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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        LIBRARY 

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- 
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run  5  years  at  a  reasonable  rental.  Reason,  ill-health.  Box 
111,  Dominion  Dental  Journal,  Toronto. 


Dominion 

Dental  Journal 

Vol.  XXXL       TORONTO,  NOVEMBER  15,  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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|l!i;i|liiH;i{ijpiiiii;!iiiiii!iiiiii!!iiim 

PORCELAm  H  ^  ^  =  " 


Iill!liii!ji!l!fi5ti;iii!iiiiiti 


liUi 


HiiniiniiiHniiiyiiiiiiiiiiililiiHiiiHiHliHiiiiiiiiiM^ 


iin 


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. 


WE  ARE  BOTH  CERTAIN 


l|i|ti! ' 
■''111 


iiiiii 


!!!llil!lilli11illlilil 


THE  L.D. CAULK  COMPANY 


OtPOTS 

PIITSBURON    \     DENTAL  FILUSO 

HUNTINGTON.  W  V*  \^f^ATERIALS 

PMIUAOtLPMIA.nNNA 


rTTTTTTTTrTTTTTTTrrrrrrnTnTrrrrTTTTTTT 


DOMINION  DENTAL  JOURNAL 


lU 


i!i!lillllllilli!iii!ill!lli!llli!lllP!llli;iil!l!lllllill!lllll!lllllli 


lliijjl!. 
il 


CAULK   PRODUCTS 


li:nl!l 


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 


$10.00 


THE  LD  CAULK  COMPANY 

\  TMF    \\r "11.11  r»*^  r.o  F.A.-PP- CT  '^ 


T«E    VVOWLDS  Or»E-^TEST^ 

DES'TAi  riLiiNr.   y^ 

OUAMABI 


Dl  »OTS 

-  .T  -,.«>.        .  \  DENTAL  riLUNG 
r..T,..6T0N.-.A\      „ATEB1ALi. 


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 


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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. 


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MANUFACTURER  OF 


DENTAL  SPECIALTIES 


OF  MERIT 


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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. 

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all  dirt  and  dust.     It  is  clean  to  use. 

A  mirror-like  polish  can  be  obtained  in  one-half  minute,  thereby  saving 
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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  condition  can  only  be  described  as  "bad." 
Not  more  than  3  per  cent,  have  a  "perfect  mouth"  and  97  per 
cent,  exhibit  dental  defects  of  varying  degree. 

Of  this  97  per  cent.,  it  may  be  said  that  75  per  cent,  are  in 
urgent  need  of  dental  treatment,  the  remainder  (which  would 
include  men  who  have  availed  themselves  of  some  sort  of  den- 
tal treatment  before  enlistment)  shew  deficiencies  in  the  num- 
ber of  teeth  present  but  are  more  or  less  free  from  "active 
caries"  and  "sepsis." 

(To  be  continued.) 


( 


lODITOR: 
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.      CjuI    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.   Thornrton, 

D.D.S..   L.D.S..    McCill    Univemiity,    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.  Bagnall,   D.D.S.,  l^.D.S.,  Charlottotown. 
Manitoba— M.  H.  Garvin.  D.D.S.,  L.D.S.,  Winnipeg. 
British  Columbia — H.   T.   Minogue,   D.D.S.,  L.D.S.,   Vancouver.. 

VoT..  XXXi.      TORONTO,  DECEMBER  15,  1919.      No.  12. 


MODERN  PROSTHETIC  DENTAL  PRACTICE 


While  dentistry  was  practised  as  a  mechanical  art 
there  was  no  need  of  assistants  for  the  dentist.  Since  den- 
tistry has  passed  from  the  mechanical  to  the  scientific  as  well 
as  the  ai-listic  there  is  room  for  those  who  may  spend  a  good 
deal  of  their  time  in  the  scientific  side  of  practice  thus  leaving 
the  mechanical  parts  to  be  done  by  others.  It  is  now  impos- 
sible for  any  one  person  to  become  expert  in  all  branches  of 
dentistry.  The  medical  and  surgical  sides  of  dental  practice 
are  sufficiently  broad  and  exacting  to  take  all  of  any  person's 
attention  without  expecting  to  become  expert  in  the  mechan- 
ical side  as  well. 

