Edward Cameron Kirk

“ Until well into the 19th century apprenticeship afforded the only means of acquiring a knowledge of dentistry. The profits derived from the apprenticeship system fostered secrecy and quackery among many of the early practitioners; but the more liberal minded and better educated of the craft developed an increasing opposition to these narrow methods. ”

“ In all operations involving the exposed dental pulp or the pulp-chamber and root-canals, it is the only efficient method of mechanically protecting the field of operation from invasion by disease-producing bacteria. ”

“ Gout, lithaemia, scurvy, rickets, lead and mercurial poisoning, and certain forms of chronic nephritis, produce dental and oral lesions which are either pathognomonic or strongly indicative of their several constitutional causes, and are thus of great importance in diagnosis. The most important dental research of modern times is that which was carried out by Professor W. D. Miller of Berlin (1884) upon the cause of caries of the teeth, a disease said to affect the human race more extensively than any other. ”

“ When artificial crowns are supported not by natural tooth-roots but by soldering them to abutments, they are termed dummies. The number of dummies which may be supported upon a given number of roots depends upon the position and character of the abutments, the character of the alveolar tissues, the age, sex and health of the patient, the character of the occlusion or bite, and the force exerted in mastication. In some cases a root will not properly support more than one additional crown; in others an entire bridge denture has been successfully supported upon four well-placed roots. ”

“ Caries of the teeth has been shown to bear highly important relation to more remote or systemic diseases. Exposure and death of the dental pulp furnishes an avenue of entrance for disease-producing bacteria, by which invasion of the deeper tissues may readily take place, causing necrosis, tuberculosis, actinomycosis, phlegmon and other destructive inflammations, certain of which, affecting the various sinuses of the head, have been found to cause meningitis, chronic empyema, metastatic abscesses in remote parts of the body, paralysis, epilepsy and insanity. ”

“ To obviate these defects the enamelled platinum denture was devised. Porcelain teeth are first attached to a swaged base-plate of pure platinum by a stay-piece of the same metal soldered with pure gold, after which the interstices between the teeth are filled, and the entire surface of the plate, excepting that in contact with the palate and alveolar border, is covered with a porcelain paste called the body, which is modelled to the normal contour of the gums, and baked in a muffle furnace until vitrified. ”

“ When properly made and applied to judiciously selected cases, the bridge denture is the most artistic and functionally perfect restoration of prosthetic dentistry.
The entire development of modern dentistry dates from the 19th century, and mainly from its latter half. Beginning with a few practitioners and no organized professional basis, educational system or literature, its practitioners are to be found in all civilized communities, those in Great Britain numbering about 5000 ”

“ Owing to the regulation by law of the educational requirements, the increase of institutions devoted to the professional training of dentists has been rapid in all civilized countries, and during the past twenty years especially so in the United States. Great Britain possesses upwards of twelve institutions for dental instruction, France two, Germany and Switzerland six, all being based upon the conception that dentistry is a department of general medicine. ”

“ The recent development of crown-and-bridge work Modern methods.has brought about a renaissance, so that a thorough training is more than ever necessary to successful practice in mechanical dentistry. The simplest crown is of porcelain, and is engrafted upon a sound natural tooth-root by means of a metallic pin of gold or platinum, extending into the previously enlarged root-canal and cemented in place. ”

“ Even when skillfully executed, the process is imperfect in that the jointing of the teeth to each other, and their adaptation to the base-plate, leaves crevices and recesses, in which food débris and oral secretions accumulate. ”

“ Where Artificial teeth.the crown only of a tooth or those of several teeth were lost, the restoration was effected by engrafting upon the prepared root a suitable crown by means of a wooden or metallic pivot. When possible, the new crown was that of a corresponding sound tooth taken from the mouth of another individual; otherwise an artificial crown carved from bone or ivory, or sometimes from the tooth of an ox, was used. To replace entire dentures a base-plate of carved hippopotamus ivory was constructed, upon which were mounted the crowns of natural teeth, or later those of porcelain. ”

“ Malposed teeth are not only unsightly but prone to disease, and may be the cause of disease in other teeth, or of the associated tissues. The impairment of function which their abnormal position causes has been found to be the primary cause of disturbances of the general bodily health ”

“ There are evidences that at an earlier date the Egyptians and Hindus attempted to replace lost teeth by attaching wood or ivory substitutes to adjacent sound teeth by means of threads or wires, but the gold fillings reputed to have been found in the teeth of Egyptian mummies have upon investigation been shown to be superficial applications of gold leaf for ornamental purposes. ”

“ Operative Dentistry.—The art of dentistry is usually divided arbitrarily into operative dentistry, the purpose of which is to preserve as far as possible the teeth and associated tissues, and prosthetic dentistry, the purpose of which is to supply the loss of teeth by artificial substitutes. The filling of carious Filling or stopping.cavities was probably first performed with lead, suggested apparently by an operation recorded by Celsus (100 B.C.) , who recommended that frail or decayed teeth be stuffed with lead previous to extraction, in order that they might not break under the forceps. ”

“ A piece of platinum foil of .001 inch thickness is burnished and pressed into the cavity, so that a matrix is produced exactly fitting the cavity. Into this matrix is placed a mixture of powdered porcelain and water or alcohol, of the colour to match the tooth. The mass is carefully dried and then fused until homogeneous. Shrinkage is counteracted by additions of porcelain powder, which are repeatedly fused until the whole exactly fills the matrix. After cooling, the matrix is stripped away and the porcelain is cemented into the cavity. ”

“ Through their extensive nervous connexions with the largest of the cranial nerves and with the sympathetic nervous system, the teeth frequently cause irritation resulting in profound reflex nervous phenomena, which are curable only by removal of the local tooth disorder. ”

“ With this as a model, a metallic die of brass or zinc was prepared, upon which the plate of gold or silver was formed, and then swaged into contact with the die by means of a female die or counter-die of lead. ”

“ German Empire, qualified practitioners (Zahnärzte) , 1400; practitioners without official qualification, 4100. Its educational institutions are numerous and well equipped. It possesses a large periodical and standard literature in all languages. Its practice is regulated by legislative enactment in all countries the same as is medical practice. The business of manufacturing and selling dentists’ supplies represents an enormous industry, in which millions of capital are invested.
Authorities.—W. F. Litch, American System of Dentistry ”