The Chiropractor
D. D. Palmer

    Pyorrhea alveolaris has been extensively written upon by Fauchard, Riggs and many others; it is known as Fauchard’s disease, also Riggs’ disease.

    Alveolar pyorrhea is an oozing of pus from beneath the gum margins; a resorption of the alveolar borders, with progressive loosening of the affected teeth, and a deposition of calcic matter, calcium, lime, known as calculi, upon the surface of the denuded roots.  With the loss of teeth these morbid conditions cease.  It is a disease of adult life, seldom found before the age of thirty years, owing to the pliability of nerve tissue during youth.  Nerve tissue becomes firmer, less elastic, as age advances, therefore it does not so readily adapt itself to heat modifications.  Pus is composed ot leucocytes, white corpuscles.  The proportion of white and red corpuscles varies slightly in different persons in health, in various portions of the body and at different ages in the same individual, owing to slight deviations of temperature; the normal amount is one of white to 700 of red.  In fever the per cent of erythrocytes is increased.  When the temperature goes below 98 degrees the proportion of leucocytes is increased.  Alveolaria is pertaining to the alveoli.  The alveola is the socket in which the tooth rests.  Pyorrhea alveolaris refers to a discharge of pus from the opening in which the tooth is held.  Pyorrhea is a disease of the dento-alveolar joint, a gomphosis articulation, one in which a conic process is held in place by a socket, which permits a certain degree of motion.  Extraction of the teeth puts an end to the disease by eliminating this membranous joint; it removes, with the teeth, the intervening pericementum.  An inflammation of this membrane is known as pericementitis.  Alveolitis is an inflammation of the alveoli, the bone surrounding the roots of the teeth; the alveoli become necrosed because of too much heat.  Alveolar periostitis is an inflammation of the alveola periosteum.  The periosteum is a thin vascular membrane of the alveoli, closely adhered to and covering the outer surface of the pericementum.  The function of the periostrum is to nourish the alveoli by vasa vasorum.  This vascular circulation is controlled by and thru the nervi vasorum.  Osteo-periostitis is an inflammation of the bone and its periosteum.  Interstitial gingivitis is an inflammation of the gums, more especially the tissue between the gum and the teeth.  The teeth become loose, the gums red and swollen and sensitive.  The gums are composed of dense fibrous tissue covered by mucous membrane, are richly supplied with blood vessels, but sparsely with nerves.  Around the neck of the teeth, at the gingival, the gum forms a tree overlapping collar, the dental ligament, where it is freely supplied with nervous papilla, visible to the naked eye.  Cementoperiostosis is an inflammatory condition of the cementum of the teeth.  Cementum is the outer cortical substance, the substantia ossea, the crusta petrosa, the rocky crust, a form of modified bone, which covers the roots of the teeth and answers a similar purpose as does the periosteum of the alveoli.  The alveoli-dental pericementum, peridental membrane, or root membrane, is a vascular layer of connective tissue attached to and lying between the periosteum of the walls of the alveoli and the cementum of the roots of the teeth.  When the pericementum, which is well supplied with blood vessels and nerves, is inflamed, it becomes swollen and very sensitive.  The tooth, as a result of the swelling, is pushed partly out of its socket, its crown projects above those of its neighbors, and strikes against the opposite tooth, causing pain and much annoyance.  The alveolar periosteum is firmly united to the root cementum by perforating fibers, establishing a communication of blood vessels and nerves between the jaw and the teeth. Pericementitis is an inflammatory condition of the peridental membrane.  The pericementum, the interstructural membrane, is composed of white fibrous tissue, interlaced with blood vessels,  nerves and glands; it is, therefore, liable to be inflamed, as other membranous tissue.  It subserves the purpose of a ligament, similar as the pericranium performs in the sutures of the cranial bones.  The same blood vessels and nerves supply the periosteum, pericementum and cementum.  Periostitis, gingivarium, is an inflammation of the gums and their surroundings.  Ulitis is an inflammation of the gums.  Gingivitis expulsiva is the gradual loosening and expulsion of a tooth or teeth from their sockets.

    The teeth are composed of four specialized tissues -- enamel, dentine, crusta petrosa and the pulp.  Between the root of the tooth and the alveolar process are the cementum and the periosteum, interposed between the latter two membranes is the pericementum.  The roots of the teeth have small apertures in their apices, which transmit blood vessels and nerves to the pulp cavity, which is filled with pulp.  The sockets of the alveoli are lined with periosteum, covering them closely, and intimately uniting the cementum with the fibrous structure of the gums.

    The pathological condition of cementoperiostosis is slow progressive expulsion of the teeth.  If the M.D.’s had this disease to treat they would class it among the incurable -- etiology obscure.  Some dental authors ascribe decayed teeth as the cause, altho they know that most of the teeth so expelled are perfectly sound.  Were they correct in their etiology of this cementoperiostitic condition that periodontitis is caused by any one of the fifteen lesions given by dental authors, it would be an unexplainable explanation, for we would want to know the cause of dental caries.

