DENTAL HYGIENE

Te Awamutu Courier, Volume 75, Issue 6441, 3 November 1947, Page 5

DENTAL HYGIENE

NEW LIGHT THROWN BROADCAST ADDRESS BY SPECIALIST The following is the text of an address given last night by Dr C. D. Hearmann, Lecturer in Preventive Dentistry and Dietetics at the Australian College of Dentistry, Melbourne. It was broadcast over the national network of stations of the New Zealand Broadcasting Service. Dr Hearman said:—As a specialist in the treatment of dental diseases, the first duty of every dentist is to save teeth. But, contrary to all previously accepted ideas, there is a great difference between saving teeth and mending them. The replacement of decayed tooth structure by a metal filling cannot be considered a successful method of treating dental decay. That operation is merely a repair service. The hopeless futility of undertaking the task of filling teeth riddled with dental decay, without first of all ascertaining, and removing, the underlying causes, must be apparent to everybody. The dental profession realises, and appreciates this fact, and in an endeavour to reduce the widespread prevalence of dental decay, they are planning an educational preventive campaign in the hope that they can gain the intelligent co-operation of the public. Strictly speaking, the dentist cannot save teeth —except by mending them. The task of saving teeth rests with the people themselves —but they must be taught how! In the light of recent discoveries it can be stated without fear of contradiction, ’ that dental disease is entirely due to malnutrition. This being so, it is paradoxical to have to record, that Australians and New Zealanders, having food resources that are the envy of most of other nations, should nevertheless, share the doubtful distinction of being the possessors of the worst teeth in the civilised world. Something is very wrong, surely, when little children, who have been otherwise well cared for, present mouths having teeth, so rotten and riddled with dental decay, that they can be classed only as incurable dental cripples. In fact, it is. not too much to say, that, nowadays the mouths of most of our people are from 10 to 20 years older than the rest of their bodies. This tragic state of affairs is entirely due to ignorance. It is unnecessary, it is disfiguring, it is a menace to our health and national welfare, and it is costing the taxpayers millions of pounds annually for treatment. That such a state of affairs should be allowed to continue in a civilised and presumably, intelligent community is absurd and nonsensical, particularly when one considers that at least half the dental decay in this colony could be prevented by the adoption of relatively simple preventive and protective measures. The dental profession pcssessesAhe knowledge—it now remains for flic Government to devise ways and means of spreading it. There is a wide distinction between a National Dental Health Service and a National Dental Repair Service!

Winston Churchill once remarked, “that evil is half cured, whose cause we know.” Well, in the last few years, modern research has enabled us to say that we know the cause. Let us then, to the task of removing the evil.

The exact chemical mechanism involved in the process of dental decay is now known. It is a problem of food fermentation in the mouth. In everybody’s mouth, there exist, certain types of bacteria, which produce a system of ferments. These ferments act on refined sugar and refined flour and produce a series of acids, in much the same way as malt is fermented •into acetic acid or vinegar. When the food residues of sugar and flour stagnate in the deep grooves of the back teeth, or between the teeth, these acids are formed and become concentrated so that the enamel is attacked —a cavity formed and the decaying process is thus started. Contrary to previously held beliefs, these acids are formed very rapidly after eating these foods. They reach their greatest concentration 15 to 20 minutes after eating, and the acids may continue to be produced in sufficient strength to damage the teeth for another hour and ahalf. This discovery explains why the tooth-brush has apparently failed, as a means of preventing decay. Nearly everybody practices the common habit of cleaning their teeth first thing in the morning and last thing at night. In the light of our recently gained knowledge regarding the rate of acid formation in the mouth, both of these procedures are practically useless. For the teeth are dirtied again at breakfast, whilst by the time we are ready to retire at night, the damaging action commenced shortly after we left the dinner table, has already taken place. Obviously the time to cleanse the teeth is within 15 to 20 minutes after meals. Admittedly this is not always possible, but good results can be obtained if a mouthful of water is thoroughly swished around and between the teeth, either at the table, or at a wash-basin afterwards. It is not as effective as tooth-brushing, but it is a great help, particularly to children taking cut lunches to school. Now' that we have the knowledge we should benefit by it, and I see no reason why all school children should not be marched to the wash room for tooth-brushing and mouth rinsing immediately after meals. Similar collective measures are adopted for physical exercises, so why not adopt a practice which would pay even better dividends in terms of national fitness? There are four methods by which we could prevent dental decay. The first would be to remove refined flour and sugar from our diet. Without sugar and flour, we would not form acids, because for all practical purposes, they are the only foodstuffs which can cause decay, it is not possible, of course, to eliminate sweets, cakes, pastries, biscuits, jams, heavily sweetened breakfast foods, and drinks from a civilised dietary. These foods have come to be regarded as a highly delectable purt of our meals and I do not suggest that anyone would be prepared to make such a sacrifice, however damaging to the teeth these foods can be proved to be. The same results would be obtained, however, if the debris from these foods were removed from the mouth, before they had time to be converted into acids. Children should not be given these foods unless tooth cleansing facilities are at once available. There is no doubt that Australians and New Zealanders consume far too many of these foods. We are the high-

