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Full text of "The pathology of dental infections and its relation to general diseases :"

The Pathology of 

Dental Infections and Its 

Relation to General 

Diseases 



WESTON A. PRICE, D.D.S., D.Sc. 

CLEVELAND, OHIO 

Director ot the Research Institute of the National 

Dental Association 



Annual Meeting 

Canadian Oral Prophylactic 

Association 



INDEX 



Aims and Objects of the Association . . 2 
The Pathology of Dental Infections and Its 

Relation to General Diseases 3 

President's Address 22 

Secretary-Treasurer's Report . . . • r .24 



TORONTO 

1916 



Aims and Objects of the Canadian 
Oral Prophylactic Association 



IN the year 1 905 a committee of dentists of Toronto was formed to 
communicate with the manufacturers of the tooth preparations then on 
the market to ascertain the composition of each, because they believed 
that a dentist should not recommend any preparation of which he did not 
know the ingredients. 

Finding there was no satisfaction to be obtained in this direction as to 
the formulae of these preparations, arrangements were made to have them 
chemically analyzed, thus ascertaining that in most of the samples were 
ingredients which should not exist in an ideal mouth preparation. 

The Canadian Oral Prophylactic Association was then organized to 
have manufactured preparations which should contain nothing which was 
not beneficial. 

After much consideration and consultation a paste was manufactured 
under the registered name "Hutax" (meaning mouth health). Later a 
powder was placed on the market, and last a tooth brush. 

These articles are the result of frequent consultations with many of the 
leading practitioners, not only in Toronto, but of the Dominion of Canada 
and the United States. 

The shareholders of the Canadian Oral Prophylactic Association origin- 
ally subscribed $5.00 each for "the good of the cause," and the charter of 
incorporation provides that the profits are to be expended for educational 
and philanthropic purposes, such as (a) bringing prominently before the 
public important information, which the dentist has, as to the influence of 
conditions of the mouth on the general health. (b) Care of the teeth of 
the poor, (c) Assisting the indigent in the profession of dentistry. Thus 
no director or shareholder receives directly or indirectly any dividends or 
other remuneration. 

Every dentist may recommend "Hutax" preparations with a confident 
consciousness that there is nothing better on the market, and that the profits 
will be utilized for the good of the profession and of humanity. 



The Pathology of Dental Infections 

and Its Relation to General 

Diseases 



Weston A. Price. D.D.S., D.Sc. Cleveland. Ohio. 

Delivered before the Annual Meeting of the Canadian Oral Prophylactic 

Association and their guests, the Academy of Medicine, 
Toronto, February 14, 1916. 

Mr. President, — I want to assure you that I come with a very deep 
sense of my inability to-night to live up to the standard and desire and 
hope that has been thrown out by Dr. McDonagh. I think it is a very 
unfair handicap to put upon a man to make such extravagant statements 
which of all men I certainly cannot live up to. 

It is, however, a very great pleasure to be here, and I come with a 
mingled feeling of joy that I am privileged to come back to Toronto and 
be with you again, and feelings of helplessness akin almost to discourage- 
ment when I realize the responsibility that is being thrust upon the dental 
profession to-day, and the utter inadequacy of the dental profession 
to meet that responsibility. One week ago this evening we had in 
Cleveland the opening of the Research Institute of the National Dental 
Association, and had as one of our speakers Dr. Charles Mayo, of 
Rochester, Minnesota. That splendid orator and magnificent physician and 
surgeon reviewed to us in detail the development of modern science as it 
relates to the healing arts. He reminded us of the splendid contributions 
of the Chinese, of those great contributions of the Greeks, and finally came 
down to the present decades and reminded us how one after another the 
great scourges, the great besoms of death, had been taken from the earth 
by medical science, and then as his climax, said the great mass of people 
to-day would not die of one of those plagues, they would die of a simple 
infection, that 90 out of every I 00 probably would die because of some 
simple infection, the result of a focal infection, which focus itself would 
give them no trouble. He then referred to the fact that 90 per cent, of the 
lesions, of the focal infections, are above the collar, and of those above 
the collar which would include the tonsils, the antrum, the nasal passages 
and sinuses, that for the largest part come from dental infections, oral in- 
fections, and then accepted the challenge of the dental profession that they 
are going to take that responsibility. Are you going to do it, brothers? 
Recently I have been corresponding with the deans of the universities and 
the dental colleges of the country, with the editors of our best journals, and 
advertising in our dental journals to find if we cannot get one dozen, or 
even one-half dozen, men who are competent to go into the department of 



4 Report of the Canadian Ural Prophylactic Association. 

research to determine the relation of mouth infections to systemic infec- 
tions. How many do you suppose we could find? I am ashamed to let 
you know. There are a few good men who are doing research work, but 
we cannot pry them loose from where they are, but alas, the tragedy is we 
haven't men in the world to-day; we haven't enough to even do one per 
cent, of the work that is demanded right now in interpreting the relation of 
mouth infections to systemic infections, and vice versa. Dr. Mayo said 
last month that at this moment we should have four dentists to every one 
that exists now in order to look after the interests of humanity. Not only 
for their own sakes, but for the State's sake. What does that mean? Well, 
my dear brothers in the profession, it means we must put our shoulders to 
this wheel. We have a great responsibility as a dental profession, namely, 
to help interpret the relation of these mouth infections to systemic infections. 
He also said to me on that occasion, as he did in Boston some weeks ago, 
we have learned as a medical profession doing research as we are in our 
institution, that these problems cannot be solved by medical men ; they must 
be solved by men with a dental vision. Where are the men with the dental 
vision ? 

Unfortunately, when we try to pick out the men with dental vision^ that 
is all they have got. Oh, the men with the medical and dental vision are the 
men that are wanted ; the man who is big enough to see all the physician 
sees, and also see what the dentist sees — these seeing both at once are the 
men we need. I visited a hospital in Chicago not long since, and one of 
the leading bacteriologists took me through one ward after another and 
showed me the many cases that were being treated and helped, because 
they had treated the mouth infections, and then we came to a room, and 
he said: "There is a great joke in this hospital. We have got to 
get a new room to store the teeth in. As a matter of fact we are ex- 
tracting so many teeth in this institution we have really got to get a new 
place to store them." I said to him, "What proportion of the teeth that are 
extracted in this hospital are in your judgment related to the other infec- 
tion that the removal of the teeth did cure or did relieve?" He said, "I 
have thought of that many times, and I have thought that three or four 
out of a dozen." The average number of teeth extracted in that hospital 
under the direction of the medical men, he said, was about twelve, and in 
his judgment as a bacteriologist not more than three or four of the twelve 
ever should have been extracted. We are honored, I understand, and I 
am glad it is so, to have a number of the medical men with us to-night. 
I don't know what your practice is here, but I do know that I go to cities 
where the feelings of the medical men sometimes are so extreme as to even 
demand that every tooth that has a dead pulp is a menace and should 
be removed, and if it isn't giving trouble it may give trouble. 