The  dental  profession  has  recognized  this  condition  of 
affairs  by  its  action  during  the  past  fifteen  or  twenty  years. 
The  early  dentists  of  Canada  did  all  their  o\\ti  mechanical 
work.  In  fact  take  this  away  from  them  and  there  was  little 
service  they  could  render  the  public.  Such  dentists  took  in 
young  men  to  train  in  the  art.  After  a  few  months  at  college 
such  dental  apprentices  were  given  licenses  to  practise  what 
they  were  taught  by  preceptor  and  by  college.     Dentistry  to 


448  DOMINION    DENTAL   JOURNAL 

such  preceptors  and  apprentices  was,  as  they  used  to  say, 
ninety  per  cent,  mechanical  and  ten  per  cent,  theory.  By  this 
system  the  dentist  received  a  ^ood  deal  of  cheap  lahor  while, 
of  course,  the  student  learned  some  mechanics.  Wherever  pre- 
ceptorship  is  abolished  the  dentist  is  compelled  to  get  some 
other  kind  of  assistants.  Some  employ  regular  dental  mechan- 
ics, others  employ  women  to  do  regular  office  work  as  well  as 
mechanical  work,  and  do  the  special  mechanical  work  them- 
selves while  the  great  majority  send  their  work  out  to  what 
has  developed  in  the  past  few. years— the  public  dental  lab- 
oratory. 

Twenty-five  years  ago  there  was  but  one  public  dental  lab- 
oratory in  the  Province  of  Ontario,  while  to-day  there  are 
scores  of  such  places  and  hundreds  of  mechanics.  There  is 
such  a  demand  for  dental  mechanics  that  all  are  busy,  and 
there  is  now  established  in  Toronto  a  prosthetic  dental  lab- 
oratory to  teach  returned  soldiers.  The  clear  tendency  is  to- 
wards dividing  dentistry,  if  the  mechanical  Y)art  may  be  called 
dentistry  at  all,  into  two  distinct  parts — the  science  and  art 
on  the  one  hand,  and  the  mechanism  on  the  other. 

AVhile  this  division  is  inevitable  the  time  will  never  come 
when  a  dentast  may  not  be  trained  in  mechanics  and  handi- 
craft, because  they  are  at  the  basis  of  dental  surgery.  The 
dental  surgeon  must  know  the  science,  the  art,  the  theory, 
au'l  the  practice  of  his  calling.  Nevertheless  there  is  a  great 
deal  of  mechanical  work  in  the  prosthetic  part  of  dentistry 
which  may  be  clone  by  a  person  who  does  not  know  anything 
about  the  science  and  practice  of  dentistry.  The  profession 
has  recognized  this  fact  and  sends  its  work  to  dental  labor 
atories  to  be  done. 

S>uch  an  important  change  in  the  methods  of  dental  prac- 
tice has  called  for  a  change  in  the  method  of  teaching  den- 
tistry in  the  Royal  College  of  Dental  Surgeons.  Formerly  the 
student  in  the  infirmary  did  all  that  a  patient  recpiired,  from 
examination  to  the  polishing  of  artificial  appliances,  but  to-day 
he  does  for  a  patient  all  that  a  dentist  does  in  the  presence 
of  his  patient,  examiniation,  prophylaxis,  extractions,  prepar- 
ation of  abutments  or  cavities,  insertion  of  filling,  taking  of 
impressions,  bites,  insertion  of  artificial  substitutes,  but  does 
nothing  that  can  be  done  in  a  laboratory.  It  is  the  duty  of  the 
operating  student  to  make  plans  and  specifications  of  each 
])i('ce  sent  to  the  laboratory  for  the  direction  and  guidance  of 
the  laboratory  mechanic.  By  this  plan  the  student  will  be 
tauiiht  how  to  design  and  specify  how  his  work  is  to  be  done. 


EDITORIAL  449 

Too  often  the  laboiatoiy  nieeluniic  dictates  the  methods  to  be 
followed.  It  is  ohvious  that  a  dentist  who  has  seen  tlie  patient 
should  be  in  the  ])ettei-  position  to  decide  the  form  of  restor- 
ation to  be  made. 

There  is  established  in  the  dental  colk*.i>e  a  strictly  up-to- 
date  dental  laboratory,  presided  over  by  Mr.  Kdwin  T.  Oanip- 
beh,  a  ^i^entleman  of  wide  ex]>ei  ience  in  dental  mechanics.  This 
laboratory  does  all  the  mechanical  work  for  the  patients  of 
the  intii-maiy.  Kach  senior  student  and  eventually  every  jun- 
ior student  will  ])Ut  in  a  couple  of  months  as  a  laboi-atory 
mechanic,  doin,i>'  the  work  sent  from  the  infirnuiry.  'inhere  are 
about  fifteen  to  twent>-five  students  in  the  la})()ra.tory  at  a 
time.  By  this  ])lan  stucU^nts  will  not  only  know  how  to  do 
dental  mechanics  under  careful  direction,  but  also  learn  how 
to  work  from  carefully  prepared  plans  and  specifications.  If 
an  inlay  is  to  be  made,  the  method,  direct  or  indii'ect,  the 
kir.d  of  investment,  the  machine  to  be  used  and  the  kai"at  of 
gold  as  well  as  how  it  is  to  be  alloyed,  are  all  put  into  the 
specification.  While  a  student  is  emi)loyed  in  the  laboi-atory 
he  sees  no  ])atient,  and  while  he  sees  patients  he  docs  no 
mechanical  work. 

