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and C.W. dental service and, in particular, its numerical inadequacy.
Throughout all this it has been generally assumed that
teeth matter and that conservation pays; but do teeth really matter?
To such a question patients invariably answer that they do, even
if placation of the attendant dental surgeon is the main motivation
but, to the corollary Why?, a patient's spontaneity evaporates.
That so few patients give thought to the reasons for maintaining
good oral health is more than perplexing to the clinician practising
preventive dentistry, especially when one considers the options,
namely, (a) no teeth, (b) artificial dentures, (c) own teeth with
trouble and (d) own teeth for life. Let us examine these options:—
(a) No Teeth
To enter into details of the aesthetic and functional disadvantages
of such a state would be superfluous although the
average person knows little of the complications arising in the
temporo-mandibular joints of the edentulous. In this category
one must include those of the little-known minority group of
persons whose mouths, for anatomical and/or physiological
reasons, will never accommodate a dental artefact.
(b) Artificial Dentures
These are being worn with comfort and satisfaction by many
who, nevertheless, are sensible of their shortcomings in facial
expression and, by some, of premature appearance of age. A
specialist in the teaching and effecting of denture construction
is designated a "prosthodontist"—a title derived from the
word prosthesis meaning a replacement of an absent part by
an artificial one—and it is significant that these specialists
have never claimed that their prostheses exceed the efficiency
of other artificial replacements. On the contrary, many papers
have been published on the inadequate percentage efficiency
of dentures when compared with natural dentition and very
few dental surgeons would consider dentures as anything but
a second best, bridging the gap between nothing and the lost
ideal. Personal experience reveals that a high proportion of
denture wearers share this view.
(c) Own Teeth with Trouble
Progress of people in this group towards denture wearing
or to the edentulous state is almost inevitable. That such a
group should ever exist is mystifying and, almost invariably,
membership arises involuntarily due to lack of interest, lack
of preventive knowledge or of its application or resulting
from the delaying of application until it is too late.