Now, that is almost as extreme as a physician as perhaps are 70 per 
cent, of the dental profession, who rather plume themselves and say. "Well. 



Report of the Canadian Oral Prophylactic Associatioi 



perhaps so and so is not competent to save this root, but I can put a bridge 
on that will be all right." I say the dental profession are taking the other 
extreme and are saying, or thinking, and are allowing themselves, perhaps, 

to be misled — or else they have not informed themselves of the danger 

and they are going right ahead and putting dental work on teeth that are 
already shortening the lives of those patients. I believe and know, just as 
much as I know I am standing here, that a lot of my dental operations have 
helped to shorten the lives of patients. I would give a great deal if I had 
not done some of the work that I have been doing. I believe absolutely 
that I have put bridges on to teeth that already had an infection, and that 
were undermining the health of those patients, and I did not suspect it. I 
have had the privilege of undoing some of that work, and if God will spare 
me I hope to undo quite a lot more of it. To show you that I have not 
been a gold crown advocate I may say I have never put a gold crown in 
any person's mouth forward of the second bicuspid. So you see I have 
not been a slave to the gold crown habit. I have refrained from devitaliz- 
ing pulps where I could accomplish the result in some other way, but I 
have felt I was so skilful that I could attach bridges to teeth that had 
deep pyorrhea pockets beside them. I thought I was so skilful that the 
patient ^vas wonderfully fortunate to be in my hands, but I know very well 
that they would have been better off in the hands of some man entirely 
unknown to the community, but who ^vith his conservatism was satisfied to 
practice a great deal less scientific dentistry perhaps but would use the 
forceps more frequently than I would. Well, some medical people will 
say, "That is what I expected, and that tooth should be extracted." That 
is just as far from the mark as the other statement, for the time has come 
when we can distinguish the type which is a dangerous type of infection 
from one which is not. Now, which is the greatest tragedy which has de- 
veloped in this entire field of research during this last two or three years? 
I know of none that is so significant and so appalling, because of its subtle- 
ness, as the abscess. The dental abscess that is causing trouble in the 
mouth of the patient is, as a rule, not the one that will be causing arthritis 
or myelitis, or a heart affection, not nearly so as that type of dental abscess 
that produces no local trouble. Let me repeat: Of the last dozen cases 
that we have studied and treated for arthritis there has not been a single 
exception to the fact that the lesions which we relieved and treated impro\- 
ing the patient's condition were giving no local trouble. Why? The very 
type of infection answers the question. What do I mean by the type of 
infection? Here we have a rapidly developing abscess with a great deal 
of inflammation and pus formation. We have not got a simple strep- 
tococcus infection; we have a stercoremia infection, with some of the 
ancillary contaminations with it. But when we have a pure streptococcal 
infection of the type that produces lesions that I referred to, almost in- 
variably, if not invariably, they give the patient no trouble. Now, this 



6 Report of the Canadian Oral Prophylactic Association. 

seems like a contradiction, but if that organism produced a very much more 
severe reaction in the human body it w^ould be a great deal better for the 
body — if it was worse it would be better. That seems like a strange 
thing, but what does that mean? If an organism growing in your body 
starts up some trouble in the body and brings forward the resisting powers 
of the body a new element is created, a chemical substance that reacts 
against that organism, and the body politic, our united body, drives it out. 
We build up a resistance, I say, and we destroy the organism. Why? 
Because it irritated our bodies. But when it grows within our bodies 
without producing an irritation the body does not react, and therefore there 
is no anti-body built up to destroy it, and consequently it lives on and on 
and the body is almost indifferent to its presence. Here is another strange 
but rather important apparent contradiction. The lower the virulence of 
the organism the more subtle it seems to be in producing these grave lesions 
like the arthrities. The lower the virulence of the organism the less ten- 
dency it has to produce a reaction on the body, and the more certain it is 
to produce those lesions like the arthrities. Now, we will see some reason 
for that. If we were to go down to a restaurant to-morrow morning, and 
if you would take along with you several other species besides the human 
species — let us say a porcupine, a grasshopper and an ant — you all go into 
the restaurant, and we will assume you are all going to order from the bill 
of fare. What would be the difference in the meal you would order? As 
a matter of fact you would all order nearly the same thing. What would 
it be? It would be largely protein. Why? You have a digestive ap- 
paratus that would digest a nice piece of chicken, like we had this evening, 
and I found my digestive apparatus inside could dissolve that chicken 
splendidly. Now, the porcupine would not take that. He would select 
a nice piece of bark, and another of the organisms would select a piece 
of horn. You could not digest the horn, and you could not digest the 
bark, so those various forms of life would select the very thing that they 
could digest. The point I am trying to emphasize is that the only differ- 
ence between you and every other form of life, including those streptococci, 
for example, is that your digestive apparatus is just a little different to 
theirs, and yours changes and theirs changes. They have the property 
of living on certain tissues of your body, and your body has the power of 
taking in food, and can select certain of those products for different organs 
of the body. Let us assume you have taken your piece of chicken. How- 
does that chicken become part of your muscle tissue? You have two 
different kinds of digestion, and the micro-organism has also. You have 
two kinds of digestive fluids, one in the stomach, another in the arteries 
and veins, in the blood stream, a digestive circulation, and the protein you 
take into your body, as, for example, the piece of chicken, is split up. It 
does not go into the body as a whole protein; it is divided up as you take 
an axe and split up the wood into fibres, and .afterwards it goes into that 



Report of the Canadian Oral Prophylactic Association. 7 

other circulation. Then each cell of your body has digestive fluid, and 
these take the particular pabulum that it wants, just as your body, which 
is a multiple of cells, and each streptococcus has one digestive fluid outside 
its body and one inside its body. All liviiig things must do three things; 
they must eat, they must assimilate, and they must excrete, and you and 
the 'pabulum are precisely alike, as we will see from different viewpoints 
as we go along. When you take into your body some protein which gets 
into your circulation, which has not been properly split up in your stomach, 
what happens? Why, immediately the chemistry of your body is called 
forward and you build up a new enzime, a new chemistry, to dissolve or 
digest that very thing; and the thing that happens is this: If, for ex- 
ample, you have got, we will say, an overdose, you have overeaten, in 
other words, bananas or eggs or milk, or any kind of food, in so large 
quantities that some of that protein gets from your stomach through into 
the circulation without having been properly split up, the blood immedi- 
ately produces a chemistry that splits up and digests that protein that has 
gone through, and ever after that if you eat eggs or bananas, or whatever 
the thing is that has poisoned you, immediately that chemistry is ready and 
splits up that protein, and that protein when split up in your blood is part 
poison, and that poison is the thing that is making you sick, and you can't 
eat those things. When you get typhoid fever, for example, the organism 
grows in your body, and that is precisely what happens. You react — 
that organism in your blood has called forth the new chemistry which 
tears down and splits up those organisms, part of which are poison, and 
that poison makes you sick. You are walking up and down the country 
with those organisms in your body; they are incubating in your system, 
but it is not until your body reacts that you are sick. What does that 
mean? Simply the time comes when this chemistry is so perfectly de- 
veloped that immediately the new organisms come into the body the defensive 
forces rush to the rescue and produce a large amount of this chemistry and 
destroy that organism. 

