Talk:Focal infection theory

Modern version?

The 2009 Textbook of Endodontology by Gunnar Bergenholtz, Preben Hørsted-Bindslev, Claes Reit putlich by Wiley page 135-136 states: "...in spite of lack of scientific evidence the dental focal infection theory never died (40, 42). The references are O'Reilly (2000) "A history of Oral sepsis as a cause of disease" Periodentel 2000 23:13-18 and Pallashe TJ (2000) "The focal infection theory: appraisal and reappraisal" California Dental Association Journal 28: 194-200

However, Saraf (2006) Textbook of Oral Pathology Jaypee Brothers Medical Publishers pg 188 is far more interesting as it says "It is becoming more validated that the oral cavity can act as the site of origin for spread of pathogenic organisms to organisms to distance body areas,..."

Henderson, Brian; Michael Curtis, Robert Seymour (2009) "Periodontal Medicine and Systems Biology", Wiley; Page 33 states: "This is why the dental and medical communities are cautiously reconsidering the biological plausibility of the 'focal infection' theory."

So was focal infection theory as a whole "completely unproven" or was it only in regard to tooth infections?--BruceGrubb (talk) 20:36, 22 October 2010 (UTC)

Bruce I think the claims made at the time were considered completely unproven, or at least that's what the source says. I haven't gotten to the surviving bits part yet, nor to the renewed interest. I'll try to work on that now.Griswaldo (talk) 16:05, 23 October 2010 (UTC)

"A large percentage of the population became denture wearers, and the focal-infection theory was thrown out. It was, of course, wrong to extract good teeth, but in looking back a great many members of the dental profession are beginning to think it was just as wrong to discard the theory entirely."(Cranin, A. Norman DDS (1971) The modern family guide to dental health)

"Additionally, recent evidence associating dental infections with atherosclerosis and other chronic diseases has also helped resurrect the focal infection theory." (Silverman, Sol; Lewis R. Eversole, Edmond L. Truelove (2002) Essentials of oral medicine PMPH usa; Page 159)--BruceGrubb (talk) 23:03, 30 October 2010 (UTC)

Insane amount of refererences

I found an article on modern focal infection theory ((2001) Fowler, Edward B "Periodontal disease and its association with systemic disease" Military Medicine (Jan 2001)) which as a ridiculous number of references which I am including so we can use them to better this article:

Manila K, Neiminen M, Valtonen V, et al: Association between dental health and acute myocardial infarction. Br Med J 1989; 298: 779-82.

DeStefano F, Anda RF, Kahn HS, et al: Dental disease and risk of coronary heart disease and mortality. Br Med J 1993; 306: 688-91.

Beck J, Garcia R, Heiss G, et al: Periodontal disease and cardiovascular disease. J Periodontol 1996; 67: 1123-37.

Offenbacher S, Katz V, Fertile G, et al: Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996; 67: 1103-13.

Oliver RC, Brown LJ: Periodontal diseases and tooth loss. Periodontol 2000 1993; 2: 117-27.

Genco RJ: Current view of risk factors for periodontal diseases. J Periodontol 1996; 67: 1041-9.

Salvi GE, Lawrence HP, Offenbacher S, et al: Influence of risk factors on the pathogenesis of periodontitis. Periodontol 2000 1997; 14: 173-201.

Kornman KS, Crane A, Wang HY, et al: The interleukin- 1 genotype as a severity factor in adult periodontal disease. J Clin Periodontol 1997; 24: 72-7.

Hart TC, Kornman KS: Genetic factors in the pathogenesis of periodontitis. Periodontol 2000 1997: 14: 202-15.

Brown WI, Brunelle J, Kingman A. Periodontal status in the United States, 1981-91: prevalence, extent and demographic variations. J Dent Res 1996; 75: 672-83.

Brown LI, Oliver RC, Lbe H: Periodontal diseases in the U.S. in 1981: prevalence, severity, extent, and the role in tooth mortality. J Periodontol 1989; 60: 363-70.

Brown LI, Oliver RC, Loe H: Evaluating periodontal disease status of U.S. employed adults. J Am Dent Assoc 1990; 121: 226-32.

Darveau RP, Tanner A, Page RC: The microbial challenge in periodontitis. Penodontol 2000 1997; 14: 12-32.

Socransky SS, Haffajee AD, Cugini MA, et al: Microbial complexes in subgingival plaque. J Clin Periodontol 1998: 25: 134-44.

Offenbacher S: Periodontal diseases: pathogenesis. Ann Periodontol 1996; 1: 821-78.

Page RC, Offenbacher S, Schroeder HE, et al: Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontol 2000 1997; 14: 216-48.

Paquette DW, Madianos P, Offenbacher S, Beck JD, Williams RC: The concept of "risk" and the emerging discipline of periodontal medicine. J Contemp Dent Pract 1999; 1: 1-19.

Miller WD: The human mouth as a focus of infection. Dental Cosmos 1891; 33: 689-713.

Hunter W: Oral sepsis as a cause of disease. Br Med J 1900: 1: 215-6.

Billings F: Chronic focal infections and their etiologic relations to arthritis and nephritis. Arch Intern Med 1912; 9: 484-98.

Mayo CH: Focal infection of dental origin. Dental Cosmos 1922; 64: 1206-8.

Galloway CE: Focal infection. Am J Surg 1931; 14: 643-5.

Cecil RL, Angevine DM: Clinical and experimental observations on focal infection with an analysis of 200 cases of rheumatoid arthritis. Ann Intern Med 1938; 12: 577-84.

Editorial. JAMA 1952; 150: 490.

Page RC: The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol 1998; 3: 108-20.

Haffajee AD, Socransky SS: Microbial etiological agents of destructive periodontal diseases. Periodontol 2000 1994; 5: 78-111.

Murray M, Moosnick F: Incidence of bacteremias in patients with dental plaque. J Lab Clan Med 1941: 26: 801-2.

Silver JG, Martin AW, McBride BC: Experimental transient bacteremias in human subjects with varying degrees of plaque accumulation and gingival ilammation. J Clin Periodontol 1980; 4: 92-9.

