps^ 

In England and France from October 1st to December 

'^Ist, 1918, and Also Showing the Grand Total of 

Work Completed Since July Ibth, 1915. 



Total Operations 
Reported to 


Fill- 
ing's. 


Treat- 
ments. 


Den- 
tures. 


Prophy- 
laxis. 


Extrac- 
tions. 


Devital- 
izing. 


Totals. 


Sept. 30th, 1918 ... 

October, 1918 

Novemiber, 1918 ... 
Decemiber, 1918 . . . 


. 844,096 
39,186 

. 30,775 
19.708 


327,353 

11.299 
9,607 
7,665 


152.264 
5,377 
4,299 
2,603 


159,784 

11.714 

9,597 

6,015 


498,423 

12,734 

9,269 

5,687 


81,369 
2,924 
2,141 
1,553 


2.063,289 
83,234 
65,688 
43.231 


Grand Totals . . . 


. 933,765 


355,924 


164,543 


187.110 


526,113 


87,987 


2.255,442 



J. ALEX. ARMSTKONG, CoL, 

Director of Dental Services 

O. E. F. of C. 

SPLENDID PRACTICE FOR SALE -Owing to other in- 
terests, I wish to sell my $6,000 Dental practice and fine 
home in one of the best agricultural towns in Manitoba. 
No opposition and no other dentist within fifty miles. For 
anyone who likes the country, or any young man just start- 
ing, this is a splendid opportunity. For particulars write 
A. E. Webster, R.C.D.S., Toronto'. 



Dominion 

Dental Journal 

Vol. XXXL TORONTO, MAY 15, 1919. Xo. 5. 

Original Communications 

« ■ 

ORAL HYGIENE 



C. H. Walsh, D.D.S., Winnipeg. 

(Read before Winnipeg Dental Society, March. 1919.) 

Aly subject to-night, while possibly not one of the most 
popular, is one of the most necessary if we are going to con- 
serve our general health and comfort. 

Mouth hygiene should include all measures employed 
by each individual for himself or herself to keep the mouth 
in the healthiest possible condition, and everyone should 
know what rules should be followed and what results may 
be expected. 

This leads us to a great educational problem; that is, the 
s])reading of knowledge of such a character that many serious 
diseases that result from mouth conditions may be prevented, 
and unless you have looked carefully into the subject it is 
astonishing how many of the diseases from \vhich we poor 
humane suffer come under the heading of " preventable. '' 

The more common diseases of the mouth, such as the decay 
of the teeth and the inflannnation of the gums and other 
tissues, may be largely controlled by the simple process of 
cleaning at regular intervals. 

Let us look first at the larger educational piobleni. 

r am sorry to say that in Canada as yet we have not 
attacked the problem of public education along the lines of 
oral hygiene with anything like the vigour with which our 
cousins across the border have done. 

The most noteworthy expression of this effort for public 
education is expressed by the Forsyth Memorial, in the city 
of Boston. 

A fund of two million dollars has been devoted to the 
erection and endowment of a splendid building for the purpose 



154 DOMINION DENTAL JOURNAL 

of caring for the mouths of the school children of the families 
of Boston, and for the larger purpose of educating the general 
public to the value of clean and healthy mouths. 

The Forsyth Memorial is not to be considered a charitable 
institution, but an educational one. An institution which will 
not only prove the value of the proper care of the mouth by 
demonstration and clinical records, but will also be so directed 
and used as to eventually place the responsibility for the 
guardianship of the healthy body and the healthy mouth, 
especially of the children, upon the state and nation. The 
position is taken that it is quite as much the duty of the state 
to look after the health of children as it is to look after their 
education. 

It is a lamentable fact that governments spend enormous 
sums of money in studying problems involved in the preser- 
vation of the health of our domestic animals, in the raising of 
crops, etc., because these are economic problems, but relatively 
speaking, little effort has been made to study and prevent, or 
to teach the people how to prevent, the diseases which carry off* 
many thousands of our population every year. As one of our 
prominent writers has expressed it: "We have not as yet 
realized that the greater economy lies in the growth and 
proper development of healthy individuals; that each child 
who is strong and well soon becomes one of the units in the 
development of those things toward which the human race is 
set; he is a producer, while the child who is weak and sickly 
becomes more and more one of the world ^s cares, a consumer 
who does not produce, and often one who may become a 
destroyer by entering the class of criminals and mental 
defectives." 

It is now a well authenticated fact that many diseases of 
the digestive tract, as well as pulmonary troubles, are induced 
by the passage thereto of thousands of virulent germs from 
the mouth, and more than ever before is being discussed the 
question of general infection from local foci in the mouth. 
Truly is the mouth the gateway of the body, and if we are to 
have a clean body we must see to it that the entrance is all 
that it should be. 

The human mouth is an excellent incubator to propagate 
disease germs, or bacteria, of which we have quite a creditable 
collection at almost any time. The temperature is just about 
right, moisture, and all the air required, along organic matter 
as a medium for growth made up of decomposing particles 



ORIGINAL COMMUNICATIONS 155 

of food, mucous secretions, deposits from the saliva, etc., and 
more than likely a certain amount of pus from inflamed and 
diseased t>ums and roots of teeth, the whole environment 
forming" simply an ideal hothouse for the growth and propa- 
gation of that dangerous little rascal with whom wc have 
become familiar under the general term of "germ." 

The absolute necessity of keeping the mouth healthy and 
in an aseptic condition is brought home to us when we realize 
that in the mouth of a nonnally healthy individual we may at 
any time find bacteria of some of the most virulent types of 
diseases, such as pneumonia, tuberculosis^ diphtheria, scarlet 
fever, etc. 

I do not think that I need enlarge on this point, but believe 
that I have brought a sufficient number of facts to your notice 
to justify the statement that many systemic troubles are 
caused by diseased or infectious conditions of the mouth, many 
more, in fact, than is realized by the general public. 

Allow me to quote the words of a man who is perhaps 
better known than any other in the medical world. I refer to 
Dr. William Osier, who said at a recent gathering: ''You 
have one gospel to preach, and you have to preach it early and 
late, in season and out of season; it is the gospel of cleanliness 
of the mouth, cleanliness of the throat, and cleanliness of the 
teeth. These three things must be our text throughout life." 
T should like also to quote 3^ou briefly the w^ords of Dr. Charles 
TT. Mayo, the eminent surgeon, of Rochester, Minn., who said 
that it was evident that the next great step in medical progress 
in the line of preventive medicine should be made by dentists, 
and he then asked the question, ''Will they do it?" x\nd most 
assuredly the dental profession is rising to the task as never 
before. Research work is being pushed continually, and the 
oral hygiene movement is sweeping over the land like a vast 
wave, so that it will not be long before the people— and parti- 
cularly the children of every village and hamlet in Canada — 
will be properly instructed in the most important branch of 
preventive medicine. 

You will notice that the keynote of both of the appeals of 
Dr. Osier and Dr. Mayo is Prevention. 

It is a great thing to be able to repair the ravages of 
disease, whether it be in the mouth or elsewhere, but it is a 
thousand times greater thing to be able to prevent the ravages, 
and to convince you that the great bulk of our troubles are 
preventable, I would say that statistics show that only 4 per 



156 DOMINION DENTAL JOURNAL 

cent, of the annual death rate is due to old age, 4 per cent, to 
accident, and 92 jjer cent, to preventable diseases. This is 
an appalling indictment. Never was there a greater truism 
than " Whatsoever a man soweth, that shall he also reap," and 
equally is it true that if we sow germs we shall reap corruption, 
and also if we sow prevention we shall reap a harvest of good 
health and happiness. 

In 1914 there was a great Medical Congress held in London, 
England, and that Congress devoted one-half of its entire time 
to preventive medicine, a radically dilferent idea to that of a 
few years ago, when it would have been a few hours possibly 
to preventive and many days to medical and surgical pro- 
cedure. 

Dr. Neff, of New York City, a recognized authority on the 
treatment of tuberculosis, in addressing an audience of physi- 
cians not so loiig ago said: "I defy the most skilled physician 
to either help or cure a tubercular patient that has decayed 
teeth in the mouth." 

During the last few years there has been considerable 
effort made to determine the efficiency or inefficiency of our 
school children as it is atTected by the condition of the mouth, 
and from the records made and tabulated, much to the surprise 
of those interested, it was learned that the cause of absence 
from school due to abnormal conditions of the mouth and 
teeth averaged 47 per cent., and an examination of the mouths 
of the school children reveals the fact that 90 per cent, require 
dental attention, and that failures in final examinations in the 
schools show that 50 per cent, were due to trouble with the 
mouth and teeth. It was also demonstrated that after these 
same pupils received ])roper dental attention their efficiency 
improved immediately from 60 to 90 per cent. 

Another important point which we, as tax ])ayers, have 
apparently overlooked, is the fact that those children and 
students who fail, are classified as repeaters, and have to be 
re-educated the following term at an enormous expense to 
the community, for instance, it costs the taxpayers of a small 
city like Poughkeepsie, population thirty thousand, sixteen 
thousand dollars a vear, and Albanv, a citv of one hundred 
thousand, forty-five thousand dollars a year to carry its re- 
peaters. So we can readily see that from an economic stand- 
point it is bad business to neglect the hygiene of our mouths. 

It has of late been borne in upon us more than ever, that 
the children are the nation's hope, and it is upon the efficiency 



ORIGINAL COMMUNICATIONS 157 

of these miniature citizens that the future independence and 
prosperity of our beloved country depends. 

When the scholar and investigatoi*, Leuweiihook, of Hol- 
land, announced, in 1578, that the air, and all material thiiii^s 
were filled with minute living* organisms, he astonished the 
world. But one day, while walking with some intimate friends, 
he chanced to meet a tramp or a vagrant, and upon passing 
this ill-kept specimen of humanity, remarked that ''There are 
more minute living things in that beggar's mouth than there 
are people in all Holland," his companions questioned his 
sanity. Time has demonstrated that the famous Dutchman 
was correct, and generations since his time have learned the 
purpose and destiny of these micro-organisms. 

There have arisen from his discoveries more debate and 
more investigation than from any physiological disclosure in 
history. He introduced to us a new phase of life, and made 
us acquainted with the value of an animate creation whose 
numbers— like the sands of the sea or leaves of the forest — 
are beyond the capacit}^ of our minds to comprehend. 

T am sure many of you have read with pleasure those 
charming letters of that famous old English wit. Lord Ches- 
terfield, written to his son, who was sent (piite early in life to 
"Westminster school, where he formed careless habits in dress 
and personal appearance, much to the anxiety of his father, 
who frequently admonished him. Tn one of these letters he 
said to the boy, "The best authors are always the severest 
critics of their own works; they revise, cori'ect, file and polish 
them, till they think they have brought them to perfection. 
Considering you as my work, I do not look upon myself as a 
bad author, and am therefore a severe critic. T examine nar- 
rowly into the least inaccuracy or inelegancy in order to cor- 
rect, not expose them, so that the work may be jDei-fect at last." 

More than once in these letters do we find the father ex- 
pressing his anxiety in regard to his son's teeth, and in 1747 
he writes: "Do you take care to keep your teeth very clean 
by washing them constanth' every morning and after ever; 
meal? This is very necessary both to preserve your teeth a 
great while and to save you a great deal of pain. Mine have 
plagued me long and are now falling out, merely for want of 
care when I was your age. Do you dress well, and not too 
well? Do you consider your air and manner of presenting 
yourself enough, and not too much, neither negligent nor stiff ? 
All these things deserve a degree of care, a second rate atten- 



158 DOMINION DENTAL JOURNAL 

tion, they give an additional lustre to real merit. My Lord 
Bacon says that a pleasing figure is a perpetual letter of re- 
commendation. It is certainly an agreeable forerunner of 
merit, and smoothes the way for it." In 1749 he again wrote 
the boy, ''Pray send for the best operator for the teeth at 
Turin, where I suppose there is one famous one, and let him 
put yours in perfect order, and then take care to keep them so, 
afterwards, yourself. You had very good teeth, and I hope 
they are still so, but even those who have bad ones should 
keep them clean, for a dirty mouth is, in my mind, ill man- 
ners." In 1751 the father admonishes his son yet again: ''I 
hope you take infinite care of your teeth, the consequences of 
neglecting the mouth are serious not only to one's self, but 
to others." 

I appreciate your kind attention to the subject of the even- 
ing, which I know only too well to be none too popular, but 
may 1 express the hope we may each for himself say, I live in 
a great measure— 

For the wrongs that need resistance, 

For the cause that lacks assistance, 

For the future in the distance, 

And the good that I can do. 



ORIGINAL COMMUNICATIONS 159 

DEMONSTRATIONS AT THE RECENT MEETING OF 
THE ONTARIO DENTAL SOCIETY 



In the department of operative dentistry, demonstrations 
were given on sterilizers, sterilization, care of instruments, 
X-ray machines, taking X-ray pictures, developing X-ray pic- 
tures, exchision of moisture for aseptic operating, ])ressure 
ampsthesia, opening into the pulp chamber, removal and en- 
larging of root canals, filling the apical third of the root canal 
and filling the balance with gutta percha and oxchloride of 
zinc. 

EXCLUSION OF MOISTURE L\ ITS RELATIONSHIP 

TO ASEPSIS. 
M. Ct.airmont. 



1. ^lechanical procedure to secure cleanliness before ap 
plying dam. 

II. Mouth Spray— 

L 2 per cent, permanganate of potash. 

2. 5 per cent. H^Ol 
.3. I^ zinc chloride— 

Alcohol— 
Winter Green— 
Water, cold— 

III. Removal of gelatinous material adhering to the sur- 
faces and necks of teeth. 

IV. Disinfect area, using IPO-, followed by thymol alcohol. 

V. Apply rubber dam. 

VI. Disinfect field of operation. 
N.B. — r%mo^ Alcohol — 

1 gr. of th}Tnol crystals dissolved in 1 H. oz. of 70 per cent. 
alcohol. 
PRESSURE ANAESTHESIA FOR RE:\[0VAL OF PULP. 

Mr. J. Lapp. 

'' i 

1. Methods— ^ 

(a) High pressure. 

(b) Low pressure. 

2. Necessity of applying rubber dam when using pressure 
an-psthesia. 



160 DOMIXIOX DENTAL JOURNAL 

3. Guard against destruction of tissue beyond apex due to 

(a) Irritation from drugs. 

(b) Infection. 

(c) Mechanical. 

4. Drugs — 

(a) Cocaine when pulp is not infected. 

(b) Cocaine and phenol when infection is suspected. 

(c) Phenol when pulp is known to be infected. 

5. I ufrrfio)i — Remove all decay and disinfect all remaining 
dentine. 

TYPES OF STERILIZERS. 

By Hu gill. 



THREE METHODS. 

7. Bij (jlas(\s — Fov purpose of disinfecting operating-room 
and office. 

1. Burn sulphur in sealed-uyj rooms; disinfect by forming 
sulphur dioxide gas. 

2. Summon health authorities to sterilize office by means 
of large formaldelyde gas generator. 

8. Most practical for dental jjractitioner is to purchase at 
drug store at cost of about one dollar a small paraform lamp 
which can be left in office to burn over night — forms formalde- 
hyde gas. 

//. Drif Heat — l^sed in connection with most modern dres- 
sing sterilizers, in conjunction with live steam — not a practical 
method in itself alone for dental sterilization on length of 
time necessary. 

///. Steam and BoUhifi^^e^i method of all sterilizing 
Avhere applicable. 

Construction of Sterilizers— All sterilizers can be made 
(are on the market) to be heated by: 1. Electricity (cleanest, 
quickest). 2. Gas. 3. Gasoline and coal oil. 4. Wood alcohol. 

Note.— Boiling instruments in ordinary pan is poor 
method. Instruments are generally in contact with base of 
pan, which is of higher temperature than water itself, and 
temper is drawn from fine working points of instruments. 

\Valls o^ Sterilizer composed of rolled copper, nickel plated 
on outside, heavily tinned on inside. 

rnstrumeiit Compartment or base of electric sterilizer 
fitted with: Indicating dial, three heats, high, medium, low, 
and oft". Water faucet for withdrawing water. Safety auto- 
matic cut-off disconnects current when it boils dry, preventing 



ORIGIXAL C()MML;XICAT](3XS 161 

burning out of storiiizer iiiid also draw in^' of temper of instru- 
ments. Lever on end of base to raise cover and tia> on inside 
of sterilizer oontainini>- the instruments, a\()idin<>- insertin«: 
hands in hot water to remove instruments. 

I)ressini>- (compartment— Doubk' walk'd with (|uarter-inch 
oi' more space between walls through which steam circulates, 
l.ever at one end of sterilizer to control hole at top of com- 
partment, accordint>- to way contents are heated, by dry aii* or 
circulating- steam; coiitents are first heated. by dry air (about 
tifteen minutes) to l)i-in,i>- to a temi)eratui-e so that when steaui 
is allowed to entei- by lexer control mentioned the steam will 
not condense and dampen the dressini»- materials. Steam 
enters top of compartment and passes out at bottom, causing 
steam to circulate through contents. 

Travs in Compartment for Placing of Dressings. 
Water Tanks — Vov sterile water, composed of same material 
as base, and compartment fitted with water faucet for drawing 
off' water. Fitted with thermometer. 

Note. — 'i'hese units are set u]) in different combinations. 
May be had in : 

Base for sterilizing instruments only. 

Base and dressing com})artment. 

Base, dresising compartment and water tank. 

Water tank on separate stand. 

Base, two dressing com])artments, two water tanks — one 
for hot sterile watei* and one for cold sterile water. 

Stands made of lieavy tubular steel, with foui- heavy coats 
of enamel, can be purchased for any of above combinations. 

AdLER SxERIfJZER. 

Made purposeh' to suit dentists' needs; especicdly designed 
for root canal work. 

(.^om])osed of three compartments, resting on stand. 

Two compartments (identically the same), each to hold a 
set of instruments. Each compartment contains six trays for 
root canal insitruments. Compartments are detachal)le from 
stand for purpose of carrying into operation room before 
opening. Third compartment is for sterilizing of dressings. 
Construction same i)rinciple as previously described dressing 
coin])artment. This ]>articnlar type stei'ilizes under ])ressure, 
fifteen pounds corres])onding to •_^')()' Fr. Fitted with safety 
appliances. 



162 DOMINION DENTAL JOURNAL 

X-RAY. 

F. D. Price and W, L. Sawyer. 



X Rays are produced in a high vacuum tube by negative 
electrons driven by a curient of 20,000 to 80,000 volts from 
the aluminum cathode against a target, the interference pi'o- 
duced by the target producing X Rays that go in all directions 
allowed by the plane of the target. The tube is usually 
inclosed by a substance, leaded glass or rubber, with an open- 
ing to allow the rays to pass out to the field to be radiographed. 

Three types of machines were shown that can take the 
commercial street current and step it up to a proper voltage 
to produce X Rays. The first shown and operated is the coil 
type that takes a direct current of 120 volts, passes it through 
a chemical interrupter that will start and stop the current 
several hundred times a second, this interruption being 
necessary to excite the induced current in the coil for produc- 
ing the X Rays. This induced current is alternating, having 
a strong impulse in one direction and weak in the other direc- 
tion. The weak impulse is cut out by a small valve tube, 
leaving a direct current to the tube. Another type showm 
was a tran'sformer type that passes an alternating current 
from the street through a transformer that steps it up to the 
voltage needed to produce X Rays, but delivering an alter- 
nating current. The machine contains also a synchronous 
motor which, revolving an harmony with the alternations, 
moves a disc with connections that pick all the positives from 
the transformer, carrying them out to one end of the tube, 
and all the negatives on the line to the other end of the tube, 
and so delivering to the tube a perfectly direct current, which 
is the ideal. The other machine contained the same trans- 
former in principle, and with no synchronous motor, thus 
delivering to the tube an alternating current which, it was 
claimed, was largely changed to a direct current by the resis- 
tance of the tube. 

Only gas tubes were shown, those in common use, the using 
of which always causes the vacuum in them to rise somewhat. 
This rise in vacuum was controlled by passing the negative 
current in very small amounts through asbestos in an arm 
of the tube, thus liberating small quantities of gas that correct 
the vacuum. In gas tubes the electrons are supplied from 
the gas in the tube. In another type — the Ooolidge tube— 
the vacuum is very high; the electrons are supplied in the tube 



ORIGINAL COMMUNICATIONS 163 

by a wire cathode beiiii*- heated to a hi^h deo:ree, and all 
regulating- is done by controllinu' the beat supplied to this 
wire cathode. 

Rays for dental work should be of ])r()i)er penetration to 
show in detail the parts radiographed. The penetration is 
found usually by finding the length of spark gap whose resis- 
tance is equal to the resistance in the tube, or, in common 
words, what parallel spark gap the tube will back up. For 
dental work this should be three and a-half to four and a-half 
inches and up to five and a-half inches where there is any 
inverse current from the machine. Below that the rays are 
too soft to penetrate all the tissues properly, and above that 
the tube is too hard, the rays j^enetrating all tissue too freely 
and operating too little contrast. Most machines have a meter 
to register the nwlamperes passing through the tube. The 
length of time of exposure is in proportion to the milamperes 
pas'sing and as the square of the distance from target to 
patient. A good working distance is fourteen to sixteen 
inches. The time must also depend upon the speed of the 
film used. 

Ordinarily the covered film is placed in the mouth on the 
lingual side of the part to be radiographed. AVith the lowers 
the film lies in about the same plane as the teeth, and the rays 
should be perpendicular to this plane. The tongue must be 
carefully depressed to get the film below the apices of the 
roots. A little angle of depression will help get root apices; 
a distal angle will also help to get third molars. The curva- 
ture of the tiaw in front Avill necessitate making enough 
ex])osures to get all desired parts in right relationship. Tlie 
curves of the palate offer more difficulty above. The film, 
following somewhat the slia|)e of the palate, is not in the same 
plane as the tooth. To find the correct direction for the rays, 
bisect the angle formed by the plane of the film and the plane 
of the tooth roots, and direct the rays at right angles to this 
bisection. It is apparent that the lingual and buccal of the 
u})per molars lie in different planes. The lingual roots should 
be considered by themselves and radiographed, as also the 
buccal roots by themselves, for correct diagnosis. The lingual 
roots will appear to pass into the antrim, and care must be 
taken to diagnose an abscess cavity where it lies over the 
antrim cavity. Mesial or distal molar roots are often shown 
lying over the lingual root, and are too indistinct. Exposures 
from the anterior or postenor angles will show the buccal 



164 DOMINION DENTAL JOURNAL 

roots separately. It is always difficult to get distinct radia- 
graplis O'f the upper second and third molars, esjjecially where 
the vault of the arch is low, because the rays must pass 
through the malar process, a thick, dense bone. This can be 
in part overcome by patience and making several radiographs 
from different angles. The mental foramen below must not 
be interpreted as an abscess of the second bicuspid nor the 
inferior dental canal as infection below the molars. 
Radiographs were made to show the technique. 

DEVELOPMENT OF AX X-RAY FILM. 

W. M. Johnson. 



Iiequ'u(^ments.— (1) Dark Room. A small room, from 
whicli all white light is shut out. In at you should have a 
sink, hot and cold water, and a small work table. A ruby light 
will serve you to see what you are doing' and will not damage 
your film. 

In the absence of a dark room a portable one may be 
obtained from any of the supply houses. 

(2) Three bowls or trays (of porcelain or enamel). 

(3) An eight-ounce graduate. 

(4) A thermometer. 

(5) A clock. 

(6) Several film holders (aluminum best). 

(7) A good developing isolution. 

(8) A good fixing solution. 

The X-Raij Film is composed of celluloid, on one side of 
which is an emulsion of silver bromide in collodion or gelatine. 

Technique of Developing.— You are now in your dark room. 
You have your ruby light turned on, your three trays in posi- 
tion, one containing the developer at a fenip>erature of from 
6D.to 70' F.; one water and the other fixing solution at temper- 
ature of 50 to 60° F. 

Open your film x^acket and attach the film holder to the film. 

immerse the film in the water to moisten the whole surface 
so that when it is placed in the developer there will be no air 
bulibles, and consequently no white s})ots. It requires from 
four to fi\(} minutes to develop after average exposure to 
the X-rays. 

Wash your film thoroughly to remove the develo])ing 
solution. Place it in the fixing solution. This dissolves out 
the silver salt, which has not been affected by the expoisurc 



ORIGIXAL COMMUNICATIONS 16S 

ill about fifteen minutes. AVasli your film tlioroucrhly and dry 
it. It is now ready for reading. 

CAUFj of dental INSTRILMEXTS. 

W. 0. (ioDNVlN. 



Cleaning. — 'llu' instruments are first washed with soap and 
water and scrubbed with a hand brush to remove all lonsc dirt. 
The more adhesive diit which remains is removed by l)uriiii.i;' 
on the lathe, usin^ a stilt* bristle brush and revolving at low 
speed. The spatula, which has become smeared with cemen^, 
is first scraped, then y)olishe(l by using the felt cone and 
[)umice. 

Files which are clogged up with soft metal, vulcanite, etc., 
are cleaned by brnshing with a steel brush, called a file card. 

After cleaning, the instruments are ready for the sterilizer. 

When it is desirable to lay the instruments away for a long 
period, and there is a tendency to rust, this can be prevented 
by smearing the instruments with vaseline or tallow, which 
protects the sui-faces of the steel not covered by the nickel 
plating. 

Cement slabs are best cared for ])y having the cement 
washed otf immediately after use. If this cannot be done, 
the slab and hardened cement are placed in hot water for ten 
minutes, which loosens the cement, after which it can 1>e easilv 
scraped off. 

It is, therefore, advisable to have a number of cement slabs 
and spatulas ready foi- use. It is especially important in the 
case of bone or ivory spatulas and instruments to remove the 
cement while fresh. Otherwise the cement must be removed 
by grinding or sandpapering, which (juickly wears the instru- 
ment down. 

Sharp instruments should be protected in handling by insert- 
ing the cutting end in a leather sleeve or cork or wrapping 
with cotton. The burs may be pre^jared for the sterilizer 
by wrapping from six to twelve in a piece of gauze. This 
prevents dulling by contact, which would be the case if a 
large number of burs were wrapped together. 

Sharpen-ing of Instruments. 

Cutting instruments should be kept sharp for the reason 
that sharp instruments cut faster, cleaner and with less pain 
when excavating a cavity or cutting dentine. 

ShaiT^ening of the in'struments is performed in three stei)s. 



166 DOiMlNIOX DENTAL JOURNAL 

The first, in which the greater bulk of metal is reduced by 
means of coarse revolving stones, such as emery and carbor- 
undum wheels. 

The principle on which the grinding operations work is 
that the abrasive cuts a series of scratches in the material 
operated on. The pores of the wheel are prevented from 
filling up with cuttings by making the matrix or binding 
material hcylding the cutting crystals soft enough so that it 
allows the crystals to fall away after performing duty for 
some time, thereby exposing a clean new surface, or the 
surface may be reduced by means of emery wheel dressers 
which, when held against the wheel, break off the crystals. 
The diamond, suitably mounted in a steel holder, is the best, 
but for ordinary use a Huntington dresser does very well. 
The steel points, revolving aga'inst the abrasive wheel, knocks 
olf the crystals exposed on the surface. It is evident, then, 
that an emery wheel can not only be trued up and resurfaced, 
but can be made to take different shapes. 

The instruments, after being ground, are then honed, using 
a coarse grain India oilstone first to reduce the edge almost 
to the desired keenness. Then the finishing is done on a 
hard, fine-grained Arkansas oilstone. The proper degree of 
edge is tested by trying on the thumbnail. If the edge bites 
in and does not slip the edge is keen. 

Overhoning, as well as improper methods or poor stones, 
causes feather edging. If this occurs, the edge is brought 
across the hone, making the edge dull again, and then the 
operation repeated. 

The instrument should not touch the hone except when 
cutting or honing toward the cutting edge of the instrument. 

The angle at which the instruments are sharpened is just 
as important as the keenness of the edge. Guessing at th'^ 
angle and sharpening by holding in the hand are not accurate. 
A holder such as illustrated holds the instrument at the pre- 
determined angle, making it possible for the assistant to 
perform the work as accurately as an experienced operator. 

The larger sizes of burs can be sharpened by means of 
oilstone slips, which are made in a variety of shapes. The 
stone is rubbed back and forth in the flutes of the bur, which 
quickly sharpens the cutting edges. 

( )il is used on hones for the purpose of holding in suspension 
the fine pieces of metal torn from the instrument in the process 
of sharpening. The oil containing the steel is wiped off. 



ORIGINAL COMMUNICATIONS 167 

leaving the surface ' clean and the pores free of foreign 

material. 

When operating- on root canals, the broach becomes charged 
with pieces of i)ulp or sei>tic material. This can be (juickly 
removed by stabbing- the broach through thin paper, which 
leaves the material behind. The paper and its septic material 
is put in the waste receptacle. 

( )PENING TXTO PULP CHAMBER AND REMOVAL OF 

PULPS. 
Mk. P>rownlee. 



1. Sterilization of all instruments and materials to be 
used in operation. 

2. Sterilization of field of operation. (Demonstrated in 
another clinic). 

3. Examination of X-ray picture. 

4. Open into pulp chamber, gaining direct access to root 
canals. 

5. With (triple X) fine ]jathfinder ascertain ap])r()ximate 
length of each canal, and bend broach to indicate length. 

6. Removal of pulp from canals large enough to accom- 
modate barbed broaches at once— triple X, fine, or larger. 

7. Technique for very fine canals : Use of disclosing 
solution (tincture of iodine, followed by oil of cloves) ; use 
of sulphuric acid paste and potassium sodium. 

8. Enlarge canal with canal files, using up and down 
motion, till Xo. 1 Kerr root caual plugger will pass within 
two millimeters of the apical foramen. 

9. Compare depth of canal enlared with pathfinder (step 5) 
and with X-ray picture. 

10. Insert diagnostic wires, with ends well concealed, seal 
in with cement or gutta percha. 

11. X-iray. (Demonstrated in another clinic). 

IlLLTXG THE OCCLUSAL TWO-THIRDS OF ROOT 

CANALS. 
H. D. Taylor. 



Methods. — ^. With small pieces of gutta percha, packed 
tightly into the canal. 

2. With oxychloride of zinc cement. 

(a) Inserting the chloride and oxide separately, and 
mixing them in the canal. 



168 DOMINION DENTAL JOURNAL 

(b) Mixing the cement on a o-lass slab and then insertiii.u' 
into the canal. 

Technique.— After the apical third has been filled, without 
removing- the rubber dam, a radiograph is taken, and if it 
shows that the apex is properly filled and the foramen s<^aled, 
then the rest of the canal may be filled innuediately. 

This may be done by several methods, but here we shall 
only deal with the two mentioned above. 

1. From the gutta percha cone, approximately the size 
of the root canal to be filled, cut ]neces about one or two milli- 
meters in length and heat these slightly on an annealins: tray 
over a spirit lamp with a very low flame. 

Select a root canal plugger that will not go quite to the 
apical filling. This will prevent the operator from forcing 
some of the filling already in through the apical foramen. 
Heat the tip of the plugger in the flame so that the gutta 
percha will adhere to it and carry the first piece into th(^ 
canal. Force it tightly to place so that it spreads laterally 
against the walls on all sides. 

As the canal becomes larger choose larger pieces of gutta 
percha and larger pluggers. Repeat this procedure until the 
canal is completely filled Avith a soilid mass of gutta percha 
to within one millimeter of the pulp chamber. Then seal 
with oxychloride of zinc cement. 

2. Filling the canal with oxychloride of zinc cement. 

(a) Mixing in the Canal. Fill the canal with chloride of 
zinc, and then insert a little oxide with a root canal plugger 
and mix with a fine broach. Keep adding the oxide a little 
at a time and mixing continually until it is of sufficient 
consistency to set. 

(b) Mix the oxychloride cement to a thin creamy consis- 
tency on a glass slab and carry it to the canal with a fine 
plugger, moistened with oil of cloves to prevent the cement 
from sticking. Tease the cement down one side of the canal, 
allowing the canal to fill up gradually from the bottom, thus 
driving out any air ahead of it. When the canal seems to be 
full, force the cement more compactly to place by using a 
piece of unvulcanized rubber and applying pressure with the 
finger or a round-ended instrument. 

If it is intended to put a post into the canal, it is advisable 
to insert into the cement before it sets a piece of gutta percha 
cone the size of the post to be used. The gutta percha can 
be easily removed before putting the post in place. This will 



ORIGINAL COMMUNICATIONS 169 

save botli time and troiibk for the operator, as the 
oxycli'loride of zinc is a very hard-settin<;' cement. 

This type of cement is used because it has been shown 
to be the only one that will resist the in,i>Tess of infection. 

Fli.LiX(} THE APK^AL THIRD OF ROOT CANAL. 
Messrs. Ross and (i if fin. 



The ohjecilrc pouii in root canal filling should be the 
sealing- of the apical foramen or foramina. The apical 
formen is the natural entrance to the canal, and through it 
infection will pass more readily than thi-ough the dentine. 
because the latter, though i)orous, is protected by the more 
or less homogeneous layer of cementum. Even though the 
canal be sterile and the tissues in the periapical region be 
healthy and non-infected at the time of filliug, one must guard 
against the daniger of an imperfectly-filled foramen becoming 
a lodging place for bacteria which may be carried to the apical 
region by the blood stream at some later date. Perhaps the 
most convincing proof we have of the need of [>erfectly filling 
the ai)ical foramen is the evidence given by Dr. A. 1). Black, 
who found that of fifteen hundred roots whose canals had 
been filled and at a later date radiographed, oii'Iy ten per 
cent, of those containing good fillings afterwards developed 
abscesses at the apices, while sixty-five per cent, of those 
containing poor fillings developed abscesses. 

Charac'teristics of the Ideal Filling. 

{a) Should be non-irritating to the soft tissues. 

{})) Should be insoluble in the tissue fluids. 

(c) Should not absoi'b the tissue fluids. 

(d) Should be capable of adaptation to the shape of the 
canal. 

(e) Should not contract. 

(/) Should be dense and homogeneous. 

The filJing' material which fulfills most of these require- 
ments, and therefore is the nearest approach to being the 
ideal material is gutta percha. 

The most successful method of fillinf/ the apical third of 
the canal known to the |)rofession to-day is that suggested by 
Dr. E. D. Coolidge, of Chicago. Briefly, this method may 
be said to consist of attaching to the i)oint of a root canal 
plugger of suitable size a small piece of a gutta percha cone, 
and then packing this piece of cone well into the apical third 



170 DOMINION DENTAL JOURNAL 

of the canal after this part of the canal has been moistened 
with a snitahlo Inbricant, which should be a solvent of g'utta 
percha. 

ESSENTIAI.S OF A SUCCESSFUL OPERATION BY ThIS MeTHOD. 

(a) From a therapeutic standpoint, the chief essential 

is the strict maintenance of asepsis throng-hont the operation. 

(/;) From a mechanical standpoint, the chief essentials are : 

1. Gain access to the apical portion of the canal. 

2. Have suitable instruments and materials. 

3. Know and follow a good techniciue. 

Asepsis.— AW instruments and materials used, field of 
operation, operator's hands, etc., should be as clean and sterile 
as it is possible by modern methods to have them. 

Access.— The canal must be enlarged sufficiently to allow 
a root canal ])lugger to pass close enough to the apical 
foramen to enable the operator to seal the foramen 
with the piece of gutta percha cone used. To be more 
definite, the point of the plugger should reach to within two 
millimeters of the apical foramen. By the use of suitable 
reamers, broaches, files and chemicals, most canals can be 
enlarged sufficiently so that they can be filled by Dr. C'oolidge's 
method. The operator wild find that an accurate knowledge 
of the internal anatomy of the tooth will be an invaluable 
aid to him when enlarging a root canal. In dealing with 
the fine, tortuous canals, which cannot thus be enlarged, the 
operator must choose^ some other methods of filling, or 
persuade the patient to have the tooth extracted. 

Instruments and Matkrtai.s. 

(a) Dam, rolls, clamps, etc., for excluding moisture. 

(h) Root canal pluggers, of all sizes available— both 
contra and straig'ht, smooth broaches, pliers, scissors, air 
syringe, alcohol or gas flame, broach dip, medicament holders, 
operating tray, etc. 

(c) Gutta percha points, cut into pieces from one to two 
millimetres long, absorbent points, alcohol, canal lubricants, 
e.g., chlorapercha, eucalyptol, resin and chloroform solution, 
oil of cajeput, eucopercha, etc. 

Technique. 

1. Place on bracket table the operating tray containing 

all the instruments to be used. Phice on medicament tray 

the drugs to be used and suitable holders containing the 

materials to be used in canal, e.g., pieces of giitta percha. 



ORIGIXAL COMMUNICATIONS 171 

absorbent cotton, absorbent points, e:te. It is nnderstood 
that all the instruments, materials, etc., have l)een previously 
sterilized. 

2. Adjust dam and sterilize field of operation. 

o. Remove dressing from canal. It is understood that 
at this sittin<i' the canal is sterile and is ready to receive 
a fillini:. 

4. Measure the len.u'th of the root canal. As it is \ery 
essential that the operator should know the length of the 
canal, the following' suggestions for ascertaining the length 
are offered : 

(a) At a previous sitting, after canal lias been enlarged, 
insert a wire in canal so that end of wire reaches to, or close 
to, apical foramen. Place a disitinguishing mark on part of 
wire exposed, e.g., a sharp bend or tile mark, and note its 
relation to a corresponding landmark placed on crown of 
tooth. Hiave tooth radiographed with wire in i)osition. 
Then, by measuring the wire and making any corrections 
necessary on account of shortening or lengthening due to 
position of tooth and film, or on account of wire not (juite 
reaching apical foramen, it is possible to get a fairly accurate 
measurement of the length of the canal. 

(b) Pass smooth broach into canal and note when it 
enters the constriction at apex or note when patient responds. 

{€} Note length of pulp tissue if same has been removed 
en masse. 

(d) Palpate end of root through gum— a method useful 
in a very few cases. 

AVhen length of canal has been ascertained, record this 
length carefully in the plugger points likely to be used and 
on any sonooth broaches or a'bsorbent points with which 
medicamemts are to be carried to apical part of canal. A 
good way of marking the length on broaches and root canal 
pluggers is to pass them through small discs of rubber dam, 
taken from the rubber dam punch. 

5. Select plugger of such a size that it will pass to within 
two millimeters of apical foramen, but no further. As the 
apical ^nds of most canals are funnel-shaped, there is little 
difficulty in selecting a plugger of correct size. By means 
of the recorded measurements the operator can tell how near 
the point of plugger has reached to the apical foramen. 

6. Select a small piece of gutta percha cone long enough 
to complete the distance from the end of the plugger point 



172 ORIGINAL COMMUNICATIONS 

to the apical foramen, and of the same diameter as the end 
of the root canal plugger selected. Attach piece of gutta 
percha to plnoger point by gently heating the latter. 

7. Wash canal with alcohol, and dry with absorbent points 
and air. 

8. Moisten apical part of canal with suitable lubricant. 
If there be a single foramen and canal be nearly round 
eucalyptol or oil of cajeput is indicated. If there be multiple 
foramina or canal be flat Callahan's resin and chloroform 
solution, chlorapercha or eucapercha are indicated in order 
named. 

9. Pass plugger carrying small p'leoe of gutta percha cone 
into canal and pack well. Since plugger has been selected so 
that it filled the canal at a point ^about two millimeters from 
apical foramen, the operator knows that he cannot force the 
filling material through the apex, and if he has made his 
measurements carefully and carried out the rest of the 
technique well, he should be reasonably sure that the apical 
foramen is filled comjjletely, but not to excess. 

10. Radiograph to check up the success of the operation. 



DEXTAL SOCIETIES. l/"3 

Dental Societies 

JOINT MEETING OF THE NATIONAL DENTAL 

ASSOCIATION WITH THE CANADIAN 

DENTAL ASSOCIATION HELD 

AUGUST 8, 1918 



President l^o^aii, of the National Dental Association, in 
calling the joint meeting to order, said: This evening, for the 
first time, in the general session we will have the (juestion of 
dentistry discussed. We have known for a long time the splen- 
did work the Canadian dentists have been doing, but we have 
not had the opportunity to see the results they have achieved. 
To-night, as a result of the kindness of their association, after 
having accepted our invitation to meet with us in annual ses- 
sion, they are with us, and we consider it a great honor to 
have them with us. 

1 introduce to you the president of the Canadian Dental 
Association, Dr. Joseph Nolin. Before retiring, I wish to 
thank you for the kindness you have extended to me as presi- 
dent of the National Dental Association and for your presence 
at these general sessions, and I wish to convey our apprecia- 
tion to Dr. Nolin, president of the Canadian Dental Associa- 
tion, for acce]:)ting our invitation and being one of us. (Ap- 
plause.) 

Dr. Nolin then took the chair, and said: Colonel Logan, 
Ladies and Gentlehien : Before taking office at this meeting, 
T wish to say that the ])leasant duty devolves upon me as 
president of the Canadian Dental Association to bid you a 
heai'ty welcome to this meeting. 

As I said the other night in responding to the address of 
welcome at the general meeting, there were some timid minds 
among the members of the Canadian Dental Association who 
had the fear that it might not be wise for the younger and 
weaker association to accept the very kind invitation of the 
National Dental Association to meet here. It was claimed that 
perhaps the greatness — 1 might almost say the hugeness and 
lavish hospitality of the elder sister might so influence and 
imbue the weaker organization as to wish to remain a part 
of the household and to lose heart and identity. T can say 
truthfully to Colonel Logan that our members no longer feel 
this timidity, and we all feel that since we have been in Chi- 
cago our stay here has been very pleasant and profitable. If 



174 DOMINION DENTAL JOURNAL 

1 may judge how easily our Canadian members have forgotten 
their furs and slid into their lighter garments and how they 
have accepted the excessive heat— I might even say a hot re- 
ception, and if I remind you that I have not heard a single 
complaint from any one or of any inclination to go home, I am 
sure 3^ou will be highly pleased. 

I wish to thank you, Colonel Logan, on behalf of the mem- 
bers of the Canadian Dental Association, for the courtesies 
you have extended to the Canadians, and personally in the 
name of our association I otfer you our most cordial thanks. 

The first paper on our program, ladies and gentlemen, is 
one by Colonel Guy Hume of the Canadian Dental Army 
Corps. 

Colonel Hume said: Mr. President and Gentlemen of both 
the National Dental Association and the Canadian Dental As- 
sociation: It is a great privilege to be here to-night. I would 
like to make an explanation, not in the way of an apology but 
in regard to the preparation for the work which is to be pre- 
sented to-night. You are all aware that the facilities for 
getting things in England are very meagre. I tried to get 
some slides with which to illustrate my work, and I asked the 
man who was in Charge of the X-ray department how long it 
would take me to get a supply from London, and he said at 
least a month; so these slides I am going to show you to-night 
were made by one of the orderlies in our department, a man 
who is an out-and-out amateur. 

The service we are called upon to give in a base hospital is 
that of general dentistry. We have at the hospital with which 
I am attached about two thousand beds or a little more. In 
connection with that we have seven D.A. beds. They are vol- 
untary beds, and then we have convalescent homes in connec- 
tion with that. Besides that, we have to give service to the 
soldiers who are in the immediate vicinity. 

Those of you who have not had any experience in seeing 
the conditions of the mouths will probably appreciate what 
we have to do for the soldiers, and so I am going to show you 
some slides in connection with that work. 

The general pathological conditions are, to say the least, 
not very good. Besides that work we are called upon to make 
certain replacements for the Canadian soldiers in England. 
Those soldiers who have received injuries in the mouth are 
sent to our hospital for replacement, as well as those in which 
vulcanite can be used. We also look after all fracture cases 
which come into the hospital. 

I At this point Col. Hume showed a number of slides, whicli we have been 
iiiiahlo to obtain, illus'trating the work done at the Orpington Ho.si>itai. — Bd.l. 



DENTAL SOCIETIES. 175 

(yol. Iliniic said in closiiit> : Your jjatieiits appreciate your 
services just in profjortion to tlie lesults you .i>-et for them, 
and function is tlie [)rincipjd point that tlie\- ai)preciate. I 
thank you. (Applause.) 

l)TS0U8STON OX THK REMARKS OF (M)l.. IILMK. 

Dr. Truman W. I^)rophy, (^hica^o: Mr. President, Mem- 
bers of the Canadian Dental Association, Ladies and (ientle- 
men: It hardly seems proper for me to enter uyion the dis- 
cussion of a paper presented by one who is fresh from the 
base hospitals, wiio has liad a lai'^e experience in treatinii 
these cases. 

T assure you, I lia\e been <4Teatly pleased with the exhi- 
bition Col. Hume has ^iven us. He has brou<>ht out and made 
very conspicuous certain ])rinciples tliat underlie the treat- 
ment of fractures of bone anywhei'e in his presentation of 
the causes of fractures of the mandible. It is a fact that has 
been long" known tliat wlienever a fracture occurs anywhere, 
especially in the mandible, we are fortunate if we can preserve 
the periosteum. I presume that in many of the cases of .gun- 
shot wounds the i)eriosteum is more or less preserved, al- 
though part of the bone is carried away, and if we can pre- 
serve this periosteum, it always carries along* with it the 
osteogenetic elements and new bone can be produced. 

When he placed on the screen that case of destruction of 
a portion of the mandible, I remarked to my friend upon the 
left here that the bone had regenerated. Here we had a wide 
space in the first picture which exhibited no bone. The next 
was a little shadow, and finally we found new bone. Yes, that 
is because he w^as ingenious enough to hold the fragments in 
their proj)er lelation and tlie teeth in the right occlusion, so 
that the bone would not drop backwards by the contraction of 
the muscles and have a malocclusion. 

One of the great secrets of success in treating fractures of 
the mandible, a bone the treatment of which is more dreaded 
by the general surgeon than the treatment of any other kind 
of fracture, is to preserve the occlusion of the teeth with the 
facilities at hand and prevent the contraction of the muscles 
in this particular region. Unless you have occlusion of the 
teeth when the bone is united you may have a pernument 
malocclusion. Col. Hume has held the bone so that the occlu- 
sion of the teeth remaining would be good, would be the same 
as it was prior to the fracture. The bone has been ke])t in 
place and the space left by the loss of bone has filled in with 



176 DOMINION DENTAL JOURNAL 

new bone. That will not always be the case, but very fre- 
quently it is the case. 

The appliances which he has employed are not based upon 
theoretical grounds, but they are the result of actual experi- 
ence and practice, therefore, they appeal to us as being of 
very great value and are reliable in the treatment of such 
conditions. 

Many years ago I learned that the first step to take in 
treating fractures was to re-establish normal occlusion. That 
lesson was taught by Professor Black many years ago, and 
his work along that line, together with the work of Dr. Thomas 
L. Gilmer of our city, has always been to me of great interest 
and of great value. Of course, we do not have in private prac- 
tice the great variety of fractures that the surgeon has in the 
treatment of gunshot wounds. I must have had a great many 
cases of gunshot wounds to treat. The first step is to secure 
the occlusion of the teeth that are left, and I was very glad 
to hear Col. Hume say that he was opposed to the practice 
which was sometimes resorted to bj' surgeons of extracting 
teeth following a fracture. The extraction of teeth follow- 
ing a fracture is little less than a calamity. The teeth should 
be retained. If the teeth are absolutely displaced ; if they are 
to be found, they should be cleaned and sterilized and put 
back, because they assist in securing the normal relations of 
the broken fragments. 

A great many years ago I remember the case of a man 
who sustained a fracture of the maxilla. He was working in 
a timber yard where great hooks and chains were being used 
for lifting heavy timbers on to flat cars. His job was to put 
the chains around the timber, and the man at the engine would 
lift the heavy timbers and place them on the car. While he 
was getting another stick of timber ready to hook, the man 
at the engine started the engine and lifted this man from his 
feet and the hook caught him so as to completely separate 
the entire face to his eyes. The bone was seriously fractured, 
parts of it being carried away. Some of the teeth were loose 
and others he had with him when he came to my office. In 
those days patients came to the office more frequently than 
they do now following such injuries. I sterilized the teeth 
he brought with him, opened the canals at once, cleansed them, 
filled the roots, and put the teeth back into place, and these 
teeth became firm and served the purpose for which they were 
intended for many years. It is important to do this. I can- 



DENTAL SOCIETIES. 177 

not see any reason why a surgeon should extract teeth foUovv- 
ing a fracture, whether from a gunshot wound or whatnot, 
provided he can get them and put them in where they belong. 
It would be better to put them in and do the root filling later. 
There is no occasion for extracting such teeth, and that is 
where the dental surgeon's services are of great value in car- 
ing for the wounded. Me has had a very large experience in 
the management of teeth and knows better what to do than 
one whose experience has been limited in this work as is the 
exf)erience of many surgeons frequently. 

I do not think I should encroach any further on your time 
in discussing the presentation of these pictures any more than 
to simply say that they are the real things. We have had an 
exhibition here to-night of matters that are living matters, 
and it is a kind of service that will be of great benefit to the 
soldier to the end of life. 

As to the little api)liances for holding the jaw in place 
that have been exhibited, 1 will say that my friend from Paris 
who is with us to-night (Professor Villin), exhibited to me 
yesterday a beautiful appliance of a lever in a slot so as to 
hold fragments where they belong and preserve the occlusion 
of the teeth on that side. We find that Professor Villin and 
Col. Hume have brought to us material of great value. The 
war has developed a kind of surgery that the world has never 
before known. Oral surgery, with ])rosthetic appliances, has 
really been a revelation not only to the general surgeon but 
to the man himself who has invented these things. He has 
achieved far more than he has exhibited or anticipated, and 
all this adds to the comfort and satisfaction of the poor sol- 
dier who has been injured. (Applause.) 

President Xolin, in introducing the next speaker. Profes- 
sor Villain, said: Three or four months ago, when a few mem- 
bers of the Canadian Dental Association met in Pittsburgli, 
it was suggested that at the next meeting of our association 
it would be an inspiring thing to have from Europe men who 
have had experience at the front in the treatment of wounds 
of the face and jaws. The first name suggested by your 
liumble servant was that of a man who had been dean of a 
dental school in Paris, studying and working and teaching 
when the war began. Happening to be a bilinguist (those 
who live in my country know what that means), 1 read s-ome 
of the French dental journals, and curiously enough 1 saw in 
them something- 1 had never seen on this side of the ocean. 



178 DOMIXIOX DENTAL JOURNAL 

and the name that was repeated at the end of every important 
article on restorative or reconstructive procedures since the 
beginning of war was the name of a man whom T am going 
to call upon this evening to address you and ask liim to tell 
you what the French military dentists have been doing and 
are doing— Professor Villain of the Paris Dental School and 
military dentist. (Applause.) 

Professor Villain then read a paper on "Surgery of the 
Face and Jaws," with the presentation of numerous charts 
and illustrations. 

DISCUSSION. 

Dr. G. E. Meyer, Chicago: I can hardly permit this pa])er 
to pass without saying a word on it because of the handicap 
under which Professor Villain has been placed here. I can 
assure you, Mr. President and gentlemen, that I am here to 
vouch for all the work that President Nolin has said Dr. Villain 
has accomplished. After serving about six months in the 
British Army I had peniiission to go with the general staff 
on a tour of inspection of some of the French hospitals and 
British casualty clearing stations. We were very interested, 
of course, in all surgery, and in the first place we were allowed 
to see the dental school in Paris and the work done there un- 
der the direction of Dr. Villain. Our president has just said 
that he hopes this literature would be published and available 
to us in this country, so that we would not have to go back to 
the beginning where they had to start, and I want to assure 
you that through the work of Dr. Villain and a few of his other 
associates oral surgery has been very well established at the 
present time in the hospitals over there. We have arranged 
to place our oral surgeons or dental oral surgeons at the 
front line where they can assist the wounded at the beirinning, 
and I want to say in this connection that this Avas a great 
handicap that Dr. Villain and Col. Hume had to contend with, 
that they did not get their patients until from four to three 
months after the men were wounded, and the reason for this 
was that we were thrown into the war, so that no one knew 
where he was at, so to speak, the French dentists fighting with 
the rest of the men, and it was some months before we were 
able to get dentists and the means for them to carry on their 
own profession in caring for this type of wounds. It was im])OS- 
sible at that time to have dental surgeons up at the front be- 
cause they had not space. It took all the space for ammuni- 
tions, for quartermasters, places for the officers and troops. 



DENTAL SOCIETIES. 179 

and it took days to ^et the wounded men l)ack at the hospital, 
so that the only thin.^- (h)ne for a wounded man \va> t^ ii'IkUm- 
first aid work at the time Dr. \"illain started his work. 

Dr. Villain for the first year and a lialf worked at h'ast 
('i,i>hteen hours a day, and he had to demonstrate to the sur- 
geons of his (lovernment that the dentist had an impoi-fant 
part to play in tiiis wai', and ho showed this \ei\ ch^ai'lN hy 
working until 1-, 1, 3 and 4 o'ch)ek in the moriiinu-. lie 
(k^monstrated to the French (xovernment that soldiers going 
ui) to the front without any teeth were unabU' to ehew, and 
after being up in the front line of trenches three or four weeks 
they were sent back to the hospital to recu])erate. He was 
abh' to demonstrate to the French Government that by ex- 
tracting decayed and infected teeth and replacing artificial 
dentures, tlie men were as good as any other men in the front 
line of trendies. So tiirough his splendid work lie wa> able 
finally to get the French (Jovenmient to allow him si.x francs 
(about a dollar and twenty cents) as a maxinmm fee for re- 
constructing a num, that is, extracting teeth, placing a full 
upper and lower denture, and placing him back into the ser 
vice. A lesser operation recpiired a lesser fee. Think of it. 

AVhen I was in Dr. Villain's hospital 1 saw thousands and 
thousands of models on the wall, i saw dozens of opei'ators 
working on these pitiful, horribly injured men with tiieir faces 
completely torn away, and dozens and dozens of other men 
making plates and extracting teeth, getting these men ready 
for the front line of trenches. I only bring out tlu*><' points 
to give you an idea of the work that this man had to go through 
in order to get where they are at the present time, and thus 
enable us to bring our relations close to the surgeon and ])ut 
us where we are at the present time. 

He spoke of the reconstruction of faces, especially jaws, 
where the eyes have been torn away and that part of the face 
where the nose had been destroyed. He showed one case, for 
instance, of a man* standing possibly two rods away from me, 
and said, ''How do you like the looks of that mauT' 1 said, 
"What is the niattei- with himf And he called the man over, 
and when he came over he removed his eye, which was attached 
to an appliance attached to a splint, and then he took off his 
nose, and 1 was wonderfully surprised at the things he was 
accomplishing. 

Tt is not so easy to place these splints when you hav(» had 
the op}>ortunity, but look over in tlie school of our Army 



18U DOMINION DENTAL JOURNAL 

where they have demonstrated all of these splints. It is not 
so easy to place them onto the soldiers, as Col. Hume has 
told you, because it is seldom we find an English Tommy with 
teeth to place them on. If he has two or three teeth when he 
goes into the trenches, after he is shot up he comes back with 
one or two teeth, then you are up against it so far as placing 
this sort of appliance, and you have to resort to some other 
sort of scheme for each individual case. 

The hour is late, and I will not attempt to go any further 
except I want to thank Dr. Villain and Col. Hume for their 
excellent papers this evening. But I want to impress upon 
you the great handicap that Dr. Villain has had put upon him 
in trying to show his wonderful work there. I thank you. 
(Applause.) 

Dr. Truman W. Brophy, Chicago: I desire to express my 
appreciation to Dr. Villain, who has come from such a long dis- 
tance to be with us here to-day to present what he has this even- 
ing. I think those of us who are interested in this work keenly 
appreciate the wonderful achievements of Dr. Villain, as well 
as others if they were here to see what he has put before us 
in the way of charts and models that are used for purposes 
of reconstruction. I am sure all of us realize the very great 
value of the lessons that have been taught us this evening. 

Dr. Villain is not at al la stranger to me. For eighteen 
years, at least, I have worked with him in the International 
Dental Federation, which has met in almost all the capitals 
of Europe, and also in America from time to time. I have 
known him as a skilled practitioner, as a man possessing the 
highest degree of ingenuity in the construction of his appar- 
atus, and I have known him as a friend, and I want to assure 
him that his coming to Chicago has been fraught with great 
benefits to the dental profession. Whenever he comes here 
he will find that he will always meet with a most cordial re- 
ception, and when he goes back to his field of work he will 
carry with him our best wishes for a safe return and for fur- 
ther successes in his work. (Applause.) 

Dr. William E. Cummer, Toronto, Ontario, Canada: After 
the brilliant surgical and plastic work presented to us this 
evening by Col. Hume and Dr. Villain, I fear that any eifort 
on my part will be overshadowed by the work of such splendid 
men as we have listened to; men who have giveii up every- 
thing and have done wonderful work for humanity at the 
front. 



DENTAL SOCIETIES. 181 

1 would like to add my words of praise and thanks to those 
of the other speakers for the results these men have obtained 
considerin^ij^ the great difficulties under which they have had 
to labor. 

Tt has been my f)ai-ticular privilege to see Dr. Villin's 
models and cliarts, and I can assure vou that the charts and 
pictures he has shown to-night do not begin to give you an 
adecjuate idea of the wonderful work he has done and is doing. 

Dr. Cummer then f)resented an illustrated paper entitled 
** Partial Dentures.'' 

At the conclusion of Dr. Cummer's paper, President Xolin 
said: In the name of the Canadian Dental Association, I 
wish to offer our hearty thanks to the gentlemen who have 
honored us with their presence and who have given us such 
an entertaining and instructive evening. Particularly to Col. 
Hume, who left England to cross the sea and give his Cana- 
dian confreres and members of the National Dental Associ- 
ation the results of his work and experience over there, do 
we owe our sincere thanks. As to our friend from France, 
Dr Villain, who was told to leave France within forty-eight 
hours to reach Chicago in time for this meeting, words are 
inadequate to express our thanks to him, and to Mr. Godard, 
the French Minister, who, when asked to send a representa- 
tive from France, took the trouble to send a cablegram to his 
Government with that end in view ,and they sent Dr. \^illain 
We owe a hearty vote of thanks to Dr. Cummer who is mak- 
ing Canadian dentistry famous throughout America. 

With these few remarks, I now declare the Canadian 
Dental Association adjourned sine die. 



OFFICERS OF THE ONTARIO DENTAL SOCIETY 

1919-1920 



President, J. A. Botliwell, Stratford; Seci-etary-Trea.'^nrer, 
J. A. Bothwell, Toronto; Vice-President, J. A. Fleming, 
Prescott; Archivist; C. A. Kennedy; Board of Governors, 
J. P. :MacLachlan, E. L. (losby, C. E. Brooks, A. J. McKini. 
F. J. Conboy, Otto Plaxton; Committee on Oral Hvgiene, 
A. Ellis, F. C. Husband, F. J. Conboy, H. E. Eaton", .1. P. 
MacLachlan; Advisory Connnittee, R. G. ^IcLaughlin, Wallace 
Seccombe, A. D. A. Mansoii, Harold Clarke and T. H.AVylie. 
The Hononarv President is Dr. J. E. Rhind. 



182 DOMINION DENTAL JOURNAL 

THE ANNUAL MEETING OF THE BOARD OF 

DIRECTORS OF THE ROYAL COLLEGE 

OF DENTAL SURGEONS OF 

ONTARIO 



The regular meeting of the Board of Directors of the Royal 
College of Dental Surgeons of Ontario was held during the 
week of May 12th, 1919. At this the first regular meeting of 
the board since the last election, there had to be an election 
of officers. Dr. W. M. McGuire, of Simcoe, was elected ])resi- 
dent and Dr. M. A. Morrison was elected \^ice-president. 

The work of the board is getting more and more onerous 
as the years go on. During the year just past 484 students 
registered at the college. This was by far the largest regis- 
tration ever held in the school. The indications are that there 
wilJ be fully five hundred students in attendance next year. 
To provide for so large a class it was thought necessary a few 
months ago to get plans and specifications for an addition to 
the building, so as to accommodate the students for the next 
few years. An addition costing about fifty thousand dollars 
will be added during this summer, and it is expected that it 
will be ready for the classes in October. By transferring the 
chemical laboratory from the basement to the top floor, and 
by putting all of the prosthetic dentistry on the first floor, us- 
inu' the old chemistry room for a new prosthetic laboratory, 
and part of the present Assembly room, it is expected that all 
the plaster work will be kept on the basement floor, while the 
top floor will ])e reserved for dental anatomy, operative den- 
tistry, chemistry, bacteriology, pathology and histology. One 
large lecture room will be added as well as a small amphithe- 
atre for demonstrating minor dental surgery. The physics 
department will be accommodated in y)art of the present 
Assembly room. Two more laboratories will be on the same 
floor as the messanine. One of these will be used for a junior 
operative laboratory and the other for a senior ])rosthetic 
laboratory. All of the present Infirmary floor will be used for 
the Infirmary. There will be added over forty chairs and 
equipment. Next year there will be a hundred chairs and ac- 
connnodation in the senior i)rosthetic laboratory for thirty 
students to w^ork at once. In this way one hundred and thirty 
students can be kept constantly busy in the senior year. A 
decided innovation has been introduced in connection with 
teaching prosthetic dentistry in the fourth year. 



DEXTAL SOCIETIES. 183 

During" the past five oi- ten years there has l)eeii a teiideiic> 
for the dental profession to nse tlie services of prosthetic hib 
oratories. It has been much more economical than for the 
dentists to do the laboratory work himself. It has so turned 
out that dental prosthesis is now a hit>hly specialized business, 
because of the «reat amount of prosthetic restorations that 
have been made foll()wini>- the extraction for focal infection. 
In order to take the best advantage of laboratory hel}) it is 
intended to teach the students how to do ])rosthetic work in a 
prosthetic laboratory, oi- in other words, he shall be taught 
how to work fiom plans and si)ecifications as laid down by the 
dentist. To follow this out the students will ])e taken into the 
senior prosthetic laboratory in g-roui)s of from fifteen to thirty 
where they will do all the prosthetic laboratory work that is 
called for in the college. This work is to be overseen by an 
expert prosthedontist as well as a clerk to look after sui)plies 
and equipment. The senior student in the infirmary will not 
do his own prosthetic work but will make designs, and plans 
and specifications of what he washes to have done and send 
his cases to the laboratory to be carried out under the instruc- 
tion of the expert there. Thus he will be trained how to in- 
struct his laboratory assistant and how to conduct a private 
])ractice. 

TRAINING DENTAL NURSKS. 

The board of directors esta'blished a course of instruction 
for dental nurses at its last meeting. The purpose is to train 
young women to fill a denuind which has developed in the ])rac- 
tice of dentistry as nursing has developed in the practice of 
medicine and surgery. Dentists in the past have trained their 
own assistants as business houses have trained their clerks in 
the years gone by. Xo matter how special the dental practice 
there are certain general principles which might be taught all 
assistants and thus economize both the dentist's time and the 
assistant's time in training. It is simply the history of all 
education or specialization. There will be only fifteen young 
women admitted next autumn. Accommodation and a course 
have been provided for their training'. Advanced standinu- 
will be given nurses who have been in dental offices and have 
had a certain amount of training. The course will last thirty 
weeks and w^ill be divided into two sections. There will be 
lectures on such subjects as care of the dental office, care of 
ecfaipment and instruments, sterilization, bookkeeping, type- 
writing and corres])ondenco and making a])|)ointments with 



184 DENTAL SOCIETIES. 

patients. The care and preparation of drugs for use, mixing 
of filling materials, sharpening and care of steel instruments, 
ethics, office manners and relation. Care of sick patients, mak- 
ing of office records, dental social service, and oral hygiene. 
There will, of course, be practical work in all of these subjects 
as well as private office experience. 

DENTAL MECHANICS. 

The prosthetic laboratory dentist of the city of Toronto 
met the directors to discuss with them the possibility of estab- 
lishing a course of training for prosthetic dentists. The board 
appointed a committee to meet with the committee of pros- 
thetic dentists to consider the whole matter and report at a 
future meeting. 

The practice of dentistry has become so broad and has so 
many ramifications that it has been found necessary to take 
advantage of all the help possible. Thus, dental nurses are 
employed in almost every office so as to save the dentist's time. 
Tt has also been found that prosthetic dentists must be em- 
ployed to make the prosthetic technical procedures in order to 
give the dentist as much time as possible to study methods of 
treatment and methods of diagnosis for the benefit of his 
patients. It is hoped by these two groups of assistants to 
permit dentists to do a great deal more work for the public. 

CHANGES IN THE CURRICULUM. 

During the past few years there has been a distinct demand 
for a better foundational training for the dentist. To meet 
this demand such subjects as biology, embryology, chemistry, 
physics, physiology and pharmathology and anatomy have to 
be more thoroughly taught. The board of directors have 
added laboratory courses in all of these subjects and extended 
the time of instruction by a good deal. Besides this there is 
a demand for far more time to be sx>ent in the diagnosis of 
oral conditions, hence a good deal more time is provided for 
infirmary practice, as well as a good deal more time for clinical 
instruction by the head of the department. During the next 
year it is expected that each student will be required to see a 
much larger number of patients than ever before. 

COMBINED COURSE IN SCIENCE AND DENTISTRY. 

Beginning with the College term of 1919-20, the University 
of Toronto will begin a defined course covering the subjects 
of science ami medicine in seven years. At the end of the first 
four years a candidate who meets the re(]uirements will get a 



DENTAL SOCIKTIES. 1^5 

B.Ss. decree, and at the end of seven \-ears an M.l>. dcurce. 
Tnasmucli as there ai-e a ^icat miiiiber of vrvy yoiniu men 
enterin<>' the dental code.^-e, and inasnineli as there is a u'reat 
demand for niuch better dental i)reparation, it was thonuht 
advisable to appoint a connnittee to ineet with a eonnnittee of 
the University to discuss tlie problem of havin<»' a eombiiuMl 
course in science and dentistry. The subjects of the first jicar 
in this course would be biology, chemistry, physics, practical 
mathematics, rehitionship of science to civilization, English 
expression. Srcoiul iicur Anatomy, histol(),i>y, einbry()lo,<>_\ , 
or<>'anic chemistry Third //car — I^hysiolo<>"ical chemistry, 
physiology, comparative dental anatomy, bactei'iolouy, dental 
anatomy. FoiirtJi //rcy/— Dental anatomx, metallurgy, phar- 
matholo^y, dental histoi)', pathology, operative dentistry, 
prosthetic dentistry. Fiftit //rv/r — Operative dentistry, pros- 
thetic dentistry, oi'thodontia, pathology, and physics. Sixth 
//^^a/— Operative and prosthetic dentistry, histor\', ethics, 
economics, Jurisprudence, patholo,i>y, suri>*ery, anathesia, 
exodontia, medicine and sui'uery. 

UNIVKHSITV RELATIONS. 

At the regular meetiui*- of the board of directors a year auo, 
a committee was appointed to confer with the i>()vernors of the 
University of Toronto to establish a basis on which the Tni- 
ve r si ty might take over the teachini>- of dentistry as a faculty. 
There were two oi- three (*onferences during- the year with the 
})resident and the ])oard of directors. At the last conference 
it was decided that the dental committee of the board should 
draw up a budget so that the Univ^ersity would know what it 
would cost it to teach dentistry. In the meantime tlie direc- 
tors wished to go on witli an addition to the pi-esent building 
and desired to get financial aid, so they consulted with the 
Provincial Government, and although nothing was done at the 
time the House was meeting, the l)()ard was recently ad\i sed 
that the (loveniment would be willing to take the whole matter 
into consideration in a vei"y short time. In view of this, no 
further action Avas taken in regard to Tniversity relations 
until it was found out what ])()licy was to be followed towai-ds 
all ])rofessional educational work. 

ADMISSION OF FOKKKiN OHAUTATES TO THK KXA M I NATIONS FOR 

AN L.D.S. 

For a number of years some of the States in the Tnited 
States refused to allow gi'aduates of the Royal Coileue of 
Dental Surgeons of Ontario to sit for examination because our 
College did not allow gi'aduates to sit foi* examination in ( )n- 



186 DOMINION DENTAL JOURNAL 

tario, without having first attended one year at the Dental 
Tollege. To reciprocate in this matter, the board has passed 
a by-law admitting recognized students of the United States 
to Jittend one year or not as they please and to sit for exam- 
inations. 

GRADUATING GLASS ROYAL COLLEGE OF DENTAL 
SURGEONS, SESSION 1918-1919 



Elmei' S. Aitken, A¥alter George Alston, Waldo Keith 
Baikley, Alex. E. Barnby, Harvey G. Bean, Milton Clarence 
(i. Bebee, Russel Bishop, Murray Howard Blandin, Eldon 
Thompson Carrothers, Arthur Edward Chegwin, Thomas 
Carlyle Clemence, Aime Couture, Stanley Stuart Crouch, 
diauncey Daryaw, Raoul L. Des Rosiers, 
John Harrison Dickson, Stanley Rodgers Dickson, Gordon 
Dodge, Lawrence Drew Drew-Brook, Duncan J. Ferguson, 
Donald Muir Flett, Claude James Foley, Luke Gardiner 
Eraser, Albert Victor Gardner, W. Orville Godwin, Lucien 
Gravel, Ralph Watson Hall, Robert Alexander Hart, Harold 
Anthony IJartford, William Norbert Hayes, Harold Wil- 
liam Hoag, Edward West Holmes, Alvin Merwyn Hord, Rich- 
ard Ivan Hotham, Wilson La Verne Hugill, Wallace Milbert 
Johnson, Harold Johnston, Alun Wynn Jones, Hubert Fred 
Klopp, A. N. Laidlaw, Martin Patrick Lamey, Julius Judah 
Lavine, George Honare Levesque, John Lawson Mackle, 
Ru])ert Paul Millan, James Allan Milne, George Fleming 
^[itchell, James Graham Montgomery, Stephen Alva Moore, 
Joseph Francis Morton, Charles Edward Moyer, Gordon 
Sutherland Murray, William Murray, Herbert John McCann, 
John Lawrence McGowan, W^illiam Morton McKay, J. C. Mac- 
La urin, Samuel M. McLeod, Alexander Archibald MacPhee, 
Alban Lawrence Norton, Charles Rayward Oke, Edward Jos- 
eph O'Lear}-^, Benjamin Myril Ott, Jack Whitton Pickard, 
Arthur Reginald Poag, Arthur Poyntz, Norman Josei)li Quig- 
ley, vSamuol Marsh Richardson, Herbert Charles Roach, Earl 
John Robinson, Colin T. Russell, H. A. Saunders, Walter Lind- 
say Sawyers, George Lugsdin Shannon, Roy Dawson Short- 
reed, Geo. A. Sirrs, Abram Slone, Earl Phillips Smith, Wil- 
liam Harry Smith, Wilson Dunn Smyth, Louis William 
Staples, Charles Elmer Stewart, James Lloyd Stewart, Ray- 
mond Melville Watson, Arthur Dobson Wood, Roy Arthur 
Wridit. 




itorzdZ 




EDITOR: 
A. L:. Webster. M.D.. D.D.S.. L.D.S.. Toronto. Canada. 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross. L..D.S., D.D.S.. Ottawa; Carl E. Klotz. L.D.S.. St. 

Catharines. 
Quebec— Eudo re Debeau, L.D.S., D.D.S. , 396 St. Denis Street. Montreal; Stanley 

Burns, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton. 

D.D.S. , L.D.S., McGill University, Montreal. 
Alberta.— H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — Jas. M. Magee, L.D.S., D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S., D.D.S., Halifax. 
Saskatchetwan. — W. D. Cowan, L.D.S., Re&ina. 

Prince Edward Island. — J. S. Bag-nail, D.D.S., L.D.S., Charlottetown. 
Manitoba.— M. H. Gar\'in, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogue. D.D.S., L.D.S., Vancouver. 



Vol. XXXI. 



TORONTO, MAY 15, 1919. 



No. 5. 



A SPECIAL CONFERENCE OF THE REPRESENTATIVES 
OF THE UNIVERSITIES OF ONTARIO 



The l^uiversities represented on the Ontario Matriculation 
Board have appointed committees to consider the advi8a])ility 
of making" any changes in the Junior Matriculation Regula- 
tion. The following- questions were sent out ])y this Coni- 
niittee with the request that all answers be returned to the 
registrar of the University of Toronto. The questions were 
sent only to teachers in High Schools and Collegiate Insti- 
tutes of Ontario, and such other schools as were prepai'ing 
candidates for matriculation. It was understood that the 
questions dealt with only matriculation into the courses lead- 
ing to the B.A. degree. At the present time this examination 
has the following- subjects : 

English. ^lathematics, History, l.atin. 
with two of the following subjects: 

Greek, Spanish, French. Experimental Science, German. 

There were 2i:) answers received up to the time of the 
conference, l,r)00 (|uestionnaires were sent out. The first ques- 
tion was. Do you favor making: French a compulsory subject 
for matriculation? 100 ves. 107 no. 



188 DOMINION DENTAL JOURNAL 

Assuinfng' that no school slmll be required to undertake 
more than two modern languages, do you favor adding Italian 
to the list of optional subjects? 163 no. 33 yes. 

Should the jjapers for pass matriculation and normal en- 
trance examinations be identical? 168 yes. 31 no. 

Do you favor adding agriculture, commercial or other 
technical subjects to the list of optional subjects of matricula- 
tion into the faculty of Arts? 120 no. 73 yes. 

There were many other subjects asked about for which 
there is no report as to the vote. There has not been suffi- 
cient time yet to tabulate all the answers. 

The Western rniversity of London re|3orts that they are 
in favor of two classes of matriculation, the one for teachers 
should have English, History, Mathematics, Latin and French, 
while the other a matriculation perhaj^s more suitable for 
science and other subjects, English, History, ^lathematics, 
and three of the following: Latin, Greek, French, Spanish, 
Experimental Science and Commercial. It is to be noted in 
this recommendation tliat Latin is not compulsory. This fol- 
lows the methods for matriculation examinatiuns in Great 
Britain, where Latin has not been compulsory for many years. 
The University of Manitoba has also decided that T^atin is 
not necessary for Junior Matriculation in that University. 
J^atin is not necessary in Great Britain foT medicine or den- 
tistry. It becomes a question whether in Canada tlie Dental 
boards should revise their matriculation standards or not, 
and whether the Dominion Council should accept candidates 
who have not the Latin option. The time is near at hand 
when the subject will not be required for matriculation in any 
of the universities with the possible exception of the course 
leading to the B.A. degree. 

The subject of training specialists in commerce for the 
collegiate institutes and high schools of the province was dis- 
cussed at some length. There w^ere read several communica- 
tions, one especially from the Ontario Educational Associa- 
tion, in which candidates in the coUegiates, high schools or 
commercial high schools should be permitted to get junior 
matriculation based upon their conmiercial training and go 
through the university in commerce and finance and then 
(jualify as specialists in collegiate institutes and liigh schools. 
This question and the one relating to Junior Matriculation 
were both submitted to a ccmnnittee who are to confer with 



EDITORIAL 189 

the Department of Education for i-eport l)a('k to the confer- 
ence at the new year. 

A ,fi:ood deal of discussion took })lace on what to do with 
the returned soldier followini^' the reading- of a coininunica- 
tion from a Canadian cluh which is composed of a num))er of 
Canadian students in attendance at Edinburgh Cniversity. 
There has been a settknl y)olicy foi* some time of .i>*i\ing every 
student or under-^raduate who has been overseas, one year 
in time on his course, in an\ of the dei)artments of tlie uni- 
versity. Kecently it has been impressed on the universities 
that somethin^i>- should be done for those youn,<>' men who have 
not yet entered the university. It Avould seem as if the j)olic>- 
were g"oini>' to be extended not only to un(ler-.L»raduates. 
but to those who have not yet matriculated, of i>'ivini>' one 
year in time at the university, and to candidates who have 
attended lii<»h school a few months will be .granted a xcai* 
of exem])tioii in the university course. Just what ])()lic>- 
should be followed by ])rofession'al schools in this rei>ai'(l 
has not yet been raised, but it certainly will come up, because 
the department or faculty of medicine has already indicated 
that it will accept any candidates who have been overseas on 
a five-year course in medicine instead of six as prescribed, to 
bei»:in irext October. One speaker at the conference asked if 
other than those teaching- in colleg-iates should not be (lues- 
tioned, and that whether those o^iving professional education 
should not be conferred with in rei>-ard to the subject of Junior 
Matriculation. This thougiht did not seem to get ^'ery much 
support. It would seem advisable at the present time to consi- 
der whether Junior Matriculation should be directed towards 
the course in Arts only, since Law, Medicine and Dentistry and 
several Tether subjects of pi'ofessional education accept Junior 
Matriculation in Arts as their foundation for entrance. It is 
possible that the subjects for professional matriculation might 
well be varied a little from that directed towards arts. At 
such a conference there doesn't seem to be anybody who is 
prepared to take any stand on the standard of matriculation 
for any subject ontside of that of arts, therefoie it might be 
wise for those who are interested in the standards of matricMi- 
latron for professional schools to have a conference and 
agree upon a basis for their entrance. There are (piite as 
many, or more, candidates, taking junior matriculation with 
the intention of using it toward professional education as 
toward arts, and therefore the subjects shouhl have (piitc as 



190 DOMINION DENTAL JOURNAL 

much consideration at the hands of the authorities connected 
with junior matriculation as that looking towards arts. It is 
in this respect that the department of education should have 
a definite policy. 

