DENTISTRY 179 



In the Hospital world in England, one of the most important events of late years has 

 been the removal of King's College Hospital to a site in the neighbourhood of Denmark 

 Hill. The new buildings were almost complete in November 1912, and the Hospital was 

 expected to be in full working-order by the beginning of the winter session, October 

 1913. Westminster Hospital, likewise, is preparing to move. 



The International Medical Congress meets in London, in August, 1913, under the 

 Presidency of Sir Thomas Barlow. (STEPHEN PAGET.) 



The progress of dentistry during recent years has been characterised by marked 

 advance in the technical procedures of its several departments and a corresponding 

 development of its underlying scientific principles. The stimulus towards scientific 

 investigation furnished by the publication of the results of Miller's studies of the 

 nature and causation of dental caries during the latter decades of the past century 

 has not only produced a large number of workers in related fields of research, but has 

 created an appreciative interest in scientific investigation throughout the dental pro- 

 fession, so that the factor of empiricism so evident in earlier dental methods is being 

 rapidly eliminated and replaced by a more rational and scientific practice. 



An extensive study has been made of the problem of dental caries, not only as 

 related to the individual, but in its broader aspects as a public health question. Care- 

 fully gathered statistics in all civilised countries point definitely to certain conclusions. 

 First, that tooth decay is practically a universal disease among civilised peoples. Sec^ 

 ond, that between 92 and 95% of people in all nations are more or less subject to it. 

 Third, that it is essentially a disease of youth and adolescence. Fourth, that in the life 

 cycle of the individual there appear to be well marked periods of immunity and sus- 

 ceptibility. P'ifth, that there appears to be a relation between the food habit of the 

 individual and susceptibility. Sixth, not only statistics but experimental observation 

 have demonstrated that decay of the teeth, its concomitant mouth conditions and its 

 direct pathological results, are the cause of a degree of physical and mental deficiency 

 in school children which, apart from humanitarian considerations, involves an economic 

 factor of the highest importance. Dental disabilities are a cause of lowered physical 

 and mental efficiency in children of school age, thus depreciating the value of the most 

 important asset of the state in its future citizens, and, purely from a pecuniary point 

 of view, it can be shown that it costs much less to remove this preventable cause of 

 inefficiency and mental backwardness in school children than it does to continue them 

 in school for the added time which the dental disability entails. 



The extent and importance of the problem of dental disease, in its relation to public 

 health and therefore physical and intellectual efficiency, is attracting the serious con- 

 sideration of sanitarians, educators, military and naval authorities, criminologists, 

 authorities of eleemosynary institutions and large manufacturing industries, generally 

 speaking, in all countries. The attention of the dental profession has been focussed 

 not only upon the improvement of all of its operations and procedures that have for 

 their object the arrest and repair of the ravages wrought by dental disease, and the 

 devices for restoration of lost dental organs, but also on the investigation of the causa- 

 tion of dental disease and particularly caries with a view to its preventative or pro- 

 phylactic treatment. Much important work has already been done in connection 

 with the fundamental aspects of the subject of dental prophylaxis, upon which later a 

 scientific scheme of prevention of dental decay can be wrought out, mainly in the di- 

 rection of so changing the composition of the mouth fluids as to render them unsuitable 

 for the localised growth and propagation of the bacterial influences that are the direct 

 cause of tooth decay, a change which at present is most hopefully sought in the di- 

 rection of improved dietetics. 



While the underlying principles of the preventative treatment of dental disease 

 present problems of great intricacy, these are the subject of active investigation, and 



1 See E. B., viii 50 et seq. 