    Pyorrhea and dental necrosis should be classed as two separate conditions, two different nerves impinged upon, creating two distinctly different morbid conditions of tissue and dissimilar abnormal functions.

    The dental profession has made much study of this disease known by several names.  They have no trouble in designating the parts affected; the morbid conditions and symptoms are readily apparent.  They are well acquainted with the pathological functions and morbid tissue, but as to the cause of the morbid changes in and around the alveoli, they are unable to give us any light thereon.  Its etiology remains obscure.  Many, very many, remedies have been tried in vain.

    The body is composed of myriads of cells; the teeth and their surroundings are no exception.  These have the quality of form alteration; they possess the ability to contract and expand, known as latent energy.  This energy is controlled and modified by heat; the amount of heat is determined by nerve-vibration, heat being a function of nerves.  Extremes of temperature, above or below normal, softens or hardens tissue, induces necrosis or sclerosis.  A living organism, or any of its organs, possess a certain degree of action and function, a condition when normal known as health.  When functions are raised or lowered from the general average, a condition of disease exists. Nerve irritation increases temperature.  Cell metabolism is a heat production.  Energy is stored in the cells of organs as a latent agent ready to be used as a functional force directed by impulses.  Extremes of heat and cold induce the various phases of inflammation by contracting nerve tissue longitudinally.  Heat within certain defined limits is essential to the development of all organized beings.  Excessive heat when applied to tissue, external or internal, causes its expansion, converts it from the solid into the fluid state.  Any interference with the normal response of an impulse results in morbid physiology -- pathology.
    All functions in any degree are controlled by and dependent upon nerve impulses.  Fear causes a contraction of the blood vessels of the head and face; shame and anger a dilation of the same vessels; these two conditions are the result of nervi vasorum force on the vaso vasorum.  With the cessation or the disappearance of the emotional state, the blood vessels return to their former degree of contraction.  The flushed condition shown by redness and excessive heat is the result of an accumulation of blood in the capillaries.  The whitened, colorless, pallid cuticle is from a lack of ordinary nerve vibration; undulation is dependent upon excitation of nerves.

    Alveola pyorrhea is always associated with nephritis, an inflammatory condition of the kidneys.  For many years I observed that every patient having pyorrhea of the gums had Bright’s disease, but not every one affected with nephritis has alveolar pyorrhea.  Fibers of the twelfth pair of dorsal nerves go to and innervate the kidneys, gums and eyelids.

    Inflammatory disturbances involve an interstitial gingivitis, an infiltration of leucocytes into the interstices of connective tissue of the gum.  When inflammation is confined to the margin of the gums adjoining the necks of the teeth, it is specialized as marginal gingivitis.  The effect of a low-grade inflammation is the ossifying or resorption of the cementum, substantia ossea dentium, the crust of osseous substance covering the roots of the teeth or periosteum of the bones.

    The alveolar process is that portion of the maxillary bone which surrounds and supports the tooth.  The surface of bone lining the alveolus is pierced by many passsages for blood vessels which furnish nutriment to the pericementum and cementum.  These contain in the musculature a plexus of vaso-motor nerves, vasoconstrictors and vaso-dilators, which control dilation of the blood vessels.  In the physiologic condition these fibers are in a state of continual contraction, giving to the arteries and veins a certain average caliber which not only permits, but by normal impulsive force causes a definite volume of blood to flow thru them in a given unit of time.  The tonic contraction and expansion, diastole and systole, is due to and modified by the amount of heat, a result of nerve vibration.  The tonicity of the vascular muscles is subject to increase or decrease in accordance to the quantity of nerve vibration and heat production; these are always correspondent in their amounts.  Increased contraction results in a decrease of diameter of blood vessels and a reduction in the outflow of the blood.  The small arteries thus determine the volume of blood passing to any given area or organ in accordance with its functional activities.  The vaso-motor nerves pass directly from the spinal nerves to the muscle-fibre through the inseparable, vibratory nerve-movement and the resultant heat therefrom, the internal diameter of the blood vessels and the volume of the blood are accurately adapted to the needs of each organ.  During the rest and activity the blood vessels and nerves maintain a constant tone, normal renitency, elasticity, activity, strength and excitability, as observed in a state of health.

    The nerves of the pericementum are derived from the fifth cranial or trigeminal nerve and the sympathetic nervous system; they enter by the apical tissue and the alveolar wall.

    Lippincott says, Exostosis (hypercementosis), pyorrhea, alveolaria, necrosis of the jaw (alveolar cancer), recession of the gums, stomatitis (inflammation of the mouth), gingivitis and gum boils, are due to inflammation of the tissues around the teeth.