Now then, what happens when the bacteria of your mouth, for ex- 
ample, get into your blood system? They do not stop there, and con- 
sequently a resistance of the body has not been stimulated, but pretty soon 
your body builds up that chemistry, and immediately it does you are 
sensitized to it, and day after day your body is reacting to that very thing 
to which it is so sensitive. Now, what is the significance of this? Many 
of you know this, but for those who do not I will call it to your attention. 
If you were to take a little of the white of an egg and inject it into your 
circulation to-day — just the ordinary white of egg which your stomach 
would digest — if you inject it into your blood system circulation to-day it 
would not do you much harm ; it would be in there as a foreign substance, 
but your body immediately builds up the chemistry to destroy that pro- 
tein, and in ten or twelve days if you put a little bit more white of egg 



S Report of the C\uuidian Oral Prophylactic Association. 

in it will kill you. Why? \ ou have been sensitized to that white of 
egg, and even so small a fraction of any of the proteins as sometimes the 
millionth part of a dram \\ill be enough to sensitize the body so that when 
the subsequent dose of that gets into the blood system the reaction is most 
violent on the part of the whole body, because it so rapidly splits up that 
protein. You all have seen this illustrated, for it is the man that is appar- 
ently the strongest that dies with typhoid. "Why is that? Because he had 
to tear down so many of those organisms immediately that his reaction has 
been stimulated. So it is the strong men that die of this disease, because 
nature reacts so vicriently and so much of the poison is set free. There are 
scores and scores of people that are going up and down our streets suffering 
from a poison that is going into their body by absorption of protein from the 
bacteriological infection of their mouths, and they are sensitized to it; 
the dental operators know what I speak of so well. You know that if we 
undertake to scale too many of the teeth the same day they are violently sick. 
I remember one woman where I simply took care of about one-quarter of the 
teeth, removing the debris from the teeth, because in that operation we open 
up the circulation slightly and let in more of these toxine poisons, and I 
said to her, "This is all we had better do to-day; let us stop now and you 
telephone me to-morrow and let me know if you have had a reaction, ' 
and although that woman had walked to the office and walked away ap- 
parently in her normal health, which was much below par, the next day, 
even with the telephone within arm's length of her bed, she reached to 
get it to telephone me, as she had promised she would tell me how she 
felt, and she was so sick she threw herself back on the pillow and said, 
"What is the use? — he told me I would be sick anyway." She was simply 
reacting to the toxine, to the protein that was being absorbed from that 
poison. Now, that is going on in a large degree in so many bodies, and 
there are probably hundreds and thousands of us that are beginning to die 
at 40 and 50 years of age because we are over sensitized to those mouth 
protein poisons. 

Now, I will not have time to go very far into that discussion, and I 
\vill take the slides at this time and discuss first some of the typical kinds of 
lesions, and because of the impossibility of covering the ground I should 
like to limit myself very largely to streptococcus infection. The first slide 
which we will put on will be one showing the Research Institute of the 
National Dental Association, a building that has been purchased for the 
dental profession of the United States, a building which contains some- 
thing like thirty rooms, and I am glad to say that within six weeks after 
the call went out to the dental profession for assistance to buy that building 
one-third of the entire cost of the property was in our hands, either in cash 
or pledges. It -is also significant that these researches that have been going 
on now for about three years, and which have entailed an expense of some- 
thing like $75,000. 90 per cent, of that amount has come from the dental 



Rtport of the Canadian Oral Prophylactic Association. 9 

profession as voluntary contributions. This building which you see has 
something like 30 rooms, and has another building at the rear with a 
splendid auditorium, and we have facilities for taking care of a large 
amount of research work. I will be glad to furnish anybody who is inter- 
ested with a more detailed description by mail. 

In this picture we have a typical infection of a streptococcus type, pro- 
ducing no general disturbance. This patient was out of business for four 
years, and for two years of that time ^v'as in sanitariums and hospitals. 
He had symptoms of gall-stone and peptic ulcer, or stomach disturbance of 
various kinds, and twice was taken to the hospital for operation. On both 
occasions it was decided not to operate, because it was so uncertain that 
there were gall-stones present. He had fallen off in weight from 156 
pounds to about 1 20. TAventy years pre\ ious to the time of the presenta- 
tion of the patient he had a boil on his chin, which in all probability was an 
external fistula to a dead pulp in a tooth. It was not recognized that the 
pulp in the adjoining lateral was dead. Our examination with the radio- 
gram showed the presence of the abscess. We opened into the right lat- 
eral and removed some of the infection and inoculated it, and studied the 
organism with our various methods, and were able to produce in animals 
the typical liver infections. By typical I mean corresponding to the infec- 
tions that Ave get consecutively with that type and strain of streptococcus. 
With no other treatment than obliterating the area of infection at the two 
roots, opening up the canals and thoroughly cleansing, this gentleman 
gained 25 pounds in twelve weeks, and went back to his business. 

He lived in another city, and his physician has written me that he has 
no doubt but vvhat we did remove \.hp entire cause of this man's trouble. 
The last time the man called on me he said he worked from seven in the 
morning till eleven at night, and looked as stout and well as could be. The 
next slide shows the typical lesions in the animal, and the section of the 
liver shows a typical focal abscess, which we get with this strain of 
streptococcal infection. I want you to note that the blood vessel is entirely 
blocked. The kidney of this animal shows a cloudy swelling, but \vithout 
an abscess, that is very characteristic of this type of infection. Here we 
have the picture of a young man who was treated in the clinic of Dr. Hart- 
zell, who is one of our directors of research supported by the Research 
Institute, and working in the University of Minnesota and in the hospitals. 
This man had not been without pain for nine months, and could not walk, 
could not feed himself, could not put on his own collar and could not 
dress himself. At the time this picture was taken, as you can see, he could 
put his hands behind his back and up over his head. The next picture 
shows us the lesion that \\as found. This man had been in the hospital 
for nine months, and the treatments given him were doing him no good, and 
he was turned over to our department. The medical men were not able 
to satisfactorily find relief for the infection. The area of absorption is 