Sconyers JR, Crawford JJ, Moriarty JD: Relationship of bacteremia to toothbrushing in patients with periodontitis. J Am Dent Assoc 1973; 87: 616-22.

Slade GD, Pankow JS, Offenbacher S, et al: Acute-phase inflammatory response to oral and systemic conditions [abstract]. J Dent Res 1999; 78: 2192.

Expert Committee on Maternal and Child Health: Public Health Aspect of Low Birth Weight. Technical report series, no. 27. Geneva, World Health Organization, 1950. 32. National Center for Health Statistics: Advance Report of Final Natality Statistics, 1991. Monthly Vital Statistics Report, Vol 42, Suppl. Hyattsville, MD, Public Health Service, 1993.

National Center for Health Statistics: Health, United States, 1982, DHHS publication (PHS) 83-1232. Washington, DC, US Government Printing Office, December 1982.

Committee to Study the Prevention of Low Birthweight, Division of Health Promotion and Disease Prevention, Institute of Medicine: Preventing Low Birth Weight. Washington, DC, National Academy Press, 1985.

Patrick MJ: Influence of maternal renal infection on the fetus and infant. Arch Dis Child 1967: 42: 208-13.

Minkoff H, Grunebaum AN, Schwarz RH, et al: Risk factors for prematurity and premature rupture of membranes: a prospective study of the vaginal flora in pregnancy. Am J Obstet Gynecol 1984; 150: 965-72.

McDonald HM, O'Loughlin JA, Jolley P, et al: Vaginal infection and preterm labour. Br J Obstet Gynaecol 1991; 98: 427-35.

Hillier SL, Martius J, Krohn M, et al: A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 1988; 319: 972-8.

Gibbs RS, Romero R, Hillier SL, et al: A review of premature birth and subclinical infection. Am J Obstet Gynecol 1992; 166: 1515-28.

Collins JG, Windley HW 3rd, Arnold RR, et al: Effects of a Porphyromonas gingivalis infection on inflammatory mediator response and pregnancy outcome in hamsters. Infect Immun 1994; 62: 4356-61.

Collins JG, Kirtland BC, Arnold RR, et al: Experimental periodontitis retards hamster fetal growth [abstract]. J Dent Res 1995; 74:1171.

Offenbacher S, Jared HL, O'Reilly PG, et al: Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol 1998:3: 233-50.

Offenbacher S, Madianos PN, Suttle M, et al: Elevated human IgM suggests in utero exposure to periodontal pathogens [abstract]. J Dent Res 1999; 78: 2191.

Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, et al: Myocardial infarction and coronary deaths in the World Health Organization MONICA Project: registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 1994; 90: 583-612.

Beck JD, Offenbacher S, Williams R, et al: Periodontitis: a risk factor for coronary heart disease? Ann Periodontol 1998; 3: 127-41.

Umino M, Nagao M: Systemic diseases in elderly dental patients. Int Dent J 1993; 43: 213-8.

Nery EB, Meister F Jr, Ellinger RF, et al: Prevalence of medical problems in periodontal patients obtained from three different populations. J Periodontol 1987; 58: 564-8.

Syijdnen J, Peltola J, Valtonen V, et al: Dental infections in association with cerebral infarction in young and middle-aged men. J Intern Med 1989; 225: 179-84.

Kweider M, Lowe GD, Murray GD, et al: Dental disease, fibrinogen and white cell count: links with myocardial infarction? Scott Med J 1993; 38: 73-4.

Manila KJ, Valle MS, Nieminen MS, et al: Dental infections and coronary atherosclerosis. Atherosclerosis 1993; 103: 205-11.

Manila KJ, Valtonen VV, Nieminen M, et al: Dental infection and the risk of new coronary events: prospective study of patients with documented coronary artery disease. Clin Infect Dis 1995; 20: 588-92.

Genco R, Chadda S, Grossi S, et al: Periodontal disease is a predictor of cardiovascular disease in a NativeAmerican population . J Dent Res 1997: 76: 3158.

Joshipura KJ, Rimm EB, Douglass CW, et al: Poor oral health and coronary heart disease. J Dent Res 1996; 75: 1631-6.

Offenbacher S, Beck JD, Elter J, et al: Periodontal status of cardiovascular disease subjects [abstract]. J Dent Res 1999; 78: 2190.

Herzberg MC, Weyer MW: Dental plaque, platelets, and cardiovascular diseases. Ann Periodontol 1998; 3: 151-60.

Erickson PR, Herzberg MC: The Streptococcus sanguis platelet aggregation-associated protein: identification and characterization of the minimal platelet-interactive domain. J Biol Chem 1993; 268: 1646-9.

Genco RJ, Wu TJ, Grossi SG, et al: Periodontal microflora related to the risk for myocardial infarction /abstract]. J Dent Res 1999: 78: 2811.

Zambon JJ, Haraszthy VI, Grossi S, et al: Identification of periodontal pathogens in atheromatous plaques [abstract]. J Dent Res 1997: 76: 3159.

Buja LM: Does atherosclerosis have an infectious etiology? Circulation 1996; 94: 872-3.

Ebersole JL, Machen RL, Steffen MJ, et al: Systemic acute-phase reactants, C-reactive protein and haptoglobin, in adult periodontitis. Clin Exp Immunol 1997: 107: 347-52.

Ridker PM, Cushman M, Stampfer MJ, et al: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336: 973-9.

Guyatt GH: Users guide to the medical literature. JAMA 1993; 270: 2096-7.

Annals of Periodontology, Vol 3, No 1. Chicago, American Academy of Periodontology, July 1998.