Editorial Notes 



A dental clinic is to be established in Lethbiid.u'e for 
returned soldiers. 

A dental department is now established at Victoria 

Hospital, London, Ontario. 

^ • 

The Board of Health, Detroit, has voted $50,000 to be spent 
in the dental department this year. 

The Dental Society of Saskatchewan will hold its annual 
meeting in Saskatoon August 4th and 5th, 1919. 

W. Gerard, Fredericton, who has been practising' dentistry 
without legal qualifications in New Brunswick, chose to go 
to jail for ten days rather than pay a fine of $30. 

In the April issue a note which said that a dentist of 
Quebec had been accused of selling liquor. It appears this 
was a mistake, the accused was a dental mechanic, of Hull. 

"Your profession has come into great honor during the 
war, and now^ had a dignity among the scientific professions 
in Canada it should have had long ago," said Sir John 
Willison in addressing the Ontario Dental Society Convention 
in the Y.M.C.A. 

m 

The forty-second annual meeting of the Eastern Ontario 
Dental Association will be held at the Chateau Laurier, 
Ottawa, Monday, Tuesday and Wednesday, June the 9th, lOtli 
aud 11th, 1919. Dr. Harold Box, of Toronto, will give a papei* 
on "Focal Infections and Pathology," and Dr. Ante, of 
Toronto, will give a paper and clinic on "Crown- and 
Bridge Work." Other essayists on the programme will be 
announced later. 

C. IT. Jt^vkt, Acfhni Sfc. 



Dominion 

Dental Journal 

Vol. XXXI. TORONTO, JUNE 15, 1919. No. 6. 

Original Communications 

RETENTION OF FULL DENTURES 



RirpERT E. Hall, D.D.S. 

Professor Prosthetic Dentistry and Bead of Department of 

Artificial Denture Construction y Chicago College 

of Dental Surgery y Chicago, III. 

Read in connection with clinic of the Hamilton Dental Society at Ontario meeting. 

May, 1919. 

The fundamental principles underlying the retention of 
artificial dentures, and of which we must possess thorough 
kn'owledge before we can intellic^ently make use of their 
application, are: Eirst, thorough knowledge of the physics 
involved. Second, full recognition of the requirements of 
the design of the denture for the maximum utilization of 
the retaining forces. 

Upon attempting to express my views on this subject I 
found it necessary to formulate and definitely define terms 
that would be accurately descriptive of my thoughts. There- 
fore, it will be necessary that we first acquaint ourselves with 
the following terminology before proceeding with our subject. 

To begin wdth, let us define some of the terms commonly 
used in denture nomenclature, which, it seems, are lacking in 
accuracy of definition and specific application. Also, perhaps, 
let us add some new terms, and then when used in the treatise 
to follow, interpret accordingly. 

DEFINITION OF JAW. 

First. Jaw may be defined as meaning all surface tissue 
of the jaw ridge, and in case of the upper, the hard palate, 
upon or about which the base of an artificial denture is adapted 
and indirectly supported or retained, except the attached flex- 
ible peripheral tissues. These may be more specifically des- 
cribed as all tissues, the fixed or rest position of which is not 
modified bv muscular action. 



192 DOMINIO'N DENTAL JOURNAL 

FLEXIBLE PERIPHERAL TISSUES. 

Second. Flexible peripheral tissues may be defined as 
meaning all tissues attached to the jaws that are moved or 
are jnovable by the action of the muscles, including the soft 
palate. 

BASE. 

Third. Base may be defined as meaning that part of the 
surface of an artificial denture that is adapted to and covers 
the jaw. 

PERIPHERY. 

Fourth. Periphery may be defined as meaning that part 
of the border surface of an artificial denture adjacent to or 
continuous with the base that is adapted to and covers the 
flexible peripheral tissues. 

INTERPOSED SALIVA. 

Fifth. Interposed saliva may be defined as meaning the 
saliva interposed between the denture and the adapted tissues. 

ADAPTATION. 

Sixth. Adaptation may be defined as meaning degree of 
conformity and closeness of apposition of the outline and of 
the surface of the base and periphery of an artificial denture 
with that of the jaw and flexible peripheral tissues, to estab- 
lish such relation as will bring their surfaces within the re- 
quired distance or proximity to each other and make active 
and adhesive and cohesive forces of the interposed saliva 
between and throughout the complete surfaces of the jaw, 
flexible peripheral tissues, base and periphery of the denture. 

BASAL SEAT. 

Seventh. Basal seat may be defined as meaning the re- 
lation the base of the denture bears to that of the indirectly 
supporting or retaining jaw in the state of adaptation. The 
jaw does not support nor retain the base directly, but in- 
directly, through the medium of interposed adhering saliva, 
the actual seat of the denture being formed and made up by 
and of the film of the interposing saliva upon or about which, 
through its adhesive and cohesive forces, the structure is 
supported or retained. 

PERIPHERAL VALVE SEAL. 

Eighth. Peripheral valve seal may be defined as meaning 
adaptation between the periphery of the denture and the flex- 
ible peripheral tissues to effect valve action and prevent the 
ingress of air beneath the base of the denture in case of 
displacement. 



ORIGINAL COMMUNICATIONS 193 

EETENTTON, 

Ninth. Retention may be defined as meaning resistance 
of the restoration to displacement and dislodgment. 

DISPLACEMENT. 

Tenth. Displacement may be defined as meaning any 
change in relation of the base with that of its basal seat. 

DISLODGMENT. 

Eleventh. Dislodgment may be defined as meaning break- 
ing of the seal of the peripheral valve. 

ADHESION, COHESION, VACUUM, PARTIAL VACUUM, ATMOSPHERIC 

PRESSURE. 

Twelfth. Adhesion means the force exerted by the attrac- 
tion of unlike molecules for one another; Cohesion means 
the forces exerted by the attraction of like molecules for one 
another; vacuum means confined space devoid of matter; 
partial vacuum means confined space with degree of empti- 
ness; atmospheric pressure means the force exerted by the 
weight of the atmosphere which envelops the earth, the weight 
of which, at sea level, exerts a pressure of 14.7 pounds' 
pressure to the square inch. 

The physical forces retaining an artificial denture in the 
absence of valve seal, are adhesion and cohesion. The physi- 
cal forces retaining an artificial denture with valve seal, are 
adhesion, cohesion and atmospheric pressure, the force of the 
atmosphere being potential, which, at the point of displace- 
ment becomes kinetic. 

ADHESION. 

Adhesion in this particular is the aggregate molecular 
attraction exerted by the molecules of the interposing saliva 
for those of the substance of the structure of the base of the 
denture and those of the adapted tissues. 

COHESION. 

Cohesion is the aggregate molecular attraction exerted 
by the molecules of the interposed saliva for each other in 
value as the surface and conformity of the base covers and 
hugs the adapted tissues. 

ATMOSPHERIC PRESSURE. 

Atmospheric pressure, contrary to the opinion of many, 
is not a kinetic force acting conjointly with adhesion and 
cohesion in the position of basal seat. The space between the 
denture and the adapted tissues is completely filled with 
aerated saliva equalizing the pressure within the space with 
that of the atmosphere without the space. In substantiation 



194 DOMINION DENTAL JOURNAL 

of this claim, we quote from Gaii'ot's physics, the folloAving: 

ADPTESTON. 

''Adhesion: The molociiJar attraction exerted between 
the surfaces of bodies in contact is called adhesion. 

''Adhesion takes place between the solids. If two leaden 
bnllets are cut with a penknife so as to form two equal and 
brightly polished surfaces and the two faces are pressed and 
turned ag-ainst each other, until they are in the closest contact, 
they adhere so strongly as to require a force of more than the 
weight of 100 grammes to separate them. The same ex- 
periment may be made with two discs of glass which are 
polished and made perfectly plane. When they are pressed, 
one against the other, the adhesion is so powerful that they 
cannot be separated without breaking; hence the particles 
have been brought within the distance of molecular attraction. 
As the experiment succeeds in vacuo, it cannot be due to 
atmospheric pressure, but must be attributed to a reciprocal 
action between the two surfaces.'' 

Since the reading of this paper the author has acquired 
the following information: The Department of Physics of 
the University of Chicago is on record as having performed 
an experiment with glass planes pressed together and having 
water interposed to exclude air. Attemps to separate these 
planes of glass were found to meet with resistance both in the 
presence of air and in a vacuum. The conclusion drawn is 
obvious: The attraction between the planes of glass being 
attributed to adhesion solely. 

PHYSICS OF DENTUKE RETENTION. 

Were the maximum pressure of the air utilizable by com- 
plete removal of the interposed saliva and evacuation of the 
space thus formed, we could then have the maximum pressure 
of the air or 14.7 pounds' pressure to the square inch of base 
and peripheral surface covering the tissues, retaining the den- 
ture. But could the maximum pressure of the air be utilized 
through such force, the human tissues will not tolerate per- 
manently even a partial vacuum of any appreciable degree. 
We see this demonstrated in the air chamber commonly used 
in attempting to permanently aid retention of upper dentures 
by this means. Hypertrophy of the tissues occurs and the 
cavity fills. Thus do we show conclusively that atmospheric 
pressure cannot be utilized as a constant force to retain artifi- 
cial dentures, owing to the fact that the interposed film of 
aerated equalized saliva between the denture and the adapted 
tissues cannot be dispensed with, and Nature will not tolerate 



ORIGIXAL COMMUNICATIONS 195 

the negative pressure of vacuation about her tissues to make 
manifest such pressure by means of vacuum. Therefore, it 
must be considered that we haA^e no degree of vacuation ex- 
isting between the denture and the adapted tissues, conse- 
quently no possible aid from atmospheric pressure in retaining 
the denture in the position of basal seat, but that it is sup- 
ported or retained in proximity with the adapted tissues by 
the attraction of the molecules of the interposed liquid for 
those of the denture. 

Since we know" the relation or state defined as ^* adaption*' 
not to exist when an artificial denture is first introduced into 
the mouth, and until adaption evolves by wear, pennitting 
the tissues, as they do, to fill in and shape themselves to con- 
formity and apposition with the surface of the base, we also 
know that during this introductory period, so to s])eak, while 
the tissues are adjusting themselves establishing adaptation 
or the relation termed basal seat, partially evacuated spaces 
exist between the denture and tissues about areas not in 
sufficiently close ap|)osition to establish adaption. Therefore, 
in this connection it is conceded that atmospheric pressure is 
an aiding force, retaining a denture conjointly with adhesion 
and cohesion. Also does it solve the perplexing puzzle of why 
many dentures lose their fit — so called. Nature responds to 
the negative pressure of evacuation, the tissues fill in and 
obliterate the spaces and the force of the atmosphere becomes 
nil and the denture is retained by adhesion only. 

A most excellent chapter upon the question of atmospheric 
pressure, as it relates to denture retention, is that by Dr. 
George H. Wilson, contained in his book, Wilson* s Dental 
Prosthetics, and is earnestly commended for your careful 
reading and study. 

INFLUENCE OF THE SALIVA IN RETENTION. 

Now that we have shown that adhesion is the retaining 
force that holds the denture in proximity with the adapted 
tissues, we will proceed to show that the strength of the ad- 
hesive force is not the force actually determining that re- 
quired to displace the structure, but that the force determin- 
ing the power required to displace the denture is that of the 
cohesion. 

The degree of viscosity of the saliva makes it a liquid the 
molecules of which, in this connection, have greater adhesive 
power than cohesive power. 

A chain is no stronger than its weakest link. Let us as- 



196 DOMINION DENTAL JOURNAL 

sume the molecules of the interposing liquid— the saliva — to 
be links of a chain. 

Since the adaptation of an artificial denture cannot be 
made so close as to reduce the interposing film of saliva to 
one layer of molecules, and since the adhesive forces of the 
molecules of the saliva are greater than those of the cohesive, 
this means that the interposed saliva in the space between 
the adapted tissues and the surface of the denture— the chain 
—has a weak link in its middle. Displacement, then, occurs 
by breaking the weak link— the cohesion. 

Since the retaining force offered for resistance to dis- 
placement of the denture by cohesion alone is low in com- 
parison with that required to resist the displacing forces of 
efficient incision and mastication, displacement of the denture 
easily and readily occurs. 

How, then, may aid by utilization of the force of atmos- 
pheric pressure be accomplished for retention of an artificial 
denture for the efficient inctsion and mastication of food? 

UTILIZATION OF ATMOSPHERIC PRESSURE. •' 

Aid by means of the force of the atmosphere, may be in- 
directly accomplished by the formation of an emergency part- 
ial vacuum rising momentarily and simultaneously with dis- 
placement of the denture by the forces of incision and masti- 
cation or by any other force causing displacement of the 
structure. 

DENTURE DESIGN. 

The requirements of denture design for the accomplish- 
ment of the emergency partial vacuum are that the base of 
the denture should cover and be adapted to the entire surface 
of the jaw, and have added to it a periphery mth border 
surface continuous with that of the base of the denture, and 
that the surface of such border be extended upon and adapted 
to the flexible peripheral tissues, so that there is created a 
seal and valve-like action between the flexible peripheral 
tissues and the surface of the periphery, to preclude, there- 
with, the ingress of air under the base of the denture and 
resist or prevent dislodgment of the same through the in- 
directly applied resisting force of the atmosphere, should 
displacement occur. 

Preventing the ingress of air between the surface of the 
base of the denture and the tissues of the jaw at the time of 
displacement of the restoration, sealing the space occurring 
between the base and jaw without admitting the air, forms, 
simultaneously with displacement, a partial vacuum. 



ORIGINAL COMMUNICATIONS 197 

The tidal or momentary partial vacuum created between the 
base of the denture and the adapted tissues of the jaw is there- 
fore manifested only when the resistive forces of the cohesion 
of molecules of the interposed saliva are overcome and dis- 
placement of the denture occurs. Since the resultant atmos- 
pheric pressure is the direct force resisting dislodgment of the 
denture when forces displace the structure, forming a relative 
partial vacuum, it is obvious that any force that creates and 
increases space, degree of vacuity and resultant atmospheric 
pressure, increases, simultaneously, resistance of the denture 
to dislodgment. The degree of vacuity of the space is in 
direct ratio to the volume of the vacuum, owing to the fact 
that the sealed periphery precludes the ingress of air and the 
increasing space between the base and the jaw still accom- 
modates the same quantity of air. Boyle's law governing 
the relationship between the pressure and the volume of gases 
under a constant temperature covers this point and is as 
follows: ^^ Pressure of a given mass of gas varies inversely 
as the volume of the space within which it is confined. ' ' 

That is, if the volume of space existing under the denture 
consists of 1 c.c. at a pressure of one atmosphere, when in- 
creased to 2 c.c. of volume the pressure, according to law, 
would be one-half of an atmosphere. 

CONCLUSIONS. 

Extent of adapted surface tissue, then, determines the 
relative extent of the respective forces exerted by adhesion 
and cohesion. 

Peripheral construction and adaptation for a seal and, 
valve-like action with the flexible peripheral tissues, sealing 
space occurring between the base and jaw created by displace- 
ment of the denture, preventing the ingress of air, forming a 
relatively increasing partial vacuum indirectly applying the 
force of the atmosphere thereby, aids in preventing or op- 
poses dislodgment of the artificial denture, should displace- 
ment occur. 

Credit for the idea of constructing and establishing such 
design and relations between the base, periphery, jaw and 
flexible peripheral tissues, should, in so far as we are in- 
formed, be given Dr. W. V. B. Ames, of Chicago, for it was 
he who conceived of their importance and in 1885 (Inde- 
pendent Practitioner, July) demonstrated their principles. 
Others notable in early appreciation and use of these prin- 
ciples were the Grreene brothers of Missouri, and special ad- 
miration and appreciation should be held for their constant, 



198 DOMINION DENTAL JOURNAL 

■ untiring and persistent labors for their adoption. Credit 
belongs to these men for the correctable modeling compound 
method. Also the excellent work of Mr. Samuel G. Supplee, 
of New York, on the technique in the use of modeling com- 
pound should not be overlooked, nor that of Dr. Russel W. 
Tench, of New York. The great good these men have done in 
directing us to a better understanding of its manipulation and 
possibilities should be appreciated. Through their work and 
efforts our knowledge and technique in impression-taking has 
been greatly improved. 

The method of impression-taking for denture adaptation 
and outline of design to be described permits, it is believed, of 
an infinitely greater tissue surface adaptation and wider 
range of movements of the denture without causing displace- 
ment and unsealing or breaking of the peripheral valve seal 
than is secured in less accurate methods of adaptation and 
design, or in the old style of design where peripheral adapta- 
tion and valve seal are entirely absent and the edges of the 
denture permit the ingress of air and dislodgment of the 
restoration. 

CLASSIFICATION OF JAWS.* 

The retention of an artificial denture can be no better than 
the jaw supporting or retaining the substitute. Hence, the 
thoroughness with which we study and utilize the jaw will 
determine in a large measure the success or failure of the 
restoration. Likewise, in the same sense that it is desirable 
to classify the teeth themselves, the various classes of mal- 
occlusion of the teeth, and make other classification, it is de- 
sirable to classify edentulous jaws. 

Edentulous jaws may be classified and divided into two 
general groups, and through such classification the operator 
may be directed to a better understanding of the modus 
operandi he should jjursue in a given case to obtain the best 
results. 

Class I may be designated as that type of edentulous jaws 
that may be classed as normal— jaws with well defined ridges. 

Class II may be designated as that type of edentulous jaws 
that are abnormal— jaws with poorly defined or excessively 
absorbed ridges. 

I wish to interpolate at this point that there exists, of 
course all gradations of forms and irregularities between 
Class I and Class II. This classification, however, deals only 
with the two extremes. Understanding and mastery of the 
requirements of Class II jaws, representing the ultra-difficult 



ORIGINAL COMMUNICATIOXS 19Q 

type, makes manag'emeiit of the types intervening between 
Class I and Class II easy of accomplishment. 

Class I jaws offer the greater amount of tissue surface 
for adaptation. The well defined ridges also offer mechanical 
retention, assisting in securing the denture against horizontal 
mobility, and, in the case of undercuts, secure the restoration 
against vertical movement. Peripheral construction and 
valve seal are not so essential to passable satisfactory reten- 
tion in this class. 

Class II jaws are entirely dependent for retention upon 
the physical forces alone, no mechanical retention whatsoever 
being afforded. Jaws of this class re<]uire for their success- 
ful management the closest adherence to every detail. Peri- 
pheral construction and valve seal should be carefully and 
positively secured. 

IMPRESSION TAKING. 

The basic essential in the taking of an impression for full 
and complete utilization of the jaw and flexible peripheral 
tissues desired to be utilized for the retention of an artificial 
denture is a tray suited to the case. It is believed that the 
only accurate and satisfactory way to procure a suitable tray, 
is to construct a special tray for each individual case. 

IMPRESSION MATERIAL. 

Plaster of Paris, mixed to the correct consistency, is far 
more yieldable and adaptable than any other material with 
which we are familiar, and by the aid of a correctly formed 
individual tray, may be handled with such control that any 
desired form of impression may be secured. 

INDIVIDUAL TRAYS. 

For the construction of individual trays, we use the S. S. 
White Impression-Tray Compound, which was suggested and 
prepared for the particular purpose of making individual 
trays quickly, efficiently and economically. It is jet black in 
color to make it readily distinguishable; has a high melting 
point to assure, when set or hardened, ample rigidity against 
distortion in removal from the metal tray and subsequent 
shaping and handling. 

It is necessary in employing the impression tray com- 
pound to have a few regular metal trays of suitable forms and 
sizes. Select a tray of the proper shape for the case, but 
somewhat larger than you would ordinarily use. Fill the tray 
with the compound, softened in hot water. Pass the exposed 
surface of the compound over a Bunsen or alcohol flame to 



200 DOMINION DENTAL JOURNAL 

remove inequalities in the surface and give it a glaze. Plunge 
into hot water to wet the surface and prevent sticking to the 
tissues, and as soon as it cools to a bearable degree, insert in 
the mouth and secure a compound impression in the regular 
way. In a short time it can be removed from the mouth and 
placed in cold water to harden. 

Remove the impression from the metal tray, and with a 
sharp knife trim away the excess compound approximating 
the peripheral outline and contour of the proposed tray. 
(Approximating the contour of the proposed restoration in 
the tray should be credited to Dr. M. M. House, of Indian- 
apolis, Indiana.) 

TRIMMING THE UPPER TRAY. 

Beginning at the labial margin, the tray is trimmed thin 
at the labial frentim and the frenum allowed liberal relief. 
Passing on to the region formerly occupied by the cuspid 
teeth on either side, the tray is allowed to retain such fullness 
and height as may be required to restore the cuspid eminences. 
The tray should be as high and full as may be required to 
lift or displace the tissues for retention of the proposed den- 
ture and restoration of disturbed facial contour — the idea 
being to accentuate— build up the jaw ridge, increasing its 
area, and make in the finished impression the desired facial 
restoration. 

Passing posteriorly from the cuspid eminences or about 
midway between the cuspid eminences and the tuberosities, 
we find the malar process of the maxilla, which registers a 
downward curve in the compound impression. The process 
is thinly covered with tissue and disposed at an unfavorable 
angle to permit of much vertical movement or bearing of the 
denture in this region, and undue pressure of the same 
should be avoided. 

Moving posteriorly of the malar process, a well-defined 
cavity, as a rule, is found, and offers extremely valuable area 
for peripheral adaptation and retention. This space may be 
called the ''buccal cavity,'' and defined as ''the cavity formed 
and bound by the malar process, the cheek, the angles of the 
mouth and the tuberosity.'' It is indeed amazing how little 
this valuable space is utilized, and, on the other hand, quite 
astonishing how extensively it may be utilized. 

In forming the tray for this space, allow it to go well up 
into the cavity, filling it bucally as well as vertically, prefer- 
ring, however, to accentuate or favor vertical height rather 
than buccal fullness. Next, outline and trim the posterior or 



ORIGINAL COMMUNICATIONS 201 

palatal border of the tray. The outline of the tray should 
approximate that of the junction of the hard with the soft 
palate. Its length, however, should extend well up on the soft 
palate, the exact length of which will be determined in a later 
operation. Finally, cut out the tray relieving locks about 
undercuts and points of impingement upon soft, flabby ridge 
tissues, allowing them to hang freely in the tray. Construc- 
tion of dentures for upper jaws not requiring facial restora- 
tion or permitting presence of base and periphery upon the 
tissues in the labial region of the jaw and flexible peripheral 
tissues, do not permit peripheral adaptation in the buccal 
areas under pressure upon the flexible peripheral tissues. 
Peripheral construction and adaptation in the buccal areas 
are desirable, but care should be exercised in preventing 
pressure. Force created by displacing the tissues would 
react against retention of the denture and would not, in the 
absence of peripheral valve seal in the labial region, be met 
with and overcome by atmospheric pressure by the forming 
of an emergency vacuum upon displacement of the denture 
as in the case of that afforded where peripheral construction 
and valve seal are complete and perfect. This class of cases 
may be sub-classed and would come under the heading of 
Class I jaws. 

TRIMMING THE LOWER TRAY. 

The general preparation of the lower tray is the same as 
that of the upper. The lower jaw, however, has its individual 
characteristics. One is that absorption takes place in such 
manner that the curve or circumference of the ridge remains 
practically unchanged or fixed, whereas, in the case of the 
ridge of the maxilla, absorption reduces its circumference 
quite extensively. Consequently, facial contour is less dis- 
turbed in the loss of the lower teeth than of the upper. There- 
fore, less fullness is required in the lower denture for the 
restoration of disturbed facial contour than in the upper. 

The lower jaw, like the upper, also has much overlooked 
and neglected valuable tissue surface for adaptation for re- 
tention. Aside from our failure to utilize the available area, 
generally the lower, like the upper jaw, has, as a general rule, 
two spaces that are much overlooked. These may be called 
the *^ lingual spaces.'' They lie on either side of the tongue 
and are bounded by the mylo-hyoid ridge, the floor of the 
mouth and the tongue. These spaces are, when present, and 
Uitilized, valuable aids to denture retention in excessively 
absorbed or so-called '^flat jaws." Fit the tray well into these 



202 DOMIXIOX DENTAL JOURNAL 

spaces, aiming to utilize them in the completed denture. The 
supporting ridge of the lower jaw is more or less circular 
back to the region of the first molars. The diverging flanges 
formed by carrying the periphery of the denture into these 
lingual cavities will act as tangents to the circle and prevent 
or assist in preventing horizontal movement of the circular 
base. 

The individual tray being approximately outlined, is now 
ready for final shaping and conformation to the tissues. 

SHAPING AND CONFORMING THE INDIVIDUAL TRAY. 

There are two ways of conforming the periphery to the 
tray to the flexible tissues. One method is that of the late 
Dr. Greene, previously referred to, and is no doubt familiar 
to most of you. The method consists of heating the edge of 
black compound tray and, when necessary, tracing modeling 
compound upon the edge of the tray (tray of Impression Tray 
CompouTid the same as upon the edge of a metal tray), and 
while hot and plastic inserting the tray into the mouth and 
having the patient make movements of the muscles, which in 
turn causes the softened tray edge or added compound to flow 
and conform to the tissues. 

The other method in its application to the upper jaw con- 
sists of successive layers of very thin plaster. As a rule, only 
two mixes are necessary. The first mix registers the position 
and approximate extent of the imperfection of the improvised 
compound tray. Where the tray is too long or impinges, the 
y)laster is displaced, and where too short, plaster is added. 
The tray is freed of excess and points of impingement are 
cut away to free the tissues impinged. The tray made up 
partly of tray compound and partly of plaster may now be 
considered perfect, and is ready for the second mix of plaster, 
with which we plan to secure an accurate impressioni of the 
jaw under such displacement and pressure upon the tissues, 
as has been previously decided as advisable and pre- 
determined in the preparation of the individual tray. 

Since adaptation upon the flexible peripheral tissues of 
the soft palate for peripheral valve seal is a prerequisite fo 
retention in its maximum degree, and since there is no means 
of confining or restricting the escape of the flowing thin 
plaster from the tray about the tissues in this region, as in 
the case of the labial and buccal borders where the tray is 
overlapped and bound in by the tissues of the cheeks and lip, 
it is obvious that adaptation of the palatal peripheral border 
of the denture to insure valve seal in this region must, if 



ORIGINAL COMMUNICATIOXS 203 

accurately made, be secured by means of some plastic material 
the flowing stress of which offers such resistance as may be 
required to insure adaptation of the periphery in this region. 

Modeling compound seems to be the ideal material for use 
in this connection. 

The foveola palatina (Rauber Kops' Anatomy) indicate 
the junction of the hard with the soft palate in the median or 
at the palatal suture. The foveola palatina and the general 
demarcation between the hard and the soft palate are more 
accurately outlined in the thin plaster impression describe3 
than with any other method with which we are familiar. 

These indications, together with those distinguishing the 
tuberosities, are taken as guides by which the outline of the 
soft palate and the desired length of the base of the proposed 
denture may be definitely determined. 

The posterior border or length of the impression and tray 
are cut off, conforming their outline to that of the junction 
of the hard with the soft palate, trimming them to such 
length as it is desired that the finished denture should be. 

The remaining outlined plaster representing the im- 
pressed surface of the tissues of the soft palate and the ex- 
tent of this area which it is decided the periphery of the 
proposed denture should cover, is next entirely cut away and 
the black compound of the individual tray exposed. 

Modeling compound, preferable Keer's in stick form, is 
softened with dry heat and traced upon the top of the exposed 
projecting surface of the black tray. The impression is next 
dipped into warm water to saturate the plaster and prevent 
the compound sticking to the tissues when it is inserted into 
the mouth and adjusted to place. Adjustment of the impres- 
sion to its seat is made as the varying temperature and flow- 
ing resistance of the compound against the tissues being 
impressed may indicate, to effect the required amount of 
pressure upon the flexible peripheral tissues of the soft palate 
to insure valve seal as adjustment of the impression to its 
seat progresses. 

If desired, the compound may be traced upon the black 
compound tray and the impression of the soft palate secured 
before applying the plaster. In case this procedure is fol- 
lowed, the application of plaster is limited to one mix, other- 
wise the effect of the compound impression of the soft palate 
is lost. 

Securing adaptation upon the tissues of the flexible soft 



204 DOMINION DENTAL JOURNAL 

palate by this or some equally scientific means, insuring uni- 
form pressure upon the tissues is strongly advocated. 

Pressure engagement of the periphery of the denture with 
the tissues by moulding or swaging the base upon casts that 
have been altered by cutting and scraping to increase the 
extent of engagement of the periphery with the flexible peri- 
pheral tissues is guesswork and unscientific. The frequent 
injury of the tissues and the suffering imposed by such prac- 
tice evidence the empiricism of the method and warrant 
discouragement of its practice. Casts made from accurate 
impressions secured in accordance with the demands of the 
case require no cutting or scraping. 

Careful study of the outline of the hard palate should be 
made, and generous relief of any pressure of the base of the 
proposed denture upon this area should be certain. Other- 
wise pressure of the base upon the tissues of the hard, un- 
yielding area may establish a fulcrum, cause rocking of the 
base and impair the stability of the structure. 



TRAGEDIES OF THE PROFESSION 



Gkay McClintock. 



G^enerally speaking, the practice of the profession of 
dentistry is not deemed an altogether dangerous one. The 
insurance companies have no clauses in their contracts 
calling attention to the fact that the lives of the members of 
the fraternity are even in continuous jeopardy, but, never- 
theless, accidents have occurred to practitioners that call 
attention to the fact that the profession is not entirely without 
the pale of tragedy. 

In looking over my notes, taken in all parts of this and 
the country to the south of us, where dentistry is now and 
has been for long an established art, there are to be found 
instances where accidents have occurred having a sad and 
tragic ending. The chances of like results to every practi- 
tioner makes this article a reasonable and interesting one. 
There are many cases where operations have resulted directly 
or indirectly in the death of the patient, but the deaths 
occurring in the cases of the operators themselves are, happily. 



ORIGINAL COMMUNICATIONS 205 

not many, and the most of them might have been averted had 
reasonable care been taken at the time of their occurring. 

About three years ago, in the city of Portland, Oregon, 
an operator was engaged in the work of opening and cleansing 
a putrescent root canal He was using a GTates-GUdden drill, 
and, like a thousand other men who do the same work day 
after day in their practice, left the drill in the hand-piece 
dangling at the end of the engine-arm. Beaching for an 
antiseptic in his case, he inadvertently raised his knee and 
struck the end of the drill with sufficient force to have it pierce 
his clothing and enter his leg just above the knee. Impatiently, 
he thrust it aside, little dreaming of the results impending. 
Three hours afterwards he was in agony of pain, and later was 
taken to the hospital, where he died within twenty hours from 
the time he was struck. The poison from a rattler's fang 
would have hardly worked more quickly. 

Dr, M , of Reno, Nevada, was suffering one winter's 

day from a severe cold in his head, which had broken out in 
a rash or abrasion on the edges of his nostril. 

Some time during the day's work he had been handling a 
patient suffering from virulent syphilis, and at the end of 
two weeks the unfortunate doctor was a victim to that dreadful 
scourge. Unfortunately, he was in a poor state of health at 
the time ; in fact, he had sought the high altitude of Nevada 
on account of the condition of his lungs ; his system could not 

stand the task of throwing off the two poisons, and Dr. M 

died, horribly diseased. He had unwittingly introduced the 
germ of syphilis to the abrasion on his nose. 

A new assistant, poorly versed in her duties, a busy 
practitioner, and another Gates-Glidden drill that had not 
been sterilized, was the cause of the death of another operator 
of Anaconda, Montana. 

The assistant, instead of sterilizing the instruments she 
had found on the operating table, had picked up a drill that 
had been in use, and had put it in the bur stand remaining on 
the table. Dr. S— , reaching across the table to pick up 
an instrument, had pricked his hand with the point of the drill. 
Blood poison set in, and the loss of the arai first did not stem 
the course of the poison, and he had to yield his life to its 
ravages. 

Dr. D , of Fielding, Wyo., was what might be termed 

a periodical man. He drank in spells, and when he was 
drinking, his ethics as a professional man were lost to him, 



206 DOMINION DENTAL JOURNAL 

aiid He paralleled his bouts with the most distasteful sort of 
advertising. The Board of Dentists in charge of the ethics 
of the state decided to make an example of hion, and took away 
his license. Throwing aside all cognizance of the virtues of 
the man in his soher and sane moments, they went the limit. 
The result so preyed on his mind that he suicided. All of 
which goes to show that the poison in the minds of a group 
of men can be as fatal as the inoculation of snake-bite. 



ESTABLISHMENT OF A COURSE OF INSTRUCTION 

FOR DENTAL NURSES IN THE SCHOOL 

OF IDENTISTRY, TORONTO 



PUKPOSE. 

To train young women to fill a demand which has devel- 
oped in the practice of dentistry, as nursing has developed in 
the practice of medicine and surgery. Dentists have in the 
past trained their own assistants as business houses have 
trained their clerks in the years gone by. No matter how 
special the dental practice, there are certain general prin- 
ciples which might be taught all assistants, and thus econo- 
mize both the dentists' and assistants' time in training. It 
is simply the history of all education or specialization. 

REQUIREMENTS OF ADMISSION. 

The candidate must be at least the full age of eighteen 
years and be capable of speaking, reading and writing the 
English language, and have sufficient knowledge of arithmetic 
to compute interest, discount and understanding the ordinary 
processes in bookkeeping and banking. 

She must be physically and mentally capable of acquiring 
the necessary training, and afterwards following the occu- 
pation of an assistant successfully. 

REQUIREMENTS FOR FOLLOWING OCCUPATION. 

1. An innate alertness to anticipate the desires of another. 

2. A fineness of feeling which will hinder an exhibition of 
selfishness or of crudeness. 

3. Clean, neat, orderly habits. 

4. A precise knowledge of the fitness of things and the 
relation of her occupation to the dental profession and the 
affairs of life. 

5. An assistant should know the essentials of a good house- 
keeper. 



ORIGINAL COMMUNICATIONS 207 

6. Must be exact in detail, careful and painstaking in her 
work, and have a sense of responsibility. 

7. Be capable of meeting and dealing with people, really 
standing as a guard between the dentist and the outside 
world, making all appointments and arrangements for the 
dentist's time and occupation. 

8. Must have a knowledge of dental bookkeeping, dental 
records and banking. 

9. Must know the names and uses of dental instruments, 
equipment and materials. 

10. Must know^ how to sterilize and sharpen dental instru- 
ments and care for equipments and offices. 

11. Must know how to keep stock of instruments, materials 
and drugs. 

12. Must know how to mix and prepare all materials and 
drugs for use at the chair. 

13. Must know the instruments and equipment required 
for every dental operation. 

14. The good assistant should take the general direction 
of the dental office, keeping track of everybody who comes in 
and goes out, keeping in mind that her chief function is to 
economize the dentist's time and smooth out the annoyances 
and make a joy in a work which is nerve-taxing. 

15. Assisting at chair. 

OUTLINE OF COURSE. 

1. Must be a suitable uniform chosen. 

2. First and second semester of four months each. 

3. Admission at opening of college only. 

4. Fee of $25.00 for each course. 

5. Limit first class to fifteen months. 

JUNIOR COURSE. 

Practical Instruction. 
Two weeks. — Examination room. 
Two weeks.— Extracting room. 
One week. — ^Appointment desk. 
Four weeks.— Drugs and materials. 
Two w^eeks.- X-ray room. 
Four weeks. — Operative room. 

Lecture Hours. 
Three hours. — Care of a dental office. 
Five hours.— Care of equipment and instruments. 
Five hours. — Sterilization. 
Two hours.— Stock and equipment keeping. 



208 DOMINION DENTAL JOURNAL 

Fifteen hours.— Typewriting and correspondence, banking 
and records, and accounts. 

Five hours.— Meeting, reception, appointments and dis- 
missal of patients. Simple pathologic technique. 

SENIOR COURSE. 

Practical Instruction. 
One week. — ^Assisting with anaesthetics. 
Four weeks.— Assisting in operations. 
Two weeks.— Assisting in prosthetic operations. 
One week.— Drugs and materials. 
Two weeks. — Operative laboratory. 
Two weeks.— Prosthetic laboratory. 

Three weeks.— Private office experience or school dental 
service and hospitals. 

Lecture Hours. 
Five hours. — Preparation of drugs for use. 
Five hours.— Mixing of materials for fillings. 
Two hours. — Sharpening and care of steel instruments. 
Five hours.— Ethics, office manners and relations. 
Two hours. — Care of sick patients. 

Five hours.— Bookkeeping, banking, records and accounts. 
Five hours.— Office care and sanitation. 
Five hours. — Dental social service, oral hygiene. 



DENTAL SOCIETIES. 209 

Dental Societies 

MINUTES OF THE ONTARIO DENTAL SOCIETY 



Y.M.C.A. Auditorium, College St., 
Toronto, Monday, April 28, 1919. 

The 52nd meeting of the Ontario Dental Society met here 
at 2 p.m., with the President, Dr. J. E. Rhind, in the chair. 

Moved by Drs. McKim and Smith, that the minutes of the 
last meeting be taken as read. 

The President made a few opening remarks of welcome, 
and asked Dr. Devitt to take the chair. 

The President read his address. It was moved by Drs. 
Conboy and Webster, that the President's address be received 
and then reported in the minutes at a later session of the 
Society. Carried. 

The Secretary read the report of the Executive Commit- 
tee, as follows: — 

^'Your Executive Committee desire to recommend— 

1. ^^That the Society appoint a committee of five to incor- 
porate itself. 

2. "That the revision of the Constitution as submitted to 
your Executive be accepted after its reading before the 
O.D.S.'' 

It was moved by Drs. Colon Smith and Webster, that the 
recommendation of the Executive Committee be received. 
Carried. 

The Secretary read a proposed copy of the incorporation. 
It was moved by Drs. Conboy and Allen, that before incorpor- 
ation the consent of the Board of Directors be obtained and 
that the chair appoint five members to complete the incorpora- 
tion. Carried. 

Dr. Willmott presented the proposed change in the Con- 
stitution. It was moved by Drs. WilLmott and Shantz, that 
the Constitution as read be adopted. Carried. 

Dr. Percy Howe, of Boston, Mass., read a very able paper 
on the '^Howe Method of Silver Nitrate Root Canal Treat- 
ment," which was followed by a discussion. 

The President named the following as a Nominating Com- 
mittee : Dr. Kennedy, Toronto ; Dr. Colon Smith, London ; 
Dr. Bald, Sault Ste.^ Marie ; Dr. Webster, Toronto ; Dr. W. 
A. Armstrong, Ottawa. 

It was moved by Drs. Bothwell and Willmott, that the 



210 DOMINION DENTAL JOURNAL 

following be the Board of Governors : For one year, Drs. 
MacLachlan and Gausby; for two years, Drs. Brooks and 
McKim: for three vears, Drs. Conbov and Plaxton. Carried. 

SECOND DAY. 

It was moved by Drs. Willmott and Webster, that the 
minutes of the pre\4ons session be taken as read. Carried. 

Dr. Webster reported for the Nominating Committee as 
follows: Honorary President, Dr. J. E. Ehind, Toronto; 
President, Dr. J. A. Bothwell, Stratford; Vice-President, Dr. 
J. A. Fleming, Prescott; Secretary-Treasurer, Dr. John A. 
Bothwell, Toronto. 

Advisory Committee : Dr. R. G. McLaughlan, Dr. Wallace 
Seccombe, Dr. A. D. A. Mason, Dr. Harold Clark, Dr. T. H. 
Wylie. 

Oral Hygiene Committee : Dr. A. Ellis, Dr. F. C. Husband, 
Dr. F. J. Conboy, Dr. H. E. Eaton, Dr. J. P. MacLachlan. 

The Archivist, Dr. Kennedy, is already in nomination, 
according to the new Constitution. 

Moved by Drs. Ellis and Conboy, that the report be re- 
ceived and adopted. Carried. 

It was moved by Drs. Conboy and Ellis, that the Board of 
Governors be authorized to give a liberal grant to the Oral 
Hygiene Committee. Carried. 

Dr. Rhind named the following as a committee to secure 
the incorporation of the Society: The President, Dr. J. A. 
Bothwell; Dr. A. E. Webster, Dr. W. E. Willmott, Dr. C. A. 
Kennedy; Secretary-Treasurer, Dr. John A. Bothwell. 

Dr. Conboy gave a short report of moneys received for 
the Canadian Army Dental Corps. 

Dr. Webster reported for the Advisory Committee as 
above. 

Dr. Ellis reported for the Oral Hygiene Committee as 
above. 

Moved by Drs. Willmott and Bothwell, that the reports be 
received and adopted. Carried. 

]^Ioved by Drs. Willmott and Colon Smith, that the next 
meeting be held in Toronto. Carried. 

Moved by Dr. Willmott and the new President, Dr. J. A. 
Bothwell, that the Board of Governors be instructed to send 
a letter to the Y.M.C.A. expressing our appreciation of the 
services rendered during our Convention. 

It was moved by Drs. Willmott and Webster, that 1,200 
copies of the new Constitution be printed and sent to each 
licentiate with first notice of the next Convention. Carried. 



DENTAL SOCIETIES. 211 

Wednesday afternoon Dr. Plall, of Chicago, presented a 
paper on ''The Hall Method of Prosthetic Dentistry.'* 

Monday night a film, "Fit to Fight/' was shown at the 
Mining Building. 

On Tuesday, Wednesday and Thursday very interesting 
progressive clinics were shown by Drs. Webster, Ante, the 
Hamilton Clinic Club and the Detroit Clinic Club. 

Two luncheons were held, Tuesday and Wednesday, at 
which Rev. A. Logan Geggie and Sir John Willison spoke 
most entertainingly. 



ROYAL COLLEGE OF DENTAL SURGEONS 
EXAMINATIONS 



Third Year Students. 

The following students have completed the subjects of the 
third year at the Royal College of Dental Surgeons of Ontario. 
Tn order of standing : 

H. A. Ross (winner of J. B. Wilmott Memorial Scholar- 
ship), G. H. McKee, W. W. Voaden, J. F. Giffen, J. S. Lapp, 
M. A. Mayer, V. D. Speer, R. Hillis, C. C. Clermont, H. G. 
Brownlee, C. Gunton, L. E. MacLachlan, H. W. Leach, E. J. 
Walroth, H. M. Brown, J. G. Countryman, G. T. Walker, R. F. 
Fralick, S. Model, C. A. McLean, C. A. Courville, W. A. 
Spence, W. T. Holmes, W. B. Mitchell, A. M. Palmer, B. 
Bregman, S. A. Milbum, A. H. Wilson, C. T. Moyle, G. A. 
Gemeroy, J. C. Green, A. F. Cooper, W. W. Speers, H. D. 
Taylor, W. J. H. Miller, K. N. Mc Vicar, J. Teich, L. A. John- 
son, F. G. Gollop, E. T. Lajoie, V. R. Farrell, M. W. Hartley, 
N. W. Haynes, C. H. Avery, P. C. Hughes, L. H. Croft, J. H. 
Strath, N. D. Winn, E. S. McBride, H. R. Garbutt, W. W. Race, 
J. E. Eraser, B. Lundy, H. McCrostie, H. W. Grace, J. R. 
McLachlan, F. E. Babcock, W. M. Seymour, F. W. Beach, 
V. A. Clark, L. M. Wintrope, G. Joynt, R. J. Hiscox, K. A. 
Blanches, L. R. Bell, R. C. McLaughlin, G. Pollock, E. A. 
Sadleir, A, H. Walton, J. D. Morrison, A. A. Backus, G. E. 
Oldham, H. J. Caulfield, H. W. Eckel, S. Kemp, J. W. Golding, 
L. J. Miller, N. J. Murphy, W. R. Richardson, W. L. Durant, 
E. J. Hesson, C. J. Kelly, R. W. Freestone, G. S. Morgan, 
W. M. Blakely, F. A. Weese, J. 0. Shaunessy, R. E. Winn, 
W. M. Box, 1. L. Himelstein, L M. Ben-Ezra, N. W. Snider, 
V. C. Long, S. I. Moss, G. A. Buttery, J. H. Herrington, G. L. 
Frawley, R. W. Bradley. 



212' DOMINION DENTAL JOURNAL 

Completed third year and all subjects upon which he wrote 
— J. T. Irwin. 

To take further examinations or complete practical work. 
Third year students : 

L. R. Bell— To complete Prosthetic Technic. 

W. M. Blakely— Inorganic Chemistry Lab. 

R. W. Bradley— Second year Chemistry; Anatomy, Chem- 
istr}^ Lab.; to complete Orthodontia and Prosthetic Technic. 

R. F. Butler— Metallurgy; to complete Orthodontia 
Technic. 

G. A. Buttery — ^To complete Orthodontia Technic. 

H. J. Caulfield— Second Year Chemistry. 

V. R. Farrell— To complete Orthodontia Technic. 

G. L. Frawley— Histology, Osteology, Organic Chemistry. 

C. S. Gilbert -Metallurgy. 

Some Returns Withheld. 

C. Gunton— First Year Chemistry. 

N. W. Haynes— To complete Orthodontia Technic. 

J. H. Herrinton — To complete Orthodontia Technic. 

E. J. Hesson— Second Year Chemistry. 

R. J. Hiscox— To complete Prosthetic Technic. 

S. W. Kemp— Second Year Chemistry, to complete Pros- 
thetic Technic. 

I. T. Lajoie— First Year Chemistry, Physics. 

J. S. Lapp— To complete Prosthetic Technic. 

H. W. Leach— To complete Prosthetic Technic. 

V. C. Long — Histology, Anatomy ; to complete Orthodontia 
Technic. 

C. J. Mahoney— Metallurgy ; to complete Orthodontia and 
Prosthetic Technic. 

L. J. Miller— To complete Orthodontia and Prosthetic 
Technic. 

C. E. Morgan— First and Second Year Physiology, Chem- 
istry, Metallurgy, Pharmacology; to complete Orthodontia 
Technic. 

G. A. Morton^Pharmacology; to complete Prosthetic 
Technic. 

S. I. Moss— First Year Chemistry. 

N. J. Murphy— Second Year Chemistry. 

E. S. McBride — Histology, Organic Chemistry, Anatomy. 

Hugh McCrostie— To complete term work in Comparative 
Dental Anatomy and Materia Medica. 



DENTAL SOCIETIES. 213 

R. C. McLaughlin— First and Second Year Chemistry. 

G. Perdue— Metallurgy. 

W. W. Race— First Year Chemistry; to complete Pros- 
thetic Technic. 

E. A. Reid— Metallurgy, Pharmacology, Second Year 
Chemistry, Materia Medica; to complete Prosthetic Technic. 

J. Rubenstein— Metallurgy, Histology. 

N. W. Snider — Second Year Chemistry. 

W. W. Speers— To complete Prosthetic Technic. 

Robert B. Steele — Metallurg}^ First and Second Year 
Chemistry, Dental Anatomy, Histology, Materia Medica, 
Osteology, Anatomy. 

J. Teich— Second Year Physiology; to complete Ortho- 
dontia Models. 

G. T. Walker— Second Year Chemistry. 

Examination returns withheld in the following cases, 
pending adjustment of office requirements : 

J. W. Bartholomew, B. J. Charles, A. M. Clark, H. David- 
son, R. A. Dean, L. F. Dupis, W. Ewart, J. A. Graham, R. E. 
Haryett, E. D. Hicks, J. V. McLeod, G. O'Connor, E. M. 
Warren. 

Second Year Students. 

The following students of the Royal College of Dental 
Surgeons of Ontario have completed the subjects of the second 
year, in order of standing : 

A. A. Cameron, T. R. Marshall, G. G. McKee, L. V. Barnes, 
C. W. Asselstine, C. B. Wilson, R. E. Johnston, C. A. Elliot, 
R. G. Woods, F. M. Corbett, R. E. Dinniwell, F. M. Graham, 
J. P. W^hyte, E. R. Upton, C. W. Steele, C. C. Smart, W. B. 
Black, H. L. Windrim, R. J. Mills, L. M. Martin, G. H. Snell, 
S. C. Atkins, B. D. Foster, H. A. Freitag, J. A. Butler, 
N. Beattie, R. G. Agnew, R. G. Hvde, W. J. Wilkey, R. C. 
McCutcheon, H. S. Abar, L. H. McCool, J. E. Irwin, G. G. 
Jewitt, M. Killoran, H. Harper, J. T. Coyne, A. E. Hilliker, 
T. L. Granovsky, J. Zimmerman, C. A. Haines, A. 0. Brad- 
ley, A. Gott, H. Adams, L. A. Letellier, J. 0. Olson, AV. J. 
Armstrong, R. Rochon, H. B. Hoar, M. A. Kinsman, J. C. 
McGowan, W. H. Hunter, J. H. Best, A. 0. Derbyshire, A. F. 
Dales, G. S. Paul, J. M. McLeod, J. C. Lumb, E. R. Dobbs, 
A. B. MacDonald, Miss I. M. Barber, R. A. McQueen, P. R. 
Wilson, G. B. Halladay, M. L. Pratt, C. J. Taylor, C. G. 
Stewart, G. Johnston, J. F. Wamica, H. E. McFeeters, 



214 DOMINION DENTAL JOURNAL 

A. Daly, H. R. Anderson, H. S. Bryans, L. M. Couglilin, 
J. A. King. 

To Take Further Examinations. 
Rr. B. Adams, Chemistry, Anatomy; A. F. Barnes, Chem- 
istry; R. J. Beckett, Histology; J. W. Bell, Chemistry, 
Anatomy, First Year Histology; R. T. Broadworth, Chem- 
istry; A. G. CalbeCk, Chemistry, Physiology; E. T. Campbell, 
Chemistry, Anatomy, J>ental Anatomy, Histology; W. D. 
Clark, Chemical Laboratory; N. S. Douglas, Chemistry, 
Materia Medica, Dental Anatomy, Physics ; J. C. Duff, Chem- 
istry; W. J. Faulkner, Comparative Dental Anatomy; E. 
Garfat, Chemistry, Physiology, First Year Chemistry, First 
Year Physiology; L. R. Garvey, Chemical Laboratory; G. B. 
Halladay, Histology ; G. W. Howson, Chemistry ; G. G. Jewitt, 
First Year Physiology; G. Johnston, Histology, Physics; 
U. N. Jones, Chemistry; A. R. Kerr, Chemistry, Materia 
Medica, to, complete practical work Dental Anatomy; J. A. 
King, First Year Histology, Physics ; C. H. M. Laidley, Chem- 
istry, Chemical Laboratory; E. Marshall, Chemistry, Ana- 
tomy, Histology, First Year Physiology, to complete practical 
work Dental Anatomy ; L. M. Martin, First Year Physiology ; 
Miss M. R. McAllister, Chemistry ; F. D. McClure, Chemistry, 
Anatomy, Materia Medica, Prosthetic Dentistry Second Year, 
Osteology, Histology, Dental Anatomy, Complete Dental 
Anatomy, Physiology, Chemistry First Year; D. McLitosh, 
Chemistry, Operative Dentistry, First Year Chemistry, His- 
tology, Physics; W. F. McLean, Chemistry; J. C. McLister, 
Chemistry, Chemical Laboratory, Anatomy, Histology and 
Physics; J. E. McMullen, Chemistry, Anatomy; J. M. Partlo, 
Chemistry; W. J. Robb, Chemistry, Chemical Laboratory, 
Materia Medica, First Year Chemistry, Physics, to complete 
practical work in Dental Anatomy; J. F. Roberts, Chemistry; 
T. A. Robinson, Chemistry, Materia Medica, Histology, 
Physics ; R. Rochon, Histology ; J. L. Rogers, Chemistry ; C. M. 
Rowsome, Chemistry; L. N. Ryan, Chemistry, Prosthetic 
Dentistry, First Year Physiology, Histology, Dental Anatomy, 
Comparative Dental Anatomy; R. J. Sockett, Second Year 
Chemistry, Chemical Laboratory; G. W. Wagner, Chemistry; 
D. A. 'Watson, Second Year Chemistry, Anatomy, First Year 
Osteology, Histology, Chemistry, Dental Anatomy and 
Comparative Dental Anatomy. 



DENTAL SOCIETIES. 215 

Pending Adjustment. 

B. Davidson, C. N. James, J. A. Spellmaii, C. D. Wood. 
The following- students have completed the subjects of the 

first year, in order of standing : 

H. H. Cummer, G. W. Bell, D. C. Goupland, R. M. E. Ward, 
W. H. Galloway, J. 0. Berry, L. C. Yack, B. Garfinkle, J. A. 
Dietrich, J. M. Brewer, G. Heidgerken, J. B. Donnelly, H. J. 
Pabey, Roy S. Freele, E. A. Rupert, R. J. Marshall, C. M. 
Snelgrove, H. L. Burrell, J. H. Dewey, J. S. Harris, H. Lands- 
berg, J. E. McMulkin, G. E. Balfour, J. Feinberg, A. G. David- 
son, E. J. O'Brien, D. M. Turner, R. Dunlop, W. G. Yoerger, 
H. T. Davidson, J. M. Lee, H. R. Hall, H. G. Harvie, J. L. 
Dickson, D. H. Mallory, R. R. Hudgins, T. J. Metcalfe, C. W. 
Soules, M. Sonoller, S. Braund, D. Rouse, A. S. Holmes, W. M. 
Stevenson, W. R. Jackson, C. W. Lyons, W. J. Kerr, L. F. 
Culver, H. W. Dixon, G. M. Martin, W. A. Sharon, W. G. 
Hancock, M. E. Webb, B. Willinsky, L. A. Jaques, Charles 
Okun, P. E. McDonald, Miss M. E. Law, J. A. McCormack, 

B. J. Clark, Miss F. N. Mollins, G. W. Long, G. E. Shragge, 
E. ^Y. Devine, Miss M. Joy, R. N. Davis, W. J. Langmaid, 
S. X. Katrak, F. E. Curran, H. S. Percival; J. H. Conboy, 
R. G. Harris, R. A. Shields, J. W. Smith, S. P. Greaves, 
P. Harrington, L. H. Holmes, C. C. Collins, D. S. Van Allen, 

C. J. K. Ryan, Miss J. A. McDonagh, G. L. Prestien, W. A. 
Gray, J. M. Wilkinson, W. M. Craig. 

C. V. Bussey— Passed in Osteology, Dental Anatomy, 
Comparative Dental Anatomy, Prosthetic Dentistry. 

L. R. Dodds — Passed in all First and Second Year papers 
on which he wrote. 

H. Moulson — Passed in Histology, Dental Anatomy, Com- 
parative Dental Anatomy and Physiology of the First Year; 
Anatomy, Materia Medica, Operative Dentistry, Prosthetic 
Dentistry and Chemical Laboratory of the Second Year. 

First Year Students. 
To take further examinations or complete practical work : 
H. G. Armstrong, Histology; V. Armstrong, Physics; G. F. 
Atkinson, Presthetic Term ; E. R. Boyle, Osteology Term, His- 
tology; I. T. Brill, Chemistry; S. Brown, Chemistry, Physiol- 
ogy, Physics, to complete Prosthetic Technic; L. W. Calbick, 
Physics; L. Carter, Histology, Physics; J. D. Evans, Chem- 
istry; W. J. Gilbert, to complete term work in Osteology; Jack 
Griss, Physics; G. M. Heisz, Chemistry, to complete Prosthetic 
Technic; L. H. Haines, to complete Comparative Dental 



216 DOMINION DENTAL JOURNAL 

Anatomy ; Miss E. M. James, Physics ; G. A. Kerr, Chemistry, 
Histology, Physics, to complete Prosthetic Technic; W. N. 
Lamond, Prosthetic Dentistry; A. C. Lane, Chemistry, His- 
tology, Physics ; Miss A. McEwen, Chemistry, Histology; C. H. 
Osher, Chemistry, Histology, Physics; J. F. Porter, Physics; 
R. G. Reid, Prosthetic Dentistry; J. E. Renton, Chemistry, 
Physics; W. R. Reynolds, term work in Osteology; S. Rosen, 
Chemistry, Histology, Physics, to complete Prosthetic 
Technic; C. J. K. Ryan, to complete Prosthetic Technic; 
L. Sharpe, Chemistry; J. M. Shultis, Physics; S. Simon, His- 
tology, Physics, to complete Prosthetic Technic; A. R. J. Snell, 
Chemistry, Histology, to complete Prosthetic Technic; F. E. 
Sproul, Chemistry; W. B. Tyson, Chemistry, Physics, to com- 
plete Prosthetic Technic; E. Underhill, Chemistry, Physics; 
R. M. Virtue, Prosthetic Dentistry; M. R. Wilson, Histology. 

To take year over— D. Maynes, J. A. Gillies. 

First year examination returns withheld in the following 
cases pending adjustment of office requirements— W. E. 
Cooper, E. C. Keyes. 



McGILL DENTAL EXAMINATIONS 



The prize and honor lists in the Department of Dentistry, 
McGill University, are as follows : 

Final Yeae. 

Stevenson Gold Medal for highest aggregate in final year 
— R. W. Edmison, B.A., Montreal, Que. 

Final year prize for second rank standing in final year— 
Nathan Lande, Montreal, Que. 

Honors— Materia Medica— 1, R. W. Edmison, B.A. Oper- 
ative Dentistry — 1, R. W. Edmison, B.A.; 2, N. Lande and 
W. H. Wisse, equal; 3, M. Kolber. Orthodontia— 1, N. Lande. 
Dental Jurisprudence— 1, R. W. Edmison, B.A. ; 2, W. H. 
Wisse; 3, N. Lande. Dental Pathology— 1, R. W. Edmison, 
B.A. Prosthetic Dentistry— 1, W. H. Wisse. Oral Surgery — 
1, R. W. Edmison, B,A. ; 2, N. Lande. Crown and Bridge Work 
— R. W. Edmison, B.A. Sessional Work— 1, R. W. Edmison, 
B.A. ; 2, N. Lande. 

Pass List. 

The following, in order of merit, have fulfilled all the 
requirements to entitle them to the degree of Doctor of Dental 
Surgery (D.D.S.) from the University— R. W. Edmison, B.A., 



DENTAL SOCIETIES. 217 

Montreal; N. Lande, Montreal; W. H. Wisse, Montreal; 
M. Kolber, Montreal. (In course) Lieut.-Col. P. H. Bradley, 
L.D.S., Sherbrooke, Que.; A. Clifford Jack, L.D.S., Montreal, 
Que.; C. F. Morison, L.D.S., Montreal, Que. 

Third Year. 

First prize for highest standing in third year— S. A. 
MacSween, Montreal. 

Second prize for second rank standing in third year— 
A. L. Walsh, Montreal. 

Honors. 

Bacteriology— S. A. MacSween; I. N. Pesner; A. L. Walsh; 
R. G. Docks ; M. E. Adams. 

Materia Medica— A. N. Jenks; I. N. Pesner; A. L. Walsh; 
S. A. MacSween. 

Orthodontia— A. L. Walsh. 

Oral Surgery— M. E. Adams; W. T. Donnelly; J. Fine- 
berg; J. Dance; W. G. Leahy; S. A. MacSween; B. Ratner; 
A. L. Walsh, equal. 

Dental Pathology- S. A. MacSween; A. L. Walsh; R. G. 
Docks; L. S. Eidinger; J. Dance, equal. 

Crown and Bridge Work— A. L. Walsh; J. Dance; M. E. 
Adams; J. Fineberg; S. A. MacSween; I. N. Pesner; B. Rat- 
ner; W. G. Leahy; A. N. Jenks. 

Operative Dentistry— M. E. Adams. 

Dental Jurisprudence — A. L. Walsh ; S. A. MacSween ; 
L. S. Eidinger; J. Fineberg; M. E. Adams; W. G. Leahy; 
R. G. Docks, B. Ratner, equal; L N. Pesner; A. N. Jenks, 
C. T. Parker, equal. 

History, Ethics and Economics— S. A. MacSween; A. N. 
Jenks. 

Prosthetic Dentistry— M. E. Adams; S. A. MacSween. 

Practical Prosthesis— M. E. Adams; S. A. MacSween; J. 
Fineberg, and A. L. Walsh, equal. 

Practical Operative— M. E. Adams, S. A. MacSween, 
equal ; J. Dance, A. L. Walsh, equal. 

Pass List. 

The following, in order of merit, have fulfilled all the re- 
quirements and passed all the examinations of the Third Year: 

S. A. MacSween, Montreal ; A. L. Walsh, Montreal ; M. E. 
Adams, Magog, Que.; J. Fineberg, Montreal; T. N. Pesner, 
Montreal; W. T. Donnelly, St. John, N.B. 

In Addition to the Above. 

J. Dance passed in all subjects of the year with the excep- 



218 DOMINION DENTAL JOURNAL 

tion of Orthodontia and Prosthetic Dentistry. 

R. G. Docks and L. S. Eidinger in all subjects of the year 
with exception of Oral Surgery and Practical Prosthesis. 

A. N. Jenks in all subjects of the year with the exception 
of Operative Dentistry and Prosthetic Dentistry. 

W. Gr. Leahy in all subjects of the year with the exception 
of Orthodontia and Prosthetic Dentistry. 

Gr. T. Parker in all subjects of the year with the exception 
of Orthodontia. 

R. Ratner in all subjects of the year with the exception of 
Prosthetic Dentistry. 



CONSTITUTION OF THE ONTARIO DENTAL 

ASSOCIATION 



Article L — The Association. 

Sec. 1. — This Association shall be known as The Ontario 
Dental Association. 

Sec. 2— The object of this Association shall be the mutual 
improvement of its members and the advancement of the 
science of Dental Surgery. 

Article II. — Membership. 

Sec. 1 — This Association shall consist of Active and Hon- 
orary Members. 

Sec. 2— Active members shall be those Licentiates in 
Ontario who have paid the Convention fee for the current year. 

Sec. 3— Such scientific and professional persons as the 
Association may deem advisable may be elected as Honorary 
members by unanimous ballot, a list of such names to be kept 
on record by the Secretary. 

Sec. 4 — On recommendation of the Board of Governors, 
any member may be expelled for unprofessional conduct, 
malpractice or immorality, by a two-thirds vote of the mem- 
bers present at any session of the Convention. 

Sec. 5— No Dentist may hold any office nor act on any 
Committee who has not paid the Convention fee for the 
current year. 

Article III.— Officers. 

Sec. 1— The Officers of this Association shall consist of 
an Honorary President, President, Vice-President, Secretary- 
Treasurer and Archivist, who shall hold office until their 
successors are elected. 



DENTAL SOCIETIES. 219 

Sec. 2— The Board of Grovernors shall select ten names, 
from which the President shall select five, who shall act as 
a nominating Committee to nominate the officers and members 
of standing committees and report to the Association for 
election. 

Sec. 3— No member may hold the same office for more than 
two successive terms, except the Secretary-Treasurer and 
Archivist. 

Sec. 4— The Secretary-Treasurer's duties shall be to keep 
a correct record of the proceedings of all sessions of the Con- 
vention ; to conduct all correspondence of the Association ; to 
keep lists of the Honorary and Active members; to act as 
Secretary of the Board of Governors; to receive all moneys, 
and pay the same only on the order of the Chairman of the 
Board of Governors, and such other duties as the Board of 
Governors may direct. 

Sec. 5 — ^Archivist. The Curator of the College Museum, 
as appointed by the Board of Directors, shall be considered 
as in nomination for the office of Archivist. The Archivist 
shall have charge of all the belongings of the Association. 

Aeticle IV. — Board or Governors. 

Sec. 1 — The Board shall consist of the Officers of the 
Association, the Chairmen of the Standing Committees and 
six others, to be elected as herein provided. 
Sec. 2— The duties of the Board shall be : 
(a) To have charge of the general business of the 

Association. 
(h) To prepare the programme for and have charge 
of all arrangements for the Annual Con- 
vention. 

(c) To appoint the follo^ving Committees in connec- 

tion with the Annual Convention and to 
assign their duties: Exhibits : — Clinic, Ar- 
rangements, Publicity, Registration, Enter- 
tainment, and any other the Board may deem 
advisable. (Practitioners not on the Board 
may be appointed on a Committee in accord- 
ance with Article II., Sec. 5, but the majority 
and the Chairman shall be members of 
the Board. 

(d) To appoint the representatives from the 

Association on the Executive Committee of 
the Canadian Dental Association. 



220 DOMINION DENTAL JOURNAL 

Sec. 3— The Board shall be called together by the Secre- 
tary, in accordance with Sec. 5. 

Sec. 4 — (a) At the first Session of each Annual Con- 
vention two members shall be elected to the 
Board for a term of three years. 
(h) The election shall be by ballot, after Nomination. 

(c) The election shall be conducted by the Hare- 

Spence system. 

(d) Ketiring members shall be eligible for re-election. 
Sec. 5— The Officers and Board of Governors shall take 

office when the former incumbents have completed the work 
of the year, but in no case later than sixty days subsequent 
to the adjournment of the Convention at which they were 
elected. 

Sec. 6— The Board shall elect its own Chairman at the 
first meeting. 

Sec. 7— Seven shall constitute a quorum. 

Article V. — Standing Committees. 

Sec. 1 — The Standing Committees shall be : Oral Hygiene 
and Advisorv. 

Sec. 2 — The Oral Hygiene Committee shall consist of five 
members, who shall be nominated by the Nominating Com- 
mittee and elected by the Convention, together with a repre- 
sentative from each Local Oral Hygiene Committee. (See 
Art. II., Sec. 5.) It shall be the duty of this Committee to 
supervise educational work in the province, working in so far 
as possible through local committees nominated by the local 
dentists. Such Local Committees shall report to the Ontario 
Oral Hygiene Committee, as well as to the local Society. The 
five elected members, together with local representatives who 
reside sufficiently near to meet regularly, shall constitute the 
Executive of this Committee. The Executive shall have 
power to act for the whole Committee. Fifty per cent, of 
the members of this Committee, or of the Executive thereof, 
shall constitute a quorum. 

Sec. 3— The Advisory Committee shall consist of five 
members, who shall be nominated by the Nominating Com- 
mittee and elected by the Convention. The duties of this 
Committee shall be to act in an advisory capacity to those 
practitioners who may be threatened with legal proceedings, 
and give them all possible assistance (except financial) in 
connection therewith if deemed advisable. 



DENTAL SOCIETIES. 221 

Article VL— Finance. 

Sec. 1 — The Annual Convention fee shall be fixed by the 
Board of Governors and announced in the first notice regard- 
ing- the Convention sent to the practitioners. It shall not be 
less than $8.00 nor more than $10.00, according to the 
character of the Convention. 

Sec. 2— Auditors. The President shall, at the first session 
of the Association after the reading of the minutes, appoint 
two Auditors for the Treasurer's accounts, who shall examine 
and report on the same to the Board of Governors-elect. 

Article VII.— Meetings. 

Sec. 1— The Regular Meeting of this Association shall be 
held each year at such place as the Association may direct 
and such time as the Board of Governors may decide upon. 

Sec. 2 — Eight members shall constitute a quorum. 

Article VIII. — Changes. 

Sec. 1— This Constitution may be amended or altered at 
any meeting by a two-thirds vote of the members present, 
notice of such amendment or alteration having been given 
at a previous session. 

Sec. 2— This Association may be dissolved at any time 
by a three-fourths vote of the members present, written notice 
of such proposed dissolution having been given by nine 
meonbers at a previous meeting, and notice of such motion 
having been sent to all active members in good standing at 
least three months before the Annual Meeting. The property 
of the Association shall be disposed of as the Association 
shall direct. 



DEGREES AT DALHOUSIE 



At the Annual Commencement Exercises of the Faculty 
of Dentistry of Dalhousio University, held in Halifax, N.S.. 
the degree of Doctor of Dental Surgery was conferred on the 
following graduates: — 
Connors, Michael Clarence, Bayfield, N.S. 
Dimock, Karl Keith, Windsor, N.S. 
Gillespie, William Lester, Moncton, N.B. 
Mackenzie, Arrabelle Catherine Macdonald, Lower Middle 

River, N.S. 
Thomas, Frank Crocker, St. John, N.B. 



222 DOMINION DENTAL JOURNAL 

WOMEN'S AUXILIARY OF THE CANADIAN ARMY 

DENTAL CORPS 



The annual meeting of the Women's Auxiliary of the 
Canadian Army Dental Corps was held at the College on 
Thursday, ^fav 29th. After a few remarks bv our President, 
Mrs. Harold Clark, Mrs. Husband, First Vice-President, took 
the chair, when Mrs. Clark read her address. 

In the absence of the Secretary, the Corresponding Secre- 
tary read Mrs. Bothwell's annual report, showing a splendid 
year's work had been done. 

Reports of committees followed, showing that all had been 
at work to make the year a success, and showing the greatest 
spirit of co-operation had prevailed among the ladies. 

The report of the Nominating Committee, with Mrs. 
Arnold as Convener, was given, and as Mrs. Clark's name 
as President for the coming year was withdra^vn, Mrs. F. C. 
Husband was unanimously elected to serve. Mrs. A. J. 
McDonagh, Treasurer, Mrs. M. B. Gausby, Corresponding 
Secretary, and Mrs. John A. Bothwell, Secretary, were 
unanimously re-elected to their offices. 

The result of the ballots cast for First and Second Vice- 
president resulted in the follo^\dng election : 

Mrs. A. J. Broughton, First Vice-President. 
Mrs. A. D. S. Mason, Second Vice-President. 

It was moved by Mrs. McDonagh, seconded by Mrs. 
Watson, that the reports as read be accepted. Carried. 

A little speech of appreciation regarding the work of Mrs. 
Clark and Mrs. Husband was made by Mrs. Webster. Mrs. 
Broughton and Mrs. McDonagh spoke regarding Mrs. Clark's 
work, both as Secretary and President. 

On motion of Mrs. McDonagh, seconded by Mrs. Watson, 
Mrs. Webster and Mrs. Clark (our two Presidents in the life 
of the Auxiliary) were made members of t ^ Executive 
Committee. Carried. 

Col. Thompson, our O.C. for M.D. No. 2, and Capt. E. R. 
Zimmerman, who had just returned from Overseas, favored 
us with their presence, making a few remarks regarding our 
helpfulness to the Corps, and Capt. Zimmerman spoke most 
enthusiastically regarding the appreciation of our men Over- 
seas, and how much our boxes of comforts and socks added 
to their pleasure, in knowing that the women at home were 



DENTAL SOCIETIES. 223 

back of them, which was a very great encouragement, so that 

we felt that our work, though not great, had not been in vain. 

There being no further business, the meeting adjourned. 

M. B. Gausby, Secretary Pro Tern. 



PROGRAMME OF THE SECTION ON ORAL SURGERY 
EXODONTIA AND ANESTHESIA 



(New Orleans, La., October 20-24, 1919). 

First Session. 

Symposium: '^Apicoectomy, Its Indications and Contra- 
indications and Root Canal Technic" (illustrated with stere- 
opticon slides, by Thomas B. Hartzell, Minneapolis, Mich. 

** Surgical Technic of Apicoectomy" (illustrated with 
stereoptieon slides), by Chalmers J. Lyons, Ann Arbor, Mich. 
Discussed by Thomas P. Hinman, Atlanta, Ga. ; William L. 
Shearer, Omaha, Neb. ; Carl D. Lucas, Indianapolis, Ind. ; 
Clarence J. Grieves, Baltimore, Md. ; H. A. Maves, Minnea- 
polis, Minn. 

''Nitrous Oxid-Oxygen Anesthesia in Oral Surgery and 
Dentistry, ' ' by J. A. Heidbrink, Minneapolis, Minn. Discussed 
by Wm. H. Def ord, Des Moines, la. ; John W. Seybold, Denver, 
Col. ; Boyd S. Gardner, Rochester, Minn. 

''Tic Doloureaux: Etiolog\^— Diagnosis— Treatment— Pal- 
liative — Blocking and Surgical," by Rudolph Matas (M.D.), 
New Orleans, La. Discussed by Herbert A. Potts, Chicago, 111. 

Second Session. 

"Impacted Lower Third Molar" (illustrated), by George 
B. Winter, St. Louis, Mo. Discussed by J. P. Henahan, Cleve- 
land, O.; Harry W. Allen, Kansas City, Mo.; 0. T. Dean, 
Seattle, Wash.; Roy S. Hopkinson, Milwaukee, Wis. 

Symposium : "Block Anesthesia." "Preparation of 
Solution," bncE. A. Litchfield, Humboldt, Neb. 

"Pharmacology of Various Local Anesthetics," by Samuel 
L. Silverman, Atlanta, Ga. 

"Indications and Contra-Indications," by Fred F. Molt, 
Chicago, 111. 

"Technic of Blocking" (most important injections). 

"Suggestive Therapy and Treatment of Abnormal Condi- 
tions During and Following Injections," by P. G. Peterbaugh, 
Chicago, 111. 



224 DOMINION DENTAL JOURNAL 

''Diseases of the Antrum'' (illustrated with stereopticon 
slides), by Charles H. Oakman, Detroit, Mich. Discussed by 
E. Boyd Bogle, Nashville, Tenn.; Truman W. Brophy, 
Chicago, HI. 



DENTAL COUNCIL OF THE COLLEGE OF DENTAL 
SURGEONS OF BRITISH COLUMBIA 



The annual election of members of the council of the 
College of Dental Surgeons of British Columbia was as fol- 
lows: Dr. W. Eussell, Victoria; Dr. K. E. McKeon, Victoria; 
Dr. E. C. Jones, New Westminster; Dr. W. J. Lea, Vancouver; 
Dr. A. Brighouse, Vancouver; Dr. J. B. Grerry, Kamloops; 
and Dr. W. N. Gunning, Eossland. 



DENTAL OPERATIONS 



Performed by Officers of the Canadian Army Dental Corps 

in England and France from January 1st to March 31st, 

1919. And also Showing the Grand Total of Work 

Completed Since July 15th, 1915. 



Dental Operations 
Reported to 


Fill- 
ings. 


Treat- 
ments. 


Den- 
tures. 


Prophy- 
laxis. 


Extrac- 
tions. 


Devital- 
izing. 


Total. 


Dec. 31st, 1918.... 

Januiany, 1919 

February, 1919 

March, 1919 


933,765 
17,753 
18,157 
16,476 


335,924 
8,442 
9,259 
8,129 


164,543 
2,510 
1,925 
1,591 


187,110 
7,114 

7.'08'0 
8,623 


526,113 
4.894 
5,895 
3,736 


87,987 
1,334 
1,588 
1,335 


2.255,442 
42,047 
43.904 
39,890 


Grand Total... 


9»6,151 


391,754 


170,569 


209,927 


540,637 


92.244 


2,3«1,283 



J. ALEX. AEMSTEONG, CoL, 

Director of Dental Services, 

0. M, F. of C, 



EDITOR: 
A. E. Webster, M.D., D.D.S., L.D.S., Toronto. CaiKulii. 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross. L..D.S.. D.D^.. Ottawa; Carl E. Klotz. L.D.S.. St. 

Catharines. 
QuBBBC. — Eudore Debeau, L.D.S., D.D.S., 396 St. Denis Street. Montreal; Stanley 

Bums, D.D.S., L..D.S., 750 St. Catherine Street, Montreal; A. W. Thornton, 

D.D.S., Li.D.S., McGill University, Montreal. 
Alberta. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
Nkw Brunswick. — Jas. M. Magree, L.D-S., D.D^., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S., D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Regina. 

Prince Edward Island. — J. S. Bagrnall, D.D.S. , L..D.S., Charlotte town. 
Manitoba. — M. iH. Garvin, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogrue, D.D.S., L.DjS., Vancouver. 

Vol. XXXI. TORONTO, JUNE 15, 1919. No. 6. 



ASSIST IN EXAMINING THE CHILDREN'S TEETH 



Every dentist in Ontario is aware by this time that the 
Ontario Government, through the Department of Education, 
has appointed a dental inspector for the province. Unfor- 
tunately the department did not employ all of the time of the 
inspector. Just what he can do in the time allotted is not too 
clear. Where there should be full time for many inspectors, 
there is but part time for one. 

The position of affairs is always the same in regard to 
public dental service. No matter how many reports of the 
oral conditions may be compiled from various parts of the 
country, they are of no avail in persuading a school board or 
municipality that anything should be done for the teeth of 
its children. This may also be said of parents and guardians, 
because in the great majority of cases the condition of the 
mouths of the children is not known. To begin with, there 
must be an examination made of the children in each munici- 
pality before the people will be persuaded to give the matter 
any attention at all. Because children have been out of 
school or sick because of their teeth in one town does not 
help matters in another. 