The  next  ])i-()l)lem  will  be  to  train  dental  mechanics  under 
the  wing*  of  the  dental  profession  and  not  leave  it  to  some 
commercial  organization  to  establish  a  training  school  for 
them.  The  lioard  of  Directors,  at  its  last  meeting,  aj)])(>inted 
a  coinmittee  to  look  into  the  whole  matter.  All  that  pertains 
to  dentistry  should  come  under  the  guidance  of  the  profession, 
othei^wise  there  will  he  off-shoots  which  will  not  })e  in  the  in- 
terests of  the  i)eople. 


THE  DENTAL  NURSE  IS  HERE 


After  two  years  of  careful  consideration  and  canvass  of  the 
whole  question,  the  Royal  (V)llege  of  Dental  Surgeons  of  Ou- 
tai'io  has  established  a  course  in  Dental  Nursing.  When  the 
matter  was  first  biought  before  the  Faculty  Council,  -it  did 
not  win  very  many  friends,  but,  as  time  went  on  and  further 
investigations  were  nuide,  it  was  established  that  over  seven- 
ty-five per  cent,  of  the  dentists  had  assistants  in  their  offices. 
It  was  then  agreed  that  the  training  of  dental  nurses  should 
be  undertaken. 

There  are  now  fifteen  young  women  taking  the  course  in 
nursing.     They  began  the  second  week  in  October.     At  the 


450  DOMINION    DENTAL   JOURNAL 

present  time  they  are  passing  from  one  department  to  another, 
nntil  they  have  covered  all  the  departments  in  the  college, 
then  they  will  receive  instruction  in  private  office  practice. 
The  establishment  of  such  a  course  has  many  angles  to  it.  In 
the  first  place,  it  trains  young  women  to  make  a  living  who 
had  not  any  special  opportunity;  it  will  train  young  women 
to  serve  the  public  and  to  serve  the  dental  profession  in  a 
manner  which  will  take  a  greater  advantage  of  the  dentist's 
education.  Dentists  who  have  had  experience  with  the  use  of 
an  assistant,  or  nurse,  have  said  that  they  can  do  twice  as 
much  work  in  a  day  with  the  help  of  a  dental  nurse.  This,  in 
itself,  is  a  great  economy  to  the  State.  Fewer  dentists  will 
be  required,  or  more  people  will  be  served  by  those  who  now 
have  licenses.  In  the  past  the  dentist  has  been  obliged  to  train 
his  own  assistant  or  do  without  such  help.  This  took  a  good 
deal  of  time  and  a  good  deal  of  the  assistant's  time.  In  the 
nurses'  course  there  are  certain  general  principles  taught  the 
young  w^omen  which  make  them  immediately  serviceable  in  any 
dental  office,  no  matter  how  special  the  practice  may  be. 

The  dental  students  in  the  college  will  have  the  distinct 
advantage  of  knowing  what  an  assistant  can  do.  This  factor, 
together  with  the  stimulus  that  young  women  give  young  men 
to  do  their  best,  is  not  a  negligible  quantity.  The  pui'pose 
is  to  train  young  women  to  fill  a  demand,  which  has  devel- 
oped in  the  practice  of  dentistrj^  as  nursing  has  developed  in 
the  practice  of  surgery. 

To  enter  the  course  a  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  understand  the  ordinary  processes  in  book- 
keeping and  banking.  They  must  be  physically  and  mentally 
capable  of  acquiring  the  necessary  training  and,  afterwards, 
following  the  occupation  of  dental  nursing  successfully.  The 
course  embraces  such  parts  as  appointments,  keeping  and  fil- 
ing of  records,  bookkeeping,  correspondence,  typewriting, 
dental  equipment  keeping  and  purchasing,  account  collecting, 
banking,  general  discussion  of  the  incidence  of  dental  caries, 
general  knowledge  of  the  causes  of  dental  caries,  methods  of 
preventing  dental  caries,  the  relation  of  diet  and  mastication 
to  decayed  teeth  and  oral  cleanliness,  tooth  brushes  and  brush- 
ing teeth,  massaging  and  rinsing  of  the  mouth,  teaching  pa- 
tients to  clean  the  mouth  and  teeth,  school  and  hospital  dental 
services,  care  of  the  dental  office,  which  will  include  methods 
of  cleaning  and  caring  for  the  general  housekeeping  of  an 