10 Report of the Canadi-aii Oral Prophylactic Association. 

shown around the molar. The removal of the dental infection and the 
making of a vaccine entirely removed the trouble, or sufficiently so that he 
was dismissed from the hospital in six weeks. He could then run up five 
flights of stairway in the Donaldson building, one foot above the other, 
where five weeks before he couldn't put his foot to the floor in the hospital, 
and no other treatment than the removal of the infection and the vaccine 
made from this culture. Here we have another case from Dr. Hartzell's 
clinic. This woman had suffered for three years. You notice the ankles 
are swollen, and the knees and the hands, and she is very much emaciated. 
She suffered very great pain, and month after month they were placing on 
record "present treatments doing patient no good." The next picture 
shows us the dental infection at the apices of some old roots, and with no 
other treatment than the removal of these roots and the making of the 
vaccine the trouble was removed. We do not emphasize the vaccines much. 
We believe they are helpful in certain cases. In a few weeks this woman 
was able to stand erect on those knees that had not been straightened for 
many months. She was dismissed from the hospital and went back to her 
family of several small children who needed her very much. She has had 
no recurrence in twelve months. Here is a case from my own practice. 
We had watched this patient getting worse for fifteen years and we came 
to the conclusion that some dental trouble was the cause. The next picture 
shows us the area of infection around the bicuspid. With very little other 
treatment than the treating and removing of that infection and the imperfectly 
filled root which I had filled some twenty years before. The radiogram 
which has done splendid service showed the imperfection, and that woman 
now has thrown away her crutches. This picture shows a patient that is 
being carried to my office. The woman could hardly move her head or 
elevate her hands, but with no other treatment than treating the dental 
abscesses in that woman's mouth those joints that were so tied up that her 
knee joint could not be flexed one-eighth of an inch will now swing through 
quite a large arc, and^ very soon she will be on her feet. The pain is 
entirely gone and she has gained a number of pounds in weight. I think 
she will be walking around by midsummer at the rate she is improving. 
When that woman was put in the chair she could only move her head half 
an inch without moving her position on the chair, so rigid were her vertibrae, 
and now she can turn her head from side to side and look over her shoulder, 
and that is from the treatment that has taken place since November. I am 
sorry that I failed to bring the slides showing the infections in that woman's 
mouth. There were five abscesses all at the apices of teeth that had had 
dental treatment, some with gold crowns and some with fillings. Only one 
of the five had a fistula. Every one of those teeth except the one v^rith the 
fistula gave us a pure culture of the strains of streptococcus, and the one 
with the fistula gave us a mixed infection. Now, what is the significance 



Report of the Canadian Oral Prophyluctk Association. 11 

of the fact that those teeth did not give trouble? That woman's teeth 
had been examined in the hospital for nine months, and this condition 
had been coming on for nine years, and they pronounced her mouth in 
perfect condition, and when I looked into her mouth without the radio- 
gram I said there is only one tooth indicating an abscess, and that 
was the one with the fistula, and the tragedy is, as I repeat, that 
the very conditions that will give these grievous troubles seem to be in- 
variably those which produce no local trouble. It means we can- 
not trust our own methods without having radiograms taken. Then we 
have here the case of a young man twenty years of age. His mother has 
been in bed for five years with an arthritis, and he has been suffering con- 
siderably with arthritic infection of increasing severity. I want you to 
note the anterior buccal roots were not filled. You notice the areas of 
infection. Our method of getting cultures practically in all these cases now 
is to get the culture from the apex of the root without the extraction of the 
tooth, before the extraction, in order that we may get a pure culture, be- 
lieving that we can get the infection more perfectly and safely without ex- 
tracting the tooth than by extracting. We did that in this case, and out of 
five in that area we were able to get the pure streptococcal culture of three 
by aspiration. There was no extraction done and yet he has had his 
infection apparently entirely relieved. I say that with the emphasis on 
"apparently." I believe that that young man is in danger of having that 
infection recur. I doubt very much whether I have ever sterilized the area 
beyond the apex of a root by any medication that I have ever been able 
to use — I say thoroughly sterilized. I think we greatly reduce the infection 
at the apex, but I doubt if we entirely remove the infection. This instru- 
ment that we use for aspirating, has a long rubber tube to it and has 
either glass tubing or copper tubing slipped into a glass tube and aspirate 
into the tube by sealing the small copper tube into the root of the tooth 
with wax or cement, preferably with cement, and almost invariably we can 
get a culture of the infection in the root of the tooth by aspiration, whether 
or not we can locate the organisms in the root itself. Dr. McDonagh re- 
quested me to leave one of these instruments with him and if you are 
interested he will be pleased to assist you in making one a great deal better 
than we often see. We find it a most indispensable instrument in connection 
with the treatment and diagnosis of these conditions. 

A great many of the infections of the mouth select out tissues that we 
had not suspected a few months or years ago, and I will now show you a few 
slides illustrating that. The one I am presenting is of a woman who is teach- 
ing in our public schools and who had to give up her profession on account of 
losing her voice. There was no apparent cause, but with no other treatment 
than the removal of an infected and impacted cuspid, and it was due to the 
infection not the impaction, that young woman had her voice entirely re- 
stored. The next slide shows the case of a young woman, now not a very 



12 Report of the Canadian Oral Prophylactic Association. 

young woman, for she has lost her voice for something Hke twenty years, or 
nearly lost it. She called me up on the long distance telephone the day before 
I came away, telephoning from another city, to show me that she could talk 
now with her voice, the first time she had talked long distance for a great 
many years, and her husband says her voice is better now than any time in 
nearly twenty years. She had no other treatment than the removal of the 
dental infections. Another important characteristic of a streptococcal in- 
fection of this type is that the alveolar bone does not recover normally as 
appears with other types of infection. Many of our dental men present will 
recognize this condition shown on this slide. Here we have a first molar, 
and you will see the area of infection at the apex. This gentleman had suf- 
fered from recurring inflammation of the throat and chronic bronchitis that 
took him to the doctor almost every week. After the infection was removed 
he has not had a recurrence for two years except a grippe infection, which 
we could not assume was caused by the old infection. I want you to note 
this, that the result is that the bone does not restore perfectly. Now, why? 
We found three months after the extraction of that tooth that we could get 
strains of that organism from the alveolar bone surrounding the socket by 
drillmg into the bone. I feel very strongly that practically every case of 
streptococcal infection of this type which is of a very low virulence, will 
carry that infection for many months in the bone around that socket, 
and every tooth that has such an infection must have a very thorough 
curettement to remove that infected bone, and not trust to simply the re- 
moval of the tooth for obliterating the infection. That is a thing that we 
as dentists have not appreciated. Sometimes the infection may be very 
extensive. Here is the case of a rather beautiful woman who got an in- 
fection in the mandible from the central incisors, lower, the result of 
which was that a necrosis destroyed the entire mandible so that she lost 
all the teeth from the third molar on one side and the second molar on the 
other and the mandible from the third molar on one side to the second, 
on the other. The chin was gone entirely, practically. That was 
not a streptococcal infection. We do not get much if any pus 
flow with this type of infection. As a rule those extreme infections do not 
come from the type of organism that will produce these disturbances. 
While we are at this I will ask you to note that the stretching pressure on 
the new forming bone was sufficient to make that chin grow out to almost its 
normal position. Here is a picture of the same woman as we see her on 
the street to-day, and again she has got a chin. By having that bone 
stretched as it was growing about an inch and a half of new bone has been 
made to grow out of about half an inch of bone that attached those two 
stumps. She could only take a liquid diet \vhen we started that stretching 
operation, and now she can eat as large a meal as anybody of as coarse food 
practically. 