226 DOMINION DENTAL JOURNAL 

It is often said that Jew dentists, or the profession as a 
whole, take little interest in public health questions. It is 
the intention of Dr. Conboy, the inspector, to have a thorough 
survey of the pupils of the province, and through this get the 
necessary data to persuade the various municipalities to 
provide dental treatment. If the members of the profession 
will communicate with him at the Parliament Buildings, 
Toronto, he will be glad to do everything within his power 
to assist in a thorough inspection of the childrens' mouths 
in the schools. If the profession take hold of this matter 
with a will, a great good will come to the rising generation. 



THE BRITISHER AND DENTISTRY 



The Dental Practitioner of London is a modest little dental 
magazine which has been published for a number of years as 
a weekly and now appears in a new form and cover as a 
monthly. It is the official organ of the National Dental 
Association. It seems strange that there should be an 
association in Great Britain of this name which is made up of 
members who have not licenses to practise. Dental legislation 
is certainly in a muddle in the Mother Country. Each candi- 
date for membership must subscribe to the following condi- 
tions before being admitted to membership. The schedule 
shows clearly the position in which advertising is held, even 
by the non-registered in England, where dental advertising 
has had sway for so long. It also shows what these same 
practitioners think of appending letters after names in 
general. In Canada, as well as in other countries, there is 
a tendency to sign almost every letter of the alphabet after 
surnames. Such letters are doubtlessly used for convenience 
in many cases, but more often to pretend that they have been 
obtained from some college or university which has for so 
many years used abbreviations for the titles conferred. 

SCHEDULE C. 
REQUIRES NOT LESS THAN TWO SIGNATURES. 
(Doctor or Dental Surgeon preferred.) 
No Member shall in any manner or under any pretext issue or publish any 
advertisement, circular, handbill, notice, or any other public announcement relat- 
ing to his practice or to any practice with which he is connected, or permit the 
same to be done, or exhibit or allow to be exhibited any show case open to 
public inspection except with the previous sanction of the Executive Committee, 
which shall consider each application for such sanction on its merits and having 
regard to the conditions of practice in each individual case, but under no 



EDITORIAL ^^^7 

circumstances shall the employment of canvassers he sanctioned. This prohi- 
bition shall not prevent — 

(a) The publication of professional card advertisements in the press; or 

\h) The publication in good faith of any announcement for the purpose of 
informing a Member's patient of his change of address or of the 
days upon which he proposes to attend at any particular town or place, 
provided that such announcement does not include any illustration or 
other printed matter than his name, address and description. 

No Member shall in any circumstances use the letters M.X.D.A. or any 
variation thereof or any other abbreviated description intended to signify mem- 
bership of the Association, but any member may, if he think tit. use the full 
and unabbreviated description. "Member of the National Dental Association" 
with or after his name. 

Every member of the Association shall be deemed to have agreed with the 
Association to comply strictly with the provisions of Nos. 12 and 13 of these 
Rules and Regulations during the period of his membership and to have 
been accepted as a member on that footing. 

We, the undersigned, have known Mr 

....of 

foi a period of not less than three years. We believe him to be an honorable 
and respectable person, worthy of being a member of the National Dental 
Association. 



Editorial Notes 



More and more women are entering the ranks of the 
dental profession. 

Dr. Field is making a tour of Western Canada in the in- 
terests of the S. S. White Dental Company. 

Dr. Layng, of Treherne, Man., has moved to Kerrobert, 
and will be succeeded by Dr. Myles as soon as he is discharged 
from the army. 

Dr. Rena B. Stillman, Calgary, is the first graduate in 
Dentistry of the Tniversity of Alberta and the first woman 
graduate of Alberta. 

There are hundreds of children in many parts of Canada 
who have not the remotest chance to have their teeth attended, 
because of lack of funds, scarcity of dentists and long 
distances from large centres. 

Park-Davis Company have just issued a neatly-printed 
twenty-four page booklet called "Dental Progress. '^ The 
publishers are not sure how often it will appear, but Say that 
it depends upon the encouragement it gets. 



228 DOMINION DBNTAL JOURNAL 

The Legislature of Saskatchewan has empowered school 
trustees, or any group of boards, to employ school nurses or 
special instructors in household science or agriculture, and 
may provide medical and dental inspection. 



It is reported in a Moncton paper that a dentist who had 
listened to a long discourse from one of his patients on the 
eight-hour day for workers, ca'lm'ly walked out of his office, 
telling the patient that he had already worked eight hours, and 
wished to spend some time with his family as the patient had 
claimed for himself. 

Dentists searching for a good opening are assured by the 
Prince Eupert Board of Trade that an excellent opportunity 
presents itself in the Northern metropolis. Prince Rupert is 
a growing city, with a remarkable history; with unexcelled 
harbor acconmaodation and rich harvest from the fishing in- 
dustry in Northern waters, the future of Prince Rupert is 
bright, indeed. Dentists looking for a change would be well 
advised to investigate the opportunities presented here. 

Ten thousand dollars has been set aside to make a medical 
and dental inspection of the rural schools of the province. 
Four physicians have been appointed, but no dentist has yet 
been named. It seems strange that only one dentist is to be 
appointed, while four physicians are required to make the 
medical inspection. A dental examination that is any good 
takes a good deal of time. It must be clear to anyone who 
has thought aJbout the matter at ail that one dentist cannot 
inspect the children of the province, nor will the whole sum 
set aside for this purpose make the dental inspection alone. 



Dominion 

Dental Journal 

Vol. XXXI. TORONTO, JULY 15, 1919. No. 7. 

Original Communications 

THE TEACHING OF ART DENTISTRY 



Dr. Joseph Nolix, ^lontreal. 



SYNOPSIS : 

Dentistry is both a profession and an art. 

The scientific and pnrely professional part of dental edu- 
cation, as given in onr dental schools, is progressing in a most 
satisfactory manner. 

As for the prosthetic and technical end of the training given 
to the present-day dental student, the essayist claims that it 
is given on lines which tend to create in the mind of the student 
the ideals of a craftsman and an artisan, rather than those of 
an artist. 

His hands, like those of an apprentice in an industrial 
school, are trained to perform a certain number of operations, 
while his mind and his eyes do not receive the education re- 
quired to make them creative and analytical, in an artistic 
sense. 

The most difficult thing in nature for a painter or a sculptor 
to reproduce, is the human face. The young dentist is not 
called upon to reproduce it, but his task is still more difficult. 
It is the human face itself, the living face, disfigured by 
disease, malformation, etc., to which he must restore its primi- 
ti\e harmony and beauty. And he knows next to nothing 
about it. 

What is the remedy? 

According to the essayist, it should consist in cultivating 
in [he mind of the student the senses of form, of direction, and 
of proportion, by the aid of lessons in free-hand dramng, and 
lectures of facial morphology and *^ artistic '' anatomy of the 
face. 



230 rX)MINION DEISTTAL JOURNAL 

Form can only be fully understood by decomposing it into 
its primitive elements. Free-hand drawing is the only exer- 
cise that will train the mind to analyze form and give the stu- 
dent a full comprehension of the laws governing morphology. 

All industrial and technical schools have grasped the truth 
of this assertion, and free-hand drawing holds an important 
place in their curriculum. 

Lectures should also be given on general and facial mor- 
phology and on the "artistic" anatomy of the face such as are 
given in schools of art. General morphology is a study of the 
laws that govern form in general. 

Facial morphology is the study of the exterior appearance 
of the face, the shape and proportions of its component parts, 
considered individually and in view of their relation to each 
other. 

'^Artistic anatomy^' is a study of the shape of the bones, 
of the muscles, and other tissues, and their influence on the 
exterior appearance of the body. 

The time required for all this would cover two hours a week 
during the whole dental course, but it would improve the 
manual ability of the student to such an extent, that the time 
saved thereby at the chair and in the laboratory would more 
than compensate for it. 



EXCLUSION OF MOISTURE IN ITS RELATIONSHIP 

TO ASEPSIS 



The first rule of modem surgery is asepsis. As applied 
to pulp treatment, this means that the field of operation should 
be treated as though it were a surgical wound. The immediate 
neighborhood should be maintained in an aseptic condition 
during each operation. Nothing carrying infection should be 
permitted to enter this field. In no case should saliva be 
allowed to enter the puilp chamber from the beginning of the 
first treatment until after the root canals are filled. This may 
be done by so simple a technique that there is no reason why it 
should not be carried out to the finest detail except in a very 
limited number of cases which present unusual difficulties. 
Under this plan, asepsis in pulp treatment requires : 
1. The mechanical procedure to secure cleanliness before 
applying the rubber dam. This may be done by first spraying 
the mouth with an antiseptic solution ; then by cleansing and 



ORIGINAL COMMUNICATIONS 231 

disinfecting the crevices and gingiva of the teeth to which the 
rubber dam is to be applied. 

N.B.~If this precaution is omitted infectious material is 
forced by the ru'bber and ligatures under the gum margin, 
where it may remain for hours. The interruption of the 
circulation of the blood favors infection of the weakened tissue. 

2. The disinfection of the field by hydrogen dioxide, fol- 
lowed by thymol alcohol. 

3. Application of the rubber in such a way as to exclude 
all moisture from the field of operation. 

4. Sterilization of the field of operation as best possible by 
swabbing the surfaces of the teeth with a good disinfectant, 
such as iodine. 



HOSPITAL CASE 



Case Reported hy Capt. Hawkshaw and G. F. Risdon, 

C.A.M.C, O.C. Canadian Section Queen's 

Hospital, Sidcup, England. 

CASE REPORT OF OSTEOMYELITIS ( SUBACUTE) OF THE SUPERIOR 

MAXILLARY. 

Reported to dental clinic because of a loose filling 10/7/19. 
The Dental Officer noticed a sw^elling over the right central 
and opened and irrigated the sinus. Slight swelling of the 
face on the following day, and wishing to be relieved of his 
duties he reported sick to Medical Officers who referred him 
to the Dental Officer. A temporary filling was placed in the 
right central and watched for some days. The right central 
and lateral were now very loose, and as he could not report 
to dental clinic he requested a civilian dentist to remove the 
central, which he did without any anaesthetic. The lateral 
the patient removed himself. He reported to the Dental 
Officer again because of the swelling and discharge and was 
kept under close observation for some days. The X-ray 
showed considerable necrosis and the case was kindly referred 
to our clinic at Queen's Hospital, Canadian Section, Sidcup, 
England. 
Complained on Admission. 

1. Two teeth loose. Left upper central and lateral. 

2. Discharge from the raw area, region of the recent ex- 
tractions. 

3. Disagreeable odor and taste. 
Present History. 

Two anterior teeth had been extracted and the left central 



212 DOAIIXION DENTAL JOURNAL 

and lateral very loose. A raw area from which pus was dis- 
charging seen in the region of the recent extractions. 

Fast History. 

As recorded above— except definite hisi:ory of syphilis, 
hard ulcer on the penis in 1916 two weeks after exposure, and 
a sore throat. The throat improved and the ulcer disappeared 
but Wassermaim was positive so the patient was transferred 




to a venereal hospital. Here he was given the usual anti- 
syphilitic treatment, seven intravenous arsenical injections, 
similar to ^'606," and eleven mercurial intramuscular injec- 
tions in three months. Two Wassermanns taken after treat- 
ment and one positive, so treatment repeated in same doses 
but in a shorter period (five weeks) and after some delay a 
Wassermann taken and the report was negative. Six consecu- 
tive Wassermanns were done in the year following treatment 



ORIGINAL COMMUNICATIONS 233 

and all were negative. The f)atient was allowed to marry and 
a son was born, and both mother and (diild apparently are 
healthy. 
Diagnosis. 

Chronic osteomyelitis (syphilitic). 
Treatment. 

In consultation with Capt. Hawkshaw, C'.A.D.C, it was 
decided that the left central and lateral should be removed 
and curetted. In doing so, a large piece of bone was removed 
from the region of the pre-maxillary area and packed with 
gauze to be changed daily. 

We requested that a Wassermann be taken, and, as patient 
was reporting back to the venereal liosi)ital, he promised to 
send the report of Wassermann to us, but to date not received. 
We hope to receive same in the near future. 



THE IMPORTANCE OF DENTAL SERVICE IN THE 

HOSPITAL 



Alfred A. Crocker, Cincinnati, Ohio. 



Dental service is necessary along with medical service in 
healing systemic disease. The relationship of the teeth to 
systemic diseases as foci of infection, or at least as relay posts 
from which the infection is increased, has so repeatedly been 
demonstrated that most physicians recognize it as a valuable 
element in their diagnosis. The examination of the mouth 
condition of the y)atient furnishes valuable data in determin- 
ing the treatment of the patient while in the hospital, as it 
tells whether, owing to the presence of pyorrhea, alveolar ab- 
scess, blind abscess, impacted unerupted teeth, the teeth can 
be counted in the treatment to follow, or eliminated from con- 
sideration. Work for the dental department of a hospital is 
furnished by maternity cases, children's teeth, and cases in 
which arsenic iodides, mercury, or phosphorus are prescribed. 
Facilities for difficult extractions under anesthesia and for 
scientific research are also afforded by a hospital dental clinic. 

During a recent visit to the Jewish Hospital in Cincinnati, 
where they have a dental clinic with Dr. Samuel Rabkin in 
full time attendance as dental clinician, I was shown the hos- 
pital card on which the tooth condition of all patients is re- 
corded by him. All his findings are recorded thereon and 
furnish data which very often help the hospital board, to- 



234 DOMINION DENTAL JOURNAL 

gether with the records placed on the same card by physicians 
and specialists in the hospital's other departments, in arriv- 
ing at the correct diagnosis and subsequent relief and restor- 
ation of the patient to full health and usefulness. As Dr. 
Hexter, the supervisor, explained, it is not enough to place 
the patient on his feet; to restore the patient to his or her 
normal self, if possible, is the aim of the hospital, and it takes 
an analysis from all departments to do it properly. Another 
work performed by the dental clinic at the Jewish Hospital 
is the care of children's teeth, the advantages of which all 
welfare authorities readily recognize. This work is part of 
the oral hygiene movement which is so active in all parts of 
the United States. 

Besides the hospital dental work above outlined, research 
work in dental pathology and dental bacteriology is carried 
on in connection with cases presented at the hospital. This 
work has shown valuable results and has been of much benefit 
to the patients treated at the hospital. 

A visit was also made at the Cincinnati General Hospital, 
where Dr. W. S. Locke has charge of the dental department. 
Patients arriving at the hospital for diagnosis and treatment 
are taken to the dental clinic at the direction of the attending 
physician. If the patient is unable to walk, a wheeled chair 
or a wheeled stretcher is used to convey the patient there. 
After the instrumental examination of the teeth, the dental 
clinician sends the patient to the X-ray department for a com- 
plete dental roentgenographic examination. Ten films are 
taken, five upper and five lower, covering the complete mouth. 
One of the large machines is used on a two and one-half spark 
gap. The developed films are returned to the dental depart- 
ment and, together with the clinical report thereon, sent to 
the attending physician with the dental recommendations for 
the case. The dental diagnosis, along with the attending phy- 
sician's diagnosis of symptoms and other tests, such as urin- 
alysis, bacteriological, etc., make up the case history, which 
is kept on an indexed chart or card. In all cases the clearing 
up of mouth conditions accelerates recovery from the sys- 
temic conditions. Part of every day is devoted to the care of 
children's teeth at the Cincinnati Hospital. Children from 
the city and neighborhood are brought to the hospital. Care 
of their teeth is along preventive lines and correction of irreg- 
ularities and dental advice to the parents. Children from five 
years up receive this attention and learn the value of care of 
the teeth. 



SELECTIONS. 235 

ORAL FOCAL INFECTION— FROM THE STANDPOINT 
OF AN ORAL SURGEON 



Theodore Blum, D.D.S., M.D., New York City. 

Read before the meeting of the Alumni Association of the College of Dentistry. 
University of Buffalo, March 21. 1919. 

So much has been written and said about the dangers of 
devitalized teeth and other pathological conditions of the oral 
cavity, that it may not be out of place to report the clinical 
findings accumulated from the experience of the last few years 
not only from private, but also from hospital practice. It 
seems that the influence of the so-called oral foci of infection 
is vastly over-estimated and that the experience of honest ob- 
servers will bring the percentage of systemic disorders caused 
by such foci either to the level or below the one caused by foci 
in Other parts of the human body. To the medical profession, 
devitalized teeth have apparently been the last straw to grasp 
in those obscure cases where the routine treatment was of no 
avail. It is unquestionably true that diseased parts should 
be either cured or removed and this holds good particularly 
for those patients who are suffering with systemic disorders, 
the cause of which is not known. On the other hand, it is ab- 
surd to my mind, to promise the patient, as is so often done^ 
a cure by the removal of infected teeth. Calm observation 
will, I am sure, finally prove that if such teeth are responsible 
for general disorders, the percentage is comparatively small 
and that the advocates of the "cure it all with removal of oral 
foci'' will be classed with the practitioners who praised emetin 
as the cure of pyorrhea alveolaris, Beebe's serum or radium 
as the cure for cancer, and those others who make disturbances. 
of internal secretion responsible for every disease known to- 
the medical world. 

While many different parts of the anatomical make-up or 
the oral cavity may harbor infection, as for instance, the sali- 
vary glands and the mucous lining of the mouth, it may be 
accepted as a fact that the peridental membrane either at the 
apex or at the gingiva is the most or only important location 
for a focus of infection. Diseases of the gingiva and of the 
pericementum at the gingiva comprise conditions generally 
and most commonly known as ''pyrrohea alveolaris" and its 
fore-runner ''gingivitis." The pathology of the apical peri- 
dental membrane is probably most often made responsible> 
for systemic disorders. Its first deviation from the normal 
as studied by means of the X-ray is properly termed chronic 



236 DOMINION DENTAL JOURNAL 

apical pericementitis, meaning a chronic inflammation (thick- 
ening) of the apical pericementum. A further growth of this 
apical area with the accompanying destruction of the sur- 
rounding alveolus results in the breaking down of a number 
of cells and liquif action necrosis in its centre. The immigra- 
tion of epithelial cells from the peridental membrane may en- 
tir( ly line the now established cavity with these cells, result- 
ing finally in the formation of a radicular cyst, a cyst origin- 
ally caused by a diseased tooth root. Such cysts may assume 
large dimensions, displace the antrum, if in the maxilla, or 
the contents of the interior dental canal, if in the mandible, 
etc. Chronic apical pericementitis may never develop any 
further. A large majority of the small areas, however, show 
a positive culture, mainly, streptococcus viridans. It seems 
that the larger the cavity, the less likelihood of finding an or- 
ganism. In fact, radicular cysts, unless secondarily infected, 
ar ? sterile. There is one other condition which is very often 
overlooked and may possibly be a cause of infection. This 
is the so-called wisdom tooth pocket, a pocket which is formed 
by a partly erupted wisdom tooth and its overlaying gum 
tissue. It often takes quite some time for such a tooth to 
•erupt and, therefore, the existence of such a focus msiy be 
very much prolonged. The treatment is obvious. 

Why do not most of the cultures taken from so-called foci 
show streptococcus viridans? It is very difficult, and at times, 
impossible, to take a culture from the apex of a tooth without 
contamination from any or all the different tissues and in- 
struments and apparatus tlie parts come in contact with. The 
•oral cavity under normal conditions harbors the streptococcus. 
Contact, therefore, with the gingiva or any part of the oral 
cavity makes our finding worthless. Instruments may not be 
properly sterilized and the culture tubes themselves handled 
in such a way as to interfere with the final results. Then 
again, the reports from unreliable commercial laboratories 
should be excluded by serious scientific investigators. Con- 
sequently, a positive culture taken by the average general 
medical or dental practitioner is not conclusive. Neither can 
a negative culture always be looked upon as final, because im- 
proper technic, as liot instruments or those covered with al- 
cohol or other disinfectants, may have killed the organism 
.before reaching the culture tube. Low temperature of the 
.test tube and its contents often interfere with the results 
which otherwise could have been obtained with proper care. 
It must not be forgotten that there are certain organisms 



SELECTIONS. 237 

which at the present time cannot be cultured, the cause of 
which may lie in the fact that a proper medium has not been 
found. 

The stand taken by the average physician regarding oral 
focal infections can be summed up in a few words. He has 
heard and read a good bit about the importance of dental foci 
of infection. In the average case he does not bother about 
the teeth at all. When, however, he is confronted with a pa- 
tient for whom the routine treatment does not result in partial 
or peiTnanent cure, then the old "stand by*' gains prominence. 
The patient as a rule is sent to a commercial laborator}^ where, 
for a small fee, not only an X-ray examination and diagnosis 
is made, but also advice as to treatment is given by incom- 
petent men. Most often a diagnosis of abscess is made, al- 
though first of all, an abscess at the apex of a tooth cannot be 
diagnosed bj' means of the X-ray alone and that secondly, 
only in a small ])ercentage of cases do these apical areas show 
pus. He recommends the removal of a tooth carrying a gold 
crown or a bridge, although its pulp may be vital. At any 
rate, the patient is advised to have the "abscessed'' teeth and 
those with gold crowns removed without consulting the pa- 
tient's dentist or some dentist as to the proper procedure. 
While the co-operation between the two professions is para- 
mount, the physician should not overstep his field by order- 
ing certain operations in a field with which he is only slightly, 
if at all familiar. 

The average dentist's view relative to this subject, while 
probably more logical because he is or should be trained in 
this special field, still is a good bit influenced by the signifi- 
cance that has been attached to his sphere of activitv by the 
medical man. The radical demands the removal of not only 
each devitalized tooth, but also of those teeth which show 
disease of the gingiva. The conservative, on the other hand, 
can be characterized by the statement of their most ardent 
exponent namely that "devitalized teeth properly treated are 
forever secure against infection" and, therefore, believe in 
the retention of most of the devitalized teeth. There is, how- 
ever, no scientific proof as yet to their contention. 

The present knowledge regarding focal infection of the 
oral cavity is so uncertain, that competent research work is 
essential. The number of capable men interested in this sub- 
ject is very small. It should be clear to everybody's mind 
that no one is in a position to do research work unless espe- 
cially trained to do so. Therefore, the fact that one holds an 



238 DOMINIOiN DENTAL JOURNAL 

M.D. or D.D.S. degree or both, is not enough qualification. 
One has to spend quite a few years in a lahoratory, practically 
away from any private work, (as is the rule at the Rock 3- 
feller Institute), to accomplish successfully the task of serious 
investigation. So many dentists believe that a microscope, 
an incubator, a few culture tubes, media and stains, etc., are 
all that is necessary. This is not so, however. One man can- 
not practice all the specialties and be efficient in each of them. 
Some dentists have established their own laboratories in con- 
nection with their office, the laboratory work being done by 
a technician under the supervision of the practitioner. The 
practitioner not being an expert in bacteriology, cannot ac- 
complish satisfactory results. One must, therefore, look upon 
the establishment of such offices as a commercial tendency on 
the part of the owner because he knows, or at least ought lo 
know, that he cannot give his patients the best advice and 
treatment. Considering the above, one arrives at the conclu- 
sion that for the conduct of scientific research, three special- 
ists are required, namely, a bacteriologist, a physician and a 
dentist. The co-operation of the three alone can throw light 
upon this subject. 

The position of the oral surgeon who acts as a consultant 
or operator in these cases is not to be envied. Patients appear 
at his office with a set of X-rays of the teeth and with the com- 
plaint of some systemic disorder. They are referred mostly 
by their physician or dentist who- usually promise that the re- 
moval of the devitalized teeth will cure them. What hopes 
can we give the patient and what should be the outline of 
treatment Every honest practitioner must admit that no 
one is in a position to assure the patient beforehand, that the 
eradication of such foci will at the same time or in due time 
improve and finally entirely correct the systemic condition 
the patient suffers from. An infected area somewhere about 
the mouth may or may not be responsible for the patient's 
general condition. If, however, directly responsible (in case 
this can be scientifically proven) the organism or their toxins 
may have injured the body tissues to such an extent, that, 
although the primary cause of the malady their eradication 
will not cure the patient even though further advance of the 
disease may be prevented. 

The most important location of infection in the mouth lies 
in the apical pericementum, either due to infection from the 
pulp proper or hemaeogenous. Only a short time ago, a well- 
known dentist in New York made the statement "that devital- 



SELECTIONS. 239 

ized teeth properly treated are forever secure against infec- 
tion" and remarked that he had demonstrated this scientifi- 
cally, although he neglected to refer me to his works on this 
subject. The only absolutely certain eradication of such foci 
consists of the surgical removal of the teeth in question, 
which, of ooiurse, includes the curetment of the socket if in- 
dicated. The fact that these areas after dental root canal 
treatment in a number of cases become smaller, as demon- 
strated by the X-ray, does not give anyone the privilege to 
assume that the infection had subsided because new bone may 
be formed while even an active process of infection is going 
on, as for instance, in a case of osteomyelitis. At this point, 
I must add that if a patient comes to my office with a history 
of some systemic malady and the dental X-ray examination 
shows a tooth with what is called a complete root canal filling 
with some rarafaction at the apex, or even one at all, I can- 
not honestly say to the patient that this tooth with its peri- 
cemental membrane— no matter w'ho treated the root canal— 
is not a causative factor of his trouble. In other words, any 
devitalized tooth, no matter what treatment it was subjected 
to, may be a focus of infection. No scientific proof has been 
presented as yet to the contrary. 

To my mind, a so-called complete root canal filling is the 
ideal result of an operation, the adjective ^' ideal" character- 
izing it as something that cannot be accomplished. The only 
means we have at the present time to judge a root canal filling 
in vivo is by means of the X-ray and everyone knows that such 
an examination will not permit the operator to state that the 
apical foramen and all the accessory foramina are hermet- 
ically sealed, nor that all the infection had been removed, nor 
that re-infection will not take place. The fact that a nega- 
tive culture was obtained from a root canal just previous to 
its being filled does not guarantee that re-infection cannot 
take place. I have yet to see the dentist who, during a root 
canal operation, will not forget himself at some time and 
touch some object which will cause the infection of the field 
of operation. And I really cannot blame him for it, because 
it certainly seems quite impossible to keep everything sterile 
during such a prolonged and intricate procedure. Even a 
root amputation is not advisable in case the patient is suffer- 
ing from a systemic malady as the remaining part of the root 
— no matter how treated— may act as a foreign body and 
present a locus minoris resist antiae. In examining the pa- 
tient, diseases of the gingiva must not be neglected, and the 



240 DOMINION DENTAL JOURNAL 

proper treatment, prophylaxis, installed. Local conditions 
(malposition, faulty articulation, etc.), if the cause, must be 
attended to as well as general conditions, which may be le- 
sponsible foT it. 

To complete one's record, cultures are taken to establish 
the identity of the organism. The value of vaccine as a p^rt 
of the general treatment has apx^arently lost its previous im- 
portance. It may do good, but it surely does no harm. Tlie 
compliment fixation test for atreptococcus is rarely used. 

In my experience, both at the hospitals and office, the num- 
bei of cases which were relieved by the removal of foci of 
infection from the oral cavity is very small. Some patients 
do not derive any benefit at all as far as their general condi- 
tion is concerned, others show slight, while again others show 
temporary improvement. I feel certain that suggestion as 
applied to patients by some practitioners has quite an influ- 
ence oh the patients' mental condition and with it, on their 
bodily ailments, still, I have never seen a case similar to the 
ones reported at dental meetings or in different journals, 
namely, of patients w^ho were brought to the office of these men 
on invalid chairs, who after the removal of oral focal infec- 
tions, regained the use of their joints and muscles to such an 
extent that they could walk in a few days. Such an improve- 
ment, of course, is impossible in chronic cases as organic 
lesions cannot be repaired in such a short time. In acute cases, 
the swellings of the joints disappear to a large extent with 
the acute attacks, when the patients' regain the usefulness of 
the affected joints. To consider a case cured because the gen- 
eral symptoms have disappeared is a fallacy on account of 
the fact that attacks of arthritis and other diseases of which 
focal infection is regarded as a cause, may and very often do 
return sooner or later. Since the advent of focal infection, 
practically every part of the body has been pointed out as a 
focus of nearly every malady, each one being claimed by their 
advocates as the most significant one. To my mind, the im- 
portance especially of the apical infections has been greatly 
over-estimated. Unfortunately, many physicians and dentists 
are so convinced of the ever present connection between in- 
fected areas about the mouth and their patient's general con- 
dition, that they promise that the removal of all bad teeth 
would cure them. It is often very difficult, therefore, to make 
these patients understand that no such promise can be given 
but that we only consider it the proper procedure to remove 
these teeth, because there is a possible or remote chance of 



SELECTIONS. 241 

their being responsible for the trouble. Past experience seems 
to show that as a focus of infection, the teeth are not nearly 
as important as other parts of the body. A genito-urinary 
surgeon cited to me the other day a case in which an oral 
surgeon positively insiisted that the patient's general condi- 
tion was caused by areas of infection about the teeth, the re- 
moval of which did not improve his condition, while later on, 
an infection of the lower alimentary canal was proven to be 
the causative factor. It may not be out of place to make the 
statement here that unfortunately, many members of the pro- 
fession have during the last few years taken undue advantage 
of the popular belief in oral focal infections. 

The fact that an organism is found at the apex of a de- 
vitalized tooth brings up the question whether such an organ- 
ism was introduced either at the time of dental treatment or 
without such (simply gaining access through the pulp cham- 
ber and canal), or whether this organism selected this habitat, 
being carried through the blood or l\'inph stream, the devital- 
ized tooth being a point of lowered resistance. Personally, 
I would consider it quite possible. 

Our present knowledge of this subject being incomplete, 
the following outline of treatment should be considered: Tt 
is possible for a tooth to be a focus for infection. Our advice 
to the patient, therefore, should be the eradication of the 
focus, the only positively certain one being the removal of the 
tooth and curetment if indicated. On the other hand, past 
experience has shown that the percentage of cases of oral 
focal infections is comparatively small. The average patient, 
therefore, who has devitalized teeth and is enjoying good 
health, should be advised to have these teeth treated by dental 
or surgical means, if possible. Patients, however, who are, 
or who have been suffering with some systemic condition, 
must have all devitalized teeth removed if one wishes to re- 
move all likely causes of such disorders. In these cases, it 
must not be forgotten that every part of the body besides the 
oral cavity should be examined for the detection of a possible 
focus. Any bridgework, crown or filling— no matter of what 
type— should be removed in any patient if they irritate the 
surrounding tissues. It is rather unfortunate that so many 
teeth must be removed, although we are not certain and can- 
not state that they are the cause. As soon as the research 
work in this subject will be done by competent men only, and 
their findings alone seriously looked upon by the medical and 
dental practitioners, more light will be thrown upon this field 



242 DOMINION DENTAL JOURNAL 

for the benefit of both the suffering patients and our profes- 
sion as welL Our hope, however, does not lie so much as in 
the enlightenment of both the profession and the public on 
one hand, and the legislative bodies on the other, in regard 
to the paramount iniportance of oral prophylaxsis. Oral pro- 
phylaxsis systematized and well established would unques- 
tionably free the coming generation of the menace of oral 
focal infection. 



VITAMINEw^ 



W. D. Halliburton, M.D., F.R.S 



The word ''vitamine" is not as old as the present century^ 
and however objectionable it may be in itself, it seems to have 
obtained a permanent footing in medical literature. It is cer- 
tainly less cumbersome than the expression '^accessory food 
factor'^ which has been suggested as a substitute. The actual 
word employed is after all of small moment; the important 
point is what it connotes. It is a matter of everyday physio- 
k)gical knowledge that our bodies are built out of proteins, 
fats, carbohydrates, salts and water, and that these substances 
must be taken in certain proportions and in sufficient quan- 
tity to repair the body waste, and furnish the energy neces- 
sary for its activities. But recent research has shown that 
these substances alone are incapable of maintainiug life. 
Something else is required, the chemical nature of which is at 
present unknown, and it is to these unknown but indispensable 
accessory substances that the term vitamine has been applied. 

Professor F. G. Hopkins of Cambridge, a pioneer in this 
branch of research, has suggested a useful simile to help us 
to understand the problem. He compares the building of the 
body to the building of a house ; the essential bricks or blocks 
of stone of which the walls of the house are composed would 
be of comparatively little use unless mortar or cement was 
also supplied to unite these components together, and it is 
the cementing material which he compares to the vitamines. 
It would be dangerous to press the analogy too far, for the 
exact role of the vitamines is still hidden from us, but the 
simile is a useful one to indicate one way at least in which 
they can render the important building stones of real service, 
and it is accurate in a quantitative sense. The mortar in the 
walls of a house makes up but a small proportion of the struc- 



SELECTIONS. 243 

ture ; it is exactly the same in the case of the vitamines — they 
bear but a small proportion to the total food supply. When 
they are withheld from the food, as when chemically pure pro- 
teins, fats, carbohydrates, salts and water are administered, 
health deteriorates, in young animals growth ceases, and, if 
the treatment is continued, death is the inevitable result. 
Health can be at once re-established if the diet is ampliled by 
adding to it a natural food, such as a small amount of milk, 
for foods as they occur in nature contain the accessory factors 
necessary for growth and maintenance. The foregoing state- 
ments are commonplaces to the modern physiologist, but to 
the practising medical man they may be new, and I trust to 
show they are important practically. So many are the treated, 
puriled, and sophisticated foods at present on the market, that 
it is most important to the dietician to remember that these 
are but poor substitutes for the foods Which are made in Na- 
ture's laboratory. 

Although biochemists have not yet got so far as to be able 
to state what is the chemical structure of these vitamines, re- 
search has, at any rate, progressed far enough to make it cer- 
tain that they are numerous, and it is around three of them 
that research has mainly centred. They are products of the 
plant world, and it is on plants that all animals ultimately 
live. Animals have greater synthetic powers than was for- 
merly believed to be the case, but, so far as is at present 
known, they are not able to synthesize or manufacture vita- 
mines. The vitamines can be separated by their varying solu- 
bilities in water and other agents, they can be distinguished 
by their varying powers of resistance to heat and other drastic 
agencies, and, further, they are differently distributed in vari 
ous parts of the vegetable world. 

Their absence prevents healthy growth and leads to death, 
but the symptoms manifested are different in the three cases. 
The diseases due to their absence are very conveniently 
grouped together as '^ deficiency diseases. '^ Among such 
diseases are beriberi, pellagra, and, coming nearer home, 
scurvy and rickets. 

The first of these vitamines is contained in the embryo or 
"germ'' of cereal seeds. When milling is carried to a high 
degree this portion of the grain is removed, hence polished 
rice and superfine white wheat flour, though they may appeal 
to the aesthetic sense, are of inferior value as foods. It is now 
firmly established that beriberi, the disease of the rice-eating 
nations, is due to the use of polished rice, and can be prevented 



244 DOMIXTOX DENTAL JOURNAL 

or cured by adding the polishings to the diet. Polished rice 
produces the disease not because it contains a poison, but be- 
cause it lacks the vitamines. Using the non-committal nomen- 
clature introduced by American physiologists, it is now usual 
to speak of this vitamine, on account of its solubility in water, 
as 'Svater-soluble B." 

The second is contained in the majority of animal fat (lard 
is an exception), and is particularly abundant in milk fat, and 
in certain fish oils such as codliver oil. It is specially important 
as a growth factor, and therefore indispensable in early life. 
It is absent in vegetable fats. Here we have one more indica- 
tion of the value of milk for the young, an explanation of the 
potency of cod-liver oil in curing malnutrition, and a warning 
of the danger of vegetable margarines if employed as the 
only source of fat in the food of the growing section of the 
population, or of expectant mothers. It is usual to dub this 
vitimiine ''fat-soluble A." There is accumulating evidei.oe 
to show that its absence or deficiency is an etiological factor 
in rickets. Like its water-soluble companion, it is ultimately 
a vegetable product, and is contained in high concentration 
in the green portions of plants. 

The third vitamine is also soluble in water, and, as Dr. 
Drummond suggests, it may be called "water-soluble C." 
.This is the antiscorbutic ])rinciple, and is found in the juices 
of fruits (the orange and lemon are here pre-eminent) and 
in most edible vegetables. It is characterized by its extreme 
lability, being destroj^ed by moderately high temperatures, 
treatment with alkali, by desiccation, canning processes, and 
the like. Hence arises the value of fresh fruit and vegetables 
in the prevention of scurvy. 

The object of this article, however, is not so much to in- 
dicate to the practitioner the elementary principles of our 
knowledge of the vitamines— that could be accomplished by 
the perusal of any recent book on physiology or scientific 
dietetics— but to go a little further, as a result of reflection 
and study of the subject. An appreciation of the main funda- 
mentals is, however, necessary to realize that the subject is 
on.3 of the highest importance and has bearings beyond those 
I have up to this point briefly summarized . 

May it not be that many so-called minor conditions of mal- 
nutrition may be due to lack of vitamines, or to a deficiency in 
their supply? Although at present three vitamines have been 
brought into the light of investigation, who can say that the 
list is complete? It is more than probable that obscure and 



SELECTIONS. 245 

apparently trivial complaints may in the future also be found 
to be deficiency diseases. An obvious state of malnutrition 
in the infant may pass away, and yet it may leave its mark 
behind it and cause far-reaching results later in life. Take, 
for example, that curse of modern days— dental caries. Al- 
ready, as Mrs. Mellanhy has shoivn, there are siqns that this 
is just such a condition, and that its cause is probably a de- 
ficiency (earlier in life) of a vitamine not very different from 
''fat-soluble A.'' 

The subject is still in its infancy; we know a few main 
facts. How vast is our ignorance ; how vast also would be our 
power to benefit humanity were this ignorance to be dispelled. 
Happily many workers are taking up the subject and explor- 
ing the numerous by-paths that the main idea has opened up. 
The most important woi-k of this nature recently brought be- 
fore the medical profession is that by Lieut.-Colonel R. Mc- 
Carrison, already well known for his fruitful work on the 
thyroid gland. His paper is entitled ''The pathogenesis of 
deficiency disease/' and appears in the current volume of the 
Indian Journal of Medical Research (January, 1919, vol. vi., 
pp. 275-355). A brief summary of his main conclusions was 
published in the British Medical Journal, February 15, 1919, 
pp. 177 et seq. I have read the full paper, and, considering 
the difficulties of research in an Indian provincial institute, 
regard it as a monument not only to the enthusiasm, but also 
to the ability of one endowed with the capacity for real re- 
search work One can only hope that sufficient has been 

said to induce those interested to read the paper, which con- 
tains the evidence in full. One also trusts that Lieut.-Colonel 
McCarrison will continue this useful and epoch-marking work, 
and that others will also x^ly their spades in this fruitful field. 
— The British Medical Journal. 



246 DOMINION DENTAL JOURNAL 

DENTISTRY AS A NATIONAL DEFENCE 



Because this newspaper five years ago pioneered in editor- 
ial discussion of sound teeth as a subject of the utmost im- 
poitance to the welfare of the nation, we are particularly 
pleased to be able to present here a chapter of war history 
which, so far as we know, has escaped the news columns. 

By way of i^ref ace to this unusual and interesting story, the 
reader should remember that army regulations in nearly all 
countries require that the recruit possess enough teeth proper- 
ly to masticate food. This, of course, is an elementary need. 
And it also should be borne in mind that insufficient or defec- 
tive teeth constituted one of the major causes for rejection 
during our recent draft, when 30 per cent, of the men exam- 
ined were rejected on physical grounds. 

In France, as throughout Europe, the average of tooth 
conditions is far below our own. Modern dentistry was ^*made 
in America," and only within recent years has it been recog- 
nized abroad as a real need. So when the allied nations found 
it necessary greatly to enlarge their fighting forces, they en- 
countered dental lacks much worse than those with which we 
had to cope in raising a vast army. 

France, alone, was compelled to reject for this reason 250,- 
000 men otherwise physically sound. And the day came when 
such a number of troops might easily spell the difference be- 
tween victory and defeat. 

Fortunately— for France and for freedom — there was in 
Paris a certain dentist. Dr. Georges Villain, who had foreseen 
this situation. With untiring energ}^ he had advocated tooth 
reconstruction as a major military measure. Finally the war 
board acceded to his plea and went so far as to build a factory 
for the manufacture of artificial teeth. 

Thus backed. Doctor Villain took up the direction of mak- 
ing over the mouths of the 250,000. It was a matter of imme- 
diate importance, for, as all the world knows, the French 
forces w^ere seriously depleted. The work was carried on with 
all possible speed, and within a few months these reinforce- 
mf-nts so sorely needed were mustered into service ! 

It is not possible, of course, to put one's finger on any one 
contribution to the final victory and say, ''But for this, democ- 
racy would have lost." Dozens of vital factors combined to 
determine the result. But it is easy to point out certain con- 
tributions and say of them, ''Without these we might have 
lost." 



SELECTIONS. 247 

Among such must be counted Doctor Villain's ''false 
tooth'' factory, which transformed a quarter of a million men 
into effective fighting units. And of all that has happened 
during the last decade to emphasize the importance of den- 
tistry as a prime factor in himian welfare, this, we think^ 
stands out as the most conclusive evidence thereof. 

To it might be added, as of ahnost equal significance, the 
recent action of the British Government in dealing with the 
problem of dental disorders. 

In England, as in France, the war revealed a hitherto un- 
suspected degree of physical unfitness due to lack of mouth 
care. Spurred by the research work of American medical men 
who had suddenly waked up to the serious disease involve- 
ments traceable to bad teeth, English doctors had discovered 
like conditions in that country. But until the war compelled 
widespread examination, no one appreciated the extent and 
seriousness of the situation. 

We like to speak of the Britisher as slow, but in this case 
he evidenced a speed which might well be emulated in our own 
land. For as soon as the mouth menace became known, a 
royal commission was appointed to deal with the matter. 

The report of this body, as epitomized in the current issue 
of the Dental Cosmos, published in this city and edited by Dr. 
Edward C. Kirk, of the University of Pennsylvania, one of 
the leaders in the dental crusade, revealed a condition which 
moved its members to urge revolutionary measures. For it 
was found that the widespread dental defects were due not 
only to lack of oral hygiene on the part of the people, but quite 
as much to a pitifully inadequate supply of qualified dentists. 

For the 40,000,000 people living in the British Isles there 
are 5,000 qualified dentists and some 12,000 unqualified per- 
sons who ''work" on teeth, usually to the disadvantage of 
those patronizing them. And, as Dr. Percy Millican, of the 
British Dental Journal, figures, if the 5,000 qualified dentists 
devoted two hours a day to each patient and worked ten hours 
a day for 300 days a year they could treat only 7,500,000 per- 
sons annually leaving nearly 32,000,000 to the mercies of the 
ignorant and unskilled 12,000, or without any dental care wliat- 
ever. 

Because of this the royal commission has urged Parlia- 
ment immediately to admit to registered practice numbers of 
unregistered practitioners; to reduce the minimum time re- 
quired for dental study; to establish a system of free dental 
scholarships with adequate maintenance grants; to make in- 



248 DOMINION DENTAL JOURNAL 

creased grants to dental schools, provide for a new classifi- 
cation of ''dental mechanics^' to deal with certain more easily 
handled phases of tooth tronble and establish a public dental 
service. 

As the Dental Cosmos says, the striking feature of this 
situation is that the British Government "has shown itself 
fully alive to the serious importance of the dental problem and 
has dealt with it as one of the elemental factors in the general 
problem of public health conservation." 

England has thus become the first nation officially to deal 
with dental and oral hygiene as a national public health ques- 
tion. And, from present indications, France will be a close 
second. How long will it be before this nation, which hereto- 
fore has led in dental progress, joins the procession? 

There is no longer any excuse for neglecting this phase of 
national defence. It is true we have more and better dentists 
than any other country and we have taken excellent dental 
care of our armies during the last two years. It is true, also, 
that in some states our public school health program includes 
periodical examination of teeth, and in a few of our cities we 
have enlarged this work to include dental clinics. 

But the fact remains that not more than one-fifth of our 
population ever visits a dentist unless impelled by pain; that 
millions of our children are paving the way to sickness, in- 
efficiency, poverty and consequent bad citizenship through the 
failure of parents to recognize the protective power of the 
toothbrush and the vital value of the dentist. 

Every day adds to the mass of testimony proving the mani- 
fold and widespread destructive influence of decayed teeth and 
diseased gums. It is, of course, an obvious fact that insuffi- 
cient teeth so interfere with proper chewing of food as to in- 
duce indigestion and faulty assimilation of the nutritive in- 
take. And while interference with the stomach and intestinal 
processes is the underlying cause of many nervous and func- 
tional disorders, the evil results of bad teeth and septic mouth 
conditions do not end here. 

Often before in this column we have referred to the many 
diseases that are attributed or actually traced to such causes, 
yet so impressive is a list recently published in the Journal 
of the American Medical Association that we feel constrained 
to reprint it. It comprises the ''conclusions" in an article on 
"The Menace of Mouth Infections," written by Dr. Oliver T, 
Osborne, professor of therapeutics in the Yale T^niversity 
School of Medicine, and is, in part, as follows: 



SELECTIONS. 249 

Chronic invalidism may be caused by mouth infections. 

The blood pressure may be raised or lowered by mouth in- 
fections. 

The thyroid ^land is frequently enlarged, and may hyj)er- 
secrete or hj^^oseerete, in these infections. 

Serious disturbances of the blood, heart, kidneys, stomach, 
intestines and joints are frequent from mouth infections. 

Glycosuria can be, and perhax)s true diabetes mellitus may 
be, caused by mouth infections. 

Serious distant focal infections may occur from mouth in- 
fection. 

Serious brain and nerve disturbances, as well as neuritis, 
may occur from mouth infection. 

TTlcer of the stomach, pyelitis, appendicitis mu] chronic 
colitis may be caused by pyorrhea alveola ris and mouth infec- 
tion 

Pneumonia, especially that which follows influenza, may 
frequently be caused by pneumococci long carried in the pa- 
tient's mouth. 

No treatment of these conditions will be of any avail until 
the mouth is made clean. 

This statement comes from one of the most conservative 
of America's eminent medical men. Like other members of 
his profession, he knows there are isolated instances of fadism 
in this matter of teeth. A few doctors to-day are ordering the 
pulling of teeth which should not be removed and a few more 
dentists are clinging to the old-time practice of saving teeth 
at any cost. 

But the great mass of doctors are coming to know that it is 
absolutely necessary to look at the teeth of every patient suf- 
fering from any one of many widely prevalent affections, and 
a majority of dentists are paying more attention to what is 
under their crowns and back of their bridges than to what 
their patients display when smiling! 

The real need now is to wake U}) the general public; to get 
it into the heads of the masses that regular care and treatment 
of teeth is one of the most important and profitable services 
that a person can render to self, family or connnunity. 

The real need now is to convince the average person that 
money properly spent in this direction is money well invested; 
that a 25-cent toothbrush and a tube of paste or can of powder, 
renewed as needed, constitute a fonn of health insurance no 
one can afford to ignore. And that a reliable dentist should 
be visited at least twice a A^ear. 



250 DOMINION DENTAL JOURNAL 

The best way to get this knowledge home to the people is 
to spread it through the schools— and the churches might take 
a hand without lessening the good they do. But in every 
school clean teeth and tooth care should be taught daily, not 
only as a matter of health protection, but as a very important 
phase of practical national defence. — T/ie North American, 



THE TRAVELLING DENTAL SURGEON 



A recent article in the Observer describes the arrival of a 
school dental officer in the following terms: "It had not oc- 
curred to me that a dental surgery could be packed into the 
side-car of a motor bicj^cle and carried round the country, nor 
had I dreamed that such things were done. One is apt to re- 
gard a dentist as a person who is permanently attached to a 
brass plate, who occupies a house where various alarming and 
substantial mechanisms are clamped to the floor. Even ex- 
perience of Army dentists who set up their clinics in tents at 
the base camps of our various expeditionary forces had not 
led me to regard dentistry as one of the roving professions. 
It was the more surprising, therefore, to learn from the owner 
of the very muddy motor-bicycle which came to rest in the 
garage of the chief inn of the village that the boxes in his 
side-car contained a complete dental outfit. On the next morn- 
ing I saw the boxes unpacked. One flat case was opened, and 
there came out various bits of metal and little cushions which 
were transformed in about forty seconds into a complete and 
indubitable dental chair. More bits of metal from another 
case were whisked into the form of that terrifying drill which 
all right-minded people detest and fear. Other cases emptied 
themselves on to a table till there was a horrible array of the 
various instruments which usually live in trays and tall cases ; 
not a detail of the familiar outfit was lacking. The dentist 
took up a card, opened the door, and called a name. A small, 
determined boy marched in and was greeted cheerily and set 
up on the travelling throne. He opened his mouth and a swift 
examination was made. "Here you are," said the dentist to 
me. "See that molar?" He pointed to a tooth far back in the 
small mouth. The centre of it was discolored. ' ' He can 't have 
had that tooth more than three months," the dentist went on, 
"and yet, as you see, it is decaying already. I shall clean it 
for him and put in a stopping, and it is quite likely that it will 
be all right when I come round next year. But if it was left 



SELECTIONS. 251 

to go on as it is going now for another year there would be no 
hope of saving it/' I closed the door hurriedly and went 
about my business, thinking as I went of a certain big marquee 
which I found in Malta some two years ago. There three 
dentists and a crowd of assistants were busy day after day, 
week after week, repairing the mouths of various thousands 
of members of the Army who would never have needed any 
treatment and who might have been spared months of pain 
and misery if there had been a travelling dentist to come and 
look at them when they were small children. This is a descrip- 
tion of what we may hope will soon be going on in all our 
village schools and outlying districts when the new State Den- 
tal Service comes into being. 



252 DOMINION DENTAL JOURNAL 

Dental Societies 

EASTERN ONTARIO DENTAL SOCIETY 



Meeting opened at 8.30 p.m. After reading the minutes of 
the last meeting, the following officers were elected : 

President, i)r. A. H. Armstrong; vioe-^p resident, Lt.-Col. 
A. W. Winnett, Kingston; secretary, Dr. Victor Pinard. 

It was mo\'ed and seconded that owioig to the fact that the 
Dominion Dental Convention will be held in Ottawa in 1920, 
the E.O.D.A. hold its meeting jointl}^ with the Dominion Dental 
Association. 

Moved by Dr. M. G. McElhinney, seconded by Dr. S. S. 
Davidson, that the sympatliy of the Association be conveyed 
to the family of the late Dr. Stanle.y. 

Dr. Winters then read his presidential address, suggesting 
many evohitions in the practice of the profession, which 
brought out very favorable discussions. 

Major W. R. Greene then gave a report of his stewardship 
as representative of District No. 1 on the E.C.D.S., which 
brought out a good hearty discussion. 

Moved by Dr. Cavanagh, seconded by Dr. Liddle, that the 
president appoint a committee of three to consult with Major 
Greene and draft resolutions in conformity with Major 
Greene's report. 

Tuesday, the 10th, was confined to Dr. Ante's lectures and 
demonstrations, which were very profitably enjoyed by all the 
members present. 

Lt.-Col. Winnett addressed the meeting on the work of the 
Canadian Army Dental Corps overseas, and eulogized the 
work done by Cols. Armstrong and Gibson, intimating that 
what was accomplished by these men could not have been 
accomplished by anyone except one endowed with the indom- 
itable spirit possessed by the Director-General of Dental Ser- 
vices, Col. Alex. Arm'strong, and what he has accomplished in 
spite of every impediment that could possibly be placed in his 
way to prevent. 

Over a million operations were performed and one hundred 
and fifty thousand dentures constructed. 

Four hundred and fifty-five thousand Canadians went over- 
seas, and Lt.-Col. Winnett claimed that four hundred thousand 
came under the observation and oare of the C.A.D.C. 

The C.A.M. Corps have had several heads, due to contro- 



DENTAL SOCIETIES. 253 

versies of the members of the corps; but the C.A.D.C. has had 
only one head from start to finish of the war, and that is Col. 
Armstrono-, an Ottawa man, of whom we should all feel proud. 

Lt.-Col. Winnett closed his discussion by expressino- regret 
that there were not more representative men of the ])rofession 
overseas, and the accomplishments of the C.A.D.C. would have 
been even greater than they have been. 

Report of the committee on resolutions. Dr. M. G. Mc- 
Elhinney chairman. 

That ill the establishment of the Federal Department of 
Health, this Association feels that the importance of the pro- 
fession of dentistry demands that it shall be fully recognized 
by and adecpiately represented in this department. 

We would recommend that such re|)resentation should be 
one of high professional standing and tested administrative 
ability, and would suggest that Col. J. Alex. Armstrong. 
C.M.G-., be appointed to represent the profession of dentistry 
in the Federal Department of Health. 

That a committee be appointed to represent the interests 
of the profession in this matter. 

That in the matter of university affiliation, this Association 
feels that it cannot pass definitely on this question on the 
information supplied, and must leave the matter to our repre- 
sentative on the board. 

A resolution was passed tendering Dr. Ante the apprecia- 
tion of the Association for his kindness in coming here and 
the fund of information he has given to the Association in his 
lectures and demonstrations. 

Meeting closed at 1 p.m., June 11th. 

C. J. JrvET, Acting secretary. 



BIRTHDAY HONORS 



CANADIAN FORCES. 

C.B.E. (Military Division): Colonel J. A. Armstrong. 
C.M.Gr., Canadian Anny Dental Corps. 

O.B.E. (Military Division): Lieutenant-Colonel C. 
Bro^\^, Canadian Army Dental Corps; Lieutenant-Colonel O. 
K. Gibson, Canadian Dental Section; Captain (Acting Major) 
J. L. Kappele, Canadian Army Dental Corps; Major (Acting 
Lieutenant-Colonel) B. L. Neiley, Canadian Army Dental 
Corps. 

M. B. E.\ C. S. M. McDerment, Canadian Army Dental 
Corps. 



254 DOMINION DENTAL JOURNAL 

MEMBERS IN ATTENDANCE AT THE ONTARIO 
DENTAL SOCIETY MEETING 



C. N. Abbott, London; J. F. Adams, Toronto; A. H. Allen, 
Peterboro ; G. P. Allen, Mount Forest; J. E. Amos,.Brantford; 
W. B. T. Amy, Toronto; M. T. Armstrong, Parry Sound; 
W. A. Armstrong, Ottawa; H. W. Anderson, Toronto; J. L. 
Anderson, Oakville; L H. Ante, E. F. Arnold, H. H. Arm- 
strong, J. W. Armstrong, H. C. Arnott, Toronto ; J. W. Ault, 
Prescott; G. W. Bald, Sault Ste. Marie; E. S. Ball, W. H. 
Walton Ball, J. C. Bansley, Toronto ; F. Barron, Paris ; Capt. 

F. W. Barbour, Base Hospital, M.D. No. 2; E. S. Barker, 
Stouffville; D. H. Beaton, Toronto; J. A. Beatty, Stratford; 

G. F. Belden, Toronto; B. X. Berry, Caledonia; M. R. Billings, 
Cayuga ; D. A. Black, Kingston ; W. A. Black, D. J. Bagshaw, 
Toronto ; J. A. Bothwell, Stratford ; J. A. Bothwell, Toronto ; 
D. M. Bracken, Grand Valley; S. W. Bradley, Ottawa; C. E. 
Brooks, A. J. Broughton, Toronto; A. J. Brown, Mitchell; 
J. J. Brown, Woodstock; W. A. BrowTilee, Grimsby; E. E. 
Bruce, Kincardine ; A. C. Burnett, Hamilton ; W. Burnet, Gait ; 
T. E. C. Butler, Toronto; Major G. L. Cameron, Toronto; 
G. H. Campbell, Orangeville ; E. T. Campbell, Toronto ; L. G. 
Campbell, Markdale ; P. W. Campbell, Toronto ; T. F. Camp- 
bell, Gait ; A. G. Campbell, Wallaceburg ; F. J. Capon, W. L. 
Chambers, J. S. Chambers, Toronto; R. M. Chambers, 
Leamington; C. G. Chapin, Toronto; H. L. Cheney, Alexan- 
dria; 0. S. Clappison, Hamilton; H. Clark, Toronto; M. J. 
Clarke, Belleville; C. H. Clarkson, Toronto; P. T. Coupland, 
St. Mary's; C. E. Collard, Toronto; R. H. Cosgrove, Ottawa; 
F. J. Conboy, W. H. Coon, W. A. Cowan, Toronto ; J. J. Craig, 
Peterboro ; H. 0. C. Crane, Toronto ; J. C. Crawford, Hailey- 
bury; H. D. Crooker, Tillsonburg; A. L. Crozier, Sault Ste. 
Marie; H. Cunningham, T. A. Currie, D. Crippen, W. A. 
Dalrymple, Toronto; D. Davidson, Woodstock; C. L. Daly, 
Toronto; M. A. Day, Belleville; P. L. Day, Harrowsmith; 
F. L. Dayment, T. W. Dawson, A. Day, Toronto ; J. C. Devitt, 
Bowmanville; E. 0. Dickson, E. A. Dolson, Toronto; L. 
Doering, Mildmay; N. K. Douglas, Owen Sound; J. A. Drum- 
mond, Petrolea; J. H. Duff, H. E. Eaton, Toronto; E. Eckel, 
Waterloo ; A. J. Edwards, A. W. Ellis, G. Emmett, G. W. Ever- 
ett, Toronto; E. W. Falconer, Sarnia; E, 0. Fallis, Toronto; 
W. J. Fear, Aylmer; R. E. Fisher, Toronto; J. A. Fleming, 
Prescott; W. A. Fleming, Alliston, S. T. Floyd, W. M. Floyd, 



DENTAL SOCIETIES. 255 

Toronto; L. L. FoUick, St. Mary's; J. 11. Frain, Norwich 
G. Fraser, Madoc; S. L. Frawley, Toronto; H. G. French 
Dresden ; E. W. Fuller, London ; W. J. Fuller, New Liskeard 

E. M. Fulton, F. J. Furlong, Hamilton; Wm. A. Giffen 
Detroit; E. L. Gausby, Toronto; G. F. Gibson, Campbellford 
Capt. Girvin, Ottawa; G. Gow, Toronto; J. F. Grant, Durham 
J. W. Gray, Hamilton; M. H. Hagey, Preston; R. E. Hall 
Chicago ; H. H. Halloran, Toronto ; R. S. Hamilton, Brussels 
J. R. Hand, Ottawa; F. Hansel, Hamilton; E. S. Hardie 
Hensall ; R. R. Harvie, Midland ; E. Hart, Brantf ord ; H. N 
Hartman, Meaford; O. G. Hassard, Windsor; R. H. Hender- 
son, Toronto; E. A. Higley, Chatham; V. Le R. Heath, Wood- 
stock; F. G. Hendry, Delhi; E. A. Hill, Sudbury; W. J. Hill, 
Alliston; R. W. Hoffman, Toronto; G. H. Holmes, Owen 
Sound; G. N. Howden, Watford; R. J. Husband, Burlington; 

F. C. Husband, Toronto ; J. Hutchison, London ; A. A. Hicks, 
Chatham ; J. A. Hilliard, Kitchener ; S. S. lonson. Port Rowan ; 
H. Irvine, Lindsay; H. B. James, Oshawa; F. S. Jarman, 
Bancroft; A. Jennison, Millbrook; F. H. Jones, Toronto; 
A. Johnston, Petrolea; J. E. Johnston, Hamilton; G. G. 
Jordan, C. A. Kennedy, Toronto ; G. T. Kennedy, St. Thomas ; 
L. T. Kennedy, Toronto; A. C. Kerr, Sault Ste. Marie; A. R. 
Kinsman, Exeter; A. E. Knapp, Kingston; L. A. Koeppel, 
Kitchener; H. M. Kalbfleisch, F. G. Law, Toronto; J. J. Leacy, 
Ottawa; S. Lederman, Kitchener; G. A. Lee, Whitby; J. A. 
Locheed, Hamilton ; C. C. Lumley, St. Thomas ; W. E. Lundy, 
Toronto; B. W. Linscott, Brantf ord; M. L. Laidlaw^, Dr. 
Lowery, Toronto; D. T. Moir, Buffalo; A. H. Mabee, 
Gananoque; L. M. Mabee, Goderich; W. G. Manning; Hamil- 
ton ; V. C. W. Marshall, Owen Sound ; G. S. Martin, Sudbury ; 
A. D. Mason, W. A. Mathieson, Toronto; J. E. Middleton, 
Peterboro; G. K. Mills, Tilbury; R. J. M. Montgomery, 
Toronto ; H. M. Morrow, Hamilton; H. J. Merkeley, Winnipeg; 
F. P. Moore, Hamilton; J. C. Moore, Orillia; W. E. Morgan, 
North Bay; G. V. Morton, Toronto; M. A. Morrison, Peter- 
boro; A. W. Muir, Fergus; R. Macfarlane, Kitchener; J. P. 
MacLachlan, W. A. Maclaren, Toronto; H. A. McClean, 
Milton; R. G. McLean, Toronto; J. H. McCullough, Perth; 
R. J. McGahey, T. N. McGill, Toronto; W. T. McGorman, 
Port Arthur; H. J. McKay, Hamilton; W. S. McKay, Gait; 
H. A. McKim, G. C. McKinley, Toronto ; R. McKnight, Sud- 



256 DOMINION DENTAL JOURNAL 

bury; R. G. McLaughlin, Toronto; W. C. Macartney, Ottawa; 
K. M. McVey, Toronto; H. G. MacDonald, Goderich; J. 
Neelands, Lindsay; D. R. Nethercott, Stratford; B. F. Nott, 
North Bay; J. F. O'Flynn, St. Catherines; E. A. Peaker, 
G. L. Palmer, C. E. Pearson, G. C. Phillips, 0. G. Plaxton, 
F. D. Price, Toronto ; W. J. Price, Orangeville ; P. R. Proud- 
foot, Russell ; F. E. Reath, St. Thomas ; H. B. Rickard, Port 
Colborne ; L .F. Riggs, J. E. Rhind, Toronto ; H. A. Robertson, 
Hamilton; M. W. Rutherford, Toronto; A. R. Robertson, Ayr; 
D. Rollaston, J. F. Ross, Toronto; C. M. Ross, Ham- 
ilton; R. R. Ross, Seaforth; G. F. Roulston, Exeter; D. E. 
Russell, Brantf ord ; H. M. Sanderson, Toronto ; L. V. Savage, 
St. Thomas; H. Scott. Hamilton^, C. G. Scott, W. Seccombe, 
Toronto; J. F. Sebben, Stratford; F. A. Sellery, Toronto; 
U. B. Shantz, Kitchener; R. E. Stewart, Elmira; R. A. 
Strathern, Kingston; AV. A. Sudworth, IngersoU; W. C. 
Smith, G. M. Sutherland, C. E. Sutton, Toronto; Lieut.-Col. 
F. P. Shaw, London; J. F. Simpson, Trenton; S. H. Simpson, 
Kingston; J. A. Slade, F. J. Stowe, A. A. Smith, Toronto; 
D. C. Smith, Stouffville; L. G. Smith, Toronto; N. Smith, 
Chatham; P. St. C. Smith, C. A. Snell, Toronto; W. R. Somer- 
ville, Haileybury; E. B. Sparks, Kingston; C. J. Smith, 
London; W.G. Spence, Listowel; R. J. Sprott, Barrie; W. D. 
Staples, Hanover; J. N. Stewart, Col. W. Thompson, Ham- 
ilton: A. S. Thomson, R. D. Thornton, Toronto; G. M. Trewin, 
Oshawa; Capt. Hariy Thompson, Toronto; S. M. Thomas, 
M. A. R. Thomas, London; C. A. Terry, Queensville; B. 
Temple, Toronto ; C. B. Taylor, St. Thomas ! W. C. Trotter, 
Toronto; J. W. B. Topp, Bracebridge; M. C. Tindale, Ham- 
ilton; R.' J. Vance, Waterdown; E. C. Veitch, A. B. Wagg, 
H. b'. Walker, W. L. Walker, R. D. Wallace, Toronto ; J. L. 
Walsh, C. F.'walt, Kingston; F. R. Watson, Georgetown; 
P J. Watson, Toronto; F. Waugh, Kingston; A. E. Webster, 
Toronto; D. J. Weadick, Hamilton; A. M. Weldon, Peterboro; 
F. L. Williamson, Hamilton; H. G. Wilkinson, St. Mary's; 
H N Wilkinson, Newmarket; D. Watson, Brantford; W. C. 
Wickett, Toronto; J. R. Will, Brantford; W. T. WiUard, W. E. 
Willmott, Toronto; J. J. Wilson, Burk's Falls; R. S. Wilson, 
London; S. C. Wilson, Perth; H. Winters, Ottawa; W. J. 
Woods, W. E. Wray, F. J. Wright, T. H. Wylie, 0. H. Zeigler, 
Toronto. 






EDITOR: 
A. E. Webster. M.D.. D.D.S., I^.D.S.. Toioiito. ('aM;i<!;i. 

ASSOCIATE EDITORS: 
Ontario — M. F. Cross. L..D.S., D.D.S., Ottawa; Carl E. Klotz. L.D.S., St. 

Catharines. 
QuBBBC. — Eudore Debeau, L.D.S., D.DjS., 396 St. Denis Street, Montreal; Stanley 

Burns, D.D.S., L..D.S., 750 St. Catherine Street, Montreal; A. W. Thornton, 

D.D.S., Li.D.S., McGill University, Montreal. 
Alberta. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — ^Jas. M. Magee, L.D.S., D.D^S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S., D.D.S.. Halifax. 
Saskatchetwan. — W. D. Cowan, L.D.S. , Regiina. 

Prince Edward Island. — J. S. Bagrnall, D.D.S., L.D.S. , Charlottetown. 
Manitoba. — M. H. Garvin, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogue, D.D.S. , L.D.S., Vancouver. 



Vol. XXXT. 



TORONTO, JULY 15, 1919. 



No. 7. 



THE COST OF DENTISTRY 



The cost of dentistry is one of the common topics of dis- 
cussion among' the people who can afford such a ^^ luxury." At 
the present time less than twenty per cent, of the public can 
afford the services of a dentist and pay for other necessities. 
Though so few get dental services, it is now recognized that 
such services are a real necessity to preserve the health of 
civilized man. Among those who have anything to do with 
dentistry, there are two things of which they seem to have a 
clear conception. Its cost and its relation to general disease. 
No other aspect of the subject seems to have sunk so deeply 
into the minds of the public. The parent who wishes his son 
or daughter to study dentistry as a profession, is also struck 
with the high cost of a dental education. 

There are many factors which have entered into the in- 
creased cost of dentistry. The cost of a dental education, 
though an important factor, is not all by any means. The most 
important cause for increased cost is perhaps a change in the 
general conception of the value or purpose of a dentist's ser- 
vices. Dentistry of but a few years ago was looked upon as 
a service for the well-to-do in one of the conveniences or com- 



258 DOMINION DENTAL JOURNAL 

forts or pleasures of life much as the hairdresser or the artist 
or the fancy goods designer. Now it is a personal and public 
health problem, and demands public attention. This change 
introduced a wide circle of increases in cost. First is the sur- 
gical aspect of dental practice along with asepsis. Next is the 
ability and equipment to make a diagnosis. With this comes 
the necessity of trained assistants, and along with these comes 
a higher knowledge in engineering and design for mechanical 
restorations ; this in turn calls for better trained mechanics to 
carry out the designs. The increased cost of dental equipment 
and supplies is also a factor in the cost of dentistry, as well 
as rents and the high cost of living. 

It would be interesting just now, when many of the pro- 
fession are on a holiday, to seriously think over what the costs 
of running a dental practice are, and come back to work with 
a clearer conception of what the profession and its individuals 
are faced with. New methods of practice and new methods of 
office management must be undertaken in many cases, and 
after a little reflection when not in the hurry of practice, might 
be the opportune time for a change. 

A dentist who has borne the cost of his own education and 
equipment, cannot afford to serve that part of the public 
whose income does not warrant four to six dollars an hour to 
the dentist. This leaves the great majority of the public 
without dental services. If dentistry is a necessity, then why 
should the majority of the people be compelled to suffer and 
die for the need of it? 

The cost of a dental education seems to be a governing fac- 
tor in the supply of a sufficient number of dentists to serve the 
public. In Great Britain the fees for a dental student have 
been a thousand dollars for many years. Besides this, the 
pupil had to pay high living expenses because he was in a 
special class. The high educational standards, the cost, and 
the small hope of reward in the j)ractice of the profession has 
resulted in a falling off of the supply, and developed a large 
number of illegal practitioners whose services are necessary 
to the public. This in turn has reduced the standards of prac- 
tice for the majority and left the few to serve the wealthy at 
high cost. The dental hospitals in which the students received 
their education are largely kept up by donations from the 
public and from the state. In America the demand for a better 
dental education may have the same result as in Great Britain 
if the supply of dentists is not sufficient to care for all classes 



EDITORIAL 259 

of the public and at a cost they can afford. The best way to 
guard against this is to make dental education within the reach 
of the poor man's child. 

A very small proportion of the pupils in dentistry can 
afford to pay for their education if it is equal to the demands 
of to-day. In this connection, a very significant communica- 
tion has been sent out by the Chancellor of Vanderbilt Univer- 
sity, Nashville, Tennessee. The communication we quote in 
full so that its significance can be realized. 

"Vanderbilt University begs to announce to present, for- 
mer, and prospective students the discontinuance, for the 
present, of its School of Dentistry. This step has been under 
consideration for some time. It seems best to take this action 
now for the following reasons : 

"(1). The last three year class has just been graduated, 
and the first four year class will not graduate for two years ; 
therefore the number of students affected is the smallest pos- 
sible. 

''(2). Several of our professors now wish to resign or 
change their work. This would necessitate reorganization, a 
thing not easily effected under all the circumstances. 

"(3). Again, the present is a critical time in the history 
of all dental colleges. Dental education is now entering on a 
new phase. It is following the path of medical education. It 
will become increasingly expensive as the years go by. Xo 
institution can conduct this work worthily without consider- 
able endowment available for this particular object. 

The endowment of Vanderbilt University has increased 
considerably in the recent past. Some of this increase was for 
the School of Medicine, some for the College of Arts and 
Science. These funds are not available £pr dental education. 

**The University is not willing to allow the quality of its 
work to decline. Vanderbilt dentists are now filling the highest 
places in their profession and it would not be endurable to send 
out graduates in the future with any training but the best. 
Better than that is the decision to discontinue the School of 
Dentistry until larger resources are provided for its work. 

'^If in the future an endowment of half a million dollars 
can be secured for this work, the University will be glad to 
re-establish the department. The training of dentists is a pub- 
lic necessity. It must be provided by public taxation or by 
private benefactions. Perhaps the closing of the Vanderbilt 
School of Dentistry at the present time is the best way to call 



260 DOMINION DENTAL JOURNAL 

attention to a need that will become greater and more pressing 
as the years go by. 

' ' June 25, 1919. ^ ' J. H. Kirkland, Chancellor. ' ' 

Here is the leading dental college of the South for almost 
half a century closing its doors rather than attempt to teach 
dentistry according to the standards of to-day on the fees of its 
students. The whole dental profession of America must regret 
the passing of a school of dentistry organized by the late Dr. 
Morgan, and so ably conducted by his son for the past twenty- 
five years, and has had on its staff such noted leaders of the 
profession as Drs. Walker, Crawford, Stubblefield, Cattell, 
and Dale. If Vanderbilt, with a going institution of 
many years of high reputation, a competent st^if, a large 
alumni, and no dearth of students, cannot teach dentistry on 
the fees of the students, and prefers to close its doors rather 
than lower its standards, does it not speak volumes to other in- 
stitutions attempting the impossible? If Vanderbilt needs an 
endowment of half a million to teach dentistry, or its equiva- 
lent, thirty thousand a year, what of those aiming to pay 
dividends on investment? 

If, then, the prim'ary cost of a dental education is so great, 
what of the cost to the general practitioner to keep himself up 
to the standards of the day ? He cannot aif ord to attend dental 
meetings, take special courses, buy and read dental literature 
without adding such costs to his services. He must employ 
specially trained assistants at more than double the cost of 
five years ago. His laboratory mechanic gets often as high as 
fifty dollars a week for his work. Xo one but the dentist him- 
self can meet and serve his patients — his skill and knowledge 
cannot be delegated to another. When he quits work, expenses 
go on, but income ceases. In the face of these and other fac- 
tors which did not exist five years ago, the cost of dentistry to 
the public must increase. Then what of the people who cannot 
afford these costs? The state must assist in dental education, 
and pay for services, or every person should have such incomes 
as would warrant their paying dental fees. 



Did you ever stop to consider that the truly Ethical 
Man is not the one who merely does not advertise and 
stops there. He is the man who places the welfare of his 
fellowmen above all mercenary considerations. A truly 
Ethical Man must jjractice self forgetfulness, he must assume 
obligations to his patients as well as to his brother practi- 
tioner. 



EDITORIAL 261 

PUBLIC INTEREST IN COMPARATIVE DENTAL 

ANATOMY 



The teeth of all kinds and sizes are shown in a new exhibit 
recently installed in the American Museum of Natural History 
in New York, says the Literary Digest. 

A press bulletin from the museum, signed by Greorge 
Pindar, chairman of the Public Information Committee, 
describes the odd varieties of teeth shown in the exhibit, from 
the complicated apparatus called "Aristotle's lantern,'' worn 
by the sea urchins, up to the fang of the lion. The former, 
we are told, consists of five pyramidal jaws, each carrying a 
long, slender tooth of continuous growth, which moves 
forward in the jaws as it wears away at the point. The 
horseshoe crab wears his teeth on his legs, at the first joints 
of which is a series of spines and sharp points. The food is 
torn to bits on these and worked into the mouth opening. The 
lobster's teeth are to be found on his fourth to ninth 
appendages. Some of them are adapted to seizing the food, 
others to grinding it. The exhibit also reveals the iittle 
known fact that the bettle and worm boast teeth as useful 
and efficient as any. 

" Of course, there are teeth of many kinds. But the typical 
tooth of a vertebrate or back-boned animal, as shown in 
cross-section, consists of pulp contained in a cavity, which, 
by deposition of lime in its exterior portion, becomes dentine, 
ivory or bone, forming the body of the tooth ; enamel, overlying 
the dentine on the crown of the tooth, and cement, usually 
surrounding the base and sometimes covering part or all of 
the enamel of the crown. The teeth of some animals, however, 
the sperm whale, for example, have no enamel whatsoever. 

' ' In man, as in mo^st mammals, the teeth are set in distinct, 
separate sockets, and are separated by a membrane from the 
surrounding bone. But nature has other w^ays of implanting 
the teeth. The extinct sea reptile known to scientists as 
ichthyosaurus had his teeth planted in a continuous shallow 
groove, as was the habit with certain birds which lived many 
centuries ago. Modern birds, however, have adopted the 
fashion of going toothless. 

''Another sort of attachment of the teeth is by means of 
a bony union of the outer side of the teeth with the inner 
side of the jaw. In a fourth case the base of the tooth is 
completely fused with the side of the jaw. It is anoth^ • 



262 DOMINION DENTAL JOURNAL 

evidence of a beneficent nature thait man, the only creature 
who is given to having his teeth extracted, does not have his 
teeth implanted in this last way. Some animals have the 
advantage of teeth which are more or less movable, due to 
the fact that they are attached to the jaws by ligaments. 



DENTAL CLINICS FOR RURAL ONTARIO 



In the near future there will be established all over 
rural Ontario dental clinics in connection with th? Women's 
Institutes and the Department of Education, as the following 
report to an institute indicates : 

There has been dental inspection for some years now in 
the town and city schools, and though it has been a long time 
in coming to us, thanks to the endeavors of the Women's 
Institutes, we are to have dental inspection and dental clinics 
throughout rural Ontario. 

Children in the country districts do not naturally have 
defective teeth, any more than do the city and town children. 
But living far from town and good dentists, it is only natural 
that the visit to the dentist is put off from day 'to day until the 
health of some of the children is greatly impaired, if not 
affected, through diseases of the mouth and defective teeth. 
Much of the sickness, ill-health and backwardness of children 
can be traced directly to neglect of teeth. 

Now that dental inspection has become possible for rural 
school children, naturally the dental clinic will follow in its 
footsteps. The great advantage of these clinics is that the 
children will receive dental attention right in the nearest 
village for a nominal sum— or, where the parents cannot bear 
the expense, arrangements will be made for the work to be 
done free. 

The work is in its infancy at present, and the appropriation 
granted by the Government for carrying on the good work 
is very small. However, as the plan gains footing and grows 
in importance, the Women's Institutes have every faith that 
their appropriations will be increased and the good work 
carried on in its every phase with the necessary thoroughness. 

All mothers in rural sections appreciate that this is a 
grand, good thing for their boys and girls. It has been a long 
time coming, and perhaps it will be many a day before it is 
perfected, but, thanks be, it is here. 



EDITORIAL 263 

CARE OF SOLDIERS* TEETH IMPORTANT IN 

WAR TIME 



The work of the Canadian Army Dental Corps during the 
war can be well illustrated by the growth of the personnel of 
the corps from its inception in 1915. At that time the streqigth 
of the corps was ')0 officers, 34 N.C.O.'s, and 40 privates; and 
at the signing of the armistice its strength had grown to 223 
officers, 22 N.C.O.'s, and 238 privates. 

