Department of Orthodontic Abstracts and Reviews

E dited byD R. E GON NEUSTADT , NEW Y ORK C ITY

All communications concerning further information about abstracted material and the accept­an ce of articles or books tor consideration In this department should be addressed to Dr. Egon

Neustadt, 133 East Fifty-Eighth Street, New York City.

The Etiologic Factor of Impaired Mastication Upon Gastrointestinal Diseases(Die Rolle del' Pathologic des Kauens in del' Klinik del' Magendarmkrank­heiten). By S.E. Gelman, Ztschr. f. Stomatol. 34: 34, 1936.

A good condition of th e masticatory apparatus does not always guaranteesufficient trituration of food ; on the other hand, a mutil ated mouth may ofte nprovide entirely sat isfac tory comminution due to changes in food selection andchewing habits . Con trary t o common belief, the ass imilation of food suffersno serious set ba ck through deficien cies of th e mas t icato ry apparatus. What ,th en , is the rOle whi ch imp aired masti cation plays ill th e eti ologv of gastro­intes tinal disNISE'S! The follow ing poss ibi lities should be cons idered : (1)mutilation of th e den tal arches; (2) superficial chewing; (3) fas t eat ing;(4) irregular meals.

STATISTICS

Two hundred people of different ages a url occupatio ns were examined.'1'h er e were 77.5 per cent men , the majority of the m between the ages of thirtyand forty years. At th e first examinat ion, th e pa t ients wer e divided into th efollowing groups: gastr itis 135 ; gast r ic ulcer s 49 ; du odenal ulcer 10 ; colitisG. At their last exa mina tio ns , these figures were modi fied as follows : gastr-it is73 ; gas t ric ulcer s 81; d uode nal ulcer 21 ; colitis 18 ; cance r 7.

'I'he condition of the teeth at the beginn iug of the disease was : ex cellen t49 per cent ; good (2 t o 4 teeth missing) 24 per ceut; fair (6 to 8 teeth miss­ing ) 11 per cent; p oor (10 to 16 teeth missing' ) 9 pel' cent ; very poor (18 t o28 teeth missing) 7 per cen t.

The condition at the time of the examination wa s : excellent 19 per cent;good 26 per cent; fail' 22 per cent ; poor 17 per cent; very poor 16 pe r cent.Of the whole number of patients. 26 used removabl e plates, The functi onalevaluation of th eir dental condit ion wa s:

MASTIf'A'rING I'OSSIBIJ,lTY

!l(1 to Iflfl%-110 pers ons75 to 89%- 48 persons50 to 74%- 20 perFo ns25 to 49%- 14 pe rsonso to 24%- 8 persons

~IAf;TiI'ATI"G F.F~'IClENl'Y

90 to 100%-126 persons75 to 89%- 44 per sons50 to 74%- 18 persons25 to 49%- 10 personso t o 24%- 2 persons

Only 35 per cent chewed thor oughly, th e ot her 65 per cent chewed qui ckl y,superficially. Fast, r estless eating wa s noticed in 67 per cent. Meals wereeaten irregularly by 58 per cent.

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212 Orthodontic Abstracts and Reviews

EXPLANATIONS

That the percentage"of men exceeds that of women, especially as ulcerpatients, is by no means a chance finding, but is to be explained by the factthat women perform lighter work, eat more regularly, and are not prone toalcohol and tobacco abuses.

The greatest number of gastric patients are between thirty and forty yearsof age . This is surprising because at that age many of them have splendidteeth; while the ages between fifty and sixty-five, when the condition of theirmouths is poor or very poor, show a smaller percentage of disease.

A marked difference between the diagnosis at the first examination andthat at the last examination was found. The reason is that many ulcerousconditions developed from simple hyperacid gastritis (81 gastric ulcers). Thegastric diseases prepondered, anyhow; intestinal disturbances contribute onlyan unimportant portion. The stomach must therefore be considered as themost vulnerable part of the whole digestive tract, not on account of a specifieweakness, but because it is primarily exposed to the damaging results of wrongmasticating-and eating methods.

The condition of the masticating apparatus must be most carefully con­sidered. It shows that three to five years after the beginning of disease, 67per cent of the patients, and, if dental restorations are also counted, even 75per cent, possessed a satisfactory chewing mechanism, and the progress or thebeginning of the disease cannot be attributed to the loss of teeth. Further­more, 85 per cent of the patients demonstrated a satisfactory masticatingefficiency, and only 6 per cent an unsatisfactory one.

However, thoroughness and c~re in chewing were in most instances sadlylacking; only 35 per cent chewed carefully, and 65 per cent chewed super­ficially, despite good teeth. The reason for this is twofold: first, the badhabit of fast eating, even if sufficient time is available; second, poor economicconditions, whi ch induce people to eat qui ckly, often standing up, so thatcareful chewing is out of the question.

The treatment consists mainly of dietary regulations; their effect is en-"hanced by dental restorations, providing greater efficiency in mastication.

This , however, is of little use unless accompanied by improvement of chewingand eating habits. The loss of teeth is of only minor importance in theetiology of gastrointestinal diseases. The real etiologic factors are: carelesschewing, which does not utilize the masticating efficiency of the jaws ; irregu­larly eaten meals ; eating of dry foods; fast, restless eating. Proper diet con­sists not only of the correct quantity and quality of food, but also of regularmealtimes, and careful chewing.