EDITORIAL  451 

office;  a  study  of  all  the  various  methods  of  disinfecting  and 
sterilizing  dental  instruments,  as  well  as  taking  care  of  the 
general  office  equipment.  The  course  is  very  thorough  in  the 
study  of  filling  .materials  and  their  preparation  for  use  in  the 
mouth,  as  well  as  the  methods  of  mixing  and  compounding 
drugs  for  the  use  of  the  dentist.  Each  assistant  will  be  cap- 
able of  taking  X-ray  photographs  and  develo])ing  them,  as 
well  as  being  capable  of  prejjaring  to  take  pathological  speci- 
mens and  make  inoculations  from  the  mouth.  The  course  of 
lectures  embraces  such  important  subjects  as  sharpening  and 
care  of  steel  instruments,  ethics,  including  office  manners  and 
re  hit  ions  and  the  care  of  the  sick  patient. 

With  a  dental  college  or  dental  hospital  training  the  dental 
assistant  will  be  made  more  efficient.  Her  place  as  a  dental 
nurse  will  be  established,  her  duties  defined  and  her  useful- 
ness to  the  community  greatly  inicreased.  The  calling  will 
attract  a  better  class  of  women  and  deter  the  brainless,  sloth 
ful  and  lazv. 


LONDON  AND  ELGIN  DENTAL  SOCIETY 

MEETING 


The  regular  monthly  meeting  of  the  London  and  Elgin 
Dental  Society  was  held  at  the  Tecumseh  House,  London,  on 
Saturday  Evening,  Oct.  11th,  with  the  President,  Dr.  Colon 
Smith,  in  the  chair. 

Among  other  communications  was  a  letter  from  Dr.  Con- 
boy,  of  Toronto,  regarding  the  Dental  Survey  of  the  School 
Children  of  the  province.  It  was  decided  to  ask  the  School 
Inspector  to  divide  the  County  into  districts  allotting  a  cer- 
tain portion  to  each  member  for  examination. 

Dr.  S.  M.  Kennedy  reported  that  progress  was  being  made 
with  the  Dental  Clinic  at  Victoria  Hospital  but  that  it  was 
being  held  up  somewhat  on  account  of  equipment. 

Dr.  Clappison,  of  Hamilton,  gave  a  very  interesting  paper 
upon  ^^Peridontoclasia"  which  brought  a  very  enjoyable  even- 
ing to  a  close. 

Dr.  O 'Sullivan,  director  of  dental  services  for  the  Soldiers 
Civil  Re-establishment  Commission  visited  Toronto  and  its 
dental  hospitals  during  the  latter  part  of  November. 


452  DOMINION    DENTAL  JOURNAL 

MENDING  BROKEN  PLASTER  CASTS 


As  all  dentists  know  to  their  sorrow,  plaster  casts  are  fre- 
([uently  broken.  To  save  the  patient  the  inconvenience  and 
the  dentist  the  time  of  having  another  impression  made,  it  is 
highly  desirable  that  broken  casts  be  mended,  but  heretofore  it 
has  been  difficult  to  find  a  cement  that  would  work  well  on  the 
plaster.  Due  to  the  porosity  of  the  material,  ordinary  ''stick- 
ems"  are  absorbed  by  the  plaster  and  the  plaster  and  the 
edges  fail  to  stick  together. 

Dr.  James  A.  Moag  who  has  been  experimenting  with  vari- 
ous cements  has  found  that  a  pyroxylin  cement  best  serves 
the  purpose.  He  says  he  tiiids  it  indispensable  for  repairing 
plastic  casts— the  best  thing,  in  fact,  that  he  has  ever  heard  of 
or  used. 

The  cement  is  waterproof  and  is  made  on  a  soluble  cotton 
base.  It  holds  together  perfectly  the  severed  edges  of  the 
broken  plaster  casts. 


Obituary 


DR.  ARNOLD  REA  DIES  OF  SLEEPING  SICKNESS 


Dr.  Arnold  Rea,  36  years  of  age,  died  from  the  results  of 
sleeping  sickness,  the  first  case  of  this  disease  to  be  reported 
in  Alberta.  Dr.  Rea  died  after  being  in  the  comatose  state 
for  a  little  more  than  24  hours.  He  had  been  ill  for  six  days. 
Dr.  Mahood,  Medical  Health  Officer,  announced  that  the  illness 
was  sleeping  sickness,  and  the  patient  was  ({uartered  in  the 
isolation  section  of  Holy  Cross  Hospital. 