From July, 19'15, when the Dental Corps began operatiori«, 
until the 31st of December, 1918, the number of operations 
totalled 2,255,442, which included 96,713 operations on im- 
perial troops. Special scientific treatments were given to 
49,449 cases of trench mouth at the oral pathology depart- 
ment. Trench mouth was practically unknown before the 
war, but it developed to an alarming extent, and at one time 
there were 10,000 cases reported. 

Every Canadian soldier on arrival in England received a 
dental inspection while in segregation camp, and, if time 
permitted, his wants were attended to there. If not, the in- 
formation was forwarded to the camp where he was stationed 
and there completed. Before going to France the soldier 
was required to pass another dental inspection. 

In addition to the general clinics, special clinics were 
organized where patients who had received such injuries as 
having the nose or chin shot away received the very best 
treatment that medical and dental science could provide. By 
a combination of facial surgery and mechanical appliances 
the injured parts were restored and the lost parts substituted- 
in such a way that not only was the patient enabled to masti- 
cate his food, but blemishes in personal appearance were 
greatly mitigated. 

The cessation of hostilities immediately reversed the aimfe 
of the C.A.D.C. Instead of making men dentally fit for war 
they were made dentally fit for peace and every Canadian 
soldier retuniing to Canada is accompanied by a document 
giving his exact dental condition at the date of his last inspec 
tion before embarkation. 



Dr. S. A. Moore, a graduate of the Royal College of Dental 
Surgeons, Toronto, has been appointed assistant dental 
surgeon in the. Public schools of London, Ont. 



264 DOMIXIOX DEXTAL JOURNAL 

Editorial Notes 

A dental surgery is to be opened in Peterboro, Ont., for 
returned soldiers. 

The dentists of St. Thomas held a luncheon as a closing 
occasion for the local society. 

Oapt. Summerville has charge of the dental clinic for re- 
turned soldiers in Owen Sound, Ontario. 

All the children of the public schools of Hamilton will have 
their teeth inspected in the fall of this year. 

The Prince of Wales is the new president of the Koyal 
Dental Hospital of London, Leicester Square. 

. Capt. George Ross is in charge of the dental department 
for. the returned soldiers at Chatham, Ontario. 

The ^'Dentogram,^' Seattle, Wash., has come to hand 
through the kindness of Dr. Emory Jones. The June issue 
announced a joint meeting of the Washington State Dental 
Association and the British Columbia Dental Society, to be 
held in Seattle, July 14th to 19th, 1919. The programme is a 
most attractive one, having such names as Roach, Smith. 
McColium, Hall, Argue, Fixott. Dr. Snipes, president of the 
British Columbia Dental Society, sends out a foreword to- his 
confreres, in which the following paragraph appears, and is 
worthy of wide circulation and thought : 



THE AMERICAN ACADEMY OF PERIODONTOLOGY 



The sixth annual meeting of the American Academy of 
Periodontology will be held in New Orleans, October 17, 18, 
1919. Headquarters, Hotel Grunewald. An instructive pro- 
gram isi being prepared for members as well as all dentists 
interested in the development of Periodontia. 

Grace Rogers Spalding, Sec'y, 

803 Empire Bldg., 

Detroit, Mich. 



REVlEvVS 265 

T H^ DENTIST ' S LIBRARY 

Student's Manual of Cavity Preparation. By J. E. Severns, 
D.D.S. Demonstrator of Operative Technique Dental De- 
partment of St. Louis University. 



Interpretation of Dental and Maxilliary Roentgenograms. 
By Robert H. Ivy, M.D. ; D.D.S. Major, Medical Reserve 
Corps, United States Army; Associate Surgeon, Columbia 
Hospital, Milwaukee ; formerly Instructor in Oral Surgery, 
University of Pennsylvania. 



Roentgen Technique (Diagnostic). By Norman C. Prince. 
M.D. Attending' roentgenologist to the Omaha Free Dental 
Dispensary for Children; Associate Roentgenologist to the 
Douglas County Hospital, Bishop Clarkson Hospital, Swed- 
ish Immanuel Hospital, St. Joseph's Hospital, and Ford 
Hospital, Omaha, Neb. With seventy-one original illus- 
trations: 



Fundamentals of Pathology. For Students and General 
Practitioners of Medicine and Dentistry and for Nurses in 
Training Schools. By Paul G. WooUey, B.S., M.D. Pro- 
fessor of Pathology, The University of Cincinnati ; Director 
of the Pathologic Institute of the Cincinnati General Hos- 
pital, Cincinnati. 

* * * 

Oral Sepsis in Its Relation to Systemic Disease. By Wil- 
liam W. Duke, M.D., Ph.D., Kansas City, Mo., Professor 
Experimental Medicine in the University of Kansas School 
of Medicine; Professor in the Department of Medicine in 
Western Dental College; Visiting Physician to Christian 
Church Hospital; Consulting Physician to Kansas City 
General Hospital; Kansas City, Mo., and to St. Margaret's 
Hospital Kansas City, Kansas. 170 Illustrations, 124 pages, 
price $2.50. McAinsh & Co., Limited, Toronto, 1918. 



266 DOMINION DENTAL JOURNAL 

NAUSEA FROM WEARING A DENTURE 



Dear Dr. Webster,— I have a case of nausea or vomiting 
caused by a denture. I cut the pallatal portion entirely out 
of on-e denture. I have made another of different rubber with- 
out any results. Do you know of an^i:hing that could be used 
on the pallatal portion of the mouth that would help. If you 
know of anything that would even help I Avould appreciate the 
information very much. 

Yours sincerely, 

J. M. Mitchell. 

(Editor).— If any of the readers of the Journal who have 
had experience in such cases would communicate with the 
Editor he would be oblisred. 



DR. CHARLES L. STRICKLAND DEAD 



Dr. Charles L. Strickland died in Charlotteto^vn, Prince 
Edward Island, on Friday, May 16th, 1919. 

Dr. Strickland was born in Bangor, Maine, in August, 1836, 
and almost completed his eighty-third year. When the Am- 
erican Revolutionary War broke out, he recruited a company, 
of which he was captain. Leaving the army in 1863, in the 
same year he opened an office in Charlottetown for the prac- 
tice of dentistry, continuing until a short time before his death, 
almost completing fifty-six years of active practice. 



Dominion 

Dental Journal 

Vni. XXXI. TORONTO, AITirST 15. 1919. No. 8. 

Original Communications 

CARE OF DENTAL INSTRUMENTS— CLINIC AT 
ONTARIO MEETING 



\V. O. (n.l.W IN. D.D.S. 



Cleani)i (J. — The iiistriiTiients ai'e first washed with soap 
and water and scrubbed with a hand bnish to remove all loose 
dirt. Tlie more adhesive dirt which remains is removed by 
bulTing on the lathe, using a stiff bristle brush and revolving 
at low speed. The spatula, which has become smeared with 
cement, is first scraped, then ])olished by using the felt cone 
an<l pumice. 

Files which are clogged up with soft metal, vulcanite, etc., 
are cleaned by brushing with a steel brush, called a file card. 

After cleaning, the instruments are ready for the sterilizer. 

When it is desirable to lay the instruments away for a long 
})eriod, and there is a tendency to rust, this can be prevented 
by smearing the instrimients with vaseline or tallow, which 
protects the surface of the steel not covered by the nickel 
])lating. 

Cement slabs are bcbt cared for by having the cement 
washed off immediately after use. If this cannot be done, 
the slab and hardened cement are placed in hot water for ten 
minutes, which loosetis the cement, after which it can be easily 
Scraped off. 

it is, therefore, advisable to have a number of cement slabs 
and s])atulas ready for use. Tt is especially important in the 
case of bone or ivory spatidas and instruuKMits to remove the 
cement while fresh. Otlierwise the cement must be removed 
by grinding or sandpapering, which quickley wears the instru- 
ment down. 

Sharp instnmients should be protected in handling by in- 
serting the cutting end in a leather sleeve or cork or wrapping 



268 DOMINION DBNTAL JOURNAL 

with cotton. The burs may be prepared for the sterilizer by 
wrapping from six t twelve in a piece of gauze. This prevents 
dulling by contact, which would be the case if a large number 
of burs were wrapped together. 

Cutting instruments should be kept sharp for the reason 
that sharp instruments cut faster, cleaner and with less pain 
when excavating a cavity or cutting dentine. 



DENTISTRY IN GREAT BRITAIN AS FOUND BY 

A COMMITTEE OF THE HOUSE 

OF COMMONS 



Appointed by the Lord President of the Council to investigate tlie extent and 
gravity of the evils connected with the practice of Dentistrj' and Dental Surgery 
by persons not qualified under the Dentists Act. Presented to Parliament by com- 
mand of His Majesty. 



CONTENTS OF REPORT. 

Introductory. 
Section I: 

The Dentists Act, 1878. 
Section II: 

Dental Practice in Great Britain and Ireland. 
Section III : 

Practice of Dentistry by Incorporated Companies. 
Section IV : 

The Evils Arising from Dental Practice by Unregis- 
tered Practioners. 
Section V : 

Dental Disease in Relation to the Health of the 
People. 
Section VI: 

Shortage of Registered Dentists. 
Section VII: 

Causes of the Shortage of Registered Dentists and 
Suggested Remedies. 
Section VIII: 

Dental Treatment Assisted by the Local Government 
Board. 
Section IX : 

School Dental Inspection and Treatment. 
Section X : 

Dental Treatment Under the National Insurance Act. 
Section XI : 

Miscellaneous Voluntary Aids to Dental Treatment. 



SELECTIONS. 269 

CONTENTS OF REPORT (CONTINUED). 

Section XII: 

A Public Dental Service. 
Section XIII : 

The Educatiou and Training of Dental Practitioners. 
Section XIV: 

Control of the Dental Profession. 
Section XV : 

Ethical Standard for Dentists. 
Section XVI: 

Prohibition of Dental Practice by Unregistered Per- 
sons. 
Section XVII : 

Admission of Unregistered Practitioners to the 
Dental Register. 
Section XVIII : 

Form of Dentists' Register and Title to be Conferred 
b}" Registration. 
Section XIX: 

Legislation to Prevent Dental Practice by Unregis- 
tered Persons. 
Section XX: 

Dentists' Fees. 
Section XXI: 

Scholarships for Dental Students. 
Section XXII: 

Dental Research. 
Sestion XXIII: 

Aid to Dental Schools. 
Section XXIV: 

Education of the Public in the Need for Dental Treat- 
ment. 
Section XXV: 

Miscellaneous. 
Summary of Principal Recommendations, and Conclusion, 

REPORT OF THE COMMITTEE. 

To the Right Honourable Earl Curzon of EIedleston, K.G., 

G.C.S.L, G.C.I.E. (Lord President of the Council.) 
My Lord,— 

1. We have the honour to submit our Report and Recom- 
mendations under your Lordship's order of reference of the 
12th day of July, 1917. 

Our meetings have been held at the Board Room, Privy 
Council Office, Downing Street, for which we are indebted to 



270 DOMTXIOX DENTAL JOURNAL 

Sir Almeric FitzRoy, K.C.B., K.C.V.O., one of our members. 
The comforts and convenience of the Committee and wit- 
nesses have been greatly added to by having such a com- 
modius and centrally situated meeting place. 

2. The Committee have met on twenty-seven days and have 
examined twenty-seven witnesses. These have included wit- 
nesses nominated by the (leneral Council of Medical Education 
and Registration of the United Kingdom, the Royal College 
of Surgeons of England, the British Dental Association, the 
Incorporated Dental Societj^, Limited, the London and 
Counties Medical Protection Society, Limited, the Medical 
and Dental Defence Union of Scotland, Limited, the National 
Dental Corporation, Limited, the Chemists Dental Society of 
Great Britain and Ireland, the School Dentists Society, and 
the Dental Society of Ireland. AVe have heard evidence from 
Medical Officers of Health, School Medical Officers, and the 
Managing Director of a Company practising dentistry. At 
the invitation of the Committee, Professor Sidney Webb, 
LL.B., and Mr. W. C. iinderson, M.P., attended and submitted 
their views to the Committee. We have not thought it neces- 
sary to ask for evidence from public departments, as the Com- 
mittee includes officers or representatives from the principal 
public departments concerned. 

3. We have been supplied with Memoranda and other docu- 
ments by representative bodies and societies and by persons 
interested in our terms of reference. AVe desire to thank our 
numerous corresy^ondents for many valuable suggestions. All 
communications have received individual and careful con- 
sideration and the principal ones are referred to and quoted 
from in the report. We wish it to be clearly understood, how- 
ever, that any opinions e:^pressed or statements quoted are to 
be regarded as those of the persons making them, and the 
Committee are not to be considered as endorsing them unless 
this is expressly stated. 

4. The Committee have decided with a view to economy in 
labor and paper, not to print the voluminous evidence heard 
by them or the numerous memoranda they have received. The 
notes of the evidence and other documents have been carefully 
filed and, if at a later date, under different circumstances, it 
^rhould be considered necessary to jmblish them, such as are 
not confidential will be available from this purpose. 

SECTION I. — THE DENTISTs' ACT, 1878. 

5. The Dentists Act was passed on 22nd eluly, 1878. 

It provided, i)iter alia, for the formation of a register of 



SELECTIONS. 271 

persons who, as stated in the preamble to the Act, ''were 
specially qualified to practise as dentists," prescribed the 
qualifications necessary for registration and reserved for the 
exclusive use of the registered jjractitioner certain titles de- 
scriptive of his profession. It entrusted the making and keep- 
of the Dentists' Register to the "General Council of Medical 
Education and Registration of the United Kingdom" which 
had been set up by the Medical Act of 1858. For the purpose 
of exercising the powers of erasure from, or restoration to, 
the register, of any entry, the General Council were to ascer- 
tain the facts of the case by means of a Statutory Dental 
Committee of the Council not exceeding five in number. Pro- 
vision was also made for the holding of examinations by com- 
petent authorities for the purpose of testing the fitness of 
persons to practise dentistry or dental surgery, and for the 
conferring of the diploma of licentiate in dental surgery or 
dentistry by the examining body. The diploma constitutes 
the qualification for registration. The General Medical Coun- 
cil were entrusted with a general oversight of the examina- 
tion and were enabled to make a representation to the Privy 
Council if, in the opinion of the General Council, the course of 
study and examination of any particular college was insuf- 
ficient to secure the requisite knowledge and skill for the ef- 
ficient practice of dentistry or dental surgery. The Privy 
(Council on receipt of such a representation wgyq enabled to 
make an order that a certificate granted by the particular 
college shall not confer any right to registration under the 
Act. 

The xjrivileges of registered persons were set out in Sec- 
tion 5 of the Act as the right to practise dentistry and dental 
surgery in any part of His Majesty's dominions (subse(iuently 
modified by Section 26 of the Medical Act, 188(5) as "subject 
to any local law in force in that part" and to be entitled to 
recover any fee or charge, in any court, for the performance 
of any dental operation or for any dental attendance or advice. 
6. The preceding paragraph states briefly the principal 
provisions of the Dentists Act,* 1878, so far as they affect the 
registered dentist. The Act also contains in Sections 3 and 5 
iinportant provisions dealing with the practice of dentistry 
by unregistered practitioners. These sections are in the 
following terms : 

"3. Penalty on unregistered persons using title of 'dent- 
ist,' etc. — From and after the 1st day of August, 1879, a 
person shall not be entitled to take or use the name or title 



272 DOMINION DBNTAL JOURNAL 

of * dentist' (either alone or in combination with any other 
word or words), or of ^dental practitioner/ or any name, 
title, addition or description implying that he is ^ ^ registered 
under this Act or that he is a person specially qualified to 
practice dentistry, unless he is registered under this Act. 

**Any person, after the 1st day of August, 1879, not be- 
ing registered under this Act who takes or uses any such 
name, title, addition, or description as aforesaid, shall be 
liable on summary conviction to a fine not exceeding twenty 
pounds ; provided that nothing in this section shall apply to 
legally qualified medical practitioners.'' 

*^5. Privileges of registered persons.— A person shall 
not be entitled to recover any fee or charge, in any court, 
for the performance of any dental operation or for any 
dental attendance or advice, unless he is registered under 
this Act, or is a legally qualified medical practitioner. ' ' 

7. Section 3 has been the subject of considerable legal con- 
troversy. Varying decisions were given in the English, 
Scottish and Irish Courts. It was not until the 15th April, 
1910, that in the case of Bellerby v. Hej^worth, an authorita- 
tive decision was obtained from the House of Lords confirm- 
ing ^ decision of the Court of Appeal, which had reversed a 
decision obtained in England in the Chancery Division. 

The effect of this decision is summarized by Harper in his 
Legal Decisions upon the Medical and Dental Acts as follows: 

^^The words 'specially qualified to practise dentistry' in 
Section 3 of the Dentists Act, 1878, import a professional 
qualification entitling the holder to registration under the Act, 
and not merely professional skill or competence. There is 
nothing in the Act which prevents any man from doing dent- 
ist's work and informing the public that he does such work 
without being registered under the Act. ' ' 

This decision constitutes the Charter of the unregistered 
dental practitioner ; in effect it seems to bring within the law fid 
occupation of any man the practice of dentsitry provided he 
does not use the description of "dentist^' or ^'dental prac- 
titioner' ' or any name, title y etc., implying that he is registered 
under the Dentists Act, 

8. Section 5 has also been the subject of important legal 
decisions. These are briefly to the effect that the Section does 
not prevent an unregistered person recovering the cost of 
artificial teeth supplied. When payments have been made on 
account under a contract in respect of operative work and pro- 
vision of artificial teeth, any payments that have been made 



SELECTIONS. 273 

may be appropriated towards payment of the operative work 
performed on the patient, and the patient may still be sued 
for payment for the mechanical work. 

SECTION II. — DENTAL PRACTICE IN GREAT BRITAIN AND IRELAND. 

9. The Registered Deiitisfs. — These consist of a body of 
practitioners whose names and cjualifications are registered in 
accordance with Section 11 of the Dentists Act, 1878. The 
register is in the cnstody of the general registrar of the Gen- 
eral Medical Council, which Council has the duty of causing 
a correct copy of the Register to be printed, published, and 
sold at least once a year. To qualify for registration, and 
been necessary for the applicant since 1879 either to be: 

(a) A licentiate in dental surgery or dentistry of any of 

the medical authorities having power to grant surgical 

degrees. 
(6)Entitled to be registered as a foreign or colonial dentist 

in accordance with Sections 8-10 of the Dentists Act, 

1878. 

In addtion to those registered undeer (a) or [b) a number 
of practitioners were registered before the 1st xlugust, 1879, 
under Section 6 of the Dentists Act, 1878. This section pro- 
vided that any person who at the passing of the Act was 
'^hona fide engaged in the practice of dentistry or dental sur- 
gery, either separately or in conjunction with the practice of 
medicine, surgery, or pharmacy, shall be entitled to be regis- 
tered." An applicant for registration under Section 6 had 
to produce or transmit to the registrar a declaration signed 
by him in a form prescribed in a schedule to the iVct. The 
form prescribed was as follows: 

'^I, , residing at 

hereby declare that I w^as bona fide engaged in the practice 
of dentistry at , at the date of the passing of 

the Dentists Act, 1878. 
(Signed) 
(Witness) 
'^ Dated this day of ,18 .'' 

The registrar was given power, if he saw fit, to require an 
affirmation as to the truth of a declaration. Provision was 
also made in Section 37 for the registration, under certain 
conditions, of articled pupils, dental students and appren- 
tices. 

10. We understand that many persons were, under Sec- 
tions 6 and 37, admitted to registration with very little in- 



274 DOMINION DENTAL JOURNAL 

(luiry, and Sir Donald Macalister, in giving evidence before 
us, stated: 

"Tlie Dentists Act which was passed in 1878 provided 
for the recognition of those who had been actually students 
or apprentices at the time, as well as those who had been in 
practice. The result was that a large number of very im- 
mature persons got the necessary papers and appeared 
either as nominal students or apprentices, and they still 
appear in the Register. Now and then we have a person 
brought before us who was registered in 1878 w^ho, when 
we look at him, must have been registered when he was 
10 or 11 years of age, if his statements are correct." 
11. The number of licentiates in dental surgery in 1878 
was very few, and the first register compiled under the Dent- 
ists Act, 1878, was mainly composed of the names of persons 
who, on their own declaration, were stated to be engaged in 
the bo7ia fide practice of dentistry at that date or who were 
admitted by virtue of being dental students or apprentices. 
The position at the j)resent time is fundamentally different. 
Out of 5,524 persons whose names appear in the Dentists' 
Register for 1918, no fewer than 4,214, or 76 per cent, were 
Licentiates or Graduates in Dentistry. The names of 1,274 
persons admitted by virtue of practice withotit any additional 
(]ualification in 1878 still remained on the register, but many 
of these have doubtless I'etired from the active work of theii* 
])rofession. Those still practising have had forty years' ex- 
perience, which in a measure compensates for the want of 
training and instruction which may have been lacking in their 
case at the time of their registration in 1879. 

The dental profession at the present time consists of about 
5,500 registered practitioners of whom at least 75 per cent, 
ai-e either Licentiates or Graduates in Dental Surgery after 
approved courses of instruction and training tested by exam- 
inations. 

. . The remaining 25 per cent, is a rapidly declining body of 
practitioners of long experience who were admitted to the 
profession in 1878. The number of Colonial and Foreign 
Dentists appearing in the Dentists' Register is ])ractically 
negligible, being only 29 in 1918. 

12. The Medical Practitioner as Dentist.— M\ legally 
((ualified medical practitioners are entitled to practise dent- 
istry and have the same legal rights to cover fees as a dentist 
registered under the Dentists Act of 1878. A legally qualified 
medical practitioner is exem])ted from any disability in the 



SELECTIONS. 275 

practice of dentistry that is iiii]josecl on persons, other tliaii 
registered dentists, by the Dentists Act, 1878. 

13. Unrcfjisterad Dental Pructifionei\^. — h\ addition to 
dentists registered under the Dentists Act and medical prac- 
titioners there ari' in the United Kino-doni a large nnmher 
of persons practising dentistry, in some or all of its forms, 
devoting the whole or part of their time to (h'ntal woi-k. The 
evidence submitted to us is to the effect that, until the outbreak 
of the war, the tendency was for unregistered dental practice 
to increase. Plsi)ecially was this the case with unregistered 
dental company practice. A number of unregistered dental 
practitioners have formed associations to protect their inter- 
ests and some of them regulate tiie conditions under which 
their members shall practise and the ethical standard that 
shall be observed. The most important of these associations 
is the Incorporated Dental Society, Ijimited, which had until 
recently a membershij) of about 1,600. This society expects its 
members to observe a certain professional standard, has pro- 
vided clinics and arranged lectures for the, benefit of its 
members, and, lin recent years, has insisted on new members 
passing an examination test conducted by its own members. 
The number of unregistered dental practitioners * wlio are 
members of some recognized dental society is about 2,000. 

14. In addition to persons practising on their own account 
there are a large number of unregistered practitioners en- 
gaged ill dental company work. The business of dental com- 
panies is mainly pursued by means of skilled advertising, 
sometimes of a misleading character, and by personal house 
to house canvassing. The sale of artificial teeth is the main 
part of company business, and so-called easy instalment sys- 
tems of payment are frequenth' used to induce persons of 
limited means to consent to having teeth removed and artificial 
dentures substituted. The evils of some forms of dental com- 
pany practice have been represented to us in the strongest 
possible terms. The evidence in this respect comes from 
re|)resentatives of unregistered practitioners as well as from 
the registered dentist. In addition to com])any practice there 
are a large number of unregistered practitioners of indifferent 
general education who have set up as dental ])ractitioners 
without any training or instruction whatsoever. By means 
of specious advertising and personal canvassing they ply 
their calling to the danger of the public, but with ver} lucrative 
results to themselves. 



276 DOMINION DENTAL JOURNAL 

15. We find ourselves unable to frame an estimate of the 
total number of unregistered practitioners. Their names do 
not appear in local or trade directories under any particular 
headings. Their total number is certainly much greater than 
that of registered dental practitiouers. Whatever may be the 
precise number of unregistered practitioners the evidence sub- 
mitted to us is conclusive that it is the least reputable section 
of unregistered dental practice that has increased most, and 
tends to increase. This constitutes a menace alike to the pub- 
lic health, the registered dental profession and the more repu- 
table unregistered practitioners. 

Evidence submitted to us indicates that dental practice is 
carried on by unregistered persons of widely varying grades 
of social standing, education and training, ranging from the 
few fully trained and qualified practitioners ivho have refrain- 
ed from registering, the graduate from a dental college or a 
University in the United States, and the old standing e'.r>» 
perienced unregistered practitioner, to the Insurance or seiv- 
ing machine canvasser, the butcher, and the blacksmith. 

SECTION III. — PRACTICE OF DENTISTRY BY INCORPORATED COMPANIES. 

16. We have in. paragraph 14 briefly alluded to the prac- 
tice of dentistry by companies. In this section we shall refer 
more fully to this subject. We have received a large amount of 
evidence of the evils resulting from company dental practice 
from, inter alia, the General Medical Council,the British Dental 
Association, the London and Counties Medical Protection 
Society, Limited, and the Medical and Dental Defence Union 
of Scotland. The evils appear to have reached a climax in the 
practice of dentistry by a number of so-called ^* Hygienic Li- 
stitutes, ' ' set up as separate Companies in the principal towns 
of Great Britain and Ireland from 1906 onwards. These hy- 
gienic institutes, we are informed, numbered at least 57 and 
sprang from a central company founded by an alien whose 
varied occupations had no connection with dentistry. The 
institutes flourished from 1906 to about 1912 and some may 
still exist. Grave injuries were inflicted on many patients, and 
when actions were taken against the company it was usually 
found that any damages awarded were irrecoverable owing to 
there being no assets, or such assets as existed being in pos- 
session of debenture holders. These institutes carried on a 
dental business by means of advertisement and house to house 
canvassing, they employed untrained and inexperienced men, 
and charged fees as high or higher than would have been 



SELECTIONS. 277 

charged by a registered dentist. These particular companies 
are referred to by each of the bodies tendering evidence as to 
the evils resulting from unqualified dental practice, and it is 
very evident that they constituted a serious menace to the 
public health. Emphasis has been laid on the fact that the 
facilities for unqualified practice and avoidance of financial 
liability for injury have in these instances been greatly 
aided by the operations being carried on by a limited company. 
17. The British Dental Association has furnished us with 
a number of instances in which damages have been obtained 
for injuries inflicted by operators working in the capacity of 
servants of companies trading as hygienic institutes. It will 
suffice to quote four cases, one from each portion of the United 
Kingdom, submitted to us by the association. They are typi- 
cal of many others in the list, and indicate the widespread 
nature of the evil. 

Case No. 1. "G^lasgow Sheriff Court. £100 damages 
against the Glasgow Hygienic Institute for injury done by 
unskilful dental operation. Patient ^s jaw fractured in ex- 
traction of seventeen teeth and mouth very much lacerated, 
his general health being seriously and injuriously affected 
in consequence. Sheriif Fyfe in his judgment said the case 
was a striking illustration of the wide gulf which often 
exists between the letter and the spirit of a Statute (the 

Dentists Act) This Hygienic Institute seemed to him 

about the most barefaced evasion of an Act of Parliament 
which ingenuity could suggest, for they go as near desig- 
nating themselves Dentists as it was possible to go.'' — 
Glasgow Herald, February 3rd, 1910. 

Case No. 2. ''Durham County Court. £56 damages with 
costs awarded Mrs. Knaggs against Bishop Auckland Hy- 
gienic Institute. The doctor's evidence stated that part of 
the jaw was literally torn away; the woman seemed to be 
suffering from cocaine poisoning and from slight lockjaw; 
bleeding continu^ed for five or six days. 'He had never seen 
a mouth in such a condition in his life ; it was torn to pieces. 
There was a compound fracture of the jaw.' ^''—Durham 
Chronicle, January 21st, 1910. 

Case No. 3. "Waterford County Court. £20 damages 
and expenses awarded against Hygienic Institute for over- 
dose of cocaine to J. O'Brien; evidence of cocaine poisoning 
necessitating medical attendance to save liie.^^— Waterford 
Evening News, April 13th, 1910. 



27?^ DOMINION DENTAL JOURNAL 

Case No. 4. ''Cardiff County Court. Judgment for £8 

and costs against Hygienic Institute, Cardiff, for illness of 

patient for fourteen day ^.'''— South Wales Daily Neirs, May 

6tli, 1910. 

The case of these "Hygienic Institutes" affords the most 

striking instance of the abuse of the Companies Act for the 

practice of dentistry hy unqualified practitioners. Numerous 

other instances have- also been submitted to us of evils arising 

from company dental practice. 

18. In 1909 the Lord President of ihe Council requested 
the Local Government Board and the LocaJ iGove'rnment 
Boards for Scotland and Ireland to collect certain information 
from Medical Officers of Health on the practice of Medicine 
and Surgery by unqualified persons. The information col- 
lected was summarized by the several Local Government 
Boards and submitted in a report to Parliament by the Lord 
President of the Council.* In the summary for England and 
Wales it is stated that : 

"Dental Companies, Hygienic and other Institutes do a 
large amount of dental surgery, largely through agents. 
They canvass from house to house, and charge fees as high 
as qualified dentists. Many unqualified dental firms make 
periodical tours of towns, advertising the particulars of 
their visit in the local press beforehand, and hiring a con- 
sulting room, e.g., at a hotel, for the occasion." 
The summary was prepared from replies received from over 
1,600 medical officers of health, many of whom had consulted 
the local division of the British Medical Association or the 
local medical society. The replies received therefrom repre- 
sent not only the opinions of medical officers of health but 
'ciho of many medical practitioners in general practice. 

19. It has been represented to us by the British J)ental 
Association that various causes induce an unqualified practi- 
tioner to work under the Companies Act. In an action for 
damages there is often considerable difficulty in a plaintiff 
ascertaining who is liable, and when damages are awarded 
against a company it is sometimes found impracticable to re- 
cover the amountf of the judgment by reason of the paucity 
of the capital and assets. In other instances debentures have 
been created and the appointment of a receiver foi* the de- 
benture holders has effectively prevented the judgment being 

*Report as to the Practice of Medicine and Surgery by un<iualitied persons in 
the United Kingidom, 1910. (Cd. 5422.) 

tThis mig-ht be met by requiring them to nial<e a deposit to meet claims, on the 
model of Insurance ConvT)anies. See .\ssurance Comipanies Act. 1909, Sec. 2 (1). 



SELFXTIONS. 279 

made operative. Besides these inducements for unregistered 
practitioners to form limited companies it has been represent- 
ed that persons unconnected with dentistry form companies 
and carry on the business by employing- uiuinalified men, the 
proprietors taking- no part in the l)usiness. 

20. Running right through the evidence we have received 
from representatives of both the i-.egistered and unregistered 
practitioners is the contention that the relation between a 
patient and his dentist is a personal one similar to that pre- 
vailing between a patient and his doctor. The I'esponsibility 
of the dentist to his patient, the maintenance of the profes- 
sional status of the dentist and the observance of an ethical 
professional standaixl are claimed to be the advantage of the 
public and necessary in the public interest. Where the dental 
operator is the servant of a company it is alleged that these 
factors hardly exist. These and other evils and disadvant- 
ages to the public described as resulting from company dental 
practice have l)een repeatedly represented to us. 

21. We have on the other hand only had one oi)portunity 
of considering the claims advanced by a dental company that 
company dental practice is in the public interest^ only one 
company having approached the (vonmiittee and expressed 
a desire to give evidence. This company is the Macdonald 
Manufacturing Co., Ltd., which has submitted two memoranda 
to the Committee, and whose managing director, Mr. J. H. 
Morris, was heard in evidence before the Committee. The 
company claimed that the time and expense involved in ob- 
taining the full qualification for registration as a dentist is 
incom])atible with the growing demand for economical den- 
tistry for the wage earning sections of the public; also that, 
with its wide spread branch establishments, it has done much 
to meet this demand, and that if the doubt as to continued 
hostile legislation was iinally removed and the company's 
rights firmly established by constructive legislation it w^ould 
be able to continue with advantage to the community. It was 
alleged that the sticcess of a company depends on its assistants, 
and that this involves care in selection and supervision of their 
work and that the assistants' position with the company iS 
dependent on their good work and conduct. It was urged 
that the company's size and stability provided a guarantee 
that complaints would be investigated and claims considered 
and (if bona fide) settled. The larger the business the more- 
valuable and susceptible is the reputation it has to preserver 
Advertisements were claimed to have a poptilarising effecl 



280 DOMINION DENTAL JOURNAL 

upon certain sections of the people not reached by the private 
qualified dentist. 

We have thought it desirable to set out somewhat fully the 
claims of the Macdonald Manufacturing Co. before reviewing 
the suggestions which have been made to us for remedying 
the undoubted abuses which exist in the operation of some 
dental companies. 

The Committee are of opinion that gross abuses have heev. 
associated tvith the practice of dentistry hy hicorporated 
Companies; that these abuses are of the nature both of mal- 
ytraxis and of fraud and that an alteration of the law is needed 
to remedy them. 

22. Various suggestions have been made to us for dealing 
with these abuses. Sir Donald Macalister referred us to the 
proposals of the General Medical Council which were in 
agreement with the terms of a Bill as introduced into the 
House of Lords in 1907, "Dental Companies (Restriction of 
Practice Bill." This Bill was introduced hy a private mem- 
ber. As introduced it provided for the prohibition of dental 
work by incorporated companies. 

The Select Committee considering the Bill, after having 
heard witnesses representing the General Medical Council, the 
British Dental Association, the companies practising den- 
tistry, and other interested persons, inserted an amendment 
in the Bill which had the effect of recognising and protecting 
the vested interest of dental companies which had, for a 
period of 5 years before the passing of the Act, been bona fide 
engaged in carrying on the business of dentistry or dental 
surgeons or dental practitioners. The Bill did not proceed 
further during that session. 

23. The General Medical Council, we were informed by Sir 
Donald Macalister, favours an alteration of the law which 
would provide for the total prohibition of dental companies 
which, in the name of the Company, and not in the name of 
the individual operator, practise upon the public. The Council 
hold a. similar view as regards medical companies. Mr. 
Xorman Bennett, on behalf of the British Dental Association, 
expressed the view that all dental companies should be pro- 
hibited. There was no objection to permitting existing den- 
tal companies to practise for a strictly limited period in order 
to enable the shareholders to take out their capital from the 
company, but after a certain date, company dental practice 
should, he considered, entirely cease. Mr. Butterfield, the sec- 
retary of the Incorporated Dental Society, was also in favour 



SELECTIONS. 281 

of the prohibition of dental practice by companies after the 
lapse of a period of 5 years. He thought that existing com- 
panies should be allowed practice for that period, and the 
managers and operating principals of branches should at once 
be admitted to the dental register and allowed to practice in 
their own name and employ qualified assistants at the end of 
the period. 

24. The Macdonald Manufacturing Company, Ltd., sug- 
gested in the event of any restrictive legislation being recom- 
mended : 

(a) That so far as Dental Limited Companies are con- 
cerned all Directors and assistants who have had pi'^ctical 
experience in dentistry should be exemjited from restrictions 
and should be registered and thenceforward no person or per- 
sons should be permitted to carry on Dentistry without being 
upon the register. 

(b) That Limited Companies should be allowed to continue 
and should be entitled to employ qualified assistants. 

(c) That no Limited Comi)any partnerships or person 
should be at liberty to use the name of dentist or dental prac- 
titioner or any name with a descri|)tion implying that the 
business is carried on by a person or persons registered under 
the proposed act, unless the dental work is hoHa fide conducted 
by persons who are duly registered thereunder. 

25. The Committee have given very careful consideration 
to the different representations that have been made to them. 
They have also had regard to the fact that at the present mom- 
ent there is no act prohibiting the fonnation of incorporated 
companies for a lawful purpose. They consider that if the 
evils that have undoubtedly become associated with com- 
pany dental i)ractice can be prevented by means other than 
by total pi'ohibition of such jjractice it is better to adopt this 
course than to suggest an alteration of the Companies Act 
for which there is no i)recedent. it would probably be 
difficult to confine prohibition of company practice to den- 
tistry alone. A i)recedent of this nature would be (] noted 
for use in other professions and trades, and would re<|uire 
to be considered by Parliament from a wider stand] )oint 
than that of dentistry. The Committee have, therefore, 
approached the i)roblem from the point of view of control 
rather than from that of total prohibition. 

26. Section 3 (4) of the Poisons and Pharmacy Act, 1908, 
affords a precedent for control. This section is in the fol- 
lowing terms : 



282 DOMINION DENTAL JOURNAL 

(4) A body corporate, and in Scotland a firm or partner- 
ship may carry on the business of a pharmaceutical chemist 
or chemist and druggist : 

(a) If the business of the body corporate, firm or part- 
nership, so far as it relates to the keeping, retailing, 
and dispensing of poisons, is under the control and 
management of a superintendent who is a duly reg- 
istered pharmaceutical chemist or chemist and drug- 
gist whose name has been forwarded to the registrar 
appointed under the Pharmacy Act, 1852, to be en- 
tered by him in a register to be kept for that purpose, 
and who does not act at the same time in a similar 
capacity for any other body corporate, firm, or part- 
nership; and 

(b) if in every premises where such business as aforesaid 
is carried on, and is not personally conducted by the 
superintendent, such business is bona fide conducted 
under the direction of the superintendent by a man- 
ager or assistant who is a duly registered pharmaceu- 
tical chemist or chemist and druggist, and whose cer- 
tificate of (lualification is conspicuously exhibited in 
the shoj) or other place in which he so conducts the 
business. 

A body corporate, and in Scotland a firm or partnership, 
may use the description of chemist and druggist, or of chemist 
or of druggist, or of dispensing chemist or druggist, of the 
foregoing requirements as to the carrying on of the business 
are observed, and if the superintendent is a member of the 
board of directors or other governing body of the body cor- 
porate, or of the firm or partnership, as the case may be. 

Subject as aforesaid, section twelve of the Pharmacy Act, 
1852, and sections one and fifteen of the Pharmacy Act, 1868, 
shall apply to a body corporate, and in Scotland to a firm or 
partnershi}), in like manner as they apply to an individual. 

27. The Patents and Designs Bill of 1917 (Bill No. 1U6) 
introduced by Sir Albert Stanley also affords in Section 17 
a precedent for control. This section is in the following 
terms : 

17. For section eighty-four of the principal Act, which re- 
lates to the registration of patent agents, the following sec- 
tion shall be i^ubstituted : 

84. (1) No person shall describe or hold himself out, or 
permit himself to be described oi' held out, as a patent agent, 
unless : 



SELECTIONS. 283 

(a) in the case of an individual, he is registered as a 
patent agent in the register of patent agents: 

(b) in the case of a firm, every partner of the firm is so 
registered : 

(c) In the case of an incorporated company, every director 
and the manager (if any) of the company is so reg- 
istered. 

(2) Every person not already registered as a patent agent 
who proves to the satisfaction of the Board of Trade that 
prior to the first day of August, nineteen hundred and seven- 
teen, he has been bona fide practising as a patent agent shall 
be entitled to be registered as a patent agent if he makes an 
application for the purpose within twelve months after the 
said first day of August, unless after giving an applicant an 
opportunity of being heard the Board of Trade are satisfied 
that he has whilst so practising been guilty of such mis-con- 
duct as would have rendered him liable, if his name had been 
on the register of patent agents to have his name erased there- 
from. 

(3) If any person contravenes the provisions of this sec- 
tion he shall be liable on conviction under the Summary Juris- 
diction Act to a fine not exceeding twenty pounds, and in 
case of a company every director, manager, secretary, or other 
officer of the company who is knowingly a party to the contra- 
vention shall be guilty of a like offence and liable to a like fine. 

(4) For the purpose of this section the expression '^patent 
agent ^' means a person, firm or company carrying on in the 
United Kingdom the business of obtaining patents in the 
United Kingdom or elsewhere. 

28. The Committee are of opinion that the abuses of com- 
pany dental practice, which have been brought to their notice, 
would be effectively prevented if dental companies were sub- 
ject to a somewhat similar system of control to that set out 
in paragraph 27. The Committee, therefore, recommend that 
no incori)orate(l company shall be pennitted to piactice den- 
tistry unless the operating staff, each of the directors, and the 
manager (if any) of the company are registered. The busi- 
ness of the company shall be restricted to the usual work of a 
dentist and not be combined with that of any other business 
or trade. Any contravention should be punishable on con- 
viction under the Summary Jurisdiction Acts by the levying 
of a fine not exceeding twenty pounds on every director, man- 
ager, secretary, or other officer of the company who is a [)arty 



284 DOMINION DENTAL JOURNAL 

to the contravention. The registered directors, manager, and 
operating assistants employed by companies would be subject 
to the same control as individual dentists, and liable to re- 
moval from the register. On removal from the register they 
would no long'er be able to act as dentists either in an in- 
dividual capacity or as servants of a company. 

29. As regards existing dental companies the Committee 
think that any manager or director who has bona fide been 
acting in the capacity for a period of 5 years before the date 
of this report should be entitled to be specially registered in 
a separate portion of the Dentists Register. Such registra- 
tion should constitute a right to take part in the management 
of a dental company, but should not entitle the person reg- 
istered to act as a dentist, unless he were also registered as 
a dentist. As regards the operating assistants and others em- 
ployed by existing companies in performing dental operations 
they should be able to obtain registration on the same terms 
as are recommended for other unregistered practitioners. 

The Committee in short recommend that Dental Com- 
panies shall not he prohibited from practising dentistry hut 
shall be controlled, all the operating and managing staff being 
required to he registered dentists, and special provision being 
made to meet the case of existing companies. Companies 
practising dentistry shoidd not carry on any other business 
or trade: 

30. The Committee have considered the question of the 
financial liability of dental companies and their servants io 
patients for negligence and have received the opinion of the 
Solicitor-General upon it. It is in the following*; teims: 

Dentists. 
^* Whether a dentist (registered or unregistered) employed 
by a company (as a servant) could be sued for damages by a 
patient injured through his negligence, as an alternative to 
suing the company, or whether an action would lie against the 
company only." 

Opinion of the Solicitor-General. 
'*In my opinion the person injured would in the circum- 
stances referred to, have cause of action against either the 
dentist or the company or both. Every agent or servant is 
personally liable for his own torts, and if, in virtue of the 
doctrine "respondent superior,' his principal or master is 



SELECTIONS. 2^? 

also liable, the liability is joint aiul several. Either ina> be 
sued separately or both may be sued jointly. 

(Signed) ''Gordon Hewart. 

"Law Officers' Department, 
12th March, 1918.'' 

Having- regard to this opinion and to the conditions under 
which it is recommended that dental companies shall in future 
work the Committee think that the interests of the pul)lic will 
be adequately safeguarded. 

SECTION IV. — THE EVILS ARISING FROM DENTAL PRACTICE BY UN- 
REGISTERED PRACTITIONERS 

31. In considering ''the extent and gravity of the evils 
connected with the practice of dentistry and dental surgery 
by persons not (jualified under the Dentists Act" it is neces- 
sary always to bear in mind the fact that under the existing 
law any person, liowever ignorant, unskilled, untrained, can 
practise dentistry and inform the public by advertisement 
and otherwise that he practises dentistry. The only pro- 
tection the public has is an action for damages in case of in- 
jury or the fear of a possible prosecutioyi for manslaughter 
In the case of death. 

32. In view of the legal position the persons who have 
taken up the calling of dentistry now comprise a body of men 
representing every degree of skill from the totally uneducated 
unskilled men to the highly skilled qualitied practitioner. 
When a particular evil associated with an unregistered 
practitioner is mentioned it must always be considered with 
reference to the possibility that the evil may be multiplied 
many times over by the number of practitioners of similar 
calibre who are practising dentistry. On the other hand the 
evil may not find a ])lace at all among unregistered practition- 
ers of reputable standing. In order to investigate the sub- 
ject thoroughly the Committee sent a circular letter to each 
representative body, that in the opinion of the Committee 
was in a position to furnish them with information on the 
subject. Each reply on receipt was carefully considered in 
detail and, if it was thought that additional useful information 
would be acquired by oral evidence, witnesses were invited 
to attend before the Committee. 

(To he continued.) 



286 DOMINION DENTAL JOURNAL 

THE AMERICAN ARMY DENTAL CORPS 



Some interesting facts and figures appear in the farewell 
letter issued by Colonel W. H. G. Logan, Medical Corps, U. S. 
Army, who for nearly two years has been the recognized 
head of the Dental Corps in the Surgeon-General's Office at 
Washington. On Apnl 8, 1917, when war was declared with 
Germany, the Dental Corps of the American Army consisted 
of eighty-six officers. On November 11, 1918, when the arm- 
istice was signed, there were 5,000 dental officers on duty 
(over 3,000 at home and nearly 2,000 abroad), while 1,500 were 
holding Reserve Corps Commissions awaiting assignment, and 
1,500 applications of enlisted dentists for commissions had 
been completed. These figures offer a remarkable contrast 
with the total of dental appointments for the British Army, 
the maximum of which at the signing of the armistice was 
about 830. We learn that on September 30, 1918, authoriz- 
ation had been secured from the Adjutant-General for the 
commissioning and assignment before July 1, 1919, of between 
9,000 and 10,000 American dental officers to care for the dental 
needs of an army of about 4>^ millions, which established the 
precedent for the assignment of two dental officers per thous- 
and men. Now that peace has come, Colonel Logan asks, 
what is to be the future quota of assignment of dental officers 
to the peace or permanent army! He expresses the opinion 
that the authorities concur in the desire of the dental pro- 
fession and the Dental Corps that an assignment of two 
dental officers per thousand shall be allowed hereafter in any 
army that represents the U. S. A. He adds that the Surgeon- 
General fully approves the establishment of a Dental Officers 
Training School in connection with the Army Medical School 
at Washington. The general plans for the building are com- 
pleted; the staff of professors and assistants will number 
seventeen, the duration of course being four and a half months 
(two courses per year). Indicating his ambitious hopes for 
the future welfare of the Dental Corps, Colonel Logan an- 
ticipates "that a post-graduate school of instruction will be 
established where all members of the Dental Corps will receive 
instruction once every five years, that full dentistry will be 
authorized in the amiy, and that complete dental equipment 
will be found at all permanent stations." In conclusion, 
Colonel Logan suggests that members of the Dental Corps 
should not develop discord in regard to important questions 



SELECTIONS. 287 

of policy and that political activities for legislation should be 
avoided. 

Commenting- upon Colonel Logan ^s farewell letter, the 
Journal of the Association of Military Dental Surgeons of the 
United States says there is need for the dental profession to 
keep a watchful eye on the new Army Bill, because it is re- 
ported that the quota of two dental officers per thousand men 
*'is to be seriously reduced." The Journal adds: ''We are 
glad to note that he thoroughly approves of a table of organ- 
ization for the Dental Corps, and that officers of the Dental 
Corps shall at all times be on duty in the Surgeon-GeneraPs 
office looking after the interests of their own Corps/ ^ The 
proposal to establish a Dental Officers' Training School is 
liearti'ly endorsed as "a huge stride in advance" but the 
Journal contends that the (^orps should not be debarred from 
dignified political activity for improving the dental service 
in the armv. —British Dental Journal 



ABOUT TEMPORARY DENTURES 



After extraction, the question of immediate or delayed 
prosthesis will always force itself upon the operator and 
patient. The solution of the question is frequently not based 
upon physiological reason. The patient is usually consulted 
regarding the amount of money he sjj.puld be willing to in- 
vest without considering the real needs of the case, and not 
infrequently the operator will advise delaying restoration. 
He has two reasons for doing so: First, the substitution of 
the artificial teeth will be easier six to nine months after ex- 
traction than if the work is done at once; second, if the restor- 
ation is delayed the patient will save one fee, but on the other 
hand wnll remain toothless for this period of time. The pa- 
tients are usually willing to do this because of the saving of 
one fee and the o})erator's statement that the case will fit 
better after resorption is complete. 

Fortunately, these two reasons are insignificant when com- 
pared with the real and major reason for immediate pros- 
thesis. In looking over the writings of leading prosthesists, I 
noted the following minor reasons for immediate prosthesis: 
To serve the patient by giving him teeth upon which to masti- 
cate during the interim betw^een extraction and completed 
resorption ; that the patient wall more easily adapt himself to 
the presence and use of the substitute if he does not have to 



288 DOMINION DENTAL JOURNAL 

wait months before it is placed in jjosition; that the patient 
will not have to appear toothless in public and thus avoid the 
humiliation and unkindly comment in reference to the pa- 
tient's age, and lastly, that the alveolar ridges will resorb 
more uniformly under the dentures with a better and firmer 
ri^ge upon which to build the permanent dentures as the re- 
sult. 

I shall not comment upon any of the above reasons unless 
it be the last one. It has been my experience, in replacing a 
poorly constructed primi-denture, that the ridges were every- 
thing but uniform and smooth, and not infreciuently such a 
case becomes a real problem, owing to the careless adaption 
of a ^^ temporary denture."— F. W. Prahm. 



PYORRHEA ALVEOLARIS AND ARTHRITIS 



Patient gave history of having intermittent rheumatic 
paims in the left shoulder and arm, extending over a period 
of two years. The patient's physician informed me that he 
had eliminated all possible foci of infection outside of the 
mouth, and since she only had a lower left cuspid remaining, 
had left this consideration to the last. Despite the admin- 
istration of all established anti-rheumatic remedial agents 
internally, the arthritis had continued until the left wrist 
and shoulder were practically immovable and the elbow en- 
tirely so. It had been necessary for him to make a plaster of 
Paris splint to brace and protect the arm. The cuspid pre- 
sented a mesial and distal pocket containing pus, but the tooth 
was vital, so no radiograph was made. A culture was made 
of the ])us about the tooth, then the tooth extracted and a 
culture made of same in both agar and bouillon. Both these 
cultures raised colonies of the streptococcus viridans, to- 
gether with some other cultures, of no immediate importance 
to the case in hand. 

After the extraction the patient was little, if any, im- 
proved, and at the end of the week, when a vaccine had been 
evolved, this was injected, following which the patient reacted 
strongly and had intense pain in the afflicted arm. At the 
end of six weeks, when about ten injections had been given, 
the patient had perfect movement of the joints of the arm, no 
pain, and it only remained for her to build up again the tone 
of the dormant muscles to have a perfectly useful extremit3\ 
No return of the symptoms has occurred. — By R. C. Coole}', 
D.D.S., Houston, Texas.— ^//(^ Dn/fdl Siunmari), 



SELECTIONS. 2^9 

HORACE FLETCHER AND HIS WORK 



A very romaikable man died recently, named Horace 
Fletcher. And his life embodied so much of good, that it is 
well to think of it as an inspiration in itself. 

At the age of 42 years, after traveling all over the world 
and accumnlating a fortune, he decided to retire from business 
and enjoy the fruits of his labor. On placing himself before 
the examination board of several life insurance companies 
where he had applied for insurance, he was amazed to learn 
that he was an extremely bad risk and that no comjjany would 
give him insurance. 

But Horace Fletcher was not ready to die, as the insurance 
people intimated that he might, but studied himself carefully, 
and all his ailments. He believed that ])(Miple ate too much, 
and chewcMl theii- food too little, thereby sufl'ering accord- 
ingly. And thus was born the famous idea of ''Fletehei- 
izing" which was to chew your food until it liquidized in the 
mouth, and disappeared, hardly realizing vou had swallowed 
it! 

This idea was not new. ^1 1-. Gladstone many years prev- 
iously advi.sed his children to chew each morsel of food at 
least 32 times, one for each tooth, and two for each tooth that 
was missing. 

Such unusual stieiigth and \igoi* did Mr. Fletcher secure 
by his method that he outchampioned chamj)ions in great 
feats of strength at ^'ale T Diversity. He also wrote inaii> 
books, and no (ioul)t built up another great fortune on his 
seeming misfoi'tune. In his book, "The A. V>. Z. of Oui- 
Nutrition," he gives in detail the reason for his l)elief. The 
book is a bit prosy, and all of the essential facts conld haxc 
been produced in much less space. 

It has bwn argued that Fletcher dying at the age of (Jii 
did not make good his claims; that Luigi Cornaro and Ben- 
jamin Franklin had already advocated the same method, and 
each lived longer than Fletcher. But it must be remembered 
in })assing that in middle life, being a physical wreck, and 
given up by his physicians, he was restored to health by 
|)ractising the "Chew-Chew" method, and was able to securc- 
the life insurance previously denied him. Had he taken uj/ 
with the idea earlier there is much reason to believe that he 
would have reached a more mature age. 

Mr. Fletohei- did a useful work and boie undeserved 
ridicule with fine good nature. He was a scientist who won 



29u DOMINION DENTAL JOURNAF. 

recognition slowly and his theories are not, even yet, accepted, 
and in practice by only a few people, simply because they are 
too apathetic and lazy to do half the things they ought to do. 

It has been announced that he left a large part of his 
estate to Plarvard University to carry forward a campaign 
in behalf of proper nutrition. 

Paste the lesson of this extraordinary man in your hat — 
and don't let it fall out I— Oral Hygiene. 



CLASSIFICATION OF TEETH REQUIRING 
EXTRACTION 



From the viewpoint of the exodontist we may note the 
following restricted summary of tooth conditions: 

1. Vital teeth or teeth only recently devitalized with 
natural texture unimpaired. 

2. Teeth devitalized for a long time with structure dried 
out and consequently brittle or chalky. This class often is 
characterized by bony adhesions or ankylosis, due to con- 
densive osteitis. 

3. Teeth in normal position. 

4. Teeth in abnormal position due to crowding or im- 
paction, or teeth not fully erupted. 

5. Teeth normal in outline and development. 

6. Teeth abnormal in this respect due to fusion, hyper- 
cementosis, or with roots abnormally curved or bent due to 
pressure. 

7. Roots exposed to view. 

8. Roots submerged. 

9. Teeth complicated by disease of supporting tissues, 
such as necrosis of the alveolar process. 

Teeth in class two are the ones which will be liable to cause 
most trouble in the attempt at extraction. They may also 
bear the characteristics of class six in addition, when the 
difficulty is increased many fold. 

In the case of an anterior tooth, central, lateral, or cuspid, 
which has been reamed out for the accommodation of a dowel 
pin, we have a problem which needs great care. The root is 
only a shell which will bear no crushing. This root must 
be dislodged by breaking up adhesions, one side at a time, by 
inserting an instrument alongside of the root. This prevents 
the biting-out of bone, periosteum and gum tissue, which 
results when forceps are used. An alveola?' forceps is an 



SELECTIOXS. 291 

instrument ichicli ucrcr should be used hi/ a dcutisi who has 
any regard for his patient. 

Teeth in class four wlu'ii impacted usually are to be re- 
garded as extraordinary cases. The patient always should be 
informed before-hand of their ini])()itance and tlie necessity 
of ])ost-oj)erative treatment. 

These operations shoukl be performed only after complete 
examination, involving- a considei'ation of the tooth and all 
contiguous tissues. The bone in which the impaction rests 
should be considered fully, as consisting of external hard 
plates and cancellous tissue in the body of the bone. The 
socket, also, is a thin plate extending down into the cancellous 
tissue. Tlie lining should be consei'ved carefully if possible, 
and in any ease should not be destroyed to a greater extent 
than necessary. The moie nearly any tissue approaches the 
normal the greater is its resistance to infection. 

Development of exti-acting technic, wliethei- to be applied 
to ordinai'y or extraordinary cases, should be towaid the con- 
servation of supporting and contiguous tissues, and the pro- 
tection of the patient from shock. Freak operations, depend- 
ing upon speed and the sy)ectacular as their claim for adoption, 
should be at least carefully considered before being tried out 
on the patient who expects an operation which is the result 
of experience. 

The man practising general dentistry will do well to limit 
his extracting to cases which examination leads him to believe 
can be ])erformed without great difficulty; even then he often 
will tind plenty of trouble finishing what he has begun. This is 
most often the case when a lower first or second molar, devit- 
alized for many years, is undertaken. It is firmly set, anky- 
losed, and unyielding. It often requires great force to dis- 
lodge it and the brittleness of the tooth, added sometimes 
to excemeintosis, creates a problem which is hard for the most 
experienced to solve.— J. P. Henehan, Practical Dental 
Journal. 



292 DOMINION DENTAL JOURNAL 

Dental Societies 



CAR FOR C.A.D.C., DISTRICT NO. 2 

The following is the report of the committee to collect funds 
for the xjurchase of a motor car for the officers of the C.A.D.C., 
District No. 2: 

Receipts. 

Drafts $ 1,095.00 

Cheques 287.00 

Cash -.... 71.00 

$1,453.00 
Bank Interest ■ 2.60 

$1,455.60 

Expenses. 

Exchange on drafts accepted $ 32,85 

Exchange on drafts returned 5.10 

Exchange on cheques 1 .05 

Total Exchange $39.00 

Long Distance 'Phone .60 

Printing 9.00 

Envelopes 2.00 

Stamps 21.55 

$72.15 

Receipts $ 1,455.60 

Expenditure 72.15 

Balance $1,383.45 

Names of the Contributors. 
By Draft,- McTaggart, Collard, M. A. Fabis, W. C. Lyn- 
burner (Smithville), C. B. Bell, Murray, R. G. McLean, 
Arnott, Kalbfleich, Huifmann, Ante, ^lontgonierv, Broughton, 
Small, H. L. Frind, D. D. Cook (Whitby), J. L. Leitch, 
Hudson, Husband, Ganton, Nichols, \V. C. Smith, Pearson, 
H. R. Stewart, Vanduzen, Fife, Armstrong, L. G. Smith, 
Watson, G. A. M. Adams, McGahey, Tome, Spalding, Wickett, 
J. B. Gordon, Wylie, L. L. Floyd, Siegel, G. L. Palmer, 
P. Butler (Aurora), Bartlam, A. R. Jordan, C. Mills, French, 
Galloway, Shields, ITuglies, G. G. Joixlan, Werrils, ^IcKim, 
\\'ard, C. TL Clarkson, Bur, Wurts, H. Scott (Hamilton), 



SELECTIONS. 293 

E. J. McDonald, Amos, Pye, Butler, G. Wilson, Bancroft, 
Baird, Wright, C. O. Fallis, Mooney, Dobson, J. A. Curam, 
G. H. Curam, Deyment, W. A. Black, Pertman, F. R. Davis, 
Vance, Lennox, Bruce, E. W. Paul, llaloran, Patterson, 
H. E. Watson, Sellery, Regan, Box, H. Wilson, Cavannagh, 
Gollop, Russell, ('oon, E. Hart (Brantford), Jinkan, Brittons, 
C. A. Kennedy, Barker, McKay, Smith, Beaton, Cunningham, 
Taylor, Stitt, Detton, H. B. Ward (Thorold), E. S. Ball, 
Siren, G. L. Ball, I. Harris, Dawson, G. Holmes, Graham. 

F. Irons, Belden, L. E. Ames, A. A. Stewart, R. W. Arms<trong, 
Frawley, Egan, Uncey, R. E. Fisher, Bass, R. M. Stewart 
(Markham), W. F. Elliott, Roos, Sutton, French, P. J. Watson, 
Duffin, Katz, Callum, W. J. Woods, W. H. Brown, F. H. Irons, 
Roper, V. E. Hart, Plaxton, Farrell, Bainsley, Cooper, J. C. 
Moore (Orillia), Lang, Gilroy, A. N. Hill, Hard, D. F. Price, 
E. A. Hill (Sudbury), Zeig"ler, Aiiderson, Priestman, R. ^1. 
Clarke, R. H. Mills (Thessalon), Grigg, Morgan, M. T. Arm- 
strong (Parry Sound), C. H. R. Clark (Newmarket), Ilarvie, 
Fitzgerald, Abell, Kilmer, Phillips, Crozier, Brett, T. E. Ball, 
Somerville, Norris,* Heath, Linscott, H. H. Armstrong, 
Berry, Permick, W. J. Hill, W. S. Elliott (Copper Cliff), 
Henry, Kinsman, Dalrymple, Shannon, Spratt, Riske, R. C. 
Davis (St. Catharines), G. C. Phillips, Heine, McPhie, 
Loftus, Bard, Bean, W. W. ^lills, W. A. McLean (St. Cath- 
arines), Leatherdale, Wallace, Trewin, R. M. McLean 
(Welland), Vander Vroot, R. W. Hull, Cole, Hardman, 
Douglas, .Robinson, H. T. Willard, F. C. Eraser (Sudbury), 
Godwin, Crawford, J. K. Scott, Richard, R. Atkinson, Gil- 
christ, E. C. Veitch, A. J. Edwards, G. C. McKinley, J. C. 
Wilson, S. M. Edwards, J. L. Grossie, W. B. Ann, H. F. B. 
Black, J. A. Cerswell, G. K. Noble, John IMills, C. R. Watson, 
H. N. Wilkinson, C. W. Ellis, Goodfellow, C. A. Snell, Corann, 
J. S. Somers. 

By Cash.-Vi. E. Willmott, Cecil Trotter, J. Frank Adams, 
J. Bothwell, A. McDonagh, F. J. Conboy, Toronto; C. J. Free- 
man, Beamsville; Pilkey, Waldron, Toronto; S. Foster, Wiar- 
ton, Vernon Fiske, T. Currie, Hertel, Toronto; J. W. Bell, 
FTamilton, R. Carruth, Toronto; R. D. Winn, Sturgeon F\ills; 
R. G. ^[cLaughlin, S. B. Gray, Hugh Cunningham, Rhind, 
A. 1). Mason, [I. K. Richardson, Arthur Ellis, H. B. Walker, 
AValton Ball, Toronto; B. F. Nott, North Bay; G. F. Allison, 
A. C. Burnett, D. Clark, C. S. Clappison, R. H. Cowan, J. E. 
Dores, G. W. Everett, E. :\r. Fulton, W. T. Griffin, F. .1. Fur- 



294 DOMINION DENTAL JOURNAL 

long, J. E. Johnston, A. V. Lester, J. A. Locheed, W. T. Man- 
ning, H. J. McKay, F. P. Moore, W. Morely, H. M. Morrow, 
J. N. Stewart, C. Thompson, H. Thompson, D. J. Weadick, 
F. L. Williamson, R . T. McDonald and Charles M. Ross, 
Hamilton; A. E. Webster, C. E. Brookes, H. W. Anderson, 
A. Rose, W. Seccombe, W. A. Porter and Chas. G. Scott, 
Toronto; Stoddart, Winnipeg; H. E. Eaton, C. F. Knight, 
Geo. W. Grieve, John T. Ross, E. L. Gausby, Chas. V. Snel- 
grove, R. T. Kenney, Lewis F. Riggs, T. N. McGill, S. Kruger, 
W. E. Cummer, A. S. Thomson, Harold Clark and F. Capen, 
Toronto. 

Acknowledgment. 
Dr. Fred J. Conboy, 

1043 Bloor St. W., Toronto, Ont. : 

My Dear Dr. Conlboy,— I beg to acknowledge with thanks 
the cheqne for one thousand three hundred and eighty-three 
dollars and forty-five cents, the sum to be applied for the 
purchase of a McLaughlin Motor Car for the use of the 
A.D.D.S., M.D. No. 2. 

I can assure you this most generous Gontribution from the 
civilian dentists is appreciated to the fullest. 

Thanking you again, and wishing you ever^^ success, I 
remain, Fraternally yours, 

W. G. Thompson, 
Lieut.-Col., Acting Director Dental Services, M.D. No. 2. 



METHOD FOLLOWED BY VICTORIA BOARD 

IN ESTABLISHING SCHOOL 

DENTAL SERVICE 



Formal Report. 
Report of Special Committee on Dental Clinics : 

Your committee appointed to investig^iate the operation of 
dental ch^nics 'in Vancouver and Seattle beg to submit the fol- 
lowing report : 

On the morning of Monday, the 14th inst, we interviewed 
Dr. Pullen, chief school dentist of Vancouver, B. C, at the 
School Board offices, where one of the clinics is held. We dis- 
cussed very fully the operation of their school clinics. They 
have five dentists employed in the forenoons only. We took 
up very fully the merits of the part time system versus full 
time and Dr. Pullen eventually admitted that the chief dentist 
should be on full time in order to secure the best results. 



SELECTIONS. 295 

On Tuesday morning, the 15th inst, we interviewed the 
superintendent of schools of Seattle, Mr. Cooper, and the 
secretary of the board, Mr. Jones, at the board rooms. Un- 
fortunately the clinic was not in operation. But we went fully 
into the matter of dental clinics with the two gentlemen above 
named and with the medical inspector's secretary. They were 
all agreed that very many students would never have been 
able to make the progress they had made in the schools but for 
the free advantages offered by the medical and dental clinics. 
The dental clinic at Seattle is under the supervision of the 
medical department. On Wednesday at 8.30 a.m. we inter- 
viewed Dr. Brown, medical inspector of schools at the Seattle 
School Clinic. He took great pains to give us all available 
information as regards the operation of both the medical 
and the dental clinics. Twenty nurses are now employed in 
the Seattle schools and four additional ones are to be appoint- 
ed at the beg'inning of the new term. Two medical officers and 
two dentists are also employed on full time. 

We discussed with Dr. Brown the merits of the part time 
versus the full time employment of dentists. He was of the 
opinion that the part time system was a failure. They had 
tried it for some time at Seattle up to five years ago, when they 
decided to adopt the whole time system. 

After going carefully into the matter, your committee 
would recommend that a dentist be engaged to give his whole 
time to the proposed dental clinic. It is obvious that there 
should be the closest co-operation between the medical and the 
dental departments of the schools. We would also recommend 
that the secretary be instructed to write to the two dental 
supply houses of Vancouver for prices of equipment, viz., one 
chair, one electric engine, one cuspidor, one bracket, etc. 

We would ask for further time in which to report upon 
a suitable location and other details connected with the open- 
ing of a clinic here. 

On motion of Trustee Deaville the secretary will forward 
a letter of thanks to the Vancouver and Seattle clinics visited, 
expressing appreciation for the courtesies extended in both 
places. The board also passed a resolution of thanks to Dr. 
Lewis Hall for his trouble in connection with the matter, and 
asked him to act for the board in an advisory capacity in con- 
nection w^ith the school clinic. 



296 DOMINION DENTAL JOURNAL 

OFFICERS OF THE SASKATCHEWAN DENTAL 

ASSOCIATION 



At the session of the Saskatche\Yan Dental Association 
held in Saskatoon, the following- officers were elected for the 
coming year: President, Dr. G. E. H. de Witt, Regina; vice- 
president. Dr. A. L. Johnston, Moose Jaw ; secretary-treasur- 
er. Dr. Parker, Regina. Dr. P. W. Winthrope, Saskatoon and 
Dr. F. E. Skinner, Saskatoon, were appointed auditors for 
the current year. A programme committee for the next meet- 
ing was appointed, consisting of Dr. Ross, Regina; Dr. 
Switzer, Saskatoon; Dr. Weicker, Regina; Dr. Graham. 
Estevan, and Dr. * Irwin, Moose Jaw. The comm|ittee on 
education appointed at the meeting consists of Dr. Truman. 
Craik; Dr. Parker, Regina and Dr. Tjane. 



OFFICERS OF THE NEW BRUNSWICK DENTAL 

ASSOCIATION 



The annual meeting of the New Brunswick Dental Society 
was held in Moncton on Thursday, Dr. Snow, of Sackville, in 
the chair. The officers elected for the ensuing year are : 
Dr. Langstroth, St. John, president ; Dr. 0. B. Price, Moncton, 
vice-president ; Dr. F. A. Godsoe, St. John, secretary ; Doctors 
F. A. Taylor and B. F. Reade, Moncton; Dr. Godsoe, St. John 
and Dr. Daly, Sussex, council. The next annual meeting will 
be held in St. John. 



DENTAL OPERATIONS 



Performed hy Officers of the Canadian Army Dental Corps 

in England and F ranee ^ from April 1st to June SOth, 

1919. And also the Grand Total of Work 

Completed Since July loth, 1915. 



Total Operations 
Reported to 


Fill- 
ings. 


Treat- 
ments. 


Den- J: 
tures. 


'l()p^,.\•- 

laxis. 


Extrac- 
tions. 


Devital- 
izing. 


Total 


March 31st. Utl!<. 

April. 1H1!» 

May. I'dJt 

June, 191!» 


. !:t86.151 

10.767 

7,486 

2,853 


381,754 
6.655 
3,752 
1,5 5 it 


170.56:' 

1.236 

1.00«> 

365 


Jii9 '.>Zl 
7,681 
5,660 
1,837 


54(1.633 

2.408 

1,655 

519 


92.344 
888 
568 
248 


2.381.283 

29,635 

20.130 

7,381 


Grand Total.. 


. 1,007,257 


393,720 


173,179 


225, 105 


545,220 


93,948 


2.438,429 



J. ALEX. ARMSTRONG, Col, 

Director of Dental Sen ices, 

0. M. F. of C, 



CORRESPONDENCE. 297 

DENTAL SURVEY OF THE SCHOOL CHILDREN OF 
THE PROVINCE OF ONTARIO 



104:] Bloor Street West, 

Toronto, August 11th, 1919. 
Dear Dr. Webster : 

Will you kindly announce in the Domjniox Dental Journal 
that the dental survey of the school children of the province 
will be started as soon as the schools re-open? The majority 
of the dentists have connnunicated with the department sig- 
nifying" their willin,i»ness to assist. We believe there are 
others who are willing to help but have not as yet written us 
and as the lists must be prepared at once, we are taking the 
liberty of asking the school inspectors to get in touch with 
them. We are very anxious that w^e may not be misunder- 
stood in this matter, we have no desire to attempt to force 
any man to perform a task he feels he cannot conveniently 
arrange to do, but we are extremely anxious to have the heli) 
and co-opei'ation of every dentist in the province, and feel 
that by sending the complete list of dentists in every insjject- 
orate to the school inspector and asking him to get in touch 
with them, no person will be overlooked. 

This department will send the complete list of dentists in 
every inspectorate to the local school inspector, he Avill inter- 
view the dentists either individually or collectively and ar- 
range in regard to. time and manner of inspection, transporta- 
tion and allotment of schools; he will write informing us of 
the number of tongue dejjressors, parents' duplicate notifica- 
tion cards and report blanks that he needs, and these will be 
sent to him. He will have them at the school when the dentist 
comes to do the inspecting. Arrangements are being made, 
to have the statistics published in the local papers, and also 
sent on to the department to be totalled and published. In 
some of the unorganized districts it will be imjjossible to 
have the work completed by this method. We do not expect 
any man to do an unreasonable amount of work and some 
other method must be arranged for some of the outlyinu- dis- 
tricts. 

Yours very truly, 

Fhkd. J. Con ROY. 



WANTED. — Back numbers of The Dominion Dent.u. 
Journal for August, 191(); November, 1917; June and Octo- 
ber, 1918. R. 1). Thornton, 111 (Jrenadier Road, Toronto. 



298 



DOMIXIOX DENTAL JOURNAL 



August 8th, 1919. 
To the Editor Dominion Dental Journal, 
Dear Sir,— 

I note your inquiry in the July number entitled, ''Nausea 
from wearing a denture." 

I have had some experience of this condition and believe 
the nausea is due to irritation to the. soft tissues of the palate, 
by the posterior margin of the plate. This can be remedied 
by taking an impression in modeling compound and following 
the modern method of muscle trimming. In this method the 
impression is taken with the mouth closed under pressure. 

Modeling compound is added to the posterior margin of 
the impression and trimmed by the tissues themselves until 
the impression is an exact reproduction of the soft tissues 
under pressure as in masticating or with the lips and teeth 
closed. 

If the denture be extended well back over the soft tissues 
a better fitting denture will be the result, and the cause of the 
nausea removed. 

In my opinion the shortening of the denture only increases 
the nausea condition. I remain, 

Yours sincerely, 

A. D. Angus. 




THE WEDDING OF CAPT. RISDON WHILE IN ENGLAND, 
i'apt. riisdon is Professor of Anatomy Royal College of Dental Surpreoiis, Toronto. 



EDITOR: 
A. i:. Webster. M.D.. D.D.S., I,.D.S.. I oioiKo. Caiiai!;!. 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross, L..D.S., D.D.S. . Ottawa; Carl E. ' Klotz. L.D.S., St. 

Catharines. 
Quebec. — Eudore Debeau. L.D.S.. D.D.S., 396 St. Denis Street, Montreal: Stanley 

Burns, D.D.S., L.D.S., 750 St. Catherine Street. Montreal; A. W. Thornton. 

D.D.S., L.D.S. , McGill University, Montreal. 
ALBERTA.— H. F. Whitaker, D.D S., L.D.S., Edmonton. 
New Brunswick. — Jas. M. Magee, L.D.S.. D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S.. D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Re&ina. 

Prince Edward Island. — J. S. Bagnall, D.D.S.. L.D.S.. Charlottetown. 
Manitoba. — M. H. Gar\in, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogue. D.D.S.. L.D.S.. Vancouver. 



Vol. XXXI. TORONTO. AUGUST 15, 1919. 



No. 8. 



CAPILLARY AT^TRACTION IN ROOT CANALS 



It is )iot wi'se to depend on capdlary attraction to fill the 
root-caual of a tooth with elilora percha, but such limpid 
fluids as water, blood, serum, Howe's solutions, the essential 
oils will readily pass up the canal if the pulp chamber is 
flooded with the fluid in such a manner as not to confine air 
in the canal. To Hll any small de])ression or cavity with a 
rtuid or semi-solid, the solution or fluid should be placed where 
it is not wanted and pushed to where it is wanted, as in pour- 
ing a model or investing an inlay. So in filling a canal place 
the fluid on the walls of the pulp chamber first, and then allow 
it to flow up the walls of the canal. A whole globule of 
chlora percha dr()})ped into a pulp chamber confines air in 
the canal and re(|nires a good deal of manipulation to release 
it. 

The writer had an experience while giving a clinic which 
demonstrated the influence of capillary attraction. The end 
of an upper central incisor root liad been amputated a day 
or two previously, the rubber (him was in place and the cavity 
over the root end i)acked with gauze to prevent fluid from 
coming down the canal. On re liad been taken not to allow 



300 DOMIXIOX DENTAL JOURNAL 

any moisture to get into the canal after the silver anmionia 
solution had been applied to the walls. Suddenly the canal 
filled with blood, this was carefully wipped away from the 
pulp chamber and paper points up the canal assured the 
operator that the blood came from the a|)ex. The X3acking 
over the apex was removed being stained with blood, and a 
new packing made and the canal re-prepared. Ag*ain at the 
moment of filling the canal blood appeared and was again 
removed in the same manner as before. After this had 
occurred the third time the operator satisfied himself that the 
blood did not come from the apex, but from a puncture into 
the canal, just at the gingival line. The deceiving point was 
that the apex was filled with blood and even stained the cotton 
covering the apex. Such an illustraiion must satisfy anyone 
who had seen it of the efficiency of capillary attraction to 
carry a fluid up a root-canal, when it is so applied to take 
advantage of this force. 



DENTISTRY INVESTIGATED 



Since the war began and especially since its close, many 
business and callings which directly atfect the public, have 
been investigated and reported upon. In Ontario the work- 
ings of the Acts atfecting public health were exhaustively 
investigated with some mild action following. At the present 
time more attention is being given to the cost of living than to 
the direct cause of disease and suffering. 

In July, 1917, a committee of the House of Commons, Great 
Britain, was appointed to investigate the dental profession. 
The report of the committee which was made up of laymen, 
contains more information on dentistry than can be found 
in any other volume in existence. AVe intend to publish 
it in full as space will permit, so that every dentist who is a 
reader of the Journal will have an ojjportunity to inform 
himself on whatever aspect of dentistry he may be interested 
in from time to time or upon the whole subject. Dental 
Legislation and the working out of Dental Acts are clearly 
set forth as well as the effects. on public health. 

In CVmada where so mueli has been done in public dental 
service, the profession will be intensely interested in follow- 
ing that part of the report, which deals with the beginnings 
and the methods of school dentistry as carried out in England. 
Just now the dentists of Ontario are being ai)pealed to, to make 



EDITORIAL 301 

a survey of the mouths of the children of the public schools. 
To those who undertake such work this report will be helpful. 
How vital dentistry must have been considered by the 
British Parliament, when it appointed a connnittee to report 
on its workings during the war! Dentists themselves often 
forget how vital their services are to their patients, it often 
takes the outsider to awaken those within. This report will 
bring them to a realization of the value of their services to 
the nation. It would appear from the report that dental 
services will be assured all classes in England. 

Following the report of the conmiittee of the House of 
Commons on Dentistry, the British Dental Association held 
a general meeting in LondDn, May 17th, 1919. At this meet- 
ing a referendum was called for on a resolution which was 
passed with a small majority. Along with the resolution the 
pros, and cons, are presented. The resolution supported the 
following suggestions to impro\'o conditions of dentistry in 
Great Britain." 

