[Sidenote: Keeping the Mouth Aseptic]
[Sidenote: Over-dentistried Teeth]
Gum infection is not always due to conscious neglect. Some people do not know how to properly cleanse the teeth. Others have tissues of low resistance, and need to give extra care to tooth- and gum-cleansing under the closest dental supervision. Others have spent large sums for dental work that has filled the mouth with crowns and bridges difficult to keep aseptic or surgically clean. There are various means which the individual can use to prevent or cure these dental evils.
[Sidenote: General Hygiene]
First, the importance of thorough attention to general personal hygiene, in order that a general resistance to mouth-infection may be built up, can not be overemphasized.
[Sidenote: Vigorous Use of Jaws]
The cultivation of normal eating habits with respect to the vigorous use of the jaws by thorough mastication, and the eating of hard, resistant, crusty foods every day is the next desirable means of tooth and gum hygiene.
[Sidenote: Cleansing]
A leading dentist expresses the hope that some day the human animal, like other animals, will, through a correct diet, be able to get along without the aid of the tooth-brush; but he adds that, in the meantime, we need to advocate more tooth-, gum- and tongue-cleaning rather than less. They should be cleaned night and morning and after each meal if possible by rapid rotary brushing. Strong pressure is not advisable.
Rapidity of movement is the important point. This stimulates the circulation and increases the resistance of the gums and cleanses the teeth at the gum margins from the acc.u.mulations of tartar which are at first soft and easily removable by a brush.
[Sidenote: Kind of Brush]
A brush should be used with bristles that are stiff and of different lengths, so that the innermost crevices of the teeth may be reached. If the gums are sensitive, a moderately stiff brush can be used until the gums can bear the more vigorous treatment.
[Sidenote: Tongue Brushing]
The tongue should also be carefully cleansed with the tooth-brush. By taking care not to hit the roof of the mouth, gagging is avoided.
[Sidenote: Tooth-Powders and -Pastes]
Tooth-powders and -pastes may be used, but should not be the main reliance. Perhaps once a day for their use is often enough. Some powders, if used too freely, are liable to unduly thin the enamel of the teeth.
[Sidenote: Dental Floss]
The use of dental floss silk between the teeth, provided care is taken not to press it against the gums, is also helpful.
[Sidenote: Emetin]
A number of investigators have reported the presence of an animal parasite, the _endameba buccalis_, in all cases of pyorrhea, and it is thought that this parasite may be one of the princ.i.p.al causes of this disease. Emetin, the active principle of ipecac, which has been successfully used in amebic dysentery, is now employed in the treatment of this trouble. Such a remedy should only be used in connection with thorough surgical treatment and dental prophylaxis. It is claimed that in the early stages of pyorrhea a mouth-wash composed of two drops of fluid extract of ipecac to a half-gla.s.s of water is very serviceable, and as at that stage a mouth-wash is entirely harmless, it should be tried, especially as it is now claimed that some degree of pyorrhea or of endamebic infection is almost universally present.
[Sidenote: Alkaline Dentifrice]
[Sidenote: Food Acids]
For an alkaline dentifrice, there is nothing better than lime-water, made from coa.r.s.e, unslaked lime. Alkaline washes are very superficial in their action, however, while fruit acids curdle and thus render removable the mucin plaques and prevent the formation of tartar. They also cleanse the tongue and membranes of the mouth generally, which may be important sources of infection. These acids are found in grape-juice, orange-juice, apples, and vinegar. Such mechanical cleansing is particularly important before retiring, as it is usually during the night that the most damage is wrought.
[Sidenote: Erosion]
The advice of the dentist should be sought as to the condition of the teeth, especially as to whether there is any erosion or destruction of enamel, before using either acid or alkaline washes exclusively.
[Sidenote: Periodic Examination]
Periodic examinations and cleanings by the dentist are the only safe measures. If the dentist has facilities for giving _preventive_ treatment by specially cleaning the teeth, he should be visited every other month. If such a program is adopted, it will generally be found unnecessary to visit him for any other purpose.