Dr.  Rea  resided  in  Calgary  for  eight  years  and  practised 
the  dental  profession  with  Dr.  Healy,  303  Alberta  Corner. 
He  is  survived  by  a  widow  and  little  daughter. 

According  to  Dr.  Healy,  Dr.  Rea  appeared  to  be  in  excel- 
lent health,  and  was  taken  ill  suddenly. 


FOR  SALE— "Good  dental  practice  in  live  city  in  Manitoba. 
Large  rooms,  good  light,  cheap  rent.  In  best  location  in  the 
city.  Reason  for  selhng  enquire  of  the  Temple-PattisoR 
Co.;  Toronto  or  Winnipeg. 


DOMINION  DENTAL  JOURNAL 


XVII 


S\\7  T?    Your  old  Gold,  Bridges,  Clippings,  Filings, 
iJL  V     i1j    Sweepings,  Platinum  and  Amalgam  Scrap 

SHIP  IT  TO  THE   NATION AL— WE    RETURN    GOLD  OR  CASH 


Gold  Beaters 

Reiinerrs 

Assayers 


National  Refining  Co.,  Ltd.  ''^"^'^M 

69  Grosvenor  Street    -     Toronto      Sopplict 


xviu 


DOMINION  DENTAL  JOURNAL 


Gilmore  Adjustable  Attachment 

For  Removable  Bridge  Work  and  Anchors  for  Partial  Dentures 

Patented  April  2,  1912. 


The  attachment  is  standardized,  adjustable 
for  tension  and  made  to  exactly  engage  a  No.  14 
Gauge  round  wire  of  clasp  metal  or  iridio- 
platinum. 

Nos.  1,  3,  7  and  9,  on  account  of  the  anchor 
arms  being  located  on  the  side,  viz.:  the  lingual, 
are  better  adapted  to  the  short-bite  cases  when 
the  space  to  be  occupied  by  the  artificial  tooth 
next  to  the  abutment  must  be  conserved. 

Nos.  2  and  4  are  designed  so  that  the  anchor 
arms  project  both  lingually  and  buccally,  leav- 
ing both  wings  of  the  attachment  free  to  open 
and  close  in  passing  over  the  angle  bar. 

Nos.  7  and  9,  on  account  of  their  extra  depth,  may  be  used  where  conditions  make 
it  evident  that  extensive  settling  would  cause  undue  strain  on  the  abutment  tooth. 

Nos.  1,  2  and  7  made  from    Kerr  Special  Metal,  for  rubber  work  only.     Nos.  3  and  4 
made  from   Kerr  Special  Gold,  for  rubber  or  soldering.     No.  9  made  from  Kerr  Special 

Gold,   for   rubber   or   soldering. 

SEND   FOR   CmCULAR   GIVING  TBCHNIC 

DETROIT  DENTAL  MANUFACTURING  CO.,  Detroit,  Mich.,  U.S.A. 


-  HUTAX  - 

TOOTH  POWDER  I  TOOTH  PASTE 

For  Sale  by  Retail  Druggists 

If  you  cannot  procure  from  your  local  druggist,  write 

direct  to  either 


THE  LYMAN  BROS.  &  CO.,  Limited, 
Toronto. 


or  LYMANS  LIMITED, 

Montreal. 


The  above  preparations  are  manufactured  and  put  up  for  the 
Canadian  Oral  Prophylactic  Association,  Limited,  by 


The  Lyman  Bros.  &  G>.,  Limited 


Toronto 


DOMINION  DENTAL  JOURNAL 


XIX 


Tufts  College 
Dental  School 

(Formerly  Boston 
Dental  College) 

Huntington  Avenue 
The  Fenway,  BOSTON,  Mass. 

Offers  a  complete  course  in  all 
branches  of  Practical  and  Scien- 
tific Dentistry.  The  opening 
exercises  of  the  school  are  held 
the  last  Wednesday  in  Septem- 
ber of  each  year.  A  catalog  will 
be  mailed  upon  application  to 
the  Secretary,  416  Huntington 
Avenue,  Boston,   Mass. 


Dentists'  Operating  Coats 

at  greatly  reduced 
prices  to   clear. 

These    are 
broken    lines 
in    imported 
mercerized 
and    woven 
Vestings. 
Regular 

$5.00 

quality,    now 

3  for 
$10.CjO 

Regular 

$6.00 

quality,  now 

3  for 
$12.50 

We  have  only  a  limited  quantity  and 
they  cannot  be  replaced  at  any  price. 

