modern SenttBtrij far tin' Eaitg ' THIRD EDITION BY Alfred A. Crocker Modern Dentistry for the Laity and Industrial Dentistry for the Corpo- ration, Modern Preventive Dentistry and Industrial Welfare Dentistry By Alfred A. Crocker Cincinnati, Ohio 1920 THIRD EDITION Published by THE DENTAL REGISTER THE MAGAZINE OF DENTISTRY Founded 1847 PIONEER DENTAL JOURNAL OF THE UNITED STATES Cincinnati, Ohio First Edition Copyrighted, July, 1918 By THE SAM'L A. CROCKER CO. Ohio Dental and Surgical Depot Cincinnati, Ohio Second Edition Copyrighted, February, 1919 By THE SAM'L A. CROCKER CO. Ohio Dental and Surgical Depot Cincinnati, Ohio Third Edition Copyrighted, January, 1920 By THE SAM'L A. CROCKER CO. Ohio Dental and Surgical Depot Cincinnati, Ohio r\EDICATED to the Dental Profession, whose avowed purpose is the prevention of decay and preservation of the teeth of the human race PREFACE TO THIRD EDITION It is indeed complimentary to the subject of dentistry that there would be a demand for a third edition of this book, and, of course, it is a pleasure to respond to such a pleased body of readers. The interest shown in this work has been pronounced, and it is hoped that this third edition will meet with the same insatiable de- mand. The program is strictly an educational one, educating and informing on a subject which has for far too long been dor- mant, but now that the author has found the way to properly present the subject for public 5 Preface consumption the response indi- cates that a popular chord has been struck and everybody is whistling the sweet music. Some of the essays of former editions have been left out and replaced with more recently pub- lished articles. One of the fun- damental doctrines of the circula- tory system, that it conveys health or illness, sees its vindica- tion in preventive dentistry. Toxins carried from the lower bowel, causing toxemias of colds and grip, are also carried from abscessed teeth, causing colds and rheumatism. The former fact has for a long time been popu- larly understood by the laity and to-day the later fact about the 6 Preface teeth being foci of infection is being popularly accepted by the laity too. This volume, along with the two previous editions, is gratefully dedicated to the dental profession, without whose efforts for research in dental matters many facts now known would still be mysteries. Alfred A. Crocker. January, 1920. 7 PREFACE TO SECOND EDITION Much information and valu- able knowledge is to be found if one will spend the time to dig it up. To dig it up and then place it before those most inter- ested to know it is indeed a valu- able work. The importance of Dentistry as a health profession has been greatly increased by the emphasis given the subject of Preventive Dentistry and Oral Hygiene dur- ing the war. The proving up of various relationships of systemic disease to oral sepsis has also hastened the necessity of bring- ing the care of the teeth promi- 9 Preface nently before the American public. The care of the teeth of children as featured in munici- pal free dental clinics is a great educational work calculated to bring in a new generation, well informed on the importance of care of their teeth. The laity at large would do well to take cognizance of the significance of children's clinics, for what is good for the coming generations is good for the pres- ent one. A clean and healthy set of teeth makes a bright scholar, likewise a clean and healthy set of teeth makes a successful grown-up. This subject is one of the principal features of general attractiveness. 10 Preface In publishing this second edi- tion Modern Dentistry for the Laity and Industrial Dentistry for the Corporation the writer has sincere hopes that this pam- phlet will help the educational contributions of others and bring the gospel of Tooth Hygiene to everybody, both young and old. The similarity, in some in- stances, of these several essays, is on account of their having been written to cover the subject as a synopsis to suit various prominent magazines in which they were published. It being the idea to make each essay cover some of the important ground and be in itself an argument. However, each one has a pro- 11 Preface gressive addition of new ideas which occurred to the writer as the subject progressed. The essay "Tooth Troubles," gives an idea of what prevention prevents. For those interested in establish- ing clinics a list of actual require- ments is given in the last chapter. Alfred A. Crocker. January, 1919. 12 PREFACE TO FIRST EDITION In writing these short essays on dentistry and its application to the individual welfare it has been the writer's intention to point out how decay of the teeth is the prime factor in the ulti- mate loss of the teeth and also how this destructive cause can be prevented. Caries, the tech- nical dental term used meaning decay of the tooth structure, has been a prime subject of dentistry and has received immense atten- tion by the dental profession. The investigator who isolated the germ of caries, the late Dr. W. D. Miller, an American, spent years on this subject and we have as a result a sure method of pre- ventative dentistry. It is to 13 Preface detect the decay. This can only be done by a dentist. The opera- tion of detecting decay is known as prophylaxis. The first monu- ment ever erected to a man of the dental profession wTas erected on the spacious campus of the Ohio State University to the memory of Dr. W. D. Miller. This statue of Dr. Miller stands in a very prominent position of the grounds of Ohio's largest university. From this you will infer the importance and inti- mate meaning of this subject of decay to humanity. To explain this subject and its application to every-day efficiency this pam- phlet is written. Alfred A. Crocker. June, 1918. 14 CONTENTS Preface to Third Edition 5 Preface to Second Edition 9 Preface to First Edition 13 Preventive Dentistry-The Zero System.. 17 Corporation Dental Service 25 Evidence of the Value of Preventative Dentistry in Industrial Corporations.. 34 Tooth Troubles and Their Relation to Systemic Troubles 55 The Possible New Life Policy 67 Dentistry in the Hospital 79 The Odontalysis 92 Itemization of Instruments, Supplies and Equipment Used in Institutional and Industrial Dental Clinics and in Hos- pital Infirmaries 95 List of Corporations Using the Dental System 102 Reviews of First and Second Editions by Magazine Editors 108 Bibliography 112 15 Modern Dentistry PREVENTIVE DENTISTRY The Zero System and Effi- ciency Dentistry Tooth In- surance-Decay Proofing. The idea to follow in regard to your teeth is prevention of decay. Decay is constantly starting its destructive process, and by the use of the tooth brush and anti- septics is partially counteracted, but it takes periodical examina- tion by a dentist to keep the teeth in perfect condition and to de- tect the decay before it gets a start toward the certain destruc- tion of the teeth. By periodical 17 Modern Dentistry prophylaxis, cleaning and exam- ination of the teeth the dentist performs a work which will save your teeth in their original per- fect condition, or if you are just starting with the periodical pro- phylaxis, the dentist will be able to preserve your teeth in as good condition as they are now or will be after he once gets them again in perfect condition. Efficiency dentistry by the zero system means preservation of the teeth, reducing the decay to the mini- mum or zero point, and maintain- ing your energy at a maximum. It also means minimizing tooth difficulties, preserving the teeth in as near their pristine perfec- tion as is possible and making 18 Modern Dentistry the necessary fillings, inlays or restorations approach the zero point. Patients who have heeded the principles of this system of periodical examination by their dentist have very few filled teeth, and where there is a filling it is a very small one. This is because the decay was caught by the den- tist at a periodical examination before it had caused very much damage. A small pin point fill- ing was all that was necessary. Had such a decay been allowed to run until the tooth ached, the whole crown of the tooth might have had to be filled or the tooth may have had to be extracted. The attention to the teeth is not a vogue of society nor an 19 Modern Dentistry effort per se to maintain good appearance. While dentistry has a feature of esthetics, its larger, its main demand is necessity. There has been evolved through the fifty odd years of the develop- ment of the present practice of dentistry by the dental profes- sion the system now termed Effi- ciency Dentistry. A patient can, by periodical visits to the dentist, minimize the decay of the teeth approaching the zero point. The dentist at each periodical visit of the patient examines the teeth and detects any unsoundness, and if a cavity is found, a filling is made. Such a discovery is, of course, made long before the de- cay would be advanced enough 20 Modern Dentistry to cause the patient to notice it by any pain. Sometimes a patient, when a small cavity is starting, complains of lassitude and lack of energy, but of course does not attribute it to a small cavity in a tooth, for at this stage the cavity is small and often be- tween the teeth and not observ- able except to a dentist, and not possible to locate it