Imperfect use of the teeth leads to many ills. When adequately exercised and made to execute for one or two hours every day a lively dance in their sockets, during which the circulation of blood and lymph in the tooth-pulp, periodontal membrane, and surrounding tissue of the gum is vigorously stimulated, and the cavity of the mouth is bathed in a copious flow of salivary and other buccal secretions, we have conditions which make alike for the health of the buccal mucous membrane, of the teeth, and of the periodontal membrane and alveoli; but when the circulation is not duly stimulated in this way the teeth do not develop properly, while the secretions of the mouth are apt to be scanty and unhealthy, both of which conditions predispose to caries. How far dental caries is due to inherent dental weakness and how far to faulty conditions outside the teeth we need not stop to inquire; Dr. Wallace attributes little influence to the former factor, contending that caries depends essentially upon faulty dental environment; and one can scarcely doubt that the state of the gums and of the oral secretions profoundly influences the growth of bacteria in the mouth, upon the acid yielded by which organisms the corrosion of the dental enamel essentially depends.

Faulty conditions of the oral secretions likewise favour the deposit of tartar.

Another result of imperfect use of the teeth is undue thinness of the alveolar walls and periodontal membrane, in consequence of which the teeth are not so firmly held in their sockets as they should be. This is, I believe, one of the reasons why they are prone to fall out prematurely among the moderns: we know that the teeth tend to drop out in old people owing to a senile atrophy of the alveolar walls; the Haversian canals get smaller and may, indeed, disappear entirely, and it stands to reason that this atrophy must be hastened by inefficient exercise of the teeth. So far as I am able to gather from an examination of skulls in museums, the teeth are rarely shed among primitive peoples before extreme old age, while among moderns they frequently fall out long ere this is attained.

A still worse evil attaching to insufficient use of the teeth is pyorrhoea alveolaris or Riggs's disease, which, in conjunction with the deposit of tartar, is the great cause of the premature loosening and shedding of the teeth observed among latter-day civilised peoples. This affection consists of a purulent inflammation of the periodontal membrane, owing to the invasion of it by pyogenic cocci, so that pus wells up on pressing the gum against the teeth. Now, when by a vigorous use of the teeth the buccal cavity is kept well flushed with healthy secretions, the growth of micro-organisms within this chamber is kept down, and when, by the same means, the vitality of the periodontal membrane and adjacent tissues of the gum is periodically stimulated, these tissues offer stout resistance to the invasion of pathogenic organisms; but when, contrariwise, the teeth are little used, the secretions of the mouth are in consequence defective both as to quality and quantity, and the growth of organisms in the buccal cavity is promoted; and when, further, the circulation in the periodontal membrane and adjacent soft tissues is not adequately stimulated by vigorous mastication, their vitality is poor and they offer but a feeble resistance to parasitic invasion.

We can thus, I think, safely infer that inefficient mastication is a potent cause of pyorrhoea alveolaris; and the chief cause of inefficient mastication being the eating of soft foods, we must also conclude that the latter practice is chiefly responsible for the disease in question; such foods further predispose to this affection in that they are apt to lodge between the teeth and by undergoing decomposition there to favour the growth of micro-organisms within the mouth. The condition of the teeth and gums among the civilised poor is, alas, little calculated to make us proud of our boasted civilisation - the spongy pus-exuding gums, the lengthening, loose, tartar-covered, carious teeth, and the putrescent breath constitute a damning indictment against our modern system of living on a soft, pappy diet, and not giving the teeth the work for which they are designed. I never examine such a mouth without being impressed with, and I may add oppressed by, this fact.

I am not, of course, contending that pyorrhoea alveolaris only occurs in those who masticate inefficiently; whatever causes an unhealthy condition of the gums and saliva predisposes to it, but it is surely much less common in those who masticate well than in those who masticate ill. Confirmatory of this statement is the fact that it is more frequent in those with irregular teeth than in those with a good bite, who are thus able to put their teeth to more effective use. This affection is very common among the carnivora of menageries as well as among dogs and cats; indeed, one seldom fails to find it in dogs over four years of age, and in old dogs it is generally rampant. Doubtless in all these cases the general conditions of life play some part in the causation of the disease, but I do not think that we can eliminate from it the factor of defective use of the jaws and teeth, for it is certain that dogs and cats are fed largely on pappy foods and are often insufficiently supplied with bones.