III. — The Resolution advocates: — 

(1). The total prohibition of all forms of dental practice, 
mechanical as well as surgical, by any unregistered person. 
(2). The suppression of Company practice. 
(3). The complete control (including advertising) of all 
practitioners by a Statutory Board, on which qualified men 
Avould have a majority representation. 

(4). Admission to the Register, by an ad hoc Committee, 
of those at present unregistered, and in practice for over five 
years, on proof of fitness and good conduct; and the others 
by examination; names to be placed in a separate list at the 
end of the Register; those admitted becoming technically 
eligible for public appointments, but de facto holding an in- 
ferior position to the L.D.S. A separate register would 
endanger full control, and would lead to differentiation of 
treatment, and to a double standard of ethical behaviour. 
This must be avoided at all costs. 

(5). The recommendations embodied in the Resolution 
provide further for immediate cessation of infamous forms of 
advertising and the consequent disappearance of those 
dependent on disgraceful methods; and for the strict limita- 
tion of those hitherto unregistered to the use of the title 
•' dentist '^ alone— a title always applied to them by the pub- 
lic, and carrying to the public mind no indication whatever of 
academic or special qualification. 



302 DOMINION DENTAL JOURNAL 

(6). It is to perpetrate a grosser fraud upon the public to 
continue to permit men to style their premises '^dental 
surg'eries,'^ and to assume titles like ^'dental specialist" (and 
probably even ''dental surgeon"), as is now the case, than 
to allow them to employ the title of ''dentist," provided that 
they might use no othei*, and were debarred from displaying 
any dental description of premises. 



Editorial Notes 



A dentist is now located in Mimico, Ontario. 

Col. Corrigan, Toronto, has returned from overseas. 

A full time dental appointment will shortly be made to 
the staff of the schools of Victoria, B.C. 

The degree of D.Sc. has been conferred on Dr. Hopewell- 
Smith, by the University of Pennsylvania. 

The dentists of Edmonton entertained Dr. C. N. Johnsou 
to a banquet during his visit to Western Canada. 

Dr. C. A. Kennedy, of the staff of the Koyal College of 
Dental Surgeons, Toronto, was married August 12tli, 1919. 

Lt.-Col. Guy G. Hume, Professor of Orthodontia, Royal 
College of Dental Surgeons, Toronto, was married June, 1919. 

The annual meeting of the New Brunswick Dental Society 
was held in Moncton. The next meeting will be held in St. 
John. 

Drs. M. L. Rhein and Geo. Wilson were guests, and the 
chief speakers, at the monthly Rotary Club meeting in Hali- 
fax, August 4th, 1919. 

The dental profession of Saskatchewan held its first real 
convention in Saskatoon, August 4th. Dr. C. N. Johnson was 
the chief attraction. 

During the mid-summer holidays the School dentists of 
Toronto look after the teeth of the children in the children's 
homes and public institutions. 



EDITORIAL NOTES 303 

Vanderbilt University which had announced its discon- 
tinuance for lack of funds, has now announced its continu- 
ance. They have raised the wind. 

Dr. Geo. H. Wilson and Dr. M. L. Khein conducted a post- 
graduate course for four days in the Dental Department of 
Dalhousie University, July T4tli, 1919. 

Dr. I^ougheed, of Saskatoon, who died from a fracture of 
the spine sustained while in swimming in the baths in the 
Saskatchewan River, was a former resident of Toronto, and 
buried there. 

The annual meeting of the National Association of Dental 
Faculties will be held in Parlor E, Alezzanine Floor, The 
(jrunewald iJotel, New Orleans. The meeting will be called 
on Saturday, October 18th, at 9 a.m., and will last thi'ough 
^Fonday. 

('apt. J. N. Dunning, of the Canadian Army Dental Corps, 
who was sent by the Government to the Windsor district to 
look after the dental hygiene of returned men there, has treat- 
ed 250 men since his ai'rival. As now outlined his plans call 
for him to remain for a year, devoting the major part of his 
time to a dental clinic in the Armories, where an operatino: 
room has been fitted out with modern (Mjuipment. 

s^ 

In Great Britain various transfer agents suggest in the 
sale of a practice that one year's income should be a fair price. 
Such a price in Canada would generally be altogether too 
high. People on this continent consult the dentist by name 
and reputation, not because he occupies a certain house or 
location. A mercantile business has inoic good will to 
transfer than a j)rofessional yjractice. 

A new dental clinic in connection with Military llead- 
tjuarters, opened recently at 149 College street, Toronto. 
This clinic is being established for the benefit of out-of-town 
patients who re])ort for dental treatment. An X-ray room 
with mechanical laboratory is the equipment in the new clinic; 
and the staff of twelve officers and twenty dental mechanics is 
under Capt. R. R. Walker. While this clinic is primarily for 
out-of-town patients, it will be able to handle any Toronto 
nien who are unable to be treated by the other clinics in 
Toronto. 



304 DOMINION DENTAL JOURNAL 

The ''plateless" form of cleft-palate obturator constructed 
by Dr. C. S. Case, embodies in its conception ideas of such 
admirable simplicity, lightness and efficiency in action, that 
it would seem as if the other or usual kinds of obturators 
should in every possible case be rejected as of relatively in- 
ferior service to the patient. When properly planned and 
adjusted, obturators attached to plates are good and service- 
able, but are seldom so perfect that one could not wish for 
further improvement. According to Dr. Case, this further 
improvement is effected simply by discarding the plate or 
other supporting device, and allowing the obturator to be 
supported solely by the living tissues which surround the 
cleft. A freely-suspended obturator of this sort should offer 
every chance of success in the restoration of speech. The 
favouring features are, in the words of Dr. Case: ''its ex- 
tremely light weight and its free mobility and quick response 
to the slightest movement of the muscles ; and when surround- 
ed within their grasp in its act of completely closing the pass- 
age to the nose, it takes the same favourable position in re- 
lation to the vibrating voice, as the normal velum palate 
whose function and activities it seems to closely imitate." 

In the shaping of such an appliance particular attention 
must be given to the designing principles upon which its 
retention depends, and in this matter the printed description 
and illustrations of the appliance are probably in some points 
lacking in clearness. For example, the obturator must be 
prevented from slipping backward and resting permanently 
against the posterior wall of the pharynx and thereby blocking 
the nasal air-way and inhibiting the production of the three 
nasal consonant sounds. The important detail in Dr. Case^s 
''hard velum obturator" which provides against this back- 
ward slipping would appear to be the posterior face of the 
T-shaped step or lateral extension in front and on the oral 
aspect of the appliance. If the tissues can be induced to 
snuggle against the shoulder thus formed on the oral side 
of the obturator, the latter will be restrained from slipping 
backward. 

DENTAL PEACTICE FOR SALE -Up to date two chair 
equipment in one of the best towns in Northern Ontario, 
population six thousand. Excellent surrounding district. 
Monthly receipts, average between eight and nine hundred 
cash. Sell at invoice cost of equipment. For full particu- 
lars apply C. ASH & CO., LTD., 11-13 Grenville St., 
Toronto. 



Dominion 

Dental Journal 



Vol. XXXT. TORONTO, SEPTEMBER 15, 1919. No. 9. 



Original Communications 



DENTAL SEPSIS AS A PREDISPOSING CAUSE 

OF CANCER 



III a paper read before the International Dentral Congress, 
1914, Dr. Steadman says that cancer rarely occurs in any part 
of the body without a more or less long standing chronic in- 
tlainmation preceding it, and that chronic septic condition of 
the mouth is by far the commonest predisposing cause of 
cancer. In support of this claim the author presents the vital 
statistics of Great Britain and Wales, in which of 114,130 
deaths from cancer, 85 per cent, occured in the alimentary 
tract, which is often in a state of chronic inflammation from 
constant infection from the mouth. 

It is generally agreed that cancer is caused from some mild 
form of irritation extending over a long term. The causes of 
i^uch irritation are : 

(1) Mechanical, chiefly friction. 

(2) Gross chemical irritants. 

(3) Radio active bodies. 

(4) Chemical irritants produced by bacteria on certain 

glands in the body. 

It has not yet been proven that friction or radio active 
rays will pioduce cancer without the ijresence of bacteria. 
Bacterial infection is the commonest know^n cause of cancer. 
The widest spread forms of bacterial infection known to the 
ciuthor is oral sepsis and is the most prevalent antecedent cause 
of cancer both direct or indirect. The actual presence of bac- 
teria in the cancerous part is not essential but from some re- 
mote part may bring about the malignant growth. The author 
presents many cases from practice to support his views, and 
states the following conclusions: 1. Apart from the sexual 
organs over 86 per cent, of cases of cancer occui* in the all- 



306 DOMINION DENTAL JOURNAL 

mentary tract. 2. That long standing;- chronic inflammation 
in the sexual organs and in other parts of the body is known 
to predispose to the develo])ment of cancer. 3. That the great 
majority of persons suffering from cancer of the alimentary 
canal have advanced pyhorrea alveolaris wliich has been pres- 
ent for many years. 4. That the advanced peridontal disease 
is not nearly so common in persons not suffering from cancer. 
5. That it is a well know fact that the constant swallowing u» 
pus can and does cause chronic gastricity. 6. That the ma- 
jority of persons suffering from cancer of the stomach have 
had chronic gastritis for many years prior to the development 
of the malignant disease. 



DENTISTRY IN GREAT BRITAIN AS FOUND BY 

A COMMITTEE OF THE HOUSE 

OF COMMONS 



(Continued from Augrust Issue.) 

We review the main evidence received before stating our 
conclusions. 

33. The General Medical Council in their reply laid stress 
on the following points in connection with dental practice 
by unregistered persons : 

(1) The great and very rapidly increasing number of un- 
registered practitioners. 

(2) The evils of company dental practice of the one man 
type in w^hich the remaining signatories to the mem- 
orandum of association are persons of straw. The 
effect of this is to annul the personal responsibility of 
the prime mover and to put him to a large extent out 
of reach of the law. 

(3) Canvassing. 

(4) Extensive advertising, often of an untruthful charact- 
er, whicli is greatly resorted to. 

(5) Administration of amvsthetics by persons devoid of 
all medical knowledge and training, without the observ- 
ance of those precautions upon which safety is known 
to depend. 

The Council by reason of the judicial nature of its functions 
was not in a j position to furnish details of individual cases 
except when on the investigation of a complaint against a 
registered practitioner facts were elicited owing to the reg- 
istered practitioner being ^^ mixed up with an unqualified and 



SELECTIONS. 307 

unregistered person.^' The Council furnished us with the 
details of one such case which came before them in this con- 
nection. 

34. The British Dental Association submitted to the Com- 
mittee a confidential memorandum setting out very fully the 
different considerations bearing upon the extent and gravity 
of the evils connected with unregistered dental practice. 
After reviewing the legal position the following opinion is 
expressed: 

**It follows, therefore, that the most widespread and mis- 
leading advertisement of claims to special skill and capacity 
in dentistry do not render the person employing them liable 
to penalties, provided that he does not claim 'special qualifi- 
cation' by naming a particular degree, diploma or so forth." 

The Association submitted a list of successful prosecu- 
tions against the use of titles implying ^^ special qualification." 
Among such titles are the following : 

Dentist; Dentist and L.D.S.; D.D.S. , U.S.A.; Dental 
Practitioner; Dental Surgeons, Outred L.D.S. 

35. In contradistinction to the above mentioned titles, the 
use of which by unregistered practitioners can be prevented, 
the Association gave us a list of descriptions and titles which 
are used with impunity by unregistered practitioners or dental 
companies. The list was as follows : 

** Dental Specialist." ''Dental Specialist of 
"Dental Consultant." Anglo-American 

' ' Dental Expert. ' ' Reputation. ' ' 

"C.D.S. (Chemists' Den- "Exponent of Modern 

tal Society)." Dentistry." 

' ' D.E., D.A. " " One of the Greatest 
' ' S.M.D. ' ' Experts in Crown, Bridge 

"Specialist in Operative and Bar Work." 

and Prosthetic Den- ' ' Finished Expert. ' ' 

tistry. " " Dental Operator. ' ' 

" Odontologist. " "Dental Pioneer." 

"D.S. Specialist." "Expert Adapter of 
' ' Teeth Specialist. ' ' Teeth. ' ' 

"M.O.F.O." "Expert in "Dental Surgery." 

Modern Dentistry." "Dental Institute." 

"Experts in the Science of "American Dentistry." 

Teeth Treatment. " "English and American 
' ' Experts in Dental Dentistry. ' ' 

Surgery." "Surgical Dentistry." 
' ' Modern Dentistrv. ' ' 



308 DOMINION DENTAL JOURNAL 

In view of what is peimissible and what is not, in the 
matter of title, the Association state it is "impracticable for 
the general public to know whether they are to be treated by 
properly qualified persons or not." The number of unreg- 
istered practitioners is stated considerably to exceed the num- 
ber of registered practitioners, and the classes more par- 
ticularly affected by unregistered practice to be the poor, and 
those of limited means among the wage and salary earning 
classes. These specially need and should obtain protection. 

36. The Association supplied lists not pretending to be 
exhaustive as follows : 

1. Cases (publicly reported) of claims for damages for 

injuries, unskilled treatment, &c., by unqualified men, 

2. Cases (publicly reported) of deaths occurring after ad- 

ministration of cocaine or of anaesthetics containing 
cocaine by unqualified men. 

3. Cases (publicly reported) of deaths following oper- 

ations by unqualified men, other than cases in which 
cocaine was used. 
Cases (not publicly reported) of complaints of injuries and 
useless dentures and of claims for damages settled by 
payments by unregistered men. 

5. List of some dental companies registered (undei* the 

Companies Act) in recent years. 

6. (a) Canvassers' cases (publicly reported). 
(b) Advertisements for canvassers. 

7. Previous occupations of some unregistered men now 

practising dentistry. 

37. The following are six cases selected from the first 
list. 

1. Boyle Quarter Sessions.— Judgment against London 

and American Dental Co. for return of £8, money paid 
for set of teeth. Evidence of a former employee that 
there were two offices, one under the above name, the 
other under another name. He worked in both. The 
Judge informed the plaintiff that ''he had fallen 
among theives.'' — Irish Independent, Oct. 21, 1908. 

2. Maidstone County Court.— £14 10s. damages against 

Gr. C. Smith for negligence. Inflammation of the mouth 
—tooth broken off. Statement that Smith had been 
twice fined for calling himself a dentist, had then 
turned himself into a ''Limited Company,'' and then, 
when an injunction against the Company had been 
obtained by the British Dental Association, had start- 



SELECTIONS. 309 

ed calling himself a dentist again. 1'lie Judge de- 
sired to draw attention to the disgraceful state of 
affairs disclosed by the evidence.— ATew^ County Stan- 
dard, Sept. 25, 1909; and for Chancery Proceedings 
see. report in L.R. 1909, 2 Ch. 524. 

3. Cardiff County Court.— £11 damages and costs against 

Templar Malins for negligence, excessive bleeding. 
Defendant stated he extracted 500 teeth a week.— 
South Wales Echo, Jan. 6, 1910. 

4. Clerkenwell County Court.— 1*20 damages and costs 

against AVilliams' Dental Institute, King^s Cross. 
Tooth broken, socket of gum crushed. Gum and roof 
of mouth had wounds.— /.v//i/r//r>y? Daily Gazette, Dec. 
2, 1910. 

5. Hull County Court.— £15 damages against T. H. Jubb 

for unskilled treatment. Fourteen teeth were broken 
by operator leaving nerves exposed. The operator 
was 21 years of age, had never attended an}^ hospitals 
or lectures on dentistry. He had often extracted 
fourteen teeth at a time. The Judge stated there was 
serious negligence. — /^^/V/^/i Dental Journal, 1912, pp. 
185 et seq. 

6. Glasgow Sheriff's Court.— A. Murray recovered £50 

damages and expenses against E. B. Mackie. Jaw 
bone broken, septic poisoning and haemorrhage. De- 
fendant had the words ^'Dental Surgeon'' on stair 
outside his rooms and ''Dental Rooms" on his door. 
Pursuer did not know defender was un<]ualified. 
Defemder appealed and his appeal fa;iled.— /yr/7/.9/i 
DentalJournal, 1915. 

38. The inferences diawn ])y the British Dental Associa- 
tion from the list of injuries, c^c.,. submitted to the Committee 
are as follows : 

ia) Injuries to mouth an<l jaws owing to unskillful 
operations are frequent. 

(h) Teeth are frequently broken, cut or snapped off', owing 
to lack of necessary surgical knowledge and skill. 

{c) Septic poisoning is frequently caused by unskilful 
work and neglect or ignorance of antisejvtic methods. 

(d) There is evidence of considei'able injury to the teeth 
and health of patients; unnecessary \iolence is often 
employed. 

{e) Great discomfort is caused by ill -fitting dentures, and 
the conse(juent im])os'sibility of adecpiate mastication 



310 DOMINION DENTAL JOURNAL 

of food exercises a prejudicial effect on the health. 

(/) Deaths from the unskillful administration of anaes- 
thetics are not uncommon. 

(g) Cocaine poisoning is frequent. 

(h) The practice of injecting local anaesthetics, such as 
cocaine and other dangerous drugs, into the gums 
gives rise to cases of poisoning owing to instruments 
not being properly sterilized; such practice is cal- 
culated to lead to the trasmission of disease from one 
patient to another. 

(i) The ignorance of the operators is fully brought out; 
'ihi'stances are given in which colliers, clerks, fire- 
beaters and others have taken up the practice of den- 
tal operations with no previous training. 

{j) The use of bad materials for dentures is frequently 
complained of, especially in cases brought against 
dental companies. 

{k) Sound teeth are frequently needlessly extracted to be 
replaced by false. 

(I) The employment of canvassers undoubtedly leads to 
(1) misrepresentation of the qualification of the em- 
ployers of the canvassers and misrepresentation of the 
qualifications of the canvassers themselves (who are 
sometimes operators), (2) patients being induced to 
have sound teeth needlessly extracted (the canvasser 
being paid commission on the amount of orders they 
secure). 

(m) In the case of dental companies registered under the 
Companies Acts, great difficulties are often put in the 
way of a patient seeking to enforce any remedy for 
injuries suffered or money paid for useless dentures. 

(n) Large profits are made by unqualified practice, thus 
inducing a constant flow of recruits to its ranks. 
The association considers that these cases afford evi- 
dence and are symptomatic of a very large amount of 

bodily injury, suffering, and pecuniary loss inflicted upon 

the public by unregistered persons practising dentistry. 

39. The Association also specially referred to the evi!«= of 
the canvassing system of dental companies, and of the hind- 
rance to the recruiting of the dental profession which uii- 
qualified practice sets up. 

We heard in evidence : 

Mr. T. A. Coysh, L.D.S. (Eng.), 
Mr. E. Y. Richardson, L.D.S. (Edin.), 
Mr. B. J. Wood, L.D.S. (Eng.), 



' SELECTIONS. 311 

as representing the Association on this part of the Associa- 
tion's statement. In their evidence the witnesses amplified 
the written statements which had been placed before us and 
illustrated from their own experience the evils associated with 
unregistered practice. Mr. Coysh represented to us that the 
Dentists Act was a failure in that it was now practically im- 
possible for the uninstructed public to distinguish between 
the titles reserved to the registered dentist and the many mis- 
leading titles adopted by the unregistered practitioner. He 
expressed the opinion that it was even doubtful if the use 
of the title ''Dental Surgeon'' could be confined to the regist- 
ered practitioner. As Chairman of the Penal Cases Com- 
mittee of the British Dental Association he was able to bring 
before us very clearly the legal position of registered and 
unregistered practitioners as it exists at the present time. He 
claimed that the Act was a complete failure so far as pro- 
tecting the public against the evils resulting from unqualified 
practice. 

40. Mr. Richardson, the Secretary of the Northern Branch 
of the British Dental Association and on the staff of the New- 
castle-on-Tyne Dental Hospital, gave us many instances of 
gross personal injuries resulting from dental practice by un- 
registered practitioners. He explained the methods adopted 
for obtaining high fees by some unregistered practitioners, 
and gave instances of bad work in denture construction. The 
following extracts from Mr. Richardson's evidence illustrate 
the nature of some of the unqualified practice that prevails 
in the north of England: 

"T have cases I can cite the names and addresses of, of 
men who were drillers and turners and butchers at the out- 
break of the war, who to-day are doing what are tantamount 
to major dental operations upon the public." 
******* 

*'The man I am specially citing employed within two 
months 20 canvassers. They were drawn from the very low- 
est types of workmen, such as casual labourers and so on. 
Six of those canvassers in my own area, within two months, 
were going about with a bag full of instruments and were 
operating on people in their homes." 

******* 

''The practice in vogue in the north is for a canvasser to 
go round with a canvasser operator, a man who has been a 
canvasser previously. They usually go round together, and 



312 DOMINION DENTAL JOURNAL 

the man who is a canvasser calls at the house to ask the 
tenants whether they wish for teeth to be extracted or 
supplied. In the meantime the operator is probably oper- 
ating at another house. The canvasser watches the operator 
here and there, and in the course of two or three weeks he 
himself becomes an operator canvasser. Usually they hunt in 
couples in the first three months. That is the class of practice 
we have chiefly in the north. ' ' 

41. In contrast with the unregistered practitioner of the 
type mentioned Mr. Richardson referred to the ethical un- 
registered practitioner in the following terms: 

^'With rare exceptions, an ethical unregistered practition- 
er is a man who has served a proper apprenticeship to a 
qualified dental surgeon, and he has naturally imbibed some of 
the professional etiquette of the qualified man with whom he 
has served. He is able to construct proper and skilful den- 
tures and, naturally, having been gifted to use his hands from 
comparatively early years, he speedily acquires a certain 
amount of dexterity in simple operative procedures.'' 

Mr. Richardson made it quite clear that the grossest evdls 
resulting from unregistered practice are mainly associated 
wiith the canvassing, advetrtising class of unregistered 
practitioner. 

42. Mr. B. J. AVood, lately the Hon. Secretary 
of the Eastern Counties Branch of the British Den- 
tal Association, and School Dental Officer of the 
Kettering Urban Education Authority gave evidence 
Avhich ooiifirmed that given by Mr. Coysh and Mr. 
Richardson as to the increase in ])ractice by unregistered 
persons. He was of opinion that the increase during recent 
years has been out of proportion either to the increase in 
registered practice, or to the growth of the population, the 
increase in practice by unregistered persons "being mainly 
by the addition of the most undesirable sort of unqualified 
men.'' He regarded j^i'^ctitioners who had been dentists' 
mechanics as constituting the greater part of the better grade 
of unregistered practitioners. 

He strongly emphasized the point that practice by unreg- 
istered persons was mainly confined to extractions and the 
provision of dentures, and that very little true conservative 
dentistry was performed, and that the existence of a body of 
practitioners mainly interested in extractions and dentures 
was H ver.v real danuor to conservative dentistrv. He in- 



SELKCTIONS. 313 

formed us that '*lie had never seen a case of fillings done by 
an unregistered jjerson for school children. ' ' 

43. Mr. J. Toivart and Mr. G. H. Watson, representing the 
Medical and Dental Defence Union of Scotland, gave very 
similar evidence as to the growth of practice by unregistered 
persons which was inliibiting the normal growth of the dental 
profession. They pointed out the evil, etfects of wholesale 
extractions by unregistered i)ractLtioners. In this connection 
Mr. Towart informed us that the Union was constantly asked 
the question whether the}^ could not "liel]) medical men in 
some way to protect their patients from this wholesale extrac- 
tion of good teeth . . . for the purpose obviously of putting 
in others." 

44. TJie British Medical Association has furnished ns 
with a valuable memorandum. The Association sent out to 
their various divisions and branches a circular letter of en- 
quiry requesting the infoi*mation which the Council of the 
Association thought wonld be most helpfnl to the Dentists 
Act Committee. Eeplies were received fi"oni 68 areas in 
England, Wales and Scotland representing areas varying in 
size from a county borough to a combination of two counties. 
The replies have been carefully sunmiarised for our use by 
Dr. Alfred Cox, O.B.E., the Medical Secretary of the Associa- 
tion. The information in the summary is so complete we 
have not considered it is necessary to ask the Association to 
give oral evidence. 

In submitting the memorandum to the Committee the 
following opinions are expressed : 

'*The replies are not so numerous or so representative of 
large bodies of medical opinion as they would have been in 
normal times, but they are numerous and authoritative enough 
to justif}^ the Association in placing them with confidence be- 
fore your Committee as generally representing the opinion of 
the medical profession." 

'^In the opinion of the .Association the result of the en- 
(juiry shows that the present state of the dental services is 
most unsatisfactory and inadequate." 

45. The following extracts from the memorandum indicate 
generally the nature and extent of the evils of unqualified 
dental practice as elicited by the replies leceived to specific 
qnesticnis asked by the Association: 



314 DOMINION DENTAL JOURNAL 

Question 1.— **Is it your opinion that it is the usual prac- 
tice of unqualified dentists to extract teeth and provide arti- 
ficial dentures instead of undertaking conservative dent- 
istry?'' 

73 replies were returned. 

67 of these stated that **such was in their opinion the 
usual practice of unqualified dentists.'' 

Question 2. — '^Do you know of any unqualified dentists 
who recommend or carry out systematically conservative 
dentistry?" 

65 replies were returned: 

39 stated that they knew of none ; 
17 replied **few," *Very few," or ^^very rare in- 
deed"; 
9 replied that they knew of instances in which un- 
qualified persons carried out or attempted to carry 
out conservative dentistry. 
Question 3.—** State evils known by you to arise out of 
the effects of inferior dentistry and the loss of natural den- 
tition : 

(a) In the production of chronic gastritis and indiges- 
tion, with consequent defective nutrition; 
(h) In the loiss in economic value of such persons by rea- 
son of this defective health and especially women en- 
gaged in work either domestic or industrial, and 
nursing mothers." 
(a) 43 replies were returned: 

37 laid particular stress on this evil; 
(h) 47 replies: 

40 express the opinion that such economic loss 
is *Wery great" or '^ great" or ^^ serious." 

*^The following examples of the immediate 
cause of this loss are given:— Severe sepsis, 
haemorrhage, necrosis, fracture, dislocation, 
non-diagnosis of empyema of antrum, good 
upper teeth cleared and lower bad teeth 
left because former were easily extracted. 
Guildford expressed the opinion that the 
greatest evil is the inability of unqualified 
practitioners to educate their patients in the 
care of their teeth and their ignorance of the 
serious evils that follow toxic infections from 



SELECTIONS. 315 

teeth and gums. Several areas express opin- 
ion that servant girls are chief sufferers." 

"Jr TT ^ 'Jr tF * It 

Question 7. — ^^ State any other facts or opinions which 
occur to you as likely to assist the Association in furnishing 
the Department Committee with evidence on the two heads 
mentioned in paragraph 1 of the letter: 

(1) The extent and gravity of the evils connected with 
the practice of dentistry and dental surgery by per- 
sons not qualified under the Dentists Act." 
23 express general opinion that the effects of un- 
qualified dental practice on public welfare are 
''definite" or "great" or ''scandalous"; 
2 consider evils may easily be exaggerated. 
46. The following remarks from other areas may be quoted: 
Northants.— "Even when they attempt conservative 
treatment, unqualified men as a class have no knowledge of 
the methods of treating the pulp and frequently the result 
is alveolar abscess or septic infection. A case of rheumatoid 
arthritis was quoted where several teeth had been filled by 
an unqualified man; pulp had necrosed and constituted a 
septic focus which almost certainly was the determining 
factor in production of the arthritis. An ophthalmic sur- 
geon quoted cases of eye affection similarly due to septic 
infection. ' ' 

Glasgow South.— "Disease of lips, gums, jaws, antral 
disease, cancer, syphilis, etc., not recognized by unqualified 
men, with disastrous results." 

Nuneaton. — "Unqualified may be divided into 2 classes: 

(a) Who have had some dental training as mechanics 
to qualified dentists; 

(b) Who have had no previous training." 

Many of former do good work, especially in making and 
fitting artificial dentures; generally work on their own 
account and arc not employed by a company. 

Of the second class it would be hard to speak too severely. 
They are employed by dental companies whose trade-names 
are constantly changing and whose one object is to make 
money. The work of these men is uniformly bad. Pro- 
cedure usually followed:— Flamboyant advertisements are 
distributed broadcast, the so-called "operators" of the com- 
pany canvass the villages from door to door. Young women 
with indifferent front teeth are their chief victims. They 



316 DOMINION DENTAL JOURNAL 

extract teeth in order to sell artificial dentures and in some 
cases even cut off teeth which are difficult to extract level 
with gums so as to fit the new dentures. Nothing but harm 
can come of the work of these men who do not in any way 
study the welfare of their victims. If the ^'company" gets 
into trouble through the bad work its name is changed or 
it moves to another district/' 

Morpeth. — ''Almost all local dental work done by un- 
qualified men and women with practically no training or 
anatomic knowledge. Their motto is 'Non arte sed vi.' 
Mouths are cleared indiscriminately, and rubbishy dentures 
supplied at fancy prices (generally paid in weekly instal- 
ments). Septic jaws frequent.'' 

Exeter.— ''As training of unqualified men must be in 
mechanical dentistry only, unqualified practice almost 
necessarily involves extraction of teeth more or less bad to 
make room for artificial dentures." 

Gateshead.— "Lucrative nature of trade attracts all 
sorts of unscrupulous persons at terrible cost to the com- 
munity. ' ' 
47. The London and Counties Medical Protection Society, 
Limited y in a memorandum submitted to the Committee drew 
attention to the objectionable advertising resorted to by many 
unregistered dentists of which "a very large proportion con- 
tain lying statements that deceive the public. ' ' The effect on 
the registered dental profession was to lower that profession 
in public estimation. The Society expressed the view that 
"Good social status does more than anything else to attract 
good men into a profession, and the status of a profession 
which, as far as the public are concerned, is regarded as in- 
cluding vulgar im])ostors who take upon themselves to practice 
dentistry without training or qualification, can never be what 
is due to men who have become properly qualified as dental 
surgeons." 

The Society brought to our notice s))ecific instances oi' in- 
jury resulting from unregistered dental practice and instances 
of blatant advertisement tending to deceive the uninstructed 
public. Mr. P. Sidney Spokes, M.R.C.S., L.D.S., J.P., who 
gave evidence before us on behalf of the Society, confirmed 
the opinion that had been expressed by other ^\'itnesses, that 
the increase of unregistered dental practice in recent years 
had been mainly "on the side of the absolutely unscrupu- 
lous" people who have seen an opportunity of coming in and 
exploiting the y)0()rer people throughout the country. Mr. 



SELECTIONS. 317 

Spokes agreed that probably the position of the better class 
of unregistered practitioner had been prejudiced by this type 
of competitor. 

48. The Incorporated Dental Society, Limited, submitted 
to us in a memorandum some valuable evidence from the point 
of view of the better clas-s of unregistered practitioner. The 
Society represented that the evils resulting from unregistered 
practice had been grossly exaggerated and that "the incidents 
of malpractice, negligence, and unskilful treatment must be 
considered as exceedingly rare in comparison with the large 
number of persons receiving dental treatment. ' ' It was repre- 
sented that an unregistered practitioner was at a great dis- 
advantage in defending an action in comparison with a regis- 
tere<l dentist and instances w^ere quoted in suj)port of this 
view. Our attention was also directed to the fact that ^^a sub- 
stantial number of claims are annually made against regis- 
tered dentists." The Society, however, did not deny that un- 
controlled unregistered practice of an inferior type had pro- 
duced certain evils. The Society described the employment 
of canvassers as a ''pernicious practice," the methods adopt- 
ed being regarded as "unscupulous and often dishonest." 
The canvassing system, moreover, was regarded as facilitat- 
ing the increase in this undesirable kind of dental practice. 

The Society mentioned other ''evils" associated with some 
varieties of dental practice, viz. :— traveling assistants and 
itinerant vendors. Reference is also made to the ''Exploita- 
tion of dentistry by a few unscrupulous persons purely as 
financiers" and to the "lack of proper supervision and con- 
trol." The Society has framed by-laws for its members pro- 
hibiting canvassing and payment of secret commissions and 
regulating advertisements, etc. Mr. Butterfield in his evi- 
dence regarded the "evils" associated with unregistered 
dental practice as "due to the lack of control or the jjower of 
control" and agreed that evils are very likely to result from 
the practice of dentistry by the totally unciualified and totally 
uneducated. 

49. Before stating the conclusions we have reached there is 
one particular "evil" we would wish to emphasize. It has 
been represented to us by practically all witnesses that the 
main business of most uni'egistered practitioners is extracting 
teeth and substituting dentures, whereas the main business of 
the registered dentist is teeth preservation. The unregistered 
practitioner explains this by stating that the working classes, 
who are his main clients, do not value conservative dentistry, 



318 DOMINION DENTAL JOURNAL 

and will spare neither the time nor money for teeth preserva- 
tion. The registered dentist on the other hand states that the 
situation arises from the fact that the majority of unregis- 
ered practitioners are untrained and unskilled in conservative 
dentistry, which requires surgical knowledge, only to be ac- 
quired by an adequate course of training. Conservative dent- 
istry, moreover, besides being less remunerative, requires the 
expenditure of considerably more time on the dentist's part 
than extracting teeth and providing dentures. 

50. Witnesses representing both the registered and un- 
registered agreed that in the public interest the preservation 
of the natural teeth should be the first aim of the dental pro- 
fession. Unfortunately the law as it at present stands affords 
a strong incentive to the unregistered practitioner to throw 
all his energies into providing artificial teeth. It is only for 
such work he is able to recover payment, as under Section 5 of 
the Dentists Act, 1878, an unregistered practitioner cannot re- 
cover in any Court a fee for the performance of any dental 
operation or for any dental attendance or advice. The gen- 
eral effect of this clause has been against the public interest 
and has tended to separate the registered and unregistered 
practitioners into two hostile camps, the one striving to main- 
tain the true aim of dentistry, viz. : the preservation of the 
natural teeth, and the other to laud the advantages of artificial 
teeth. Hence the show cases of artificial teeth of all kinds and 
the *'free advice '^ notices to be found outside the premises of 
certain unregistered practitioners. 

51. We have very carefully weighed the evidence both 
written and oral which has been submitted to us and the con- 
clusions we have arrived at are the following : 

The practice of dentistry and dental surgery by persons 
not qualified under the Dentists Act is mainly responsible 
for the following evils : 

(a) Lowering the social status and public esteem of the 

dental profession. 

(b) A great shortage of registered dentists owing to the 

unattractiveness of the profession. 

(c) Inability by the general public to distinguish between 

a registered and unregistered practitioner. 

(d) The dental treatment of the public being largely in the 

hands of uneducated, untrained and unskilled per- 
sons. 

(e) Grave personal injury on account of lack of skill and 

of technical knowledge. 



SELECTIONS. 319 

(/) Extractions of sound and only slightly decayed teeth. 

((/) Application of artificial teeth over decayed stumps and 
into septic mouths. 

(h) The existence in the public mind of the belief that 
there is no advantage in preserving the natural teeth 
and that these should be allowed to decay and when 
trouble arises have all the teeth out and substitute 
a plate of artificial ones. 

52. We have had a certain amount of evidence suggesting 
that venereal disease is likely to be spread by dental operators 
who are ignorant, or disregard aseptic methods. No actual 
case which we can regard as proved has, however, been 
brought before us. In the nature of things, adequate and 
satisfactory proof would be difficult to obtain, and we are 
content to express the opinion that the risk is not wholly 
negligible. 

SECTION v. — DENTAL DISEASE IN RELATION TO THE HEALTH 

OF THE PEOPLE 

53. The Committee have realised that it would be unable 
to report upon its reference until it had taken evidence of the 
effect of dental disease upon the general health, and of the con- 
dition of the teeth of different age groups of the population 
as regards dental decay. 

The number and kind of dentists required in the future 
will be mainly conditioned by these two factors. 

(a) EFFECT OF DENTAL DISEASE ON HEALTH. 

54. The evidence we have received under this heading is 
contained in replies to circular letters sent out by the Com- 
mittee to representative bodies, insurance committees, and 
approved societies. From its nature it is necessarily mainly 
medical in character, being furnished by medical practitioners 
directly or founded on reports of medical practitioners. We 
proceed to review the chief evidence we have received. 

The British Medical Association 

55. As a result of enquiries addressed to the different 
divisions in England and Scotland the Association expressed 
the opinion : 

^^That a considerable economic loss arises from the effect 
of dental disease owing mainly to reflex influence thereof on 
the general bodily health, particularly through digestive 
trouble and resulting anaemia. The effect is most note- 
worthy in women.'' 

(To be continued.) 



320 DOMINION DENTAL JOURNAL 

Dental Societies 

SUMMARY OF THE TRANSACTIONS OF THE A^ NUAL 
MEETING OF THE NOVA SCOTIA DENTAL 

ASSOCIATION 



The 29th Annual Meeting was held in the Dental Depart- 
ment of Dalhousie University on Monday, July 14th, 1919. 

Only a business session was held, as on the following day 
the Dental Post Graduate School was opened. 

Dr. M. F. Eonnan, of Antigonish, the President, occupied 
the chair. The President's report was very suggestive and 
inspiring. 

The lieport of the Dental Board was read by the Secretary- 
Registrar, Dr. G. K. Thomson. 

The summary of the report is as follows : 

No. of names on register 176 

No. added during the year 4 

No. passing Board of Examiners 5 

No. failed in examinations 1 

Several cases of illegal practice were dealt with success- 
fully. 

x\t the last session of the Nova Scotia Legislature the fol- 
lowing bills were introduced: 

No. 175.— An Act to register Victor S. Primrose, D.D.S. 

No. 125.— An Act to register Walter Kennedy, D.D.S. 

These were withdrawn after having passed the Lower 
House. 

No. 192.— An Act to amend the Dental Act which was pro- 
moted by the Dental Board was passed and has become law. 

Be it enacted by the Governor, Council and Assembly as 
follows : 

1. Section 13 of Chapter 105 of the Revised Statutes, 1900, 
as enacted by Section 3 of Chapter 22 of the Acts of 1911, is 
amended by adding thereto the following subsection : 

(6) Where a person who is a graduate of a Dental College 
recognized by the Board which requires less than four years 
or thirty months' attendance has for one or more years— 
(a) been engaged in the practise of dentistry in Canada, or 
(h) served as a commissioned officer in the Canadian 
Army Dental Corps during the War, such person may upon 
filling such certificates and declarations as the Board may 
require, be eligible for examination in all respects as though 



DENTAL SOCIETIES. 321 

he had complied with the provisions of sub-section 1 hereof 
in respect to studentship. 

No. 174.— An Act to amend the Dental Act was passed and 
has become law:— 

Be it enacted by the Governor, Council and Assembly as 
follows:— 

Section 24 of Chapter 105 of the Revised Statutes of 1900, 
;*The Dental Act,'' is hereby amended by substituting there- 
for:— 

(24) Subject to the exceptions hereinafter made, no person 
shall practise Dentistry in any of its several branches in Nova 
Scotia, unless his name is registered in the DcMital liegistry, 
and unless he has received from such Board a license to prac- 
tise; provided, however, this section shall not apply to, or be 
construed to extend to any paid assistant not registered under 
this Chapter, employed by any registered dentist or dental 
surgeon in his office ; but this proviso shall not be construed to 
permit any such assistant to act outside the office of his em- 
ployer, nor shall such assistant be employed in any additional 
office or offices, or places of business conducted by such dentist 
or dental surgeon unless the same is in charge of a dentist duly 
qualified and registered under this Act. 

2. Said Act as further amended by Chapter 22, Acts of 
1911, is further amended by substituting for section 6 of said 
Chapter 22 the following section: 

(6) No action shall be commenced under said Act after 
two years from the date of the oif ence or cause of action. 

This latter Bill was introduced by Mr. Chisholm, M.P., and 
defended in the House by Dr. J. D. Mahar; of the Boston 
Dental Parlors, and J. J. Power, Esq. A strenuous elTort 
was made to defeat the Bill, but it was passed and is now the 
law. 

RECOMMENDATIONS. 

1. — That the annual dues be $3.00 for the ensuing year. 

2.— That the Board be authorized to act for the Associa- 
tion between meetings in all matters concerning the D.D.C. 
and C.D.A. 

3.— That the sum of $400.00 be granted to the Faculty of 
Dentistry of Dalhousie University. 

The report of the Treasurer showed a balance on hand of 
$626.63. Outstanding accounts receivable approximate $1,000. 



322 DOMINION DENTAL JOURNAL- 

The election of officers of the Association for the ensuing 
year resulted as follows:— 

President— Dr. Gordon R. Hennigar, Halifax. 

1st Vice-President— Dr. H. S. Tolson, Halifax. 

2nd Vice-President— Dr. C. S. McArthur, Truro, N.S. 

Secretary— Dr. W. C. Oxner, Halifax. 

Additional Member of Executive— Dr. F. 'W. Dobson, 
Halifax. 

Auditors— Dr. R. H. Woodbury; Dr. J. H. H. Rice. 

Three members were elected to represent the Association 
on the Provincial Dental Board: Drs. F. W. Ryan, Frank 
Woodbury, W. C. Oxner. 

The report of the Provincial Representatives to the Do- 
minion Dental Council was presented by Dr. Frank Woodbury 
and adopted. 

The following resolution respecting affiliation with the 
Canadian Dental Association was adopted : 

Whereas, at the biennial meeting of the Canadian Dental 
Association, held Aug. 5tli to 8th, in Chicago, a constitution 
was adopted. (This provides for the affiliation of the Pro- 
vincial and other Dental Associations and Societies) ; 

Therefore resolved that the Nova Scotia Dental Associa- 
tion desires affiliation and agrees to subscribe to the constitu- 
tion, by-laws and code of ethics, and hereb}' requests the 
ay)proval of the Executive Council of the Canadian Dental 
Association. 

Also resolved that the two representatives to which this 
Association is entitled, besides the President and Secretary, 
be appointed at this meeting. 

The following statement respecting the P^'aculty of Den- 
tistry Avas presented by Dean AVoodbury: 

Dalliousie University, in common with all of the educa- 
tional institutions in Canada, suffered severely during the 
pei'iod of the war, in attendance, income, and sacritice. 

Mr. W. J. Cameron, a first year Dental student of lJ)14-ir), 
has made the supreme sacrifice on the battle field. Others 
have been wounded. Several of our graduates have been over- 
seas and acquitted themselves with credit. Notwithstandine 
tJie war the attendance has been increasing. This yeai- four 
men and one young lady receixcd tlieii* diplomas. 

LABOBATORIES. 

The (capacity of our laboratories is being doubled this year. 
Accommodation is being made for .")() students, and we mav be 



DENTAL SOCIETIES. 323 

compelled to enlarge still more. Our halls could have been 
filled had we lowered our standards, but this Dalhousie wall 
never do. Her standards must be met. 

An X-Ray machine of the latest tyi)e is being installed. 
Additional lantern slides and technical devices have been 
added to illustrate the latest methods. 

The Library and reading room are supplied with the cur- 
rent Medical and Dental Journals. The Library is growing 
in an important way. Files of journals are being completed 
and bound, and new works of reference are being secured. 
The College has subscribed to the Dental Index, by which 
any article in any journal may be found at once. 

The Museum is taking very definite shape. A system of 
classification has been adopted whereby any specimen may be 
found in its proper class and the name of the donor and the 
history attached. This will be of great scientific value to the 
profession. 

A Research Laboratory has been established and some 
work is being carried on which we believe will be of great in- 
terest to the profession. Dalhousie will be one of the centres 
of Dental Research in Canada. To Drs. Ryan and Ritchie is 
due great credit for untiring faithfulness in the development 
of the Library, Research and Museum. 

It is our desire to fulfil the true functions of a University 
Faculty, and besides the work of educating the individual 
student create an educational centre from which beneficent 
influences mil radiate ito the whole profession and public. We 
are proud to be associated with the profession in promoting 
the Post Graduate School which opens to-morrow. The Uni- 
versity looks upon the Faculty of Dentistry as a permanent 
institution. It is of your creation. The resolutions passed by 
this Association in 1906-7, and the legislation you secured 
made the school possible. As the years pass, and this school 
becomes one of the great ones of the Continent, this group of 
100 men who had the vision, and have persistently made 
money grants for its promotion, will be looked upon as bene- 
factors. The teaching staff and management have been proud 
to each do their "bit" to bring the vision of those days to a 
realization. 

Passed for filing. 

The Report of the Committee on Dental Education of the 
Public was read by Dr. G. K. Thomson. 

The following is a report of your Committee for the past 
year. Six Lectures on Oral Hygiene, including tooth-brush 



324 DOMINION DENTAL JOURNAL 

drill and instructions with regard to first aid dental treat- 
ment in the public schools were delivered to the students of 
the Normal College by the Professor on Oral Hygiene of the 
Dental Faculty of Dalhousie University. The subjects of 
Oral Hygiene has been added to the curriculum of the Normal 
College and a course of lectures will be given each year. 

Several meetings of your Committee have been held during 
the year, and interviews held with members of the Council of 
Public Instruction, Superintendants of Education, Provincial 
Health Ofificers, Massachusetts Relief Committee and the 
School Board of Halifax. 

These officials realize the importance of educating the 
public and providing dental services for the school children, 
and have promised their co-operation and assistance. A grant 
of $300.00 for Dental Education in the schools has been placed 
in the Provincial estimates for 1918-19. 

Arrangements have been made for special lectures by 
members of the Dental profession throughout the Province ; 
purchase of charts and slides and first-aid dental equipment 
for schools. Dental services in County, Health Clinics to be 
established under the Public Health Act; additional Dental 
services in Halifax schools, establishment of Dental Surgeries 
by Massachusetts Relief Committee and appointment of 
representative of Dental profession on that Committee. 

Negotiations have begun with the Halifax School 
Board with a view to provision of Dental services for the poor 
school children by the Dental College, one chair to be devoted 
for this purpose. 

During the school year, the teeth of all the children in 
Grades 1, 2 and 3, of the Halifax Public Schools were care- 
fully examined and the results are being tabulated for publi- 
cation. The work of looking after the school clinic has in- 
creased to such an extent that it was found necessary to add 
another half day per week, and Dr. Stultz was appointed to 
take the extra period. 

It is the intention of the Medical and Dental Committee of 
the School Board to gradually increase the time devoted to 
Dental work in the schools, and eventually the full time of one 
practitioner will be occupied by the clinic. 

The Dental Surgery at the Halifax Dispensary has been 
a great boon to the people of Halifax. Several hundred 
mouths have already been placed in a healthy condition, much 



DENTAL SOCIETIES 325 

to the benefit of tlie patients. The Halifax DispcMisary bears 
the entire expense incurred by the clinic. 
Your Committee recommends: 

(1) The appointment by this Association of a permanent 
Committee to be called "The Oral Hygiene Educational Com- 
mittee/' 

(2) The appointment of a member of the profession in 
each town to educate the public, encourage the purchase of 
charts and first-aid equipment and the teaching of Oral Hy- 
giene in the schools. This work to be carried on under the 
direction of the Oral Hygiene Educational Committee. 

(Signed) 

George K. Thomson, Ch airman. 
S. G. Ritchie, Secretary/. 
Frank Woodbury. 
F. W. Ryan. 
R. H. Woodbury. 
Passed and recommendations: adopted. The same commit- 
tee was re-appointed and will be known hereafter as the 
Oral Hygiejte Educational Committee. 
On motion the meeting adjourned. 

SECOND SESSION. 

President in the chair. 

Minutes read and approved. 

The report of the Dental Board respecting the Dental 
Legislation ])assed by the Provincial Legislature last winter 
was brought up and discussed at much length, wliieli resulted 
in passing of a resolution as follows:— 

Resolved, that this Association hereby registers its strong 
disapproval of the pernicious legislation enacted by the Pro- 
vincial Legislature during the last session and em])owers the 
Provincial Dental Board to inform the profession of the con- 
dition of affairs and take proper steps to secure its repeal. 

The annual report of the organization of the Provincial 
Dental Board was presented as follows by the Secretary: — 

Halifax, JulyUth, 1919 

Gentlemen,— The annual meeting of the Provincial Dental 
Board was held for the election of officers at the close of the 
lase session: — President, Dr. F. AV. Ryan ; Vice-President, Dr. 

Frank Woodbury: Secretary, , Registrar, Dr. G. K. 

Thomson; Treasurer, . 



326 DOMINION DENTAL JOURNAL 

The Executive Committee consists of the members of the 
Board residing in Halifax. 
Respectfully submitted. 

(Signed) Geo. K. Thomson, Secretary, 

Passed for filing. 

The usual resolutions of thanks were passed and the Presi- 
dent elect, Dr. G. R. Hennigar, was then inducted, and ac- 
cepted the office in a neat and pointed speech. 

A motion to adjourn the 29th Convention was passed. 
(Signed) 

W. C. OxNER, Secretary, 
J. A. RoNNAN, President. 



POST GRADUATE COURSE IN DENTISTRY 



July 15th to 18th inclusive. 



Beginning July 15th and continuing four days, a Post Gra- 
duate Course in Operative Prosthetic Dentistry was held in 
the Dental Department of Dalhousie University, under the 
auspices of the Nova Scotia Dental Association, Halifax Dental 
Society and the Faculty of Dentistry of Dalhousie University. 

Fortunately the Committee was able to secure the services 
of Dr. M. L. Rhein, of New York, and Dr. George H. Wilson, 
of Cleveland, as lecturers and demonstrators. 

Dr. Rhein conducted the class step by step through his 
method of root canal treatment, reaching the periapical region 
by the use of his special set of instruments and potassium 
sodium ; the filling of the canals with gutta percha and chloro- 
form in such a way that the apices are encapsulated. 

His lectures on Oral and Dental Pathology were of special 
interest and profusely illustrated by lantern slides. At the 
Y.M.C.A. Auditorium, Dr. Rhein gave an evening lecture and 
moving picture demonstration of his methods of root canal 
treatment, also a film showing a tooth brush drill in one of the 
public schools of New York. Special emphasis was laid upon 
the necessity of asepsis in all operations in the mouth. 

As Dr. Rhein was demonstrating and explaining the action 
of potassium sodium in opening and cleansing root canals, he 
was asked by one of the class ^^if he had ever used * Purine* 
for that purpose. *' The Doctor remarked *'that he had not 
heard of it before coming here ; but understood it was a pro- 
duct of the Dalhousie Dental Research Laboratory, and if it 



DENTAL SOCIETIES. 327 

will do all that is claimed for it, it will be a valuable acquisi- 
tion." Members of the Research Committee present an- 
nounced the substance to be ^* Chloric Acid." The mystifying 
name '^Purine" had been given it by an English chemical com- 
pany who used it as a purifying agent for some of their pro- 
ducts. 

Its very remarkable action in cleansing and opening root 
canals and facilitating the removal of pieces of broken broa- 
ches, etc., forcibly impressed the Committee. Samples were 
given some members of the Faculty for chemical applications 
and very favorable reports have been received. Dr. Rhein and 
many members of the class were given samples, and their 
verdict is awaited with nmch interest. 

Dr. Wilson gave a course in modern impression methods 
and the use of Spence's Compound, instead of plaster, for 
models. He carried through to successful completion a diffi- 
cult case of upper and lower dentures, using the Hall Articu- 
lator. He also took impressions of extremely difficult mouths 
to illustrate his methods. 

Time was found for recreation and social enjoyment. On 
Tuesday, July 16th, the Committee, guests and members of 
the school were entertained at the Rotary luncheon where Drs, 
Rhein and Wilson had an opportunity to make addresses. 

On Wednesday, the members of the Halifax Club tendered 
a luncheon to the instructors and officials of the various orga- 
nizations represented in the school. 

On Tuesday evening a dinner was given by the class in the 
Tally-ho in honor of the instructors. Dr. A. W. Faulkner pre- 
sided and acted as toastmaster. The Lieut.-Governor, Mayor 
Parker and President MacKenzie of the University were also 
guests. It was a notable occasion and much enjoyed. 

On Friday evening the class was given a motor ride to 
points of interest, after which an enjoyable luncheon was 
given at the Waegwoltic Club. 

The school was a great success in every way and all felt 
that the week had been most profitably spent. 

The work of Drs. Wilson and Rhein was of the highest 
order. They also proved most congenial men and in every 
way good sports. 

There w^ere forty registered students in attendance. This 
is the first of what is hoped to be a series of Post Graduate 
schools in the Maritime Provinces. A Post Graduate study 
class is being promoted for the coming winter. 



328 DOMINION DENTAL JOURNAL 

The officers of the Post Graduate School were:— A. W 
Faulkner, Chairman; F. A. Konnan, Vice-Chairaian ; H. S. 
Tolson, Treasurer; W. C. Oxnei-, Secretary. 



DOMINION DENTAL COUNCIL EXAMINATIONS 



PASSED IX MEDICINE AND SUKGERY. 

Boyd, W. E.; Boyd, B. M.; Bier; Brown, J. W. E.; Cle- 
ii?ence; Cox; Chegwin; Crouch; Connors; Dinimick; Dickson, 
&. E. ; Dickson, J. 11. ; Flett; P^erguson; Foley; Gillespie; 
Hotham; Hugill; Hall; Holmes; Johnstone; Laidlaw; Mc- 
Kenzie, A. C. M. ; Mclntyr^; Ott; Oke; Poyntz; Pommer; 
Quigley; Kobb; Sawyers; Shoitreed; Wood, A.D. ; Wood, B.H. 

PASSED IN ANAESTHETICS 

Aitken; Alcom])ash; Boyd, W. E.; Bier; Boyd, D. M. ; 
Brown, J. W. S. ; Clemence; Cox; Chegwin; Carrothers; 
Crouch; Connors; Conn; Dimmick; Dickson, S. R. ; Dickson. 
J. H. ; Dnnsmore ; Flett ; PVrguson ; Foley ; Gillespie ; Hotham; 
Hugill; Hall; Hohnes; Johnstone; Lebbetter; Laidlaw; Mc 
Kenzie, A. C. M. ; McTntyre; Ott; Oke; Pichard; Poyntz; 
Poag; (Quigley; Ross; Robb; Sawyers; Shortreed; Thomas: 
Vandervoort; Wood, A. 1).; Wood, H. B. 

PASSED IN MATERIA MEDICIA AND THERAPEUTICS. 

Alcombach; Brownlee; Boyd; Blakely; Benezra; Brown, 
J. W. E. ; Croft; Coyst ; Clemiont; Cox; Crouch; Connors; 
Conn; Dickson, S. R. ; Dickson, J. H. ; Dunsmore; Ferguson; 
Foley; Fralick; Gunton; Gemeroy; Hillis; Hughes; Hotham; 
Hugill; Haj^ies; Johnstone; Morrison; Milne; Morton; Mc- 
Intyre; MacLachlan; McVicar; Pommer; Ross, H. A.; Robb, 
T. I.; Snider; Sawyers; Vandervoort ; Winthrope; Wood, 
H. B. 

PASSED IN PHYSIOLOGY AND HISTOLOGY. 

Adams; Abar; Brownlee; Boyd, W. E. ; Boyd, B. M. ; 
Black; Barnes, L. B. ; Barnes, A. F. ; Brown, H. M. ; Brown, 
J. W. E.; Best; Croft; Corbett; Cameron; Crowe; Crouch; 
Dickson, S. R. ; Dinniwell; Elliott; Ferguson; Foley; Finni- 
gan ; Falkuer; Gunton; Granvisky; Gott; Hyde; Haynes; 
Hoar; Hotham; Hall; Haynes, N. W. ; Johnstone; McAllister; 
McCutcheon; Pichard; Poyntz; Quigley: Smart: Steele; Saw- 
yers; TTpton; Wessles; Windram. 



DENTAL SOCIETIES. 329 

PASSKD IN OPERATIVE DENTISTRY (PAPER.) 

Aitkeii; Alcombach; Browiilee; Boyd, W. E.; Bier; Boyd, 
D. M. ; Brown, J. W. E.; Clemence; Cox; Chegwin; Carro- 
thers; Crouch; Connors; Conn; Dinimick; Dickson, S. R. ; 
Dickson, J. 11. ; Dunsmore; Flett; Ferguson; Foley; Gillespie; 
Hotham; Hugill; Holmes; Hall; Johnston; Laidlaw; McKen- 
zie, A. C. M.; Mclntyre; Ott; Oke; Pichard; Poyntz; Poag; 
Quigley; Ross, H. A.; Robb, T. I.; Sawyers; Shortreed; 
Thomas; Vandervoort; Wood, A. D.; Wood, H. B. 

PASSED IN OPERATIVE DENTISTRY (cT.INICAl). 

Aitken; Alcombach; Boyd, W. E. ; Bier; Boyd, D. M.; 
Brown; Clemence; Cox; Chegwin; Carrothers; Crouch; Con- 
nors; Conn; Dimmick; Dickson, S. R.; Dickson, J. II.: Duns- 
more; P^lett; Ferguson; P^ley; Holtham; ilugill; Hall; 
Holmes; Johnston; T.aidlaw; Milne; MacKenzie; Mclntyre; 
Ott; Oke; Pichard; Poyntz; Poag; Quigley; Richardson; 
Robb; Sawyers; Shortreed; Yanderwort; Wood, A. I).; Wood, 
H. B. ^ 

PASSED IN PATHOLOGY. 

Aitken; Hall; Ott; Oke; Pichard; Poyntz. 

PASSED IN ORTHODONTIA. 

Aitken; Alcombach; Boyd, W. E. ; Bier; Boyd, D. M.; 
Brown, J. W. E.; Clemence; Cox; Chegwin; Carrothers; 
Crouch; Connors; Conn; Dimmick; Dickson, S. R. ; Dickson; 
J. H. ; Dunsmore, R. J.; Flett; Ferguson; Foley; Gillespie; 
Hotham; Hugill; Hall; Holmes; Johnstone; Laidlaw; McKen- 
zie, C. M. ; ]\lcTntyre; Ott; Oke; Pichard; Poyntz; Poag; (Quig- 
ley; Robb; Sawyers; Shortreed; Thomas; Vandervoort, 
Wood, A. D. ; Wood, H. B. 

PASSED IN BACTERIOLOGY AND PATHOLOGY'. 

Alcombach ; Brownlee ; Boyd, W. E. ; Boyd, B. M. ; Blakely ; 
Brown, D. M. ; Benezra ; Brown, J. W. E.; Clermont; ' Cle- 
mence; Cox; Crouch; Connors; Conn; Dickson, S. R. ; Dick- 
son, J. H. ; Dunsmore; Ferguson; Foley; Gunton; Gemeroy; 
Gillespie; Hillis; Hughes; Hotham; Hugill; Holmes; John- 
stone; Milne; Morgan; Mclntyre; Pommer; Poag; Ross, H. 
A.; Robb, T. I.; Sawvers; Shortreed; Vandervoort; Wood, 
A. D. ; Wood, PI. B. 

PASSED IN CHEMISTRY. 

Best ; Haines ; Morton ; Zimmerman. 

PASSED IN PHYSICS AND CHEMISTRY. 

Adams ; Abar ; Boyd, W. E. ; Bier ; Boyd, D. M. ; Clemence ; 
Cox; Chegwin; Crouch; Connors; Dickson, S. R. ; Dinniwell; 



330 DOMINION DENTAL JOURNAL 

Elliott; Ferguson; Foley; Finnigan; Fralick; Gunton; Grano 
vosky; Gott; Gemeroy; Gillespie; Hyde; Hoar; Hotham 
Haynes; Johnston; Lumb; Morrison; MacLachlan; Mc Vicar 
McAllister; McCutcheon; Ott; Pichard; Poyntz; Pommer 
Quigley; Smart; Steele: Sa^vye^s; Taylor; Upton; Wilson 
Windram : Wilson, P. R. 

PASSED IN ANATOMY. 

Adams; Abar; Brownlee; Boyd, W. E. ; Boyd, D. M. 
Black; Barnes, L. V.; Blakely; Barnes, A. F. ; Brown, H. M. 
Best, J. H. ; Benezra; Brown, J. W. E. ; Croft; Corbett 
Cameron; Crowe; Crouch; Dickson, S. R. ; Dinniwell; Elliott 
Ferguson; Foley; Finnigan; Granovsky; Gott; Hyde; Hoar 
Hotham; Haynes; Johnstone; Macintosh; McCutcheon 
Reed ; Steele ; Sawyers ; Taylor ; Upton ; Wilson, C. B. ; Wea- 
sels ; Windrain ; Zimmerman. 

PASSED IN PEOSTHETIC DENTISTRY AND METALLURGY. (PAPER.) 

Aitken ; Alcombach ; Bro\vnlee ; Boyd, C. M. ; Brown, J. W. 
R. ; Clemence; Cox; Cheg\\in; Carrothers; Crouch; Connors: 
Conn; Dimmick; Dickson, J. H. ; Dickson, S. R. ; Flett; Fer- 
guson; Foley; Gunton; Gillespie; Hughes; Hotham; Hugill; 
Hall ; Holmes ; Johnstone ; Joynt ; McKenzie, A. C. M. ; Mcln- 
tyre; McLachlan; McVicar; Ott; Oke; Pichard; Poyi'tz; 
Poag; Quigley; Ross, H. A.; Robb, J. I.; Sawyers; Shortreed; 
Thomas ; Vandervoort ; Winthrope ; Wood, A. D. ; Wood, D. S. 

PASSED IN PROSTHETIC DENTISTRY ( CLINICAL). 

Aitken; Alcombach; Boyd, W. E.; Bier; Boyd, B. M. : 
Brown; Cox; Clemence; Chegwin; Carrothers; Crouch; Con- 
nors; Conn; Dimmick; Dickson, S. R. ; Dickson, J. H. ; Flett; 
Ferguson; Foley; Holtham; Hugill; Holmes; Hull; Johnston; 
Laidlaw; Milne; MacKenzie; Mclntyre; Ott; Oke; Pichard; 
Ponytz; Poag; Quigley; Richardson; Robb; Sawyers; Short- 
reed; Vanderwort; Wood, A. D. ; Wood, H. B. 

PASSED IN JURISPRUDENCE AND ETHICS. 

Aitken ; Boyd, W. E. ; Bier ; Boyd, D. M. ; Brown, J. W. R. ; 
Clemence; Chelg\\^n; Corrothers; Crouch; Connors; Dimmick; 
Dickson, S. R. ; Dickson, J. H. ; Flett; Ferguson; Foley; Gil- 
lespie ; Hotham ; Hugill ; Hall ; Holmes ; Johnstone ; Lebbetter • 
Laidlaw; McKenzie, A. C. M. ; Ott; Oke; Pichard; Poyntz; 
Poag; Quigley; Sawyers; Shortreed; Thomas; Wood, A. D. 



DENTAL SOCIETIES. 331 

BRITISH COLUMBIA DENTAL SOCIETY 
CONVENTION 



Em?:ry Jones, D.D.S., New Westminster, B.C. 



At Seattle, Wash., during- the week of July 14th, the 
British Columbia Dental Societ}^ and the Washin.^ton State 
Dental Association held their first Joint Convention. By this 
co-operation of the two societies, they were able to stage one 
of the largest and most enthusiastic Post Graduate Courses 
that was ever held in the West. About seventy dentists from 
British Columbia and two hundred and fifty from Washington 
wei"e present. The members were divided into classes not ex- 
ceeding fifty for each Post Graduate Course. Dr. T. Ewing 
Roach, of Chicago, ably assisted by Dr. C. A. Furrow, had an 
enthusiastic class of fifty in Partial Denture Prosthesis. The 
series of lectures and blackboard talks were freely inter- 
spersed with chair clinics. Several remarkable appliances 
were made for patients before the class and Dr. Roach's tech- 
nique was splendidly illustrated from beginning to end. The 
class showed appreciation by presentations to Dr. Roach and 
Dr. Furrow. 

Dr. Arthur E. Smith, of Chicago, had a full class in Nerve 
— Blocking Anaesthesia. His lecture course was very instruc- 
tive, for he is a born teacher and knows the human anatomy 
from A to Z. His clinical instruction covered all extra-oral 
and intra-oral blocking injections, including all methods 
of local anaesthesia for oral surgery, exodontia, pulp removal, 
apicoetomy, cavity preparation, etc. 

The lectures were illustrated by several carefully dissected 
wet specimens. So pleased were the British Columbia mem- 
bers that they at once arranged with Dr. Smith to repeat 
his course in Vancouver in January. 

Dr. Rupert E. Hall, of Chicago, also had a large class 
awaiting him, in Full Denture Prosthesis. Dr. Hall felt that 
the time given him too short to complete his w^ork; and there- 
fore so abbreviated his instructions that most of the class 
seemed quite dissatisfied with the small amount of information 
given. 

Dr. B. B. McCallum, of Los Angeles, was unable to attend 
on account of sickness, but he was very ably represented by 
Dr. Frank Williams. A large class were thoroughly in- 
structed in the best technique of making cast inlays. 



332 DOMINION DENTAL JOURNAL 

Of the local men giving instructions, special mention 
should be made of Dr. J. E. Argue on Porcelain Jacket Crowns. 

Dr. W. B. Power on Orthodontia, Dr. Cline Fixott on 
Radiography and Drs. C. L. Rion and 0. T. Dean on Oral 
Surgery. 

Grreat credit for the success of the meeting is due to the 
efforts of the officers and committees, and particularly the 
Presidents, Dr. E. B. Edgars of Seattle and Dr. T. W. Snipes 
of Vancouver. The $6,000 required to make the meeting a 
success was raised by assessment without any difficulty, and 
the instruction given was worth ten times the price. 

The officers of the British Columbia Dental Society are: 
T. W. Snipes, Vancouver, president; F. W. Proctor, Victoria, 
first vice-president; J. G. Smythe, Nelson, second vice-presi- 
dent; George Telford, Vancouver, treasurer; and Wilbur 8. 
V^atson, Vancouver, secretary. 



WANTED : A DIAGNOSTIC SENSE 



Dentists as a class are gradually losing all sense of clinical 
diagnosis, leaning almost exclusively upon radiography with 
results that are not by any means invariably satisfactory. If 
radiographs could be depended upon, in all instances, to por- 
tray accurately the nature of pathological processes occurring 
within calcified tissues, no valid objection could be raised 
against its emplojonent even to the abandonment of other 
methods of diagnosis. Radiography has a place in dental 
diagnosis, superseded in importance by perhaps no other 
method, but radiography alone cannot be depended upon for 
a correct diagnosis in all cases, any more than clinical diagno- 
sis can be relied upon to the exclusion of radiography. The 
happy combination of radiography w^ith clinical diagnosis 
leads to an accuracy of results which cannot be attained by 
either of these methods separately and should be practised 
jointly whenever possible. To rely upon a radiograph for a 
diagnosis without the assistance of the history of the case, 
all subjective and objective symptoms, percussion and palpa- 
tion, and other recognized procedures in diagnosis, is to place 
the patient ^s physical welfare at the mercy of the inaccuracies 
of the X-ray machine. 




^ditoridZ 




EDITOR: 
A. E. Webster, M.D.. D.D.S.. li.D.S.. Toronto, rnnaclii 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross, UD.S., D.D.S., Ottawa; Carl E. Klotz. L..D.S.. St. 

Catharines, 
Quebec. — Eudore Debeau, L.D.S., D.D.S. , 396 St. Denis Street, Montreal; Stanley 

Burns, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton, 

D.D.S., L.D.S., McGill University, Montreal. 
ALBERTA. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — ^Jas. M. Magee, L.D.S., D.D.S. , St. John. 
Nova Scotia. — Frank Woodbury. L.D.S., D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Reg-ina. 

Prince Edward Island. — J. S. Bagnall, D.D.S., L.D.S., Charlottetown. 
Manitoba. — M. H. Garvin, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogue, D.D.S., L.D.S., Vancouver. 

Vol XXXI. TORONTO, SP^PTEMBER 15, 1919. No. 9. 



A PERNICIOUS AMENDMENT TO THE NOVA SCOTIA 

DENTAL ACT 



At the last meeting of the Legislature of the Province of 
Nova Scotia, an amendment to the Dental Act was passed 
which permits a registered dentist to employ a person who is 
not registered to perform dental operations for patients. This 
kind of legislation is much more pernicious than granting un- 
qualified persons a license to practice. Members of Legis- 
latures are persuaded by interested parties, who, by the way, 
are usually dentists, that if the work of such unqualified per- 
sons is supervised by the dentist, the public can be served at 
less cost than if all the work were done by a qualified person. 
Members are also led to think that the dental profession is a 
trust or monopoly such as the meat, coal, or iron trusts, and 
that the most effective way to break such a combination is to 
allow qualified dentists to employ the unqualified. 

Such arguments seem reasonable to those who have not 
studied the problem, or are not acquainted with how it works 
out. 

In the first place, the work of a dentist cannot be super- 
vised in such a way that the patient is safe from the blunder- 



334 DOMINION DENTAL JOURNAL 

ings of tbe unqualified. Even the dentists who promote such 
legislation will admit that they cannot, or do not intend to 
supervise the work of the unqualified assistant. Such dentists 
are not teachers, nor is the pujjil sufficiently educated in the 
basic sciences to understand instruction if given him. No 
patient is safe from the mistakes of the untrained, even with 
an instructor by his side all the time. As a matter of fact, such 
assistants are left on their own resources to do as best they 
can from anaesthetics and diagnoses to treatment. As a gen- 
eral rule, a patient is just as safe in the hands of an unqualified 
person in his own office as in the hands of an unqualified per- 
son in the office of a qualified. If a person is qualified to prac- 
tice dentistry or surgery for patients in the office of a licen- 
tiate, he is qualified to practice on his own account in his own 
office, and should be granted a license. As a matter of fact, 
such assistants usually apply for a license later on, and their 
chief claim is that they have always practiced in the office of 
their employer without assistance or advice. 

The legislator who thinks he is breaking a monopoly by 
allowing qualified dentists to employ the unqualified, is in 
reality creating a monopoly of a very pernicious type. Assist- 
ants so employed are not paid a sufficient salary^ to maintain 
a family, and soon find out that there are very few employers 
in the provinces in which such practice is pemiitted, hence 
they find themselves sweatshopped and must do a little prac- 
tice on the side to make a living. The employer loses a few 
patients, discharges his assistant, who in turn asks the Legis- 
lature for a license. If the promoters of such legislation were 
asked to sujjport giving everyone a license who acts as an 
assistant, they would immediately object. It is only because 
a few wish to employ such unqualified assistants to their own 
benefit that makes it profitable. 



CANADIANS GRANTED LICENSES TO PRACTICE 

IN GREAT BRITAIN 



There were a great number of colonial and foreign applica- 
tions to the General Medical Council of Great Britain for 
licenses to practice. The following are the applications which 
were in a completed stage at the last general meeting. Among 
them ai)pear a number of Canadians who are well known mem- 
bers of the C.A.D.C. : 

From Captain E. P. Hawkshaw, C.A.D.C, who is a D.D.S. 



EDITORIAL 335 

of the McGill University, 1910. Captain Hawkshaw forwards 
the General Announcement of the Department of Dentistry, 
1938-1919, and the examination papers for 1909-1910, from 
which it appears that the course extends over four years, after 
matriculation. The syllabus, the provision for teaching, and 
specimens of examination papers appear to be satisfactory. 
The Committee recommends that this application be 

acceded to. 

From Major G. H. Alford Stevenson, C.A.D.C, D.D.S., of 
the University of Bishop ^s College, Quebec, 1900 (now incor- 
porated in McGill University), Licentiate in Dental Surgery 
of the Province of Quebec (see case of Mr. P. E. Picotte, Min- 
utes, 1918, pp. 326-327). Major Stevenson forwards a copy of 
the Announcement of the Dental College of the University of 
Bishop's College for 1904-1905, from which it appears that the 
course extended over four years. The general subjects are 
taught in the Medical Department of Bish>>p's University (the 
medical courses of the University were recognized by the 
Royal College of Surgeons of England and of Edinburgh, and 
by the Faculty of Physicians and Surgeons of Glasgow as 
qualifying for admission to examination). 

He is also a T/icentiate of the College of 1 )('ntal Surgeons of 
Quebec, 1900. • 

The Committee recommends that this application be 

acceded to. 

From Major G. A. Briggs, C.A.D.C, a D.D.S. of the Uni- 
versity of Bishop's College, 1901, and L.D.S. of the College of 
Dental Surgeons of Quebec, 1901, and M.D., CM. of the Uni- 
versity of Bishop's College, 1904. Thus Major Briggs holds 
full medical qualification, as well as his dental qualification, 
but it is not one registrable in Great Britain, though an ad 
eundem degree of McGill University obtained in virtue of it 
would entitle him to registration in the Medical Register and 
so confer rights under the Dentists Act. 

The Committee recommends that this application be 
acceded to. 

From Captain Harold Cowan, D.D.S., of Dalhousie Uni- 
versity, 1914, diplomate of the Dominion Dental Council, 1914, 
U.D.S. Saskatchewan; he also possesses the Dominion Dip- 
loma. 

The constitution of the Dominion Dental Council requires 
for the Class A Certificate which Captain Cowan holds, ma- 
triculation in the Faculty of Arts of a Provincial University, 
bona fide academic study for four years at a dental college. 



536 DOMINION DENTAL JOURNAL 

graduation certificate from any recognized Canadian dental 
school, and the passing of the final examination required by 
the Dominion Council for this class. 

Dalhousie University requires four academic years of eight 
moitths each. The educational requirements seem quite ade- 
quate, and the standard of the examination papers is excellent. 

The Committee recommends that this application be 
acceded to. 

From Captain Charles Edward Wright, C.A.D.C, L.D.S., 
of the Royal College of Dental Surgeons of Ontario, 1911, 
D.D.S. of the University of Toronto, 1911. The period of 
study for the License and the Degree extends over four years. 

Captain Wright states that he also possesses a certificalte 
from the Dominion Dental Council. 

The Committee recommends that this application be 
acceded to. 

From Captain Charles H. Moore, C.A.D.C, who states that 
he is an L.D.S. of the Royal College of Dental Surgeons of 
Ontario, and holds the D.D.S. of Toronto University; he also 
possesses the certificate of the Dominion Dental Council, and 
has been in practice for ten years. A certificate from the 
Royal College of Dental Surgeons of Ontario is supplied, 
showing that Captain Moore attended four sessions of the col- 
lege and graduated in 1909. 

The Committee recommends that this application be 
acceded to. 

From Captain Fred Mallory, C.A.D.C, who after matricu- 
lation at the Royal College of Dental Surgeons, Ontario, in 
1896, graduated at the same college in 1900, after a full 
course of study. He has also the Diploma of D.D.S. of the 
University of Toronto, 1900, and is licensed to practice in 
Illinois. He has furnished particulars of his curriculum, the 
general subjects being taught by the professors in the Medical 
Department of the University of Toronto. The syllabus of 
studies is satisfactory. 

The Committee recommends that this application be 
acceded to. 

From Charles Percy Curtis, D.M.D., Harvard University, 
1884. Mr. Curtis 's claim to registration is that he obtained 
his degree before its recognition was suspended by the 
Council in 1893: there was therefore a considerable period 
during which he could have obtained registration. 

The Committee reconamends that this application be 
acceded to. 



EDITORIAL NOTES 337 

The Registrar has had much corresx)ondence with a firm of 
solicitors who made an application for the registration of a 
client whose only claim was based on a certificate of being in 
practice in the Isle of Man on December 2, 1908, when the local 
Dentists Act was passed. 

The application was refused by the Registrar. 



Editorial Notes 



Dr. Arthur Poyntz has been appointed school dentist at '/ 
Saskatoon. 

The bogus dental diploma mill of St. Luke's Dental Col- 
lege, Nile, Michigan, is again doing business in England. 

The wife and daughter of Dr. Kriel, Niagara Falls, X.Y., 
were killed in an automobile accident at Niagara Falls, On- 
tario. 

The Dental Educational Committee for Saskatchewan for 
the year 1919-20 are Dr. Truman Craik, Dr. Parker, Regina, 
Dr. Lane. 

Among the various degrees granted by British universities 
in dentistry, none offer a D.D.S. There are B.D.S., M.D.S., 
B.Ch.D., M.Ch.D., M.S. (Dent.),B.S. (Dent.). 

in 

Drs. Bell and McQuaid, of Prince Edward Island, have 
won scholarships in the University of Maryland, which are 
post-graduate courses in Columbia University. 

The British Dental Journal gives great praise to the Can- 
adian Army Dental Corps for the businesslike reports it sends 
out and for the volume of work accomplished. 

Dental graduates of the Universities of Harvard, Michigan 
and Pennsylvania (U.S.A.), are exempt from certain examina-= 
tions or portions of them if they desire to qualify in Great 
Britain. 



33fi DOMINION DENTAL JOURNAL 

Major Cameron, of Swift Current, Sask., who has been in 
hospital, Toronto, taking treatment for wounds received in 
battle, has gone to Regina to take charge of the military den- 
tal clinics there. 

1^ 



It has been illegal in the United States for a physician to 
prescribe any narcotic drug for a patient which is for the 
purpose of keeping him comfortable or is not prescribed for 
the purpose of curing him from some real ailment. 

