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Early Dental Practices

Every science has its beginnings in myth and folklore. Early dental practices, in particular, are deeply tied to the mysticism surrounding the teeth and tongue. Because the mouth is the center of speech and nourishment, diverse cultures treat dental events in their lives with respect.

There is a universal human belief that teeth confer power. These remedies and practices were intended to cultivate that power-by keeping teeth for a lifetime. The same spirit-much refined-motivates modern dentistry.

Toothache

For relief, boil earthworms in oil and pour into the ear on the side where there is pain (Pliny, 77 AD).

Pour juice of onions by drops into the mouth, bite a piece of wood struck by lightning (ibid.).

Put tobacco in the armpit; hold a heated root of a birch on the cheek; or hold a small frog against the cheek or lick a toad's abdomen (Norwegian folklore).

Lay roasted parings of turnips, as hot as they may be, behind the ear; keep the feet in warm water, and rub them well with bran, just before bedtime (John Wesley, 1747).

Tooth Extraction

"Round the tooth to be drawn, he fastened a strong piece of catgut; to its other end he affixed a bullet. Then he charged a pistol with this bullet and a full measure of powder. The firing performed a speedy and effectual removal of the offending tooth" (Dr. Monsey, 1788).

In the US and Europe, the blacksmith did extractions, presumably because they had the "proper tools."

"If one had a tooth extracted, it must be burned, because, if a dog got it and swallowed it, one would have a dog's tooth come in its place" (Dr. Holmes, 1862).

Tooth Cleaning

To clean the teeth, rub them with the ashes of burnt bread (Poor Will's Almanack, 1780).

To stable and steadfast the teeth, and to keep the gummes in good case, it shall be very good every day in the morning to wash well the mouth with red wine (London, 1598).

In parts of England, the superstition persists: one prevents a toothache by "clothing one's right leg prior to the left" (G.P. Foley, 1972).

Tooth Growth

To make the teeth of children grow hastily, take the brain of a hen and rub the gums therewith. It shall make them grow without any sorrow or diseases or aching (London, 1934).

Roast the brains of a rabbit and rub a small amount on the gums (US, 1942).

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Root Caries: A Significant Dental Problem

People are living longer and keeping their natural teeth more than ever before. The advances in tooth retention, the desire to look one's best, and higher expectations about oral health have raised dental awareness among older adults.

With the significant increase in the older portion of society, with even greater increases expected, more older adults will have more teeth that are susceptible to root caries. Root caries may emerge as one of the most significant dental problems among older adults during the next decade. A recent study conducted by the National Institute for Dental and Craniofacial Research (NIDCR) showed that over half of older adults have decayed or filled root surfaces. The frequency of root caries is strongly age-dependent and will continue to be a major dental problem among the elderly.

Root caries lesions can be caused by new or primary root caries, caries around existing dental fillings or recurrent caries, and abrasion or erosion of the root surfaces. Root caries progress quickly due to the relatively soft nature of the root surface, as well as the risk factors associated with the incidence of root caries.

Risk factors associated with the high prevalence of root caries among older adults include decrease salivary flow or xerostomia, exposure of root surfaces due to periodontal (gum) disease, chronic medical conditions, radiation treatment for head and neck cancer, physical limitations, and diminished manual dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple medication use, and changes in dietary habits. One or more of these risk factors or life changes, which are more common among older adults, can increase root caries in an individual who has not had dental caries for many years.

Root caries can be a challenge for the dentist to treat depending on the size and the type of root caries lesion, the extent and rate of caries activity for that person, the physical and mental condition of the individual, and where the root caries are located in the mouth. Many root lesions have limited accessibility and visibility, are often more complicated by pre-existing extensive dental work, and are difficult to isolate from oral fluids during the restoration process. Also, many people who have widespread root lesions have limited tolerance for dental treatment because of medical conditions, illness, and mental health problems.

By Denise J. Fedele, DMD, MS