T HE value ot x-ray in the tliagnosi~ ot’ dental pathology has been appreciated by a few tncn in both the dental and medical profession for a nunlber of

years. More recently the incrcasc of x-ray equipment, together \z ith consider- able literature on the subject, both in professional and lay periodicals, has won- derfully broadened the field and increased the application of this modern diag- nostic aid.

‘l’herc are still a large numi~cr oi IIICII in both t11c (1~~11Iitl and medical iraterni- ties who do Iwt avail thcmwlvc.- oi this help in diagnosis. at lca~t to a suliici~~nt extent for their own welfare. Whether this neglect is due to ignorance, habit, or an asaggcratcd opinion oi uric‘> o\vn ciiagno5tic aiJiiitF, it I\ certainly incscu5abltl. There still remain a few physicians wlw, will ~oluntcer 10 treat iracturcs \vitho111 the aid of the s-ray, ewn when radiographs arc a\.aiiahic; but through slon education, the we Oi the s-ray iias hwmc SO Lmiv~rsal, tirat the iailurc 10 pro- cure an x-ray csamination in fracture>. when pokbie, now constitutes a prima facie cause for an action oi malpracticc~. I I i> onI?- :L qucqtiotl of lime, ii tlic liillc has not alread! :lrrivccl, \vllen the faiiurc oi the dentist or I>h?4cian tll ;I\ ail 11in1- self of the aiti of the x-ray in dental conditions, will rcndcr him liable ior maI- practice to tiic 9111~ crtcnt. ‘1‘11~ 11~ c,i tiic s-r;\- tticll. i~cw.titutc.,. a form of insurance against ni;~lpractic~ suit<. anti liie premium i5 IGlitl I,>- llic p;lricnt.

The nwrk of Dr. Rowno~ ;~long IIIC lilac of hactcriai vrigiii (Ii arthritis, ulceration, appcntliciti~. gall i~iadtlcr (IiJca~c~S. c:z.. ic ianiiiiar 10 311 in t.lic pro- fession. So mucil 11;)s appcaw~i ill the I:I~ iilcraturc r~~.cnIl~ along this lint. that the public is beginning 10 dcmantl an h-r-a)- cxamiilatiOn of tiic lcctii, sonicthi(5~ even before the ~~ii\3iciari~ or cieiitist,5. Aithou~il all my \;wh ih rufcrrctl \\ork. 1 have reccntix h:1(1 s~\cr;~l c;tac> apl~t%i- for ciental raciiogrnpii~ I\-ithout lk:in< referred, ~.hen the symptoms \~crc conlined to h ~wicral join1 contlitioll< or to lhc abdominal organs. It i< certainly ~iiorc io the c.rctlit oi the :lttcnding nlall to anticiI)ntc :I IXIticY:l’, I\ isiica- iI1 tlii. i.“,q, ,II.,] 11~111 11) II:~\c. 111~ course’ oi n~~i~~ri suggested by the pntisni.

It i< 0itcn 2 (Ic.3irc ictr c~wnon~~~ 011 r11(~ 11313 oi tllc attendant when hc does nnt ask Or insist 011 :I radi(JgrafJh. Nuniernu5 ttspcricnccs ICI\-c sholvn me the fallacy of this lint, c,i prowdnrc. cl)nc ciissati5tied patient can do more harm than several picawd I)I~CS C;III &I gor~i. .\ patient wlw, ha5 hccn treated fat several ~~ccl~s or c\~*n months IIV one man and tlwn chnngcs t-o another. IYIW refers the ca.w for a raliiograph anti with it.5 aid compictes :I curt in n short time. has good rcawn 10 I;CCI IIW ;t “kr.ockcr.” .\ patient’s health is his most valued poswssion. antI 11~ \viii apprwintc your interest in his caw a5 she\\-n ti)* ynii~ &sire for all 1iic‘ iniornia!io!i pns,4hlc. cwn though llw radiograph ,gives no mntcriai aid.

T hnvc inlcntic,nail? omitted i11 the I-mly of thiq nrtiric. ~111 ctnumeration

Plea for More General Use of X-Kay

Fig. 1-A. Fig. 1-B.

Fig. I.--Typical apical abscesses.

727

Fig. Z.-Absorption of tip of root and dccalcitica- tion of surrounding alveolar process.

Fig. 3.-Small area of rarefaction (apical abscess) at tip of lateral incisor.

Fig. 4.-Small areas of rarefaction at tips of right middle and lateral incisors.

Fig. S.-Small fragment of alveolar process left after extraction of tooth and causing persistent sinus.

of the specific class of cases in which the x-ray has proved of inestimable value, as this has been ably covered time and again in recent literature. My plea is more for a general line of attack, than a plea for the use of the x-ray in any specific class of cases, and you will find this general attitude of availing yourself of all possible aids in diagnosis to rebound to your benefit.

~1 recent case \vhich came under my otlscrvatiOll. ShJ~v5 tllc \‘;dLlc Of aIlc,thcr

latmratory test. but the application is the same. A speci:ilist wit 2 C;I~C tu the

hospital one day and engaged the opcraling room for tlic folio\\-ing morning, intending to do an cstraction of all the teeth for an aggra\2tcd case 10i ~~~oI-~~Ic;L The young internc at the hospital noticed the peculiar pallor of rhc pati~,~~t ;IIIC~

Plccl for More Gencrnl L:sc of AT-Rny 729

rip. Ij.-J’rotrusion of root canal tilling. carlhing necrosis.

Pig. 16..*I.

i:ig. 16.~-Stereoscopic radiographs showing the direction of growdh of unerupted teeth.

took a blood smear, which showed an advanced typical case of leukemia. Need- less to say the operation was postponed, and well it was. for the patient died within a week, and his death would probably have been attributed to the opcra- tion, had it been done.