Report of the Canadian Oral Prophylactic Association. 13 

There are some types of infection that will be carried in dead teeth 
for a great many years. The next is the case of a woman whose teeth were 
giving no trouble at all, but they were discolored. I felt that it was my 
duty to remove the dead and putrescent pulp. I opened into the dead 
tooth after demonstrating that it was dead, and that tooth that was giving 
her no trouble took on an active form of inflammation so severe and rapid 
' that by ten o'clock that night she had a fever of 1 03, and the next morn- 
ing when she came to the office her head was all tied up and she had a very 
high fever and very much prostrated, so much so that she almost had to be 
carried in and threw herself on the lounge. By that time we had made a 
sufficient study of the organism to identify it. It was a free baccillus 
which grows with two expressions. When it does not get oxygen it pro- 
duces very slight inflammation locally, but by opening up the tooth and 
letting the air or oxygen in \ve get an entirely new expression from that same 
organism, and the opening up of the tooth allows it to take on a new con- 
dition of very grave irritation. We asked this woman if she had had any 
severe illness, and she said seven years previously she had pneumonia. This 
bacillus very commonly grows along with the organism of pneumonia, and in 
all probability this tooth had its vitality lowered at the time of the 
pneumonia and it remained there al! these years, and this illustrates how a 
patient may carry in the body an organism that is r^ady at a moment's 
notice to re-infect with a very grave infection, which organism came in at 
the time ^vhen they had some general infection, and that suggests what so 
!n«uiy dentists in this room have seen over and over again, an epidemic of 
abscessing teeth. Now, I find very few physicians have sympathy with 
that. They do not understand that, but as a matter of fact the men of the 
dental profession have had the experience of seeing, perhaps, more absces- 
sing teeth in two weeks of one period than they may have seen for six 
months before or after. What is the trouble? A streptococcal infection is 
going about, or some other form of infection, and the organism goes 
through the system and lodges at the apices of the teeth where there is a 
good culture medium, and immediately that patient is troubled with 
abscessing teeth, the infection gets to the teeth through the blood stream and 
causes that epidemic. 

Value of Vaccines. 
The next slide is particularly interesting because it shows where a third 
molar was extracted, and under normal conditions the alveolar bone has 
restored more in six weeks than in some other location it would in six 
months. This is a streptococcal infection that was producing a chronic 
irritation of the throat with bronchitis, which cleared up entirely after the 
removal of this infected tooth. This slide will suggest to us the use of 
vaccines. Where shall wt use vaccines, and how much of them shall we 
put in them, and what kind of vaccine will we use? We have the 



14 Report of the Canadian Oral Prophylactic Association. 

extremes of opinion in the dental profession as we have in the medical 
profession, but my judgment would be and is that vaccines can be benc- 
hcially used in very carefully selected cases, but we are liable to place 
altogether too much confidence in them. This slide shows a young woman 
twenty years of age who had a necrosis going on for something like four 
months which did not subside or respond to local treatment. She was 
o.erwhelmed with an infection, and the making of a vaccine from the 
contents of this pocket ^\•hich is shown completely changed the condition. 
The pus had stopped almost entirely in three or four days and the sinuses 
were healing up. Before that time we could inject a solution of medicine 
into the seat or focus of this necrotic area we had to get at both the 
lingual and buccal to the third molar, and even the second molar, and with 
no other treatment this picture was changed completely and the young 
woman was restored in a very few days to health again. 

The next picture shows a gentlemcm fifty years of age. A vaccine was 
made, and the restoratives gave him improvement for something like five 
weeks and then lost its efficiency entirely. No\v, ^\'hat is the difference be- 
tween these cases? If you have people with lots of resistance and lots of 
reserve who are suddenly overwhelmed by infection you may bring out 
nature's hidden strength, as it were, by means of a vaccine and help them to 
overcome this temporarily overwhelming infection, but with people beyond 
fifty years of age we must not expect much from vaccine. The next slide 
shows one of the tragedies of our modern splendid dental service. This mam 
was willing to pay for the best dental service that could be got in the world, 
and he was able to pay for it, and was trying to pay for it, and yet tor 
something like five years he has been compelled to deny himself practically 
all the privileges of public life because of irritation of the bladder, and 
during the last twenty years he has been suffering with that trouble. A 
bacteriological culture from the urine gave us a typical streptococcal infec- 
tion. The radiagram showed this area of infection where the absorption 
hod been going on for years. We got a very prolific streptococcal infec- 
tion, and with no further treatment than the treatment of that tooth which 
the dentist had very securely anchored to the next tooth back of it, with 
no other treatment than the extraction of that tooth the irritation of the 
bladder cleared up. Now, is It not a tragedy that we as dentists will hitch 
onto a sick old tooth which nature would eliminate if she could? We will 
hitch it onto some good healthy tooth and prevent nature from throwing 
il off, and I have no hesitation in saying that the Cliff Dwellers with their 
healthy mouths without decay were infinitely better off than our civiliza- 
tion with our boasted dentistry, because we do not know better than to 
hitch sick teeth onto well teeth. 

This slide shows the case of a whole series of infections nearly, starting 
at first with an acute inflammatory process in her joints, then a heart 
infection, then a liver disturbance, so much so that they thought she would 



Report of the Canadian Oral Prophylactic Association. 15 

have to be operated on for gall stones and then peptic ulcer. Then 
finally a carbuncle from which her physician thought he took a teacup 
full of pus, if such were possible, and then when I saw her at one time I 
think she had probably a hundred boils of various sizes. Her physician 
said he did not take any stock in all this bunco about mouth infection, and 
he didn't think the bad teeth had anything to do with it, and if she didn't 
want them out she didn't need to. Now, that to me is a tragedy, that the 
men of our dental profession cannot have the united co-operation of the 
medical profession, and I use that as an illustration, and I hope it is a rare 
one. I am sorry to say it is not a rare one in our city to find medical men 
who Jo not yet recognize the importance of mouth infection. 

Now, I wish to differentiate between mouth infections and lesions 
produced by impacted teeth and the lesions produced by pus under 
pressure. We were told by Dr. Mayo last Monday evening that pus will 
produce a typical type and successive chain of expressions of the nervous 
system; when not under pressure, produces an entirely different type 
of expression ; when under pressure, coming not from pus but from an 
impacted third molar, we get a re-action on the nervous system that 
is entirely different, and very often involves a mental disturbance so grave 
that we will have these people locked up in our sanitariums. Here 
we have the case of a young woman who has been in an asylum for two 
years, part of the time in a plaster of paris jacket because she was so 
violent. She had all sorts of hallucinations. With no other treatment 
than the removal of the impacted upper third molars and the removal of 
the remains of the distal root of a second molar that was entirely grown 
over she was completely relieved so that in two weeks she was dismissed 
from the asylum as cured, and has been for the last nine months studying 
grand opera in Boston, putting in five hours a day at her studies zmd is 
apparently perfectly well again. I want to emphasize that the type of 
expression that comes from an impacted tooth is quite different from the 
expression that comes from a septic infection, and with no. other indicatior 
but the deposit as shown in the next slide we will have an acute inflamma- 
tory process take place. 

