DENTISTRY IN CHILDREN

Abstract

IT SEEMS only proper to begin this discussion with a few words about dental decay. Certainly in view of the prevalence of this disease, it deserves recognition as one of the great health problems. The study of dental caries as a disease process has received a striking amount of attention in the past few years, yet we are forced to go back to an early theory of the etiology of this disease in order to discuss it intelligently. Many years ago a theory was proposed in which it was stated that bacteria, with their enzyme systems working on a substrate of fermentable carbohydrate found primarily in plaques upon the smooth surfaces of teeth, lead to the decalcification of the mineral portion of the tooth. The theory also stated that the organic material is then destroyed by proteolysis. Much of the work which has been done in the field of caries since the time of this proposal has borne out the soundness of the original theory. But certainly we cannot regard dental caries as such a simple and straightforward disease. As a matter of fact, we know that dental caries is an extremely complex disease and each new area of research merely emphasizes this point. For instance, we know that dental caries cannot arise without bacteria being present. This has been demonstrated in the experiments with animals raised in a germ-free environment in which it has been shown conclusively that no caries occurs. To further elucidate the picture, we also know from the experiments of Shaw and Kite that animals fed by stomach tube will not develop dental decay.