Dental formula

“ It is written in popular style, and the author certainly intended it for the instruction of the public, and not for professional men; so true is this, that in it he does not speak of the technical part of the extraction of teeth, or of gold filling—a method already known for a long time—or of dental prosthesis.
The first part, relative to diseases of the eyes and the manner of curing them, has no importance for us. ”

“ Dental caries is produced, according to Galen, by the internal action of acrid and corroding humors, that is, it is produced in the same manner as those cutaneous ulcers which appear without any influence of external causes. ”

“ The pain resulting from advanced caries of the deciduous teeth, owing to the difficulties encountered in controlling the patient, is not easily treated; moreover, the injurious impressions thus made on the system of the child abide through life. There is no doubt hundreds of thousands of teeth are unnecessarily extracted each year, and then drugs are given with a view of curing the patient of the disorders of digestion and other abnormal conditions which follow, and which in turn arise from imperfect mastication of food, verily for the want of teeth. ”

“ It is a matter of importance to note that a blue line is rarely seen in the mouths of those persons who pay attention to dental hygiene; where the teeth are clean, the gums closely adherent to the teeth, and entire absence of pus and freedom from deposit we have never seen a Burtonian line produced. Many of the so-called healthy mouths with perfect teeth have yet infected gums.
On examining sections of such a line, it is interesting to note that at first sight the particles appear to be situated deeply in the tissue, and mainly in relation to the bloodvessels supplying the gum. ”

“ The first step towards the preparation of the mouth [Pg 270] for dental operations is the removal of calculus and decayed fangs. Let this be done in a manner that will insure future cleanliness, where the proper after attention is given on the part of the patient.
As regards the preparation and filling of cavities, there are so many conflicting conditions, that we must be governed entirely by the case before us; but to be thorough in our preparation, we must so shape the cavity as to have the walls nearly plumb, uniform margin, slightly undercut. ”

“ As the products of inflammation can not escape, they collect and work their way downward, where they produce the most painful inflammation of the roots and the periosteum. The chief object of the rational treatment of caries of the teeth consists in the removal of every particle of carious substance out of the diseased tooth and the protection of the sound dentine that has been exposed against external injurious influences by covering it with a fine substance which is not attacked by acids—gutta-percha, cement, or gold. ”

“ Disposition to caries shows itself even in the developing tooth in the composition of its enamel, which is undulating, whereas teeth with quite smooth enamel have much greater power of resistance. The enamel appears to be the only tissue in the body which is subject to no metabolism, and which remains quite unchanged. Every alteration in it which is caused by external influences, and every defect of the enamel, remains during the whole of life, and can never be repaired. Dentine also shows differences in structure as regards its disposition to caries. ”

“ Although the dentine is not as unchangeable as enamel, but manifests, by becoming firmer or softer, that it is not quite uninfluenced by tissue-changes, yet its caries is not an irritative process that the dentine takes an active part in, but a passive process, and consequently the removal of all diseased portions and the protection of the non-carious part of the tooth suffices to stay the morbid process completely. ”

“ 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. ”

“ Before the dental capsule has become definitely formed the enamel organ and the dental papilla undergo important changes. The rounded epithelial cells forming the core of the enamel organ undergo a peculiar transformation into a tissue closely resembling ordinary embryonic connective tissue, while at the same time the epithelium adjoining the dental papilla and covering the inner surface of the enamel organ, acquires a somewhat different structure to the epithelium on the outer side of the organ. Its cells become very markedly columnar, and form a very regular cylindrical epithelium. ”

“ The enamel is restricted to the front of the incisor, so that in gnawing the softer dentine is worn away at the tip faster than the enamel, thus keeping the tooth sharp. There are no canine teeth. Rodents are mostly herbivorous in diet, are usually small, and have clawed digits. ”

“ The scalpriform incisors of the rodents, already alluded to, have the enamel band on the front face of the tooth; the softer dentine behind wears away more rapidly, keeping the cutting surface bevelled, like the edge of a chisel, while the hard enamel forms the sharp edge. In some instances the enamel is absent altogether and the teeth are composed entirely of dentine, as in the elephant tusk. ”

“ He admits the existence of distinct germs for the enamel and for the dentine. According to him the incisors are formed from three points of ossification, the canines from one, and the molars from three or four. The tooth after its eruption is an extraneous body “with respect to a circulation through its substance, but they have most certainly a living principle by which means they make part of the body, and are capable of uniting with any part of a living body.” The milk teeth, says Hunter, are not shed by a mechanical action of the second teeth, but by an organizing law of Nature. ”

“ In those cases where the success of the operation has not equalled our expectations, in endeavouring to estimate the probable incompatibility of the filling material as a cause of failure, it is, I think, necessary to consider whether in the ordinary operation for filling, the whole of the diseased dentine has been so thoroughly removed, as to admit of its proving a satisfactory test case, for the microscope reveals to us a change in the dentine in the sides of a decayed cavity, even when it appears sound to the eye, and also to the feel of the instrument ”

“ It is advisable to inform the patient of the possibility of pain following the extraction of a tooth, especially after periodontitis, and in all cases where a large number of teeth have been extracted a mouth-wash [20] should be prescribed; for, even if there is no pain, it will prevent the discharge from the sockets of the teeth undergoing putrefactive changes.
In pain due to necrosis of the socket deodorant antiseptic injections must be used, while in extensive laceration of the soft and hard parts an anodyne mouth-wash [21] may be tried. ”