[Sidenote: Saving Teeth]
Some dentists and physicians have until lately given too much attention to the saving of teeth, without fully realizing the dangers of infection from the mechanical devices employed. The teeth should not be extracted on mere suspicion and without proper effort to save them, but it is far more important to save a heart or a kidney or a set of joints than it is to save a tooth. This is not to say that all bridge- and crown-work is improper, but that such work should only be of a character that will permit of surgical cleanliness in the mouth, and that such teeth should always be examined by the X-Ray, when there is evidence of systemic disease in order to be sure that the roots and sockets are not infected.
[Sidenote: Irregularities of Teeth]
In early life the jaws should be carefully examined by both dentist and doctor in order to determine whether or not the proper development is taking place. If upper and lower teeth fail to fit well together, extra strain is placed upon certain teeth and the sockets are liable to injury and infection. Faulty development can often be corrected and deformities that interfere with proper mastication and place a strain on certain teeth can thus be avoided.
[Sidenote: The Temporary Teeth]
The temporary teeth should not be allowed to be removed by decay.
Thorough dental and home care should prevent this. If cavities form, they should be filled under proper precautions and the teeth should be saved until the last minute, unless they are causing infection.
[Sidenote: Teeth and Infectious Diseases]
Amazingly good results from teeth-hygiene have been shown in a Boston asylum, which cares for over 300 children. Before the introduction of a dental clinic into this asylum, infectious diseases--diphtheria, mumps, scarlet fever, pneumonia, measles, whooping cough, tonsillitis, chicken-pox, croup, etc.--had been occurring for four years at the rate of over 80 cases per year, but for three years after the dental clinic was established the average was only 3 per year.
CHAPTER IV
ACTIVITY
Section I--Work, Play, Rest and Sleep
In order to live a hygienic life it is not only necessary, as shown in the foregoing three chapters, to supply the body with wholesome substances and to exclude unwholesome substances, but it is also necessary that the body should at times act, and at other times be inactive. There are two great forms of activity, work and play; and two great forms of inactivity, rest and sleep. All four of these are needed in the healthy life and in due relation to each other.
[Sidenote: The Daily Rhythm]
The whole personality should be utilized and energized in a daily rhythm. When, as too often happens, the equilibrium and mutual proportions of the various wholesome elements in a well-rounded life have been lost, the balance should be restored if possible the next day.
If a physician has had his sleep broken, he should aim to make it up at the earliest opportunity. If the afternoon exercise has had to be omitted, an extra amount should be taken as soon as possible. Some people find that while it is difficult to live a complete life every single day, it is quite within their power to give every element its due proportion in each week, taken as a whole. To go a step farther, when the balance has not been kept even in a week as a whole, the next week should be modified to compensate. But it is ideal to make the day, not the week, the unit. It is almost as absurd to relegate all our exercise to Sat.u.r.day afternoon as to do all our eating on Sunday.
[Sidenote: Adjusting the Proportion of Work and Play]
It is distinctly unhealthful either to overdo or to underdo work, play, rest, or sleep. "Moderation in all things" is a rule that is particularly important in this realm. Not all people are in need of exercise, nor are all in need of rest; but almost every one needs to change his proportion between the two. To-day many people are suffering from too much or too little work. For instance, the increase in diseases of the heart is often due to nervous overstrain combined with either too much or too little physical exertion.
The remedy for the evils of idleness is obviously to find some useful work which will inspire real interest and enthusiasm. There are few things more necessary to a normal healthy life than to have purposeful work. A great dream or ambition in life often obviates personal ailments and nullifies their potency. Work, when done with zest, is a wonderful tonic. Exertion of any kind is usually pleasurable at first, and becomes drudgery only when too far protracted.
[Sidenote: Need of Work]
Normal work is one of the greatest blessings of life, but too many miss the joy of it, some because their work has gone to the extreme of drudgery and others because it has shrunk into nothingness and futility.
Sometimes people become ill because their personality, hungry for work, is given nothing but introspection to feed upon. This is the self-imposed curse of the idle rich.
[Sidenote: Prevention of Overstrain]