Cleaton-Jones, P. E.

Richardson, B. D.

English

Wits Institutional Repository on DSPACE

16 April 1977 S A  M e d i e s e  T y d s k r i f 527
Briewerubriek
Die menings gelug in die Briewerubriek van die 
SAMT is nie noodwendig die van die Mediese 
Vereniging van Suid-Afrika nie.—Redakteur.
Correspondence
The views expressed in the Correspondence pub­
lished in the SAMJ are not necessarily those of 
the Medical Association of South Africa.—Editor.
CHARGES FOR MEDICAL CONGRESSES
To the Editor: It is still customary for organizers of medical 
congresses, general and specialist, to charge entrance fees from 
doctors in full-time hospital service which are different to 
the fees for those in part- or full-time private practice. In­
variably, the private practitioner has to pay the higher sub­
scription.
This dates back to the period when there was a con­
siderable difference in the earnings of these two groups, and 
the full-time group was considered to be underpaid.
The situation now, however, has changed — the full-time 
hospital staff is better remunerated and, with overtime pay, 
to which many are entitled, their salaries, with the other 
advantages of being in full-time practice, make them quite 
as well off as most private practitioners.
In addition to this, a private practitioner who attends a 
medical congress loses his earning capacity for the duration 
of the congress. The full-time practitioner continues to receive 
his salary (although not overtime pay), and may even be 
subsidized if, for example, he delivers a paper at the con­
gress. For these reasons, I feel that this customary differen­
tial should be scrapped.
I suggest that at all congresses of the Medical Association 
or its groups, equal subscriptions should be charged, except 
for interns, who should be able to attend the congresses 
without charge.
H. Muller
812 Medical Centre 
Heerengracht 
Cape Town
RAMPANT CARIES AND LABIAL CARIES — 
SYNONYMS?
To the Editor: Caries in the deciduous dentition has received 
much attention. Workers in many parts of the world have 
studied aspects of its aetiology, especially associated factors, 
such as the use of sweetened comforters, bottle feeding, and 
its relationship to socio-economic gradings. Workers in this 
field have not failed to notice the widespread decay so often 
associated with caries in the very young, which may be so 
extensive that ‘such a process may lead to the entire destruc­
tion of the deciduous dentition by two-and-a-half years of 
age’.1 There is no doubt that this extensive caries may be 
aptly described as rampant (there is perhaps no better word), 
which is defined by Webster’s English Dictionary as ‘overleap­
ing restraint or natural bounds’.
Winter et al.,1 in a discussion of rampant caries, wrote: 
‘Although there is little universal agreement on a definition 
of rampant caries, it may be described as a lesion of acute 
onset involving many or all of the erupted teeth, rapidly 
destroying coronal tissue . . .’ These authors go on to discuss 
labial caries as merely the primary stage of a more wide­
spread disease of the deciduous dentition, which can undergo 
partial or complete arrest. Several definitions of rampant 
caries have thus arisen. Rampant caries is present if there are 
a minimum of 2 maxillary incisor teeth which either have 
carious lesions involving the labial or palatal surfaces, or 
have been extracted;1 if there is labial caries on at least 1 
deciduous incisor;2 or, according to Whitehousc.1 if a child 
has 10 or more DMF teeth, and if no attempt has been made 
to classify on the number of anterior teeth alone. Surely the 
first two descriptions fit the term ‘labial’, and the third that of 
‘rampant caries’?
In order to avoid unnecessary confusion, we feel that 
labial caries should be reported separately, and be defined as 
being present if there is a carious lesion affecting at least 1 
maxillary incisor on its labial surface. This may or may not 
occur in the presence of caries affecting 1 or more teeth on 
surfaces other than labial. The term ‘rampant caries’ should 
be defined as carious lesions present on 5 or more teeth, i.e. 
25 % of the deciduous dentition, irrespective of whether there 
is or is not labial surface involvement. The two terms are not. 
in our opinion, synonymous, and therefore a clear delineation 
may assist in avoiding the present confusion. This differen­
tiation does not preclude the fact that labial caries may well 
be the primary stage of a more widespread carious process, 
nor that a child with 5 or more carious teeth, i.e. with wide­
spread decay, but with no labial involvement, should be re­
garded as not suffering from rampant caries.
To cite an example, in a survey of dental caries in South 
Africa on 736 Black (519 rural, 217 urban) and 518 White 
children aged from 1 to 6 years, the overall prevalence of 
caries was 36,0 % in Black rural children, 47,9% in Black 
urban children, and 67,6% in White urban children. In 
children with rampant caries, defined as a DMF score of 5 
or more, prevalences were 13,7% in Black rural children, 
27,6% in Black urban children, and 34,7% in White children, 
respectively. However, the prevalence of labial carles (defined 
as caries on the labial surface of 1 or more maxillary incisor 
teeth) was 11,6% in rural Black children, 2,8% in urban 
Black children and 11,2% in White children. Thus there were 
marked differences in the prevalence of total and rampant 
caries compared with the incidence of labial caries. The two 
conditions can hardly be regarded as the same.
B. D. Richardson
National Research Institute for Nutritional Diseases of the 
South African Medical Research Council 
Transvaal Memorial Hospital for Children 
Johannesburg
P. E. Cleaton-Jones
MRC Dental Research Unit 
University of the Witwatersrand 
Johannesburg
1. W inter, G. B., Hamilton, M. C. and James, P. M. C. (1966): Arch. 
Dis. Childh., 41, 207.
2. Jackson, D ., M urray, J. J. and Fairpo, C. G. (1974): Brit. dent. J., 
137, 317.
3. W hitehouse, N. M. (1973): Dissertation for D iploma in Dental Health, 
University of Birmingham. Birmingham, England, p. 45.
MEDICAL TREATMENT OF HYPERTENSION
To the Editor: With reference to Dr Y. K. Seedat’s article,1 
I wish to point out that although the seventh edition of 
Harrison’s Principles of Internal Medicine, 1974, gives 
‘Mutabase’ as a trade name for diazoxide, the registered trade 
name in South Africa is ‘Hyperstat’.
G. W. Begg
Medical Director
Scherag (Pty) Ltd 
PO Box 46 
Isando, Tvl
1. Seedat, Y. K. (1977): S. Afr. med. J., 51, 127.


Rampant caries and labial caries - synonyms?

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Rampant caries and labial caries - synonyms?

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