Textbook of cariology

Textbook of cariology

J. Dent. 46 1987; 1.5: 46 Printed in Great Britain Book Reviews Section Editor: P. N. Hirschmann Textbook of Cariology Edited by Anders Thyl...

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J. Dent.



1.5: 46


in Great Britain

Book Reviews



P. N. Hirschmann

Textbook of Cariology Edited by Anders Thylstrup and Ole Fejerskov. Pp. 392. 1986. Copenhagen, Munksgaard. Hardback, f 33.25. A galaxy of Scandinavian cariologists have clustered under the editorial pens of Professors Thylstrup and Fejerskov to produce a new cariology textbook for students and dental practitioners. The result is a wellwritten, carefully conceived and erudite text which deserves to be widely read by the profession. The philosophy behind the book is that dental caries can no longer be regarded as an inevitable disease, out of control of mankind. It is a disease which the dental profession can handle by active intervention to arrest the progress of tissue destruction. Such early intervention should obviate the need for operative treatment. Thus, preventive procedures should be considered as treatments which interfere with the rate of progression of tissue destruction. This philosophy has far-reaching implications for today’s practitioner who is mainly remunerated for operative intervention and given little financial encouragement to carry out preventive treatments. An opening chapter sets this philosophical scene. While the experienced clinician will understand the argument, the junior undergraduate may be baffled and a future edition would benefit from a very simple introduction to the subject. Unfortunately Chapter 2, which seeks to cover the principles of diagnosis, is even more difficult to understand and in the opinion of this reviewer requires considerable editorial attention in a future edition. Early chapters then describe relevant factors in the oral environment such as saliva and microorganisms and their metabolic activities and the role of diet. A chapter follows on the equilibrium between dental enamel and the oral environment and shows how disturbances in this equilibrium may lead to a loss of enamel mineral. The pathology of dental caries is particularly well explained and excellent chapters follow on the value of radiological examination and caries activity tests. After a chapter on epidemiology, the various treatments that will effect caries progression are described. These include oral hygiene, fluoride, antimicrobial agents and dietary counselling. Rather surprisingly, fissure sealing is not covered. Final chapters concentrate on how to measure caries progression and the biological rationale for the surgical treatment of more advanced lesions when alternative treatment has failed to arrest their progress, Most of this book is very clearly written and individual chapters can be read in isolation from the rest. The publishers have produced the book beautifully with a clear typeface and well-produced illustrations, although it

is a pity that the photomicrographs give no indication of the magnification. Dental students and practitioners will find this book useful, but all concerned with the teaching of cariology and operative dentistry may be interested to study this text and ponder the editorial philosophy. E. A. M. Kidd

Crown and Bridge Prosthodontics. D. N. Allen and P. C. Foreman. Pp. 154. 1986. Bristol, Wright. Softback, f 12.50. This paperback is described as an illustrated handbook and illustrated it certainly is, with copious small drawings accompanying a brief descriptive text, One of the dangers in a book of this kind is that illustrations are used for their own sake rather than to clarify the text, and this is indeed so in several parts of this publication. Does it, for example, really help the reader to understand the importance of a history of cardiovascular disease to see a diagram of the human heart? Or the significance of epilepsy or Parkinson’s disease by a stylized drawing of the brain? There is a tendency to concentrate on mechanics to the exclusion of the underlying philosophy. On medical history, we are told the questions to ask but not why we need the information. This approach continues throughout the first chapter with drawings of a scruffy little man smoking a cigarette to underline the importance of personal hygiene and of an ice cream cone for dietary counselling. The chapters on clinical procedures for crowns do, in general, utilize illustrations for their true value in amplifying the descriptions in the text: they are, however, light on background theory. Fixed bridgework is a large subject and it is doubtful if it can be covered adequately in such a small book. Nevertheless, this chapter is comprehensive, although rather conventional (some would say dated) in some of the views expressed. The sections on bridge design are useful and the illustrations, in general, supportive. It is disappointing that the everdeveloping subject of resin-retained bridges is only briefly covered. The case report designed to illustrate the problems of treatment planning is useful, but an illustration of the study casts and radiographs would have made understanding so much simpler: yet this is one of the few parts that is not illustrated. There is useful information and a few practical hints and tips to be gained from this book and, at f 12.00, it is certainly not expensive. It is a text, however, that will probably have limited appeal. A. R. Grieve