with the tongue. Besides, the average patient does not complain until a tooth aches, and, of course, by that time the decay has reached the sensitive nerve pulp. During the development of a decaying tooth, from the time of the first infinitesimal pit until it has en- larged and deepened until it 21 Modern Dentistry starts to ache, there is a sapping of the patient's energy and an increasing condition of debility is developed, until the ache and pain in the tooth announce to the patient the true cause. By following the Zero System of fillings by adhering to Efficiency Dentistry, the decay is discovered by the dentist long before it reaches the climax in the aching tooth, and consequently the fill- ings are very small and the teeth remain strong and vigorous. Patients who have, upon advice of their dentist, faithfully fol- lowed this principle of Efficiency Dentistry, have very few filled teeth and have never had a tooth- ache. They have likewise always 22 Modern Dentistry been at high nerve force so far as their teeth are concerned. The dentist eventually gets the pa- tient, but what about the energy and health of the patient in the meantime? The dentist is con- sulted so late and the decay has gone so far that it means a large filling, a withdrawal of the tooth, restoration of some kind, an arti- ficial tooth, crown or bridgework. This calamity is all saved by Effi- ciency Dentistry, and the nerve energy for work or pleasure also conserved. Let your dentist put your name on his list of patients for periodical prophylaxis, with a full understanding of the prin- ciples involved. When you are in possession of the facts regarding 23 Modern Dentistry the advantages of periodical pro- phylaxis by the dentist as out- lined in this article, you are in position to apply the logic of it for yourself. Efficiency Dentistry by Zero System through periodical pro- phylaxis by your dentist is your tooth insurance. Efficiency Den- tistry decay-proofs your teeth. Decay-proof your teeth now so you will not have a "toothless day. ' ' 24 CORPORATION DENTAL SERVICE During the war while all available time for essential manufacturing was needed and all operatives were needed in good physical condition, par- ticular attention was paid by welfare committees of the va- rious war industries in study- ing the upkeep of human energy. The United States Army and Navy plan was followed as closely as possible, and this resulted in the establishment of dental pro- phylaxis (means detection of de- cay), together with the regular medical attention given opera- tives. The human health and 25 Modern Dentistry energy has an intimate relation to and dependence upon good teeth, more so than the majority of people realize, and it is for this reason that the medical staff of the United States Army and Navy required dental prepara- tion of recruits before entering the service, and afterward re- quired periodical attendance at the Army and Navy dental offices for dental upkeep, called prophy- laxis. It was found that by pre- venting decay, which is continu- ally starting, the teeth could be saved, the nutrition maintained, systemic diseases avoided, as the teeth and gums are one of the three foci of infection, the other two being the nose and throat or 26 Modern Dentistry tonsils. Manufacturing compan- ies which use this system find that at least three hours a year is saved on every operative, and in some factories the number of hours is much greater. This means three thousand hours if one thousand operatives are employed. One company making air planes saved 21,031 hours in six months opera- ting four thousand people. Fac- tories today are generally far out of the city, and a trip to the den- tist means loss of much time. To have a dentist for several hours each week, at stated times, at the factory, eliminates this waste of time, keeps the operatives at their work, preserves the health, and 27 Modern Dentistry makes excuse for tooth troubles unnecessary. Only a superficial understand- ing of the relation of improper teeth to systemic disorders, or as it is technically stated, Oral Sep- tis in its Relation to Systemic Disease, is necessary to appre- ciate what dental service in man- ufacturing corporations can do toward maintaining efficiency of workers, both clerical and techni- cal. Welfare programs have al- ways included medical service and rest rooms, athletics, libra- ries, social meetings, wholesome noon lunches. Some plants have gone into summer picnics, boat rides, roof gardens and billiard rooms. All these have their place. 28 Modern Dentistry In dentistry there is a practical benefit which is generally appre- ciated only when it is too late to derive the great good that it can render if it can only render it in time. Dental troubles fall into a class which can by prevention be entirely avoided. An aching tooth is notice that it is too late for a dentist to save it, not that it is time to go to the dentist to save it. It is for this reason that where people are called into a dental room and a dentist makes an ex- amination detecting the decay, if any, and making the then small filling, the tooth can be saved and the ache avoided. Not only this, but the health is conserved. While a tooth is decaying it does 29 Modern Dentistry not ache, but absorbes energy from the system and poisons the blood, in both ways lowering the vitality of the patient. A great deal can be said right here, but only enough is possible in a short explanation of corporation dental service to start interest in this direction. Companies using dental attention in their welfare work report gratifying results of the work. There is a difference be- tween doing dental work where work is needed and doing dental prevention. It is the dental pre- vention that interests the corpo- ration dental clinician. He is not there to put the teeth of opera- tives in order and do a a whole lot of bridge work and filling. 30 Modern Dentistry His work is to indicate what work they need done and to advise them to have their family dentist do it, and see that it is done, check- ing it np when completed. After that the periodical upkeep by him will maintain tooth health. French and English factories took up this subject following the example of the French and Eng- lish Armies, and have derived much good from it during the war. Some companies had the dental service in operation some years before the war. Here in the United States there are ninety- nine corporations using dental service at the present time. Their lines of activity cover meat pack- ing, cork, statistics, worsted, op- 31 Modern Dentistry tical, telephone, milling machine, toilet requisites, iron, coal, steel, ammunition, air planes, matches, women's wear, department stores, rubber tires, tooth brushes, auto- mobile, rubber sundries, men's clothing, pickles, preserves, har- vesting machinery, life insurance, mail order houses, abattoir, cash registers and dental instruments and equipment. Corporations installing dental service for operatives are taking a step for economy in manufac- turing, conservancy of manufac- turing hours, maintenance of health of operatives. They are filling a gap that exists without it, as medical service alone does not remove the cause of the multitu- 32 Modern Dentistry dinous systemic disorders which are due to tooth neglect. Corporations which have in- stalled dental service find that it increases the attendance at work, increases the output by the amount of hours saved, maintains health, improves mental alert- ness, raises the character, rounds out their welfare work, helps their educational programs, makes their recreative work more consistent. For these reasons in- dustrial managers and welfare experts are paying more attention to the subject of corporation den- tal sendee. 33 EVIDENCE OF THE VALUE OF PREVENTATIVE DENTISTRY TO IN- DUSTRIAL CORPORATIONS In my work of presenting the subject of Preventative Dentis- try to manufacturing corpora- tions, various industrial and trade magazines have accepted my articles, believing in the fundamental benefits of good dental advice to humanity, al- though the subject of dentistry is foreign to the general subject and class of trade to which their magazines are devoted. The regular dental publications which are read mostly, and I might say 34 Modern Dentistry almost exclusively, by the dental profession and trade have been filled for years with the subject of Preventative Dentistry, and the wish has often been expressed that its benefits to public health be brought to the knowledge of the public. Industrial managers, all over the country are interested in the subject, and you will find it as one of the principal items of wel- fare work as outlined by the National Safety Council, of which Dr. L. A. Shoudy, Chief Surgeon, Bethlehem Steel Com- pany, South Bethlehem, Penn- sylvania, is chairman. In reply to my questionnaire to various companies using the den- 35 Modern Dentistry tai service system the following replies have been received: The Joseph & Feiss Co., Cleveland, say: While it is difficult to trace the defi- nite results of benefit obtained from this work we feel convinced after six years' experience that it should be classed along with medicine and surgery in first aid work. I am not able to answer questions as to the relative importance of dentistry and medicine. We are convinced with- out drawing any comparison that den- tistry, medicine and eye work form an essential and profitable part of our work and are all of them a tremendous aid in the development of steady and efficient men and women. Sincerely yours, ej :fy Ernest Joseph. Armour & Co., Chicago, say: We would advise you that we have had our dental work going such a short 36 Modern Dentistry time, we are unable to draw any con- clusions as to the effect of this work upon efficiency, lost time or quality of finished product. We feel that, in principle, this department should have an influence on all of these items, but as yet, we have been unable to ascertain just what it is. The results of the Den- tal Department are more or less in- tangible and are similar to welfare and medical work,-in that they increase the morale and loyalty and efficiency of employees, all of which are extremely beneficial to any employer of labor. It has been our aim, for the present at least, to make our Dental Department more educational than anything else, and if we succeed in teaching our people the value of caring for their teeth, we shall feel that the department has been a suc- cess. We can say, confidently that it is our belief that the Dental Department is an institution with us which will re- main. Yours very truly, Armour & Co., hge :ga H. G. Ellerd. 