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ETIOLOGY OF DENTAL DECAY. 207

In all cases the starch is first transformed into grape-sugar by
the pt valine of the saliva or of the pancreatic juice, and is then
split into lactic acid bv the lactic acid ferment of various bac-
teria. Xow, it is well known that many chemical bodies possess
other affinities at the moment of their formation than at other
times. According to the experiments referred to, this appears
to be the case with sugar. For other reasons, also, I consider
starch and amylaceous substances more detrimental to the teeth
than sugar, particularly as sugar, being readily solnble, is soon
carried away or so diluted with the saliva as to be rendered
harmless, whereas amylaceous matter adheres to the teeth for a
greater length of time and consequently manifests a more con-
tinued action than sugar.
Hesse's ^-" observations in respect to caries of bakers' teeth lend
support to this opinion. He writes, " In the Dental Institute of
this city [Leipzig] I have had the opportunity of seeing a great
numV)er of patients among the industrial and working classes, and
have been particularly surprised at the bad condition of the teeth
of our bakers. They are aiiected by caries to such a degree that I
have been able in many cases, since my acquaintance with this phe-
nomenon, to determine the calling of a patient by the condition
of his teeth. There can be little doubt that we have here to do
with a disease which stands in causal connection with the calling,
and the theory of caries recently propounded by Miller gives a
satisfactory explanation of it. A few confectioners' children are
the only individuals I have seen who could bear comparison with
bakers, although their teeth were not in quite so bad a con-
dition. Probably the millers may be able to compete with the
bakers, and it would be desirable to be enlightened on this
point."
Busch, on the contrary, is of the opinion that " baker caries"
is due rather to the inhalation of sugar-dust than to that of flour-
dust.
Difterent sugars manifest but little dilference in their capability
of being split up into acids. Those kinds belonging to the
— grape-sugar (dextrose), fruit-sugar (levulose),
grape-sugar group
lactose (galactose), and maltose—are directly fermentable and de-
compose according to the equation : C^HigOg = 2C3Hg03. Cane-