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Fig. 13. Explorer and scraper ("Bass' 55") for exploring, scraping and securing material from gingival crevices and periodentoclasia lesions.

The material is spread in a small area (2 to 5 mm. in diameter is enough) upon a microscope slide. Removal of the small amount of material from the blade of the explorer and spreading it upon the slide can be facilitated by the use of some kind of teasing needle or other small pointed instrument. Several such specimens from different crevices can be placed at different locations on one slide, and all stained and examined at the same time. The author usually mounts on one slide for examination all the specimens taken at a sitting from a given subject.

The slide is ready for staining and examination. Any one of many staining methods may be used satisfactorily. A good one for general purposes is as follows: (1) Fix with heat; (2) Carbol fuchsin one-half minute; (3) Rinse; (4) Crystal violet one-half to one minute; (5) Wash, dry and mount in oil for examination.

Pus and other cells are satisfactorily seen with the low power (16 mm.) objective. Higher powers and the oil immersion objective are needed for study of the bacteria, spirochetes and ameba (Endameba buccalis) that may be present.

Widespread Prevalence of Periodontoclasia

Periodontoclasia is practically a universal disease. There are suppurating lesions about some or all of the teeth of all people except those who have learned and follow the necessary personal oral hygiene to prevent the disease. Anyone who is interested can confirm this by examining, as indicated above, material from his own interproximal gingival crevices, and from those of others.

Inflamed and ulcerated inner surfaces of the free gingiva bleed easily from the slightest force or manipulation. Uninflamed epithelial surfaces do not bleed Therefore "bleeding gums" can be considered practically diagnostic of inflammation and ulceration—the early stage of periodontoclasia.

In view of the widespread prevalence of this disease it is hardly necessary, for diagnostic purposes, to make microscopic examinations for pyorrhaea, as suggested above. It can be assumed to be present about some of the teeth of practically all adults and most younger people. During a period of several years the author has examined a considerable number of people, mostly medical students and other university personnel. In no instance has he failed to find pus from some of the gingival crevices, and also one or more demonstrable lesions where some receding of the gingival attachment has taken place. This experience, which will be confirmed by those who employ appropriate technic, indicates the extensive prevalence of the disease, the inadequacy of the oral hygiene procedures presently in general use and the need for a better method.

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