I presume one of the greatest contributions that has come from this 
entire field of research has been made just recently by Dr. Hartzel! by 
shcv^ring that even the amount of infection we may have in these spaces 
will be sufficient to gain entrance directly through the open lymph channels 
and blood vessels and infect the apices of roots, and a little more deposit 
produces this amount of inflammation. This slide shows what I should say 
is our graveyard of dentistry, the gold crown. I do not know of any 
operation that we as a dental profession have made that has produced so 
much local and general disturbance as the gold crown, because wnth it we 
may cover up an infected pulp, and not only that but primarily we may 



It) y.eport of the Canadian Oral Prophylactic Association. 

produce an irritation at the gingival margin and by that irritation start an 
infection that may invohe not only the tissues around the tooth but involNe 
the apices and all the periodental tissue, and secondly, all the tissue parts 
of the body. Very frequently I have slides referred to me such as these, 
ilthough these were taken from Dr. Black's book, where particularly the 
medical profession are not interpreting the slides correctly. Here we have a 
dental abscess for example, which is not a dental abscess, but a nerve 
foramin. 

This slide is put in to show you the proper position of the X-ray tube 
to get the proper light and shade. If, for example, we have the angle of 
the rays at right angles to the long axis we will get a lengthening of the 
root, and if we make the angle of the ray at right angles to the him we 
will have a shortening of the tooth. The proper position or angle of the 
rays is at right angles to a plane which is halfway between the long axis of 
the tooth and the plane of the film as shown in the lo\ver picture, which 
will always give you the shadow of the tooth the same length as the tooth 
itself. This slide shows the type of dental lesions that may produce very 
serious systemic infections without local disturbance, for practically all 
these cases were not giving local disturbance, and yet they were giving 
serious systematic disturbance. Here \\e have the typical abscess with a 
fistula into the hard palate. Here we have a blind abscess, and of all the 
types the blind abscess is by far the most dangerous and serious because it 
produces a type of infection that does not make a local disturbance usually, 
but does produce serious systemic disturbance. 

If we had time I would like to emphasize the difference in a number 
of organisms in a healthy mouth and an unhealthy mouth. If for example 
we take the amount of debris from a decaying tooth that would be repre- 
sented by a milligram, an amount that you could carry on the head of a pin 
almost, and count the organisms in it you would have all the way from 
10,000.000 to 250.000,000 or 500.000,000 organisms in that small 
quantity, a thing we have not dreamed of, and when you realize that that* 
milligram of material would only be a fraction of the total amount in the 
mouth we get an idea of the amount of infection we are carrying around 
with us. Then if we note the different types of mouths and the amount 
of infection in each we will readily see that an immune mouth with 1 0,- 
000.000 and a dirty mouth with primary caries with 500.000,000 
organisms we have the answer almost immediately for the decay, the num- 
ber of organisms being almost in proportion to the decay, and I have here 
a slide with the columns illustrating this. 

If we had time to go into study of the pathological aspects, we would 
find this gingival notch to which I am pointing on the outside of the tooth 
may have so slight an infection that the gum is only slightly reddened, and 
yet the blood vessels as shown bv Dr. Hartzell will come to within three 



Report of the Canadian Oral Prophylactic Association. 17 

or four or five microns of ihe surface, and all the germs have to do grow- 
ing in that area is to travel through that four or five microns of distance, 
and when you consider that a micron is the 25,000th part of an inch, and 
when you realize they have to go less than 1 ,000th part of an inch to get 
directly into the veins you get an idea of what importance it is not to have 
the seal broken at that point. The human body is a sealed envelope as 
nature intends it to be. If any one of us had an abscess area as large as 
a penny on our hand our physician \vould be very careful to have it co\ ered 
or protected, but if we have an abscessing area or pyorrhea pocket one- 
eighth of an inch deep around each tooth in the head how many square 
inches of abscessing area do you suppose we have? Four square inches. 
Now, what surgeon or physician would allow his patient to go for one 
moment with that much suppurating surface from which infection can come, 
and yet we pay no attention to it because it is in the mouth. Now, the large 
part of infection seems to enter the system by means of the blood stream, 
and the organisms pass through these large blood vessels into the smaller 
ones and finally overcome the capillaries, and the blood has the property 
of causing a coagulation so to speak, a groupmg or clumping of the 
bacteria, and that clumping makes it possible for them to block up these 
little end arteries, and you will see that process taking place when we come 
to the later pictures. We have some very interesting cases of this blocking 
of the arteries. (Pictures were shown of stomach infection and skin 
infection and so on.) 

I presume no work of this decade is so valuable and significant as that 
of Dr. E. C. Rosenow, formerly of Chicago, but now of the Mayo Institute. 
He has shown when he has taken the germ from an appendix for example 
and inocculated it into animals that the lesions produced in that animal 
would in 68 per cent, of the cases be the appendix of the animal. That 
means that organisms have a specific selective action for certain tissues. The 
strain taken from the appendix selected the appendix in the animals, where 
if the organism was taken from streptococcal cultures from other sources 
than the appendix, only 5 per cent, had infections of the appendix. It is the 
same way with the stomach ulcer, 65 per cent, had infection of the stomach 
when it was taken from the stomach, and only 20 per cent, when it was 
taken from miscellaneous infections, and it seems to follow on through in 
the same way. What does that mean? He suggests it means this, if you 
and I have an infection in our mouth that is selecting out our liver or our 
appendix or our stomach and producing stomach ulcer, that germ may have 
so definite and aggravated a form that if we place it on a drinking cup and 
somebody else takes it off that drinking cup we may possibly transfer to 
that person an infection of gall stones, an infection of peptic ulcer, or some 
other infection of the body. That seems almost too far to take the possibili- 
ties of this, and yet who knows but that may be true. The thing that 
seems to be suggested to us is that we must be exceedingly careful to keep 



18 Report of the Canadian Oral Prophylactic Associuiion. 

cur mouths just as clean as possible and prevent the possibility of carrjring 
it to others. Dr. Rosenow has done probably the most important work that 
has ever been done with respect to mutations of organisms, and in this 
slide we see illustrations of his work. Some of the bacteriologists chal- 
lenged his work and gave him a strain of pneumococcus and asked him to 
change it to streptococcus, and here we have an illustration. That means 
they are simply expressions of the same organism. Mutations are ver>' 
unlikely to occur except in rare cases. Now, the medical men look in the 
patient's mouth to see whether or not he is suffering from a lead poisoning 
or mercury poisoning or phosphorus poisoning, simply because the most 
susceptible tissue of the entire body to poisons is the tissue surrounding the 
teeth, and that is probably the reason why pyorrhea is so prevalent. That 
susceptibility is shown so clearly in this case where some devitalizing paste 
was put into the tooth of this dog and with every precaution in sealing it 
into the tooth, using the cement and amalgam over the cement, yet the result 
of the amount of paste that passed through the apex or through the wall 
of the root and came back to the gingival border was enough not only to 
destroy the gingival border around those teeth in three days but to produce 
this necrotic area on each side of the tongue of the dog, showing the 
tremendous susceptibility of that tissue to the Irritation of that drug. The 
next slide will show us some of the lesions at the apices of the root, but 
that is so large a subject we will not have time to dwell on it except to say 
that we of the dental profession should hesitate to use these things as the 
men of the medical profession and the surgeons hesitate to use bichlorid* 
of mercury in the abdominal cavity. A few years before that he used a 
rather strong solution of carbolic acid, but he does not use the strong solu- 
tion of bichloride to-day, for he has found out that what kills the germs will 
kill the tissues, and he has found the thing he must do is to keep out of 
nature's way. We dental surgeons as a profession are still putting things 
into roots a dozen times too strong for the health of those tissues. 

