The Relation of Oral Infection to Mental Diseases

Cotton, Henry A.

doi:10.1177/00220345190010030201

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…The alleged evidence for the ravaging effects of the septic oral foci consisted of clinical case reports. Despite the lack of more substantial evidence supporting the theory, both the medical and the dental professions readily adopted the concept and began a virtual crusade against teeth and tonsils (46, 99), which were thought to host the septic foci. In 1918, A. D. Black enthusiastically noted that dentists are ‘coming to realize that it is their positive duty to free the mouths of patients from infection, even though this requires the extraction of a number of teeth […] This is preventive dentistry that is worthwhile, for it is cutting off at the source much systemic disease’ (37).…”

Section: The Era Of Focal Infection 1900–1950: Periodontal Disease Ismentioning

confidence: 99%

Periodontal disease epidemiology – learned and unlearned?

Bælum¹,

López²

2013

Periodontology 2000

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The notion of periodontal disease being the major cause of tooth loss among adults was rooted in the focal infection paradigm that dominated the first half of the 20th century. This paradigm was established largely by personal opinions, and it was not until the development of periodontal indices in the mid-1950s that periodontal epidemiology gained momentum. Unfortunately, the indices used suffered from a number of flaws, whereby the interpretation of the research results took the form of circular reasoning. It was under this paradigm that therapeutic and preventive intervention for periodontal diseases became entirely devoted to oral hygiene, as poor oral hygiene and older age were understood to explain nearly all the variation in disease occurrence. In the early 1980s, studies appeared that contradicted the concepts of poor oral hygiene as the inevitable trigger of periodontitis and of linear and ubiquitous periodontitis progression, whereby periodontal epidemiology was led into a relatively short-lived high-risk era. At this time, it became evident that old scourges continue to haunt periodontology: the inability to agree in operational clinical criteria for a periodontitis diagnosis and the inability to devise both a meaningful and a useful classification of periodontal diseases based on nominalist principles. The meager outcome of the high-risk era led researchers to resurrect the focal infection paradigm, which is now dressed up as periodontal medicine. Unfortunately, these developments have left the core of periodontology somewhat disheveled and deserted.

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Section: The Era Of Focal Infection 1900–1950: Periodontal Disease Ismentioning

confidence: 99%

Periodontal disease epidemiology – learned and unlearned?

Bælum¹,

López²

2013

Periodontology 2000

View full text Add to dashboard Cite

show abstract

“…The lesions in question had hitherto gone undetected and unsuspected because they were not acute, fulminating disorders 'in which the patient, by reason of pus, pain, temperature, and other symptoms, is only too well aware of the presence of infection' (Cotton (1921), p. 74; see also Cotton (1919), p. 287). Rather, the damage was done by chronic, latent, masked infections, which lurked unnoticed in the body, occasionally directly invading the tissues of the brain, but more commonly and insidiously poisoning the system through 'the toxin, generated by the bacteria and transmitted to the brain via the bloodstream' (Cotton (1921), p. 72).…”

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confidence: 99%

“…Failure in these cases at once casts discredit upon the theory, when the reason lies in the fact that we have not been radical enough' (Cotton (1919), p. 273).…”

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confidence: 99%

“…Not that the task was easy, even for the skilled physician alert to the problem:' I can state,' said Cotton,' that not only is the difficulty of locating foci of infection a tremendous one but the problem of eliminating them when found is almost stupendous. It takes patience and ability to stick to the work of elimination' (Cotton (1919), pp. 286-287) -a choice of words that was, I might add, closer to the mark than perhaps his audience realized.…”

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confidence: 99%

“…But all protests must be ruthlessly pushed aside, as short-sighted preference based upon imperfect knowledge: 'If we wish to eradicate focal infections, we must bear in mind that it is only by being persistent, often against the wishes of the patient... [that we can] expect our efforts to be successful. Failure in these cases at once casts discredit upon the theory, when the reason lies in the fact that we have not been radical enough' (Cotton (1919), p. 273).…”

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confidence: 99%

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