That is the exact order it is in and should provided us with more than enough to work with.--BruceGrubb (talk) 14:46, 28 October 2010 (UTC)

• More refs on FI

Price

Any reason Weston Price isn't mentioned once? --THE FOUNDERS INTENT ^PRAISE _{GOOD WORKS} 16:31, 28 October 2010 (UTC)

I was looking mainly for modern references regarding the theory. Price's work on focal infection theory in a 1925 article seems cautionary in it statements. It seems to indicatr that he had a more moderate view and that move studies needed to be done.--BruceGrubb (talk) 04:05, 31 October 2010 (UTC)

Price stated in his 1939 Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects that "The evidence seemed to indicate clearly that the forces that were at work were not to be found in the diseased tissues, but that the undesirable conditions were the result of the absence of something, rather than of the presence of something."--BruceGrubb (talk) 00:36, 15 May 2016 (UTC)

Focal infection in its hayday

I found this very interesting reference to how focal infection was thought to work: "Dr. Darby has very effectively stated that many pulpless teeth should be extracted not merely because they are pulpless, but because it is impossible to prevent them from being reinfected" (Journal of dental research Volume 1; American Association for Dental Research, American Dental Association, International Association for Dental Research; Page cxxxi)

"All focal infection is not of dental origin, but a sufficiently large percentage is to demand a careful study of the mouth and teeth in all cases of the mouth and teeth in all cases of systemic infection, forin thse cases all foci should be removed." (1918) Dental summary: Volume 38; Page 437)

This would seem to put a very different light on the situation.--BruceGrubb (talk) 14:30, 29 October 2010 (UTC)

Check out this information. [1]

The above link is to The American Dental Hygienists' Association's Continuing Education Series "Inflammation: The Relationship Between Oral Health and Systemic Disease" by JoAnn R. Gurenlian, RDH, PhD--BruceGrubb (talk) 20:06, 21 January 2011 (UTC)

Despite this...

Moved for discussion. Seems like undue weight to me: --Ronz (talk) 16:07, 2 March 2011 (UTC)

Despite this there were still medical books and articles promoting the merits of oral focal infection for teeth as late as 1955 and tonsillectomies as late as 1957.

I don't get it, how can one sentence be undue weight? --THE FOUNDERS INTENT ^PRAISE 18:35, 2 March 2011 (UTC)

I don't get it either. I see little difference between this sentence and the one that preceded it. If anything it adds further detail to the situation. Ronz can you explain what you mean by it being UNDUE. Thanks.Griswaldo (talk) 18:55, 2 March 2011 (UTC)

It's added as a counterpoint, but the sources are just examples. Maybe I should have mentioned WP:SYNTH as well then? --Ronz (talk) 19:11, 2 March 2011 (UTC)

Ronz, may I offer an alternative? Maybe you could help find a better source, if this one isn't to your liking. Your help is appreciated. --THE FOUNDERS INTENT ^PRAISE 14:43, 3 March 2011 (UTC)

Well the two sources are no different from each other in this regard. If the 1951 article was significant we don't know that from the article itself (which is a primary source in this regard). The same can be said for the 1957 article. I"m not sure if either should be in there, sourced to themselves anyway, but if not one then not the other.Griswaldo (talk) 19:16, 2 March 2011 (UTC)

I was assuming that the 1951 article was a review of the research of the time. --Ronz (talk) 19:30, 2 March 2011 (UTC)

Ronz, it was published 60 years ago. What we're doing here is writing a historical narrative of FIT from inception to the present day, and not up until 1951. That's why we need to rely on secondary sources that are more recent. If these sources point to the 1951 review as exemplary of what happened to the theory then great, but that review is itself a primary source in the historical narrative of FIT and a source that can't tell us anything about dates succeeding it. What I think Bruce was attempting to do was to use another primary source to point out that everyone had not abandoned FIT, in the manner that the 1951 source claims. I don't see much difference between these sources at this stage. Yes one was a review, but again 60 years ago. It's a primary source at this point if you ask me. Cheers.Griswaldo (talk) 19:38, 2 March 2011 (UTC)

Thanks for verifying my assumption. Yes, it would be best if we used recent histories instead. In the meantime, I think we should do our best to pay attention to the quality of sources that we have, taking their age into consideration of course. --Ronz (talk) 19:50, 2 March 2011 (UTC)

Griswaldo is totally right. The 1951 article implies that oral FIT ended then but other sources show that even in the peer reviewed material there were those who still supported it as late as 1957. While the US Army did mention in their 1971 dental manual it was only one of many possible causes listed and one got more an impression of laundry list of causes then a primary cause as in the 1957 article. As for sources that give the history of FIT those are somewhat a mess freely mixing FIT with the application it was put to in dentistry and oral surgery.--BruceGrubb (talk) 04:00, 3 March 2011 (UTC)

Seems like UNDUE and OR - To WP:NPOVN? --Ronz (talk) 18:13, 6 April 2011 (UTC)

I've tagged the article as having NPOV problems given this. --Ronz (talk) 20:28, 7 April 2011 (UTC)

Griswaldo, The Founders Intent, and I don't see any NPOV issues. In fact I have followed the sentence Ronz keeps challenging with a paragraph explaining that there is "major disagreement about not only when oral focal infection theory fell out of favor but also to the degree it did" using direct quotes from Ingle's Endodontics 5th edition (2002), Carranza's clinical periodontology (2006), and Textbook of Endodontology (2009) as examples of this fact. Furthermore the 2009 PDQ Endodontics by no less than Ingles states "And even today, cancer and neuroropsychiatric disorders are blamed on focal infection." and recommends the Pallasch 2003 article for additional details. For this reason I have removed the tag.--BruceGrubb (talk) 06:14, 8 April 2011 (UTC)

Irrelevant. It's still undue weight and original research if the specific information from the primary source isn't referenced by a third party. --Ronz (talk) 19:24, 8 April 2011 (UTC)

No one else here sees there being a problem as it is trying to present the information in as much a NPOV manner as possible. The fact that Ingle's Endodontics 5th edition, Carranza's clinical periodontology and Textbook of Endodontology all make conflicting statements shows there is no agreement that FIT ended in 1951 and those are third party sources.--BruceGrubb (talk) 18:13, 9 April 2011 (UTC)