Write  us  to-day,  giving  your  breast 
rTieasiirement.  and  we  will  send  you 
sa'T.ples  of  materials  of  coats  we  have 
in   ^  )ur  size. 

THE   MILLER   MFG.  CO.,  LTD 

44-46  York  Street.  Toronto 


SCREWPOSTS 


For  Amalgam  Restoration,    Bridgew^ork  Abutments  and  Anohori.!!^  Inlays 

13    14     15     16    17     18         ^  ,  Q  ,      . 

Une    dozen   ocrewposts    in 

box,    packed  each    one   in    a 

sanitary      aseptic    translucent 

capsule,    assorted     sizes,    any 

length  or  of  any  size  with  key 

or  screwdriver,  price    .   $1.25 

Without  k«y  or  screw- 
driver    ....       $1.15 

Precious  metal  prices  on  applica- 
tion.— 18  kt.  gold,  gold  platinum, 
irid.  platinum. 

Key 
Price  10c 


0 


Length  27  64"— Medium 

n 


Length  21  64"— Short 


Length  %"— Ex.  Short 


Screwdriver 
Price   10c 


jS^Sig^;?;;; 


BLUE  ISLAND  SPECIALTY  CO. 

Orlhodonlic  Appliances  and  Supplies      Blue  island,  111.,  I).  S.  A. 

For  Sale  by  Dental  Dealers  Everywhere 
Canadian  Agents: — THE  Tl^.MPLiE  PATTISOX  CO..  T/ID..  Toronto.  Canada, 


XX 


DOMINION  DENTAL  JOURNAL 


i'H'I'l''' >>>illMiiilliiiiiiiiiiiiiiiiiiiiilIllliliiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii iiiiiiiiiiiiiiiiii iiiiiiiiiiiiiiiiiiiiiMiiirriiiiiiiiMiiMiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiHiiitiitiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii'iii.iiiiiii 

=  ^■MiuiiiuiiiiiitiuiiMniiiiiiiiiiiiiiiiMiiuiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiirMiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiMiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii iiiii iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiMiiiiiiniiHiHiiuiiiiiiuiiiiiiiinit: 


EXTRA  QUALITY 


Made  from  XX  Fine  to  Coarse 


75c  per  Dozen 


6  Dozen  - 


12 
24 


ti 


a 


-  $  3.50 

-  6.00 

-  10.00 


The  Broach  that  will 
give  you  satisfaction. 


The  Temple -Pattison  Co.,  Limited 

Toronto       London       Winnipeg       Regina 
Calgary        Edmonton        Vancouver 


=  giiiiiii'MiiiiiiiiiiiiMiiiiiiiiiiiiiiimiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiHiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiMiiiiiiiiiiiiiiiiiiiMiiiiiiiiiiiiiiiiiiimiiiiiiiiiiiiiiiiiiiiiiniiiiiNiiiiiiiiiuiiiiHnM 

^iiiiiiiiiiiiitiniiiiiiilliMiininiiiiiiiriiiiMiiiiiiiiiiiiiiiMiiiiiriiiiiiiiiiiiiriiiiiiiiiiiiiMiMiiiii liiirMiiiiiiiiiiiiiiiiiiiiiiiiiiriiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiriiiiiiiiiiiiiiiiiiiiiiMiiiiiijiiiiiiiiiriiiiiiuiiiniiirniil 


DOMINION  DENTAL  JOURNAL 


XXI 


Prescribe   Something   More 

Than  a  Tooth  Paste  for  a 

Diseased  Condition 

If  you  are  treating  a  patient  for  a  diseased  condition  is  it 

reasonable  to  have  him  use  only  a 
dentifrice?  It  falls 
short  in  convincing 
hinn  of  the  necessity 
of  treatment  of  the 
gums. 

Let  your  prescription 
convey  the  idea  that 
you  have  prescribed  for 
the  patient  something 
which  will  do  more 
than  merely  poHsh  his 
teeth.  Let  it  be  of  a 
consistency  which  will 
encourage  massaging 
with  the  fingers. 


FOR 
THE  GUNS 

BRUSH  YOUR  mTH 

wrrH  IT 

FCRMCcA  Of 


"tiv/  YORK   ClTt 


,„FbrIi  tin's., 


,  ^-'t ration  (^; 
;^»*»IN.,  OR  p. 

'■*'■''  ".J.rcR.oi. 


PHICL.  I»  '^^1 


,^^Hans  LTD.MoNT^tAuCA*^ 


Actual  Size. 