“ In proximal cavities attacked by this kind of caries, separate freely on the lingual side, and fill with tin. When such fillings have been removed the dentin has been found somewhat discolored and greatly solidified as compared to its former condition; this solidification or calcification is more frequent under tin than gold, which is partly due to the tin as a poor conductor of heat. Nature will not restore the lost part, but will do the next best thing—solidify the dentin. In some cases, under tin, the pulp gradually recedes, and the pulp-cavity is obliterated by secondary dentin. ”

“ The dentine tubes cither run regularly closely side by side, when the teeth have greater power of resistance; or they branch and surround cellular bodies, or even small air-vesicles, when the teeth fall an easy prey to caries. ”

“ Hunter says that the enamel of the teeth is a fibrous structure, and that its fibers depart from the body319 of the tooth like rays. He believes it to be entirely inorganic, as it is absolutely impossible to convert it into animal mucus. The tooth is constituted for the most part by a long mass (it is thus he calls the dentine) , which is, however, much harder and denser than any other bone. This part of the tooth is formed of concentric lamellæ, and is vascular, as is proved by the exostosis of the roots and the adhesions that exist at times between the roots and the alveoli. ”

“ Decayed teeth may be filled, according to Valescus, to satisfy four different indications: To calm or prevent pain, to prevent any further spreading of the caries, to kill the worms, and to sweeten the breath. He advises that the carious cavities should be filled up with powdered nigella, pepper, myrrh, salt, and theriac; or else with pyrethrum, gum ammoniac, and opium; or else with celery seeds pulverized, opium, and hyoscyamus; or with the cast-off skin of serpents boiled in vinegar; or with gallia and cyperus. ”

“ The visible part or crown of the tooth is covered with a very hard white ivory-looking substance called enamel, which serves to prevent it from being worn down by friction, and into which neither bloodvessels nor nerves have been observed to penetrate. Owing to this structure, the tooth can be safely exposed without sustaining damage—a privilege on which most persons will be disposed to place a higher value after having experienced the pains consequent upon injury of the nerve from a portion of the enamel being broken off. ”

“ When the complex molar cuts the gum, the cement is first rubbed off the digital summits; then their enamel cap is worn away, and the central dentine comes into play with a prominent enamel ring; the digital processes are next ground down to their common uniting base, and a transverse [Pg 271] tract of dentine, with its wavy border of enamel, is exposed; finally, the transverse plates themselves are abraded to their common base of dentine, and a smooth and polished tract of that substance is produced. ”

“ This was so much of a success that I threw aside chloroform and ether in removing the living nerve of a tooth with instruments instead of using arsenic; and for excavating sensitive caries in teeth, preparatory to filling, as well as many teeth extracted by it. But this was short-lived, for it led to another step. Sometimes I would inflict severe pain in cases of congested pulps or from its hasty application, or pushing it to do too much, when my patient invariably would draw or inhale the breath very forcibly and rapidly. ”

“ So able a writer as Wm. Henry Potter (of Harvard) says: “In the first place, it may be said that caries of the teeth does not resemble caries of the bone. The term caries, as applied to the teeth, is a misnomer, given at a time when the true nature of the process was not understood.... The pathological change which occurs in caries is a decalcification and disintegration of the several tissues of the teeth.”
I confess that strikes me as a very excellent description of what surgeons usually term caries, namely, a molecular death of bone tissue. ”

“ If a child be brought up on the lines indicated and under healthy conditions generally, it is tolerably certain that the maxillary apparatus will develop normally, that the teeth will be strong and well opposed, and show little tendency to disease; but, inasmuch as the methods advocated are but seldom put into practice, disorders of the teeth, more especially caries and irregularities, are common, and hence with a [Pg 175] view to promote more efficient mastication it is always advisable to examine our patient’s teeth. ”

“ Mix a little salt and alum, equal portions, grind it fine, wet a little lock of cotton, fill it with the powder and put it in your tooth. One or two applications seldom fail to cure. 3. To one drachm of collodion add two drachms of Calvert's carbolic acid. A gelatinous mass is precipitated, a small portion of which, inserted in the cavity of an aching tooth, invariably gives immediate relief. 4. Saturate a small bit of clean cotton wool with a strong solution of ammonia, and apply it immediately to the affected tooth. ”

“ Ali Abbas, another great Persian physician (who died in 994) , wrote a lengthy treatise on theoretic and practical medicine, one chapter of which is dedicated to the diseases of the teeth. When a molar tooth is affected by caries, and the pain cannot be subdued in any other way, Ali Abbas applies, inside the carious cavity, the end of a small metallic tube, into which he repeatedly introduces red-hot needles, leaving them123 in the tube until quite cooled. ”

“ The enamel of the teeth is formed once for all during childhood. The substance of the teeth is mineral, chiefly lime. It will therefore be appreciated that the child needs abundance of mineral in order that he may have sound tooth material. This he can get only from mineral in his food (see page 169) , or, before his birth, from his mother’s diet. Good circulation in the jaws is also essential for normal development both for teeth and jaws, therefore the importance of some hard food every day after ten months. ”