TTiere is in the peridental tissue a network of cells running all the way 
from the gingival border to the apex of the root, and that chain or network 
seems to be a very important factor in the development of pyorrhea, for 
pyorrhea does not develop from a point around the tooth but develops con- 
tinuously and progressively towards the apex of the root. Why this is so has 
never been solved, but it has been suggested partly by the finding of this 
network of eplphelial cells by Dr. Black, that it will be sho^vn that that 
network is related to pyorrhea. We have in the mouth an organism 
that has caused a great deal of speculation in the last year or two, the 
ameba, but we do not believe it is important as being a factor in pyorrhea. 
We believe it is probably there because there is lots of food for it, which 
food is the breaking down lymphocytes and leukocytes. We do not believe. 
as I said, that it is to blame for pyorrhea. 



Report of the Canadian Oral Prophylactic Association. 19 



Here is the picture of a young lady who has had a very sudden loss of 
her immunity. Suddenly her teeth are decaying very rapidly. The teeth 
were very sensitive. We have taken the debris from one of the cavities and 
put it on the microscopic slide, and you will note it is almost a pure culture. 
We then show a culture from that same patient's mouth showing organisms 
from other parts of the mouth, and you W\\\ notice an entirely different 
type and variety. On this slide we have an organism that has been blamed 
for pyorrhea and of being able to carry bacteria into tissue that is capable 
of infection. You will note how slowly it moves. (Shows various kinds 
of organisms.) 

The next picture will show you these organisms which were taken from 
a blood system of a patient suffering from pyorrhea infection. We inoccu- 
lated a frog with a quantity of that organism, and it produced in the blood 
vessels of the frog the formations that I spoke of. You will see, first, the 
rhythmic motion of the lung of the frog. We cut a hole through the frog's 
back, so to speak, and then another hole through the anterior chest wall, 
and let the light go through the hole in the back and come out through the 
hole in the front, and we got this view of the circulation. We have, first, 
the rhythmic motion of the lung as it is stirred with the heart beat. You 
will notice the blood stream as it rushes through the veins and the arteries 
and the capillaries. We injected into the circulation two minims of a 
media carrying this organism, and the effect on the frog's blood was to 
cause what you might call clumps of bacteria blocking up the small end 
arteries, just as it happens to us in our bodies when we have an invasion of 
streptococci, or any other invasion of infection. The effect is a blockmg of 
the end arteries and the formation of a clot. You will see the bacteria 
block up and block up, and then the pressure behind will break it up and 
it rushes away. 

There was a time when you and I were one sole organism, very much 
like some of these organisms we have seen on the screen. We had many 
characteristics in common, so, as a matter of fact, they are very close cousins 
to us. Keep in mind three things now, for we will have to make these ob- 
servations by inference : How do mutations occur by which new strams of 
bacteria develop in an abscess ; second, how do these various forms of bac- 
teria differ, and in what respects are they like ourselves, for. as a matter 
of fact, there was a time when each of us was a single germ cell, and at 
that time we were very, very much like these organisms we have been look- 
ing at. as you will see. and, thirdly, what are the conditions that determine 
the development of those organisms > The first of the pictures will show 
you the fertilizing process of certain forms of egg. I know of no operation 
in chemistry that is so rapid and so spectacular, and when you realize that 
practically all those processes are purely mechanical, it is wonderful. It is 
a process of physical chemistry. We will see how these bacteria produce 



20 Report of the Cuiuidiaii Oral Prophylaefie Association. - 

ihe lesions they do and select the tissues they do \sithout any conscious effort 
and without any influence except purely a matter of chemistry and physics. 
The first film will show the fertilizing process of a form of sea life. These 
organisms deposit their eggs into the water and they are fertilized in the 
water, and they behave almost like bacteria. See how quickly these little 
male atoms rush to that egg purely by a chemical process, and the first one 
that gets in is the only one that gets in, and as it does so it produces a chemi- 
cal action on this membrane which prevents any other germ from getting in. 
This chemical process is so rapid that it takes place in a very small fraction 
of a second. As soon as the egg is fertilized, it di\ides into two, and pres- 
ently into four, and then we have formations of eight. Here is an egg that 
did not fertilize, and you see the mass of germs that have been attracted 
purely by chemical attraction. Now, that process means that this nucleus 
of life has had carried into it the determiners of character and the deter- 
miners of resistance, and as it has been carried into it, it has been subject to 
modification of environment. Now, the thing I want to emphasize is, there 
is one condition under which an influence may take place, put there rapidly 
and rapidly modified, that is the determiner of the resistance of the body. 
Those are principally just when the membrane is forming in the early stages 
of development, and that may throw some light on \vhy some people are 
subject to typhoid or inflammatory rheumatism, and so on. You will notice 
how these eggs separate or part as soon as the first germ enters, and that 
chemical process takes place, as I said, in a few seconds and is a physical 
operation that we can hardly conceive of, because of its rapidity. It is not 
difficult to modify that development process by the addition of very small 
quantities of chemicals, and very many people are susceptible to disease be- 
cause at the time they were being fertilized as embryonic forms of life one 
of the parents, or both, was under the influence of alcohol, or the mother 
was suffering from the retention of some systemic poison — acid particularly, 
probably, and you will see some pictures of what Avas caused by the addi- 
tion of a very small portion of alcohol, and how it is capable of making 
monstrosities, some with only one eye or with the eyes too close together, or, 
in some cases, serious head deformities and nervous deformities. The same 
deformities are produced in guinea pigs. In this case you can see the heart 
beat in this embryonic form of life. Here is one showing a head deformity 
on account of being treated when it was an egg with a very small percentage 
of alcohol. Many people have their resistance lowered because of influences 
that have come into their lives at the time that the determiners were being 
transferred through this very sensitive stage. In contrast to that, you see 
here a few cells of tissue taken from a frog's throat, which would be identi- 
cal to those taken from the human throat. Here is a specimen showing two 
mouths, and if we cut the head off entirely and cut it up in sections, they 



Report of the Canadian Oral Prophylactic Association. 21 

will respond tp food just exactly as if the rest of the body were there, show- 
ing it is an entirely mechanical process. Here we have a young squid, and 
you will notice it has a sucking bottle. Nature gives some of these organ- 
isms a quantity of food to sustain them for a time. You can see him drink- 
ing out of his sucking bottle. Here we have a pair of twins with their backs 
fastened together. Here is a monstrosity simply because we added a little 
alcohol to the sea water in which it was developing. 

