"Technique of Root Amputation." TO THE EDITOR OF THE DENTAL COSMOS: Sir,―The article by Dr. Prinz in the May issue of the DENTAL COSMOS is presented in his usual masterly style and has undoubtedly been read by hundreds of your readers with the greatest interest. There are a few points, however, in the paper that are not perfectly clear to the writer, and believing that scores of others must also be in the haze, this letter is written in the hope that Dr. Prinz will make them clear. (1) After the cavity is sponged and appears "as clean as a billiard ball," why should its surface be painted with iodin? What does the iodin do to this perfectly clean and sterile surface? (2) What action upon this iodized clean and sterile surface has the surgical powder? (3) The writer says that when a broken instrument is in the canal, it is sometimes necessary to "push the obstructing agent back into the canal." Let us now analyze the conditions obtaining. The root-canal and zone surrounding the root-end are filled with organisms, etc. The end of the root is cut off, "the obstruction pushed back into the canal," the necessary curetting is thoroughly done, and the wound is practically closed. The bony sac containing the granuloma has been rendered practically free from infection, but what of the infected canal opening into this sterile cavity? Why does not the cavity become reinfected at once from the infected canal? And suppose, later on, in attempting to extricate the broken instrument which is always more or less difficult it should be pushed out of the canal, and, infected as it is, lodge in the area beyond the root-end? As a matter of fact, if the instrument could be removed through the pulp cavity after the amputation of the root-end, why was it not done in this manner before the amputation? This whole procedure appears so inexplicable that I am sure many of your readers will be glad of an explanation. "Success" is merely a relative term, as is well known. Many a surgeon has been discussing the details of a successful operation while the friends of the subject were putting flowers on the grave. When, therefore, Dr. Prinz reports two hundred cases without a single failure, it surely is in perfect order and without the slightest disrepect to the writer that we ask, What constitutes success and what constitutes failure in this operation? For thirty years the writer has been advocating the use of oxychlorid for the filling of root-canals, and so few appear to appreciate its advantages that it certainly is reassuring to have a man of Dr. Prinz' known ability indorse its use. Apicoectomy, as it is most commonly called, appears to be of so very much interest to the entire profession today that it is hoped this discussion of Dr. Prinz' paper will be accepted in the spirit in which it is offered. With many men it appears to be a commonplace operation; many others are contemplating taking it up. Dr. Prinz' paper must appeal to the latter class, and with these doubtful points more fully explained by him, it should furnish all novices with all the instruction they desire. Respectfully, C. EDMUND KELLS, D.D.S. NEW ORLEANS, May 3, 1918. THE DENTAL COSMOS A MONTHLY RECORD OF DENTAL SCIENCE. Devoted to the Interests of the Profession. EDWARD C. KIRK, D.D.S., Sc.D., LL.D., Editor. L. PIERCE ANTHONY, D.D.S., Associate Editor. PUBLISHED BY THE S. S. WHITE DENTAL MFG. CO., PHILADELPHIA, PA. SUBSCRIPTION PRICE, including postage, $1.00 a year to all parts of the United States, Hawaiian Islands, the Philippines, Guam, Porto Rico, Virgin Islands, Cuba, and Mexico. Canada, $1.40. To other foreign countries, $1.75 a year. Original contributions, society reports, and other correspondence intended for publication should be addressed to the EDITOR, Lock Box 1615, Philadelphia, Pa. Subscriptions and communications relating to advertisements should be addressed to the BUSINESS MANAGER of the DENTAL COSMOS, Lock Box 1615, Philadelphia, Pa. PHILADELPHIA, JUNE 1918. EDITORIAL DEPARTMENT Industrial Dental Service. THE Conspicuous progress which has characterized dental activity since our country entered the world struggle in the cause of democracy is without parallel. To provide for our military forces the benefits of dental and oral surgical service has not only taxed dental resources to the limit for the time being, but the demand, implying as it does practical recognition by our governmental administration of the indispensable character of dental service in the efficient conduct of the war, has stimulated wide interest in the larger problems of dental service and the importance of dental and oral conditions as related to the general health. As a direct consequence of the growing interest in dentistry as a health factor and the direct bearing of mouth hygiene upon human efficiency, the question of the economic relations of dental [VOL. LX.-35] welfare service in the productive industries is a problem which is more and more engaging the attention of industrial interests. From philanthropic motives much has been done toward bringing dental service, especially in the larger centers, within reach of that large portion of our population that is financially unable to pay for dental service. Municipal clinics, public school and dental college clinics do much in taking care of the dental ills of those unable to pay a normal fee for dental care. The active propaganda which has resulted in the wide dissemination of knowledge of the importance of oral hygiene has produced results which cannot fail to accomplish much in improving the general health standard of our population. It is to be noted, however, that the animating motive of the general oral hygiene propaganda was, in its initial stages at least, largely humanitarian and philanthropic. As experience began to bear fruit it soon became evident that reasons other than prevention and relief of suffering justified the claims of dental service for consideration as a public welfare measure. The relief of dental disorders was quickly