"GOOD DENTISTRY."

Auckland Star, Volume LX, Issue 112, 14 May 1929, Page 15

"GOOD DENTISTRY."

DISCUSSED BY DENTISTS. DEMANDS OP THE PUBLIC. OVER-EMPHASIS ON EXTRACTION (From Our Own Correspondent.) WELLINGTON, this day. In his address at the opening of th New Zealand Dental Association's con ference in Wellington to-day, the presi dent. Dr. John Y. Warren, D.D.S., o Auckland, raised several points for dis cussiou. He questioned some popula beliefs regarding dental troubles am their causes, and suggested that the de mand for artificial dentures, while justi fied to some extent, is ignoring the ful resources of the dental profession in th< way of conserving the natural teeth and is failing to take full advantage o; conservative methods of treatment whicl are available. Dr. Warren traced the developmem of dentistry and its advance in know ledge and methods-which had, he sug nested, led to an over-emphasis of tlu mechanical art. •"Professional opinion on many matters 13 in such a state of flux," Dr. Warrer said, "that it would be difficult for ar assembly of dentists to agree on a definition for the term 'good dentistry. If there could be a general understanding of what is meant by that term, it would help to ensure progress, especially in the prevention, diagnosis, and treatment oi various dental diseases. The conflict oi professional opinion on these matters must be held partly responsible for the premature loss of so many teeth, that the laity have come to regard the term 'permanent teeth' a misnomer; and the wearing of artificial dentures is becoming so general that overseas visitors wonder whether it has acquired the status of being a national custom in New Zealand. '•'From this state of affairs an intelligent layman might infer that the dental profession is almost destitute of knowledge that would enable more people to retain their natural teeth. If this inference is a logical one, and I think L is, our status as a profession is so adversely affected that we should produce the evidence to prove that it has :no foundation in fact. Errors In Diet. "The first responsibility of the dental profession is tlie prevention of deutai caries, and we have made many worthy efforts to discharge it. We all agree to the broad statement that diet is perhaps the chief causative agent of dental caries, but in contradistinction to those who contend that the local deposition of food is the principal cause, I would maintain that the basic cause,of dental disease must be attributed to dietetic error, which, resulting in malnutrition, lowers the general resistance of the tissues, including the dental tissues, perverts the secretions, e.g., the saliva, and thus establishes a condition that is favourable to the organisms of caries.- If daily observation possesses any value, it would seem that excessive consumption of such foods as bread, potatoes, milk puddings, jam and all kinds of confectionery induces a state of carbohydrate poisoning, which, becoming chronic, constitutes one of the basic causes of dental disease, and, on medical authority, of many other maladies." Dr. Warren discussed- in detail the ' commonest dental diseases. Referring to pyorrhoea, he quoted an expert opinion "that in 90 per. cent of cases pyorrhoea is- a filth disease," and said that if this were true, then attention to oral hygiene ishould lessen its prevalence. J Daily Cleaning and Rinsing. "The patient should be taught," he isaid, "to regard the interstices of the teeth as stagnant areas which swarm with bacteria. If this condition is not •disturbed at frequent intervals, the adjoining gum and alveolus lose their 'power° to resist the bacteria, and continued neglect finally results in such a destruction of tissue, that the condition known as pyorrhoea becomes established. The local pathology ■ indicates the local treatment, viz., a daily .brushing of the teeth, then irrigation of the interstices by forcible rinsing with an antiseptic solution or salt and water; if water alone is advised the patient will probably rinse more often. Irrigation would probably be carried out more •effectively by using a rubber bulb syringe, but the patient is more likely to continue a prescribed treatment if it can be carried out conveniently and economically." . (, T Dr. Warren concluded by saying, x am not indifferent to the fact that, as in "many other callings, the dentist must comply with the demands of the general public if he wishes to. succeed: He may feel that in many cases conservative treatment would give good results,, out he knows that only" a comparatively small section of the public appreciate, it well enough to afford the time and money which it entails, therefore much,of,his practice must be devoted to the -extra? tion of teeth, and their replacement by artificial dentures. This is one of £toe chief reasons why the wearing- of artificial dentures has become so prevalent— • not because the dental profession tute of any other knowledge. /