37 Modern Dentistry The Dayton Metal Products Co., Day- ton, say: It encourages us to know that many other large industries are interested in this comparatively new branch of wel- fare work, which is of such vital impor- tance at this time. They have awakened to the fact that there is a very close con- nection between Mouth Infection and Systemic Diseases, that good teeth means good health, and good health means efficiency. There never was a time in the history of our country when it was so necessary to bend every effort toward the mainte- nance of human efficiency than at pre- sent. This work has saved us 21,031 hours so far this year. Yours very truly, The Dayton Metal Products Co., mh. Dr. H. B. Millhoff, Clinician. The Emporium, San Francisco, say: Our Clinic is open daily from 9 to 12 and we handle on an average, 200 38 Modern Dentistry cases each month. We find, that our employees are very eager to take advant- age of the opportunity of having good work done, with the least expenditure of time and effort. It certainly ranks with medicine and surgery as a welfare feature and we find that the two branches work splendidly together. We have arranged to have all appointments made during store time without any deduction for the time lost, and we are confident that our employees are not abusing this privilege, but are grateful not only for the temporary relief but for the permanent treatment which our dentist gives. Yours very truly, The Emporium, Miss Leslie Wilde, lw :eht. Assistant Welfare Director. Kabo Corset Co., Chicago, say: We are pleased to state we consider dentistry in factories as of more benefit than either medicine or surgery. The 39 Modern Dentistry results of dentistry in our factory have in many ways exceeded our expectations. Dentistry in our factory has saved our employees, as well as ourselves, over 2,000 hours in the past six months, time which would have been counted as lost working time, as well as protecting said employees from the clutches of unscru- pulous advertisers and incompetent prac- titioners. It has increased production in proportion to working hours saved. The preventative features of dentistry are not apparent to everyone, such as medicine and surgery is, but it is these preventative features which lead us to ex- press the opinion that dentistry exceeds in benefit and importance to either medi- cine or surgery. We have one instance in which we are confident a valuable employee was saved from insanity and a great many cases where pyorrhea was prevented, thereby saving the employee and ourselves much valuable time for work that would have eventually been lost. We do not hesitate in saying that we consider dentistry, and especially pre- ventative dentistry, as of equal import- 40 Modern Dentistry ance to medicine and surgery as welfare features in any corporation. Yours very truly, Kabo Corset Company, By Frederick H. Mill, Mgr. Ind. Serv. Dept. Lord & Taylor, New York, say: Our dental clinic is operated under the supervision of the Department of In- struction and Training. You may de- duct from this that it is a part of the educational scheme. We compel an oral, as well as a physical examination, of all those entering our employ, for the pur- pose of doing preventative work. The clinic is still in an experimental stage and we are not prepared to give statistics. Yours very truly, Isabella Brandow, Department of Instructions and Training. The T. Eaton Co., Limited, Toronto, say: We find that the most apparent result of dentistry in our establishment is the 41 Modern Dentistry emergency work which usually retains the individual at work who would other- wise have to have treatment outside and thereby lose from an hour or two, to half a day, or perhaps longer. The work of our dentist is confined to giving relief in cases of toothache, giv- ing advice, making examinations, charts, and when necessary, making X-Ray plates for employees to take to their own dentist, and the cleaning of teeth. We consider that it increases efficiency inasmuch as an improved physical con- dition is bound to have this effect. It has been of undoubted benefit to numbers of our employees, whose ap- preciation is evidenced by the numbers who take advantage of it. Yours truly, The T. Eaton Co., Limited, r. Per P. L. Reid. The Ford Motor Co., Detroit, say: Will state that the dental work done at this plant so far has been very limited. We have had one dentist for the past year who devotes his time exclusively to 42 Modern Dentistry dental work called for through injuries received by employees while at work, and to the inspection given to employees who come under our observation requiring dental attention. It is impossible to definitely estimate the good done by this department, but to date we have no cause to regret the in- stallation of the dental department, and contemplate increasing its scope in the future. Respectfully, J. E. Mead, jem :her. Chief Surgeon. H. J. Heinz Co., Pittsburg, say: We can not give specific answers to your questions, because none of our wel- fare features was ever undertaken with the conscious purpose of improving our output or our profits. When we add any new feature for the benefit of employees, the determining factor is whether the em- ployees will be interested and will take advantage. Consequently, we have never figured the dollars and cents value of 43 Modern Dentistry our Dental Department, or made any ob- servation as to reduction of lost time. The department is in charge of a grad- uate, experienced dentist, who does all sorts of dental work except bridgework. This work is done on the Company's time and at the Company's expense. We do feel, however, that more important than dental surgery is instruction in oral hy- giene, and so our man always teaches his patients the use of the toothbrush and of dentifrices. This element of the work ex- tends beyond the factory, for the em- ployees carry into their homes and to the neighborhood the gospel of the tooth- brush. Yours very truly, II. J. Heinz Company, cfo:m By C. F. Ohliger. The Narrow Fabric Co., Reading, say: It is, of course, exceedingly difficult to measure the benefits derived from a department of this kind. However, we do know that we are experiencing a grad- ual and consistent increase in the per- sonal efficiency of our employees, in the 44 Modern Dentistry decrease in illness, absenteeism, and other evils which decrease production. In most instances, we have arranged for a regular semi-annual examination of the teeth of our employees. In this way the cavities are discovered before they have progressed very far. Inasmuch as this results, of course, in the preservation of the natural teeth, the beneficial effects in the personal health and efficiency of the employee inevitably follow. We can say, without reservation, that the results fully equal our expectations; that it has reduced the number of hours lost through illness, and has, consequent- ly, increased to that extent, the output of the mill. While, of course, dentistry is not quite as vitally needed to take care of accident cases or persons suffering from acute illnesses, nevertheless, we be- lieve that in the long run, preventative dentistry is as important as medicine, and that it frequently prevents the neces- sity of resorting to the latter. Respectfully, The Narrow Fabric Company, jek :evf J. E. Kissinger. 