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OBAL DISEASES AND THEIR TBANSMISSION. 161

a point of entrance and thus become able to manifest their special
actions." This fact, now well recognized, is being constantly demon-
strated in the use of the various appliances that may, through careless
handling, injure the mucous membrane. So much is this the case that
a large proportion of gingival inflammations have undoubtedly had
their origin from this cause. It has come under the observation of the
writer that injuries thus received, although apparentlv unnoticed bv
i entist or patient, have resulted in the course of forty-eight hours in
very disturbing pericementitis, confusing to the operator and very painful
to the patient. The necessity for such antiseptic precautions here as are
taken in general surgery is almost entirely overlooked. Before placing
the coffer-dam, the clamp, or ligature, that portion of the mouth should
be thoroughly washed with an antiseptic solution and an effort made
to render the appliances equally sterile, or at least to inhibit develop-
ment for a definite period. When the operation has been completed
the same care should be extended to the tooth and contiguous structures.
The evidence is abundant that many cases of pyorrhea alveolaris have
had their origin from this careless indifference to accepted and necessary
precautions.
The mouth as a source of disease to the general system does not
properly belong to this article to discuss, but its importance cannot be
overlooked. Dental writers have devoted much attention to this sub-
ject. It is for the dentist to understand that he is, to a large degree,
responsible for the general health of his patient as far as the mouth is
concerned, and he should insist on prophylactic measures that Mill at
least reduce this source of disease to a minimum. The constant danger
of what Miller aptly calls " auto-infection " from the collection and
propagation of pathogenic bacteria in the fluids of the mouth should
suggest to the dentist constant efforts to effect the removal of all deposits
on the enamel, gingival margins, tongue, and mucous membrane. This
line of study will bring about in the future an entirely different dentistry
as to hygiene and prophylaxis from that practised at the present time.
The pulp of a tooth is not ordinarily regarded as a point of in-
fection, and yet it is well known to be a serious menace to the health
of an individual. Israel, quoted by Miller,^ asserts that " the root
canal furnishes a point of entrance even for the ray-fungus, actinomyces,
and in one case the microscopic examination revealed the elements of
this organism in the canal of a pulpless tooth." AVhen it is considered
that some individuals have decomposed pulps in a number of teeth at
the same time, and frequently a score of dead and broken roots, sending
out their infectious material, it is not surprising that disease of a serious
nature may supervene. While there is no record of cases coming
^ Tlie Micro-organisms of the Human Mouth, p. 285.
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