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This material was originally presented as a preliminary report at the California State Dental Convention, held in San Francisco, April 9, 1931. At that time, the author was confronted with the problem of discussing a dental subject with dentists which had been approached by an analytical route. This necessitated a very primitive and superficial discourse. In this article, the converse is true. My readers are not dentists; nevertheless, I must introduce a very superficial discussion from a dental viewpoint in order that we may thoroughly appreciate the importance of this subject.
Pyorrhea is a term, emanating from the dental profession, which is universally used. In many instances, it is not a primary disease entity but a symptom or an end result of either a functional, a mechanical, or an organic cause. Briefly stated, the following are the principal factors involved in the cause and course of pyorrhea:
The mechanical theory—that malocclusion, producing excessive occlusal stress, results in chronic traumatic irritation. The supporting structure of the roots is injured with resultant alveolar absorption. This constant trauma plays an important rôle in many of the most perfect restorations. Most of the injurious stress is executed while the mouth is empty—that is, not caused by mastication. When the stress occurs while the patient is awake, it is called occlusal neurosis. It may be purely a habit done to an emotional state, or an effort to get some relief from dental discomfort. Bruxism is defined as occlusal stress during sleep.
The bacteriological, based upon which the chemical houses thrive. There is no doubt that a Vincent's angina with its concomitant gingival irritation may lay the foundation for a future pyorrhea.
At the last American Medical meeting, McCollum stated that much pyorrhea is due to improper diet, and lack of or unbalance in the vitamin content.
The systemic theory—gastrointestinal disturbances, such as intestinal parasites, focal infection, and card