There are constant relationships between carious dental surfaces and surfaces having enamel defects, such as pits or fissures ; between caries and anatomical formation of a surface where dilution by saliva is not possible ; between the highest percentage of caries and anatomical defects which cannot be cleansed by any known methods of mouth toilet. A constant relationship may occur between oral absence or presence of L. acidophilus, and absence or presence of enamel defects, such as pits and fissures. Teeth are built in pairs, and a constant relationship is found in the bilaterality of caries because of similar anatomical formation. As a result of research, clinical observations, and statistical findings, a definite operative procedure has been advocated —prophylactic odontotomy—which, when applied, effects large reductions in loss of teeth and in number of carious cavities. In New Zealand, where every school-child receives the benefits of prophylactic odontotomy, reduction in loss of teeth has been very marked. Filling of all pits and fissures, even when no decay is seen, has been officially endorsed by the American Dental Association, Canadian Dental Association, Carnegie Foundation’s Bulletin on Dental Education, and over 44 dental societies throughout the world.
No data have been collected, in scientific research, showing results—on matters relating to behavior, class study-hours, and physical condition of children—when reduction of caries, prevention of loss of teeth, and mouth hygiene have been obtained. There are numerous isolated records, such as those obtained in Atlanta, Ga., and Bridgeport, Conn. There is no chart for systematic collection of such data ; no procedure has been set forth, no research has been done, to show what present-day preventive methods have accomplished and can accomplish. Carefully tabulated data of this kind would provide incontestable evidence of the practical value of prophylactic odontotomy in all public-health work for children. Inasmuch as public-health work is primarily devoted to preventive procedures, to include adults over 18 years of age in a dental program would be impractical, and the results would reflect unfavorably on the dental profession, for the effort would necessarily be confined to reparative and restorative work. To repair all carious cavities in the population of the United States—taking only one half-hour to complete each—would require 100,000 dentists working 10 hours every day for 14 months, including Sundays and holidays. All the recognition dentistry has received up to now has been based on knowledge of existing deplorable conditions, on logic, opinions, and belief—but not on facts as to results obtained.
References: Den. Cosmos, 1920, 1923, 1924, 1925, 1930, 1931, 1932 ; Den. Items Int., 1923, 1924, 1925, 1928, 1932; Den. Digest, 1924, 1927, 1928, 1930; Den. iVIag. Oral Topics, 1924, 1925, 1927, 1928, 1930; Intern. J. Orth., 1927, 1935; Austral. Den. J., 1927 ; New Zeal. Den. J., 1938.