45 Modern Dentistry The National Cash Register Co., Day- ton, say: We realize that it has been of ma- terial benefit to those employees who have received treatment, and without a doubt is as necessary as the medical treatment. Yours truly, W. A. Pearson, rnh:cw Welfare Dept. D. H. Holmes Co., Ltd., New Orleans, say: Our dentist, Dr. J. S. Hull, spends two hours, from 8:30 to 10:30 a. m., with us. Every employee knows that he or she is welcome to dental service. However, it is the duty of the welfare secretary to see that attention is given to the teeth whether the store dentist is used or not, and to urge the employees to keep their appointments with the dentist. Even at the beginning the response on the part of the employees was gratifying, but it was necessary to urge in many cases that the appointment be kept. We 46 Modern Dentistry do not insist that our dentist be used, but we do insist that care be taken of the teeth. Our reports show that 72 per cent, of our employees make use of our dentist. Most of the work has been general filling and treatment. The dentist found many bad cases of neglect, but on the whole we were surprised at the prompt response which met our dental offer. The equip- ping of our dental office was our greatest expense. We pay for all materials used and we find that we are more than repaid. We consider that most diseases are enhanced, if not produced, by bad teeth. Our gen- eral health has improved and we lay a great part of this improvement at the door of the dentist's office. The instructing in dental hygiene and the advice about toothbrushes, etc., is left entirely to the dentist, although through- out the year at least three lectures on the teeth have been given for the benefit of all the employees in the store. Our dentist's report for the last six months is most gratifying and shows that the teeth of a large per cent, of our nine 47 Modern Dentistry hundred employees are being examined and properly attended to semi-annually. We are very happy to tell you of this work. Very truly yours, D. II. Holmes Co., Ltd. Per Lois Janvier, lj:AD. Welfare Secretary. Babson's Statistical Organization says: Referring to your favor of the 28th, 1 would say that we have now had a dental clinic for about a year. It has fully met with our expectations. It is impossible to express any results in specific terms, but from the surpris- ingly large number of instances where unhealthy conditions which required correction existed when the clinic was first started, we are thoroughly con- vinced that dental hygiene is worth while. We have about sixty employes who attend the clinic and have their teeth cleaned by a trained dental hygienist about once every month or six weeks. 48 Modern Dentistry As a means of protection and conserva- tion, we feel that the work is invalu- able. We are very enthusiastic over it and can not too strongly urge its gen- eral adoption. Yours very truly, Leroy D. Peavey, ldp :pss. Vice-President. The fire insurance business has recognized the value of peri- odical inspection in the reduction of fires. This has increased the insurance business and reduced the number of fires, and reduced the liability to fires. Instead of allowing the fire conditions to run down, producing greater and greater liability of fire and con- sequent increase of rate for carrying the risk, the companies make at their periodical examin- 49 Modern Dentistry ation of premises recommenda- tions of improvements and clean- up that will reduce the fire risk; also the fire liability; also all new building has to conform to cer- tain requirements for fire proof- ing. The insurance companies have realized that their work in reimbursing fire losses on in- sured property, also consists in preventing fires as far as is possi- ble. Welfare work is very similar. Instead of waiting to repair the damage which certain conditions are gradually bring- ing about, modern welfare workers realize the value of pre- venting the damage before it comes and of intercepting the process. 50 Modern Dentistry As a brief summary of the dental service plan from which the above-mentioned companies are deriving such good results, let me conclude by outlining their system. Dental troubles fall into a class that can be readily prevented if caught in time, but are sure to accrue if not detected. Dental prevention consists of having the dentist examine each patient periodically, about twice a year, and note on a chart the condition of each tooth, directing the patients to their family den- tist for needed work, if any, and checking the work when it is done. That is, seeing that the work is done. The dentist does first aid work, relieves toothache, per- forms treatment that would re- 51 Modern Dentistry quire numerous trips to the family dentist and consequent loss of operative time, prevents excuses for toothache. There are many systemic conditions in the duration of which operatives lack pep, which are due to con- ditions of the teeth. As opera- tives are not aware of this cause, their dentist is not ordinarily brought in to consultation until too late. The industrial plan of having the industrial clinician call in the patient as a welfare feature of the establishment has made it possible to correct these systemic conditions before doing great damage, and the result has been greater regularity in attend- ance, better health, greater num- ber of operating hours given to 52 Modern Dentistry employment. As most com- panies have adopted dentistry from an educational standpoint, they have not kept data on per- centages of increase derived from that source, but you can see from the above expressions in their letters what their views are after use of the system. They class the results as intangible because what Preventative Dentistry pre- vents, never happens. It is like the fire that is prevented by cer- tain recommendations and pre- cautions, the prevented loss of which is impossible to estimate. The only difference is that in Preventative Dentistry, the thing at stake is health and efficiency. Dentistry in the factory is placing at the disposal of the 53 Modern Dentistry operatives information and ex- perience of the dental profession collected over the past fifty years. Of course there are things about it that the patient would not know, but the welfare department offers it gratis with the assurance that it is the right thing to do, knowing as it does, the benefits the operatives will derive from it. Corporation dentistry is a growing subject, and after reflecting what might have been if you yourself have lost some teeth which some pre- vention would have saved, the subject will take hold and leave you convinced that it is a good thing. Preventative Dentistry produces industrial health. 54 TOOTH TROUBLES AND THEIR RELATION TO SYSTEMIC TROUBLES Value of Dental Service The mouth is one of the three points at which systemic disease has its inception. The other two are the tonsils and the nasal cav- ity. In considering the decay of a tooth or the abscess at the base of a devitalized tooth or the pyor- rhea condition of the gums, the laity lose sight of the intimate re- lationship of these conditions to other parts of the body. This is due to the lack of public informa- tion on this subject and also to the painless or relatively painless 55 Modern Dentistry condition of the teeth and gums, when in this condition, in con- trast to the pain and inconven- ience experienced in other parts of the body during the time the exciting cause is allowed to run undetected. Dr. Duke, of Kansas City, Mis- souri, has made a long series of clinical observations on this sub- ject, and reports presence of streptococci bacteria in the blood of people having abscessed teeth. These bacteria affect the heart and are known to be the bacteria of joint inflammation-rheuma- tism. Physicians have recognized that these same conditions are brought on by septic formation in the tonsils. The tonsils have 56 Modern Dentistry had their share of investigation, and the operation of removal of the tonsils has become a necessary and popular one wherever the tonsils can not be made normal by treatment. The tonsils have also been found to be a cause of deafness. Likewise the tooth poi- son from the abscess going di- rectly into the blood produces deafness, and in some cases defec- tive eyesight. The streptococci take up their work where the pa- tient is weakest, or in some part that is below normal at the time the streptococci get into the blood stream from the tooth abscess. The liver is another point of at- tack. So there are quite a num- ber of systemic organs that are 57 Modern Dentistry directly affected by the poison of pus from the tooth abscess. Dr. Hartzell, of Minneapolis, Minnesota, has long been an ori- ginal investigator of the phenom- ena of Systemic Disorders Due to Defective Mouth Conditions. On account of his ability and in- clination in following up this sub- ject he was given the task of re- porting on this subject for the Research Branch of the Ameri- can Dental Association. Dr. Hartzell was the first American doctor and dentist (he is both) to show the connection between the abscessed tooth and rheuma- tism. He has made complete ex- planation of this and also reports, as does Dr. Duke, that the, follow- 58 Modern Dentistry ing systemic diseases, rheuma- tism, arthritis, neuritis, iritis and other eye inflammations, vegeta- tive endocarditis, myocarditis, peritonitis, meningitis, gastric and duodenal ulcer, pancreatitis, pneumonia, pleurisy, etc., are often of streptococcic origin due to direct infection from chronic points of infection (foci) as pyorrhea and abscessed teeth. Dr. Hoff, of Ann Arbor, Michigan, reports that it has long been supposed that rheumatism was the result of infection, but nothing definite as to the source of the infection was clearly made out until recent years. As most internal infections have of late been connected in some way with 59 Modern Dentistry the