COTTON, WAITE A.: Division of Child Research, New York University, New York City (Oct. 1, 1938).

Caries depends upon three factors acting simultaneously : (a) food debris, (b) stagnation, (c) microorganisms. Flaws or faults in enamel, such as roughness, shape, pits or fissures, or any relationship to adjoining teeth favor­ing lodgment of food particles, increase susceptibility to caries. Lodgment of food debris can be prevented, to a large extent, by polishing all rough sur faces and filling every flaw, groove, pit, or fissure where stagnation occurs. This method of care is not ” 100-percent effective ” against caries, but with it all permanent teeth can be saved in children. Oral mucous-glands discharge, directly on the teeth, secretions that inhibit growth of microorganisms. Where all factors for caries are present and it does not develop, the mucous secretions inhibit action of microorganisms on carbohydrates in retained food debris, thus preventing formation of the acid that would start caries. In susceptible persons, caries varies in proportion to the inhibiting quality of the mucous. Worry, fear, and other disturbing mental conditions, frequently influence the quality of the mucous secretions, permitting caries. There is no relationship between incidence of caries and (a) degree of hardness of teeth (in soft teeth the process is more rapid), or (b) adequacy of diet (children receiving de­ficient diets may be free from caries; children on adequate diets may show excessive caries).

Some children showing little evidence of home care, and plenty of lodgment of food debris, may be free from caries. Why—with all necessary destructive factors present? Since caries is an individual disease, and not communicable, the con­ditions that allow it to be produced are also individual. Anything that diminishes the bacteria-inhibiting quality of oral mucous-secretions favors initiation of caries. In one person it may be nervous indigestion; in another, overeating rich foods; in another, consumption of too much sugar (which is also highly irritant to sensitive oral membrane) ; in another, too much cereal food—the inability of some persons to utilize cereals suggests a form of allergy.

Reference: J. Am. Col. Den., 6, 65, 1939.

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