DENTAL CARIES AND MODERNIZATION  40R3-260-1


  Dr. Weston A. Price served as honorary chairman of the "Oral


Diagnosis and Bacteriology Section for Dental Centenary Celebration


(260-1); his introductory comments, preceeding a major presentation


by Dr. E.C. Rosenow, addressed the subject of the modern diet as


the cause of the advent of dental caries in primitive races:


  "In my studies among primitive races in various parts of the


world ..., I have found many isolated groups where less than one


percent of the teeth in a community have been attacked by dental


caries.  ... [However,] the immunity to dental caries was lost when


they changed their nutrition ... to the foods of modern commerce of


the white man.  White flour and sugar constituted the principal


displacing factors. ... The exposure of the dental pulps by caries


provided bacterial access to the interior of the fortress and


serious systemic involvements developed from focal infection of


dental origin."






EXPERIMENTAL EVIDENCE, ETIOLIGICAL ROLE OF PULPLESS TEETH 40R3-264


"Barnes and Giordano have isolated from [pulpless teeth], after


death of the patients, streptococci with which they reproduced in


animals the disease from which the patient died.  I have had


similar results."  Dr. Rosenow illustrated with the case of a


patient who died of pulmonary embolism, from whom the same "usual


green-producing Streptococcus" was isolated from both embolus and


a pulpless tooth normal in roentgenogram, which streptococcus from


both sources reproduced pulmonary embolism when injected in rabbits


and dogs.  40R3-264






PULPLESS TEETH: THE INSOLUBLE PROBLEM OF APICAL ENDS 40R3-265


Specific mention was made of three supporting studies, one in which


89% of 100 pulpless teeth and 4% of vital teeth yielded


streptococci, a second in which the number of colonies from the


apexes of pulpless teeth was 700 to 1000 times greater than the


number obtained from identically treated vital teeth, and a third



in which 96% of 1220 root-filled pulpless teeth and 98% of 582 non-


root-filled pulpless teeth yielded a growth, chiefly green-


producing streptococci.






"BLOOD-BUILDING TISSUES" AND FOCI: AIDS?  40R3-271


TRIGEMINAL NEURALGIA, PRESENCE OF FOCI CONSTANT IN  40R3-271


"The lesions most frequently seen in patients referable to focal


infection are those of the locomotor system, joints, muscles,


tendon sheaths and ligaments.  The kidney, skin, heart, stomach,


duodenum and eyes are often affected.  Less commonly, other organs


such as those of the nervous system and blood-building tissues may


be involved.  Rarely, very unusual localizations of streptococci


from dental and other foci of infection such as onychia occurred as


shown by Haden and Jordan, thyroid disease (especially thyroiditis)


as shown by Cantero and lesions of the gasserian ganglion produced


electively in experiments of my own in cases of trigeminal


neuralgia.  The removal of foci in instances of trigeminal


neuralgia (and in my experience their presence is constant in this


condition) obviously should be done as a preventive measure ... ." 


40R3-271






EXPERIMENTAL ENCEPHALITIS FROM STREPTOCOCCUS  40R3-271


"Van Kirk and Swanson [J.Dent. Res., Sept. 1935 15, 315-316]


produced encephalitis in rabbits by the intravenous injection of


streptococci obtained from the pulpless teeth from patients who had


encephalitis, an observation corroborative of our own studies." 


40R3-271






TOXINS AND STREPTOCOCCI   40R3-271


"... streptococci that manifest elective localizing power have been


shown to produce within themselves, and to free in dextrose-brain


broth cultures, poisons or toxic products which specifically


localize and produce lesions in the same tissues as do the living


micro”rganisms.  Specific effects have been produced by the


intravenous or intracerebral injection, respectively, of the living


streptococci, the dead bacteria or filtrates of active cultures


obtained from patients suffering from pyelonephritis, myositis,


endocarditis, myocarditis, arthritis, dental neuritis fand


puo;itis, ulcer of the stomach or duodenum and myasthenia gravis." 


40R3-271






SLOWING ACTION OF CONVALESCENT SERUM ON STREPTOCOCCI  40R3-275


[While Rosenow characterized this as "charge-reducing", this might


also be viewed as a function of size; i.e., a case may be made for


the effect of the serum being one of causing the organisms to


agglutinate or otherwise become larger thus slower.] 40R3-275






BEYOND KOCH: ROSENOW'S SIX TYPES OF EVIDENCE OF ETIOLOGY[40R3-277]


1. IV and other injection in animals 40R3 [FULFILLED KOCH]


2. induction with streptococci of foci in teeth in dogs 40R3


3. cataphoretic studies 40R3


4. diagnostic cutaneous tests w/euglobulin of horse serum 40R3


5. precipitation reaction with blood serum and antiserum 40R3


6. agglutination tests 40R3






MERIT OF INTRAMUSCULAR INJECTION; DOES NOT PRODUCE FOCUS [40R3]


"Injection of bacteria into soft tissues does not suffice to


produce a chronic focus from which bacteria and their products are


continually disseminated.  Prompt healing with dicroorganisms,


unless the microorganisms are highly virulent, usually occurs... ."


40R3






ODOR - BAD BREATH AND HEART DISEASE  40R3


  Dr. Rosenow noted that during a visit with a large European


clinic, "the chief himself had been ill in bed suffering from an


unexplained fever for some time prior to my visit.  It was clearly


evident that his condition was an example of the very problem under


discussion.  His teeth were literally floating in pockets of pus


arising from pyorrhea and his breath was malodorous.  He died


several years later, long before he should have died, from cardiac


disease."






ETIOLOGICAL IMPORTANCE OF NON-VITAL OR DISEASED VITAL TEETH  40R3


     The insidious nature of pulpless teeth:  "The [oral] focus


affords ready entrance of bacteria and their toxic products which


may, depending on inherited or acquired predispositions or other


factors, cause infection in remote tissues, general ill effects,


hypersensitiveness or allergy or a combination of some or all of


these in the same persons, or perhaps at times increased resistance


and immunity.


  "The localizing and necrotizing power peculiar to these organisms


(usually streptococci) determines largely the site or tissues to be


affected.  ...  The common practice of waiting until the disease is


far advanced or until a serious condition, such as a hemorrhage in


ulcer or a cardiac attack in heart disease, has developed, or until


advanced age has ocurred before evident foci, especially pulpless


teeth are removed, is most deplorable." [40R3]






RELATION OF FOCI OF INFECTION TO HYPERSENSITIVENESS & ALLERGY 40R3


  Dr. Rosenow here reviews the works of several investigators


relating focal infection to allergic states, and bacterial allergy


as a factor in various diseases.  "Might not the dinherited


rheumatic diathesis, the neuropathic or the allergic constitution


and other 'diatheses' and 'constitutional predispositions' be


expressions in part of a peculiar interaction between host and


invading organism, and not expressions merely of an inherited


'weakness' of joint, brain or other organ, as is usually assumed?" 


40R3