536 The International Journal of Orthodontia.
even in a modest degree, for his services,
may prove a bur'den to the parent, if,
indeed, the orthodontist is not accused of
" h i g h w a y robbery." A child of twelve
or fifteen years of age, with much ir:~gu-
larity, requires a t r e a t m e n t period of the
greater part of one year, with a succeeding
retention period of two years' time.
Because of the reqt, irement as to time,
and the consequent fee demanded in these
established or somewhat " m a t u r e cases,"
only one out of the many can ever be
treated. Possibly one out of seventy-five
or a hundred cases only, will have the
services of the o r t h o d o n t i s t - - a n d in com-
munities where there is no specialist the
proportion of treated cases is practically
nil. The result is t h a t hundreds of thou-
sands of children all over the land must go
on through life with varying degrees of
dental and facial deformity, much of which
could have been prevented by the intelli-
gent co-operation of the family dentist.
In filling teeth with gold, certain well-
defined principles are adhei'ed to in order
to arrive at a certain degree of success.
So, out of all the chaotic beliefs with
reference to t r e a t m e n t of malocclusion of
teeth, certain well-defined basic principles
have finally been accepted by those who
have t h o u g h t most upon the subject.
The great fundamental in orthodontia is
normal ocdusionl TO work to any other
principle is to acknowledge a degree of
defeat at the outset.
A brief resume of the avenues of pre-
vention of malocclusion might, therefore,
be as follows:
(a) The preservation of the deciduous
teeth for their normal life period.
(b) The mechanical retention of the
space i f the deciduous tooth be perma-
nently lost.
(c) By nothing to decidious teeth are
not retained tot a considerable longer
time than is normal.
(d) By stimulating the lateral growth of
the decidious dental arches when the nor-
mal "growth spaces" are not in evidence
say, at six years of age.
(e) By paying some attention to the
naso-pharynx and nose to see t h a t the
child has no occlusion oi the air passages.
(f) By bearing in mind t h a t prevention
is better than cure.
(g) By remembering the best time to
correct existing malocclusion is now.
If the question be asked: W h a t mechan-
ical procedures may the general practi-
tioner follow in dealing with incipient
malocclusion ? I may reply:
1. Where the second deciduous molar,
for instance, is lost, he may fit and solder
a band to the first permanent molar; an-
other to the first deciduous molar; connect
the two bands by means of soldering a
strong wire betwee,a them, and cement the
little appliance thoroughly to place. In-
spect it at intervals of three months until
the second bicuspid makes it appearance.
2. The dentist may stimulate the lateral
development of crowded deciduous arches
by means of bands fitted to the cuspid
teeth on either side to which a soft lingual
wire is soldered, the ends pa~sing a bit
distal to the cuspids, to engage the lingual
aspect of the first deciduous molar. With
a suitable wire-stretching device the wire
may be gradually lengthened, thus secur-
ing a considerable degree of expansion of
the anterior part of the arch. This
method will not successfully move both
crown and root of the cuspid, as may be
done by some of the newer methods.
3. The dentist may note the influence of
an abnormally attached frenum-labium in
causing serious separation of the perma-
nent central incisors, and may, by follow-
ing a fairly simple technic, put an end to
the abnormal muscular attachment, with
the electro-cautery drawing the teeth
together and retaining t h e m pending the
eruption of the lateral incisors.
4. If the dentist considers this work,
even in its simpler phases, undesirable or
burdensome, in most communities of con-
siderable size he may co-operate with a
specialist. In any event, let us not un-
thinkingly pass by conditions, which in
their incipiency w o r k n o great ill, but the
neglect of which is fraught with conse-
quence which scarcely the full purse of t h e
patient and the skilled hand of the operator
may fully correct.
Mastication and Food Utilization.--
Again and again in e v e r y d a y life we find
that some dictum which either c o m m e n d s
itself to common sense or lends itself
freely to a r g u m e n t a t i v e proof is being
made the basis of a widespread propaganda.
W h a t was more reasonable t h ~ t o a~sume
that water ingested with meals would
dilute the gastric juice and thus diminish
its proteolytic efficiency? A n d w h a t was
more logical t h a n to urge the abolition of
such an assumedly harmful custom of
 Excerpts.
water drinking? Y e t i n v e s t i g a t i o n has
showed t h a t some of t h e p o s t u l a t e s in this
c o n t e n t i o n are wrong, a n d t h a t unsur-
passed factors f u r t h e r v i t i a t e t h e conclu-
sions. Indeed, u n d e r c e r t a i n conditions
water m a y even p r o m o t e t h e gastric secre-
tion, a n d t h u s upset these revered tra-
ditions.