seen to have eliminated a factor of physical disability which, particularly in the case of the unhygienic mouth, constituted a positive interference with physical and mental efficiency. Dental and oral hygiene work in public schools demonstrated the improvement which practical oral hygiene produced in the mental and physical efficiency of the pupils, and the relief of many cases of actual retardation due to dental defects among school children furnished conclusive evidence of the dental origin of their retardation. It is today well recognized that humanitarian considerations alone amply justify the encouragement if not the practical enforcement of oral hygienic measures among children of school age, but in consideration of the fact that by far the greater number of them are educated at the expense of the taxpayer, and that retardation by reason of physical or mental disability entails an augmented tax for educational purposes, the economic factor becomes an added and cogent reason for effective oral hygiene work among public school children. It is this economic element that is stimulating an active interest in the industrial phase of oral hygiene work. The managers of business enterprises are sensitively sympathetic toward any and all plans and activities that give fair promise of reducing costs and increasing efficiency. The conviction is growing that the working capacity of a body of employees as to both kind and amount of output is directly related to their physical and mental health standards. Hence the rapid growth of various phases of welfare service in connection with large business establishments. Among these, dental service is taking its proper place. At the Congress of the National Safety Council held in Detroit in October 1916, Dr. Lee K. Frankel of the Metropolitan Life Insurance Co. of New York presented a report on "Dental Work in the Industries" based upon a survey of some twenty-seven establishments which provided dental service for their employees. Since that date the work has been largely expanded, though figures representative of the present stage of development are not at this time available. This activity has developed to a point where it could well profit by organization with a view to bringing together for conference and mutual improvement the whole body of dental surgeons who are specializing in this field. Such an organization in medicine is already actively at work within medical lines. The American Association of Industrial Physicians and Surgeons was organized at Detroit in June 1916 in conjunction with the American Medical Association. One hundred and fifty members were in attendance. Its objects are to interest industrial physicians in a common purpose to put industrial medicine and surgery on a higher plane and to interest the general medical profession in the activities of industrial physicians and surgeons. At the 1917 New York meeting of the A. M. A. the membership of the American Association of Industrial Physicians and Surgeons had increased to three hundred and fifty. Its next meeting will be held in Chicago June 10th. In view of the common purpose involved it would seem desirable and practical to form a society of Industrial Dental Surgeons in affiliation with the general medical organization, dealing as it does with the broad question of the physical well-being of industrial employees. To further the plan of organization herein suggested, the DENTAL COSMOS will be glad to receive from its readers the names and addresses of industrial concerns within their knowledge which have already provided dental treatment for employees as a feature of their welfare service, and the names and addresses of dental practitioners who are engaged in industrial welfare work. As the public service relations of dentistry are developing so rapidly in such a variety of ways, it would seem to indicate the desirability of creating in our National Dental Association a division dealing with the Public Service Relations of Dentistry, having its subdivisions of military, school, eleemosynary, and industrial dental service. The present sectional division of National Dental Association work has outgrown its practical usefulness as the profession itself has outgrown its swaddling-clothes. A Correction. IN the signature of Dr. C. W. RATCHEFF of Chicago to his interesting communication, "A Case of Tooth Gemination," published in our April issue, page 300, his name was inadvertently printed "BATCHEFF." BIBLIOGRAPHICAL A HANDBOOK OF ANTISEPTICS. By HENRY DRYSDALE DAKIN, D.Sc., F.I.C., F.R.S., and EDWARD KELLOGG DUNHAM, M.D., Emeritus Professor of Pathology, University and Bellevue Hospital Medical College. Pp. 129. Cloth, price $1.25. New York: The Macmillan Co. 1917. In this little volume of 129 pages the authors present in a very convenient form a rehearsal of the most approved chemical antiseptics as they are employed in the present war. In a general discussion of the members of the aromatic series (e.g. phenol), the heavy metals, aniline dyes, atomic oxygen (hydrogen peroxid), boric acid, iodin, etc., the authors present a more intimate study of the various members of the chlorin group. Of these, the chloramins receive the bulk of attention, as it is here that the authors have carried out their important research work. Of all the known chemical disinfectants, chlorin, freshly prepared and in the presence of moisture and a suitable temperature, possesses the greatest known germicidal power. Chlorin forms the active constituent of Labarraque's solution, Javelle water, antiformin (dental radicin), electrozone, (or dental meditrina), and of the antiseptic solution so successfully employed at present in the English and French war hospitals according to Dakin's formula by the Carrel method. The great success obtained with Dakin's solution rests primarily upon the fact that a fresh preparation according to a specific method is employed, which, while acting deleteriously on the germs, does little harm to the tissue cells, as it |