est sugar consumers in the world and sugar has been proved to be the cause of 90 per cent, of dental decay. Flour, not mixed with sugar, causes about 10 per-cent.* of the trouble, but when sugar is mixed with flour the fermentation action is so speeded up and so much acid is produced that the saliva in the mouth cannot hope to neutralise it. We eat five times as much sugar as the Russian, six times as much as the Italian or Spaniard, and 20 times as much as the Chinese. This is the reason why these races have such relatively good teeth. This excessive consumption of sugar connot be justified on a nutritional basis. The claim, frequently made by commercial interests, that sugar is necessary to provide energy, is nothing more than a dangerous half truth. Before it can bo used as energy in the body, sugar requires Vitamin Bl to burn it. Otherwise, it is of no more value as a fuel than is coal thrown into a furnace without fire. Sugar does not contain the necessary vitamin, and most of it is removed from our cereals in the process of making white flour. So you can see how rapidly the body can run into debt with this Vitamin when excessive amounts of sugar are eaten. One wonders what people did, when there was no sugar and that wasn’t long ago. In England in 1700, the consumption was 41b per head per annum, ours is now about 1251 b per head per annum. So every effort should be made to reduce these foods, which only provide us with empty calories in our dietary. Unless we are prepared to make this sacrifice, the profession will have to resort to the use of chemical safeguards to prevent decay. This method is about 33 to 40 per cent, efficient, but it represents a completely negative approach to the problem. The idea is to employ a harmless and palatable chemical to prevent fermentation in the mouth. These chemicals are known as inhibitors. Several are known and already employed extensively overseas. One which has received wide publicity lately is fluorine. This chemical when present in the water supply in the part per million has a protective action on the teeth and many states in America arc now adopting the policy of adding fluorine to the water supplies. There are, however, some disadvantages of this method. The front teeth obtain the greatest degree of protection, because they contact the water in the act of drinking. Unfortunately, not many of us drink water regularly. It seems that the best means of using fluorine is the spray treatment. This method of painting or spraying the teeth with a fluorine solution is done by dentists and it is thus controlled. The fluorine acts in two ways. It •prevents some of the acids from forming in the mouth and it makes the tooth les§ soluble in the remaining acids. The use of fluorine is still being investigated by research groups. Another inhibitor is Vitamin K, which occurs in natural greenstuffs such as lucerne and sugar cane. This vitamin is used in chewing gum which must be chewed after meals. Dr Fosdick, an American investigator, has tested this method on a group of dental students and claims a 90 per cent, reduction of dental decay by this method. Other inhibitors such as urea, and Zephiren are being incorporated in tooth pastes, and much research is taking place in this field.

The final method of defence is really one of offence. It is an attack on the fermentative types of bacteria in the mouth. It has been found that the main offender of this group cannot live in human saliva unless sugar is present. So the method employed is to place the patient on a sugar free diet for a period of four weeks and a modified diet for another two weeks. Periodical checks are made, by bacterial counts, and when the restricted dietary has achieved the necessary reduction, the patient acquires an immunity lasting from six months to two years. The idea that decay of the teeth was related to poorly formed, soft or chalky teeth is entirely wrong. Everybody starts life with good strong sound teeth, unless the mother suffers from certain fevers during the prenatal period. The teeth only become soft and chalky, because of the acids formed from sweetened foodstuffs. Even the Maoris, who had perfect teeth when they lived on natural foods, soon lose their teeth when they eat the white man’s sugar and flour.

There are a few individuals who can eat sweets and still retain their teeth. These fortunate people owe their immunity to certain natural inhibitors which are normally present in their mouths. To summarise then: Reduce sweetened foodstuffs to a minimum in your .diet. Practice tooth cleansing or mouth rinsing as soon as possible after meals. Avail yourselves of the new preventive and protective measures as soon as they become available. The popular idea that decay is inevitable because we have rotten teeth should be knocked out once and for all. Rotten teeth, toothache, pus and pain and all the misery and bad health which go hand in’hand with this state of rottenness are simply the result of a rotten diet. No farmer, however simple and uninformed, would continue to feed a diet to his stock after he had found that it rotted and decayed their teeth, and it is incomprehensible that human beings, living in a modern scientific ■age, pay more attention to the welfare of their farm animals than they do to their own children.

Custom and long usage have resulted in the previous acceptance of these foods without question, but the despotism of custom has often proved to be a longstanding hindrance to human advancement. Let it not be said that the benefits of modern scientific knowledge were denied to those who need them most, simply because apathy and disinterest resulted in no demand being made for them.