Again, irrelevant. Since no one is addressing my concern, I've removed the information under dispute as not having support from any secondary sources. --Ronz (talk) 20:21, 10 April 2011 (UTC)

Ronz, no one is addressing your concern because no one else is seeing this as a problem. This seems to be variation of the nonsense seen in Wikipedia:Biographies_of_living_persons/Noticeboard/Archive97#Noticeboards.2C_source_criticism_and_claims_of_BLP_issues as well as a repeat of the Wikipedia:Recentism issue brought up in Wikipedia:Fringe_theories/Noticeboard/Archive_21#Weston_Price_and_Quackwatch to exclude relevant material.--BruceGrubb (talk) 09:16, 12 April 2011 (UTC)

After 1951

This is the article about FIT, it's hard to be UNDUE in an article like this. If a source like JAMA says it, you can't just delete it. --THE FOUNDERS INTENT ^PRAISE 20:02, 3 March 2011 (UTC)

Actually, it's very easy to have all types of NPOV and OR problems when we're relying upon contemporary sources rather than histories for such information. --Ronz (talk) 20:33, 3 March 2011 (UTC)

The problem is like most shifts in theory and concepts there are those who will hold to the old ways. "The focal infection theory of disease is making a comeback after most applications of it were disproved by the emerging science of the 1930s and 1940s." (2001 CDS review pg 43) and yet there is peer reviewed material (JAMA) that shows parts of Billings' FIT were still regarded as relevant clear into the 1950s.

This is ignoring all the marginal stuff that abounds like (1960) The Dental clinics of North America pg 739; Burket, Lester William (1971) Oral medicine: diagnosis and treatment pg 550; Fonder, Aelred C. (1977) The dental physician pg 55; and Zegarelli, Edward V.; Austin H. Kutscher, George A. Hyman (1978) Diagnosis of diseases of the mouth and jaws pg 115

Modern books are not much help either. (regarding infants from 1977-1986) "Focal infections, such as meningitis, pneumonia, scalp abscess, and catheter-related illnesses, were common occurrences." Feigin, Ralph D. (2004) Textbook of pediatric infectious diseases: Volume 1; Elsevier Health Sciences; Page 937

"By 1950, medicine was making great strides in discovering the true etiologies and dentistry was making great strides in the prevention as well as the treatment of caries and periodontal disease and so the era of 'focal infection' as a primary cause of systemic diseases finally came to an end." (Jaypee Brothers, Medical Publishers (2008) Essentials of clinical periodontology and periodontics; Page 116)

"But we do have to be careful. The theory of focal infection held sway before the era of antibiotics,..." ((1990) Bulletin of the history of dentistry: Volumes 38-39 American Academy of the History of Dentistry pg 31)--BruceGrubb (talk) 02:14, 4 March 2011 (UTC)

Yes, you understand the situation. Unless we can find histories to guide us, it's difficult to do much here that won't risk WP:OR and WP:NPOV problems, short of just trimming the article. --Ronz (talk) 17:52, 4 March 2011 (UTC)

I understand the problem but do you? The histories we have give conflicting and in one extreme example demonstratively inaccurate information. No matter how you want to handwave it Ingles' 2002 statement of "In the 1930s, editorials and research refuted the theory of focal infection..." claim can easily be proven to be wrong with peer reviewed sources presenting it as a viable theory clear into the 1950s. In fact, the Carranza's clinical periodontology (2006) Saunders pg 313 states "The focal infection theory fell into disrepute in the 1940s and 1950s when widespread extraction, often of the entire dentition, failed to reduce or eliminate the systemic conditions to which the supposedly infected dentition had been ..." This statement is backed up by Essentials of clinical periodontology and periodontics Jaypee Brothers; Page 116; Textbook of pediatric infectious diseases: Volume 1 (2004) Page 937; Periodontal Medicine and Systems Biology (2009) Wiley Page 33; and many others.--BruceGrubb (talk) 08:11, 6 March 2011 (UTC)

Two notes

1) I updated the lead, to summarize what I believe sources say and the body is starting to say. Please check it.

2) I've started the article on holistic dentistry, which somewhat surprisingly we didn't have. There are oodles of sources on it. Help would be great.

Cheers, Ocaasi ^c 12:27, 12 April 2011 (UTC)

Point 1 seems good and I have added more examples of critics to focal infection theory in the early days as well as a 1986 Harvard University Press book.--BruceGrubb (talk) 15:40, 12 April 2011 (UTC)

Observations

This article relies way too much on primary sources instead of good secondary sources. There are also way too many disjointed quotes rather than a more encyclopedic style of paraphrased summary. I have already removed some mention of Price that placed way too much weight on his views, which seem to be a carry over of the dispute on the Weston Price page. Yobol (talk) 02:45, 14 April 2011 (UTC)

Considering the quote is nearly an entire paragraph who here besides Ronz agrees with Yobol's claim? We now have Wikipedia:Neutral_point_of_view/Noticeboard#NPOV_issues_in_the_Focal_Infection_theory_article on this article and I am really getting tired of this nonsense.--BruceGrubb (talk) 05:41, 14 April 2011 (UTC)

• First removal is from "Modern Nutrition" which isn't a reliable source so it needs to be removed.
• Second removal is from the 1925 JAMA which suggests Price didn't support FIT, which is clearly not the case, so it should be removed as OR.
• Third removal is an entire paragraph from a primary source (from Price) that is one big quote that is at best tangential to FIT (he is using this as a means of promoting his book's thesis about nutrition) - clearly an WP:UNDUE violation. Why would you think it is appropriate that the biggest paragraph on the discussion of the history of FIT is quotes taken from a primary source on Price? It seems, quite frankly, that you have just taken material that you couldn't get included in the Weston Price article and stuck it in here. I will make more adjustments to include more secondary and remove more primary sources as I have time. Yobol (talk) 13:17, 14 April 2011 (UTC)

Let's look at the quote from Price Nutrition and Physical Degeneration shall we?