The dental hygienists of Colorado are licensed to remove 
deposits, tartar, accretions and stains from the mouth in pub- 
lic schools and in other public institutions, in institutions and 
in the ofl&ces of registered dentists, but only under the super- 
vision of a dulv licensed dentist. 



At the recent convention of the Great War Veterans' As- 
sociation, held in Vancouver City, it was decided to call upon 
the Dominion Government to provide travelling dental boards 
and make arrangements for dental treatments for soldiers at 
local points. These were the terms of a special resolution pass- 
ed by the convention. 

The World Trade Club is endeavoring to persuade the 
people of the United States that the metric system is to be 
preferred for weights and measures to other now cumbersone 
methods. It seems strange that it should take a campaign by 
any organization to persuade a people to adopt a decimal sys- 
tem of weights and measures, and measures which it has 
adopted in its money system. 

Graduates of the Universities of Australia and New Zea- 
land are recognized without examination in Great Britain. 
No recognition or exemptions are granted graduates of Cana- 
dian universities or the Dominion Dental Council. Is it not 
desirable that some official recognition should be given grad- 
uates in dentistry from Canadian universities? Individual 
Canadian dentists should not be required to present all their 
credentials to get consideration. 



EDITORIAL NOTES 339 

The transactions of the Sixth International Dental Con 
gress have just been published. The congress came to a short 
and abrupt end during the early days of August, 1914. It is 
remarkable that so much of the matter prepared for the meet 
ing could have been kept together for publication. If there 
could have been discussions of the comnuini cations, the Con • 
gress would have gone down as the greatest of its time. 

The National Food Refonn Association of England was 
organized in 1908, and at a recent meeting its name was 
changed to ^^The Food Education Society." It seeks to place 
before the public the best available facts regarding food and 
diet, to give instruction in scientific and economical cookery. 
It has also undertaken a campaign for the preservation of the 
human teeth. The address of ihe society is Dane's Inn House, 
265 Strand, W.C. 

A few weeks ago the President of Vanderbilt University, 
Nashville, sent out a notice of the discontinuance of the dental 
dejjartment of the university for the want of sufficient funds. 
He said the department required $30,000 a year above the 
students ' fees to teach denti stry as demanded by the standards 
of to-day. We have just received an announcement of the 
continuance of the department — the presumption is the neces- 
sary funds have been found. 

m 

As quite a number of the men who are serving in the 
C.A.D.C. were still overseas at the time fixed by the Dominion 
Dental Council for closing applications for the Class ^^C Cer- 
tificates, it has been decided to treat the applications from 
these men the same as if they had been received on June 30th 
last. Therefore, all men overseas on date 30th June, 1919, and 
who are entitled to a Class '^C Certificate may apply to the 
Secretary for the forms, and if the applications are found to 
be in order, certificates will be issued upon the payment of the 
usual fee of $100.00; all are men serving in the C.A.D.C. 
and who were overseas at the time of the holding of the recent 
examinations, and, conseijuently, could not take such examina- 
tion by reason of their absence, will be permitted to take the 
Chiss ^'D'' examination this fall, upon jiroving eligibility foi- 
such examination. The examination will stai't in each Prov- 
ince on Monday, the 24th day of November, and will continue 
until completed. All applications should be sent to the "Secre- 
tary, Dr. W. D. Cowan, House of Commons, Ottawa.'' 



340 DOMINION DENTAL JOURNAL 

The Metropolitan Life Insurance Co., of New York City, 
has issued an edict that Dental examination is now a require- 
ment of employment in that institution, reading as follows: 
*"The services rendered by the Dental Division since its estab- 
lishment in 1915 have been so curative of impaired health con- 
ditions and so premanently helpful to the employees who take 
r>dvantage of the opportunities offered, that henceforth every 
home office employee will be required to undergo examination 
and cleansing of the teeth in the Home Office Dental Division 
twice a year. If the service of the family dentist is desired 
rather than that of the home office dentists, such examinations 
and cleansings by him will be accepted, but they must be pro- 
cured without expense to the company and the employee must 
furnish a satisfactory certificate from him that the required 
work has been done.'^ This, we believe, is the first time in Ihe 
world that such a requirement has ever been made by any large 
company. 



The dental examination of the school children of the Prov- 
ince of Ontario is making progress, as indicated by reports 
from 'the following places : 

' Hamilton-^ The dentists have consented to make a dental 
gu'f"vey of all the school children of the city, hut as the arrange- 
xnent committee of the board of education passed a resolution 
providing for such inspection the gratuitous services will not 
be needed. Thie department of education is grateful to the 
Harnilton dentists for their kind offer. 

Fort William— The board of education has placed in the 
estimates $2,000 for the establishment of a permanent system 
of dental inspection and treatment. The work will be de- 
veibped during 1920. 

Windsor— A dentist has been appointed to give free dental 
service for the school children of Windsor and Walkerville. 

Brantford— The city has a permanent dental inspection 
^cl. the work shows great promise. 

Watford— Dr. G. R. Howden has been appointed to exam- 
ine the teeth of the school children of the town. 

Morrisburg— Dr. W. C. Davy and Dr. G. Gorrell have com- 
pleted a dental inspection of the school children. 

Brampton— Dr. J. L. Mackle conducted a dental clinic at 
Mai ton July 8 and 9. Forty-five children were examined, and 
in some cases necessary operations were performed. 



CORRESPONDENCE. 341 

The new prohibition law in the United States allows the 
physician to prescribe not more than one quart of liquor for a 
patient at a given time, and m no case shall he prescribe alco- 
holic liquor unless the patient is under his constant personal 
supervision. The prescription, which is non-refillable, must 
show the name and address of the patient, includino^ the street 
or apartment number, if any, the date when prescription was 
written, condition of illness for which prescribed and the name ji 

of the pharmacist to whom prescription was presented for fill- !! 

ing. Physicians desiring alcohol for strictly scientific or med- 
icinal purposes must file application for a permit with the Col- j| 
lector of Inland Revenue of the district in which they live. 
This application must be accompanied by bond furnished by a 
surety company, or signed by two individuals as sureties. Both 
the application and the bond must be in duplicate. A bond for 
Jf'lOO allows the physician to have on hand, or in transit, twenty 
gallons of alcohol or liquors. The same privilege is open to 
dentists who may become applicants for a permit. An acoouint 
of all alcohol or alcoholic liquors purchased and on hand must 
be ready at any time for the inspection by an Inland Revenue 
officer. Alcohol or alcoholic liquors purchased under these 
conditions cannot be used for the physician ^s own coin- 
sumption. 

NAUSEA FROM DENTURES 



310 Herald Building, Calgary, Alta., Aug. 17, 1919. 
Dear Dr. Webster: — 

In reply to enquiry re '^Nausea from Dentures" I might 
give you my experience, trusting it might help Dr. Mitchell. 

"Nausea is not caused by a properly fitting upper denture 
entending too far backward, but by an imperfedt fit of the 
posterior margin of the denture, so that the soft tissues in 
moving up and down just touch the denture and a tickling 
sensation is caused which results in nausea. 

"If an effort is made to secure a fit by carving the model 
so that the posterior margin of the denture passes up into the 
soft tissues, nausea may be the result of unequal pressure. 

"If the impression be finished with the mouth closed and 
the impressions under normal biting strain, the upper denture 
may be carried as far back as is required without causing 



nausea. '^ 



Very cordiallv, 

^ LESLIE WRIOHT, D.D.S. 



342 DOMINION DENTAL JOURNAL 

VANCOUVER DENTIST DRO WNED:AT, KAMLOOPS 



While attempting- to save another lad from drowning, 
Ralph Peach, 20, son of Mr. and Mrs. J. R. Peach, Vancouver, 
met a like fate in the Thompson River near Kamloops, British 
Columbia. 

According to meagre details of the accident, young Peach, 
who was studying for the dental profession, attempted to save 
tiie life of Thomas Ivens, a returned soldier with an injured 
leg, who got beyond his depth in the swift-flowing waters of 
the Thompson. Peach went to the rescue in the treacherous 
waters and was carried away by the current. 

After half an hour's dragging of the water, the bodies of 
both men were recovered and were shipped to Vancouver Cit> 
for interment. 



WHY FACINGS BREAK AND A METHOD OF 

PREVENTION 



Facings do not ordinarily break from the direct strain of 
mastication, but usually by reason of the flow of gold under 
or near their incisal edges. Each impact of the opposing 
tooth causes a little flow, and the gold immediateh' under the 
cusp in its endeavor to expand pries off the facing. This 
physical process can be compared to the splitting of a solid 
rock by a growing tree. 

Repair can be quickly made by grinding away the gold in 
contact, and thus removing the cause of breakage. Then with 
pliers flatten the pins on the bridge, bending them slightly 
together. Select a facing, and grind off* its pins. Now grind 
a groove mesio-distally in the facing deep enough to allow it 
to seat properly, and cement to place. The site of the groove 
may be determined by cai-hon paper or wax. If a close fit 
cannot be had, paint both pins and facing with cement, and 
use a very thin mix of amalgam as a filler. 

This method of repair is not original, as I had occasion to 
remove a facing which had been repaired in this manner and 
which had been in the mouth fifteen years.— Dr. R. W. Burch. 
Fort Tjauderdale, ¥\r. — Dental Cosmos. 



Dominion 

Dental Journal 

Vol. XXXI. TORONTO, OCTOBER 15, 1919. No. 10. 

Original Communications 

ADDRESS TO FRESHMEN 



Prof. R. D. Thornton y Royal College of Dental Surgeons, 

Ontario, Sept., 1919. 



I say fellow students, thoughtfully, because I hope that so 
long as I remain in the profession of dentistry, I may be con- 
sidered a student, and I trust that you, who are entering dent- 
istry to-day, are also looking forward to becoming students 
for the rest of your life. The study of dentistry cannot end 
with our course within these College walls. It is a real pleasure 
to see so many of you entering upon the study of dentistry. 
To me, it is an indication of the ever-increasing appreciation 
by the laity of the service that can be rendered by the pro- 
fession of dentistry for the improvement of the health and 
hap[)iness of their fellow men. 

If I were to take a census of this class, I would find many 
different reasons for your presence here to-day. Some would 
inform me that "father is a shrewd business man and that he 
has observed that the two or three dentists in his town are 
driving 'flivvers.' " Indeed, there may be one or two of them 
who own automobiles, consequently dentistry must be a very 
desirable vocation. With a few, your presence here is largely 
a matter of chance. Others, again, look upon dentistry as an 
easy occupation in return for which they receive some real 
monetary consideration. Others, again, have decided that they 
would not care for the uncertain hours so frequently associ- 
ated with the practice of medicine; law does not appeal to 
them; school teaching and theology are under-paid, and, so 
by the process of elimination, they are entering dentistry. 
Some will consider that their mechanical ability makes them 
specially adapted for this work. Another group, and I am 
pleased to say that I believe this last group is ever growing 



344 DOMINION DENTAL JOURNAL 

larger, see in the practice of dentistry a real opportunity to 
promote the good health and happiness of their fellow men 
and, consequently, further their own happiness. This is a 
very worthy object and one which we believe should dominate 
the life of every individual. 

Just what constitutes a worthy life would require more 
thought than I have been able to give to these few remarks 
and would take more time than I have at my disposal this 
afternoon. That belongs to the Department of Ethics. Suffice 
it to say at this point that heretofore success in life has too 
often been judged by the accumulation of wealth. The hap- 
penings of the past five years have changed the views of many 
people on this subject. Some have made their millions and 
enjoyed the luxuries of this life in comfort at home, while 
other, more patriotic fellow men, have suffered all kinds of 
hardship and even sacrificed their lives on the battlefields of 
France and Flanders for the things that are really worth liv- 
ing for— freedom, justice, mercy and truth. I believe these 
are the men who have done the thing worth while and who 
will ever be honored as such as long as history is recorded. 
Man's higher life is made up of moral relations. He is a social 
being and must find his own happiness by including \\athin it 
the happiness of others. This necessitates a control over his 
lower physical wants. We are born into this world very help- 
less creatures, but with certain instincts, chief of which is that 
of self-preservation. This instinct of s-elf-preservation, un- 
less controlled by higher motives, leads to selfishness, 
which interferes with those with whom we come in 
contact and ultimately reacts upon our own lives. We must, 
therefore, appreciate our sense of duty toward our fellow men. 
We cannot hope to promote our own desires by giving pain 
or doing injury to others. We must live a socially efficient 
life. 

There are three chief factors in Social Efficiency. The 
fint is Knowledge. This implies that we must know how to 
do things. The second is Skill. We may obtain knowledge 
by the reading of text-books, but we must acquire skill or the 
ability to do things by practice in doing them. The third 
factor is the right feeling toward our fellow men. The 
machinist may know all about the gasoline engine, and may 
have the skill to make an excellent running engine, but, if he 
lacks that higher motive of right feeling toward others, he 
may turn out an engine for an airplane full of flaws, due to 
careless workmanship, with the result that the engine may 



ORIGINAL COMMUNICATIONS 345 

explode at two thousand or three thousand feet altitude and 
bring the life of the pilot and his passenger to an untimely 
end. 

Were I to ask the members of this class what their objects 
are in taking a college course, some wonld tell me that it will 
give them a certain social standing. Others would tell me 
that they desire to enter a certain profession, and a college 
course is the only means by which they can acquire a degree. 
A great many, however, would reply that they see in such a 
course an excellent opportunity for cultural effects and in- 
tellectual development. The real objects, I believe, of a college 
course are: (1) To enrich the experience of the student so 
that he may develop intellectually, physically, spiritually and 
socially. The Scriptures state in Luke 2, 52, that this is the 
manner in which the Master, Himself, developed. It is a 
splendid thing, sometimes, to chart ourselves, or what is bet- 
ter still to get somebody else to chart our development so 
that ^'we may see ourselves as others see us.^^ The Y.M.C.A. 
has a method known as ^'Standard Efficiency Tests, '^ by means 
of which they will grade your standing in this four-fold 
method. Were we to look at the development of such men as 
Jack Johnson or Tom Longboat, we would notice that intel- 
lectually they begin very low in the scale; physically, they 
would measure up into the 90 per cent, class; spiritually, I 
do not imagine they would rank very high, and socially, we 
know that Johnson is completely off the map. Even the Gov- 
ernment of the United States does not want him to live within 
the bounds of the country. This is merely an example of an 
unbalanced man. Occasionally, we have men entering the 
study of dentistry who substitute dentistry in the column in- 
tended for intellectual development. Their chart would show 
that they know a great deal about dental subjects; physically, 
however, by the time they graduate they are total wrecks; 
spiritually, they become agnostics, or something akin to that, 
and socially, they are '' boorish" in their manners. They talk 
'*shop" in place and out of place. Our chief aim should be 
to reach as high a standard as possible in every phase of our 
development. The second object of a college course is to fit 
men and women so that they may render more valuable ser- 
vice to their fellow citizens than would otherwise be possible, 
in return for whicfh they may demand adequate compensation 
to provide for the necessities, comforts and even some of the 
luxuries of life for themselves and those who may be closely 
associated with them in the making of their homes and also 



346 DOMINION DENTAL JOURNAL 

for those who may be dependent on them. The third object 
is the promotion of an advanced t}^e of civilization. We ex- 
pect a great deal more from our educated men than we do 
from the ignorant classes. 

Our education is acquired in two ways— inlformal and for- 
mal The worthy life is not a natural growth. We have stated 
before that we are born into this world with certain instincts, 
chief of which is that of self-preservation. The development 
of this instinct, unless influenced by higher motives, tends to- 
wards selfishness and even intemperance. In the home and 
at play the child gets a certain amount of education from its 
parents or guardians in an informal way which tends to 
broaden its' viewpoint. Formal education is carried out by 
controlling the student's reactions upon liis physical and so- 
cial surroundings. 

These reactions are of three different forms. The first is 
instinctive. Instinct has been defined as ^Hhe ability of an 
organism to react upon a particular situation, so as to gain a 
desirable end, yet without any purpose in view or any pre- 
vious training.'' The second form is habitual. The young 
child aims at self-preservation. By this instinct it learns that, 
if it is able to move about from place to place, it will be better 
able to promote its own interests, consequently it learns to 
walk, and to use its hands, and after m'ore practice is able to 
do these by habit, very little intellectual force being required 
to guide it. The third form of reaction is ideal or conscious. 
This last form lias a strong influence over the preceding forms. 
Our habits of hygiene, for instance, are greatly improved by 
conscious reaction. A few centuries ago, the people of Europe 
did certain things in regard to their hygiene, largely as a 
matter of habit. Great plagues broke out, such as the ^' Black 
Death" of 1348, or the later plague of the seventeenth cen- 
tury. In recent times, however, we have brought our con- 
scious reactions into force and established means of prevent- 
ing such plagues. This has resulted in the promotion of De- 
partments of Health in all thickly populated districts, and, 
even, in many of the sparsely populated rural districts. 

How may a course in dentistry be made to comply with all 
the objects of a college course ? Many of you who have learned 
Grreek, Latin and Mathematics in High School, or Collegiate, 
have already forgotten a great deal that you learned there. 
However, the fact that you have once learned these subjects 
has increased your intellectual capabilities and, as a result, 
you are able to retain a great deal more knowledge than would 



ORIGINAL COMMUNICATIONS 347 

otherwise be possible. Your course in dentistry should have 
a similar effect. Many of the subjects taught in dentistry 
have a marked cultural value. You will be ^iveii a slight in- 
sight into the field of natural his-tory. We hope this will stim- 
ulate your interest to progress and investigate this fertile 
field still further. Dentistry at the present time is only in its 
infancy. Many of our methods of practice are still very crude. 
A great field, therefore, is open to you for research, investi- 
gation and discoveries that will make for the advancement of 
civilization. I think you will readily appreciate that the higher 
the degree of perfection you can reach in both the science and 
art of dentistry, the greater will be your opportunity for ren- 
dering comfort and happiness to your fellow men. 

The history of dentistry primarily began with dentistry 
of a preventive nature. The ancient Greeks learned that they 
could ward off certain ailments by the use of medicinal |)i*epar- 
ations. Their imperfect knowledge, however, of medicine and 
the utter impossibility of having every person carry out their 
instructions absolutely, still left many ailments that had to 
be cured. Many centuries later, attention was turned toward 
the restoration of lost parts. This art, possibly, reached its 
climax in the early years of the present century when the 
dental profession aimed at building up crowns, fixed bridges, 
etc., on almost any kind of old root remaining in the mouth. 
Recent research work has shown us quite conclusively that 
many of these old roots have been retained in the patient's 
mouth long after they ceased to be of service and even for 
years after they began to be a menace to their owner's health. 
Nowadays, we feel cpiite certain that the retention of un- 
hejilthy teeth in the mouth is the cause of general systemic 
ailments. Many of these diseased teeth have their origin in 
imperfect substitutes. Our inability to make perfect substi- 
tutes for natural teeth, or even for pai'ts of the natural teeth, 
has driven us to the conclusion that the old adage is right, 
'^An ounce of prevention is worth a pound of cure," conse- 
quently our efforts at the present time must be directed chieHy 
toward the prevention of dental lesions. We will, however, 
be faced for generations to come with the problem of restor- 
ing lost parts. Consequently, it becomes im])erative that the 
restorations which we make must be of a nature that will pre- 
vent further injury. One of the chief aims of modern dentis- 
try is the relief of pain when it occurs. It is our duly, of 
course, to prevent this as much as possible, but it is also our 
privilege to exercise our skill in administering relief to suffer- 



348 DOMINION D-ENTAL JOURNAL 

ing humanity when occasion demands. We must aim chiefly 
at the prevention of dental caries and other lesions of the 
mouth. The restoration oif lost and broken down tissues also 
calls for our serious attention, so that we may restore for our 
patients in a limited degree the functions of mastication, cor- 
rect speech and proper contour of the face. Many sources of 
infection are located in the mouth, either directly associated 
with the teeth, or in adjacent tissues. These are frequently 
the cause of systemic ailments and should be cared for by the 
dentist. By so doing we will have the opportunity of greatly 
improving the health and general comfort of those who come 
under our care. We have referred earlier in our remarks to 
the progress that has been made in medicine toward prevent- 
ing the outbreak of great epidemics which have swept off 
one-third, or even one-half of the population of certain coun- 
tries. One of the best services that can be rendered by mod- 
ern dentists is the prevention of dental troubles. This is be- 
ing accomplished at the present time by the establishment of 
dental clinics which care for the dental welfare of school chil- 
dren and by educational propaganda throughout the length 
and breadth of the land. 

It may be difficult for the student of the first year to grasp 
the relation existing between the studies of the Freshman 
year and the practical use to which they may be put in actual 
practice. Formal education aims at classifying problems so 
that when they are met in our daily experiences, we can more 
readily recall the particular facts that are required for the 
solution of the problems presented to us. For example, many 
people take courses in First Aid to the injured or drowning. 
This is not done with the intention of making a practice of 
rendering such aid, but merely to prepare the person so that, 
in case of emergency, they will more readily be able to call 
up the necessary course of procedure for such emergency. 
Without such a course, they might be able to reason out the 
procedure necessary, but much valuable time would be lost. 
In our daily practice, many difficult problems will arise that 
we have never met in our course at college, but the very fact 
that we have learned the fundamentals upon which the solu- 
tion of these problems is based enables us to overcome our 
difficulties much more readily and more efficiently than would 
otherwise be the case. Your time, after you graduate, will 
be much more valuable to you than it is at the present, and, 
perhaps, when it is too late you will begin to feel the need of 
the fundamental subjects which are covered in the First year. 



ORIGINAL COMMUNICATIONS 349 

I would strongly advise, therefore, that you make the best 
possible use of your time so that it will not be necessary for 
you to take more valuable time later on in your career, to 
learn work which you should have covered in the early years 
of your course. 

Our education is acquired from many different sources. 
The Church, at one time, was the only source of formal edu- 
cation and this reached but a limited class of people, namely, 
the priesthood. With the advancement of printing and the 
more general spread of learning, the masses began to demand 
some share in the advantages to be received from learning, 
oonsequently our schools and colleges have been formed and 
so much interest taken in the education of the public that it 
has become a State proposition up to a certain age. Just why 
the State should drop education of the public at any particu- 
lar age is a subject of considerable debate, and I believe that 
the present Minister of Education is making a careful survey 
of our educational problems with a view of improving the situ- 
ation. It may be that, instead of making education compul- 
sory up to fourteen years of age, it should be raised to 
possibly seventeen or eighteen years, or even higher. The 
introduction of machinery has made the division of labor so 
complex that the education acquired in a vocational way dur- 
ing the apprenticeship of mechanics has been largely abolished. 
The result has been the establishment of technical schools for 
the education of those who have not had a long enough period 
of formal education in their younger days. Night classes 
have been established for the teaching of many things which 
were formerly passed on from master mechanic to apprentice 
during the long period spent in learning a vocation. The home 
always has, always should, and, I hope, always will play an 
important part in the education of our youth. The modern 
tendency seems to be to delegate a good many of the things 
that should be taught in the home to the school and the church, 
but it is utterly impossible to exert the same influences there 
in the brief period spent in these institutions that can be 
brought to bear on the young minds in the home. Many other 
institutions, such as our public libraries, Fanners' Institutes 
and Women's Clubs, aim at educating the general public in 
some degree. It would seem, therefore, that the attitude of 
the people demands a higher standard of education, and we 
trust that the Department of Education will be able to solve 
the problem satisfactorily. Only a few years have elapsed 
since the teaching of dentistry has been taken over entirely 



350 DOMINION DBNTAL JOURNAL 

by the schools of denttstr3\ Formerly, a student indentured 
with a graduate practitioner who taught him some of the 
practical sides of his profession during the vacations between 
college sessions. This was very similar to the appreniticeships 
spent by tradesmen with their master mechanics. This, how- 
ever, has been abolished and the full course is now given by 
an institution which makes teaching its business. 

There are three main views held in regard to the purpose 
of ihe school. These are the civil, the individualistic and the 
social or eclectic views. Those who maintain that the civil 
view is correct are divided into two classes. The first class 
claim that the school should conserve for the future the in- 
teliedtual and moral achievement of the pre'sent and past. It 
requires only a limited number of scholars to guide the whole 
community. This is known as the aristocratic view. The 
democratic view maintains that a chain cannot be stronger 
than its weakest link, therefore everv^ individual should be 
made an intelligent and consequently a more useful member 
of society. It will readily be seen that both these views aim 
at public education for the benefit of the State. Those who 
hold the individualistic views are divided into three classes. 
The first of these maintain that the possession of conventional 
knowledge gives polish to the individual; that this polish 
raises the individual in social standing, consequently, the 
learned classes are separated from the ignorant. This is 
known as the cultural aim. According to the utilitarian aim, 
the school should aid the individual to gelt on in the world. 
Advancement in comfort of the individual implies an increase 
in the comfort of society, so that, if every person were edu- 
cated to the point where they could make a comfortable liv- 
ing for themselves, society would not be burdened with the 
indigent poor, who too frequently become a menace. The 
third aim, known as the psychological, maintains that man is 
born with certain attributes which are at first potential, but 
which may be developed into actual powers. The true aim 
of education then is to unfold this potenltial life of each in- 
dividual so as to allow it to realize itself. There are, how- 
ever, certain limitations to such an objective. Certain people 
show a tendency to lie, steal, or exhibit other undesirable qual- 
ities. Whether these are the result of heredity or environ- 
ment is, I presume, a debatable question. If they are inher- 
ited, then the less they are developed the better for humanity. 
This would imply then that only those desirable qualities 
should be developed from their potential state into actual 



ORIGINAL COMMUNICATIONS 351 

powers. Those who hold the social view maintain that the 
good of the individual can never be oi)posed in reality to the 
good of humanity. The suppression of undesirable tenden- 
cies by education and the development of desirable qualities 
by the same methods, not only improves the individual, but 
also all society. This view is dynamic. While the education 
of the individual enables him to make more of his own higher 
nature, it also makes it possible for him to contribute some- 
thing for the elevation of society. We must remember that 
man is truly moral only when moral character is functioning 
in right action. It is not sufficient that his character be merely 
passive. It must exert its influence in an active manner. 

In conclusion let me say that no single view seems entirely 
sufficient. There is a certain amount of good in each of them. 
Unfortunately, the utilitarian view is too frequently the main 
one. On this side of the Atlantic, our lives are so full of the 
hurry and rushing after the almighty dollar that we have no 
time to develop those higher (pialities which make for the cul- 
tuie and refinement of the graduate of some of the univer- 
sities of the Old Land. The utilitarian view leads to selfish- 
nejis. You may read ''Brother Bill's Letters" and ''Profit 
able Practice," if you wish. They are cold business talks, 
but contain little in them that is humanitarian. Of course, 
there is the business side to professional life. We owe to those 
who are closely associated with us in the making of a home 
and to those who may be dependent upon us, even more than 
we owe those who place their dental welfare under our care. 
Some maintain that the business side of our i)ractice is the 
one that concerns us chiefly. Others have stated that our 
first consideration is the welfare of our patients, regardless 
of what remuneration we may receive for our efforts. Per- 
sonally, I believe, our aim should be to render to our fellow 
men the best service that we can possibly give them and, in 
return for this, we have a perfect right to look after the busi- 
ness side of the question, to the point where we may demand 
and make sure that we receive adequate remuneration for the 
service we have rendered. 

I should like to draw your attention to the responsibility 
which rests upon the faculty in protecting the public against 
unskilled or obsolete methods of practice. It is their duty to 
graduate, so far as this can be accomplished, men and women 
who will not only have knowledge and skill when they leave 
here, but will also have that right feeling toward their fellow 
men, which calls forth their best effoi-'ts. Our graduates must 



352 DOMINION DENTAL JOURNAI, 

also be of the class that we may expect will continue 
as students throughout their entire life. Both the science and 
art of dentistry are making such rapid progress that, unless 
one makes an effort to keep pace with the advancement, he 
will be considered behind the times three years after his grad- 
uation. The faculty must aim, therefore, at developing cul- 
tured and refined men and women who possess sufficient 
knowledge and skill in their profession and are animated by 
the desire to improve the welfare of their community. You 
have made a momentous decision to-day. It will either make 
or mar the future joy and happiness of yourself and those 
intimately associated with you, and will do much for the im- 
provement or de&truction of the comfort, health and happi- 
ness of those who may subject themselves to your prof e&si'onal 
care. If there are any in the room who have entered this class 
for purely mercenary reasons, I hope you will make applica- 
tion at the office first thing in the morning for the return of 
your fees. If, however, you are entering the profession of 
dentistry with a view to increasing your own joy and happi- 
ness, as well as that of your fellow men, I know of no voca- 
tion which offers better opportunities as a medium for leading 
a worthy life than the one you have chosen. 



ORIGINAL COMMUNICATIONS 353 

PORCELAIN 



Douglas Gabell, Glasgow, Scotland. 



The shrinkage of packed porcelain powder when first fused 
has nothing to do with the co-efficient of expansion and con- 
traction of porcelain by heat, but is due to the closer packing 
together of the porcelain particles. It is a weak force, occurs 
whilst the porcelain is plastic, and is very large in amount; 
the mass shrinks one-third in bulk. 

It is due to surface tension between the fluid and flux and 
the infusible particles of the porcelain, and will vary in force 
and speed with the fluidity of the flux, which depends upon its 
quantity, composition, and temperature, and upon the size, 
condition, and composition of the infusible powder. These 
conditions vary much in different porcelains and give each its 
peculiar working properties. 

The co-efficient of expansion and contraction for porcelain 
is very small, and about one-thousandth in length for each 100 
degrees C, but it is a very powerful force, strong enough to 
break the porcelain itself, and occurs partly after the porce- 
lain has lost its plasticity. I have not investigated the amount 
of this co-efficient of expansion and contraction. I am more 
concerned with the shrinkage that occurs when the powder i-s 
first fused. 

Dry porcelain powder does not pack closely; the addition 
of water or alcohol at once draws the particles closer together ; 
thorough jolting, while wet, is the best method of condensing 
the powder; pressure on the surface is of very little help. The 
very fine powders do not pack so well as the slightly coarser 
ones. The different makes of porcelain differ slightly (5 per 
cent.) in the closeness with which the particles can be packed, 
and in the time it takes to get the best condensation. The 
slight variation in the amount of shrinkage between the differ- 
ent makes depends on this more than upon their fusibility. 

Moderately condensed powder will fuse to as solid a result 
as tightly packed powder, but there will be greater shrinkage 
of the former and more liability to cracking, distortion, and 
accidental staining. 

The powders consist of a mixture of easily fusible flux and 
less fusible particles, and a temperature sufficient to melt the 
flux will cause the full amount of shrinkage if sufficient time 
is allowed for the particles to be drawn together. 



354 DOMINION DENTAL JOURNAL 

All the porcelains on the market can be fused at several 
degrees below their advertised fusing points if given a quarter 
of an hour to consolidate. Longer time or greater temperature 
than the minimum necessary will weaken the porcelain and 
cause it to expand by the formation of minute bubbles within. 

AVhen porcelain has to be fused in several fusings, it has 
been advised to "biscuit" it only at first, and fully fuse at the 
last The "biscuit" stage is a wide one for most porcelains, 
reaching from the stage when the flux first softens and binds 
the mass lightly, with little shrinkage, to the stage when the 
fluid flux has drawn the particles together and eliminated all 
porosity and the porcelain is fully shrunk, and is at its great- 
est strength, but still unglazed. 

The first bake should be carried almost to this latter stage, 
when practically all the shrinkage h'as taken place, but just 
enough porosity remains to draw the new powder into close 
contact with the already fused mass. 

T have made many rods of porcelain, equally well packed, 
as tested by weighing wet and dry, and have fused them at 
different temperatures and for various times, and I find that 
the strongest are those with the highest specific gravity (as 
each porcelain varies in weight, comparisons must be only 
made between the same porcelain diiferently used), that they 
all fuse soundly before the surface glazes, and that further 
heating weakens them. All porcelain work, w^here the fusing 
is judged by the eye, is therefore over-fused so far as stolidity 
and strength are concerned. Repeated fusing weakens some 
porcelains, any bubbles increasing with the fuse. Although 
the various makes of porcelain vary greatly in specific gravity, 
yet, they vary greatly in tensile strength when well worked, 
though two makes (Rose's and Ash's high fusing) I have 
never been able to bring up to the strength of the others, and 
both show much porosity. (See notes 3 and 4). 

There is no way of preventing the shrinkage from either 
cooling or the running together of the powder, but if their 
action is understood, much can be done to direct the effects so 
as to render it harmless to the work. 

In the first place, if an intentional or accidental crack, or 
even a sheet of lesser condensed powder exists in the mass 
before fusing, then it is certain that this flaw will widen when 
the powder fuses, the material drawing off* on either side. 

In a surface of platinum, porcelain, or Price's artificial 
stone (note 5), has porcelain well packed against it on fusing, 
and whilst plastic it will tend to draw towards that surface 



ORIGINAL COMMUNICATIONS 355 

and will exert only a very li^lit bending stress on it. But as 
the porcelain cools after solidifying, a very small but very 
powerful bending stress occurs if the support does not con- 
tract at the same rate. Artificial, stone shrinks less than porce- 
lain, and must not, therefore, be allowed to perform a well 
fitting internal supi)ort to a bulk of porcelain, or the latter will 
crack. Or if the contraction is within the elastic limits of the 
porcelain, then it will so firmly grasp the stone that the two 
are very difficult to part. 

Shellac varnish, the Dental Manufacturing Com|)any's 
investment powder (this last must not be exposed to moisture 
unless well varnished), and flexible collodion are useful means 
of preventing adhesion where it is undesirable, and are use- 
ful additions to the deep scorinig of the powder in order to 
prevent disturbance of the teeth when adding the i>orcelain 
gum. 

With such aids it is possible to do continuous gum work 
without fixing the teeth by soldering, and the use of platinum 
can be dispensed with. 

When platinum foil is used for a base, it is very important 
to have it perfectly clean and quite free from creases, as any 
dirt or air bubbles will cause a hole in the work and spoil the 
surface of the porcelain when the foil is stripped. This may 
be an advantage in inlav work, but it is fatal to cleanabilitv in 
prosthetic work. Platinum gauze very markedly darkens the 
color of the porcelain body in which it is enclosed. 

Porcelain is not strong enough to bear tensile or bending 
stresses, though quite able to withstand enormous crushing 
stresses, so that the large work must have a rigid strong base 
to support it, and this may be of gold or vulcanite, or have an 
internal skeleton of platinum sufficiently strong to resist all 
tensile and bending stresses, the porcelain only being trusted 
to oppose compressing strains. The principle of ferro-con- 
crete work may be applied to platinum-porcelain structures. 
The co-efficient of contraction of platinum is verj' slightly 
greater than porcelain. 

Different porcelains vary in their ability to hold together 
during the first fuse, and this does not depend entirely on their 
liability to shrink, but also on their plasticity while hot. The 
subject is a complicated one to investigate, for the liability to 
fissure depends greatly on the thoroughness and evenness of 
the packing of the powder, the shape and bulk of the work, the 
nature and extent of the surrounding support, the temperature 



356 ORIGINAL COMMUNICATIONS 

and duration of the heating, as well as on the nature of the 
powder. 

I believe the Dental Manufacturing Company's porcelain 
holds together better than the S.S.W. porcelain, and is there- 
fore more useful for prosthetic work. The S.S.W. stands as 
carved even too well for prosthetic work. 

On the other hand, a porcelain that becomes very fluid has 
a great tendency to ^'bair' up, and thus both lose its shape and 
distort its supports. Obviously the low-fusing porcelains are 
more affected by, say, 100 degrees F. of overheating, and are 
thus more liable to be damaged, but porcelains of the same 
fusing points differ in their resistance to over-fusing. 

Firm packing in investment powder is a great protection 
against this distortion from undue fluidity, and should very 
seldom be omitted. Working at exact low temperature for a 
quarter of an hour is also a great safeguard, especially when 
there is no metal or stone base. 

Some porcelain, when spread over quite a wide sur'face in 
a moderately thin layer, will be sufficiently held by it to pre- 
vent all but a very slight contraction in either length or width, 
the whole of the shrinking occurring in the thickness, and this 
is more likely to happen successfully if the porcelain is firmly 
buried under a very fine and indifferent investment. Other 
porcelains are not sufficiently plastic when fused and break 
into several small sheets. A convex surface layer will crack 
much more readily than a flat or concave layer. 

Ash's investment powder slightly retards the heating and 
leaves the work with a rough surface. 

The Dental Manufacturing Company's investment powder 
has less retarding influence on the heating, and if carefully 
used can be made to produce a glazed surface on the work. 

Porcelain long exposed to heat in an open and porous fur- 
nace is liable to deteriorate from lo>ss of the flux, but when 
buried in an investing powder in a glazed crucible this is pre- 
vented and the work is better fused. Also, the heating is more 
even and the annealing more perfect, and considerable time 
can be saved when much work has to be done. 
The functions of gum enamels are : 

(1) To give a natural appearance. 

(2) To give a self -cleansing surface. 

The two are not quite compatible, because a high gloss is 
essential for the latter and not quite suitable for the former 
At the back of the mouth the second function is far more im- 
portant. 



ORIGINAL COMMUNICATIONS 357 

The enamels may be heated for a long time at a low tem- 
perature, or fused quickly at a higher one ; if the latter method 
is used, there is a risk of spheroiding the already fused body 
unless there is a big difference in their fusing points. 

Gum enamel should adhere well to the body porcelain, have 
the same co-efficient of expansion, and not tend to warp ut; 
the body. 

The various makes also vary as to translucency, bleaching 
under heat, readiness of flow, and coarseness of grit. 

Ash's high and low fusing gums, some low-fusing gums of 
the Dental Manufacturing Company, and Jenkins' prosthetic 
are about the only enamels that can be used with English teeth. 
They are all very opaque and lifeless, resist bleaching well, 
and give a fairly good surface, but the range of colors is very 
poor. For American teeth, and where a temperature of 1,600 
degrees F. may be used for five minutes with safety, one may 
use the Dental Manufacturing Company's enamels, which are 
made up in five shades, and, moreover, are translucent, so that 
the color of the foundation also tints the enamels (they have 
an intentionally granular surface, do not warp the body, but 
are readily bleached by overheating), or the S.S.W. medium 
fusing enamel, which has a brilliant smooth surface, retains 
any carving well and is sufficiently translucent and not very 
readily bleached. 

For 1,800 degrees F., the S.S.W. 92 enamel is very good, 
but very apt to w^arm its base. Allen's enamel requires 2,000 
degrees F. for ten minutes to fuse it, and it warps badly. 

The use of a small adjustable sliding resistance between 
the main resistance and the furnace, having a total resistance 
greater than the difference between the buttons on the large 
resistance, will enable the operator to keep the furnace con- 
stant at any temperature for any length of time, and is a very 
great help to accurate work, and saves a lot of watching. 
Also, it soon becomes very useful on the working of the pyro- 
meter. 

On my own furnace, as fitted with internal crucible, the 
temperatures are as on the small note for the different pegs. 

A small Lorch 1^-inch centre lathe wdth the side rest and 
milling attachment, is a very useful instrument for accurately 
fitting down large porcelain blocks to the gold plate ; for rapid- 
ly drilling parallel holes in the porcelain with small diamond 
drills, and for quickly making posts to fit exactly any hole. 

It can also be used for drilling the holes in the gold plate 



358 DOMINION DENTAL JOURNAL 

exactly opposite and in a true direction with the holes in the 
porcelain. 

Hollow posts with an internal screw thread for fixing the 
work to the plate (gold or vulcanite) can easily be made, and 
thus the porcelain work be made easily removable for repair, 
and the great risk of fracture whilst vulcanizing be avoided. 

In conclusion, I should like to mention a few applications 
of porcelain work which I think are of practical utility. 

By always exposing the work to the heat for a quarter of 
an hour, much lower temperatures are needed, a great econ- 
omy in the wear of the furnace is effected, and it is easy to 
work on English teeth with Jenkins' prosthetic, Ash's founda- 
tion, low and high fusing, and the Dental Manufacturing Com- 
pany's medium and high fusing porcelain. The Dental Manu- 
facturing Company's foundation and the S.S.W.'s high-fusing 
porcelains must also be used, but one is then perilously near 
to the bleaching point in English teeth, and a very small error 
may ruin the work when it is almost finished. 

I prefer Ash's foundation for English teeth, and the Den- 
tal Manufacturing Company's foundation for American teeth, 
working at 1,600 degrees and 1,700 degrees F., respectively. 
Ash's gum enamel is very dark in color, but endures overheat- 
ing well; the Dental Manufacturing Company's gum enamels 
are purposely made to give a granular and not a highly polish- 
ed surface, which I regret; the S.S.W. gum enamels give very 
clean surfaces. 

English tube work and dowel crowns mounted on gold 
plates can be verj much improved with little trouble by the 
addition of continuous gum. 

The spaces between the teeth can be cleanly filled, the 
natural contour of the gnims restored, short and very long 
teeth may be safely employed when attached to each other 
laterally, and the appearanoe of the denture is much improved 
as well as its oleanableness. 

The six should not thus be united if there is a heavy bite 
on their lingual sloping surfaces, for fracture will be sure to 
occur under such a strain. Metal-backed teeth are the only 
means of dealing with s'uch cases. 



ORIGINAL COMMUNICATIONS 359 

CASES OF FOCAL INFECTION 



W. A. Black, M.A., D.D.S., Toronto. 



October 1st, 1919. 

Case 1.— In 1917, a Mrs. C, a^e about fifty, was referred 
to nae for treatment. She was suffering from neuritis in her 
right arm, and could not raise it without pain. Her mouth 
was full of ill-fitting crowns and bridgework, and radiographs 
showed ten areas at the apices of teeth. 

I first of all removed all bridge work, and a marked im- 
provement followed. Six of the infected teeth were extracted 
and the sockets curretted, and the remaining four teeth 
treated. All symptoms of discomfort disapi)eared. In about 
six weeks she returned, complaining that her left ankle was 
badly swollen. The four teeth that had been treated were 
again radiographed, and as two of them still looked bad, they 
were extracted and replaced by bridgework. Since that time 
the patient has suffered no return of the trouble. 

Case 2.— While in Halifax recently. Dr. Frank Woodbury 
called me in to see a case of his son's. Dr. Karl Woodbury. 
The patient, a young lady of about thirty, who had been suf- 
fering for a period of some two years with wry neck and with 
a sense of numbness from the ramus of the jaw to the sym- 
physis on the left side. The radiograph showed a small area 
at the apex of the lower left second bicuspid in which a small 
synthetic filling had been inserted. We all agreed that this 
tooth should be removed, and the patient reluctantly gave 
consent. Dr. Woodbury writes me that all the numbness has 
since disappeared and that the stiffness in her neck has nearly 
gone and a full recovery is expected. 

Case 3.— Mrs. E., a lady about fifty years of age. She had 
been suffering for some months with a very painful stiff knee 
joint. I radiographed all her teeth. Most of the upper ones 
were infected, and a large amount of absorption had taken 
place from over-strain due to bridgework. The lower teeth 
showed no areas. The upper teeth were all extracted. The 
knee condition became worse for two or three days. A few 
davs later she informed me she had walked downstairs with- 
out any discomfort for the first time in months. 

Case 4. — ^A lady of about forty complained of rheumatic 
conditions in hip joints and lumbar region, which had troubled 
her for some months, and she could not sit long enough for 
the radiograph of her complete mouth, but was compelled to 



360 DOMINION DENTAL JOURNAL 

get up and walk around between exposures. The radiographs 
showed small areas at apices of five crowned teeth and a large 
pocket at the mesial root of a second lower molar that had 
been implanted three years previously. The five crowned 
teeth were extracted, also the lower implanted molar. Two 
days later she said she had had the most comfortable day in 
months, and could sit for two hours without discomfort. 



DENTISTRY IN GREAT BRITAIN AS FOUND BY 
A COMMITTEE OF THE HOUSE 
OF COMMONS 



(Continued from September Issue.) 

''Of 43 replies received by the association as many as 
37 laid particular stress on the production of chronic gas- 
tritis and indigestion as arising from the effects of inferior 
dentistry and the loss of natural dentition. ' ' 

Appkoved Societies undek the "" National Insubance 

Act, 1911/' 

56. Our attention had been directed to the following para- 
graph in the report of the ''Department Committee on Sick- 
ness Benefit Claims'' [Cd. 7687] : 

"193. ... It is stated that the absence of any pro\T^sion 
for dental treatment — which, it may be observed, is a possible 
additional benefit in the event of a society realising a sur- 
plus— has produced much sickness of various kinds resulting 
in a drain of sickness benefit funds, which would have been 
avoided had there been provision for the treatment of teeth. 
Inattention of teeth results in certain cases in prolonged 
gastric illnesses, and in a very large group of cases, on which 
benefit is being paid, no permanent cure is possible until the 
teeth have been attended to. Even in the event of decayed 
teeth being removed, there is ground for believing that there 
is no sufficient means by which artificial dentures can be sup- 
plied to insure persons, either gratuitously or at a reduced 
cost." 

57. In view of this opinion we sent a circular letter of in- 
quiry to a number of approved societies accompanied by a 
"questionnaire." Two of the "questions were in the following 
terms : 

"1. Have you had cases brought to your notice in which 
neglect of teeth trouble has led to ill-health?" 



SELECTIONS. 361 

2. In particular has your attention been directed to the 
following diseases being attributed to or aggravated by de- 
fective teeth? 

(a) Anaemia. 

(b) Gastric troubles. > 

(c) Debility. 

(d) Tonsillitis. 

(e) Neurasthenia. 
(/) Rheumatism.^' 

The replies received to these questions afford strong 
ground for believing that much ill-health leading in many 
cases to chronic invalidity is to be ascribed directly or in- 
directly to dental neglect. 

58. The following are some of the opinions expressed in 
the replies received by the Committee : 

Prudential Approved Societies (Membership, 3,000,000). 

The following sums up generally the opinions of sev- ^ 
eral of our medical referees who have examined some thous- 
ands of cases for us in all parts of England. 

Neglect of teeth trouble is the cause of quite half of the ill- 
health found among the industrial classes, and of these a large 
majority in young women. 

The chief sequela.^ of dental caries and oral sepsis are found 
to be (in the following order of importance) : 

(a) Generail debility (the starting point). 

(b) Anaemia (especially in young women). 

(c) Rheumatism, including premature senility, myocardiac 
and arterial degeneration (in older people, especially 
men). 

(d) Gastric troubles, including chronic gastritis and ulcer, 
appendicitis and chronic constipation. 

(e) Neurasthenia. 

These conditions (a—e) often co-exist, in fact, as a rule two 
or more of them are present in all cases and it is rare to find 
a patient suffering from oral sepsis who is not also neuras- 
thenic to a greater or lesser degree. 

Tonsillitis is not found to be a common sequela of dental 
caries, and one is inclined to remove the disease from the list; 
on the other hand a large number of diseases of auto-intoxi- 
cation, such as Graves's disease, must undoubtedly count oral 
sepsis as an etiological factor in their incidence. 

The opinion is also expressed that there can be no doubt 
that there are thousands of persons receiving sickness benefit 



362 DOMINION DENTAL JOURNAL 

who would not be doing so had they received proper dental 
treatment. 

National Federation of Women Workers 
(Membership 20,000). 

The absence of provision for Dental Treatment under the 
National Health Insurance Act has resulted in many claims 
upon the Sickness Benefit Funds of the Society. Many claims 
would never had been made, while a still larger percentage 
have been prolonged in duration by the fact that the mem- 
ber has been unable to obtain dental treatment prescribed as 
necessary by the panel doctors. 

Anaemia, gastric troubles, rheumatism, debility, tonsillitis, 
neurasthenia, can, according to the panel doctors, be traced 
to the need of dental tre'atment, and cases have been aggra- 
vated by inability to obtain it ; cases of anaemia, gastric trouble, 
and rheumatism being specially prominent. ' ' 

Domestic Workers^ Friendly Society 
(Membership — women only, 63,000). 

The following replies were received to the two questions 
asked by the Committee : 

Question 1.— Yes, repeatedly. As this Society ascertain- 
ed by independent valuation that it would have a substantial 
surplus, grants have been made to the Domestic Servants' 
Association to provide its members with free dental treat- 
ment, including the supply of new dentures at half cost. 

A number of patients, after the completion of dental treat- 
ment, have stated that they have been much improved in health 
thereby. Many of these had been undergoing medical treat- 
ment for various complaints, but stated that this only gave 
temporary relief. 

Question 2. — The diseases mentioned in this list are those 
most commonly met with as being caused or aggravated by 
an unhealthy condition of the mouth. Our members, owing 
to the nature of their occupation, are peculiarly liable to 
gastric trouble and carious teeth. Many apply for dental 
treatment on the advice of the doctors, in order to bring about 
the cure or relief of these complaints. 

Insurance Committee under the National 
Insurance Act, 1911. 
59. The Committee sent a letter of inquiry (Para. 57) to 
representative Insurance Committees similar to that sent to 
Approved Societies. Insurance Committees administer San- 



SELECTIONS. 363 

atorium Benefit, and the reply received from London dealt 
with the relationship between tuberculosis and neglected den- 
tal decay. 

^'I am directed to state that there is a deiinite rehition 
between 'un-cared for' mouths and pulmonary tubercul- 
osis. Unsound teeth and septic conditions of the mouth pre- 
dispose to tuberculous infection and render recovery more 
difficult when the disease exists. The experience of the San- 
atorium Benefit Sub-Committee is that very many con- 
sumptives reconmiended for benefit have need for dental 
treatment." 

60. At the sugo-estion of the London Insurance Committee 
we invited the Medical Adviser of the Conmiittee, Dr. Xoel D. 
Bardswell, ^I.V.O., to supply us with further information on 
the subject. Dr. Bardswell, in his reply, expressed the follow- 
ing opinion : 

*^My experience as Medical Adviser to the L.I.C. is that 
amongst consumptives of the working classes, deficient den- 
tistry and septic mouths are very commonly met with. 
These conditions prejudice the prospects of recovery, and 
almost certainly are a predisposing factor to infection with 
tuberculosis. Further, that in my judgment provision of 
efficient dental treatment of this class of the community is 
quite inadequate. At the same time I would say that the 
lack of facilities for dental treatment does not entirely 
account for the kind of mouths that I so constantly see. 
Ignorance and indifference as to the care of the teeth is a 
large factor." 

61. The Aberdeenshire Panel Committee, the County of 
Durnham Insurance Committee, the Birmingham Panel Com- 
mittee and the Edinburgh Insurance Committee all stated 
that cases had been brought to their notice in which neglect 
of teeth trouble has led to ill-health, and they all agreed that 
the disease mentioned in Question No. 2 were attributed to or 
aggravated by defective teeth. 

62. The Manchester Insurance Conimititee ciroulated a 
copy of the ^'questionnaire" to every doctor of the *' panel" 
and furnished us with 115 replies. With very few exceptions 
th replies to Question 2 (a-f) were wholly or partly in the 
affirmative. Some of the replies expressed veiy strongly the 
writers' opinion that much sickness was due directly to want 
of teeth. The replies read as a whole leave no doubt in the 
reader's mind that a large amount of preventable illness 



364 DOMINION DENTAL JOURNAL 

among insured persons in Manchester is to be ascribed to 
neglected teeth. 

Medical Officers of Health. 

63. The evidence we obtained from approved societies and 
insurance committees was confirmed by that of the Medical 
Officers of Health who gave evidence before us. Dr. Robertson 
in particular stated : 

''I do not think that anybody who has for their life's work 
the preservation of the health of the people generally can fail 
to be impressed with the large amount of harm that is done 
by defective dentition at the present time.'' 

And in speaking of the masses of the people of Birming- 
ham he added : 

^^In dealing with those masses, I have no hesitation in say- 
ing that neglect of teeth is everywhere evident. That is an 
opinion of which you cannot get very good evidence, but I feel 
very strongly all the same that real damage to health is done 
by the condition one finds in all the masses. Life is shortened 
and probably minor ailments are produced and these induce 
other diseases ; so that although you do not get a man dying 
from something wrong with his teeth, you get him dying from 
tuberculosis or pneumonia or bronchitis, or anything else at 
an ear^lier age than he otherwise would have died at, by reason 
of the fact of the defective condition of his teeth. It is -a de- 
bilitating condition. ' ' 

64. Dr. Robertson further informed us that the Birming- 
ham City Council had appointed a dentist in connection with 
the tuberculosis work organized by the Council, as it had been 
found that many tuberculosis cases have bad teeth— more so 
than the average population — and he regarded the defective 
teeth of young adults as one of the debilitating causes which 
induced tuberculosis. He regarded it as quite likely that the 
tubercle bacilli gained access to the throat through defective 
teeth, and it was only by having the teeth attended to that the 
real benefit from sanatorium treatment became available. As 
regards the relationship existing between bad teeth and var- 
ious forms of intestinal sepsis and internal disorders, which 
were becoming more prevailent in Birmingham, Dr. Robertson 
was of opinion that these diseases 

^'Are unduly prevalent. I am sorry to say that colitis, 
appendicitis, duodenal ulcer, and various things like that (of 
which we do hot know the causes at the present time, but may 
be due to defective teeth) are really becoming more prevalent; 
they are not only becoming better known, but more prevalent. ' ' 



SELECTIONS. 365 

Board of Education 

65. Sir George Newman, K.C.B., the Chief Medical Officer 
of the Board of Education, in a memorandum to the Com- 
mittee refers to the results of dental decay in children in th- 
following terms: 

^^The gravamen of dental defect is its secondary result. 
Dental sepsis is associated with four effects— (i) tooth caries, 
(ii) periodental inflammation (pyorrhoea), (iii) conditions due 
to dead teeth or irregularities or abnormalities of denture, 
(iv) the collection of tartar and muco-purulent matter in the 
denture. Obviously, these conditions vary widely in degree 
and prevalence. Here, too, the gravity of the condition is its 
secondary result, the absorption of toxine and so forth. 

The principal secondary results of dentail disease in child- 
ren, often appearing subsequently, are as follows • 

(a) The inflammation, pyorrhoea, and ulceration of the 
gums, leading to diseased condition of the mouth and 
to glandular infection. Many medical and dental 
authorities hold that even tuberculous infection may be 
established in this way. 

(b) General malaise of the child, tiredness, lassitude, de- 
pression—in fact, a toxic neurasthenia. 

(c) A group of microbic intoxications which in some cases 
lead to joint affections stimulating rheumatism in its 
symptons. 

(d) Various forms of anaemia. 

(e) There are a group of somewhat mysterious and remote 
results of dental disease which leave their mark on 

the skin (acne, urticaria, eczema, etc.) affect the eyes 
(recurring iritis) or ears and dispose to nervous dis- 
orders. 

(/) There is a large group of alimentary toxaemia or gas- 
tro-intestinal conditions traceable to continued dental 
sepsis. 

Miscellaneous. 

66. The evidence we received from medical sources, or 
derived indirectly from medical sources, was strongly confirm- 
ed by Mr. W. C. Anderson, M.P. Referring to the present 
inadequate school dental treatment, he stated that this neglect 
in childhood especially has cumulative results. He was in- 
formed that many of the approved societies were quite con- 
vinced that the drain on their funds would be diminished very 



366 DOMINION DENTAL JOURNAL 

much if there was adequate dental treatment for adults. He 
very strongly represented to us that if the nation spent its 
money in providing dental treatment it would be an economical 
investment. In Mr. Anderson's words: 

"The nation would get it back in respect to good health, 
better workmanship, better work, less sickness, and so on, all 
of which surely are vital to the nation." 

67. In a memorandum we have received from the Army 
Council as to the condition of the teeth of recruits joining the 
army, the following extract from the report from the Southern 
Command indicates the close relationship of general illness 
with dental defect : 

"The loss of man power to the State owing to defective 
dentition can best be gauged from a comparison of medical 
and surgical cases in hospital. It will be noticed that men 
returning sick show 25.4 carious teeth, as compared with 6.4 
only of wounded, and 4 sound teeth only as compared with 17.6. 
Of the 304 medical cases examined, 160 are according to the 
Medical Officers, suffering from troubles directly attributable 
to defective teeth, e.g., gastritis and indigestion, and from 
60-70 from troubles indirectly so attributable ; e.g., rheumatoid 
arthritis, rheumatism, etc. 

It is noteworthy that more than 50 per cent, of the medical 
cases were suffering from sickness of a kind directly or in- 
directly attributed to defective teeth. This percentage is in 
agreement with some of the evidence submitted by approved 
societies. 

(Continued in November Issue.) 



UKXTAL SOCIKTIHS 367 

Dental Societies 



DOMINION DENTAL COUNCIL OF CANADA 
PROFESSIONAL EXAMINATIONS, 1919 



ANAESTHETICS. 

EXAMINER : W. B. STEAD, D.D.S. 
Value Question 

10 (.— (a) What j)rcparation should a patient receive be- 
fore taking- a general anaesthetic? 

(b) What drugs would you prescribe for a \'ery ner- 
vous patient in order to facilitate a tranquil anaes- 
thesia? 

(c) What dangers, in the nature of accidents, not 
due to the anesthetic, are to be guarded against in 
the administration of a general anaesthetic f 

10 2.— (a) Is N^O a safe anasthetic from a physiological 
standpoint? State why. 
(b) How are the circulatory, and respiratory sys- 
tems afPected? 
10 3. — Describe the stages of ether narcosis. From what 
dangerous dey^th of narcosis is it possible to rr-siore 



a pati 



p^ 



9 



10 4. — Describe in detail a method of artificial respiration. 
Mention stimulants used in conjunction with arti- 
ficial respiration. 

10 5. — Describe the effects of chloroform on the respira- 
tory, circulatory, and nervous systems. 

10 6. — Discuss the advantages, or disadvantages, of local 
anasthesia as compared with general anasthesia, in 
operations on the mandible and maxilla, and related 
structures. 

10 7.— (a) What properties should a local anasthetic solu- 
tion possess? 

(b) Discuss the preparation of solution and care of 
instrumentarium. 

(c) What remedies should always be on hand when 
using a local anasthetic, to overcome any un- 
toward effects ? 

10 8.— (a) Describe minutely the technique of injecting the 
inferior dental nerve. Wliat length of needle is 
necessary? 



368 DOMINION DENTAL JOURNAL 

Value Question 

(b) What percentage, and amount, of solu'tion would 
you use? 

(c) What dental operations can you perform, and 
which can you not perform, painlessly, without a 

. supplementary injection! 
10 * 9.— (a) Give in detail, the technique of the injection at 
the Maxillary tuberosity. 

(b) What peculiarity of the anatomy makes this in- 
jection somewhat difficult, and how is this diffi- 
culty overcome? 

(c) What other injection is necessary in order to 
block the nerve supply of the molars, and describe 
the technique of such injection. 

10 10.— What is infiltration anaesthesia? Which teeth are 
favorable for successful infiltration, and why? 

ANATOMY. 

examiner: c. h. weicker, d.d.s., d.d.c. 

12 1.— Give origin, insertion, nerve supply and action of the 

Pterygoid muscles. 
10 2.— Describe the Sub-Lingual Salivary gland and its 

ducts. 
10 3. — What blood vessels supply the Antrum and teeth of 

Superior Maxillary Bone? 
10 4.— Mention the muscles attached to Superior Maxillary 

Bone. 
12 5.— Describe the joint in which the Lower Maxilla works 

and the tissues constituting the joint. 
10 6.— With what bones does the Ethmoid Bone articulate? 
12 7.— Describe : 

(a) The Antrum of Highmore. 

(b) Sphenoidal Fissure. 

14 8.— Describe briefly: 

(a) Inferior Dental Nerve. 

(b) Vidian Nerve. 

10 9.— Name and give the action of the Ocular Muscles. 

DENTAL JURISPRUDENCE AND ETHICS. 

examiner: h. g. dunbar, d.d.s. 

15 1. — Define: Injunction, Negligence, Damages, Rescis- 

sion, Contributary negligence. Ethics, Waiver of 
privilege. 
15 2. — Discuss briefly: 



DExMTAL SOCIETIES. 369 

Value Question 

(a) Liability of parent. 

(b) Liability of husband. 

(c) Effect of malpractice on liability. 

15 3.— Under what conditions is a practitioner liable for 
resultino- damages in the administration of a gen- 
eral anaesthetic? 

15 4.— (a) Give five most important clauses in code of 
ethics. 

(b) How do you propose handling the application of 
' the colored populace for dental services? 

10 5.— Distinguish between ordinary and expert evidence. 

10 6.— What requirements do the most usual fonn of statute 
provide as a prerequisite to the right to practice 
dentistry? 

10 7.— Enumerate some of the grounds for revocation of a 
license by the board issuing same. 

10 8.— Give examples of '^unprofessional conduct.'' 

CHEMISTRY AND PHYSICS. 

examiner: harry s. Thomson, d.m.d. 

10 1.— Write explanatory notes on the following: 

(a) The law of multiple proportions. 

(b) Supersaturated Solution. 

(c) Oxidation and reduction. 

(d) Molecular weight. 

10 2.— Write the reactions for the following: 

The making of Sodium Carbonate from Common 
Salt. 

The making of Magnesium Oxide. 

The making of Iron Sulphide. 

The making of Silver Nitrate. 

The making of Oxygen (draw apparatus). 
10 3.— Compare Methyl Alcohol and Ethyl Alcohol as to 

(a) Methods of preparation; (b) Physical proper- 
ties; (c) Physiological action; (d) Reactions with 
metallic sodium; (e) Oxidation products. 

10 4.— Describe Mercury. State some of its general uses. 

(b) How may it act as an irritant poison, (c) AMiat 
precautions should be observed for its safety. 

10 5.— Explain the chemical composition of the various 
parts of the tooth structure, (b) and the changes that 
take place during the disintegration of the tooth. 



370 DOMINION DENTAL JOURNAL 

Value Question 

10 6.— Fully explain electricity as used for X-Ray work, 
how the Rays are produced and briefly the construc- 
tion of an X-Ray machine. 

(b) A\Tiat do you understand by the terms, Ampere, 
Volt, Resistance, Potential, Induction, Force? 
10 7. — Give a description of the term '^Natural Forces." 
Describe in detail their utility in dentistry. Give 
illustrations. 
10 8.— Give your procedure in Urinalysis: 

(b) Give your method of disting-uishing between 
normal blood corpuscles, and other elements in a 
given specimen containing an abundant sediment. 
10 9. — Define the terms: Radical, Reducing Agent, Isomer- 
ism, Combustion, Hydrolysis, Osmosis Anhydride, 
Chemical Affinity, Homologous 'Series, Diffusion. 
10 10. — Describe 'the dental uses of Zinc Oxide, Zinc Sul- 
phate, Zinc Chloride, also explain how each is pre- 
pared. 

MEDICINE AXD SURGERY. 

EXAMINER : C. N. ABBOTT, D.D.S. 

10 1. — Describe what you consider the most satisfactory 
method of treating fractures of the Inferior Maxilla. 
AVhat are the essentials ? 
10 2. — Name three dangers in Chloroform x^naesthesia 
which are slight or absent in Ether. What possible 
preventative measures might be used? Give contra 
indications to Chloroform. 
10 3. — Describe preventative measures and local treatment 
of Leucoplakia. When would you resort to surgical 
measures! 
10 4. — What are the causes of localized Neuritis? Classify 

the causes of multiple Neuritis. 
10 5.— What would you consider the drawbacks in the use 
of Cocaine Anaesthesia? Which of the substitutes 
would you prefer? In removing the first Inferior 
Molar where the process is badly infected— Describe 
the injection of your anaesthetic solution. 
10 6. — Describe the Etiology of Endocarditis. What rela- 
tion does Rheumatism bear to the trouble? 
10 7. — Name and describe the three chief clinical types of 
infection. 



SELECTIONS. 371 

Vialue Question 

10 8. — Describe the Mucous and other lesions found in the 

secondary stage of Syphilis. 
10 9.— Describe symptoms, prognosis and treatment of 

Haemophilia. 
10 10.— AVhat circumstances tend to produce Arterioscler 

osis? Describe briefly the three different forms. 
MATERIA MEDICA AND THERAPEUTICS. 

examiner: WILLIAM P. BRODERICK, D.D.S. 

10 1. — Describe, give uses and method of application of the 
following: Antikamnia, Bichloride of Mercury, Hy- 
drate of Chloral, Antipyrine, Phenacetine. 

10 2.— Write two prescriptions of three components each, 
one for a mouth wash, the other for a nerve sedative. 

10 3.— Name three cardiac stimulants: give correct dose 
and method of application. 

10 4. — Give dental use of'arsenious acid, and describe its 
action on the pulp. 

10 5. — ^Define: Empyema, Cicatrix, Alkaloid, Inflammation, 
Styptic, Distillation, Incompatibility, Maceration. 

10 6.— Name and give average dose of two salines and (b) 
two vegetable cathartics. 

10 7. — Give three methods of reducing local inflammatory 
conditions. 

10 8.— Name five disinfectants of value in the treatment of 
putrescent root-canals, (b) Two suitable for steril- 
ization of hands, (e) Three for sterilization of in- 
struments. 

10 9.— Give etiology and treatment for Pyorrhoea Alveo- 
laris. 

10 10. — Give treatment for Phosphor-necrosis, Aphthous 
Stomatitis. 

ORTHODONTIA. 

EXAMINER: M. A. ROSS THOMAS, D.D.S., D.D.C. 

10 1. — Give the classification of the irregularities of the 
human teeth. 

10 2. — Discuss fully the results of the extraction of the two 
lower first molars in a child of ton years of age. 

10 3. — Define anchorage. Give illustrations of the different 
kinds. 

10 4. — Describe peridental membrane. Illustrate. 

10 5.— What is the Frenium Labium? Describe the sur- 
gical operation for its removal and subsequent treat- 
ment. Illustrate. 



Z72 DOMINIO'N DENTAL JOURNAL 

Value Question 

10 6.— What is retemtion ? Discuss it fully. 

10 7. — Describe the process of making models and discuss 

the value of them. 
10 8.— Give the forces which govern normal occlusion. 
10 9.— What is the value of X-Kays to the Orthodontist? 
10 10.— Discuss Tonsils and Adenoids re the dental arch. 

What results would you expect to obtain from their 

removal % 

OPERATIVE DENTISTRY. 
examinee: w. a. black, m.a., d.d.s. 

10 1.— Give your conception of a complete examination of 
a patient from a dental standpoint who complains of 
his health being below normal. 

10 2.— Give your technique of root resection of a superior 
left lateral with an area say two to three millimetres 
in diameter when there is no pus present. 

10 3.— Diagnose and treat an acute alveolar abscess. 

10 4. — Discuss the psychological attitude of the dentist to- 
wards his patient or in other words, the personality 
of an ideal dentist. 

10 5.— State causes of active hyperemia of the pulp— Give 
symptoms and treatment. 

10 6.— Define the terms: 

(1) Traumatic Occlusion. 

(2) Gingivitis. 

(3) Periodontoclasia. 

(4) Neuralgia. 

10 7.— (a) Under what condition do you deem it necessary 
to devitalize the pulp of a tooth? 
(b) State methods of devitalization and advantages 
and disadvantages of each. 
10 8.— Give your technique for inserting an amalgam filling 
in the distal occlusal of a second lower molar. 

10 9.— (a) Why are third molars more subject to caries 
than other teeth % 

(b) When is calcification of first molars complete! 
10 10. — ^Discuss root canal fillings and describe what you 

consider the best method of filling a canal recently 

devitalized. 



DENTAL SOCIETIES. 373 

PATHOLOGY AND BACTERIOLOGY. 

EXAMINER : D. N. ROSS, M.D., L.D.S. 

Value Question 

12 1.— Define inflammation. Give an account of the various 
pathological conditions that occur in inflammation 
from its inception to its termination. 

12 2.— Define: Healing by second intention, hypertrophy, 
osteoma, epithelioma, aneurism, blind abscess. 

10 3. — Name and describe the various deposits found on the 
teeth. What conditions may arise from their pres- 
ence ? 

14 4.— Describe the different forms of Stomatitis. 

10 5.— Define caries and necrosis of bone and give their 

pathology. 
12 6. — Define Immunity. Give an account of the various 

forms of immunity. 
10 7. — What are antitoxins? How are they prepared? 
10 8.— (a) Give the morphological classification of bacteria. 

(b) Define: Sapremia, Septicemia, and Pyemia. 
10 9.— What are the means employed to destroy bacteria? 

PROSTHETIC DENTISTRY, CROWN AND BRIDGE- 
WORK AND METALLURGY. 

EXAMINER : JOHN W. CLAY, D.D.S. 

12 1.— In a given case, with the right upper bicuspids and 
first molar absent, discuss the relative merits of a 
partial denture and removable bridgework for the 
replacement of the missing teeth. 

15 2.— Give the technic of the manufacture of a partial den- 

ture where the upper bicuspids are missing. 
12 3.— Describe the mechanical treatment of cleft palate 

cases. 
12 4.— Give your method of replacing the lost crown of an 

upper central tooth. 

12 5. — Describe the process of making a cast gold restora- 

tion for a badly broken down lower molar, with only 
the distal wall remaining, assuming proper cavity 
preparation completed. 

13 6.— Give the technic of the replacement by bridgework 

of an upper right central and lateral. 

12 7.— Specify the alloys of silver with other metals com- 
monly used in Dentistry. Give their formulae. 

12 8.— What metals are used, and in what proportion to 
produce a low fusing alloy for dental purposes? 



374 UHXTAL SOCIETIES. 

Value Question 

Give the fusing point of each and the reason for its 
inclusion. 

PHYSIOLOGY AND HISTOLOGY. 

EXAMINER : A. W. COGSWELL, M.D., CM., D.D.S. 
PHYSIOLOGY. 

10 1.— By the process of reconstructive analysis, it has 
been demonstrated that living matter yields certain 
classes of bodies; name these, giving the approxi- 
mate chemical formula of each. 

10 2.— Name, describe and give the functions of the circu- 
lating fluids which have been distinguished in the 
higher animals. 

10 3.— Define the Phenomena Diapedesis. 

10 4. — Name and describe the most conspicuous events in 
the beat of the heart, in itheir normal sequence. 

10 5.— In its widest sense what is the sum total of the pro- 
cess of respiration f 

HISTOLOGY. 

10 6.— Describe the development of the colored blood cor- 
puscles. 

10 7.— Describe the formation of tissue from the embryonic 
cells. 

10 8.— Describe an epithelia; how are they classified? 
Name the classifications. 

10 9.— What are the modes of termination of sensory nerve 
fibres! 

10 10.— Name and describe the three principal special or- 
gans of termination of sensory nerve fibres. 







EDITOR: 
A. E. Webster, M.D., D.D.S., I^.D.S., Toronto. Canada. 

ASSOCIATE EDITORS: 
Ontario— M. F. Cross, L..D.S., D.D.S., Ottawa; Carl E. Klotz. L.D.S.. Si 

Catharines. 
Quebec. — Eudore Debeau, L.D.S., D.DjS.. 396 St. Denis Street, Montreal; Stanley 

Bums, D.D.S., Li.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton 

D.D.S., L..D.S., McGill University, Montreal. 
ALBERTA. — H. F. Whitaker, D.D.S., L..D.S., Edmonton. 
New Brunswick. — Jas. M. Magee, L.D.S., D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S. , D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Regrina. 

Prince Edward Island. — J. S. Bagrnall, D.D.S. , L.D.S., Charlottetown. 
Manitoba. — M. iH. Garvin, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogrue, D.D.S., L.D.S., Vancouver. 

Vol. XXXI. TORONTO, OCTOBER 15, 1919. No. 10. 



LARGE STUDENT REGISTRATION AT 
PROFESSIONAL SCHOOLS 



All schools in Canada have an unusually large registra- 
tion this autunin. Accommodation is over-taxed in all de- 
partments. This is especially true in professional and higher 
education. There are two main reasons for the over-crowd- 
ing. In the first place there was not the usual increase in 
buildings and teaching staffs during the war, and in the sec- 
ond place a great many of the youth of the country who in- 
tended to enter schools were employed in war work both at 
home and abroad. As soon as such work was completed a 
large number entered schools and colleges. 

Dental schools in Canada have registered more students 
than ever before. Over eight hundred offered for registra- 
tion at the Royal College of Dental Surgeons. Of this num- 
ber almost four hundred wished to enter the first year, and 
of these almost three hundred were soldiers. McGill, Laval, 
Halifax and Edmonton all have large freshman registrations. 
At first thought it would seem that there are entirel}^ too many 
entering dentistry, but a review of the situation shows that 
it is not so bad as it seems. During the war the nonnal num- 



376 DOMINION DENTAL JOURNAL 

ber of dental students was not forthcoming so there is the 
accumulation of four years. Besides this the dental schools 
of Canada are educating the dentists for Canada. At almost 
any time during the past twenty years there have been more 
Canadian dental students obtaining their education in foreign 
countries than at home. This was caused in part by a shorter 
course and a lower matriculation standard in the United 
States. At present this is all changed. The matriculation is 
now the equal of that in Canada, the courses are large in most 
colleges and the cost greater, and an announcement of an 
additional year in the near future. 

It being quite impossible for all who applied to be regis- 
tered at the Royal College of Dental Surgeons, it was decided 
to accept all the soldiers and all civilians over twenty years 
of age who had full junior matriculation with the physics and 
chemistry options, and provide a course of one year prepar- 
ation for all others who wished to take it. This scheme re- 
duced the numbers sufficiently to meet the accommodation. 



VITAMINES 



Of recent times a good deal of discussion has taken place 
concerning the relation of vitamines to the development of the 
teeth and their subsequent decay. Haliburton says, in an 
article in the British Medical Journal : 

Their absence prevents healthy growth and leads to death, 
but the symptoms manifested are different in the three cases. 
The diseases due to their absence are very conveniently group- 
ed together as ^'deficiency diseases." Among such diseases 
are beriberi, pellagra, and, coming nearer home, scurvy and 
rickets. 

The first of these vitamines is contained in the embryo or 
''germ'^ of cereal seeds. When milling is carried to a high 
degree this portion of the grain is removed, hence polished 
rice and superfine white wheat flour, though they may appeal 
to the aesthetic sense, are of inferior value as foods. It is now 
firmly established that beriberi, the disease of the rice-eating 
nations, is due to the use of polished rice, and can be pre- 
^-ented or cured by adding the polishings to the diet. Polished 
rice produces the disease, not because it contains a poison, but 
because it lacks the vitamines. Using the non-committal nom- 
enclature introduced by American physiologists, it is now usu- 



EDITORIAL 377 

al to speak of this vitamine, on account of its solubility in 
water, as ' ' water-soluble B. ' ' 

The second is contained in the majority of animal fat (lard 
is an exception), and is particularly abundant in milk fat, and 
in certain fish oils, such as cod liver oil. It is especially im- 
portant as a growth factor, and therefore indispensable in 
early life. It is absent in vegetable fats. Here we have one 
more indication of the value of milk for the young, an explana- 
tion of the potency of cod liver oil in curing malnutrition, and a 
warning of the danger of vegetable margarines if employed as 
the only source of fat in the food of the growing section of the 
population, or of expectant mothers. It is usual to dub this 
vitamine **fat-soluble A.'' There is accumulating evidence to 
show that its absence or deficiency is an etiological factor in 
rickets. Like its water-soluble companion, it is ultimately a 
vegetable product, and is contained in high concentration in 
the green portions of plants. 

The third vitamine is also soluble in water, and, as Dr. 
Drummond suggests, it may be called ^'water-soluble C' This 
is the antiscorbutic principle, and is found in the juices of 
fruits (the orange and lemon are here pre-eminent) and in 
most edible vegetables. It is characterized by its extreme la- 
bility, being destroyed by moderately high temperature, treat- 
ment with alkali, by desiccation, canning processes and the 
like. Hence arises the value of fresh fruit and vegetables in 
the prevention of scurvy. 

May it not be that many so-called minor conditions of mal- 
nutrition may be due to lack of vitamines, or to a deficiency in 
their supply f Although at present three vitamines have been 
brought into the light of investigation, who can say that the 
list is complete ? It is more than probable that obscure and 
apparently trivial complaints may in the future also be found 
to be deficiency diseases. An obvious state of malnutrition in 
the infant may pass away, and yet it may leave its mark be- 
hind it and cause far-reaching results later in life. Takej for 
example J that curse of modern days — dental caries. Already, 
as Mrs. Mellanby has shown, there are signs that this is just a 
condition, and that its cause is probably a deficiency, earlier 
in life, of a vitamine not very different from ^^fat-soluble A.^' 



No stronger argument for keeping the mouth clean could 
be put forth than the statistics which show the prevalence of 
cancer in the alimentary tract as compared to all other parts of 
the body. 



378 DOMINION DENTAL JOURNAL 

MANAGEMENT OF INFECTED CANALS 



In the September issue of the Items of Interest appears a 
paper setting forth the methods of treatment of putrescent 
root canals by two methods. Anterior canals are treated by 
the Cameron method, and posterior canals by the Howe 
method. Most members of the profession understand the 
Howe method, but few know the detailed technique of the 
Cameron method. Dr. Cameron opens the pulp chamber and 
applies 10 per cent, solution of formalin, and evaporates this 
with hot air ; then the canal is further opened and more solu- 
tion applied and evaporated ; and as soon as the apecal half 
of the canal is reached, the solution is reduced to 4 per cent. 
If the apex is reached, the canal is filled then or a few days 
later after being sealed with a mild antiseptic. 

