Presented at the annual meeting of the Fifty-year Club, May 12, 1959, Biloxi, Mississippi. Tulane University School of Medicine, New Orleans, Louisiana.
YOUR INVITATION TO me to be present here today gives me an opportunity to present a brief statement relative to the work in which I have been engaged for many years. Several years ago, after I was retired from active duty, I undertook intensive study and research relative to the cause and prevention of the two principal diseases from which almost all loss of teeth results, viz. caries (tooth decay) and periodontoclasia ("pyorrhoea"). Practically all people in this country have more or less caries. The average ten-year-old child has already more than two decayed, missing or filled teeth. By 15 or 16, he has several more and by adult age, still more. Treatment, fillings and restorations of decayed teeth usually last for only a limited length of time. They generally break down, sooner or later, and have to be renewed from time to time, throughout life or until the tooth is finally lost. Periodontoclasia is a universal disease of man, beginning in childhood and never ending until all the teeth are lost, if the individual lives long enough. These two diseases together present this nation's most prevalent health problem. Caries causes less than 25 per cent of the loss of teeth in America; periodontoclasia more than 75 per cent. Damage to the dentition from these diseases accumulates as the individual grows older. Many people have lost most of their teeth or are entirely edentulous by the age of 50; many more by 60. Life expectancy is rapidly increasing and so is the proportion of older people in the total population. Now, one of every 11 persons is past 65; and the percentage will most certainly be increased as further medical advances are made. If we take 70 years as a convenient figure for life expectancy at the present time, it is evident that a large proportion of the population must spend many years of their lives toothless or nearly so. The long continued infectious pathological conditions in these diseases and the ultimate loss of teeth therefrom impairs, more or less, the health, the nutrition, the pleasure, the comfort, the welfare, and the longevity of all people in all walks of life. Under these circumstances prevention of these diseases and prevention of further advancement of existing lesions is of the greatest importance. Prevention in this case offers not only longer life but happier, more pleasant and more enjoyable life. The universal prevalence of these diseases, the constant accumulation of the damage, the crippling and the disfigurement they cause and their end results, even in people who do take advantage of the best dental health service available, all go to show that whatever is known and done is quite inadequate to prevent them and their consequences. Something more, something different, something better is necessary. Measures for prevention of these diseases and for prevention of further damage by them must be based upon correct information as to the local etiological and pathological conditions. Each of them is caused by microscopic organisms, the early lesions are microscopic in extent, they advance microscopically, the tissues involved are composed of microscopic elements and the pathological processes by which the tissues are destroyed are microchemical. Therefore, one can know of his own knowledge and understand the etiological conditions at the locations where the lesions originate and advance, only by microscopic studies of appropriate material, mostly extracted tooth specimens and biopsy material. Employing technics and methods acquired through many years of teaching and research, concerned largely with microscopic pathological processes and micro-organisms, it was possible to secure accurate information as to the local etiological conditions that have to be prevented or minimized in these diseases. Most of these observations relative to these conditions have been described in a number of publications. Based upon this necessary information, and upon information published by others, and after considerable experimentation I designed and have described in detail1,2 the method of personal oral hygiene which every person must know and follow to maintain the highest degree of oral cleanliness and dental health. For all practical purposes these two diseases can be entirely prevented or controlled if this exact method is followed. They cannot be without it. Our method is different from, and in some particulars quite the opposite of oral hygiene practices generally recommended3 and followed. Oral hygiene is a personal and an individual matter. Each person must be taught by someone who knows the method (there is only one effective method now known) and the basis for it and who is capable of teaching it to others. People rely upon the dental profession, not only for treatment and repair of damage they have sustained from dental disease, but also for advice and information about prevention of future damage. By application of the information we now have, not information that must be discovered later, every normal person should retain all of his teeth through ripe old age. By learning and following the method of personal oral hygiene we know to be necessary and effective, under the supervision of informed and interested dentist health service, no normal person should ever lose one tooth from either caries or periodontoclasia. Some of the dentists in more than half of the states in the United States are now teaching and recommending this effective method to their suitable patients, as a part of their service. Much the largest number of these are in Texas. This is explained by the fact that the method and the information upon which it is based have been taught, for several years, at University of Texas, Dental Branch. No doubt similar results will follow whenever, as surely will have to be done sooner or later, the method and the facts upon which it is based are taught at dental schools in other states. Further delay in this regard is a reflection upon dental education in this country.
REFERENCES 1. Bass, C. C.: The necessary personal oral hygiene for prevention of caries and periodontoclasia. New Orleans M. and S. J., 101:52, 1948. 2. Bass, C. C.: An effective method of personal oral hygiene. J. Louisiana State M. Soc., 106: 57;106: 100, 1954. 3. Bass, C. C.: Some important developments presently influencing dental health. J. Louisiana State M. Soc., 109:201, 1957. Number 2, Pages 36, 37, July 1959.
"A Clean Tooth Does Not Decay, nor does periodontoclasia occur about a clean tooth." C. C. Bass, M.D.