1)He directly refers to his "two volume work on "Dental Infections," Volume I, entitled "Dental Infections, Oral and Systemic," and Volume II, entitled "Dental Infections and the Degenerative Diseases,""

2) He expressly states "I have been unable to find an approach to the problem through the study of affected individuals and diseased tissues." and "The evidence seemed to indicate clearly that the forces that were at work were not to be found in the diseased tissues, but that the undesirable conditions were the result of the absence of something, rather than of the presence of something."

Price is directly referring to the very volume used for FIT. Price expressly states "the forces that were at work were not to be found in the diseased tissues". And you say this is not relevant? Yobol, you are clearly straw grasping here. Who agree with Yobol's view?--BruceGrubb (talk) 08:38, 15 April 2011 (UTC)

Yobol the question was who agrees with your view and no one stepped forward. Stop removing relevant material.--BruceGrubb (talk) 07:38, 6 May 2011 (UTC)

Continually adding material about Price that is out of context and violates WP:UNDUE will always be removed by me. Yobol (talk) 13:08, 6 May 2011 (UTC)

Agree with Yobol, per WP:MEDRS. Unless we are treating this article as mostly of historic interest, in which case WP:RS. Lesion (talk) 21:57, 15 December 2013 (UTC)

Article for the place

This article was only a member of Category:Dental disorders but I just added it to Category:Epidemiology. I just made Focus of infection after being prompted that this term might work for the concept of a place that spreads infection. I wanted to have an article in which I could list such places. After I made this article, someone else informed me that this article, "focal infection theory", already exists. I could find no such thing when I looked before and I had never heard this term "focal infection" or "focus of infection" before.

Perhaps the place article should be merged into this theory article, or perhaps not. I have not checked the literature but I am sure many examples of places should be able to be listed, if the place article could be more developed as a list. Blue Rasberry (talk) 14:59, 12 July 2014 (UTC)

Resolved

I was very confused. This is a horrible idea. The two concepts have nothing in common with each other. They should not be merged. Blue Rasberry (talk) 14:15, 14 July 2014 (UTC)

Opening paragraph

I've updated the opening paragraph per WP:PSCI and WP:FRINGE/PS. I also simplified the wording to use less medical terminology. I plan to review the rest of the article over the next few days to verify sources and update the wording according to WP:FRINGE and WP:NPOV. I'm also concerned about some areas that look like potential copyright violations, so I'll check on those too. I think this article needs a lot of work so I posted at WP:FTN#Focal infection theory requesting input and assistance. —PermStrump(talk) 07:38, 25 July 2016 (UTC)

Major revisions to article

The accusation made today that the version that I restored "seems poorly-sourced and rather fringe-y" is overwhelmingly and blatantly false, suggesting a failure to even check the citations. Rather, the present version, which I attempted to undo, is outdated and poorly sourced, removing the actually authoritative, reliable sources to insert marginal sources. Occurring (talk) 16:03, 28 July 2016 (UTC)

What!? On consulting the cited works it became clear that FIT is a discredited form of pseudoscience. The edits to make our article properly reflect that bring us much closer to neutrality, which is a good thing. Alexbrn (talk) 16:07, 28 July 2016 (UTC)

No. The cited works do not slur it as "pseudoscience". The accurate term would be bad medicine. And, as I explain in the article, including in the lead, it was discredited as a major explanation of disease, but not utterly debunked as explanation of any disease. Further, interest in the theory has been revived, reentered the mainstream, and been transformed into the concept of periodontal medicine. Further, the actually reliable sources explain that there is ongoing support for that focal infections can explain certain pathology. The revised lead erroneously omits all debate and cites poor sources to give the populist but false impression that the theory was wholly disproved and is mere "pseudoscience". Occurring (talk) 16:19, 28 July 2016 (UTC)

From the first reference: "Viewed from the vantage point of the year 2000, autointoxication and its related connections between intestinal health, microbes and mental health, was largely relegated to a somewhat embarrassing pseudoscientific footnote in medical history" [my bold]. To frame this as a "debate" would be to fall into the WP:GEVAL trap. We label WP:PSCI stuff as such, and prominently so as required by policy. NPOV is a non-negotiable pillar of Wikipedia. Alexbrn (talk) 16:22, 28 July 2016 (UTC)

What you omit is that I myself added that citation, but it is a journal article of one opinion, and omits many other opinions. Occurring (talk) 16:23, 28 July 2016 (UTC)

Also, note that this is 2016, not 2000. Occurring (talk) 16:24, 28 July 2016 (UTC)

Yes, the question is long-settled (even long before 2000). If you are in doubt about the fringe/pseudoscience nature of this stuff I suggest maybe seeking a widened consensus at the current section on this topic at WP:FT/N. Alexbrn (talk) 16:27, 28 July 2016 (UTC)

On a public computer earlier, I could barely respond to your fallacy of selective attention. You misrepresent the very article that you quoted, which is historical, not scientific, and actually focuses on autointoxication and only tangentially addresses focal infection. Nearly every reliable, authoritative source used in your preferred lead is a citation that I added to Wikipedia articles, even the Bested et al paper that supposedly, but actually does not, claim that focal-infection theory is mere pseudoscience. Bested et al shun revival of the term autointoxication, associated with "pseudoscience" via overzealous explanations that virtually all diseases have only that one cause, but actually argue that the basic principle itself and focal-infection theory are overwhelmingly supported by scientific evidence.

The present lead promulgates overzealous conclusions not supported by the sources. For instance, the lead claims that "that there is no evidence supporting alleged focal infections as the cause of systemic disease". But one of the authoritative citations added claims merely that "there is no valid, scientific evidence linking endodontically treated teeth and systemic disease" ["Focal infection theory", AAE fact sheet, 2012]. I had already thoroughly summarized and explained that—what the American Association of Endodontists actually said on the fact sheet—by my citing endodontic textbooks, not a mere "fact sheet" misread as making sweeping, and scientifically untenable, claims about all evidence and the entire principle of focal infections whatsoever.