    It is true, all of these morbid conditions are attended by inflammation, are the result of excessive heat.  Chiropractically, these diseases should be placed in three classes: Pyorrhea, recession of the gums; gingivalgia, pain in the gums, and gingivitis, inflammation of the gums.  Gingivalgia, pain in the gums, and gingivitis, inflammation of the gums, are because of an impingement on the twelfth pair of dorsal nerves, while hypercementosis, caries of the teeth, alveolar burrowing abscesses, toothache and gum boils are due to an impingement on the third pair of cervical nerves.  Stomatitis can be relieved by removing pressure from off the right fifth dorsal nerve.

    The dental profession give as probable causes of gingivitis that of uric acid diathesis, mercurial poisoning, gonorrheal infection, bacteria, drug action, faulty metabolism, auto-intoxication, irritants in the blood and disturbed peripheral nutrition, as systemic causes; that of malocclusion, overuse and disuse of the teeth, as mechanical excitants, and a lack of, or an excess of, friction, and fermentable material lodged about the necks of the teeth, as local causes.

    I discovered and have proven by relieving a number of cases that expulsive gingivitis is caused by inflammation of the twelfth pair of dorsal nerves, a portion of the fibers of which ramify the gums as nervi vasorum.  A relief of this nervous affection may be had by removing the impingement on these nerves.

    Burchard’s Dental Pathology states: “In cases of hypercementosis it is assumed that the source of irritation is pressure upon the nerves of the pericementum by the hypertrophic growth.  Very widespread disorders may arise from this source.”

    Burchard assumes that widespread disorders (spreading over many and varied conditions of disease) of the teeth and gums may arise from pressure upon nerves.  Chiropractors do not, or, at least should not, assume the source of irritation.  They should know the origin of disease, and be scientific as well as efficient in the art of adjusting.

    Burchard mentions trifacial neuralgia as being a reflex disturbance from pressure upon nerves.  Trifacial neuralgia includes odontalgia, toothache and neuralgia maxillaris.

    A reflex action is one executed without consciousness.  Such movements are accounted for by chiropractors as a bounding back -- a return of an impulse -- a motor, impulsive response to a sensory impulse -- the conveyance of an impression to the central nervous system and its transmission thru a motor nerve to the periphery.  A reflex or reflected pain, according to pathologists, is one referred to some location other than that of its origin.  This definition, if accepted by chiropractors, would define all pains as being reflex, originating in one locality by an impingement on a nerve, and its expression of disease, in another area, at its peripheral ending.

    Dental neuralgia, odontalgia, toothache and dental caries arise from nerve excitation of the third pair of cervical nerves, the cause of inflammatory conditions, while that of the hard tissue of the gums because of pressure on the twelfth pair of dorsal nerves, the cause of dental neuralgia and caries, can be traced to the third pair of cervical nerves.

    Through the intestinal sympathetic connection of the fifth cranial nerve with the seventh, ninth and tenth cranial nerves, salivary, muscular, nervous, alimentary and pulmonary disturbances become possible.

    Pathological dentition readily demonstrates the relationship existing between pressure-impingement, irritation, inflammation and their “reflex disturbances.”  Increased dental temperature stimulates the salivary glands, increases the flow of saliva, creates a disturbance of funcitonal activity -- functions performed in excess is disease.

    Fever is diffused inflammation.  Temperature above that of normal creates disease.  Impulsive nerve-vibration determines the amount of heat.  The degree of heat of the body of a living being regulates the amount of function.  Functions performed above or below normal creates conditions known as disease.

    Burchard affirms: “Neuralgia pain is a condition produced thru the overexcitation of any portion of a sensory nerve.  The causes should be sought for and, if possible, removed.”  Chiropractors are able to locate the cause of nerve overexcitation and relieve toothache in less than a minute by the removal of pressure.

    Burchard tells us that overuse, abuse and disuse of the teeth are causes which produce inflammation of the pericementum (interstitial gingivitis), inflammation of the gums, resulting in purulent or non-purulent liquefaction (necrosis) of the gingival (gum) portion of the pericementum (pyorrhea alveolaris).

    Burchard blames dental irritation for gout, obstinate pains in the toes and fingers, also sciatica, ovarian and uterine neuralgia.  He speaks of violent attacks of trifacial neuralgia as a common reflex disturbance from functional disorders of the eye and ear, and motor disturbances of chorea, epilepsy, paralysis, malaria, syphilis and amenia as producing neuralgia.  The same old Allopathic explanation -- one disease produces another.  He fails to grasp the fact of nerve-distribution, that a nerve is composed of one or more fibers, which ramify one or more areas, consequently one or more affections, in as many parts of the body, may arise from one impingement upon a nerve containing many fibers.  He maintains that neuralgia pains in the teeth are because of pressure on exposed dentine, that pulp degeneration as a cause of affections outnumber all others.

    Dentists and physicians are alike in ascribing one disease as the cause of another, and, that other is the cause of the one, simply from the fact that two or more affections are frequently associated together.  Chiropractors elucidate this heretofore mysterious connection of morbid anatomy and functional variation of two or more organs, collectively known as disease.