T h e I/roper m a s t i c a t i o n of food has
certain o b v i o u s justifications. I t pro-
motes a more extensive insalivation, which
is not w i t h o u t ad,vantage to c e r t a i n types
of foodstuffs, a n d it permits a speedier
a d m i x t u r e of the a l i m e n t a r y digestive
secretions with t h e individual c o m m i n u t e d
food particles. E n t h u s i a s t s h a v e not been
c o n t e n t with t h e insistence on these indis-
putable a d v a n t a g e s , but h a v e a t t e m p t e d
to infuse far-reaching effects into the h a b i t
of every c o m p l e t e mastication. We m a y
be r e a d y to a d m i t t h a t insufficient masti-
cation is the cause of direct or indirect
evils which m a y be greatly exaggerated in
certain pathologic conditions. W h e n , how-
ever, we are urged to chew our food with un-
r e m i t t i n g vigor because it "secures proper
insalivation of food, increases t h e q u a n -
t i t y of alkaline saliva passing into the
s t o m a c h , s t i m u l a t e s t h e h e a r t a n d circula-
tion, influences t h e n u t r i t i o n of t h e jaws
a n d t h e i r a p p e n d a g e s b y s t i m u l a t i n g blood
and l y m p h circulation, and, finally, t e n d s
to diminish t h e a m o u n t of food c o n s u m e d
because it is more economically disposed
of in t h e s y s t e m , " one m a y well pause to
m a k e a few related inquiries. W h e r e is
the boarderline between " t r u t h and
p o e t r y " in these m a t t e r s ?
T h e two e x t r e m e s of practice are d o u b t -
less r e p r e s e n t e d b y u n d e r m a s t i c a t i o n , as
involved in t h e h a s t y b o l t i n g of food, a n d
o v e r m a s t i c a t i o n , to which t h e e p i t h e t
"fletcherizing" is s o m e t i m e s applied. Fos-
ter a n d H a w k h a v e c o m p l e t e d studies of
the utilization of typical protein as influ-
enced b y different degrees of mastication.
The principal p r o t e i n c o n s t i t u e n t of t h e
diet was cooked beef in t h e form of 15-milli-
meter cubes. I t h a p p e n e d t h a t protein
utilization was most complete as t h e re-
sult of good mastication, a n d last com-
plete w h e n bolting was practiced. T h e
3 u t p u t of fecal n i t r o g e n was highest dur-
mg t h e food bolting, a n d macroscopic m e a t
residues a p p e a r e d in every stool u n d e r such
:onditions. Yet t h e discrepancies in t h e
protein utilization d u r i n g these extremes
~f m a s t i c a t i o n a v e r a g e d only 1.6 per cent.
Such insignificant differences surely
33 7
c a n n o t be used in s u p p o r t of a n y e n t h u s -
iastic claims for t h e alleged marvelous effi-
ciency of t h e excessive m a s t i c a t i o n of food.
even w h e n judged b y t h e o t h e r extreme
of food bolting. I n a n o t h e r recently pub-
lished series of e x p e r i m e n t s o n m a n i
which v e g e t a b l e products, n o t a b l y potatoes
a n d cereat breads, formed t h e p r o m i n e n t
articles of diet, u t i t i i a t i o n was a p p a r e n t l y
i m p r o v e d b y good mastications. N e i t h e r
these nor the earlier q u o t e d results are to
be t a k e n as a n appeal for complete indit-
ference in the m a t t e r of eating, b u t r a t h e r
as a n indication of t h e r a t i o n a l i t y of t h a t
h a p p y m e d i u m of p e r f o r m a n c e in masti-
c a t i o n which is usually a sign of physio-
logic wisdom in o t h e r functions.--.rour, of
the American Medical Association, A u g
28, 1915.
Taking the OccAtmton and Re0jat'ra-
tio~ of the C o n d ~ Path,--By O.
A moedo, Hon. President of the Soclete
O d o m o t o g i q u e de France, Hon. Prof. of
t h e Eeole O d o n t o t e e h n i q u e de France.
(Read a t t h e X V I I t h Inter. Med. Congress,
Londot~, 1913.--A $ h ' s Monthly, Auffust.
1 9 1 5 ) . ~ N u m e r o u s are t h e i n v e s t i g a t o r s
who h a v e arrived a t t h e conclusion t h a t
t h e condyle p a t h s v a r y g r e a t l y in ddfferent
i n d i v i d u a l s in t h e i r angle of inclination as
t h e y pass forwards a n d downwards, l
h a v e found v a r i a t i o n s of no less t h a n 35
b e t w e e n t h e right a n d t h e left side in the
same person.
T h e question arises, How are we to re-
cognize t h e inclination of t h e condyles in
different individuals, a n d t h u s d e t e r m i n e
the true occlusal c o m p e n s a t i n g plane~
M y o b s e r v a t i o n s h a v e lead me to t h e con-
viction t h a t t h e d e n t a l a r c h n e i t h e r pre-
sents a c u r v e of c o m p e n s a t i o n nor a
c u r v e of Spee, but, in fact, two occlu~al
planes. I will therefore begin b y a n
exposition of the occlusal plane of the
d e n t a l arches.
I n children u p to t e n a n d twelve years of
age, all the t e e t h of t h e u p p e r arch rest
u p o n t h e occlusal plane; in o t h e r words, if
t h e u p p e r arch of a child who-has chang~ed
all his u p p e r t e e t h is placed u p o n a flat
surface, t h e four incisors, t h e t w o canines,
the four bicuspids, a n d t h e two m o l a r s - -
in all, twelve t e e t h - - w i l l all rest upon this
flat surface.
This is t h e occlusal plane of the d e n t a l
a r c h e s - - a n i m m u t a b l e plane, for it witl be
t h e same in the child, in t h e adult, and in