To undo severely violation of neutral point of view—the lead asserting only one viewpoint that is not the only major viewpoint and excludes significant minority viewpoints—I will revise the lead for due weight. As I properly explained in the lead, "Entering the 21st century, scientific evidence supporting general relevance of focal infection theory remained slim, yet evolved understandings of disease mechanisms had established a third possible mechanism—altogether, metastasis of infection, metastatic toxic injury, and, as recently revealed, metastatic immunologic injury—that might occur simultaneously and even interact.[5][10]" The two sources: Jacobson JJ & Silverman S Jr, ch 17 "Bacterial infections", in Silverman S et al, eds, Essentials of Oral Medicine (BC Decker, 2002), pp 159–62; Babu N & Gomes A, "Systemic manifestations of oral diseases", J Oral Maxillofac Pathol 15(2):144–7. The latter, dated May 2011, opens,

"The oral cavity might well be thought of as the window to the body as oral manifestations accompany many systemic diseases. But with recent research it may be said that the oral cavity has opened a door for many systemic diseases. The concept of 'focal infection' was propounded by Dr. William Hunter in 1910, whereby disease at a distant site, such as the mouth, could contribute to diseases such as anaemia, gastritis, colitis and so on. This theory is currently being carefully reconsidered. At the landmark conference at the University of North Carolina in Chapel Hill in March 1997 was devoted to this theme, that periodontal disease itself can instigate conditions such as cardiovascular disease, low birth weight babies, and that periodontal therapy may contribute to the control of diabetes". And so, as to the error and ironically pseudoscientific dogma aired in the present lead, the case is closed. — Occurring (talk) 21:59, 28 July 2016 (UTC)

Please don't use weak sources like PMID 22529571, especially for fringe claims. Alexbrn (talk) 22:05, 28 July 2016 (UTC)

Please, do not foist your opinion as stronger than that source, or that a "landmark conference at the University of North Carolina at Chapel Hill" was held by cranks. Further, please, do not use weaker sources to support the claim that the theory is only pseudoscience. The sources in the present lead are Bested et al, which I properly characterized in my above response, and, rather astonishing to me, Sultan, Michael (28 October 2014), "Ring the alarm", The Dentist Magazine, retrieved 25 July 2016. To begin with, I have added overwhelming sources, including textbooks, still in the article, supporting my claims. Occurring (talk) 22:12, 28 July 2016 (UTC)

I think it relevant here to emphasize my astonishment that one claims that a review article published by Wolters Kluwer is "weak" source. Occurring (talk) 22:17, 28 July 2016 (UTC)

Kluwer publishes some junk eh! J Oral Maxillofac Pathol. is not MEDLINE-indexed (a red flag) and has an impact factor of 1 (another red flag). Not WP:MEDRS for startling health claims. Alexbrn (talk) 22:22, 28 July 2016 (UTC)

Besides that that was far from the only source in the article that substantiates the present interest in the principle of focal infection, what is the impact factor of your favored citation: http://www.the-dentist.co.uk/article/2934/ring-the-alarm ? Occurring (talk) 22:34, 28 July 2016 (UTC)

My what? In general, since FIT is obviously pseudoscience pretty much any source will do to support that categorization. WP:PARITY could apply too since this is a WP:FRINGE topic. Alexbrn (talk) 22:45, 28 July 2016 (UTC)

Please, in order to contradict academic dentists publishing review articles in peer-reviewed journals published by major publishers, offer more than your mere opinion about what is supposedly obvious. — Occurring (talk) 22:52, 28 July 2016 (UTC)

We must follow the sources and abide by WP:FRINGE. Major publishers and peer review mean little: you're aware Elsevier publishes the Homeopathy journal, e.g. Alexbrn (talk) 22:57, 28 July 2016 (UTC)

And? What journal would you prefer to cite for the viewpoint of homeopaths? Please, remember that Wikipedia is not a platform where you assert your opinion about what is "obviously" pseudoscience. Occurring (talk) 23:01, 28 July 2016 (UTC)

We follow the sources. Obviousness of pseudoscience is an important consideration in WP:FRINGE/PS topics. Let's see where the sources take us. Alexbrn (talk) 23:06, 28 July 2016 (UTC)

There is nothing "obvious" to your claim that the principle of focal infection has no possible truth or relevance whatsoever in any way shape or form. That is flatly and simply not obvious, hence the controversy over it and, despite your personal opinion, the actual professionals still investigating it and taking interest in it. The only thing obviously deluded about focal-infection theory is the historical interpretation by many doctors that it was effectively the sole cause of all diseases. Occurring (talk) 23:11, 28 July 2016 (UTC)

General Dentistry is indeed Medline-indexed: "In recent years, the controversial focal infection theory (originally presented in the early 1900s) has received a resurgence of support, as oral infections have been linked to several systemic conditions. This article reviews pertinent literature detailing both the historical basis of the focal infection theory and current viewpoints on the possible association between oral and systemic diseases. Dental professionals should be aware of the potential negative effects of oral infections on systemic health. While endodontically treated teeth have not been implicated in systemic disease, effective treatment regimens for periodontal disease may reduce the occurrence of systemic disease for certain individuals" [Goymerac B & Woollard G, "Focal infection: A new perspective on an old theory", General Dentistry, 2004 Jul–Aug;52(4):357–61]. — Occurring (talk) 22:42, 28 July 2016 (UTC)

Useful for historical stuff, but too old for biomedical information when we have newer content. Alexbrn (talk) 22:57, 28 July 2016 (UTC)

That article is dated 2004, whereas you claimed primacy for an article dated 2000. — Occurring (talk) 22:59, 28 July 2016 (UTC)

WP:MEDDATE applies to WP:Biomedical information. The classification of a topic as pseudoscience is not subject to that time limitation, as it is not in the realm of biomedicine. Alexbrn (talk) 23:03, 28 July 2016 (UTC)

Yes, but the article is mostly historical, and is not biomedical. The article is not a treatise on the epidemiology and treatment of focal infection. Numerous sources suffice to disprove your claim that there is no professional interest in the topic since it is utterly and only pseudoscience. Occurring (talk) 23:05, 28 July 2016 (UTC)

Pseudoscience, fringe science ... ?