In a paper in the same issue by Cameron, who sets forth 
his success in treating putrescent canals extending over a 
period of seventeen years, appears the discussion in which 
Dr. Wield shows that encapsulation of the end of the root with 
chlora percha is all moonshine. The chlora percha does not 
attach itself to the root end, and is absorbed. He suggests 
bismuth, iodoform and formacreosol in all large ended root 
canals upon which the g*utta percha is packed. However, after 
further examination of his cases, he sees evidence of tissue 
loss. Dr. McLean, in continuing the discussion, stated that he 
long since gave up the use of any drugs in the treatment of 
root canals. His method is to mechanically cleanse the canals 
and then mechanically fill them. He showed many X-ray 
photographs to corroborate his statement of the efficiency of 
the method. 



MEDICAL, DENTAL AND NURSING WORK IN WEST 
CHINA-A GREAT ADVANCE PLANNED 



About mid-September the Board of Governors of West 
China Union University, representing five constituent denom- 
inations, convened in Toronto. A great many very impor- 
tant questions were dealt with by the Board, especially look- 
ing toward large developments of the institution in the future. 
Great stress was laid upon the importance of promoting med- 
ical, dental and nursing instruction, for China is especially 
weak along these lines. 



EDITORIAL 379 

Victoria College took advantage of the occasion to give a 
dinner to the members of the Board, in order that they might 
meet with some of the leading doctors and dentists of the 
city, together with other guests. 

The great theme of the occasion was the consideration of 
an enlarged scheme of professional education in connection 
with the Chengtu University, for which the three professions 
of medicine, dentistry and nursing in Canada and Newfound- 
land, are being asked to specially provide. A central com- 
mittee has already been formed in Toronto and every member 
of these professions in this country will be circularized and 
invited to co-operate in a movement which must mean large 
developments in niodical, dental and nursing insti*uction among 
the one hundred millions of Chinese, Aborigines and Thibetans 
in West China. 

Rev. Dr. Goucher, Chaii'uian of the Board of Governors, 
sketched the scope and outlook of the University and its im- 
mensely strategic position ; and Rev. Dr. Beech, the President 
of the University, followed with a lucid survey of its rise and 
development, illustrating it most convincingly by the exhibi- 
tion of some beautiful lantern slides showing buildings and 
groups of students. These pictures visualized the institution 
and impressed all with its wonderful progress since its begin- 
ning ten years ago, and also with its possibilities for a great 
future. 

Dr. C. AV. Service, of Chengtu, was then called upon to 
make a statement as to the medical needs of China. He urged 
that fully 99 per cent, of China's need for doctors and nurses 
and almost 100 per cent, of her need for dentists have still to 
be met. He stated that the proposal for enlisting the hoaling 
professions of Canada and Newfoundland in an etfort to se- 
cure more adequate facilities for training Chinese doctors, 
dentists and nurses would do much to help meet these dire 
needs. 

Dr. N. A. Powell, in a brief but earnest address, spoke on 
behalf of the members of the medical profession, promising 
hearty sympathy and co-operation. 

Dr. A. E. Webster, Dean of the Royal College of Dental 
Surgeons, enthusiastically seconded Dr. Powell's address, 
making mention of the fact that four of the dental surgeons 
of China were g^i^aduates of the institution now under his care, 
and that three of these, Drs. Lindsay, Thompson and Mullett, 
are now in Chengtu, engaged in the practice and teaching of 
dentistry. 



380 DOMINION DENTAL JOURNAL 

The meeting was a most encouraging send-off for the new 
project and it seems certain that the medical, dental and nur- 
sing professions of Canada and Newfoundland will rally 
splendidly to give West China a measure of the privileges in 
skilled men and women and scientific facilities for their work 
that Canada enjoys so bountifully. 



DOMINION DENTAL COUNCIL OF CANADA 

SUPPLEMENTAL EXAMINATIONS 

TIME-TABLE, 1919 



Tuesday, Nov. 18, 10 o'clock, Operative Dentistry (paper). 

Tuesday, Nov. 18, 2 o'clock, Prosithetk? Dentistry (paper). 

Wednesday, Nov. 19, 10 o'clock, Operative Dentistry (clin- 
ical). 

Wednesday, Nov. 19, 2 o'clock, Prosthetic Dentistry (clin- 
ical). 

Thursday, Nov. 20, 10 o'clock. Orthodontia. 

Thursday, Nov. 20, 2 o'clock, Pathology and Bacteriology. 

Friday, Nov. 21, 10 o'clock. Materia Medica and Thera- 
peutics. 

Friday, Nov. 21, 2 o'clock, Medicine and Surgery. 

Saturday, Nov. 22, 10 o'clock, Anasthetics, Physics and 
Chemistry. 

FOR SALE— Fully equipped laboratory in Alberta, Canada. 
Highest prices, gross receipts in plate work alone average 
$600.00 per month, which can be greatly increased. Terms 
$1,250.00 cash. Box No. 112, Dominion Dental Journal. 

WANTED— Capable and experienced operator. Salary 
$50.00 and 5 per cent, commission on all work to start, but 
would give more to high class operator with considerable 
experience. Apply F. W. Glasgow, comer Portage and 
Donald, Winnipeg, Man. 

FOR SALE : Three chair dental practice in a western Cana- 
dian city, population 25,000 people. Practice established 
ten years ; all the work two operators can do. Location of 
office the best in the city. Nine-roomed suite with lease to 
run 5 years at a reasonable rental. Reason, ill-health. Box 
111, Dominion Dental Journal, Toronto. 



Dominion 

Dental Journal 

Vol. XXXL TORONTO, NOVEMBER 1 5, 1919. No. 11. 

Original Communications 



MEDICAL AND DENTAL INSPECTION IN 
PUBLIC SCHOOLS 



Will C. Davey, Morrisburg, Ont. 

Read before the Dundas County Teachers' Association. October 8th, 1919. 

Mr. President, Ladies and Gentlemen, I can assure you I 
feel it an honor conferred upon me by your Program Com- 
mittee to be asked to address you at this your. annual con- 
vention. It affords me pleasure to have the opportunity of 
again meeting this association of which I was at one time an 
active member and of which you made me an honorary mem- 
ber some years ago. But there is another feeling which is at 
the present moment paramount, i.e., responsibility. In the 
short time at my disposal I want not only to entertain and 
instruct you, but to send you back to your various fields of 
labor, enthusiasts on this question of Dental and Medical In 
spection, ready and eager to do all in your powers to produce 
a favorable impression and demand for this innovation in 
rural school sections. 

If, in this talk, the necessity of dental inspection accom- 
panied by preventive and curative measures may seem un- 
duly prominent, remember that it is not because it is being 
presented by a dentist, but that in such emphasis many prom- 
inent physicians concur most heartily. Dr. Chas. Mayo, of 
the very reputable Mayo Bros, of Rochester, Minn., says, 
"The greater number of people to-day die of a simple infec- 
tion and that 90 per cent, of them die owing to the outcome 
of some simple infection of a local nature, the primary focus 
not necessarily giving any trouble itself, and that 90 per cent, 
of these local infections arise above the collar line, found in 
such conditions as diseased tonsils, antri, nasal discharge, 
sinuses and the vast majority from dental trouble." With 



382 DOMINION DENTAL JOURNAL 

this quotation your indulgence is craved for any seeming 
partiality to the dental aspect of this question. 

The human body is a great machine beautifully and won- 
derfully constructed, magnificently balanced in all its various 
parts and capable of performing a wide variety of functions. 
Complicated mechanical chemical actions and almost inex- 
plicable psychological phenomena all co-related and interde- 
pendent form a network of activities which in Ufe must be 
maintained in its normal physiological condition as originally 
designed by the Great Creator if that life is to be pleasurable 
and useful to oneself and to humanity at large. 

Prof. Russell H. Chittenden, of Yale University, says, *'A 
proper physiological condition begets a moral, mental and 
physical fitness which cannot be attained in any other way. 
Further, it must be remembered that lack of a proper physio- 
logical condition of body is more broadly responsible for 
moral, social, mental and physical ills than any other factor 
that can be named. Poverty and vice on ultimate analysis 
may often be traced to a perversion of nutrition. A healthy 
state of the body is a necessary concomitant of mental and 
moral vigor, as well as of physical strength. Abnormal meth- 
ods of living are often the accompaniment or forerunner of 
vicious tastes that might never have been developed under 
more strictly physiological conditions. Health, strength 
(mental and physical) and moral tone alike depend upon the 
proper fulfilment of the laws of nature, and it is the manifest 
duty of a people, hoping for the fullest development of phys- 
ical, mental and moral strength, to ascertain the character of 
these laws with a view to their proper observance. Poverty, 
crime, physical ills, or perverted moral sense are the penalties 
we may be called upon to pay for the disobedience of Nature's 
laws; penalties which not only we may have to pay, but which 
may be passed down to succeeding generations, thereby in- 
fluencing the lives of those yet unborn." 

Here we have concisely depicted for us the morbid results 
emanating from disturbances of normal healthy body pro- 
cesses. Let us for a few minutes consider the primary causes 
of the vast majority of such disturbances. 

If the chemico-mechanical processes of the body may be 
compared with anything humanly devised, perhaps the most 
suitable illustration would be the reaction of the chemical lab- 
oratory. As teachers you all, or nearly all, have studied 
chemistry. You remember in the performance of ideal ex- 
periments you must have: 1st, pure materials; 2nd, proper 



ORIGINAL COMMUNICATIONS 383 

preparation of those materials; 3rd, correct proportions; 4th, 
suitable conditions of light and heat; 5th, clean retorts, tubes, 
receptacles and other apparatus. Thus as a result we have : 
1st. ideal reaction; 2nd, pure products; 3rd, economical man- 
ufacture; 4th, a minimum residue or ash which represents 
complete combustion. 

In the physical chemical laboratory the complicated com- 
pound reagents such as salivary, biliary, pancreatic, intestinal 
and other digestive ferments and juices are automatically sup- 
plied. The retorts for the reception of raw material, manu- 
factured product and waste with their miles of tubery, lym- 
phatic, blood vascular and excretory, are given to us in per- 
fect condition (unless contaminated by hereditary taint). By 
direct volition we have no control over these processes which 
elicit the wonder and admiration of the greatest scientists. 

We are made partners, however, in this great chemical 
laboratory. We are entrusted with the first step. It is sim- 
plicity itself yet so capable of abuse that many on life's sea 
become derelicts upon the reefs of improvidence and self in- 
dulgence. That first step is the selection and preparation of 
our food for entry to the stomach. The selection of food 
properly belongs to the field of dietetics, but for the normal 
individual under normal conditions the variety of foods con- 
ve?iiently at our disposal generally furnishes us w^th a fairly 
balanced diet. 

The quantity of food ingested and its preparation by mas- 
tication are controlled by the individual per se, and, if time 
permitted, arguments and experiments might be advanced to 
convince you that the quantity ingested varies in proportion 
largely with the thoroughness of mastication. 

Arguing in this manner we have arrived at a point where 
we can emphatically declare that the volitional act of life of 
the greatest importance is the proper mastication of food. In 
order that food may be properly masticated two things are 
necessary: 1st, The possession of healthy masticatory appar- 
atus, which comprises (a) strong masticatory muscles, (b) 
healthy tissues surrounding the teeth, (c) teeth properly 
aligned and free from disease; 2nd, Concentration of the 
mind upon the thorough pulverizing, salivation and liquefying 
of the food before swallowing. 

(a) STRONG MASTICATORY MUSCLES. 

As with other muscles of the body so with those of masti- 
cation. In order that any muscle shall be developed and be 



384 DOMINION DENTAL JOURNAL 

strong it must have adequate exercise, i.e., work to do. Soft, 
pulpy foods as fed to many children and adults and the habit 
of bolting food unchewed of necessity militate towards un- 
developed masticatory muscles. Because these muscles are 
not properly used, the nasal cavities and other portions of 
the face are not developed as they should be. These in turn 
are clogged with adenoids and polypi causing mouth breath- 
ing, facial disfigurement and predisposing to enlarged tonsils. 
These pathological or diseased conditions form ideal places 
for the start of infections (foci of infection) which are readily 
carried to other parts of the body. But more of this focal in- 
fection later. 

The preventive measure is obviously the thorough masti- 
cation of fibrous and granular foods and. elimination as far 
as possible of foods which do not necessitate mastication be- 
fore swallowing. 

(b) HEALTHY TISSUE SURROUNDING THE TEETH. 

The laity to-day are becoming informed about so-called 
pyorrhoea, that disease of many names and many manifesta- 
tions. It is not a new disease as many suppose, but is at least 
as old as the mummies in the Egyptian pyramids because in 
those mummies we find evidences of its ravages. The disease 
which results in the ultimate loss of the teeth by the disinte- 
gration of surrounding tissues has many phases from rough- 
ened enamel through stains of different kinds, a slight red- 
dening of the gums at the margins down to conditions where 
the gums are badly swollen, bleed easily, form pockets close 
to the teeth from which pus exudes and the teeth become ex- 
tremely loose and drop out. Proper mastication cannot be 
performed with such mouth conditions. 

{c) PROPER ALIGNMENT OR FREEDOM FROM DISEASE. 

The third division essential to a healthy masticatory 
apparatus was teeth properly aligned and free from disease. 
That alignment is necessary is self-apparent. Teeth which 
do not meet properly cannot masticate properly. 

Probably each of you has experienced in his or her life- 
time the effect of a decayed tooth. The cavity may have been 
small but it permitted the food to crowd against the gum 
tissue with the result that you promptly ceased to masticate 
on that side of the mouth. A larger cavity made you more 
assiduously avoid not only that one tooth but the whole side 
of the jaw. The writer has seen cases where one such tooth 
neglected for a considerable time, causing lack of proper 



ORIGINAL COMMUNICATIONS 385 

friction and exercise of the entire side, has caused such a mor- 
bid condition that diligent and painstaking care for long 
periods have failed to restore the organs to their wonted ser- 
vice. Let this cavity be duplicated on the other side of the 
mouth or multiplied so that we have six, a dozen or more cav- 
ities and we have arrived at a condition where proper masti- 
cation is impossible. 

The possession of unhealthy masticatory apparatus rend- 
ers null and void any concentration of the mind upon thorough 
pulverizing, insalivation and liquefying of food, because, de- 
spite the concentration, there is not the machinery with which 
it may be done. 

What are the immediate results of unhealthy masticatory 
apparatus or improper use of a healthy one? 

L P'ood is not reduced to sufficiently fine particles for 
further digestion. 

2. Food is not properly mixed with saliva which is the 
first digestive ferment. 

3. Bolters of food ingest far more food than is necessary 
for the physical economy. 

4. Food is contaminated by nasal or tonsil discharge drip- 
ping into the throat, by pus from pyorrhoea pockets, open 
abscesses in the mouth and multitudes of germs from carious 
teeth. 

The unhealthy mouth is the best incubator in the world 
for germs of all kinds. There they have protection, food, 
heat and moisture. If you will permit a comparison disgust- 
ing enough to do Billy Sunday credit yet quite true, we will 
state that those cavities full of perhaps last week's dinner 
are just as filthy and dirty as that garbage pail which has 
stood in a July sun for a week. We would not permit a child 
to eat even one portion of food from that garbage pail, but 
quite unconcernedly we permit and sanction the existence of 
from one to twenty garbage pails in the child's mouth. Espe- 
cially is this true of children's temporary teeth as will be 
shown in the report on the inspection of the teeth in the prim- 
ary division of the M. P. S. 

Not only are these decayed teeth the home of germs of 
putrifaction, but they are the nursery for bacteria-ijroducing, 
contagious and infectious diseases. There they may lie in wait 
for indefinite periods waiting the strategic moment for attack 
on their liarborer or a successful raid on some neighboring 
victim. 



386 DOMINION DENTAL JOURNAL 

Previously foci of infection were mentioned in the paper. 
They are those little hotbeds perhaps around a tooth or in 
tonsil cripts or other localities varying from approximately 
the size of the head of a pin or a pea to something larger, 
where dangerous bacteria are living in unsuspected dugouts 
from which, with the bloodstream as a trench system, they are 
distributing millions of their kind to unsuspecting strongholds 
of the body. So insidious is their work that some day the 
individual wakens to find out that this enemy about which he 
knew nothing has gained a victory and that counter attacks 
are often fruitless in entirely displacing this enemy and re- 
constructing the damage done. He may find himself chained 
to some of the following: Heart disease, hardening of the 
arteries, sciatica, some skin disease, some form of rheumatism, 
some form of eye trouble, neuritis, a derangement of an in- 
ternal organ, or a score of other troubles which a few years 
ago even a dentist would laugh at if told it came primarily 
from "that innocent old root which has been broken off like 
that for ten or fifteen years and never gave me any trouble. 
Why I never knew it was there." 

So skeptical do some of our patients look when we are 
pouring forth an imprecation against some old root, exhort- 
ing the patient to erect a wooden cross to it, and when we are 
singing a funeral dirge about focal infection, so skeptical do 
they look that if they opened their mouths to speak the one 
concise and comprehensive word uttered would be '^Ananias." 
In fact a friend of mine the other day in the midst of what I 
considered a lucid and serious explanation of focal infection, 
said, '^Look here, Bill, you're a fisherman, so am I, so cut out 
those yarns.'' 

Focal infections surrounding teeth and in the tonsils have 
even been shown to cause insanity as shown in the report of 
Dr. Henry A. Cotton, Medical Director of the New Jersey 
State Hospital for the insane. 

Again let me quote from Dr. Mayo, of Rochester, Minn. : 
"Why do we often read or hear of men dropping dead on the 
street or being found dead in bed over 53 years of age 1 An 
enormous number of such were caused largely by preventable 
conditions due to the mouth." Let me quote again a sentence 
of his, read at the opening of this paper. "The greater num- 
ber of people to-day die from a simple infection and that 90 
per cent, of them die of some simple infection the primary 
focus not necessary giving any trouble and that 90 per cent, 
of these local infections arise above the collar line found in 



ORIGINAL COMMUNICATIONS 387 

such conditions as diseased tonsils, antri, nasal discharge 
siimses and the vast majority from dental troubles.'' 

We were dealing with the immediate results of unhealthy 
masticatory apparatus, but from their intimate connection we 
have wandered into some of the remote results. Let us briefly 
state the remaining remote results. As in your chemical ex- 
periment any error in starting your experiment would evidence 
itself in the results, so in our physical chemical laboratory, 
if we start with a surplus of contaminated, improperly pre- 
pared food we in time break down Nature's delicate labor- 
atory. Organs are overworked, poisoned, rendered incapable 
of performing their allotted tasks and the result is an early 
breakdown evidencing itself in chronic indigestion, kidney 
troubles, diseased livers, bad arteries which, with high blood 
pressure, predispose to strokes, and myriads of other 
diseases which are merely the evidence and the punishment 
for not maintaining a proper balance between the necessary 
fuel demanded by the body and the amount and manner of 
feeding it to the body. Your gasoline engine, no matter how 
perfect, if not fed gas, air and oil in proper proportions, will 
*^buck" and '^quit. " (Excuse the slang phrases, they are des- 
criptive.) The human engine, while more long suffering, is 
only flesh and blood, and will most assuredly start to "buck" 
and "quit" probably years before it was necessary. 

Does someone say, "You have proven to us the necessity 
for a healthy masticatory apparatus and the proper use of it 
as the fundamental, the corner stone upon which a proper 
physiological condition may be maintained but why so much 
talk about it? Is a healthy masticatory apparatus so rare?" 
To this question a most emphatic "yes" must be given. In 
schools where dental clinics have not been established dental 
examination has shown that from 93 to 98 per cent, of the 
children have imperfect teeth. Perhaps it might be well just 
here to give you a summary of the results of a dental exam- 
ination given the children of the Morrisburg Public School. 

1. One hundred and sixty-five pupils were examined. 

2. Of the one hundred and sixty-five, nine had perfect teeth. 
Of these nine seven needing cleaning. 

3. In the school there were 90 teeth lost prematurely, 81 
to extract, 494 cavities to be filled and 262 fillings already in 
place. 

4. In regard to cleanliness the girls had taken much better 
care of their teeth than the boys. 

5. Seventy of the 165 pupils had received some kind of 



388 DOMINION DENTAL JOURNAL 

dental attention. Only 18 had made what were called regular 
visits to the dentist. 

6. Power of mastication was bad in 22 cases and only fair 
in 29 others, making a total of 51 pupils whose food entered 
the stomach without being properly prepared. 

7. Many of those who had the poorest teeth were the dull- 
est pupils. 

8. There was almost an utter disregard of the children's 
temporary teeth. In the two lower rooms there were 60 pupils 
examined ; 24 teeth were to be extracted, 57 were prematurely 
lost, 193 decayed and only 36 had been filled, while in these 
same two rooms with the pupils ranging from 5 to 8 years of 
age, 8 permanent teeth had been extracted and 50 needed fill- 
ing. It would seem that the general public has no knowledge 
of the necessity of caring for the temporary teeth or of the 
time the first permanent molars appear. 

This will be found to be but the average, possibly above 
the average condition, to be found existing in the mouths of 
the children in rural districts. 

From an economic standpoint the neglect of children's 
teeth costs the country vast sums of money. The writer has 
under preparation a paper on "The Economics of Dental In- 
spection and Clinics'' which requires much time to gather 
statistics for, but which he believes when finished will con- 
vince the most skeptical that aside from consideration of in- 
dividual comfort, health and morality, the compulsory care 
of children's teeth is an economic saving of immense value to 
the nation. Costs 'of re-education through failure at exam- 
inations, computations of the cash value of years of postponed 
production, estimates of lowered production through life and 
calculations of premature inability to produce, cost our con- 
tinent billions of dollars each year and much of this cost is 
directly or indirectly chargeable to dental troubles and pre- 
ventable. 

The moral aspect we will dismiss by requoting a sentence 
from the first of this paper, "The lack of a proper physio- 
logical condition of body is more broadly responsible for 
moral, social, mental and physical ills than any other factor 
that can be named." 

In the late war, but for the activities of the C.A.D.C., thou- 
sands of our men would have been reported as physically un- 
fit for service. If a man cannot fight for his country efficiently 
with poor mouth conditions neither can he fill any other post 
in life efficiently with i)oor mouth conditions. If a soldier 



ORIGINAL COMMUNICATIONS 389 

with bad teeth is a menace to his fellow soldiers as a possible 
disease carrier, he is equally a menace to his fellow employees 
in civil life. 

The prevalence of dental troubles auion<4' industrials may 
be realized from the following: "Carl E. Smith, D.D.S., B. F. 
Goodrich Co., Akron, Ohio, claims to have made 80,000 
mouth examinations in the past sixteen months. This for 
17,000 Americans and 13,000 foreigners. Of this number, 96 
per cent, were in need of dental service, and only 4 per cent, 
had clean, healthy mouths; 9 per cent, were without cavities 
and could be made healthy by thorough cleansing, the balance 
had all the ijathological conditions known to dentistry." Some 
of the most progressive industrial concerns are to-day estab- 
lishing dental clinics in connection with their businesses. 

I have here a list of 52 large business concerns in the 
United States and one in Canada who have established dental 
clinics for their employees. The earliest one was inaugurated 
eight years ago, but the most of them have been started within 
the last two or three years. They employ from one to thirteen 
operators. Many of them are free to the employees. Some 
make nominal charges, while a few clean up the teeth and make 
a thorough examination. These clinics are established not 
merely as philanthropic acts, but as paying business proposi- 
tions. There are probably over 400 medical dispensaries in 
connection with industrial concerns. 

Employers are beginning to realize that people with ))oor 
teeth are inefficient, are disease carriers, are more frequently 
di.^turbers of industrial peace, are more often absent from 
business, and are less pleasing in appearance. All these mili- 
tate against the employment of those not possessing a hygienic 
mouth. In but a short time many concerns will be requiring 
(as do all hospitals of the girls entering for training) that the 
api)licants for employment produce satisfactory medical and 
dental certificates. 

The report of the Army Examining Boards of the Ignited 
States shows that 31 per cent, of the men between 30 and 40 
years of age were unfit for service and that the causes for 
such unfitness were in the large majority of cases preventable. 
Doubtless many of them should have been detected and pre- 
vented while attending school. 

Dr. W. W. Belcher, of Rochester, gives us the following 
statistics for the Ignited States: "Over one per cent, of our 
school children are handicapped by organic heart diseases; 
five per cent, have defective hearing; twenty -five per cent. 



390 DOMINION DENTAL JOURNAL 

have defective eyesight. A like number suffer from malnutri- 
tion, the result of poverty and incorrect living. It is calculated 
that 75 per cent, of all school children have physical defects 
which are potentially or actually detrimental to health. '^ He 
adds : ^* We have looked upon the country boy, enjoying fresh, 
outdoor air, as essentially a healthy product, but statistics 
show that a larger proportion of country boys were refused in 
the army draft because of physical ills than were their city 
brethren. ^ ' 

The public accept the necessity of paying heed to so-colled 
medical ills, but the immediate and far-reaching influence of 
dental troubles is almost universally unknown. The scriptural 
remark, ''The poor you have always with you,^^ has its dupli- 
cate in the mind of the majority of people. Bad teeth we have 
always with us, and there is an end of it. Only 10 per cent, of 
people are credited with the habit of visiting a dentist, and a 
large percentage of those for reasons far remote from any 
given in this paper. Such are justifiable pride in natural teeth, 
dislike of the evidence of approaching old age as depicted by 
the ordinary denture, relief from immediate pain, etc. Prob- 
ably of that 10 per cent., 99 per cent, are ignorant of the doc- 
trine of focal infection. It is comparatively new to the dental 
and medical professions themselves. 

A business man who has anything to dispose of to the pub- 
lic must make the public feel that the possession of that article 
or whatever it may be is an advantage, that it is wanted, that 
it is needed, then he will have sale for it. That is just the posi- 
tion dental and medical inspections are in to-day. We must 
have a propaganda showing the necessity of, and creating a 
demand for, such inspection and its logical successor, the 
established clinic. Then, and not till then, will it be a realiza- 
tion. 

We have the propaganda. What we need are the propa- 
gandists or distributors. Possibly after the 20th inst. we will 
have a lot of these people out of employment. If they could 
be engaged in securing dental and medical inspection and 
establishing clinics to remedy the evils found, they would be 
engaged in a greater work than fighting John Barleycorn with 
all his proclivities for evil. For this statement we have no 
less an authority than the highly reputed Dr. Osier, who places 
thb ills of liquor traffic second to those from the lack of oral 
hygiene. 

The Governments of this country spend annually millions 
of dollars in conserving the natural resources found in our 



URIGIXAL COMMUNICATIONS 391 

fisheries, our mines, our forests, etc. Their policy should be 
much more aggressive in conserving our greatest resource, 
the life and health of our boys and girls. Just here let me say 
that the medical profession, through the last thirty years, has 
raised the average life of the citizen twelve years, largely by 
saving infant life. There is still much to be done in this direc- 
tion. . Minnesota has a low infant mortality, but even at that, 
the death rate was more than twice as high as that of her sol- 
diers at the front. The Montreal ^'Star^' of September 20th, 
says, editorially: "Figures have proven that the man at the 
front had a far better chance of life than a Montreal baby. An 
abominable state of affairs exists here when over 5,000 chil- 
dren under 5 years of age, are taken yearly to the cemetery." 
The subject of baby care should be taught in our schools, be- 
cause when girls grow up to womanhood and motherhood you 
cannot reach the class of people where this mortality is taking 
place. The writer visited a magnificent Child ^s Welfare Ex- 
hibit in Montreal. It must have cost many thousands of 
dollars to stage. It was most attractive and instructive. It 
was complete. Upon enquiring if they were reaching the class 
of people they desired, thp writer was informed that the chil- 
dren were brought there in a body from the different schools, 
but the adults who visited the exhibit were nearly all people 
who put in practice what the exhibit desired to teach them 
regarding their children. 

It is difficult to get people to attend lectures on these sub- 
jects. The ones you see before you are generally people who 
are already conversant with what you have to tell them. The 
only place to start these reforms is in the schools. The waiter 
is no prophet, but predicts that the next decade or two will 
materially lengthen the average life of citizens by preventing 
so many deaths at middle life through the elimination of pre- 
ventable disease. 

The Governments of this country also spend vast sums in 
fighting foot and mouth disease in cattle, hog cholera, etc. 
Ought not those Governments to be more deeply concerned in 
eradicating, or rather preventing, disease in our boys and 
girls! Cattle and hogs can be killed, grain and fruit destroyed, 
but the diseased, blemished child lives, is allowed to marry and 
propagate progeny with hereditary weakness if not disease. 
Preventive medicine has been brought home most forcibly to 
us in the late war. 

In the Crimean war, 25 out of every 100 soldiers died of 
disease yearly. In the Spanish-American war, 20,000 were 



392 DOMINION DENTAL JOURNAL 

sick with typhoid in ^ve months in the training camps. The 
Americans lost 353 from injury and 8,000 from disease In 
the Spanish-American war one man out of five contracted 
typhoid. In this war, for a period of 21 weeks, ten men out 
of one million American soldiers who had received serum 
treatment developed typhoid, or one in every one hundred 
thousand. 

Preventive treatment in tetanus, pneumonia, diphtheria 
and spinal meningitis was also very effective. 

The pamphlet, ' ' What Britain Has Done in the War, ' ' con- 
tains this statement : ' ' The constant preoccupation with young 
and healthy subjects has favored a new attitude towards or- 
ganic disease, as something to be checked by preventive 
methods rather than cured when it has reached an advanced 
stage. The efficiency of the British service is proved by the 
fact that during the first three years of the war the entire 
expeditionary force lost only 3,000 men by disease, as com- 
pared with 50,000 deaths from disease during the South 
African war. The health of the troops at home and abroad 
(excluding admissions to hospitals by reason of wounds) is 
actually better than it was in times of peace. ' ' 

The Government at Ottawa by a bill passed on April 11th 
last, established a Dominion Department of Health. Let us 
hope it will not be long in the incubation stage but soon become 
a live, effective and comprehensive factor in Canadian life. 

Several large cities have established dental and medical 
clinics with inspections. In New York State, New York City, 
Rochester and Buffalo support such organizations. Detroit 
this year has authorized an expenditure of $50,000 for mouth 
hygiene. The staff consists of twenty operators. 

Some of the States of the union have authorized and are 
organizing the rural districts and maintaining a qualified 
staff of nurses and operators to carry on this most necessary 
work. 

New York State has an organizaation for medical inspec- 
tion of schools outside New York City, Buffalo and Rochester. 
A year ago it was estimated that over 1,000 physicians and 
nurses were engaged in this most necessary work. Twenty- 
one dental dispensaries were in operation, and a State dentist 
was to be appointed as superintendent of the oral hygiene 
department. 

Dr. Wm. S. Howe, B.S., M.D., State Medical Inspector of 
Schools for New York State says : '^The plan we have in mind 
will make oral hygiene an intrinsic part of the educational 



ORIGINAL COMMUNICATIONS 393 

system of the State of New York in its program for the con- 
servation of the health of the school child. It will place oral 
hygiene where it is most needed and where it can be taught to 
thr; greatest advantage, in our schools. It dignifies oral hy- 
giene with State authority as an educational problem concern- 
ing which there should be no difference of opinion." 

A larger number of our cities in Ontario have established 
inspections and clinics, but as yet practically nothing has been 
done in rural districts. 

The Hon. Dr. Cody, Minister of Education, promised the 
Central organization of the Women's Institutes at their con- 
vention this spring that the schools of the Province should 
have a medical and dental inspection. To this end four medi- 
cal men have been employed and one dentist (for part time). 
Ten thousand dollars have been appropriated for this purpose. 
While we are thankful for small mercies, we cannot fail to 
remark that this appropriation is a mere bagatelle. It does 
not adequately pay the men who have been placed at the head 
of this movement, and leaves many, many hours of tedious 
w^ork to be done gratis by the medical men and dentists 
throughout the Province. 

Dr. Fred J. Conboy, of Toronto, for years a member of the 
Board of Education of Toronto, and chairman of the same, 
has been appointed by the G-overnment to supervise the oral 
hygiene department for the Province. Nothing abashed by 
lack of funds, he sent out an appeal to the dentists of Ontario 
to assist him in getting a survey of the condition of the mouths 
of the children in the rural public schools. The appeal was 
not made to those dentists residing in cities where examina- 
tions and clinics are established. At the last report, over 200 
dentists throughout the Province have signified their willing- 
ness to give a portion of their time gratis in order to complete 
the necessary information. 

Probably the procedure will be somewhat as follows : just 
as soon as enough men are procured to carry on this work 
throughout practically all parts of the Province, a general 
plan of action will be issued and uniform inspection blanks 
furnished. 

The campaign will likely also consist of lectures to be .given 
to Teachers' Institutes, Women's Institutes, Mothers' Clubs, 
Boards of Education, public gatherings, etc. Newspaper arti- 
cles, pamphlets, etc., will be supplied giving the public much 
useful information of which it is now ignorant. Teaching 
charts and suitable text books will be probably authorized. 



394 DOMINION DENTAL JOURNAL 

The final aim will be to have established permanent clinics 
in communities large enough to warrant them. In smaller 
communities probably soime form of a travelling clinic may be 
devised whereby all sections will have placed at their door 
advantages as enjoyed by the pupils of urban centres. 

At these clinics the mouths of all children will be examined, 
and those requiring work referred to the family dentist, or 
where pecuniary circumstances will not permit, the work will 
be done by the dentist in charge. The clinics are to be sup- 
ported from the general taxes. Variations from the above will 
possibly exist in different sections, but a general idea may be 
adduced from the above. 

We have ample precedent for this method of supplying 
funds. The state and municipalities provide competent treat- 
ment for those who are una^ble to pay for same. We have asy- 
lums for the insane, hospitals for the sick, schools for the 
blind, sanitaria and isolation hospitals for contagious and 
infectious diseases, old people's homes, free clinics, etc. 

All these institutions are estimable, but work on the prin- 
ciple, when you get sick we will make you well. What we are 
endeavoring to establish by medical and dental inspection is a 
far wiser principle, viz., now we have you well we'll keep you 
well. 

Of course, there will be difficulties to contend with in reach- 
ing our goal, not the least of which will be objections raised 
by the ignorant, the penurious and the pessimistic. As teach- 
ers, each of you should be looked up to in the communities 
which you serve as a leader in modern thought and progressive 
action. You owe it to your community, to your profession, and 
to yourselves. From this convention you go to the various 
centres in which you work, and we would ask you to make 
known what is contemplated in this matter of medical and 
dental inspection. It should not be difficult for you to create 
such a state of public opinion that the communities under your 
influence should be enquiring about and asking for these ser- 
vices which are to make their growing boys and girls healthier, 
happier citizens, better able to cope with life's vicissitudes and 
problems. 

Surely the Governments of our country will speedily have 
a healthy enlargement of the heart and contribute adequately 
by authoritative and financial support to this phase of conser- 
vation, the most valuable from any viewpoint of any or all our 
other natural resources, the health of our boys and girls. This 
is one matter in which our members of Parliament should act 



ORIGINAL COMMUNICATIONS 395 

as statesmen, not as politicians. They should reco^ize its 
importance to Canada's future and fearlessly inau^rate 
effective machinery to bring it to full fruition and not wait till 
public opinion forces it on them. May the time soon come 
when our boys' and girls' health is considered at least as im- 
portant as our rocks, our trees, our fish, our game, or our 
cattle. 



DIAGNOSIS IN DENTISTRY 



A. E. Webster, D.D.S., M.D., 

Read before the Hamilton Dental Society, October, 1919. 

Diagnosis may be described as the art of distinguishing 
one disease from another, or the determination of the nature 
of a case of disease. There may be a clinical diagnosis, based 
on the symptoms shown during life, irrespective of morbid 
changes producing them. A differential diagnosis is the dis- 
tinguishing between two allied diseases by contrasting their 
s}Tnptoms. There are two general methods of making a diag- 
nosis; one is known as the direct method, which is a patho- 
logic diagnosis by observing structural lesions, or pathogno- 
mic symptoms; the other method is by exclusion, recognition 
of a disease by excluding all other known diseases. Of course 
there is the laboratory diagnosis made by the examination of 
various body fluids and the secretions in the laboratory. 
Pathologic diagnosis is made by observing the structural 
lesions present. A physical diagnosis is the determination of 
disease by inspection, palpation, percussion or oscultation. 
Of course there are many other styles of diagnosis, as re- 
gional or topographical. 

The time was when there was no attempt by the physician 
or dentist to make a diagnosis. The patient usually told the 
physician what was the matter with him, and it was the con- 
sultant's duty to apply the remedy. If, for instance, a patient 
consulted a dentist of say forty, or fifty, or a hundred years 
ago, he would tell the dentist what he wished to have 
done, or from what disease he suffered, and, as a consequence, 
would nearly always dictate the treatment. It is only within 
the past ten years that a diagnosis has been important in 
the dental profession. We used to be satisfied to do that which 
we could see to be done, not knowing that there were any hid- 
den causes of svstemic disease in the mouth. 



396 DOMINION DENTAL JOURNAL 

To practice dentistry successfully to-day, one must know 
well the general chronic systemic diseases and be prepared to 
know whether these may have been caused by any local lesions 
whether in the mouth or not. Before such a society as this, 
it is unnecessary for me to name, or even discuss, the general 
diseases which may be caused by focal infection in the oral 
cavity, but I do desire to discuss the advisability or the essen- 
tialness of making a definite and positive diagnosis in all 
dental cases. It is not sufficient for the dentist to extract 
teeth, or fill teeth, at the dictation of the patient, or of some 
family physician, because the dentist is held responsible for 
the operations he performs whether they are right or wrong. 
He cannot wash his hands of any responsibility, simply be- 
cause the family physician advised a certain treatment. There 
is a case now before the Court in which the family physician 
recommended the extraction of certain teeth and guaranteed 
a cure of the patient's systemic disease— the teeth were ex- 
tracted, the patient did not get better, and now the dentist 
is being mulcted in Court proceedings for damages for ex- 
tracting teeth which did not need to be extracted. He cannot 
shirk his responsibility in this regard; he must take the full 
responsibility of his actions. 

Of the two methods of making a diagnosis spoken of, the 
dentist usually follows the first, the direct. Very rarely, I 
believe, does the dentist proceed on the basis of exclusion. 
The method of determining the cause of the disease, by ex- 
clusion, is far more certain than the direct. 

Dentists have not studied the general methods of making 
. a diagnosis as the general practitioners in medicine bave been 
compelled to do, because they have been able to see the 
patient's troubles immediately before them. In the great ma- 
jority of cases, the dentist can, by close observation, see every- 
thing that is required for his patient and may, at once, pro- 
ceed with the necessary treatment. As the scope of the pro- 
fession enlarges, these methods must be supplanted by other 
and more exact means of determining what is the cause of a 
patient's disease. We go on from day to day making fillings, 
adjusting crowns, placing dentures, treating, extracting teeth 
and treating the mucous without making very much of a diag- 
nosis. Everything that we require for a basis of diagnosis 
is presented before us at once, and too often the diagnosis, 
when it is made, is a mere guess. No successful dental treat- 
ment can be undertaken upon such conclusions. 



ORIGINAL COMMUNICATIONS 397 

I know of no better way of bringing this matter concretely 
before our minds than to take the history of an ordinary child 
through the early months until advanced years. As a child, 
he may suffer from the ordinary diseases of dentition. The 
dentist is rarely called upon to determine whether the child 
is suffering from undeveloped or unerupted temporary teeth 
or not, until, perhaps, he is six or eight months of age. Of 
all the diseases that a child can suffer from there is none so 
prevalent in the mind of the mother as that of teething, and 
yet, very frequently, those diseases which are thought to be 
caused by teething really have their cause in other source. 
For example, children suffer from ricketts, scurvy, diarrhoea 
and many nervous disorders, such as chorea and convulsions, 
without having an3rthing to do with the teeth whatsoever. If 
a dentist wishes to make a diagnosis in such cases, he must 
have a complete knowledge of the symptomatology of all of 
these diseases. As a child's teeth begin to be decayed or di- 
seased, after two or three years of age, then the patient is 
presented to the dentist for a diagnosis. Many such teeth 
that appear to be decayed are really a solution, the diagnosis 
of which is of vital importance to the child because of some 
grave systemic diseases w^hich may cause the solution of the 
temporary teeth. 

During the period of the loss of the temporary teeth and 
the development of the permanent, a diagnosis must be made 
as to the question of occlusion. If mal-occlusion should now 
present itself, it is the duty of the dentist to give that his first 
attention because of all the consequences which may follow 
upon such a misfortune. Then again, an important factor to 
be determined at this time is the question of the power of 
mastication and the ability of the patient to properly prepare 
hi^ food for digestion. 

About the same period appears the first evidences of pul- 
pitis, and following cases of pulpitis are those of peridontitis. 
A clear and definite decision as to which cases are pulpitis and 
which are peridontitis must be made. Again, take the whole 
question of children's diseases and their manifestations in 
the mouth," among these may be syphilis, measles, whooping 
cough, and various other systemic diseases. 

There is a whole group of mouth infections which are pre- 
sented to the dentist, some which may be distinctly infectious, 
while others may not be infectious at all. In this group the 
dentist must be prepared to determine which are infectious 
and which are not. He also must be prepared to make an accu- 



398 DOMINION DENTAL JOURNAL 

rate differentiation between this group of diseases and the 
group of diseases which are caused by general systemic con- 
ditions. Then there is that group of mouth manifestation 
which are caused by drugs. 

We should be able to distinguish the ordinary inflamma- 
tory processes in the mouth from malignant disease, or from 
such diseases as syphilis and tuberculosis. 

A great number of our patients apply to us for the relief 
of pain. It is necessary that we study the whole problem of 
pain and know what diseases cause pain and those which do 
not. As a rule, it is better to follow the method of diagnosis 
by exclusion. There is nothing more bewildering to the laymen 
or the general public than to see or hear of a patient suffer- 
ing from pain. Many have not any idea of how pain comes 
about and yet they undertake to treat it. If we could recog- 
nize that, as a rule, pains are caused by traumatic injury, 
infection and those remote or chronic conditions which are 
the result of some infection of a previous date, then we might 
be on the road to the diagnosis. The history of a pain is of 
vital importance in determining what its cause may be. If 
there should be a history of an accident or pressure upon 
nerves, or lodgment of foreign substances about the mouth, 
there is every evidence that the pain is due to traumatism. 
Pains due to infection come on much more slowly than those 
due to trauma, and noted by a gradual ascent to the highest 
pitch of acuteness and then gradually waning off, only to be- 
gin again at some future time. 

If the pain should be located in a spot where the inflam- 
matory process may be observed, there is not very much diffi- 
culty in making a diagnosis, but, if the pain is felt at a point 
remote from the point of infection, as most frequently occurs 
in dental pain, such as pulpitis or impaction of the third molar, 
then there is a serious difficulty in making a diagnosis, but it 
must not be forgotten that in many cases of impactions that 
mental and nervous manifestations are the chief character- 
istics of such lesions. 

Among chronic diseases there are such as general rheu- 
matism, influenza, uterine and cerebral disturbances which 
may be referred to the jaws, and patients often have one tooth 
after another extracted until they are all lost without relief. 
If one could only sit calmly by and think for a moment of all 
the possible causes of pain and exclude each until a final con- 
clusion is reached, results would be improved. The dentist of 
to-day cannot get along without a good working knowledge of 



ORIGINAL COMMUNICATIONS 399 

general pathology and general medicine. At this time allow 
me to present a few cases with very interesting histories which 
would have been better treated if a correct diagnosis had 
been made. 

Case 1. — A young married man consulted a rhinologist 
for some disturbance in his nose. During the process of this 
treatment, the young man noticed that the gums over the in- 
cisor teeth had something wrong with them. He called the 
rhinologist 's attention to these disturbances and he was sent 
to me for consultation. When I saw the case, the mucous mem- 
brane was very thin and seemed to be detached from the bone 
between the cuspid teeth and as high up as the attachment 
of the lip. In a few days, the whole mass stripped off. The 
characteristic part about this was that there was very little 
apparent infection of the tissue, no marked inflammatory pro- 
cess along the borders and that there was very little pain. 
The family physician was consulted, who had a Wassermann 
made which proved to be positive syphilis. 

Case 2.— During the early years of my practice, I had to 
treat a lateral incisor for my landlady, the pulp of which had 
died sometime before. I opened the canal and during the pro- 
cess of clearing out, I must have undoubtedly deposited a 
good deal of infectious material beyond the end of the root, 
because within forty-eight hours, the patient began to experi- 
ence extreme pain. When I came home one evening, she was 
suffering so badly that I gave her a prescription to buy some 
aconite ajid gilsemium at the drug store. After I had been 
out for some time I came in and found my patient in bed and 
quite unconscious. I could not help feeling that she had taken 
too much of my strong medicine, I called in consu/ltation, the 
family physician. He examined the patient and assured me 
that she would be all right in the morning. I didn't make a 
diagnosis of just ordinary alcoholism. I presume the patient 
was continuing to suffer after having taken my medicine and 
took the treatment into her own hands, and, undoubtedly took 
several good drinks of ordinary whiskey. The next day the 
patient's face was swollen so badly that I could hardly believe 
that one lateral incisor was the cause of so much infection. 
1 tested the cuspid and central incisors, adjoining the lateral, 
and found that they did not respond to changes of temperature, 
I concluded that the pulps were dead in these teeth also, 
and upon this diagnosis, opened into both of the teeth, only to 
find that the pulps were alive. I did not know, at that time, 



400 DOMINION DENTAL JOURNAL 

that pulps do not respond to changes of temperature during 
a highly inflammatory process around about them. This was 
again a mistake in diagnosis. I made an incision over the apex 
and allowed a good deal of pus to escape, but, unfortunately, I 
left the incision to heal up, consequently, I had to re-establish 
the sinus the next day with the lancet, a mistake in practice. 
Further on in the treatment I learned for the first time that 
the lateral incisor is very prone to cause an opening on the 
hard palate. 

Case 3.— Some years ago, a child of ten or twelve, in my 
practice, had the lower second temporary molars retained 
a good deal longer than should have occurred. The lower 
second molars, being considerably wider than the bicuspids 
which should follow them, the incisor teeth were being badly 
crowded. In order to overcome crowding and at the same time 
give an opportunity for the second bicuspids to erupt, I had 
the two second temporary molars removed, expecting that the 
bicuspids would soon come through, I left the spaces and un- 
fortunately there were no bicuspids to come, and, as a conse- 
quence, the first bicuspid tipped backwards and the first molars 
tipped forward, and the normal occlusion was destroyed. After 
that I had an X-Eay picture made and found that there were 
no bicuspids to come. Then it became necessary to regain the 
lost space and set the teeth in occlusion and put on the neces- 
sary retainers. If I had had X-Eay photographs at the begin- 
ning, then there would not have been any difficulty whatever 
retaining the space, or I might have left the temporary molars 
in position for some while longer. 

Case 4.— During the College term last winter, a healthy 
looking woman consulted the infirmary for a severe pain and 
swelling in the region of the upper first and second molar. 
After the pain had left her several hours, her face would swell 
in this region, and in some cases there would be pus exude. 
We told the woman to come to us during the height of the 
inflammatory process and then we would try tO' make out its 
origin. We saw her in about three weeks afterwards with the 
face considerably swollen and a little pus coming out from the 
side of the second molar. After examining all of the teeth 
carefully, she gave the history of having the third molar ex- 
tracted. We had X-Kay photographs made of the teeth an- 
terior to the third molar and tested them all and found pulps 
alive. We sent the patient to a rhino'logist for the examin- 
ation of the antrum. The report came back that the antrum 



ORIGIXAL COMMUNICATIONS 401 

seemed to be alright. Later on, a full sized plate of the head 
was made and the presence of a molar tooth in the antrum 
of Highmore was clearly shown. An operation was made and 
the tooth was easily removed. This was again a case of a poor 
diagnosis. It appears that the third molar had been pushed 
into the antrum during attempts to remove it. It is very un- 
usual that a third molar is so close to the antrum. 

Case 5. — A man, in out door occupation who had all his teeth 
in his mouth except one upper molar, had frequent attacks 
of pain and swelling in his lower jaw. After walking from ten 
to fifteen miles from his work to the nearest tov*Ti to consult 
a dentist, the lower first molar was extracted. The pain and 
swelling, instead of getting better, increased until the patient 
felt very ill. He consulted a physician who sent him to the 
nearby hospital. After remaining in the hospital a day or two, 
he decided to go back to the boarding house, where he was 
treated by a third physician and nursed by the boarding house 
keepers. In this house he 'became very ill. The physician in 
charge, after seeing him constantly for a week or two, removed 
a tooth which had detached itself from the tissues, with a pair 
of tweezers. In the meantime a large swelling had developed 
on the neck and was opened. The patient was so ill that it 
was found advisable to put him into the hospital again. This 
time a diagnosis was made of fracture of the lower jaw, the 
presumption being that the dentist had broken the jaw in the 
process of removing the first molar. Upon this assumption 
after the patient had recovered action was taken against the 
dentist for the recovery of damages for mal-practice. A 
careful examination and history of the whole case showed that 
this was one of faulty diagnosis from the ver}^ beginning to 
the end. The surgeon had an X-Ray plate made of the 
lower jaw and mistook the root of the second molar for an 
indication of a fracture. He, besides this, was quite sure that 
he felt a fracture, because he got crepitation in the large wound 
which he had made. The crepitation, no doubt, was the lower 
border of the jaw, which had become detached in the inflam- 
matory process. This was shown in court. The history of 
the case from the beginning shows that the pain and swelling 
had come from an impacted third molar and that the first 
molar was not to blame at all. When the first molar had been 
extracted, it is quite within the range of the facts, that the 
third molar went on in the inflammatory process as before, and 
that the tooth removed with the pair of tweezers was the third 



402 DOMINION DENTAL JOURNAL 

molar which had thrust itself out during the inflammatory 
process. 

Such cases as these illustrate the value of a correct diag- 
nosis, and the responsibility the dentist takes when patients 
consult him. 



CAST CLASP TECHNIQUE FOR REMOVABLE 

BRIDGE WORK 



Norman Beverley Nesbett, D.M.D., Boston, Mass. 

Instructor in Casting Technic, Dental Department , Harvard 

University. Instructor in Cast Clasp Bridgeivork, Dental 

Department, Columbia University. 

Reported by E. A. Grant, D.D.S., Royal College of Dental Surgeons. 

The Toronto Dental Society held its first regular meet- 
ing at the King Edward Hotel, on November 3rd. A'bout one 
hundred and twent}^ dentists gathered to hear a paper and 
clinic by Norman Beverly Nesbett, D.M.D., of Boston, on 
*^Cast Clasp Technique in Bemovable Bridgework.'' 

Dr. Nesbett in opening his paper referred to the general 
unrest as regards dead pulps— the necessity of pulp conser- 
vation and consequently the increased interest in correctly 
constructed partial dentures. 

He distinguished between partial dentures and removable 
bridges, the former being a piece where saddles were used to 
receive the burden of the stress, while the abutments were 
principally for retention; but when the abutments carried 
the stress regardless of whether a saddle was used or not, then 
the structure should be called a removable bridge. 

The cast clasp in Dr. Nesbett 's opinion had its chief field 
as an attachment for removable bridgework having only a 
very limited use in partial dentures where usually more re- 
siliency was required. It especially excelled as an attachment 
where mutilation of the abutment teeth is not desirable. 

He outlined the different methods tried out and discarded 
iii his experimental work, such as trying to obtain the wax 
pattern by the direct method in the mouth— then on a plaster 
model— using different kinds of wax and varying the tech- 
nique. 

The method of taking an impression with self-separating 
plaster, pouring the model with a hard investment material 
and casting directly on to, this did not measure up to his re- 



ORIGINAL COMMUNICATIONS 403 

quirements although he admitted fairly satisfactoi^ clasps 
could be made by this method. 

Experiments had been tried of cutting horizontal notches 
into the enamdl on buccal and lingual surfaces of the clasped 
teeth and of setting short round-headed pins into the buccal 
surface which engaged corresponding depressions in the clasp 
after the manner of a dome fastener. These were unne<iessary 
and contra-indicated. 

The advantages of his present technique which he fully 
described in his clinic were that he had an unblemished model, 
an which the clasps could be correctly designed in relation to 
one another and the final fitting and adjustment made. 

Five years' experience with the cast clasp had proved that 
it was a most desirable attachment for posfterior removable 
bridges where mutilation of tooth structure is to (be avoided, 
being adapted to all f onns of bicuspids and molars and 90 per 
cent, of cuspids. If a suitable casting alloy was used, breakage 
was very rare. The clasp should grip hardest at its extremi- 
ties, and this was secured by the use of Taggart's Wax, which 
being a highly heated wax, shrinks when built on to the wax 
pattern. The most useful field for cast clasp removable 
bridges was in short spaces not longer than 22 m.m. or where 
not more than two teeth were missing and where there were 
sound unmarred abutment teeth for larger spaces, a partial 
denture should be > constructed and for these the cast clasp had 
only a limited use. 

The wise prosthodontist should have many methods at his 
command and the success of his work depended quite as much 
on his wise selection as upon the technical ability shown in 
carrying it out. 

DISCUSSION 

Major Cummer in opening the discussion, congratulated 
the Society in having secured such an able essayist and clini- 
cian. 

Having been engaged for some time in similar lines of 
work, he felt— although he had never met the essayist until this 
evening— especially drawn towards him by the peculiar bond 
of fellowship existing between those who, though perhaps very 
far apart, are working along the same lines of thought; and 
that now, having heard the paper, he was inclined even at the 
risk of upsetting the dignity supposed to surround a citizen 
of the town from which he came, to offer an unusual degree of 
appreciation. 



404 DOMINION DENTAL JOURNAL 

Major Cruimner was of the opinion that the cast bridg-e 
with cast clasp attachments as outlined by Dr. Nesbett was 
absolutdy standard for short spaces with adjoining unmarred 
teeth. He emphasized the necessity of exact technique, es- 
pecially as the cast clasp is the most difficult casting we are 
called upon to make. He thought that the demon sit ration of 
the balanced grip between the 45 degree l>evel of the occlusal 
rest and the distal grip of the ends of the clasps was the finest 
piece of applied physics he had seen for some time. 

Only a random account can be given of the discussion as 
Dr. Nesbett insisted in answering each question in turn. He 
stated he was anxions to have his innings right away in order 
to thank Major Cummer whose published writings had been 
the very greatest inspiration to him in his work. 

The essayist had a busy time for the remainder of the 
evening as the members showed their keen interest in the 
snbject 'by asking many questions. 

Dr. Clark characterized the paper as a simple, clear tech- 
nique of something everybody wanted. He asked if teeth clasp- 
ed in this manner showed any disintegration of the enamel 
under the clasp after a lapse of years. 

Dr. Nesbett in answering this question, took care to state 
that this was not a slap-through method. A colleague had des- 
cribed it as the greatest joke ever perpetrated on the dental 
profession. It looked so easy that there was a danger of it 
being used where it was contra-indicated. Some men had re- 
ported disintegration in as high as 50 per cent, of cases, but 
he was sure that this was due to improper selection and faulty 
technique. He had kept very careful statistics and had only 
1 per cent, show any disintegration. A patient had found the 
piece so comfortable that he didn't remove it for some time 
and the teeth showed a white chalky line under the clasp. This 
had been infiltrated with silver nitrate and he expected would 
stand up for some time. He had never had any pu'lpal trouble 
in any of these cases. Patients must be watched and if any 
showed lack of prophylactic precautions, he jumped right on 
them hard. Even polished Bostonians sometimes talk rough to 
their patients. 

Dr. Belden asked if fusible metal could be used for the tooth 
form instead of amalgam. Also what alloy was used for cast- 
ing clasps. Dr. Nesbett objected to fusible metal for two 
reasons: He did not think it gave as accurate a model as 
amalgam and also it was not possible to anchor and parallel 



ORIGINAL COMMUNICATIONS 4C5 

the guide pins in the fusible metal which was easily done in 
the amalgam and these guide pins are absolutely necessary to 
prove the finished piece. He had experimented with many 
alloys for casting clasps but was now using Ney's E-Oro 
Alloy which had the proper resihency. 

In answer to another question he stated he used a technique 
alloy for packing the tooth forms. He expected this would be 
on the market shortly. 

Dr. Pearson asked for some details about the cast saddle. 
What alloy was used for it? Was there a definite arm and 
w^hat solder was used? 

The essayist replied that he used Xey 's B. Gold— a definite 
alloy of great strength for casting the cup saddle. That the 
T-shaped formation of the base of the cup helped to increase 
its strength. The riders to the clasp were accurately conform- 
ed to them so that only a minimum amount of solder was re- 
quired. 18k. solder was sufficient, but 22k. might be used if 
desired. He deprecated the use of old bridges and other scrap 
material in casting saddles as very brittle and easily broken 
castings often resulted. 

Dr. Chambers asked if Dr. Nesbett ever used a slot instead 
of simply bevelling the marginal ridge. Dr. Xesbett's ob- 
jection to the slot was that it required a great deal more work 
— generally necessitating inlays w^ith boxed-in slots. There 
was a greater danger of caries and while the slot provided 
against occlusal stress, it did not provide the wedge obtained 
from the 45 degree bevel and which was necessary to counter- 
balance the grip of the free ends of the clasps. 

Dr. Clark asked if these cases could be used in the upper 
jaw, citing a case where the molar to be clasped is somewhat 
conical in form. Dr. Xesbett stated that this type of cast 
bridge could be used on the upper jaw with as much facility as 
in the lower. Some upper teeth are more difficult than others 
to clasp. He himself had lost a six-year molar at the age of 
17, and for a long time had not been able to get anything to 
stay there. This had had a great influence on the evolvement 
of the present technique. The man who has only used an old 
style clasp has a revelation in store for him when he comes to 
use cast clasps. 

Dr. Webster remarked that the essayist was very much con- 
cerned about grinding buccal or lingual surfaces— but little 
concerned about grinding the marginal ridge. He also drew 
attention to the accidental swallowing or inspiration of small 



406 DOMINION DENTAL JOURNAL 

removaible dentures and bridges, and asked the essayist what 
precantion-s were taken and what instructions given to the 
patients to counteract this. He congratulated the essayist on 
confining himself to one subject, thoroughly presented, and 
which could be easily understood, in striking contrast to papers 
covering the whole range of dentistry and nobody carried any- 
thing home. 

Dr. Nesbett im replying to Dr. Webster, said he had the 
danger of swallowing bridges always in mind. There was no 
danger with this type, once it was in place, but he always warn- 
ed the patient to be most careful when inserting or removing it. 
He himself never trusted his naked fingers to do this, but 
always used a napkin— to ensure a firm grip. 

As to grinding buccal or lingual surfaces— observation 
shows that they 'will decay while occlusal surfaces are often 
worn right down by wear— without any decay. Also the 
enamel plate is thickest at the marginal ridge, and there is not 
much danger of going through it. 

Dr. Conboy in moving and Dr. Amy in seconding a hearty 
vote of thanks to the essayist of the evening, both emphasized 
the precise and clear manner in which the clinic had been pre- 
sented so that any of those present would feel confident thait 
they could carry out the technique. 

Dr. Nesbett in replying, said that he had only presented one 
phase of his work. Prosthetic dentistry was a very large field 
of which only the surface had been scratched. There were 
many problems requiring solution, and he urged the younger 
members of the profession to tackle some of these, quoting the 
late Theodore Roosevelt, when he said that, *^ Every man owes 
some of his time to the upbuilding of the profession or busi- 
ness to which he belongs.'' 

CLINIC 

Dr. Nesbett gave a splendid clinic— his models were mas- 
terpieces of precision and every step in the technique was 
clearly shown. He first premised that he was showing a bridge 
and not a denture— which was supported entirely by the clasps 
on the teeth— and not at all by any saddle resting on or sup- 
ported by the rid ge. That it was especially indicated for short 
spaces between sound unmarred vital teeth. It was first nec- 
essary to thoroughly clean and polish the teeth to be clasped. 
Then with a smalil cylindrical inlay stone, the marginal ridge 
at the point where it is desired to place the occlusal rest is 



ORIGINAL COMMUNICATIONS 407 

bevelled slightly to a 45 degree angle, without penetrating the 
enamel, and polished with cuttlefish disks. A plaster impres- 
sion of the space and adjoining teeth is then taken, separated 
for removal and assembled in the usual way; this impression 
must present a perfect picture of any parts it is desired to 
work upon. A wax bite and a compound impression of the 
opposing teeth are also obtained. 

So far, the technic has been along weM established lines, 
but just at this stage Dr. Nesbett introduced one of his own 
''stunts," which ensures accuracy and makes it possible to 
prove the fit of the finished piece. 

Amalgam is packed into the impression of the teeth to be 
clasped, and a post about 20 m.m. in length inserted into the 
amalgam in each tooth, to a depth of about 5 m.m. These posts 
must be tapering and rectangular in any cross section. The 
common picture frame brad is excellent for the purpose. • 

When the posts have been inserted, they must next be par- 
alleled in two planes, i.e. mesio-distally and bucco-lingually. 
This can quite easily be done by the naked eye without the aid 
of any complicated paralleling device. The amalgam is now 
allowed to set over night and the next day, the exposed sur- 
faces of amalgam and posts are lightly smeared with vaseline 
and the rest of the impression poured with one of the artificial 
stone compounds, and mounted on the articulator. 

To make the wax pattern, for the clasps, the outline of the 
clasip and occlusail rest on each tooth, is carefully studied in 
relation to the other and marked on the amalgam tooth form 
with a lead pencil. The amalgam tooth form is then removed, 
very slightly oiled and a sheet of Solbrigg's Sheet Casting 
Wax, 28 gauge, warmed in the fingers to body temperature, 
is wrapped right around the tooth form, adapting firmly with 
the fingers, but taking care not to stretch it. Taggart's Inlay 
Wax is now traced over this with a fine spatula, to conform to 
the pencilled outline, which can be plainly seen through the 
semi-transparent pink wax— and built up to the thickness and 
form desired in the finished clasp .This, on cooling, will con- 
tract, ensuring a firm grip of the casting. In fact, Dr. esbett 
claimed he could produce four different degrees of tension in 
the casting, simply by the manner in which the Taggart wax 
was traced on. The sprue is now attached with stick}^ wax, about 
the contact point— the surplus pink wax trimmed away— and 
the model thoroughly chilled. Now comes the delicate oper- 
ation of removing the wax pattern from the tooth form with- 



408 DOMINION DENTAL JOURNAL 

out breakage or distortion. The free ends of the clasp are 
first freed by inserting a sharp pointed knife slightly into the 
^vax, not below or above the bulge in the tooth surface, but at 
the point of greatest convexity occluso-gingivally. With both 
ends freed in this manner, the clasp is carried directly upwards 
off the tooth form by the sprue wire and should be immedi- 
ately invested. 

Ash tube teeth are used for dummies; ground for length 
and occlusion— and a cup with post and two '^risers'' to the 
clasps, cast or swaged. The risers should be accurately adapt- 
ed to the clasps, so that a minimum amount of solder is re- 
quired. 

The parts are now assembled on the \\x)rking model, waxed 
together with stick}^ wax; the porcelain tooth removed and in- 
vestment placed on the model around the cup and clasps and 
allowed to set in position. When it is removed, the amalgam 
tooth-forms will come away with it. These are removed, the 
clasps taken off them and waxed into position again in the in- 
vestment—the investment completed and the piece soldered. 

To test the finished piece and determine whether there has 
been any distortion during soldering, the amalgam tooth- forms 
are placed into position in their respective clasps and an at- 
tempt made to place the whole on the stone model. If the posts 
go easily to place and the amalgam forms go right home on 
the model, one may be sure that the case is ready for insertion 
in the mouth. Should there be any distortion, the guide posts 
will be throwTi out of parallel relation and will bind and pre- 
vent proper setting. It will then be necessary to saw apart 
and resolder. 



NERVOUS AND MENTAL DISEASES DUE TO 

INFECTION 



Hexry a. Collin, M.D., 
Medical Director Neiv Jersey State Hospital, Tre^iton, N. J. 



Finally, the most serious result of infected teeth is to be 
found in the relation of this infection to nervous and mental 
conditions. We have been for years groping in the dark, try- 
ing to find a cause for these unexplainable conditions. We have 
considered mental diseases as something apart from 
general diseases where such things as worry, grief, fear, 
overwork, ajid many other elements are usually given as 



ORIGINAL COMMUNICATIONS 409 

the cause of disease of the mind. Since we have found at 
the State Hospital at Trenton that many of the patients suf- 
fering from mental diseases had also very serious chronic in- 
fections of the teeth, tonsils, and gastro-intestinal tract, and 
that by eliminating these infections our patients recovered, we 
are justified in concluding that these chronic infections play 
a very important role in the causation of the mental condition. 
Of course, other factors, sucfh as we have mentioned, have a 
profound effect in lowering the vitality and allowing a latent 
infection to become active. 

By recognizing the fact that mental diseases' may be the 
result of infection and the toxemia or poisoning due to this 
infection, we have been able to restore many patients, who 
with our former methods of treatment, became chronic patients 
and remained in the hospital until the time of their death. 
Thus we have been able to discharge 87 per cent, of the pa- 
tients admitted to the hospital in the last nine months, whereas 
for a period of ten years, the proportion of discharges to ad- 
missions was only 43 per cent. In other words, we have 
doubled the number of patients who leave the hospital as a 
direct result of our researches. 

As a prevention of mental diseases, then, it would seem 
that the proper care of the teeth is of the utmost importance, 
and we would emphasize the fact that the proper care is en- 
tirely different from what the usual dental examination re- 
veals, and that only by refusing to have devitalized teeth 
(teeth in which the nerve has been destroyed), crowned, or 
otherwise preserved, and insisting upon having these teeth 
extracted, can we hope for better teeth and prevent infection, 
which later will have serious consequences. This is a matter 
ivhich can be controlled by the individual, and it is the public 
in general who can bring about a better state of affairs by 
insisting upon good dentistry, in the sense we have explained, 
and by not allowing the kind of dental work which preserves 
the teeth to the detriment of the patient's health. Such re- 
sults as we are trying to obtain can only be brought about 
by educating the public in these matters, as well as the medical 
and dental profession. For this reason we believe that the 
widest publicity should be given to these facts and their im- 
portance, emphasized both from the standpoint of prevention 
and cure. 



410 DOMINION DENTAL JOURNAL 

A GREAT OPPORTUNITY 



Never in its history has the dental profession of Canada 
been faced with such an opportunity for extending its influ- 
ence, and serving its day and generation as is being presented 
at this time, in the proposed erection of a joint medical and 
dental and nursing college in affiliatioxi with the West China 
Union University at Chengtu, in the Province of Sze Chuan, 
West China. 

At the present time there is no dental college in China, yet 
three of our Canadian dentists are doing heroic service in 
this far distant land, and it is their hope that a dental college 
may be established in connection with a medical school for the 
training of Chinese students in dentistry at this centre. These 
three men are Drs. Lindsay, Thompson and Mullett, all grad- 
uates of the Royal College of Dental Surgeons. 

Dr. C. W. Service, who is home on furlough, and who has, 
during the past year, spent several months on the residence 
staff of the Gynecological Service at Johns Hopkins' Uni- 
versity, estimates that 200,000 physicians, 70,000 dentists and 
400^000 nurses are required to supply China's need. He gave 
an address recently before the Empire Club of Toronto on 
^'Some of China's Problems," which was much appreciated 
by those privileged to hear him. 

Dr. Service expects to visit Canada from coast to coast 
and also Newfoundland in the interests of this project, and 
it is hoped there will be a response worthy of the man and 
the cause. 

A prospectus outlining the scheme is being mailed as far 
as possible to every physician, dentist and nurse. Already 
the nurses of Toronto have subscribed nearly $2,000 for this 
object. 

Shall we as a profession be lacking in our appreciation of 
a worthy cause and a great opportunity of helping our fellow 
practitioners in far off China? 

I can conceive of no greater opportunity for investment 
where the returns will be greater or more enduring, for we 
shall thus help to solve China's health problem, which is a 
menace to the world, and assist in cleaning up one of the dark 
corners of the earth. 



EDITOR: 
A. E. Webster, M.D., D.D.S., L.D.S.. Toronto, ('nnjiilu. 

ASSOCIATE EDITORS: 
Ontario — M. F. Cross. L..D.S., D.D.S., Ottawa; Carl E. Klotz. L.D.S., Si 

Catharines. 
Quebec. — Eudore Debeau, L.D.S., D.DjS., 396 St. Denis Street. Montreal; Stanlej 

Bums, D.D.S., L.D.S., 750 St. Catherine Street, Montreal; A. W. Thornton, 

D.D.S., L.D.S., McGill University, Montreal. 
Alberta. — H. F. Whitaker, D.D.S., L.D.S., Edmonton. 
New Brunswick. — Jas. M. Magee, L.D.S., D.D.S., St. John. 
Nova Scotia. — Frank Woodbury, L.D.S., D.D.S., Halifax. 
Saskatchewan. — W. D. Cowan, L.D.S., Regrina. 

Prince Edward Island. — J. S. Ba&nall, D.D.S. , L.D.S.. Charlottetown. 
Manitoba. — M. H. Garvin, D.D.S., L.D.S., Winnipeg. 
British Columbia. — H. T. Minogue, D.D.S., L.D.S., Vancouver. 

Vol. XXXI. TORONTO, NOVEMBER 15, 1919. No. 11. 



GOVERNMENT AID FOR THE STRONG-MINDED 

IN PREFERENCE TO AIDING THE 

FEEBLE-MINDED 



From the statements made by the leaders of the dental 
profession and those associated with them, it would appear 
that there is no department of science in which research work 
is needed more than in dentistry. It is claimed that there is 
no department in which less is done in proportion to the need. 
Almost all the improvements in the practice of dentistry are 
introduced from other arts and sciences, even fillino' materials 
arc* nearly always used in some other calling* before they are 
used in dentistry. There are but few dentists who are doing 
research work. Most of those who are doing research along 
dental lines have had training in some other department of 
science, and, in fact, were trained for another calling in life 
and happened to drift into dentistry, or, perhaps, have no 
knowledge of dentistry at all. Within the past few years, 
there has been a great improvement in dental research and, 
in fact, an improvement in research in all departments. It 
is interesting, in this connection, to study the foundation of 
research in many other departments, so that we may be the 



412 DOMINION DENTAL JOURNAL 

better able to determine the basis of research in dentistry. 
In a recent paper, or address, by the President of the Royal 
Canadian Institute, Toronto, Professor Fields made a few 
very cogent statements. We have been in the habit of making 
the statement '^that the people of the nation are the greatest 
asset of the nation." This is only partially true unless the 
people have a certain amount of intellectuality. The wealth 
of the race consists of the thoughts of a limited number of 
men accumulated through the generations. Through these 
thoughts, or certain of them, they are able to reproduce things. 
It takes no great mental effort to realize that of all the mate- 
rial products of mankind which existed fifty years ago but 
little remains of value to-day. 

Most all the comforts, pleasures and happinesses of living 
of to-day are the products of the brain or thoughts of those 
gone before. The few, specially gifted men, are of more value 
to the race than all the mediocres that may be educated. Pro- 
fessor Fields raises the great problem of whether it is worth 
while to spend time in trying to educate the mediocre beyond 
a certain point. Instead it is of far more value to take the 
specially endowed and give them an opportunity to develop 
something that may be of world-wide value. It would seem 
from the study of the methods of higher education in Europe, 
that there is special attention given to the highly gifted man. 
The methods followed in France are interesting. The Gov- 
ernment provides pupilage for all those who can enter three 
or four of the higher universities of the land. Those who are 
admitted come by comparative examination, thus, only those 
of the highest attainment get Government aid. When such 
young men have three or four years' training in these institu- 
tions supported by the Government, they are then compelled 
to spend ten years in the service of the country, after which 
they may go out on their own account. It is from among such 
men as these that the professorial staffs of the universities 
are chosen. It is from among these that the research workers 
of the nation are found. On this continent the feeble-minded 
get Government aid and the specially gifted may shift for 
themselves, while it is the latter who make national as well 
as world-wide progress. 

In the Naval Department of the British Government there 
is ? similar method of taking advantage of those who have 
unusual endowment. It appears that, in the dockyards of 
Great Britain, there are regular classes going on all the time. 
If a young man there shows high attainments, he is given four 



EDITORIAL 413 

years at a regular Naval School, and, if still higher attain- 
ments can be secured, he is sent to one of the higher univer- 
sities. P^rom among the dockyard apprentices, have come the 
great naval construction experts of the British Navy. Thus 
it would seem that great brain power has been gathered and 
developed from among the apprentices and, in fact, the whole 
British Navy has been built up, in a technical sense, by those 
who joined as apprentices. Here again is an example of the 
State educating specially gifted men for their own purpose. 
In Germany, the professorial staff of the universities are ap- 
pointed from among the men of the highest attainments of 
the nation, and are looked upon as employees of the nation. 
From among these the whole scientific research work of the 
nation is developed. It would appear from the statements of 
Professor Fields, that the Government, or Governments of 
European nations, look upon the universities more as national 
service stations than of ordinary educational institutions. 
These universities are expected to do the research of the 
nation as well as to train those who are to follow them. It 
would appear that a university, in a European sense, is an 
institution in which research is done for the good of the nation 
as well as educational work for the highly, mentally-trained 
young men of the nation. These young men are very largely 
trained for the purpose of taking up research work and 
supplying the vacancies in professorial staffs. It would 
also appear that those who attend universities in Europe 
have a much higher educational and mental training than those 
on this continent. The universities of this continent do High 
School work chiefly, having very little to do with research 
work until within the past generation. In fact, Professor 
Fields points out that in one university where several of the 
members of the staff were writing scientific articles for pub- 
lication and the Regent having found out that this was going 
on, wrote to the professors in the university and told them 
they 'Were engaged to teach, not to write. This illustrates the 
attitude of the Board of Regents towards research work in 
an American University. 

This same idea of the functions of the university may be 
illustrated in another way. In Cambridge or Oxford, for ex- 
ample, a professor is expected to lecture from twenty-five to 
thirty times each year. As a matter of fact, however, most of 
them lecture double that number of hours. In fact, they are 
expected to lecture two to three times a week for thirty weeks. 



414 DOMINION DENTAL JOURNAL 

In America, on the other hand, it is not at all nnusnal for pro- 
fessors to give from three to five hundred lectures in a session, 
besides doing laboratory and other teaching. In such institu- 
tions there is not much opportunity for professors to do any- 
thing else. 

In Europe, as well as in America, there have been estab- 
lished a few specially endowed institutions for research work. 
This is especially true where a large endowment is given for 
the prosecution of research along some definite line. It would 
appear that these institutions are not very productive of re- 
sults. As national institutions, they do not seem to fill their 
functions. They may attain very high skill and report results 
along the line which they are prosecuting for a short while, 
but in such institutions there is not a body of men from whom 
recruits may be gathered. As a national organization, there 
is not anything better than the university, because, where re- 
search work is being being done in a university, there the 
young men who are liable to make good future research work- 
ers are to be found and may become interested. It is in com- 
mercial research that the nation gets its largest repayment 
for educating men in universities. It is from the university 
that all commercial research work is usually recruited. In 
America the National Dental Association has undertaken re- 
search work. It has- several centres throughout the country 
where financial aid is given for this kind of work. Besides 
this, it has a specially equipped institution in Cleveland under 
the general guidance of a committee of the National Asso- 
ciation. The finances are gotten by assessment of the mem- 
bers of the Association. In 'Canada there is now established 
an organization for doing dental research. It is expected 
that an endowment of $100,000 will be obtained, and, from 
this, research will be conducted in one of the universities of 
'the country at a time. 

" ' One of the difficulties in connection with doing research in 
'allof the universities, under any circumstances, is to get suffi- 
cient funds to carry the work on properly. A great impetus 
has' been given to research work in Canada by the appoint- 
ihenf , or establishment of research laboratories at Ottawa, 
Hj!nder the general guidance and direction of Professor Mc- 
'Gaiium. Research along the lines of dentistry might well be 
'tiildertaken in such an organization for the good of the nation. 



EDITORIAL . 415 

BLOCKING ANAESTHESIA 



The advantages of nerve blocking by conductive anaes- 
thesia are many, but the folloA\ing will serve as suggestions 
of some of the most important. 

1. The long duration is of great value, and is important, 
if not the most important for the removal of impacted third 
molars, reducing fractures, treating the antrum, root amputa- 
tion, removal of tumors, cavity preparation, removal of pulps, 
sealing teeth, in the observation and practice of the oral sur- 
geon and general practitioner. 