SPECIAulST  IN 
DISEASES  Of  THE  MOUTH 

PREPARED  FOR  THE 
PRE5CRIPTIOH  OF  THE 

OmikX  PROFESSION 

UNDER   AOTHORITV 
BY 

FORHAN'S  Ltd. 
Montreal, 

CANADA 


Small  Tube  35c 
Large  Tube  60c 


A  diseased  condition  of  the  mouth  requires 
constant  and  consistent  treatment  and  the  pro- 
fession has  come  to  realize  that  Pyorrhea  cases 
should  be  refused  unless  the  full  co-operation 
of  patients  can  be  secured. 

Forhan's  for  the  Gums  (paste) 
may  be  prescribed  through 
druggists,  but  the  liquid — 
Forhan's  Astringent  is  on  sale 
through  dental  houses  solely, 
and  is  sold  ONLY  TO  DENT- 
ISTS—not  to  the  public. 

Forhan^S  Ltd.,  Montreal 


XXll 


DOMINION  DENTAL  JOURNAL 


MILLIONS  of  Successful  Operations 


PERFORMED  WITH  THE  AID   OF 


i'OCALANMSIiitli^ 


Dn  R.  B.  Waiters 

Antiseptic  Local  Anaesthetic 

Prove  it  to  be  THE  PERFECT  LOCAL  ANAESTHETIC 


THERE  HAS  NEVER  BEEN  A  DEATH  FROM  ITS  USE 

During  the  twenty -five  years  it  has  been  on  the  market,  and  it  is  being 
used  in  practically  every  country  in  the  world. 

For  those  Doctors  who  wish  a  Novocain  Solution,  we  put  up  WAITE'S 
WITHOUT  COCAINE.  This  is  the  same  as  Waite's  with  Cocaine,  except 
that  it  contains  Novocain  instead  of  Cocaine. 


PRICES: 

1  oz.  2  oz. 

Waite's   1    and  2  oz.   with   Cocaine    80c  $1.60 

Waite's  1  and  2  oz.  without  Cocaine  (Novocain)  80c  $1.60 


12  oz.  50  oz.  100  oz. 
$8.40  $30.00  $55.00 
No  quantity  rates. 


THE  ANTIDOLOR  MANUFACTURING  CO. 

50  Main  Street,  SPRINGVILLE,  Erie  Co.,  N.Y. 

^^^^^^-^-^— ^—  ORDER    OF   YOUR    DEALER 


m 


Twa  LivE  SubiectB 


rP^ 


/IND 


OR/iy 

iHVCrEN 

h^/  C/jBrcfpeuiic  Value 


LAVORIS   CHEMICAL  CO. 

Minneapolis,  Minn. 


DOMINION  DENTAL  JOURNAL 


XXlll 


ROYAIv  VINOLIA 

TOOTH  PASTE 

A  British-made   dentifrice — a  favorite  with 
the  Profession  all  over  the  Empire. 

An  honestly  made  dentifrice — free  from  fad- 
dism  or  extremes — that  performs  its  work  as 
a  tooth  cleanser  efficiently  and  satisfactorily. 
It  is  not  subject  to  variation  in  any  degree, 
as  we  do  not  allow  the  high  price  of  its  in- 
gredients to  interfere  with  our 
formula  being  uniformly  carried 
out — a  decided  advantage. 

All  Druggists    and    Stores    Sell    Royal    Vinolia 
Tooth  Paste 

VINOLIA  COMPANY  LIMITED 


OPOtNThlf^ 


London 


TORONTO 


Paris 


SO*PMAK€RS  TO  M  M  IM[  KINO 


The  Blue  Broache" 


Sold  on 
Approval 

Sent  Parcel 
Post  Anywhere 


XX  Fine 
X  Fine 
Fine 
Medinm   and  Assorted 


Per  doz.,  50c.     $4.50  a  gross. 
$4.00  a  gross  in  5  gross  lots. 

**Once  used  alfvay^s  used.** 

Guaranteed  and   Sold   by 

WESTERN  DENTAL 
SUPPLY  CO. 

411  Somerset  Blk.,  Winnipeg 

Canada 

Lai   us   quote  yau    price*  on   anything  for  the 
Dental    Profession. 


Harvard  Dental  School 

A  Department    of    Harvard    University 

(Graduates  of  secondary  schools  ad- 
mitted without  examination  provided 
they    have    Uiken    required    subjects. 

Modern  buildings  and  equipment.  Fall 
term  opens  September,  22,  1919. 
Degree  of  D.  M.  D.     Catalog. 

EUGENE    H.    SMITH,    D.M.D.,    Dean. 

Boston,  Mas.s. 


Sal  Hepatica 


Mi 


MATERIALLY  AIDS 

Local   Treatment  in 

PYORRHEA 

Bristol-Myers  Co. 