Looking at recent sources it seems the situation is maybe more complicated than I realised and so I'm going to change my mind: while FIT in its original form seems to be categorized as pseudoscience, in recent years there has been some scientific investigation of the relationship between periodontopathic bacteria and systemic diseases in ways which can be likened to the original FIT. Perhaps today it is a species of fringe science? I'm looking at PMID 24128801 which seems a good source we'e not using (though we use a lot of outdated/weak sources which need a good trimming). Alexbrn (talk) 06:39, 29 July 2016 (UTC)

Alexbrn, I could be wrong, but I'd kind of been thinking of it like leaky gut syndrome and how there's a separate article for intestinal permeability. Could that make sense here? I'm not sure what FIT's counterpart is, but its primary advocates in the last decade have been exposed as major frauds yet they continue to have a following and I'm positive they have nothing to do with the source you just linked, so I feel like there must be 2 kind of separate ideas using the same or a similar name. I have to brush up my memory on who the main players are and re-find the articles I had read a few months ago. I'll come back with sources when I find them again. I'm kind of shooting from the hip here, but IIRC, the fringe stuff all connects to Weston A. Price and a few currently active, sketchy nonprofits named after some variation of his names and they slightly alter the organizations names every couple of years, making them difficult to track. —PermStrump(talk) 13:38, 29 July 2016 (UTC)

I must admit I had exactly those thoughts. What we have is the problem of a well-identified piece of nonsense, and some subsequent related research which has some points of contact with the old nonsense, and sometimes adopts the same vocabulary. Perhaps one option would be to have articles on "Focal infection" (a MeSH term, which we identify as the 'real' phenomenon under research) and the "Focal infection theory" (not in MeSH - the pseudoscience). It's maybe a case where we need to be active in organizing our terminology for the benefit of our readers. Could be one for wider discussion at WT:MED? Alexbrn (talk) 13:47, 29 July 2016 (UTC)

Yeah, I think it would be good to get more input, because I only accidentally stumbled on this stuff a few months ago. I read a lot in a short period of time back then and then ran out of steam and had to put it away for a while to focus on other things. That's the extent of my knowledge here, so I'm definitely not an expert. I'm also trying to stay open to the possibility that I have no idea what I'm talking about. There's something that raises my alarm bells though. I'm not exactly sure what my question would be for WT:MED though. Do you have a specific question in mind? —PermStrump(talk) 14:24, 29 July 2016 (UTC)

I think I'd want to ask whether this article should be split so that we have a distinction between the original theory and modern work and focal infection, and if so what names the articles should have. I suppose we could just run a RfC. But I want to read a but more first ... Alexbrn (talk) 14:27, 29 July 2016 (UTC)

Yeah, that makes sense. Here are a few things I had read before that were easier to find.[2][3][4] (use ctrl F) I'm not necessarily suggesting them as sources for the article, but I'm putting them on the talkpage for now so people can understand where I'm coming from and either tell me why it's wrong (in good faith) or keep moving in a similar direction, so FWIW... —PermStrump(talk) 14:34, 29 July 2016 (UTC)

The main problem with this present discussion on this talkpage is that so far, I am the only one in it mainly covering and balancing the historical, medical, and scientific aspects of the topic, not mainly parroting or alluding to allegations made by apologists for orthodox clinical diagnoses and practices who are attacking merely one extreme interpretation of focal infection. There are no "outdated" citations in the Wikipedia page, since any of them that are old are used specifically to reveal historical opinions, which are properly contextualized, via other and current sources, in light of both contemporary divergence and later developments.

There is no need for two different pages on focal infection, since the present concept, supported by mainstream research, is—as numerous reliable, authoritative sources explain—nothing but the olden principle of focal infections, merely not its overzealous interpretation and application that led to the theory's historical fiasco. So far, this present discussion is severely mistaking the "pseudoscience", which, since medicine is not science, more actually is quackery—healthcare practices posing focal infections as effectively the sole cause of virtually all diseases and thereby the effectively sole intervention point to prevent or treat virtually all diseases—with the basic principle of focal infection, already and long accepted in conventional medicine as a real phenomenon.

The only major debate is the clinical relevance and significance of focal infections, not whether focal infections ever occur. To begin with, one of endodontic therapy's very purposes is to treat or prevent focal infections: there is no debate that a badly infected tooth can cause systemic pathology. Today, the only major "pseudoscience" or, more actually, quackery to address in the article—and which I already properly addressed in the article—is fringe assertion that all endodontically treated should be extracted since they are all focal infections. Please, cease mistaking that for the entire principle of focal infections. Nor must the article adhere to biomedical guidelines, since it is not a biomedical article on, for instance, the epidemiology, etiology, and chemotherapeutic or surgical treatment of focal infections. — Occurring (talk) 18:21, 29 July 2016 (UTC)

That said, I do not altogether oppose a biomedical Wikipedia article titled simply "Focal infection", which could discuss such biomedical aspects as etiology and treatment. But since I know of no mainstream biomedical focus on focal infections, I do not see how that would go. — Occurring (talk) 18:41, 29 July 2016 (UTC)

You've clearly been researching this for a lot longer than us and we're still playing catch-up, so that must be frustrating. My last few comments were basically me thinking aloud trying to untangle my thoughts. I didn't mean to come off like I had a definite opinion yet about splitting the article or what the lead absolutely, definitely has to say. I had hoped that by acknowledging how little background I have with this topic and being upfront about what it seems like to me so far, that would open up the dialogue beyond WP policies and give other editors a chance to either say it looks like I'm heading in the right direction with my research or call me out if I'm missing the big picture, so I don't waste my time going the wrong way. Honestly, the best thing that could happen right now would be if someone could save me the time of having to immerse myself in the literature by giving a convincing ELI5* overview of the significant POVs on this topic and clarify each POV's prominence in the highest quality sources available (fully cited in a way that clearly demonstrates knowledge of and adherence to WP's policies/guidelines). Even if it blew my version of the lead out of the water, if someone were to do that and make a group of editors feel confident we were all on the same page, I swear I would be more than happy to adjust my perspective if it saved me the time and energy of immersing myself in the literature. ^{*In case people aren't familiar with ELI5 on reddit, these should help: /r/eli5, explainxkcd (read the explanation), and HuffPo (I highly recommend the video. I just started watching it and it's hysterical.)}

