1) Past History
A survey on 124 pupils of a school for the handicapped in Shizuoka, Japan and 30 patients with cerebral infantile paralysis revealed disturbances durin labor such as premature delivery, difficult labor due to narrow birth canal, abnormal presentation, and coiling of the umblical cord. Many patients had history of acute febrile illness such as measles, whooping cough, and jaundice. Inability of sucking milk resulted in disturbance of general growth leading to abnormalities in the development of the jaws and teeth.
2) Measurement of the palate
The width of the palate tended to be smaller in the cerebral form than in the spinal form, while no such difference was noted in the height, indicating an abnormally intense biting pressure against the teeth during jaw movement. This might influence the maxilla of the patient in the process of growth. In an adynamic state, on the other hand, normal masticatory pressure is not exerted against the maxilla in the absence of action of muscles around the oral cavity, resulting in the height of the oral cavity.
3) Mode of development of carious teeth
Development of carious teeth was studied in 117 pupils of the school for the handicapped. More than 10 carious teeth were found in 31.4% of patients with cerebral infantile paralysis and 10.4% of patients with spinal infantile paralysis, probably due to the difficulty in nutritional intake during the suckling and infant stage, leading to nutritional disturbance and providing an unfavorable condition in odontogenesis. Marked motory disturbance of various organs in the oral cavity makes the self-cleansing of the oral cavity difficult, so that food debris remains in the oral cavity.
4) Relationship in occlusion and alinement of the teeth
The shift of midline between the upper and lower jaws seen in 20 of 25, and in all of the 11 with involuntary movement type. Torsion of the teeth was noted in 25 patients with cerebral infantile paralysis. Transposition of the teeth or crowded growth was seen in 9 of 25 cases of cerebral form, in 6 of 11 cases of involuntary movement type, and in 9 of 30 cases of spinal type. The shift of midline between upper and lower jaws was seen in 100% of the type of involuntary movement, indicating the abnormal anterior movement of the jaw and tongue especially the intense lateral and anterior-posterior movement of the jaw.
These are also probably related with the frequent occurrence of the transposition and torsion of the teeth in the alinement of the teeth.
5) Hypoplasia of the teeth
Among 79 cases of cerebral infantile paralysis and 49 cases of spinal infantile paralysis, dental hypoplasia was seen in 41.77% of patients with cerebral infantile paralysis and 24.48% of patients with spinal infantile paralysis. The frequency in the latter was much smaller than that in the former. From the past history, the frequency of appearance of a white spot appeared to be higher as the attack on the process of growth was more severe.

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For the education and management of dental health, it is important to take proper measures by understanding the number of teeth and decayed teeth of each individual as well as by grasping the points of dental problems.
For the above purpose, the author devised the value of deciduous teeth regarding decayed teeth and filled teeth as well as the existence teeth on the infants.
As the materials of the present study, a total number of 9, 296 infants were employed, their age ranged from 12 months to 5 years and 11 months, living in Tokyo.
They were divided sexually, and then, 1 year old infants were classified into four groups, that is, every 3 months old group; 2, 3 and 4 years old infants were classified into 3 groups, that is, every 4 months old group; and 5 years old infants were classified into 2 groups, that is, every 6 months old group. On each group, arithmetic mean and standard deviation were calculated on the value of existence teeth. And the width of the upper and lower ±1/2σ of the mean value was set as average, the width of upper a was set as numerous, and the width of the lower a was set as scanty.
Moreover, more than numerous was set as far numerous, and lower than scanty was set as far scanty.
As for def, decayed teeth, the value of deciduous teeth of the filled teeth, cumulative frequency distribution (%) was prepared, the snallest to 6.7% was set as far scanty, 6.8-30.9% was set scanty, 31.0-69.1 % was set as average, 69.2-93.3 % was set as numerous, and more than 93.4% was set as far numerous.
1. The value of existence teeth was clsssified into 5 divisions namely, far numerous, far scanty, average, numerous, and scanty. In view of sexual difference on the above divisions, each“division evaluating value”was more numerous in males up to 18 months old, while it was more numerous in females from 24 months old to 36 months old.
2. The value of decayed teeth and def were classified into 3 divisions, namely, far numerous, numerous and average.
Surface caries and deep seated root stump caries were classified into 2 divisions, namely, far numerous and numerous.
Also, the value of filled teeth was classified into 1 division of far numerous each.
When each was compared on sexual difference, the difference of value was very minor.

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Citrate may play a role in the transport, mobilization and perhaps deposition of calcium in bone. It is capable of rendering soluble the insoluble calcium salts. Tanner (1967) has observed that citrated rats disclosed severe porosity with alveolar atrophy and myelofibrosis accompanied by bone resorption and hyperemia of the gingiva. This indicated citrates to be directly attributed to loss of alveolar bone and intimately related to advanced alveolar atrophy. This study was designed to confirm the histopathological changes in periodontal tissues in citrated rats and simultaneously to evaluate the calcium and citrate levels in blood. Since it is known that coenzyme Q which is now generally recognized to have an important role in the electron transport system has a profound influence on the citric acid metabolism, the effect of coenzyme Q on the changes in blood and periodontal tissues found in the citrated rats were also studied.
Male albino rats of the Wistar strain, 5 to 7 weeks old and weighing 120-140 gm. were initially fed on powdered normal diet. All animals were given this diet for two weeks before the beginning of the experiment. The animals were then alloted to two groups; one group continuing with the normal diet and another group with the citrate diet which consisted of 10 gm. of sodium citrate and 10 gm. of citric acid homogenized with 80 gm. of powdered normal diet. Both normal and citrated rats were further assigned to subgroups. One subgroup of both groups served as a control. Animals in the second subgroup of both groups were given the diet added coenzyme Q₇ powder; each subgroup was fed on normal diet contained 0.005% coenzyme Q₇ and citrate diet contained 0.005% coenzyme Q₇, respectively. The experimental period lasted three months. At the end of that time the animals were given water but received no food for 15 to 18 hours before the blood was collected. After the blood collection by heart puncture the animals were stunned by a sudden blow on the head and decapitated. The mandibles were fixed to 10% formalin, and then decalcified in a solution of 5% nitric acid and formalin. They were then imbedded in paraffin, and stained with hematoxylin and eosin. The citric acid content of blood was determined by the method of Ettinger et al. (1952) and the serum calcium by the method of Kingsley and Robnett (1957).
In the citrated rats, marked osteoporosis of the alveolar bone and atrophy of the periodontal membrane accompanied by myelofibrosis were observed. These histopathological findings were alleviated by prolonged administration of coenzyme Q. Hypercitricemia with hypercalcemia found in the citrated animals were also restored to the normal level by coenzyme Q administration.

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