Page 359 - My FlipBook

POLSTS OF ATTACK IN SOFT TISSUES OF THE MOUTH. 331 ;

olar margin, disagreeable odor from the month. Xo symptom
was present which wonid have justified me in designating these
cases as anything other than real pyorrhrea alveolaris.
Three other children had previously shown the same symp-
toms, but were at the time l)eing not atfiicted with the disease
the rhachitic symptoms had likewise also consideraljly dimin-
ished in consequence of proper liygienic regulations (sea air,
good food, and care). Four children, eleven and twelve years
old, who had been cured of severe rhachitis, had perfectly normal
teeth and normal healthy gums.
In other diseases of the osseous system, caries, coxitis, osteo-
myelitis, as well as arthritis, tuberculous inilammation of the
joints, tuberculosis, lupus, malum Potti, etc., of which I exam-
ined sixty-five cases, I could discover no especial predisposition to
pyorrhoea alveolaris. The teeth were also comparatively better
than those of the higher classes.
I formerly regarded scrofula as an important ]3redisposiug
factor in pyorrha^a alveolaris. Its frequent appearance together
with rhachitis renders it difficult to distinguish between theeti'ects
of these two diseases. After examining over twenty cases of
scrofula, not complicated by rhachitis, I concluded that I had
overrated its predisposing effect, at least in regard to children.
It is a fact known to every dentist that constitutional diseases
are often followed by local expressions on the gums, the perice-
mentum, and the alveolar margin. I need only mention scor-
butus, mercurialism, and the gingivitis and pericementitis which
accompany exanthematic diseases.
Particularly striking are those affections of the gums that
occur during pregnancy, and which lead to swelling, puffin ess,
and suppuration of the gums at the neck of the tooth, especiidly
between the superior central incisors. These aflections bear
considerable similarity to pyorrhoea alveolaris, and are asserted
by some to result in this disease after repeated pregnancies,
although as a rule the symptoms, while yielding to no treatment,
completely disappear of themselves after confinement.
As unfavorable hygienic conditions we designate poor quarters,
bad food, bad air, want of exercise, etc.
'J'he etiological significance of these fiictors in the origination