Each individual tooth should be inspected in a good light for the
presence of caries, and careful note should be taken of the “bite,”
a normal bite implying not only a proper opposition of the two rows
of teeth but the capacity of the lower ones to move freely across the
upper; mere vertical movement of the mandible does not constitute
efficient mastication. In this connection it must not be forgotten that
an unopposed molar is useless for purposes of mastication, and it is by
no means rare to find in a mouth several sound unopposed molars which
are for this reason absolutely functionless. Nay, more than this, it
may happen that teeth, perfectly sound ones, too, far from helping, may
actually interfere with mastication; thus, among the poor, we sometimes
find all the teeth gone save the upper canines and the lower incisors,
and the teeth and gums being alike unable to come into contact, nothing
worthy of the name of mastication is possible; it would be far better
to be without any teeth whatever, for the toothless gums would then be
permitted to come into contact along their entire extent, under which
condition they gradually harden and come to be quite efficient grinding
agents.
Next the gums, the alveoli, and the roots of the teeth must be
examined, especially for the presence of erosion, tartar, and pyorrhœa
alveolaris, this latter condition being evidenced by the welling-up of
pus upon pressing the gums against the sides of the teeth.
If our examination of the mouth discloses anything likely to interfere
with mastication the aid of the dentist should at once be sought, but
every physician should be so far acquainted with disorders of the
teeth as to be able to say, in the majority of cases, at all events,
when this is necessary. I am convinced that far more illness than is
generally supposed is attributable to dental defects, and this even
among the more leisured classes. With regard to pyorrhœa alveolaris, it
has to be remembered that it not only does harm by causing loosening,
lengthening, and shedding of the teeth, and thus interfering with
mastication, but also by contaminating the stomach and the blood and
thus upsetting the digestion and causing constitutional diseases, such
as anæmia and arthritis; and inasmuch as poisonous discharges from
the nose, the naso-pharynx, the pharynx, and the tonsils may act in a
similar way, these parts also should be inspected in connection with
the examination of the teeth. In the dust-laden atmosphere of towns
they are very liable to disease, and even when healthy are necessarily
dirtied; some go so far as to advise all town dwellers daily to wash
out the nasal passages and to gargle the throat; but, whatever may be
thought of this, it is certain that under existing dietetic conditions
special means are needed in order to keep the mouth and teeth clean.
When man fed on raw food this was not necessary, the food itself
and the copious flow of saliva, induced by prolonged mastication,
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