2. Can be used with perfect safety on alcoholics and habit- 
ual drug users. 

3. Large and small areas may be anaesthetized. 

4. Infected and inflamed areas may be blocked by anaes- 
thetizing nerve branches at a point some distance from the 
operative field and in healthy tissue. 

5. When skilfully made, nerve blocking injections are done 
without any appreciable pain. 

6. One or two insertions of the needle will block the oper- 
ative field, depending, however, upon the nature of the opera- 
tion, and the area to be blocked. 

7. Co-operation of the patient. It is well known that this 
is of material advantage to the operator, because he can oper- 
ate with ease and complete the operation on the patient with a 
minimum of laceration, and without the loss of much blood and 
raucous. 

Some of the disadvantages the essayist has met with in 
ijonductive anaesthesia are : 

1. A majority of patients become nervous immediately af- 
ter the injection and often feel quite faint. 

2. Post-operative pains. 

**A number of factors can cause these conditions. The ner- 
vousness is due to the action, or over-amount of the vaso con- 
stricting agent, suprarenin, and from their psychic state. 

^^The post-operative pain is caused from many factors, 
however, the most conmion causes are : 

**1. From injecting a solution that is not physiologically 
isotonic. 

*^2. From injecting a solution too rapidly (one minium per 
second should be the rate). 

**3. From injecting a solution into muscle, ligament or be- 
neath the periosteum. 



416 DOMINION DENTAL JOURNAL 

''4. From using a stock solution, or from the injection of a 
solution which is too hot or too cold. 



Editorial Notes 



Over ninety French dentists died in the service of their 
country during the war. 

\ Lieut.-Colonel Coughlin, Guelph, was in command of the 

'^ guard of honor to the Prince of Wales. 

The Hall Method of prosthetic dentistry will be taught hy 
the Dental Educational Association, Toronto. 

Dr. McDonagh and Dr. Box were in attendance at the Na- 
tional Dental Association meeting in New Orleans. 

A regular post-graduate course in dentistry will be given 
in the Royal College of Dental Surgeons every year in the 
future. 

Miss Rose Herbert, a graduate in dentistry of Laval Uni- 
versity, Montreal, has applied for a license through the courts 
of Quebec. 

A dental car has been engaged to go from school to school 
in Nassau County, Long Island, to care for the school child- 
ren's teeth. 

Doctors Manning and Thompson of the dental staff of the 
Hamilton Board of Health, are in charge of a dental survey 
now being made. 

No stronger argument for keeping the mouth clean could 
be put forth than the statistics which show the prevalence of 
cancer in the alimentary tract as compared to all other parts 
of the body. 

The British Press are reporting numerous cases of officers 
who were formerly professional men being without employ- 
ment. Among them are many dentists. An officers' union has 
been formed for the purpose of getting employment. 



EDITORIAL NOTES , 417 

The post graduate course given by the Royal College of 
Dental Surgeons in September, to the members of the C. A, 
D. C, who had returned, was well attended. Drs. Smith and 
Hall, of Chicago, were among the teachers of the course. 

The dentists who have incurred travelling expenses in con- 
nection with the dental survey are requested to write to Dr. 
Conboy for an expense fonn. This form must be filled out and 
passed by the auditor before the account can be paid. 

It has been illegal in the United States for a physician or 
dentist to prescribe any narcotic drug for a patient which is 
for the purpose of keeping him comfortable or is not pre- 
scribed for the purpose of curing him from some real ailment. 

The will of the late Dr. Patton, the Canadian dentist \v'ho 
many years ago served the emperor of Germany in his pro- 
fessional capacity, was probated at Osgoode Hall, Toronto, 
a few days ago at one hundred thousand dollars. Thei bulk 
of the estate was made up of Canadian stocks. 

Dr. Elmer S. Best addressed the Toronto Dental Society 
during a recent trip to visit his old home in Ontario. He took 
as his subject a review of the present tendencies in dentistry. 
He placed above everything else the systematic care of the 
mouth for the purpose of preventing the involvement of the 
dental pulp. 

The dental hygienists of Colorado are licensed to remove 
deposits, tartar, accretions and stains from the exposed sur- 
faces of the human teeth in public schools and other public 
institutions, in charitable institutions, and in the offices of 
registered dentists, but only under the supervision of a duly 
licensed dentist. 

The World Trade Club is endeavoring to persuade the 
people of the United States that the metric system is to be 
preferred for weights and measures to their now cumbersome 
methods. It seems strange that it should take a campaign by 
any organization to persuade a people to adopt a decimal sys- 
tem of weights and measures which has adopted it in its 
monev system. 



418 DOMINION DENTAL JOURNAL 

The transactions of the sixth International Dental Con- 
gress have just been published. The congress came to an 
abrupt end during the early days of August, 1914. It is re- 
markable that so much of the matter prepared for the meeting 
could have been kept together for publication. If there could 
have been discussions of the communications, the congress 
would have gone down in history as the greatest of its time. 



Obituary 



DR. A. H. WEAGANT 



Dr. Allen Henry Weagant, dentist, died of pneumonia, 
Saturday, November 1st, 1919, at the General Hospital, Winni- 
peg. He resided at 896 McMillan avenue and was associated 
in business, at 526 Somerset block, with Dr. Herbert Weagant, 
dentist, and Dr. Alex. Weagant, physician. He was born at 
Williamsburg, Ont., in 1851, being a son of the late Samuel 
P. Weagant. He graduated with honors at the Royal College 
of Dentistry, Toronto, and practised for many years at Smith's 
Falls, Ont. He came to Winnipeg in 1906, where he resided 
until his death. His wife, formerly Anna Maley, of Kempt- 
ville, Ont., survives. He is also survived by one brother, Alex., 
of Aultsville, Ont., and three sisters, Mrs. Allen Gallinger of 
Vancover, Mrs. Russell and Miss Jennie Weagant, of Brook- 
lyn, N. Y. 

The late Dr. Weagant was a veteran Odd Fellow, and 
Anglican in religion. The funeral was held at 2 p.m. Tuesday, 
November 4th, from Holy Trinity Church to St. John's ceme- 
tery, under the auspices of the I.O.OF. 

DENTAL OPPORTUNITY- Suite of rooms in best location 
in Saul't Ste. Marie. Physician occupies adjoining suite. 
Address I. Taylor, Taylor Block, Sault Ste. Marie. 



DOMINION DENTAL JOURNAL 




ths^SS^ 



LOCAL ANESTHETIC. 



A SATISFACTORY synthetic anesthetic— a product of our 



research laboratories. 



Apothesine is a local anesthetic of marked efficacy. It 
is as potent a& the popular synthetic anesthetics, and less 
toxic than most of them. 

Its serviceability has been demonstrated in thousands of 
dental operations. 

Apothesine is not a derivative of cocaine. It does not 
cause "habit" formation. 



Apothesine is used in the removal of impacted molars, 
preparation of cavities, scaling for pyorrhea, removzil of nerves, 
extraction, terminal anesthesia, pressure anesthesia, etc. It is 
applicable in any procedure in which a local anesthetic is 
properly used. 

It can be sterilized by boiling. It can be combined with any 
of the usual synergists. 

IN HYPODERMIC-TABLET FORM 

H. T. No. 218. — Apothesine- Adrenalin (Dental). Lach taoier concain4 
y^ grain Apothesine and 1/2500 grain Adrenalin. One tablet in I mil 
(16 minims) of physiologic salt solution gives 2 ^ of Apothesine, and Adrena* 
kn I part in 40,000. Supplied in tubes of 20 and bottles of 100 tablets. 

Order through your Druggist or Dental Depot. 



WALKER VI 



ONTARIO. 



Parke, Davis & Co. 



DOMINION DENTAL JOURNAL 



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PORCELAm H ^ ^ = " 



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We know that DE TREY'S SYNTHETIC POR- 
CEIAIN is right by eleven years of the 
most rigid clinical and laboratory tests — 

you know it is right by eleven years of daily 
practical use and by the presence of this 
seal on the package. 




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THE L.D. CAULK COMPANY 




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PIITSBURON \ DENTAL FILUSO 

HUNTINGTON. W V* \^f^ATERIALS 

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DOMINION DENTAL JOURNAL 



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lliijjl!. 
il 



CAULK PRODUCTS 



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lU'lti 



From first visit to final "received payment'' the 

CAULK APPOINTMENT BOOK 

and WARREN CARD SYSTEM 

provide a complete, permanent record 
of every patient 

THE CAULK APPOINTMENT BOOK is not a yearly diary. It may be 
started at any time. Each day is divided into half hours frorr 
eight to six, with extra space for notes and evening hours. 
Substantially bound $1«15 

THE WARREN CARD SYSTEM comprises 

EXAMINATION BLANKS— for notes of work to be done, estimates, 
references, etc. 

CHART CARDS i300)— These are the permanent records of services ren- 
dered. Diagrams of upper and lower teeth (permanent and 
deciduous) on which are noted the location and character of 
work done. Columns for charges and credits are on the 
reverse side. 

ALPHABETICAL INDEX for each of the three divisions of Active 
Accounts, Open Accounts — finished but unpaid. Closed 
Accounts— pa\d but ready to be moved up to the active com- 
partment whenever that patient returns for further work 

CASH CARDS— Receipts and expenditure account. Bank balance. Con- 
dition of your Dental Depot deposit account, etc 



The complete card sys- 
tem is contained in a 
handsome, substantial 
metal case, with lock 
and key. In it your 
practice is safe at all 




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DOMINION DENTAL JOURNAL 



In the prevention and treatment of 

PYORRHEA 

The Dentinol and Pyorrhocide Method 
is a recognised standard 

Dentinol (liquid) applied by the dentist. Combines high 
germicidal efficiency with minimum toxicity. 
Relieves soreness following instrumentation. 
Promotes rapid healing of diseased tissues. 

Pyorrhocide Powder (Antiseptic — medicated with Dentin- 
ol, 3%.) An auxiliary treatment used by the 
patient. Aids in repairing Soft, Bleeding, 
Spongy, Receding gums. Cleans and Polishes 
the teeth. 

Improved Dentinol Pyorrhea Scalers (set of 12). Angled 
to reach all crown and root surfaces, with positive 
rest on anterior teeth. 

Improved Dentinol Prophylactic Files (set of 8). For final 

smoothing of root surfaces and continued prophy- 
laxis. 

Dentinol Perfect Syringe (Iridio platinum flat tip). An- 
nealed lead glass — ^barrel and plunger ground to 
fit — no packing — easily sterilized. 



Write for FREE copy of "Causes and Effecte of 

PYORRHEA, Its Treatment and Prevention," 

and Instrument Circular. 



THE DENTINOL & PYORRHOCIDE XO. 

Incorporated 

1480 Broadway - New York 



DOMINION DENTAL JOURNAL 



Watch the Teeth 

Cleaned With Pepsodent 



You will meet them con- 
stantly, for millions of teeth 
are now cleaned with it. 

Note how Pepsodent reduces 
the tartar formation — how it 
combats the plaque. 

The use of Pepsodent means 
this : 

The daily application of ac- 
tivated pepsin to the protein 
plaque — particularly in the 
interstices. 

Efficient daily polishing with 
tricalcic phosphate, the chief 



tooth constituent. It is unique- 
ly effective, yet the most ex- 
haustive tests prove it harm- 
less. 

An alkaline mouth condition. 
Pepsodent is acid in reaction. 
It contains no soap or other 
alkali. Therefore it stimulates 
the flow of alkaline saliva. 

Every dentist who tests it or 
watches the results will ap- 
prove it and urge its general 
adoption. 

Ask VIS for a tube to try. 



^Pl^ VHHI^H^Hi^HHi^MHM CANADA J 

Dental Mucin Digestant 

Based on activated pepsin. 
Contains no soap, no chalk 

248 



THE PEPSODENT COMPANY, 

5114 Ludington Bldg., Chicago, III. 

Please send me, free of charge, 
one regular 50c size tube of Pepso- 
dent, also literature and formula. 



Name 



Address 

Enclose card or letterbead 



VI 



DOMINION DENTAL JOURNAL 





S.S.WHITE 

^ GERMICIDAL ,^ 

<;iIVER CEMENT 

^*AliPTABliFVR ALL WORK 





Cool and Grmdml 



The setting of S.S. White Cement 
is never accompanied by a high 
temperature because of the gradual 
chemical reaction between liquid 
and powder. The heat of reaction 
is given off, to be sure, but there 
is no sudden rise in the tempera- 
ture of the mix, never above 135° 
F. And they mix easily — you'll 
like them. 

S. S. White Zinc Cement 

Made in six colors. Per ounce - $2.00 

S. S. White Silver: 
Cement "A" 

(Germicidal) 
Made in one color. Per ounce - $2.50 

SIX-OUNCE QUANTITY 

Zinc and Silver Cements, either or both, 
in any selection. 

In Mahogany Cabinet - - - $13.50 
In Quantity Package - - - 12.50 

YOUR DEALER WILL SUPPLY YOU 

S.S.White Company of Canada Limited 

489 College Street, Toronto 

Wholesale Distributors in Canada for 

THE S. S.WHITE DENTAL MFG. CO. 
Philadelphia, U.S.A. 



Send for descriptive literature 




DOMINION DENTAL JOURNAL 



Vll 




S. S. White Buff Rubber Dam 



Clean latex from the British East Indies, principally 
from the Island of Ceylon, is J^ed, with sulphur, to 
produce Buff Rubber Dam. This rubber is cultivated 
and handled like any of the products of modern agri- 
culture — with system and scientific care. 

The high quality of the rubber stock gives to Buff 
Rubber Dam its strength and elasticity. The beautiful, 
uniform light color is convincing evidence of clean 
compounding and the purity of the rubber itself. 

BUFF RUBBER DAM reflects light and helps to 
illuminate the work it protects. 

Individual Style Sheets 



In Rolls 5 Inches Wide 

Thin. Per half-yard - - - - $0.85 

" Per yard ----- 1.70 

Medium. Per half -yard - - 1.25 

" Per yard - - - 2.45 

One yard = 1,296 sq. inches. 



Thin— 

20 sheets (5x6 inches) - $1.35 
Medium — 

20 sheets (5x6 inches) - 1.65 
Always full measurement. 



YOUR DEALER WILL SUPPLY YOU 

S. S. White Company of Canada Limited 

489 College Street, Toronto 

Wholesale Distributors in Canada for 

THE S. S. WHITE DENTAL MFG. CO. 

Philaaelphia, U.S.A. 



^riii DOMINION DENTAL JOURNAL 



Are Your Patients 
Comfortable 



p 




RITTER CHAIR 

Standard Position 



To make your patients comfortable, you must use an 
Operating Chair built on right principles — one that 
does not require you to make complicated adjustments 
for each occupant. 

THE RITTER CHAIR is designed to meet anatomi- 
cal requirements. Placed in the standard operating 
position, raising or lowering the head rest is the only 
change necessary for ordinary work. 

Other adjustments, when required, are made by a 
slight touch on the lock levers — no catches to un- 
fasten — no wheels to turn. 

It almost adapts itself to a position which is com- 
fortable both to yourself and your patient. 

RITTER DENTAL MFG. CO., INC. 
Rochester, N.Y. 



DOMINION DENTAL JOURNAL 



IX 




For more than four decades "Dental Items of Interest" 
has served the Dental Profession — nearly half a century. 

To-day, in its forty-second year, it regularly brings its 
monthly report of the progress that has been made in 
dentistry — things accomplished and things yet in the 
experimental stage. 

"Dental Items of Interest" is in fact a living record — 
a text book of Dentistry which is constantly being revised 
and brought up to date. 

Don't miss any chapters — don't let your subscription 
expire, and be without it. 

To-day, when everything is being driven at high 
pressure, when changes constantly occur, one must be in 
a position to pass judgment upon the theory and technique 
of other men. "Dental Items of Interest" supplies the 
means. 

If you have not yet renewed for 1920 — do it now. 



Consolidated (^) Dental Mfg. Co. 

130 Washington Place, New York, N. Y. 



DOMINION DENTAL JOURNAL 




DOMINION DENTAL JOURNAL 



XI 



iijiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiitiitiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiy^ 



For 1920 



Subscribe Now For 

The Dental Digest 



The forthcoming articles on "Prosthodontia" 
and "Dental Econonaics" are alone worth 
more than the subscription rate, which re- 
mains the same — $L00 a year in the U.S.A. 
and Possessions. - ■ "±~.r 

The 1920 Premium will be a Supplement to 
"Professional Denture Service," containing 
new developments in scientific denture con- 
struction, including simplified technique and 
time-saving methods. The Supplement will 
be a valuable aid to better denture service. 
FREE with "The Dental Digest" for 1920. 

Subscription Terms 

United States and Possessions $1.00 

Canada 1.40 

Foreign 1.75 

Subscribe Now 

The Dentists' Supply Co., Publishers 
220 W, 42nd Street - - New York 



Xll 



DOMINION DENTAL JOURNAL 



<(Xm: OIiD REIXABLE.'' 



UfflBEiitE'S 




flpiflifigiii 



This AMALGAM has received the endorsement of the Dental Pro- 
fession at large for over sixty years, whicli would seem to render any 
remarks as to its excellence superfluous. 

BEWARE OF FRAUDULENT IMITATIONS, whether from so- 
called analysis or otherwise, and remember that Lawrence's Amalgram 
is always put up in a white lithographed envelope, covering a brown 
one containing the Amalgam, with Trade Mark on the lap of each, 
and both copyrighted. 

THE S. S. WHITE DENTAL MANUFACTURING CO., Chesnut St., 
Cor. Twelfth St., Philadelphia, Pa., is sole Agent, and all communica- 
tions from the TRADE should be addressed accordingly. 

Prices : 1 oc. $2.50; 5 oz. lots, per oz. $2.00 



Manufactured only by 

UCBROSE LAWBENOE, M.D., 109 St. Botolpli Street, Bottom, ICi 
FOR SALE AT THE DENTAL DEPOTS. 



J. W. IVORY 



MANUFACTURER OF 



DENTAL SPECIALTIES 



OF MERIT 



PHILADELPHIA, PA., U.S.A. 



DOMINION DENTAL JOURNAL 



xni 



Another Way to Use 

Calxine 





A TEMPORARY 
CEMENT 





When separating the cast from the impression in crown and bridge 
work, it sometimes happens that a tooth is broken from the cast. More 
often than not it is a tooth on which a crown has been placed. Calxine 
is better than other cements for replacing this broken tooth. Because 
it is mixed thin, the length of the tooth will not be increased appreciably. 
Because it sets quickly, the work will not be delayed. It resists the heat 
of soldering better than other cements. Try it the next time you have 
this unpleasant accident. 

A six-portion package of Calxine contains six liquids and six powders 
— pink, white or assorted — 

and costs $7.75 

20^/r less than the same amount of material in single-portion packages. 
Calxine is made in the Laboratories of 

THE CLEVELAND DENTAL MFG. CO. 

CLEVELAND, OHIO, U.S.A. 



cLEY-DtKt; 



xiv DOMINION DENTAL JOURNAL 



"ALSTON" 



RUBBER PLATE 
POLISH 



A rubber plate polish guaranteed to produce a finish of 
incomparable lustre and capable of withstanding the acid 
secretions of the mouth longer than any other finish put 
on a rubber plate. 

Nothing so enhances the value of a plate to a patient as 
the appearance, and "Alston" Plate Polish is a distinct 
improvement on all other methods of polishing. 

It coats the plate and it possesses the peculiar property of 
preventing foods, fats and the like clinging to the plate; 
this eliminates the disagreeable and annoying taste caused 
by food sticking to the plate. 




Universally Approved! 

The largest dental laboratories in America have stamped "ALSTON" 
Rubber Plate Polish as being the greatest asset acquired by the 
prosthetic department of the dental profession in the past twenty years. 

You need use no more whiting or other powders causing dust and dirt. 
"ALSTON" Plate Polish is made in a cake form, thereby eliminating 
all dirt and dust. It is clean to use. 

A mirror-like polish can be obtained in one-half minute, thereby saving 
the busy dentist and mechanic much time. 

Price, $2.50 per Large Box 

Sold by all Dental Depots or Post Free from Makers 

THE DENTAL MANUFACTURING CO., Ltd. 

919 Candler Building, 220 W. 42nd Street 
NEW YORK CITY, U. S. A. 



DOMINION DENTAL JOURNAL 



XV 




Harmony) 



-^C^ie^ IntercKangeatle Facings, in 4ie Trubyte Forms. 
o\)ercome 4ie faults and deficiencies of disnarmonious teem, in 
matching approximating teem, face fornns and shade. Tnej) ha^)e 
e-Oer^ ad-Oantage of interchangeabilit^), being standardized me 
same as me regular -^C^^i^-^^ Interchangeable Facings, and no 
complicated technic is inA)owed in meir use. 

,^/ii.vdu Trubyte Facings 

are supplied in anteriors onl^? at me present time 
Mola Cnarts on request 



THE COLUMBUS DENTAL MANUFACTURING COMPANY 



COLUMBUS, OHIO, U. S. A. 



XVI 



DOMINION DENTAL JOURNAL 



PHILLIPS' MILK OF MAGNESIA 

**THE PERFECT ANTACID '^ 

For Lx)cal and Systemic Use 



SENSITIVENESS 

GINGIVITIS 



CARIES 
EROSION 

Are successfully treated with it. It effectually neutralizes oral acidity. 



STOMATITIS 

PYORRHCEA 



PHILLIPS' PHOSPHO- MURIATE OF QUININE 

NON-ALCOHOLIC TONIC AND RECONSTRUCTIVE 

With marked beneficial action upon the nervous system. To be relied 
upon where a deficiency of the phosphates is evident. 

New York THE CHAS. H. PHILLIPS CHEMICAL CO. London 



OAnadlaa Agents: The Wln^te Chemical Go., 545 Notre Dame W. Monu«ttl, 

who will te pleased to send samples on request. 



The New Local Anaesthetic for Dentists, 
prepared in tablet form, offers the pro- 
fession an absolutely reliable product 
which is free from irritating quali- 
ties and conspicuous by its 
non- toxicity. 




For the 

Dental Profession 

Manufactured by 

The Wingate Chemical Co., Limited 

MONTREAL 



Dominion 

Dental Journal 



Vol. XXXI. TORONTO, DP^.CEMBEK 15, 1919. No. 12, 

Original Communications 



INTERESTING CASES IN DENTAL PRACTICE 



Editor. — For a great number of years the Editor of the 
Dominion Dental Journal has attempted to help the dentists 
of this country in solving some of their problems. Among 
these problems ap|)ear now and then the most difficult (jues- 
tions in the practice of dentistry. During the past couple or 
three weeks, he has received among others the following ques- 
tions. It has })een thought that, i)erliaps, a number of the pro- 
fession woukl be interested in the subjects under discussion, 
and to see the replies sent. It is hoped that the members of the 
profession will join in helping to answei- the questions asked. 

Dr. A. E. Webster, 

Royal Dental College, Toronto. 

Dear Sir:— I am writing you in regard to my own case, to 
ask your advice. Condition of teeth at present time as shown 
by X-Ray pictures taken in St. Joseph's Hospital, and diag- 
nosed by dentist. 

Condition of health at present time: Inclined to feel to a 
1 ertain extent nervous and have more or less headache. I can- 
not see any effect on system apart from this. During the last 
three months menstruation lasts 8, 10 or 1:2 days, with only 
about three weeks space between times and does not look as 
good a "color" as when teeth are in good condition and there 
is a brownish colored flnid thrown otf a day or two, or more 
before menstruation, also more or less during the period. 
When this fluid is thrown off my back aches, but I do not have 
painful meiLstruation. Will you tell me if this trouble is being 
caused from my teeth, also what this brownish colored fluid 
is, and what causes it? 

Past conditions :— About two and one half or three years ago 
I had lower left molar, farthest back (the one just back of the 



420 DOMINION DENTAL JOURNAL 

one as described in 4tli picture) treated for some time, then ex- 
tracted; there being an abscess on root. I still suffered, and 
finally had an X-Ray taken, had jaw bone operated on and 
dead tissue removed. 

From the time that this tooth bothered much, I had trouble 
with menstruation, as I have now, but it grew much worse 
then and for a short time previous to extraction and during the 
time between extraction and operation and for a time until jaw 
bone began to heal, I menstruated every day for probably two 
and a half or three months and had very much more trouble 
with this brownish fluid being thrown off than I have now. 
From the time it first began until I became normal, it was 
nearly a year and I remained normal until about three months 
ago. No ordinary trouble with teeth such as filling, havin^- 
nerves destroyed, etc., affects me in this way, it seems to take 
place only when I have abscessed ones. I flowed a great deal 
for several months during menstruation, even after it ceased 
to remain every day and began to have a lapse of two or three 
weeks between times until I became normal and about mid-way 
between the periods for about a week at a time, this fluid would 
pass off, but after a time cleared up of its own accord. Two 
dentists have both done the best they could do for me, and are 
very anxious for yonr opinion. A dental specialist in Ottawa, 
best in city, told my brother when he consulted him about me, 
to have me inform you of the condition of my teeth, and if they 
were affecting my health, that you were a medical and dental 
doctor, and the only one he knew of that could tell me. My 
dentist sent me to a medical specialist three years ago, when I 
had trouble, but, it was totally unsatisfactory, as he evidently 
didn't seem to know what effect teeth would have on the sys- 
tem, told me that I was just nervous, that a bad tooth wouldn't 
hurt people if they didn't worry about it and by so doing run 
their health down. His X-Ray pictures that he took of the 
tooth that troubled then which I had extracted were no good. 

Now, Dr. Webster, my dentist intends to remove abscessed 
molars and any dead tissue by extracting and scraping which 
they think will be necessary on one of the lower left molars, 
next to the one where they had to scrape jaw bone three years 
ago, as spoken of in picture No. 5. They think others which 
may be infected might clear up if asbcessed molars were ex- 
tracted. I am anxious to preserve all I can, do you think they 
would probably clear up? 

In regard to upper left bicuspid, as spoken of in Picture 1, 



ORIGINAL COMMUNICATIONS 421 

would it be all right to operate, remove area and by excising 
roughened end of root preserve tooth. My dentists vary in 
opinion, one thinks he had better extract tooth, the other thinks 
there is no reason why the tooth cannot be preserved and told 
me he would cnt in and remove trouble, he thought quite easily, 
didn't think from picture it was serious at all. I am anxious 
to preserve tooth especially so because they claim it a difficult 
place to bridge one on, and think I couldn't wear it, I myself 
would like to have my dentist try it, thought 1 could have it ex- 
tracted later if it became necessary, but before having it done, 
g:ive me your opinion as to whether it is unwise in present con- 
dition of health, also if you think such operations are a failure,, 
tooth has to be extracted soon anyw^ay. 

- Ii thought that if condition of health was due to teeth, by 
extracting abscessed molars it would be removing most of the 
trouble, and if I had bicuspid operated on, at once, I couldn't 
see how it could injui'e me much. Advise me as to what you 
think best, I could have it extracted if I felt any bad effects 
later if it wavsn't satisfactory. I'm most anxious to save it, if 
the risli is not too g'reat. 

You will greatly oblige me, if you will reply and advise me 
what to do and tell me if my trouble is coming from teeth or if 
you have ever known of a case where teeth have had the same 
effect on the system. 

My Dear Miss M. : — 

Let me at the outset, congratulate you on the clear and con- 
cise description of your case and symptoms. Since I have not 
seen the X-Ray pictures, nor examined your teeth carefully 
myself, J would be half inclined not to hazard a diagnosis, but 
yet you have had these symptoms before and, since they were 
entirely relieved by the treatment of infected teeth, one is led 
to the conclusion that if the present teeth were treated you 
would get a recovery now. Under the circumstances, I would 
certainly have the molar tooth extracted and, perhaps, the 
bicuspid as well, but, if there is an opportunity of performing 
the operation as described by you, that is the curretting of the 
abscess and amputation of the end of the root, then, perhaps, 
that might well be tried and, if it did not succeed, the tooth 
could afterwards be extracted. The brown or liquid brown 
discharge, which comes from the vaginal regions should be 
looked upon in a suspicious way, but, since it is not continuous 
and only comes during the regular menstrual period, then one 



422 DOMINION DENTAL JOURNAL 

is inclined to think that, perhaps, something is wrong in the 
general systemic condition. Such disturbances do occur in 
connection with focal infection. I would advise you to consult 
your dentist, having with you the X-Ray pictures, and then 
follow his advice, even if he should advise the extraction of 
several teeth. 

Ottawa, Ont., 

Sept. 10, 1919. 
])r. A. E. Webster, 
Dear Sir :— 

Have had the pleasure of taking your Journal, and several 
others, since leaving R. C. D. S., but was confronted with a 
question yesterday which I was not posted on, viz.— a gentle- 
man, aged 32 years has had nine amalgam fillings in his teeth 
in a period covering five years. He also has an extensive fixed 
bridge in the upper arch, opposing some of the amalgam fill- 
ings in the lower teeth. He complains of sore throats and 
quinsy and his physician orders him to have his silver fill- 
ings replaced with gold. 

I am quite aware of an electric charge 'between two fillings 
or a filling and a metal instrument but would be glad to be 
enlightened on the subject above. 

My Dear Doctor:— 

This is not an unusual question. There are those practi- 
tioners of homeopathy who believe that the mercury which is 
used in the making of the amalgam by some means escapes 
into the patient's general system and they thus suffer from 
iiiercurial poisoning. Although this has been thought, or 
held, by the homeopath for a great number of years, yet it has 
never been established that the mercury, which is in the amal- 
gam, escapes at body temperature. It is quite true that mei 
cury will escape if the temperature is raised high enough. I 
don't think that I would pay very much attention to the opin- 
ion of such a general practitioner. However, one must be a 
little careful in this regard when he is young in practice. 
You may explain to the patient that, perhaps, there is more 
chance for the condition at the root ends of his teeth causing 
his disease than from the amalgam. 

Dr. A. E. Webster, 

Royal Dental College, Toronto. 
Dear Sir : — 

I have received a good deal cf literature lately on the Re- 



ORIGINAL COMMUNICATIONS 423 

duction Method of Si'lver Nitrate and FoiTiialin in treating 
abscessed teeth,etc. Could you give me some information about 
it as to its success? 

In being away from the office for three years one loses 
touch with new methods and I am endeavoring to pick up 
anything that I have missed and which will be helpful to me in 
my practice. 

S'o if you will be kind enough to enlighten me on this sub- 
ject ] will be very thankful to you. 

Dear Doctor : — 

The Howe method of reducing silver in the root canals of 
teeth is now established and is looked upon as, perhaps, one of 
the most efficient methods (>f treating root canals of infected 
teeth. 

Dr. A. E. Webster, 
Dear Sir: — 

At our graduation banquet at the close of the "Summer 
Session'^ 1916, either you or one of the otiier members of the 
Faculty very kindly invited us to correspond with any of the 
Faculty in regard to any difficulties we might encounter in 
practice. 

I have a case on my hands which is giving me a good deal 
of concern. The patient, a young lady school teacher, born 
March 1900, well built, robust, active and athletic, while at- 
tending Normal School last spring— about March— began to 
suffer more or less pain in the lower anterior teeth, cold water 
and air chiefly causing the pain, and also some i)ain was no- 
ticed in the upper right second molar. She consulted me in 
June, on finishing her course, thinking the trouble was aris- 
ing from the lower left cuspid which had a small defect in 
enamel structure near the gum line. I filled same with silicate 
at that time. All the anterior teeth upper and lower are ex- 
tremely well formed, free from caries and the gum tissue per- 
fectly healthy in appearance. The filling of this cuspid did 
iK.t relieve tihe symptoms and she consulted me again in Sep- 
tember having been obliged to give up her school. There 
would be very severe pain in the lower teeth anterior to and 
including first bicuspids on taking anything cold in the mouth, 
particularly left cuspid and first bicuspid, any pressure or 
touching the teeth together would also cause pain. After try- 
ing counter irritation, etc., I placed an arsenical treatment in 
cuspid and first bicuspid but this did not help any and was 



424 



DOMINION DENTAL JOURNAL 



just left in two days. Tliere were no third molars visible, and 
suspecting impaction, 1 sent her on Sept. 15 for X-Rayi; ex- 
amination, I am enclosing iihe pictures he took. By this time 
the girl's whole nervous system was more or less upset, and I 
decided she could not undergo the operation of removing the 
third molars, and 1 removed the left second molar on Sept. 
] 7tli and the right on Sept. 20th. 

About this time she commenced taking nervous chills, and 
we left her in bed for some days. I had her examined by a 
physician but he could not discover anything else organically 
wrong. For a few days the pain was somewhat relieved, but 






/ 




the upper front teeth began to bother her in exactly the same 
way and on Oct. 1st and 2nd I removed the upper second 
molars. 

Now hot drinks cause worse pain in all front teeth than 
cold, even the air coming into her mouth on opening her lips 
starts the pain. She can't eat or touch anterior teeth to- 
gether. The pain is worse when she gets up in the morning, 
or after walking or moving about, any excitement brings on a 
nervous chill lasting four to five minutes. Her feet are always 
cold, her head always hot. After taking any nourishment 
there is a beating at her temples. Her mother is of a nervous 
disposition, subject to facial neuralgia and fainting spells for 
a great many years. 



ORIGINAL COMMUNICATIONS 425 

A dentist friend has snggested devitalizing all lower an- 
terior teeth first, but same does not appeal to me. We dis- 
cussed Dr. Brophy's Chapter on Trigeminal Neuralgia. In 
that he mentions impacted teeth as a frequent cause and states 
that even on removal of the pressure, the pain persists. Do you 
think the pains will persist after the third molars erupt fur- 
ther? Would cutting the tissue over the same help to relieve 
the pressure? None of the third molars are in sight yet, 
though I could see them after extracting the second molars. 
Would you suggest removing the third molars? My idea was 
that they would probably erupt and be more or less useful. 
What would be your opinion of alcoholic injections? I 
thought probably this might relieve the pain till the third 
molars erupted. There are also the more radical operations 
suggested by Brophy. 

I hesitated to bother you in this matter, but I can assure 
you that both Miss M. and myself are eagerly w^aiting and will 
appreciate very much any expression of opinion that your ex- 
perience can suggest. 

Dear Doctor:— 

You certainly have come across a very difficult problem in 
diagnosis. The symptoms which he gives are all indicative of 
pressure, whether from an inflamed pulp or pressure from an 
inflammatory process farther back in the jaw bone. Pain 
from unusual temperature and from exertion, especially upon 
rising, are usually indicative of a hyperemic pulp. The sore- 
ness to pressure of the anterior teeth and the soreness to 
touching food against them is not unusual where the pulps of 
the teeth are involved, but this might occur in the lowers due 
to pressure from the third molars forward, but, since that has 
subsided, or since you have removed the second molars, there 
does not seem any good reason for soreness to the anterior 
teeth, having their cause in pressure from the third molars. 
It would be well if you make a thorough examination of each 
tooth, separately, testing for the vitality, or non-vitality of 
the pulp. Do this wath the rubber dam in place and test with 
heat and cold, as wel'l as an electric current if you can obtain 
it. I do not think that it would be wise to undertake the in- 
jection of alcohol, but you could use blocking anaesthesia with 
the regular long needle and, by this means, you could, pea*- 
haps, determine whore the source of the pain is and, at the 
same time, give your patient temporary relief. In the mass 
of contradictory symptoms which you have given and since 



426 nOMINlON DENTAL JOURNAL 

you do not mention that the patient has any temperature and 
since you mention the history of nervousness, it might be well 
to think of hysteria in this connection. 

October, 27, 1919 

Dr. A. E. Webster, 

Royal Dental College, Toronto. 
Dear Doctor:— 

This afternoon I extracted twenty-one teeth for a man and 
the last tooth to be extracted was the upper second or third 
molai< on the left side. It is hard to say^ wQiich as several 
were missing adjacent to it. This tooth was the most difficult 
of all and it fractured leaving the disto-buccal root. I at- 
tempted the removal of this root which I expected to be very 
simple and it apparently disappeared. 1 know I did not ex- 
tract it and I found upon probing that I wasi apparently in 
tlie antrum. The hemorrhage was profuse and I could not 
gain a proper dry field to examine it carefully so I placed a 
packing in the cavity and asked the patient to return on Wed- 
nesday morning. 

This tooth was one of about only four that I believe were 
not infected but it was of no assistance, rather a hindrance to 
be left remaining, so I extracted what was possible. 

As you have so graciously proffered advice on many occa- 
sions, I am writing to ask you what procedure I should take. 
I have not told the patient what I fear, but am waiting to get 
a dry field for examination, however I feel quite sure that 
there is an opening into the antrum, perhaps up the lingual 
root. 

In the eventuality of the root being gone I am wondering 
wlhat should be done. Also what procedure should be taken 
regarding the open antrum. I have carefully packed it to 
prevent the fluids of the mouth from gaining entrance. 

Dear Doctor:— 

It has often occurred that teeth have been lost track of 
during extraction; and crowns, partial dentures, and bridges, 
as well as dental instruments have gone astray at other times 
with the suspicion that they had been swallowed or inspired. 
Such patients have been operated upon for the removal of 
the suspected article only to later find it in a much less harmful 
place. Because of this fact I would advise little or no probing 
of the antrum or medication of it until an X-Ray should show 
its presence in the antrum. If the root is shown to be in the 



ORIGINAL COMMUNICATIONS 427 

iintrnm you may be able to '-snare'' it with a wire loop as a 
oork is snared in a bottle. The openin.i»- will usually heal up 
if left alone. The opening should be covered with a plate but 
not plugged. 

Dr. A. E. Webster, 

In an ^xtraetion the other day the niesio-buccal root of an 
upper left second molar entered the antrum. It is still there. 
Opening into antrum fairly large, but difficult to see and work 
through on account of heavy cheek. 

What is the prognosis! What is the treatment? Will 
opening from antrum to mouth close ? 

Dear Doctor: — 

This is the second case within a week which has come to my 
notice in regard to the lossi of the buccal root of a molar. 
From observations of a good immber of cases of this charac- 
ter I should say that the prognosis is not very good. Of 
<'0urse one never knows how many of these cases go on during 
the remaindei- of the i)atient's life without cansing any nmrked 
disturbance. But every case that I have known of sooner or 
later becomes infected. The treatment, of course, should be to 
remove the root. An X-Ray photograph should be made 
which would indicate the location of the missing root. This 
guide together with a wire snare and perhax)s an enlargement 
of the opening may make it possible to get the root out. If the 
root can be removed and infection avoided and the opening 
protected from the fluids of the mouth, the chances are it w^ill 
heal up (juite readily. 

Dear Doctor: — 

Would you kindly advise me if you think it jjrobable that a 
man showing three years standing in an American University 
would be permitted to operate under me here! I haven't the 
particulars at hand, I know, but 1 thouglit you could give me 
an idea before any expense was incurred by either the appli- 
cant or myself. He spent two years at l^niversity of Philadel- 
phia and one at some other college in Philadelphia and did 
some operating in the United States navy. If these and other 
credentials prove satisfactory do you think it probaible that he 
conld get a i)ermit 1 

Dear Doctor: — 

Yours of November Cth to hand re undergraduate dentist of 
American University operating under your guidance in your 
office. According to the Dental Act and By-laws thereof, no 



428 DOMINION DENTAL JOURNAL 

one but a licentiate or a regularly indentured student is per- 
mitted to operate for patients in the Province of Ontario. If 
the vouno; man vou mentioned has Matriculation in Ontario 
and desires to attend College to complete his dental educa- 
tion, the best plan is to make direct application to the Boyal 
College of Dental Surgeons of Onario, Toronto, and through 
it make all arrangements. 



THE VALUE OF RESEARCH IN DENTISTRY 



A. E. AVebster, .M.D., D.D.S., Toronto. 

Xotfts on a Lecture d^^ldvered to the Dental Club, Toronto, December 5th, 1919. 

Thoughts and ideals endure forever. That which is built 
or constructed lasts at most but a few hundred years. In the 
realms of religion, science, mathematics and art, it i^ the 
thoughts of the few which realh^ guide. 

The discovery of a new idea while often first brought forth 
by one person— there may have been several ready to bring it 
out. When one, or perhaps many, facts are known about a 
subject, then someone is likely to discover a useful applica- 
tion of them. 

Scientists often predict certain discoveries long before they 
come. 

The discovery of the arch as a support was worth more 
to the world than thousands of builders working their lives 
through. 

One discovery makes another possible. Newton's discov- 
eries made Watts ' possible. Watts discoveries made the com- 
bustion engine possible. Think of the world w^ithout steam 
power or combustion engine power. 

The discovery of electricity made the telegraph, telephone, 
the phonograph, the kynotograph. X-ray, and the wireless pos- 
sible. 

In all these epoch making discoveries do we really think 
of how few persons were involved in them? When it is all 
summed up, the hundreds do the thinking for the millions 
and the tens set up the signal posts for the tens of millions. 
There are but few Newtons, Watts, Voltaires, Edisons and 
Marconis. 

Very few discoveries are made b}^ chance. An actual dis- 
covery is always preceded by collecting fact upon fact, toil- 



ORIGINAL COMMUNICATIOXS 429 

ing day in and ni^ht out. Nature never reveals her hidden 
treasures or her secrets to the ignorant. 

The careful collecting and recording of facts concerning a 
subject is called research. The application of these facts to 
something useful comes as a consequence. 

The bacilhis of diphtheria was discovered by Klebbs and 
Leffleur independently in 1881. It was over ten years after- 
wards that the diphtheria serum was discovered which is now 
the recognized cure of the disease. 

What has been true in other walks of life has been espe- 
cially true in the field of dentistry. The few have done the 
thinking for the many. 

Dentistry of recent times reached its highest development 
in France. INlerchaund, Fercheau and others corrected irreg- 
ularities of the teeth over a hundred years ago as well as 
practised transplantation, replantation and implantation. 

John Hunter, the great anatomist was the iirst to describe 
the fonns and structure of the human teeth. Hunter ^s obser- 
vations made it possible for W. Spooner, a Montreal dentist, 
to discover the use of arsenic as a means of destroyinfr the 
vitality of the dental pulp and thus relieve toothache. 

The discovery of anaesthesia by Wells, a dentist, not only 
relieved surgery of its terrors, but made many operations 
possible. Without anaesthesiia abdominal surgery of to-day 
would be impossible. 

The discovery of cocaine anaesthesia made the pains of 
dentistry as nothing. Without it pulp removal and much 
mechanical restoration would be impossible. 

The studies of Black in dental histology, dental pathology 
and the physical properties of gold, amalgam, and cements 
make the saving of thousands of teeth possible. 

Miller's discovery of the cause of dental caries was a great 
advance and led to the application of new methods of preven- 
tion, prophylaxis filling. This is one case in which full prac- 
tical results have not yet been attained from the discovery. 

The application of the casting process to the prevention 
of dental decay by Taggert was another advance, the fruits 
of which have not yet been fully realized in the prevention 
of pain, suffering, disease and death. 

Why enumerate more? Is it not clear that the few highly 
trained intellectual persons really do the work of millions of 
the ignorant. The man who discovered the railway track lay- 
ing machine, every one of which does the work of hundreds 



430 DOMINION DENTAL JOURNAL 

of navvies, has done as much for the progress and happiness 
of the world as thousands of others. 

What must we do! Keep on training- the average person 
to do the average things but give all of those who show special 
skill or ability the chance to prosecute their bent of mind. 
Who knows but there sits before me a Hunter, a Newton, a 
Miller, a Black or a Cummer. Opportunity is all any young 
person should ask or get. 

Thinkers are few, research workers are scarce and money 
is hard to get, but if each person here really believed that great 
benefits could be conferred on the world by their eiforts either 
in research or search for funds for others, the problem of pre- 
venting nine-tenths of the people suffering from dental disease 
and with a higher mortality than any other canse could be 
solved or ameliorated within a very few years. 



STANDARDS FOR DENTAL EDUCATION 
AND PRACTICE 



Augustus S. Downing, Albany, New York. 



For a full understanding of this paper, I must respect- 
fnliy ask you to accejjt or reject a few fundamental premises 
upon which our conclusions rest. I hope that you will feel at 
liberty to discuss these premises and whatever else may be 
said, most freely and frankly, for New York is not tb in-skinned 
nor is her present representative; nor have we any desire 
other than to protect the interests of the public, by promoting 
the best interests of the profession. 

Then, (1) dentistry is a profession by legal enactment un- 
der the provisions of the public health law. A profession does 
not become such in any State until there is a statute enacted 
by the Legislature and signed by the Grovernor creating such 
profession. Every State in the Union has its public health 
laws. In these laws, dentistr^^ is included as a profession. 
That being true, dentistry must meet the definition of a pro- 
fession. 

(2) Definition of "profession/' The word '* profession '^ 
assumes proficient attainments in special knowledge as dis- 
tinguished from mere skill and the practical application of 
such special knowledge in use for others as a vocation, as 
distinct from its pursuit for onc^s own use or benefit. For 
dentistry it implies specialized knowledge and peculiar skill 



SELECTIONS. 431 

ill the ap])licati()ii of that knowledge for the benefit of another. 

(3) Schools are necessary for iinpartin<> this special know- 
Uidge and foi- demonstrating its practical a])plication to the 
conservation of public health, and to the imparting of the trne 
professional spirit to the men who are to carry on thf^ pro- 
fession. 

(4) Adecjuate academic education is an essential int-re- 
quisite for entrance to such schools. 

(5) Systematic arrangement of this special knowledge in 
a course of study that will give to those who complete the cur- 
riculum the fullest ])ossession of such knowledge and the high- 
est skill in applying it for the benefit of others is Vital. 

(6) To the end that men who do satisfactorily secure this 
special knowledge and high skill may have an opportunity to 
serve the public, and that no others shall have that oppor- 
tunity, there nnist be established, by the State, standards of 
examination for a license to practice the profession. 

All the altruism of ]>rofessional life is summed np in the 
definition T havx^ given of a ^'profession,'' whether in medi- 
cine, law, dentistry, or any other profession, if you claim 
the title of ''profession" for your vocation, you have forever 
surrendered for that vocation as a primary purpose, your 
own benefit, your own aggrandizement, your own self; and 
you ai"e morally bound, whatever the ])rofession may be, to 
take into account first the benefit of those others whom that 
profession is to serve. The altruism of the profession which 
involves questions of public health is of a type wholly differ- 
ent from that which may actuate the other professions, such 
as law, accountancy, et al. 

The failure to lay hold upon the content of this definition 
is the source of all the trouble whicli dentistry both in its ])rac- 
tice and its educational institutions, is heir to. Not a small 
minority of dentists look upon their vocation as a commercial 
enterprise or venture. They unblushingly advertise their pro- 
fessional knowledge and professional skill as a hardware mer- 
chant adveiiises his wares. They compete for patronage as 
a carpenter or ])lumber solicits trade. 1'hey have no ])rofes- 
sional sense. They have none of the thrill of professional 
spirit that actuates a man who has only the interest of human- 
ity at heart. Many of the dental schools, in their manage- 
ment, are actuated by the same commercial notions that actu- 
ated the advertising of unprofessional but licensed dentists. 
In fact, many of the instructors in good dental schools lose 
sight of, or, at least fail to imbue their students with, the spirit 



432 DOMINION DENTAL JOURNAL 

of the profession; those schools of dentistry that are inde- 
pendent of college or university affiliation, that are dependent 
upon tuition fees for their maintenance, that divide the sur- 
plus of earnings among the instructors, are naturally and 
necessarily purveyors of the commercial spirit among their 
students. They are naturally opposed to right entrance re- 
quirements and to right professional instruction. They make 
the most of the mechanics of dentistry and fail to lay stress 
upon the scientific knowledge required for its right practice. 
In these respects your profession is far behind the medical 
profession. Medicine has driven to the wall (because they 
have made them of no account in the estimate of the public) 
proprietary medical schools. The dental profession is still 
cursed with the existence of a large number of such propri- 
etary dental schools. There are still too many dental schools 
that are wholly dependent for their maintenance upon the 
students' fees. The commonwealths in which such schools are 
located and which are responsible for their existence, have 
not come to a full realization of the true purpose of any pro- 
fessional school. The only justification for the existence of 
any professional institution is its willingmess to train men 
who will devote their lives to the conservation of public in- 
terests. The time has arrived when no professional school 
should be permitted to be incorporated, or to start upon its 
career without incorporation, unless it is an integral part of 
a college or university. In my own State two of the four 
dental schools are as yet not parts of a university, but I proph- 
esy that within five years there will be no such independent 
dental school in New York State but that all will be under uni- 
versity jurisdiction. The two independent schools of my 
State have, however, ceased to be in any sense proprietary, 
through the advancing requirements set by the Board of Re- 
gents. 

The third premise, namely, that schools are ne^essarj^ for 
imparting this special knowledge and for demonstrating its 
practical application to the conservation of public health, and 
to the imparting of the true professional spirit, to the men 
who are to carry on the profession, is at the present time 
indisputable so far as procednre as to standards is followed 
in the majority of the States in the Union. Formerly it was 
not so. I ought to say that there are still some States in the 
Union that do not require professional training in a school. 
These States are still laboring under the delusion that den- 
tistry is a vocation and not a profession; that dentistry is 



SELECTIONS. "^^^ 

largely a mechanical vocation, the successfnl practice of which 
is based upon manual dexterity and skill rather than upon 
scientific professional knowledge. Naturally, these States or 
representatives from thes« States w^ould not acknow^ledge this 
imputation, but their procedure in the licensing of men to prac- 
tise dentistry is confirmatory of at least the right to make the 
assumption. 

The fourth premise, namely, that adequate academic edu- 
catioTi is an essential prerequisite for entrance to such schools, 
is an admitted fact, with wide difference of opinion of the 
meaning of the word "adequate.'' In the beginning, a man 
who had not completed even a grammar school course was 
eligible to register as an apprentice in a dentist's office, just 
as a boy in his early 'teens could be bound or might bind him- 
self to a carpenter to learn a purely mechanical trade. But 
as tiime went on, it became evident to those who were most 
seriously concerned, namely, the preceptors, that it was im- 
possible*^ to teach their apprentices to become skilled dentists 
unless they had had at least a grammar school education. And 
when schools began to be esitablished, even though they were 
puvely commercial in purpose, the reputation of the school 
and consequently its commercial success depended upon the 
product of the institution; and the instructors in the school 
soon found that young men who had had only a modicum of 
ediication w-ere incapable of taking the training, and one school 
after another established entrance requirements, some higher 
and some lower. Our own State, when the administration of 
the professional laws was charged as one of the duties of the 
Board of Regents, established, for all of the professions,^ en- 
trance requirements to professional schools to be recognized 
by them; and the statutes governing the respective profes- 
sions fixed the minimum, prerequisite, academic education for 
admission to the school : at first one year of high school, then 
two, then three and at last four. The statute of 1916 made 
the presentation of a dental situdent certificate to the dental 
school a necessary act before such school might matriculate 
the applicant for admission; and further left it in the hands 
of the Board of Regents to prescribe the course of study for 
admission to the school. 

In our State there are three factors in advancing the edu- 
cational requirements: 

(a) The State Board of Dental Examiners, who are all 
members of the dental profession and are supposedly familiar 
Avith the requirements of the profession. 



434 DOMINION DENTAL JOURNAL 

(bj The State Dental Council, which is composed of the 
deans of the dental schools. These men are certainly familiar 
with all of the problems involved in right dental education, 
and the condition of the profession : for example, as to the 
supply of students and the demand for practitioners. This 
factor, better than either of the other two perhaps, is in posi- 
tion to say whether an advance in the prereqursite entrance 
requirements will seriously affect the attendance upon a school 
by curtailing the number of students, and whether such cur- 
tailment of the student body will react dis-astrously upon the 
supply of practitioners and therefore be harmful to the in- 
terests of public health. 

(c) The Board of Regents is the legislative body, for this 
Board approves, by enactment into rule, the conclusion which 
may be reached by joint agreement of themselves and the other 
two factors. 

Therefore, after a considerable number of yeiars (during 
which the requirements for admission to medicine had ad- 
vanced first to the satisfactory completion of a four-year high 
school course ; then to the including in such course a year of 
physics, chemistry and biology; then the requirement of a 
college year, including college work in these three sciences, 
and a modern foreign language and English; and then two 
years of college work with the same requirements as to science, 
EInglish and modern foreign language) ; the requirements for 
admission to the study of dentistry during the same period 
having only reached a requirement of four years of high 
school work, in 1913 such prerequisite four-year high school 
course was made to include at least two of the three sciences ; 
and after Januarv 1, 1916, a vear\s work in each of the three 
sciences.* All of the schools in the State of New York were 
able to exact such requirement even though it did curtail the 
number of students that were admitted; and, moreover, be- 
cause of the centralized system of educational administration 
in our State, there could be no juggling with the entrance re- 
quirement which an}' student might present for admission, 
for every student admitted was required and is required to 
present to the registrar his dental student (jualifying certi- 

*SubseQuent to the reading of thds paper the Board of Regents of the University 
of the State of New York have made the following: rule: 

"A dental student certificate may be secured, after Januavry 1, 1&21, upon the 
presenitati on of satisfactory evidence of the completion of not less tilian one year 
of instruction in a-n approved college of liberal arts and science after tlie com- 
pletion of an approved four-year hig-h school course based upon eight years of 
elememtary preparation. The year of college instruction must be of at least 15-week 
hours, including EngMsh (3), physics (3), biology (3), and chemistry (3)." 



SPXECTIONS. 435 

ficate issued by our Department, or a letter stating- that he is 
entitled to such certificate and that the same will be issued at 
the earliest date possible, when the applicant for admission 
presents himself for matriculation. 

The debatable question then, at this point, may be stated 
as follows: Is an elementary knowledge of the principles ot* 
phy&ics, of chemistry and of biology prerequisite for the right 
study of dentistiy? The three factors mentioned above as 
determining prerequisites are in perfect agreement that such 
preliminary elementar}' knowledge is fundamental. This con- 
clusion is based upon an affirmative answer to either or both 
of two questions, namely, may dentistry legitimately be con- 
sidered a branch of medicine? Or, is dentistry so closel}' 
allied to medicine that many of the diseases treated by the 
medical practitioner may have their origin in diseased con- 
ditions of the teeth? Not a single sane instructor in any 
medical school in the country questions the fact that at least 
an elementary knowledge of physics, chemistry and biology 
is a fimdamental prerequisite to the study of medicine. If, 
then, the questions asked above are answered affirmatively, 
there can be no negative to the proposition that an elementary 
knowledge of physics, chemistry and biolog}^ must be funda- 
mental and a prerequisite to the study of dentistry. But the 
answer comes invariably that our high schools do not teach 
biology. My answer is that it's high time that they did. All 
the approved high school courses in the State of New Yoi"k 
include physics, chemistry and biology. It is true that a stu- 
dent is not required to take all three, but if he is going into 
dentistry he ought to take all three. In place of the biology 
course there are also included in the high school courses the 
electives : a half year of botany, a half year of zoology, or a 
half year of physiology, or year courses in each of these sub- 
jects; and we have always accepted the half year of zoology 
and the half year of botany as meeting the biology require- 
ment, if the student had physiology in his grammar school 
course, or if he bad the half year of physiology in the hisrh 
school course. 

The argument is made by those who are unable to meet 
this] prerequisite of the three sciences, that you are forcinir 
the boy to make his choice of his life's work in the early years 
of his high school course, and that many boys do not know 
until after they have gone through three years, or even four 
years, that they want to study dentistry, cind that these in- 
dividual boys ought to have their chance to enter the school 



436 DOMINION DENTAL JOURNAL 

on two sciences or even one science and to make up their defi- 
ciencies after they have entered the dental school. There is 
nothing* to this argument if you accept the definition of "pro- 
fession," which I have given, namely, that the profession is 
for the conservation of the public health of a community and 
is not primarily for the individual. This individual or the 
few individuals who find themselves debarred from entrance 
to a professional school, because they happen to be deficient 
in ])hysics or in chemistry or in biology, or in two of these 
subjects, can't make up the deficiency during the time they 
are taking the professional course. You can't lay the foun- 
dation to a house while you are building the first story or 
the second story or the third story or the fourth stor3\ The 
boy who finds 'that he wants to enter dentistry, but has not 
the prerequisite academic knowledge to properly study the 
subject, should wait another year and accpiire that knowledge, 
to the end that he may better fit himself for his life's work 
and to the end that the dental school may be assured that the 
man will not be a menace to the public when he is graduated. 

The university schools of dentistry argue that this boy 
should be given the privilege of making up his science defi- 
ciency in the college of liberal arts and science while he is tak- 
ing his dental course. It is the old cry of the university med- 
ical schools years ago. New York was slow to require the 
three sciences in medicine as a x^i^erequisit'e, until it believed 
that the schools would not be seriously disturbed in their stu- 
dent body, and until such a time when it was generally believed 
that the exactment of such prerequisite, was for the good of 
the public. The same is true of the exactment of two of the 
sciences after January 1st, 191)], and then the exactment of 
th^ee sciences after January 1st, 1916, foi* admission to the 
study of dentistry. But in this entrance requirement the 
public suffers, the profession suffers and, I believe, the schools 
sutfer, because the schools are not honest with themselves 
and honest with each other in the enforcement of entrance re- 
quirements which they say they will enforce. The schools of 
New York have no oi)tion in enforcing them and no chance 
not to enforce the requirements, because they cannot admit 
students without a dental student certificate issued by our 
Department and signed b}^ me, unless I am to be away from 
the office for a considerable number of days. 

Jt ma}' seem to you that my statement that the schools are 
not honest with themselves and with each other is too severe 
an arraignment of those who have charge of the admission 



SELECTIONS. 437 

of students, but I have oonelusive evidence of this in the files 
of the Department. When we announced this advancinii: re- 
quirement, two schools protested upon the gTound tliat they 
could not meet the advance. In order to show that the appli- 
cants could not present tliree sciences, these two schools 
analyzed the entrance credentials of the class of 1915; and in 
such analysis both of them conclusively demonstrated that 
more than 50 i)er cent, of the entrance class did not have even 
two sciences, although the deans of these schools, in applying;- 
for re.i>*istrati()n by the Board of Hei»ents, had made affidavit 
that they would exact entrance re(juirements not lower than 
ofrnduation from a four-year hi<ih school course of study, in- 
cludin,ii^ a year of two of the tliree sciences : j)hysics, chemistry, 
biology. These are not the small, inconse(iuential, connner- 
cial schools. One is a university school and the other an in- 
dependent school, and both of them recently classified as ^'A'^ 
schools. 

1 have presented this matter to you at len«'th foi- the rea- 
sojl that many of the dental schools of the Connnon wealth 
will not appear on the list of schools reg'istered by the Board 
of Eegents next year. Will the schools here represented be 
among those that nuist be omitted from the. list? 

'^(5) Systematic arrangement of this special knowledge 
in a course of study that will give to those who complete the 
cu)-riculum the fullest possession of such knowledge and the 
highest skill in applying it for the benefit of others," is vital. 
Like its kindred, medicine, dentis'try has passed through suc- 
cessive stages of advancement of the professional require- 
ment, from two years of study to tliree years, and now to 
four years. But the duration of the course of study is only 
one element in the determination of its value. Content must 
go pari passu with length of time. For many years is was 
deemed that a three-vear course of studv was sufficient for the 
proper preparation of a man for entrance upon the i)ractice 
of dentistry. Effort in recent years was repeatedly made to 
increase the length of the course from three to four years. 
NcAv York consistently opposed such increase on the ground 
that the schools would get another year's tuition without giv- 
ing adequate return in professional knowledge and skill. It 
was proposed to add to the course more academic training 
to make up for the deficiencies which the high school students 
might show in English, in sketching, in chemistry, physics, 
biology, penmanship, et al. From the standpoint of a j)ro- 
fession that proposal was in no way honest. From the stand- 



438 DOMINION DENTAL JOURNAL 

point of a private high school or a private preparatory school, 
it could not be criticized, but from the standpoint of an in- 
stitution whose sole existence is justified because it prepares 
men for public service in matters pertaining to health, it was 
indefensible. When, however, it became the judgment of the 
three factors interested in advancing requirements that the 
public weal demanded a broader professional training for 
dentists than it was possible to give in a three years ^ course, 
New York advanced its professional course of study in length 
from three to four years, and the Board of Dental Examiners, 
and the Deams of the Schools and their Faculties, were charged 
with the responsibility of presenting a purely professional 
course to the Board of Regents for approval, cutting out all 
so-called ancillary subjects which, in my judgment, have no 
place in a professional course. In the course approved by the 
Board of Regents (copy of which may be found in the dental 
handbook, several of which I have with me) you will note a 
mild exception to this statement in that we provided, for gen- 
eral chemistry, 180 hours in the first year's course— 60 recita- 
tion and 120 laboratory hours. This seemed only fair for the 
reason that a number of outstanding dental student certifi- 
cates had been issued when chemistry was not a required 
subject, but which are valid for presentation to a dental school 
at any time after their issuance. It is contemplated that this 
requirement in chemistry will be eliminated in two years from 
no Nv— probably, one year — and that additional professional 
work will be substituted for such academic instruction. 

It was further believed that 4,000 hours should be the mini- 
mum course of study: 1,000 hours each year. If any school 
wanted to add to this number of hours, it might do so; but in 
dentistry as in medicine, I, for one, am confident that the men 
are hurried from one recitation to another; that the work is 
so heavy that there is little time for reflective consideration 
of the instruction given; and that it would be better to have 
fewer hours than obtain in most schools, and demand a severer 
exaetment of accurate comprehension of the instruction given, 
which can only be secured by reflective consideration on the 
part of the student of the instruction given. The ancillar}' 
subjects are high school subjects of study; and New York be- 
lieves that it is an economic waste to include such subjects in 
a professional course. It is a far better jjublic policy to bring 
schools to the pupils than to bring pupils to the schools, and 
a man who is entering a professional school should be able 
to get his full preparation for such professional study at his 



SELECTIONS. 439 

home, where his living expenses can be had at eos^ ; and he 
should not be 'taken away to a professional school whore he 
is charged a high rate of tuition for instruction that he was 
entitled to have at home, and at the same time be robbed of 
the opportunity of acquiring the professional knowledge and 
skill which will enable him to serve the public best, and afford 
him the opportunity of becoming a high grade practitioner. 

Moreover, medicine and dentistry are so closely allied that 
dentistry is now once more coming into its own. The two 
professions are coming together, and no medical school, worthy 
of the name, pretends to give a course of study that is not 
strictly professional, within the full meaning of that term. 
In the dental course are included the subjects of anatomy, 
pathology, histology, physiology, bacteriology, the same as in 
medicine. These subjects should be taught in the dental 
schools as thoroughly and as well as they are taught in the 
medical schools. In the courses of study approved by the 
teaching faculties of the university schools and of the inde- 
pendent dental schools, the fundamental principle that you 
cannot combine professional training and the acquiring of 
academic knowledge fundamental to such training, has been 
ignored. In Chicago I spoke (for example) of the including 
of dental rhetoric, free hand drawing, and similar academic 
subjects, and the assigning of a number of hours under the 
blanket term "and other subjects.'' Such courses cannot be 
approved as meeting the requirements of New York State. 
If the courses in the university schools and the other good 
dental schools of the country meet the minimum number of 
hours in the approved four-year course, as published in our 
announcement and as exacted in our schools, and they then 
choose to add a lot of other subjects, and if the instruction 
given in the professional courses is equal in grade or rank 
with those given in New York, there can be no objection to 
registering these schools, but otherwise these schools cannot 
be included in the registered list. 

The dental curriculum is one of the most vital subjects 
that can be brought before a body such as this, for, upon the 
integrity of this course must depend the future of the pro- 
fession, and the respect which dental schools and dentistry 
itself will conmiand among professional men and among edu- 
cated men and women generally. 

"(6) To the end that men who do satisfactorily secure 
this special knowledge and high skill may have an opportun- 
ity to serve the public and that no others shall have that 



440 DOMINION DENTAL JOURNAL 

opportunity, there must be establislied by the State, standards 
of examination for licen'se to practice the profession." In 
our own State the first standard for examination is evidence 
that the applicant for examination is over twenty-one years 
of age and has met all the preliminary and professional edu- 
cational requirements, and that he has been graduated with 
the degree of D.D.S. from a dental school registered by the 
Board of Eegents; and, second, that he has attained a rating 
of 75 per cent, or more in each of the following subjects: 
Physiology and hygiene, chemistry and metallurgy, oral sur- 
gery and pathology, operative dentistry, prosthetic dentistry, 
tln^rapeutics and materia medica, histology, and practical ex- 
aminations in operative and prosthetic dentistry. When an 
applicant has met these requirements, we believe that he 
should be allowed to practice his profession, and that a candi- 
date who cannot meet these requirements, should not be so 
allowed. 

There is one more requirement for the protection of the 
profession, secondarily, and for the public, primarily, that to 
me seems absolutely indispensable, viz., annual registration 
of all licensed dentists within the Commonwealth. Otherwise, 
in any State there will be fraud, deceit, and swindling by men 
who practice dentistry without requisite training and requisite 
skill, and without scientific knowledge; and there will be no 
way of pro'tecting the public against such charlatanism. The 
penalties imposed for violation of the statute must be severe 
and the enforcement of the statute must be thorough. I com- 
mend to your State the present dental law in force in the State 
of New York. It is the opinion of the best men of your pro- 
fession, men who have given their lives to the study and up- 
building of the profession, that it is far and awa}^ the best 
dental law in the United States. 

The scientific advance of the past few years finds the pro- 
fession of dentistry hardly equipped to solve the daily prob- 
lems and to meet the responsibilities of a thoroughly profes- 
sional dental practice; and yet no field offers greater oppor- 
tunity for distinguished service. The highest honors are wait- 
ing for the men who have prepared themselves by thorough 
education and careful painstaking study for their task. The 
reward of a grateful public, both in name and in possession 
of worldly treasure, are waiting for bestowal upon such men. 
Virtually a hundred per cent, of all the medical schools worthy 
of the name require at least two years' college preparation 
for admission to the study of medicine. Shall dentistry admit 



SELECTIONS. 441 

that it will continue to he not as learned a profession as that 
of medicine? Shall it <»o on satisfied with ])ein.*i: characterized 
as a vocation and not strictly a i)rofession? Shall it fail to 
rise to its opportunities and to its responsihilities ? Study 
if you will, as I have, the trainin.i»- of the men who are the 
deans of our dental schools, and of the men who are in>truct()rs 
therein, and you will be appalled by the small number of these 
men who have had a broad academic ti*ainini>', who have be- 
come distinguished because of their i)rofessional knowh^l^e 
and their professional skill, it is to my confident belief in the 
greatness of the i)rofession of dentistry, in its opportunity to 
serve mankind, that can be attributed the persistent, untiring 
effort for and defence of the highei* standards for dental 
education and dental practice, which J am bound to make so 
long as it shall be my opportunity as well as my duty to ad- 
minister the professional laws of the Empire State. 

Once more, may I say that I appreciate the courtesy of the 
invitation to come to talk to you, and 1 cordially invite your 
discussion, your criticism— whether favorable or adverse— 
of the six premises laid down in this ])aper and upon which 
are based all of the deductions found iher em.— Journal of 
Dental Research. 



DENTISTRY IN GREAT BRITAIN AS FOUND BY 

A COMMITTEE OF THE HOUSE 

OF COMMMONS 



(Continued from October Issue.) 

(b) THE rONDITIOX OF THE TEETH OF DIFFERENT AGE GROUPS OF 
THE POPULATION AS REGARDS DENTAL DECAY 

The evidence before the Committee as to the condition of 
the teeth of the masses of the people presents a picture of al- 
most hopdess neglect, except in so far as it is relieved by den- 
tal work aided by grants from the Board of Education and the 
Local Government Board. 

68. The Chief :\redical Officer of the Board of Education, 
in a memorandum submitted to the Committee, estimates that 
out of 6,000,000 children on the registers of Elementary 
Schools in England and Wales not less than half, or 3,000,000, 
are in need of dental treatment, and not less than 500,000 
urgently so. In many areas recent figures have shown that as 
many as 80 per cent, of children aged 6-8 years require treat- 



442 DOMINION' DENTAL JOURNAL 

meiit. In some areas it is over 90 per cent., as in the West 
Riding of Yorkshire. In London, 81 per cent, require treat- 
ment. 

69. Dr. Robertson informed us that the artisan population 
of Birmingham paid no attention whatever to their teeth ; the 
numbers who have defective teeth being very large indeed. 
Some of the girls from the point of view of appearance some- 
times have their teeth attended to, but so far as the men were 
concerned he regarded the condition as * ' very dreadful. ' ' Dr. 
Lewis Graham, the School Medical Officer of Birmingham, 
stated that 95 per cent, of the school children of Birmingham 
required some treatment of their teeth. 

70. Dr. J. D. Jenkins, Medical Officer of Health and School 
Medical Officer of Rhondda, informed us that out of 45,000 
school children medically examined not more than two or 
three have been noticed to have any dental fillings, although 
the condition of the teeth is a subject at every routine exam- 
ination. He estimated that 24,000 schoo^l children were in 
need of denal treatment in the Rhondda schools. 

71. Dr. Wheatley, Medical Officer of Health and School 
Medical Officer for Shropshire, submitted figures indicating 
that about 95 per cent, of children aged 5 years attending 
elementary schools in the area under his control had been 
found to have one or more decayed teeth. The average num- 
ber of decayed teeth in children at this age was 6.6. The 
examination had been made without probe or mirror. The 
corresponding figures for children aged 12 were over 96 per 
cent, and an average of 4.7 decayed teeth. He estimated that 
the 40,000 school children had amongst them 160,000 to 220,000 
decayed teeth, and that only the "merest fraction had had 
treatment." Dr. Wheatley referred to the conditions of the 
teeth of women examined for county council nursing scholar- 
ships. These women he regarded as representing the better 
working-class population of the county; they numbered 77, 
and the ages varied from 20 to 40, the average ag"« being 27 
years. The average number of teeth lost or decayed was no 
less than 18. 

72. Dr. Barwise, Medical Officer of Health and School 
Medical Officer for Derbyshire, commented on the deficient 
dentition of patients in the County Sanatorium for Tubercul- 
osis. He estimated that three-fourths of the male and female 
patients were in need of dentures, and that the female patients 
had each on the average of 11 extractions. 

73. The evidence submitted to the Committee indicated that 



SELECTIONS. 443 

the condition of the teeth of the women of the nation was worse 
than that of the men. Having regard to the direct connection 
between defective dentition and ill-health a greater amount of 
sickness would naturally be expected in respect of women 
than of men. The results revealed by the working of the Nat- 
ional Insurance Act are in accordance with this expectation. 

74. The Committee are in a position to estimate with a con- 
siderable amount of exactitude the condition of the teeth of the 
adult male population. The letter given below was sent to the 
Secretary of the Army Council, and the Counnittee has been 
furnished with a memorandum containing reports by the ad- 
visory dental officers of the various commands, which includes 
information regarding the dental condition of men on joining 
the Army. The memorandum also contained valuable in- 
formation on other points which is referred to elsewhere : 

The Secretary, 

Army Council. 23rd March, 1918. 

Sir, 

I am directed by the Dentists Act Committee to enclose for 
the information of the Army Council a copy of the terms of 
reference to the Committee. 

The Committee in order to be able to report usefully upon 
their reference have found it necessary to obtain information 
to enable them to form an opinion as to the general condition 
of the teeth of different age groups of the population. Evi- 
dence has been submitted to the Connnittee that much pre- 
ventable sickness and invalidity is to be ascribed to neglected 
teeth. 

The Committee have also been furnished with a consider- 
able amount of evidence which tends to the conclusion that in 
the inmiediate future an increasing demand will arise for 
skilled dentists. Public dental service under maternity and 
child welfare schemes, school dental services and treatment 
under the National Insurance Act will ail tend to increase. 
The extent and nature of the service required from dentists 
will, however, be largely conditioned by the condition of the 
teeth of the existing population. 

The Committee understand that under the Military Service 
Act, and previously by voluntary enlistment, a very large pro- 
portion of the adult male population between certain ages 
have come under tJie review of the Araiy Medical Authorities. 

The Committee have had great hesitation in asking the 
Army Council for information in the present stress of circum- 



444 DOMINION DENTAL JOURNAL 

stances but it is hoped that the Army Council already possess 
information as to the dental state of recruits which coukl be 
made available to the Committee without trouble. In these 
circumstances the Committee would be much oblig*ed if they 
may be furnished with a short memorandum giving any avail- 
able information on this matter, and expressing any view\s 
which may have been formed by the Army Council as to the 
invalidity caused in the Army and the charges falling on the 
Army funds owing to defective dentition of soldiers. 

I am also directed to state that the Committee would wel- 
come an expression of opinion by the Army Council as to the 
importance to be attached from a military point of view to any 
general improvement that can be effected in the condition of 
teeth of the adult male population. 

The Chairman and Secretary of the Committee will be very 
pleased to confer with any officer of the Army Council further 
on the matter if this should be considered desirable. 

I am, &c., 

F. H. 0. Jerram, 

Secrctaru. 

75. The following are extracts from the memorandum : 

Scottish Command 
In view of the fact that since 25th February, 1915, recruits 
who are otherwise physically fit are not rejected on account 
of their teeth, the dental condition of men joining the Army 
is practically the same as that of men in the same classes in 
Civil Life. 

(a) Young men 18 to 25 years usually require to have some 
hopelessly decayed and septic teeth extracted. In some cases 
extensive extractions and the provision of dentures is indi- 
cated, the proportion of such varies very much with the 
domicile and social status of the recruit. Fillings required 
are numerous. 

{h) Men from 25 to 35 years. Generally some loose and 
decayed teeth to be extracted, arrested decay is common. Fill- 
ings not required in same proportion as in young men. Mouths 
frequently septic and very dirty. Proportion of men re- 
quiring dentures much larger than in {a). 

(c) Men from 35 to 45 years, usually fall into two classes: 

1. Those with sufficient teeth left for mastication, and 

2. Those who require dentures. 

{d) A number of men on joining are in possession of den- 
tures, the majority in (/;) and {c) ^ many are satisfactory but 



SELECTIONS. 445 

a considerable })r(>i)()rtioii require their dentures lemodelied 
to make them dentally fit. 

# * # # # 

Recruits from industrial areas and of the artizan or 
laboring- class show little or no evidence of having had any 
attention paid to their teeth previous to enlistment, and almost 
every man requires dental treatment. 

Recruits drawn from offices, banks, professional and com- 
mercial pursuits freciuently show evidence of having had atten- 
tion paid to their teeth previous to enlistment, and conse- 
quently require much less dental treatment. 

Men from the Dominions and Colonies are usually much 
better in respect of Dental health and efficiency than Home 
Troops. 

In this connnand it was estimated that 44 per cent, of the 
men are dentally unfit in a military sense, /.p., they lack the 
minimum of dental efficiency which will ensure effective masti- 
cation of food. 

Aldershot Command. 

Out of 35,645 men recently examined it was found that : 

27.8 per cent, had teeth in good condition ; 

61.3 per cent, required conservative treatment and scal- 
ing; 

10.9 per cent, required extensive treatment and dentures. 
The amount and nature of dental treatment required by the 

above was as follows : 

37,483 Extractions. 

42,974 Fillings, many of which required root treatment. 
4,985 Dentures. 
Out of 8,500 young soldiers, not yet 19 years of age, ex- 
amined, over 7,000 required extractions and conservative 
treatment. 

London Command. 

The dental condition of recrnits on joining is generally 
bad, about 70 per cent, requiring dental treatment. These 
may be sub-divided into three classes : 

(a) Requiring slight treatment (2 or 3 fillings or extrac- 
tions which can be completed at one visit), 22 per cent. 

(b) Requiring extensive treatment (extending over sev- 
eral visits, but not necessitating the provisions of arti- 
ficial dentures), 40 per cent. 



446 DOMINION DENTAL JOURNAL 

{c) Requiring more extensive treatment (involving mul- 
tiple extractions and the subsequent provisions of den- 
tures which necessitate treatment extending over a 
month or more), 38 per cent. 

Western Command 

• It is considered that of men joining the Aniiy during the 
year April, 1917, to March, 1918, between 70 and 80 per cent, 
were in need of dental treatment. 

It was found in this command that of recruits between 18 
and 19 years of age 83 per cent, required dental treatment, 
whereas of recruits aged 19 to 44 years 93 per cent, required 
dental treatment. 

Irish Command. 

The dental condition of men on joining the Army is very 
unsatisfactory, at least fifty per cent, of recruits requiring 
dental treatment. 

Southern Command. 

The most noticeable feature in examining men's mouths is 
that dental treament previous to joining the Army, with the 
exception of extractions, is practically unknown. With refer- 
ence to young soldiers, the teeth on the whole are very good, 
extraction of the first permanent molars, if not already per- 
formed will generally leave a fit clean mouth. 

The number of sound teeth include in most cases the upper 
and lower front teeth, and leave very few for mastication, and 
one can say that all men with less than 15 sound teeth should 
in civil life, have at least one artificial denture, and men with 
less than 10, two dentures. 

Of the teeth marked "Carious,'' about 50 per cent, only 
could be filled, the remainder are stumps or so septic as to be 
unserviceable. 

Eastern Command. 

The dental co