nose, mouth and throat, much experimentation has resulted in tracing these infections directly to the tonsils and teeth. At first it was thought that the infection was taken into the system through the stomach and alimen- tary canal, from open sores in the tonsils, and suppurating gums, alveolar abscesses, etc. But, as all such infection would be sub- jected to the destructive influ- ence, as the gastric and intestinal juices before absorption, it does not seem probable that there could be enough of the active vi- rus absorbed through this means to account for the exterior dis- turbances often encountered. At the present time it is believed that 60 Modern Dentistry so far as the teeth and tonsils are at fault the infectious virus is ab- sorbed directly from the tissues by the absorbent vessels and is carried through the lymph and blood vessels to the joints and muscle tissues where it is de- posited or finds favorable condi- tions for development, and so local points of disease are estab- lished in various tissues through- out the body where conditions favor development of these micro- organisms which cause this par- ticular disease. It is usual to find rheumatism affections in the joints and muscle tissues, which become pathologic, that is painful, or even in some instances abscessed. If it should locate for 61 Modern Dentistry instance, as it frequently does, in the heart muscle, it becomes a most serious affection and may be fatal in a short time; or in some other tissue not so high- ly specialized, it may assume chronic form and only annoy without fatal results. Dr. Goadby, of England, in 1912, reported his observations on Oral Sepsis, and his findings were the same as those already men- tioned. The pus in the abscess at the root of a tooth is pressed by force of the jaw pressure in eating and gains entry into the blood by veins and arteries that surround the pus sack. At every mealtime this occurs similar to a hypodermic of streptococci three 62 Modern Dentistry times a day. This process goes on unthought of by the patient. The rheumatism, the low pulse, low blood count, headache, are doctored for the malady, not for the removal of the cause, unless the physician has the patient con- sult the dentist. In the case of a blind abscess under a filled de- vitalized tooth or teeth an X-Ray would disclose the abscess. In pyorrhea conditions the spongy gums and pus pockets would be observable to the eye. The in- gress into the blood direct from tooth abscess of such regular amounts of streptococcus and staphylococcus bacteria lower the value of the blood, cause it to be less vital, and the heart becomes 63 Modern Dentistry weaker and altered in action, tak- ing the pep out of the patient. In severe cases vegetative endo- carditis takes place. The picture of this condition of the heart looks like cobwebs stretched all across every way over the valves. Dr. Barber, of Chicago, Illi- nois, has written at length upon the value of good teeth as the nec- essary requisite for good health through good digestion. Many people by loss of teeth, through decay and extraction, have not enough teeth to properly masti- cate the required food. In some cases the articulation of the teeth has changed, so that occluding teeth do not actually touch each other in biting. This allows the 64 Modern Dentistry food to go to the stomach in an indigestible form and makes di- gestion incomplete, causing indi- gestion. This brings up the case of Horace Fletcher, a member of the American Association for the Advancement of Science, who on account of indigestion was at fifty given up to die. He went to his dentist and was advised to have his teeth regulated so he could properly masticate the food and obtain one hundred per cent, di- gestion. With this done he paid particular mental attention to his eating, seeing to it that he did not swallow the food until he had thoroughly chewTed it. He wrote some about this subject also and the newspapers took it up, and 65 Modern Dentistry this publicity resulted in the expression ' ' Fletcherize. ' ' Mr. Fletcher at last reports was over seventy.* The foregoing points very plainly to the value of Preventa- tive Dentistry, and as already ex- plained elsewhere to do this it is necessary to call the patient peri- odically and perforin the dental prophylaxis. Greater public edu- cation is needed on the value of this work. It is so easy to pre- vent dental troubles, but after they have gained a start it takes an operation to stop them. Pre- vention through periodical pro- phylaxis is the best system. * He has since passed away while in war work in France. 66 THE POSSIBLE NEW LIFE POLICY Life insurance performs a national service by providing for the families of insured persons after death of the insured, return- ing a lump sum amount in cash representing in various degrees the insured's earning power. On policies with health indemnity clauses there is a payment for the duration of the sickness de- pending upon the terms of the particular policy. These two operations of insurance com- panies do much toward keeping the mechanism of business turn- ing, besides benefitting depend- ents of the insured. 67 Modern Dentistry The next step would seem to be to pay attention to the insured during life with an advisory and first-aid service pertaining to his health. Also to providing through the operations of the same service of an enlarged field for insurance by bringing the health of applicants up to the point of an insurance risk. As my allotted subject is to point out the importance of Dentistry in this respect, I will mention the value of health serv- ice in localities where much in- surance is already written or in- tended to be written. This service is of much value to the insured and indirectly to his de- pendents. Every medical clinic 68 Modern Dentistry of this kind would do well to have at least one unit of dental equip- ment and at least one dental clinician besides the attending physician and nurse. At the present time the popu- lace are only ten per cent, sold on the subject of Dentistry and much less per cent, sold on the subject of Preventive Dentistry leaving very great the possi- bilities to increase the health of the nation and to reduce the death rate through prevention of dental troubles, especially through the systemic disorders which arise in the teeth and gums as foci of infection. That is another way of stating that the people do not realize the intimate relationship 69 Modern Dentistry that exists between the teeth and the general human system. They do not realize how important a part of the human anatomy the teeth are. If it is understood that the four cylinders of the heart are in constant automatic operation and that one pair of valves take the venus blood from the system and drives it through the lungs, and the other pair take the then arterial blood from the lungs and drives it through the body system from which it re- turns to repeat the cycle, then it can be easily understood how blood circulating around ab- scessed teeth carries the infection at once to the heart and the next moment to the arms, fingers, 70 Modern Dentistry limbs, feet, intestinal regions, and. head. Under the influence of bacteria in the blood from abscessed teeth and pyorrhea gums the heart is not normal and often excludes the applicant for insurance from a clean record on his heart to the extent that he is declined as a risk. This condition can be corrected by dental attention and upon a sub- sequent test of the heart the ap- plicant could be accepted. The dangerous systemic infec- tion at an abscessed tooth or pyorrhea gums often is held back by the natural health of the patient until some fever reduces his resistance, at which time the infection gains headway, or heart- 71 Modern Dentistry way in this instance, in the blood, and complications set in. The regular list of bacterial infection diseases results from tooth infec- tion such as arthritis, pneumonia, myocarditis, endocarditis, peri- tonitis, gastric ulcer, pancreatitis, pleurisy, nephritis, iritis, menin- gitis, rheumatism, also deafness and insanity. A dollar spent in prevention saves large amounts in cure or relief. You have no doubt heard or read of persons contracting a cold or grip and the developments leading into one or more of the above catagories. The teeth play their proportional part in this in- fection the same as do the tonsils, throat, and nose. Dentistry is a 72 Modern Dentistry health profession, a highly de- veloped specialist branch of medi- cine, and has an important field in the preservation of health. The first-aid health service should comprise the kind of supervision that would enable the insured to live his natural term of life in which the organism naturally wears out, not permit- ting a part, such as a tooth, to wear out and through neglect to poison the whole system and cause the death. Inasmuch as the mortality tables are compiled from actual death statistics and the load in the premium is based on the cost of operating insurance com- panies, it is possible by bringing 73 Modern Dentistry a larger number of applicants within the requirements of the insurance risk to greatly increase the number on whom insurance can be written without much in- creased cost of procuring this additional business. Another idea is the tooth ex- amination of