In conclusion, I want to show you how mechanical they are when un- 
der an electric current. They couldn't go in any other direction if they 
wanted to, and they turn in whichever direction the current is changed. 
When the current is changed too quickly, they simply oscillate. 

I thank you very much for your most splendid attention. (Applause.) 

At the close of Dr. Price's address, H. B. Anderson, M.D., CM., on 
behalf of the Academy of Medicine and the audience, moved a vote of 
thanks to the speaker for his excellent address and extraordinary illustrations. 
F. Arnold Clarkson, M.B., in a clever and witty speech, seconded the 
motion. 



22 Report of the Canadian Oral Prophylactic Association. 



President's Address 



A. J. McDoNAGH, D.D.S., L.D.S., Toronto, Ont. 

Read before Annual Meeting- of Canadian Oral Prophylactic Association, 

January, 1916. 

Gentlemen, — Another year has gone around, a momentous year in the 
history of the world; the events which have taken place in the year just 
past have had a wonderful effect on every phase of human society, and 
we in our little society unfortunately have not escaped the far-reaching 
influences resulting from the world's greatest and most sanguinary struggle. 

We have been hampered in more ways than one, and we have been 
deprived of the active co-operation of several of our best members. Doctors 
(now Capt.) Gow, Capt. Mallory and Capt. Hume have taken up the 
cause of their country, sacrificing themselves and their practice, and are 
now helping the poor soldiers who are fighting at Salonika. We wish 
them all success and hope they will soon return and be again happy, health- 
ful participants in the work of this Society. 

In the last year we have also lost three good friends by death — Dr. 
J. B. Willmott, the respected and worthy Dean of our College, was a 
friend of the Association from its inception, and Dr. Doherty, whose 
presence we were fortunate to have with us at our last annual meeting, 
and also Dr. Minns, who was just recently a member of our Association. 
The loss of friends such as these can never be repaired. 

As I said in the beginning, business conditions in the last year have 
been very much disturbed ; in fact, for a time we had difficulty in doing 
any business at all. Last year you were good enough to elect an Adver- 
tising Committee, which would act in conjunction with the Executive. That 
committee formulated an excellent scheme of advertising, got all the in- 
formation necessary and the contracts all ready to sign, but just when we 
were on the point of signing the contracts and putting the fruits of their 
labors to the test we were confronted with the unfortunate condition that 
we could not get enough goods to supply the demand. Kent & Son, having 
got contracts from the Army to supply brushes to them, and having, of 
course, lost some of their employees, have not been able to supply us 
with our brushes. 

Lyman Bros, reported to us that, although they had seven hundred 
gross of tubes on order in the Old Country, they could not get one to 
put up Hutax Paste, and consequently we could not get the paste, so 
that advertising to create more business was out of the question. 

Just about that time we came in contact with a gentleman, Mr. 
Greatrix, who is with us here to-night, whose services were available and 
who was willing to promote the good of our enterprise and to manage 
the business for us. Through Mr. Greatrix' efforts principally, we have 



Report of the Canadian Oral Prophylactic Association. 23 

been able to induce Lyman Bros, to get a sufficient quantity of tubes 
from the United States to supply the immediate demand, and through 
him, also, we have given a supplementary order to the Dupont people, 
of France, for one hundred gross of brushes, to be delivered as soon as 
possible; however, that will take time; in fact, it will be some time yet 
before the supply of our goods will be normal. 

Notwithstanding all these drawbacks and the many factors which have 
militated against our progress during the past year, the sale of our brushes 
has increased by the substantial total of one hundred and thirteen gross, 
that of our paste and powder, forty gross. 

In our Financial Secretary's report you will find there is one item left 
out, which could not be put in because the account for that item was not 
straightened up by the time of the annual report, and that is, at Christmas 
time, we donated powder and paste to about seventeen charitable institu- 
tions in the city, of a retail value of something over $175.00 — the cost 
to us, of course, being less than that, as we got them at wholesale prices. 

Our Educational Committee of last year and year before last has been 
working under difficulties, but our Secretary, Dr. Broughton, has been 
able to do a good deal of the work and has been able to assist the Edu- 
cational Committee. The committee has been handicapped this year be- 
cause Dr. Hume, who was a member, had to go to the military camp, 
and Dr. Grieve, the Secretary of the Committee, was forced to take up 
Dr. Hume's work at the College; besides, unfortunately. Dr. Grieve had 
the affliction of his wife dying, and through that, also, an extraordinary 
burden laid upon his shoulders. 

This coming year your Executive hopes that the Educational Com- 
mittee which you will appoint will undertake and do a great deal of the 
work which has devolved upon the Executive up to the present time; in 
fact, we hope to carry out the suggestion made by the Educational Com- 
mittee that they meet at the same time and with the Executive. 

It has been suggested that this Association provide a certain sum of 
money as a permanent endowment for research, and your Executive re- 
spectfully request that you express an opinion on that subject this evening. 
The Educational Committee will report the work done throughout the 
Dominion. 

I want to thank the members of the Society for their loyal support in 
the past, and particularly the members of the Executive Committee, who 
have, as usual, thought no work of the Society a burden. I want, also, 
to thank the members of the other committees and the auditors for their 
services to the Association. 



24 Report of the Canadian Oral Prophylactic Association. 

Secretary-Treasurer s Report 

The annual meeting of the Canadian Oral Prophylactic Association was 
held JcUiuary 20th, 1916, at the Walker House, Toronto. Owing to the 
fact that the programme arranged for our annual meeting — a lecture by 
Dr, Weston A. Price, on Blood Circulation, illustrated by Moving Pic- 
tures — would be of special interest to all the profession, it was decided to 
go on with the business part of the meeting, the reception of reports, etc., 
adjourn to Monday, February 14th, for the programme and to invite all 
the members of the Dental Profession of Toronto and vicinity to hear Dr. 
Price's lecture. 

President's Report presented by Dr. A. J. McDonagh. 

Educational Committee's Report presented by Dr. Geo. W. Grieve. 

Financial Report presented by Dr. A. J. Broughton. 

Receipts $2,699. 1 7 

Expenditures — Charity and Educational $ 646.29 

Donations to: — 

Canadian Dental Association for the Army Service Com- 
mittee $ 1 06.28 

Sick Children's Hospital 50.00 

Army Dental Fund of the C.D.A 100.00 

Sunnyside Orphanage 3.48 

Toronto University Hospital Corps $36.06 

McGill Hospital Corps 25.38 

Army Service Corps 52.35 

113.79 

Lantern slides 1 3.80 

Oral hygiene charts 70.00 

Exhibit at O.D.A. convention 32.64 

Prinring 1 56.30 

Expenditures of operating 1 ,225.02 

Balance for 1916 2,453.97 

Assets 3,943.47 

Total gain over preceding year in revenue, $385.55. 

Total gain over preceding year in tooth brush sales, 1 1 3 gross. 

Total gain over preceding year in paste and powder sales, 40 gross.