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duces decay and disease respectively. Suffice to say that germs
plus plaque results in gum disease causing loss of underlying
bone and a loosening of teeth whilst germs plus plaque plus
starchy foods, particularly sugar, lead to the disease known as
tooth decay. In this latter condition not only do the germs in
the plaque act as the staff of a "chemical factory" by converting
food supplies into substances which attack the teeth but there
is also evidence that sugar is built up into large molecular chains
of building materials for the said "chemical factory". After 30
minutes or so of "clearance time" during which the destructive
processes exhaust themselves nature, by "remineralisation",
attempts to repair the damage. It can clearly be seen that the
decay-forming powers of plaque, if its presence is permitted,
depend not only upon the availability of raw materials, especially
sugars, but also on the frequency with which these carbohydrates,
both liquid and solid, are supplied. Such an exposition can be
counted unusual in an Annual Report but it is justified on the
grounds that it clarifies the conditions against which preventive
measures must be aimed, viz. bacteria, unhygienic oral conditions and faulty diets. Elimination of micro-organisms from the
mouth cannot be achieved without affecting other parts of the
body, principally the alimentary tract. Plaque, on the other hand,
can only act if it is present and, logically, tuition and conscientious application of proven oral hygienic procedures will largely
prevent its formation. It has been shown beyond contradiction
that as the community's consumption of fermentable carbohydrates increases, so the rate of dental decay rises. Control of
dietary sugars, and therefore plaque, lies in the hands of the
individual.
No outline of a preventive programme could be complete without reiterating the place of fluoride as an effective preventive
measure, particularly in the minute physically harmless concentration of one part per million in drinking water. The attraction
of such a method is that its efficiency is independent of the
active participation by the individual. Its life-long benefits are
independent of parental supervision or of "patient" co-operation.
Its effectiveness is independent of a community's socio-economic
structure. Its competency as a preventive measure is independent
of dental surgery attendance. It is infinitely cheaper than dental
treatment. It is, unfortunately, not available,