the applicant for life insurance. The plan that seems best to the writer's mind is to have one or more dental clinicians in every locality just the same as you have one or more physicians in every locality. The dental clinician according to this plan would make a prophy- laxis and tooth examination both instrumental and by X-ray of each applicant and render the 74 Modern Dentistry dental recommendations on a formal card. The applicant could then have his family den- tist put his teeth in order ac- cording to the recommendations outlined by the insurance dental clinician and then return to the insurance dental clinician to have the work checked up. The card with the O. K. could then be turned in along with the medical examination card. A popular opinion about the teeth is that not until a tooth aches is it time to go to the dentist. This is just inverse of the truth. It is then too late as the pain announces the arrival of the danger point, and in many cases only an operation can pre- 75 Modern Dentistry vent serious trouble. Peri- odical prophylaxis intercepts the process of decay and discovers the formation of pyorrhea and abscesses while they are still in a curable stage, without the ac- cruing of systemic maladies or unnecessary loss of the service- ability of the teeth. The payment of life insurance premiums by a policy holder is his financial prophylaxis, a pre- vention from leaving his depend- ents in want. Health prophylaxis is the next subject that should interest him. He should inter- cept the forces which are at work and which only announce their presence too late by pain. The fear and pain connected 76 Modern Dentistry with Dentistry are not the den- tist's fault. By going to the dentist periodically all pain is avoided, health is maintained, and natural teeth are preserved for old age. With health service alongside, life insurance would mean pre- servation of life, besides pay- ment of an indemnity at death. It is possible to give a health serv- ice along with life insurance poli- cies, or at least health directions at the writing of the insurance, applicable to the individual, that would materially lengthen the life of the insured. And it is possible by clinical first-aid health service and health restorative recommendations to greatly in- 77 Modern Dentistry crease the number of available life insurance risks. Summarizing the foregoing, it is possible through Dentistry to increase the number of holders of life insurance policies and to lengthen the life of policies in force, and to reduce the claims on sick and debility clauses. It is besides evident that a clean tooth certificate from the dental clinician is very desirable, be- cause so many contractable dis- eases are traceable to the teeth. 78 DENTISTRY IN THE HOSPITAL Dental service is necessary along with medical service in healing systemic disease. Ad- ministration of certain drugs re- quire previous dental attention and removal of dental foci of in- fection for safety. In order to know all the con- ditions affecting a patient at the hospital, it is necessary not to leave out any of the tests, as such an omission may lead to an erro- neous diagnosis. In quite a num- ber of cases the neglect to exam- ine the mouth and teeth, both instrumentally and by X-Ray, is decidedly incomplete diagnosis. 79 Modern Dentistry Hospitals in which the installa- tion of dental equipment origin- ally was made for care of frac- ture of the maxillary and prac- tice of oral surgery, have recog- nized that there is more general use of the dental service than was originally expected. The relationship of the teeth to sys- temic diseases as foci of infec- tion, or at least as relay posts from which the infection is in- creased, has so repeatedly been demonstrated that most physi- cians recognize it as a valuable element in their diagnosis. In the light of the present knowl- edge of this subject the examina- tion of the mouth condition of the patient is valuable data in 80 Modern Dentistry determining the treatment of the patient while in the hospital. This examination is called odon- talysis. Whether the odontalysis shows pyorrhea, alveolar abscess, blind abscess, impacted un- erupted teeth or not, it becomes important information of condi- tions, as it tells whether the teeth can be counted in the treatment to follow, or eliminated from con- sideration. Besides oral surgery and examination for tooth foci of infection, dentistry in the hos- pital is very valuable for prepar- ing maternity cases, as all un- healthful conditions of the teeth of prospective mothers should have immediate dental care and treatment. It is eminently best 81 Modern Dentistry for both the mother and the off- spring that all conditions which lower the vitality and have such influence upon the purity of the blood be corrected to normal be- fore confinement. The care of children's teeth is a subject which also receives much attention in the hospitals using dental service. Non-atten- tion to children's teeth is re- gretted by parents and relatives in after years, when it is a diffi- cult matter to make corrections of irregularities which in child- hood and youth could have been made very easily. This work has a direct bearing upon the child's health also, and can, when promptly attended to, have much 82 Modern Dentistry to do with the child's future health. It is a function of hos- pital dental service that should receive application to all children cases which come under the in- fluence of the hospital authori- ties. In such cases the work is preventive dentistry, inasmuch as the proper correction and care in childhood prevents serious dental troubles and impaired health in adult life. The treatment of cases in -which the remedies prescribed are arsenic, iodides, mercury, phosphorus, requires dental at- tention, as the effects of the use of these drugs is to stir up latent infection. As the mouth condition of such patients 83 Modern Dentistry may respond to the action of these drugs complicating sys- temic conditions, dental care be- comes necessary. Difficult extractions under an- esthesia is another facility which a Hospital Dental Clinic affords. One of the important features of the treatment of pulmonary tuberculosis is the filling of all tooth cavities and mainte- nance of oral hygiene. There are calls for many operations for impacted teeth or what might be called miscarriage of the teeth. Patients suffer very often, believing the trouble in other parts of the body, as the nervous system is deranged by pressure of the tooth on a nerve 84 Modern Dentistry in its endeavor to erupt. This is generally called a neuralgia, or in other words, a pain, which does not explain it at all. The Hospital Dental Clinician can generally locate the offending tooth by having an X-Ray pic- ture taken, which will disclose the tooth below the gum in an inclined or horizontal position. An important part of hospital dental work is the great oppor- tunity for research work. Cases offered at a hospital in the dental department are different in some ways than those offered in a pri- vate dental practice. More oral surgery and malignant systemic cases come under hospital dental attention than come into a pri- 85 Modern Dentistry vate practice. Treatments, fill- ings, artificial teeth and bridge- work are called for, but not so much as in private practice. The unusual cases which a gen- eral hospital receives offer great opportunities for dental obser- vation and research work. This work, of course, is very interest- ing to dental clinicians. During a recent visit to the Jewish Hospital in Cincinnati, where they have a dental clinic, the writer was shown the hos- pital card on which the tooth con- dition of all patients is recorded. All findings are recorded thereon and furnish data which very often help the hospital board, together with the records placed 86 Modern Dentistry on the same card by physicians and specialists in the hospital's other departments, in arriving at the correct diagnosis and subse- quent relief and restoration of the patient to full health and usefulness. The supervisor, ex- plained, it is not enough to place the patient on his feet, but to re- store 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 properly do it. Another work performed by the dental clinic at the Jewish Hospital is the care of children's teeth, the advan- tages of which all welfare au- thorities readily recognize. This work is part of the oral hygiene 87 Modern Dentistry 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 present- ing 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 a tour of the dental department was made. Patients arriving at the hospital for diagnosis and treatment are taken to the dental clinic at the direction of the attending physi- cian. If the patient is unable to 88 Modern Dentistry walk, a wheeled chair or a wheeled stretcher is used to con- vey the patient there. After the instrumental examination of the teeth, the dental clinician sends the patient to the X-Ray depart- ment for a complete dental roentgenographic examination. They take ten films, five upper and five lower, covering the com- plete mouth, using one of their large machines on a two and one- half spark gap. The developed films are returned to the dental department 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 physi- 89 Modern Dentistry cian's diagnosis of symptoms and other tests, such as urinaly- sis, 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 re- covery from the systemic condi- tions. Part of every day is de- voted to the care of children's teeth at the Cincinnati Hospital. Children from the city and neigh- borhood are brought to the hos- pital and given treatment. Care of their teeth is along prevent- ive lines and correction of irreg- ularities and dental advice to the parents. Children from five years up receive this attention 90 Modern Dentistry and. learn the value of care of the teeth. Oral surgery is performed fdr all cases coming to the hospital and receive immediate attention by the skilled operatives in the dental department. Dentistry in the hospital has shown its value in so many ways and so many patients arriving at the hospital require dental care that the department is very much in demand. 