XXIV 


DOMINION  DENTAL  JOURNAL 


ESTABIilSHKD  1866. 


SAMSON  RUBBER 


Eugene 
Doherty 


Trade    Mark 
No.  3768 


Dental 
Rubbers 


^vivci^ 


SAMSON    RUBBER 


Per  lb. 
$4.00 


Pink  Rubber,  light  shade  , 

Pink  Rubber,  medium  ligtit  shade 

Pink  Rubber,  deep  shade  

White  Rubber   , 


Per  lb. 

No.  1  Rubber,  medium  red  I  #0  qc 

No.  2  Rubber,  extra  ligrht  red   )  ♦'^•^^ 

Mottled  Rubber,  light  or  dark  shade 4.25 


5-lb.  lots. 
$3.85 

Per  lb. 

$6.00 

5.50 

5-Tb.  lots^ 

$3.80 
4.00 


Per  lb.       5-lb.  lots. 

Para   Black   Rubber    ] 

Pure  Black  Rubber  \  $3.75  $3.50 

J  et  Black  Rubber I 


10-lb.  lots. 
$3.70 

5-lb.  lots. 

$5.50 

5.00 

10-lb.  lots. 

$3.65 

3.70 

10-lb.  lots. 

$3.35 


Registered 
June  20,  1876 

25-lb.  lota.  50-lb.  lots 
$3.60  $3.60 

10-lb.  lots.  25-lb.  lots 

$5.00  $4.50 

4.50 

20-lb.  lots.  40-Ib. lots 

$3.40  $3.26 

3.60  3.40 

20-lb.  lots.  40-lb.  lots. 

$3.25  $3.15 


Per  lb. 
Outta    Peroha,    Pink    or    White    for    Base    1   ««  cc 

Plate. )   '^-^^ 

Eugene  Doherty's  New   Hold-Fast 

Per  lb. 

Maroon   Rubber,   light   shade    \      $4  qo 

Maroon    Rubber    ' 

White    Gutta   Percha,    in    round    sticks    for 
Permanent    Filling    


5-lb.  lots.     10-lb.  lots.  20-lb.  lots.  40-lb. lots. 

$3.55  $3.46  $3.35  $3.26 

Maroon   Colored   Rubber. 

5-lb.  lots.     10-lb.  lots.  25-lb.  lots.  50-lb.  lots. 
$3.50                $3.40                $3.30  $3.20 


Red  Vulcanlzable  Gutta  Percha.  for  plates   

Black  Vuio^.Jzable  Gutta  Percha,  for  plates 

Maroon  Vulcan izaible  Gutta  Percha,  for  plates  

Pink  Vulcanizable  Gutta  Percha,   for  coating  purposes. 


Per  lb. 

$4.75 
5.00 
5.00 
7.25 


10-Lb.  lots. 

$4.50 

4.75 

4.75 

7.00 


25-lb.  lots. 

$4.26 

4.60 

4.60 

6.76 


Deep   Orane«  Rubber   

20  Minute  Rubber,  for  repairing  purposes 

Bla.ck  or  Red  Flexible  or  Palate  Rubber  for  lining 
platee 


Per  lb. 

$3.50 

4.00 

4.26 


5-lb.  lots.     10-lb,  lots.  26-lb.  lot* 
$3.30  $3.10  $2.90 


NONPAREIL    RUBBER 
New  Idea  Rubber  


Per  lb. 

$3.00 

3.50 


5-lb.  lots. 

$2.85 

3.16 


10-lb.  loU.  20-lb.  lots. 
$2.76  $2.70 


Rubber  Dam,  medium,  5  and  6  inches  wide 
Rubber  Dam,  thin,  5  and  6  inches  wide 


Per  yard  roll. 

$1.75 

1.35 


Per  half-yard  roll. 
$  .90 
.70 


No.  2  Weighted  Rubber,  for  upper  or  lower  plates 

No.  1  Wetted  Rubber,  for  lower  plates  

Black  W^4«hted  Rubber,  for  lower  plates 


Per  lb. 

$4.60 


4.60 


5-lb.  lota. 
$4.30 
4.30 


16-lb.  lota. 
$4.10 

4.10 


SO -lb.  lota. 
$8.80 

S.tO 


EUGENE  DOHERTY  RUBBER  WORKS,  Inc. 
tlO  and  112  Kent  Avenue,  Borough  of  Brooklyn,  N.Y.,    US.A. 


UniTersity  of  Toronto 
Library 


Acme  Library  Card  Pocket 

Under  Pat.  "Ref.  Index  File" 

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