However...I looked through past versions of the lead the other day to see if I could gain a better understanding of the POVs at play based on the wording different editors have tried to introduce, but I didn't see anything that reflected the balance you're referring to, at least not in a way that was understandable to the uninitiated. I could tell where you were trying to show both sides, but it also seems like it's hard for you to step back and pretend you're reading the article for the first time with a fresh pair of eyes, because there was a lot of medical jargon and the sentence structure was overly complex, making it extremely difficult, if not impossible at times, to follow. I also think some of the attempts at balance ended up seeming like the article was arguing with itself and had the feel of WP:SYNTH or OR. It also seemed two present to viewpoints as equal and opposing viewpoints, which is more like journalism neutral as opposed to WP neutral, which should make it explicitly clearly which are the dominant vs fringe POVs. This was also likely due to the fact that the original historical documents from the early 1900s were frequently cited directly instead of more recent secondary sources written by academics, and ideally review articles where possible, that would allow us to reliably contextualize the historic viewpoints in a clear and concise way. —PermStrump(talk) 20:53, 29 July 2016 (UTC)

I disagree with some of your points and concede other of your points, yet in any case thank you for your sincerity. At the moment, I cannot respond adequately. I will try to respond more fully within three days. In meantime, I think that rereading the article and checking the citations included ought to resolve most of your concerns. I think that much of your concern is that the lead as you found it did not apply any slurs such as pseudoscience and fringe, and, rather than using such stigmatizing phrasing that incites bias, simply respectfully stated which views were minority and which were major. Occurring (talk) 22:47, 29 July 2016 (UTC)

For now, I am too busy to rehash this, already elucidated in the article version that I restored last week. Yet as it now is, the article will require fundamental revision, since the declaration that it is a "dispelled theory" is severely miseducating the public. Simply put, you confused the belief that endodontically treated teeth routinely transition to focal infection—which, as I clearly explained in the article, is the allegedly "dispelled theory"—with the basic principle of focal infection, far from dispelled and a thoroughly entrenched principle in mainstream medicine. I suggest less reliance on apologists of orthodox medicine who are attacking heterodox healthcare, and more reliance on scientific sources, such as David Schlossberg, ed, Clinical Infectious Disease, 2nd edn (Cambridge University Press, 2015), and Yomamoto T, "Triggering role of focal infection...", in Harabuchi Y et al, eds, Recent Advances in Tonsils and Mucosal Barriers of the Upper Airways (Karger, 2011). Occurring (talk) 19:14, 2 August 2016 (UTC)

I just noticed that the lead, betraying and promoting fundamental confusion, says, "Within alternative medicine and later holistic dentistry, some practitioners retained the belief that untreated dental infections cause systemic disease and the theory gained renewed attention from advocates in the 21st century". Well, that might be true, but there is a consensus, rather, in mainstream dentistry and mainstream medicine that untreated dental infections cause systemic disease [Gavett G, "Tragic results when dental care is out of reach", PBS Frontline wesite, 26 Jun 2012]. I think that, rather than the lead that I restored needing any major revisions to begin with, it simply needed to be read by, not attacked by, persons extremely unfamiliar with the topic. Occurring (talk) 19:42, 2 August 2016 (UTC)

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2019 Documentary "Root Cause"

The 2019 documentary 'Root Cause' is an excellent example of Focal Infection Theory in its modern form. In it root canal treatment is blamed for a variety of health complaints that are resolved when the offending tooth is removed.

I am not adding this to the main page as a) I am not sure where to add it — perhaps in its own subheading under documentaries. And b) I am on an antique iPad which makes editing Wikipedia difficult anyway. If some ones across this post feel free to add it. — Preceding unsigned comment added by 203.114.167.88 (talk) 21:55, 13 January 2019 (UTC)

Not without reliable, independent sources about it. --Ronz (talk) 00:04, 14 January 2019 (UTC)

Films are not RS. Also this one seems suspect:

Most dentists are still performing root canals. Most patients are still asking for them: it “saves” the tooth (well, allows the dead tooth to remain). But the evidence presented is convincing: of 30 000 root canals studied, and every single one of them without exception was infected.

https://assholeswatchingmovies.com/2019/01/22/root-cause/ Extraordinary claim. Zezen (talk)

In 1886, Pasteur welcomed to Paris the emigration from Russia by international scientific celebrity Elie Metchnikoff—discoverer of phagocytes, mediating innate immunity—whom Pasteur granted an entire floor of the Pasteur Institute, once it opened in 1888.

-this sentence sounds a clumsy. It is necessary to read it twice to understand the meaning. Consider changing, e.g. splitting into multiple sentences. Also, it seems strange phrasing to "welcome the emigration of someone". Rather, we normally welcome the emigrant / émigré. Also consider "to whom Pasteur granted", if we will lead the sentence with an object pronoun... But maybe better as a new sentence. "Pasteur granted him an entire..." 94.181.193.115 (talk) 09:22, 1 November 2022 (UTC)

"Reporting surgical treatment in 1908, Lane eventually offered total colon removal, but later favored simply surgical release of colonic "kinks", and in 1925, abandoning surgery, began promoting prevention and intervention by diet and lifestyle, how Lane secured his contemporary reputation as a crank."

There are grammar errors here. Consider

"Reporting surgical treatment in 1908, Lane eventually offered total colon removal, but later favored simple surgical release of colonic "kinks".

He abandoned surgery in 1925, and began promoting prevention and intervention by diet and lifestyle, which secured his contemporary reputation as a crank." 94.181.193.115 (talk) 09:27, 1 November 2022 (UTC)