91 THE ODONTALYSIS One of the most valuable find- ings of the research department of the American Dental Society, is the relation of tooth troubles to systemic troubles. The bene- fit of this finding is important to humanity, as it points to the remedy for many ailments that have heretofore remained unex- plained. The benefit to dentistry is that it demonstrates to the pub- lic the importance of care of the teeth. Whether the teeth are in themselves the origin of the trouble, which sometimes they are, or relay points, the bad con- dition of which augments a sys- temic condition originating some 92 Modern Dentistry other place, it remains a domi- nant fact that care of the teeth is necessary not only for preven- tion of disease, but for its cure. Hospitals where general analyt- ical tests, such as blood test, temperature, breathing, urin- alysis, Wasserman's, etc., have been the regular schedule for the majority of the patients, are be- ginning to add the1 ' Odontalysis, ' ' meaning the test of the tooth condition. This is a new word we have coined to express this new hospital department work. Hospital attention to the teeth of patients reduces the time neces- sary for recovery from sickness. This item alone, in many cases, will reduce the otherwise longer 93 Modern Dentistry stay of the patient at the hospital for recovery. " Dentistry in the Hospital" and the allied subject, "Dentistry in the Factory," are making rapid progress toward popular appreciation of the value of "Care of the Teeth," to which the dental profession has untiringly given so many years of study and patient thought. 94 ITEMIZATION OF INSTRUMENTS, SUPPLIES AND EQUIPMENT USED IN INSTITUTIONAL AND INDUSTRIAL DENTAL CLIN- ICS AND IN HOSPITAL INFIR- MARIES. Instruments and Supplies 1-Z FIRST AID INSTRUMENTS AND PROPHYLAXIS SUPPLIES Instruments and supplies "1-Z" together with any equipment "2-Y," "3-X," "4-W," "5-V," "6-U" or "7-T" make a complete First Aid Outfit. Instruments 1 C. S. D. P. Scaler No. 1. 1 C. S. D. P. Scaler No. 5. 1 C. S. D. P. Scaler No. 6. 1 C. S. D. P. Scaler No. 9. 1 C. S. D. P. Scaler No. 11. 1 C. S. Chisel No. 48-L. 1 C. S. Scaler No. 2. 1 C. S. Scaler No. 13, Younger-Good. 1 C. S. Scaler No. 33. 1 C. S. Scaler No. 34. 1 C. S. Scaler, Tomkins, No. 11. 1 C. S. File, Tomkins No. 1. 1 C. S. Smith Prophylaxis File No. 13. 1 C. S. Smith Prophylaxis File No. 14. 14 C. S. Handles No. 10-A. 95 Modern Dentistry 1 C. S. Explorer Point No. 17. 1 C. S. Explorer Point No. 6. 1 C. S. D. E. Handle No. 17. 1 Set L. H. Bates Scalers. 1 Pair Pliers No. 11. 1 Mouth Mirror. 1 Woodson D. E. Plastic Inst. No. 1. 1 Woodson D. E. Plastic Inst. No. 2. 1 Woodson D. E. Plastic Inst. No. 3. 1 Amalgam Carrier and Plugger No. 7. 1 Cement Spatula No. 36. 1 Hand Porte Polisher, Contra Angle. 1 Water Syringe, Moffatt. 1 Kuroris Cotton Carrier. 1 Alcohol Lamp. 1 Gum Lancet. 1 Mounted Arkansas Stone, in box. 1 Magic Napkin Holder. 1 Ribbon Saw. 1 Package Kerr Broaches, fine. 1 Package Kerr Broaches, extra fine. 1 Package Pulp Canal Cleaners. 1 Broach Holder. 1 Ivory Cotton Roll Clamp, Bicuspid. 1 Ivory Cotton Roll Clamp, Molar. 1 Pair Tooth Forceps No. 150, Incisor and Root, Upper. 1 Pair Tooth Forceps No. 151, Incisor and Root, Lower. 1 Pair Tooth Forceps No. 18-R, Upper Molar, Right Side. 1 Pair Tooth Forceps No. 18-L, Upper Molar, Left Side. 1 Pair Tooth Forceps No. 15, Lower Uni- versal Molar. 96 Modern Dentistry 1 Pair Tooth Forceps No. 213, Incisor and Cuspid, Upper. 1 Pair Tooth Forceps No. 210, Upper Third Molar. 1 Pair Tooth Forceps No. 222, Lower Third Molar. 1 Chip Blower. 1 Abscess Syringe with Platinum Point. 1 Hypodermic Syringe, Tag Record complete with Needles and Attachments. 1 Contra Angle "U" attachment for Doriot No. 3. 1 Gross S. S. W. Asst. No. 2 Burs. 6 Huey Mandrels. 1 Porte Polisher Mandrel No. 307. 1 Cement Slab No. 8. Supplies 1 Box Prophylaxo Tablets. 1 Bottle Taxi. 1 Box Burlew Polishers, Asst. 1 Box Mounted Wheel Brushes. 1 Box Mounted Cup Brushes. 1 Box Tooth Polishing Brushes for Porte Polishers. 6 Mounted Carbo Points. 1 Box Wood Points for Hand Porte Polisher. 1 Lb. Pumice. 1 Box Temporary Stopping, Asst. 1 Oz. Sterling Alloy. 14 Lb. Cone Mercury, Sacco. 1 Box Caulk Petroid Cement. 1 Box C. & B. Cement. 97 Modern Dentistry 1 Box 100 Absorbent Cotton Rolls, 6-in., Asst. 1 Box 50 Aseptic Dental Napkins, J. & J. No. 2, 6x6. 1 Small box Absorbent J. & J. Cotton. 1 J. & J. Waste Receiver and Cartons. 1 Cotton Holder No. 1. 1 Spool 150 yds. Waxed Floss Silk, J. &. J. 1 Oz. Waites Anesthetic, without Cocaine. 1 Tube Procaine (Novocaine) Tablets. 1 Tube Salt (Ringer) Tablets. 1 Dissolving Cup 3cc Pyrex Glass. 1 Dappan Glass Cup. 1 Bottle Peroxide Hydrogen. 1 Apron for Patient, Oiled Silk. 1 Miniature Bunsen Burner and Tubing. 1 Box Finishing Strips, Asst. 6 Boxes Polishing Disks, Asst. 1 Box Abscess Remedy and Root Canal Filler. 1 Box Gutta-percha Points. 1 Box J. & J. Absorbent Cotton Points. 1 Package Orange Wood. 1 Box Carmi Lustro Tape. 1 Bottle Phenol 95%, Dental Medicine. 1 Bottle Eugenol, Dental Medicine. 1 Bottle Tricresol and Formalin, Dental Medicine. 1 Bottle Black's Mixture, Dental Medicine. 1 Bottle Campho Phenique, Dental Medi- cine. 1 Bottle Trichloracetic Acid, Dental Medi- cine. 1 Bottle Tincture Aconite, Iodine and Chloroform. 98 1 Bottle Tricresol. 1 Bottle Tincture Calendula. EQUIPMENT 2-Y 1 Harvard Peerless Chair. 1 Electro Dental Wall Type Engine, Fold- ing Bracket Type, All-Cord, A. C. or D. C. 1 Doriot Handpiece and Wrist Joint. 1 Weber Cuspidor Pedestal, Type 55. 1 Harvard Cabinet No. 62-D. 1 Electro Dental Sterilizer, Onyx Base. 1 Glass Top Aseptic Table, 20x16. 1 Sacco Boss Wail Bracket. 1 Consolidated Vitrilite Top Aseptic. EQUIPMENT 3-X 1 S. S. W. Equipment Combination "D," consisting of Diamond Chair S. S. W. All-Cord Electric Engine, Doriot Hand- piece No. 3, D. C. or A. C., Current any Voltage, Bracket and Table Glass Top No. 3, Electric Light and Bracket, Spiral Flush Fountain Cuspidor, Air ' and Gas Connections. 1 American Cabinet No. 60-E. 1 Castle Sterilizer, Electric, No. 410-D. 1 Glass Top Aseptic White Enamel Table, 20x16. EQUIPMENT 4-W 1 Ritter Ideal Columbia Chair. 1 Ritter Wall Type Folding Bracket, En- gine Model "C," A. C. or D. C., All- Cord. Doriot Handpiece No. 3. 99 Modern Dentistry 1 Weber Cuspidor No. 55, with Attachment to Chair. 1 American Cabinet, Steel, No. 110. 1 Consolidated Sterling Bracket for Wall. 1 Cleve. Dent. Peerless Aseptic Vitrolite Top. 1 Castle Electric Sterilizer No. 410-D, on Separate Stand. 1 Aseptic Glass Top Table, 30x24. EQUIPMENT 5-V 1 Harvard Peerless Dental Chair, Black Enamel. 1 Ritter Unit Equipment, consisting of Rit- ter Electric Engine A. C. All-Cord Type, Clark 65 Streamline Cuspidor, Bracket and Glass Top Table, Complete Switch Board of Appliances, Mahogany Finish or Black. 1 All Metal White Enamel Cabinet with Opal Glass Table Top. 1 Pelton & Crane Sterilizer. 1 Glass Top Stand, 20 x 16, Glass Top, 1 Glass Shelf, Metal Frame, White Enamel, with Rail. EQUIPMENT 6-U 1 S. S. W. Diamond Chair. 1 S. S. W. Equipment Unit Stand No. 3, consisting of Spiral Flush Fountain Cuspidor, Electric Light and Electric Engine any Voltage D. C., and Doriot No. 3 Handpiece, Bracket and Bracket Table No. 3. 100 Modern Dentistry 1 Lee Smith & Sons Co. Steel Cabinet No. 506. 1 Aseptic Glass Top Table. 1 Holmes Electric Sterilizer. 1 Sanican Receptacle. EQUIPMENT 7-T 1 Ritter Ideal Dental Chair, Mahogany. 1 A. C. Clark & Co. "U" Pedestal Unit, con- sisting of Pedestal, A. C. Clark & Co. Double Bowl Streamline Cuspidor, Bracket and Table, Ritter Swivel Type Model "C" Electric Engine, All-Cord with Doriot Handpiece, Mahogany Finish. 1 American Cabinet No. 60-E, Mahogany. 1 Castle Sterilizer, Electric. 1 Sanitary Can. 1 Glass Top Table with Glass Shelf and Rail. SUMMARY Outfit 12-Y-Z-Supplies 1-Z; Equipment 2-Y. Outfit 13-X-Z-Supplies 1-Z; Equipment 3-X. Outfit 14-W-Z-Supplies 1-Z; Equipment 4-W. Outfit 15-V-Z-Supplies 1-Z; Equipment 5-V. Outfit 16-U-Z-Supplies 1-Z; Equipment 6-U. Outfit 17-T-Z-Supplies 1-Z; Equipment 7-T. 101 Modern Dentistry The following corporations are opera- ting dental clinics. This list shows sev- eral additions of important industries that have taken up industrial dentistry since our list published in February, 1919, number of the Dental Register: Adamsville, Alabama- Tennessee Coal & Iron Co., Wenonah Mines. Tennessee Coal & Iron Co., Ishkooda Mines. Birmingham, Alabama- American Cast Iron Pipe Co. Tennessee Coal & Iron Co. Bessemer, Alabama- Tennessee Coal & Iron Co. Ensley, Alabama- Tennessee Coal & Iron Co., Bayview Mines. Fairfield, Alabama- Tennessee Coal & Iron Co. Johns, Alabama- Tennessee Coal & Iron Co. Davenport, California- Santa Cruz Portland Cement Co. Fresno, California- California Associated Raisin Co. Oakland, California- The Alameda Co. San Francisco, California- The Emporium. 102 Modern Dentistry Denver, Colorado- The Colorado Fuel & Iron Co. Pueblo, Colorado- The Colorado Fuel & Iron Co. Trinidad, Colorado- The Colorado Fuel & Iron Co. Milford, Delaware- The L. D. Caulk Co. Wilmington, Delaware- Dupont Powder Co. New Haven, Connecticut- Kolynos Co. Chicago, Illinois- Morris & Co. Montgomery & Ward Co. Armour & Co. Chicago Telephone Co. The Crane Co. The Diamond Match Co. Hart, Schaffner & Marx. Kabo Corset Co. Sears, Roebuck & Co. The International Harvester Co. Peoria, Illinois- The Avery Co. Indiana Harbor, Indiana- The Inland Steel Co. New Orleans, Louisiana- D. H. Holmes Co. South Brewer, Maine- The Eastern Mfg. Co. 103 Modern Dentistry Boston, Massachusetts- The Hood Rubber Co. Filene Co. Operative Assn. Chelsea, Massachusetts- Forbes Lithographic Co. East Watertown, Massachusetts- Hood Rubber Co. Florence, Massachusetts- The Florence Mfg. Co. Framingham, Massachusetts- The Dennison Mfg. Co. Southbridge, Massachusetts- American Optical Co. Wellesley Hills, Massachusetts- Babson Statistical Organization. Detroit, Michigan- The Ford Motor Car Co. Minneapolis, Minnesota- The Washburn-Crosby Co. The Northwestern Knitting Co. Kansas City, Missouri- Jones Store Co. St. Louis, Missouri- National Lamp Works. Concord, New Hampshire- Union District Dental Clinic. Manchester, New Hampshire- The Amoskeag Co. Nashua, New Hampshire- Nashua City Dental Clinic. Maginnis Cotton Mills. 104 Modern Dentistry Jersey City, New Jersey- Colgate & Co. Hurley, New Mexico- China Copper Co. Brooklyn, New York- Schrader & Sons. Buffalo, New York- Larkin Co. McGregor, New York- Metropolitan Life Insurance Co. New York, New York- Bloomingdale Bros. The International Garment Workers' Dress and Waist Makers' Union. Lord & Taylor. Macy Mutual Aid Assn. James McCreery. Metropolitan Life Insurance Co. New York Telephone Co. Wanamaker Store. Niagara Falls, New York- Oldsbury Electro Chern. Co. Rochester, New York- The Bousch & Lomb Co. Akron, Ohio- The Firestone Tire & Rubber Co. The B. F. Goodrich Co. National Lamp Works. Cincinnati, Ohio- The Cincinnati Milling Machine Co. The R. K. LeBlond Machine Tool Co. 105 Modern Dentistry Cleveland, Ohio- The Bailey Co. The Joseph & Feiss Co. The Kaynee Co. National Lamp Works. R. & E. Blouse Co. Dayton, Ohio- Dayton Electric Laboratories Co. The Dayton-Wright Airplane Co. The Dayton Metal Products Co. The National Cash Register Co. Hamilton, Ohio- The Hooven, Owens, Rentschler Co Warren, Ohio- National Lamp Works. Youngstown, Ohio- National Lamp Works. Erie, Pennsylvania- Erie Forge Co. Philadelphia, Pennsylvania- John Wanamaker. The S. S. White Dental Mfg. Co. Pittsburg, Pennsylvania- The Armstrong Cork Co. The H. J. Heinz Co. Lee S. Smith & Son Co. Reading, Pennsylvania- Berkshire Knitting Mills. Bristol, Rhode Island- National Indian Rubber Co. Bosevaine, Virginia- Pocahontas Fuel Co. 106 Modern Dentistry Itman, West Virginia- Pocahontas Fuel Co. Jenkinj ones, West Virginia- Pocahontas Fuel Co. Maybeury, West Virginia- Pocahontas Fuel Co. War, West Virginia- Williams Pocahontas Coal Co. I Appleton, Wisconsin- Kimberly Clark Co. Beloit, Wisconsin- Fairbanks-Morse Co. Kohler, Wisconsin- Kohler Mfg. Co. Neenah, Wisconsin- Kimberley & Clark Paper Mills. Niagara, Wisconsin- Kimberley Clark Co. Toronto, Canada- T. Eaton Co., Ltd. 107 Modern Dentistry The following book review appeared in The Investment Weekly and Business Digest, New York, December, 1918. This recognition of "Modern Dentistry for the Laity and Industrial Dentistry for the Corporation" is very much ap- preciated. This is a review of the first edition. "Modern Dentistry for the Laity and Indus- trial Dentistry for the Corporation." By Alfred Armstrong Crocker, 6 pp., 16mo. Dental Register, Cincinnati, Ohio. Advocates a plan for the installation by corporations of a dental clinic. The corpora- tion dentist keeps a chart of the teeth of each employe, and whenever he finds a decayed or abscessed tooth calls it to the attention of the employe's dentist. Many illnesses are directly or indirectly due to bad condition of the teeth, so that dentistry is a real aid in the manu- facturer's problem. This system has been in use in the Army and Navy, in nitrate plants and the airship corporations and has been adopted by sixty-three large corporations in different parts of the country. The following is also a review of the first edition, which appeared in the January, 1919, number of The American 108 Modern Dentistry Jeweler, Chicago, Ill. This notice of "Modern Dentistry for the Laity and Industrial Dentistry for the Corpora- tion" helps show the diversified lines of thought to which this subject appeals. "Modern Dentistry for the Laity and Indus- trial Dentistry for the Incorporation," by Alfred Armstrong Crocker. Published by the Dental Register, Cincinnati, Ohio. Industrial dentistry, like industrial optics, is a new phase of welfare work, particularly of large corporations and requires more or less publicity to bring its merits to the attention of those who are chiefly interested. The sub- ject is covered by about sixty pages, five of which contain a list of the corporations who are operating dental clinics at their factories. The subject is treated in seven short chapters, giving various aspects of dentistry as a factor in industrial corporations and the reasons for corporation dentistry. The following review was written by The Modern Hospital, Chicago, and pub- lished in their Book Review Department. It is a review of the second edition of this book. This complimentary assist- 109 Modern Dentistry ance in the popularization of the bene- fits derived from preventive dentistry is greatly appreciated. "Modern Dentistry for the Laity and Indus- trial Dentistry for the Corporation." By Alfred A. Crocker, Cincinnati, Ohio.* This little volume consists of a number of short essays on dentistry and its application to individual welfare and industrial efficiency. The author deals with the importance of proper care of the teeth in relation to the health of every individual; he also lays stress on the necessity of corporations realizing what a large part the teeth play in the general health of their employes. The idea to follow in regard to your teeth, he says, is the pre- vention of decay, and this requires visits to the dentist at least twice a year. In order to insure the proper care of teeth on the part of employes, the best plan for the corporation to follow is to install a dental clinic, similar to the medical department now almost indispen- sable in large corporations. The function of the dental clinic is not to treat the teeth of the employes, but simply to examine them and recommend the treatment necessary so that the patient may go to his family dentist im- mediately. Many companies do not absolutely require this examination twice a year, but find that the employes are glad of the opportunity and willing to take advantage of it. As for * The Sam'l A. Crocker Co., Cincinnati, Ohio, 1919. 110 Modern Dentistry the value of this plan to the corporation, "cor- porations installing dental service for employes are taking a step for economy in manufactur- ing, conservancy of manufacturing hours, and maintenance of health of operatives." The im- portance of proper care of the teeth has been emphasized by preventive dentistry and oral hygiene during the war, since the United States Government required every recruit for the army or navy aviation corps to have his teeth put in good prophylactic condition. The last essay, "Tooth Troubles," gives an idea of "what pre- vention prevents." A list of actual require- ments for establishing clinics concludes the book. The essays, which appeared originally in various magazines, are written in such a way that the average person can easily and quickly read them. The few technical terms which occur are defined. The book is dedicated to "the dental profession, whose avowed purpose is the prevention of decay and preservation of the teeth of the human race." 111 BIBLIOGRAPHY A Study of Streptococci from Pyor- rhea Alveolaris and from Apical Ab- scesses.-Thos. B. Hartzell, M.D., D.M.D., and Arthur T. Henrici, M.D. Oral Infection in Relation to Consti- tutional Infection.-Thos. B. Hartzell, M.D., D.M.D. The Mouth as a Factor in the Patho- genesis of Heart, Kidneys and Joint In- flammations.-Thos. B. Hartzell, M.D., D.M.D. The Dental Path-Its Importance as an Avenue to Infection.-Thos. B. Hart- zell, M.D., D.M.D., and Arthur T. Hen- rici, M.D. Oral Sepsis in Its Relationship to Systemic Disease.-Wm. W. Duke, M.D., Ph.D. Care of the Mouth and Teeth.-Jos. Herbert Kauffman, D.D.S. Educational Lectures on Dental and Oral Hygiene.-T. C. Trigger, D.D.S. Mouth Hygiene-A Course of In- struction for Dental Hygienists.-Alfred C. Fones, D.D.S. Profitable Practice.-George Wood Clapp, D.D.S.- Business Science of Dentistry.-Ed- ward S. Barber, D.D.S. 112