Oral cavity

“ Among the primary papillae smaller accessory papillae are sometimes present.
The appendages of the head are the antennae, the jaws and the oral papillae. The mouth is at the hinder end of a depression called the buccal cavity, and is surrounded by an annular tumid lip, raised into papilliform ridges and bearing a few spines (fig. 2) . Within the buccal cavity are the two jaws. They are short, stump-like, muscular structures, armed at their free extremities by a pair of cutting blades or claws, and are placed one on each side of the mouth. ”

“ The teeth.—Imperfect use of the teeth leads to many ills. When adequately exercised and made to execute for one or two hours every day a lively dance in their sockets, during which the circulation of blood and lymph in the tooth-pulp, periodontal membrane, and surrounding tissue of the gum is vigorously stimulated, and the cavity of the mouth is bathed in a copious flow of salivary and other buccal secretions, we have conditions which make alike for the health of the buccal mucous membrane, of the teeth, and of the periodontal membrane and alveoli ”

“ When the aforesaid means of cure—that is, the mouth washes and the filling—are of no use, Guy advises the margins of the carious cavity being taken away with a scalpel and file, so that alimentary substances may not be retained inside it. ”

“ 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. ”

“ 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. ”

“ Mouth Cavity in Man.—In our study of a frog we find that the mouth cavity has two unpaired and four paired tubes leading from it. These are (a) the gullet or food tube, (b) the windpipe (in the frog opening through the glottis) , (c) the paired nostril holes (posterior nares) , (d) the paired Eustachian tubes, leading to the ear. All of these openings are found in man.
In man the mouth cavity, and all internal surfaces of the food tube, are lined with a mucous membrane. The mucus secreted from gland cells in this lining makes a slippery surface so [Pg 301] that the food may slip down easily. ”

“ There is infection; therefore, the first thing to do is to remove the pus.
Dental Treatment.—If there is a large cavity in the tooth, try to enter the root canals and remove the putrescent matter. If the face is badly swollen, make a digital examination, and over the root of the affected tooth you will find a spot about the center of the swelling where it seems to be spongy, appearing to hold the impress of the finger. Take a clean, sharp, cycle-shaped lancet, place on the spot, holding the patient’s head firm with your other arm for fear of his moving. ”

“ Soft mucous polypus may exist for many years, without depressing the palate, or projecting into the fauces. The anterior nasal cavity is its most frequent seat, and it widens and fills up the fissure between the anterior and posterior cavities: frequently it projects backwards, but is not visible, though it may be felt with the finger behind the soft palate. Its growth is slow. ”

“ In young teeth, he says, the dental cavity is very large, in proportion to the size of the tooth. According to some anatomists, the central cavity of a tooth is coated by a very soft and thin membrane, formed by a tissue of very small vessels and nerves; and besides, this cavity is filled with marrow, like hollow bones. The observations of the author, however, do not agree with these statements. The dental cavity does not contain any fatty substance analogous to the marrow of bones. As to the above-mentioned membrane, Eustachius doubts its existence. ”

“ Plugging cavities, either with gold or tinfoil, of good quality, should never be neglected. Carefully remove all rotten portions; thoroughly cleanse and dry by means of cotton; then introduce the metal gradually, pressing it into all parts of the cavity with as much firmness as possible, until it becomes a solid mass with the exterior surface, even and smooth. ”

“ This may be done by wrapping a two-inch square piece of linen or gauze, saturated with the mouth-wash, around the little finger and wiping every portion of the cavity—not far enough on back of the tongue to provoke nausea. If it is necessary to clean the throat, a small swab may be employed. For thorough cleaning of the mouth several sponges are necessary. These may be received in a piece of paper and at once burned. While cleaning the mouth of a delirious patient the nurse for her own protection must place some hard substance between the patient’s teeth. ”

“ In making use of the actual cautery, the immediate end in view was to cause the cessation of obstinate toothache. “When the teeth give great pain and no relief is to be derived from the use of other remedies, one ought to cauterize the caries after having removed the extraneous substances that290 may eventually be found in the carious cavity. After the cauterization one scrapes the cavity and fills it up with cotton-wool soaked in oil of cinnamon. ”

“ The cavity of the mouth leads into a sort of stomach, which is very unlike those of the higher animals, in the circumstance that it opens at the lower end into a cavity of the body, and all the digested matter, converted into nourishment, is thus distributed through the rest of the body. ”

“ The cavity of the mouth is actually larger than that of the body, thorax and abdomen together. The upper jaw is very narrow, but greatly arched from before backwards, to increase the height of the cavity and allow for the great length of the whalebone-blades ”

“ The gums are pale, or violet-red, hard and lumpy, sometimes bleeding; the toothache is continuous. Among the numerous remedies recommended against this malady (mouth washes, frictions, draughts, pills) , one particularly deserves mention: it is the urine of a child used as a mouth wash.
7. Tchong-che-tong. Pain in the teeth after mastication; there is also sometimes excoriation of the gums; flow of purulent mucus mixed with blood; bad-smelling breath; the tooth falls; it is decayed, and one can perfectly well distinguish a small hole; the root is unsound ”

“ Remember that toothache indicates something seriously wrong with the teeth which can only be permanently corrected {276} by a dentist. In toothache if you can find a cavity, clean it out with a small piece of cotton or a toothpick. Then plug it with cotton, on which a drop of oil of cloves has been put if you have it. If no cavity is found, soak a piece of cotton in camphor and apply it to the outside of the gum. Hot cloths and hot bottles or bags will help in toothache, just as they do in earache. ”

“ He describes accurately (p. 226 and table xvi.) the cavity in the superior maxillary bone, to which his attention was drawn by a lady patient, in whom an abscess of this cavity, ever since known as the antrum of Highmore, was drained by the extraction of the left canine tooth. He became a magistrate for Dorsetshire, and attained considerable practice as a physician. ”

“ 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. ”

“ Every woman, and especially every mother, should know the time and order in which the infant teeth come, and, when any of the above symptoms appear, should examine the mouth, and if a gum is swollen and inflamed, should either have a physician lance it, or if this can not be done, should perform the operation herself. A sharp pen-knife and steady hand making incision to touch the rising tooth will cause no more pain than a simple scratch of the gum, and usually will give speedy relief. ”

“ Our teeth, says the author, grow old together with us, and toward the term of life they abandon us, a fact which also distinguishes them from the other bones. When, however, it occurs, through illness, that the teeth are extracted or fall out spontaneously before the period of old age, the alveoli become filled up with a bony substance; and in addition the two osseous scales of the maxillary bones approach one another and unite together in such a manner as to form a sharp margin, every vestige of a cavity being obliterated. ”

“ The Symptoms that generally indicate the cutting of teeth, in addition to the inflamed and swollen state of the gums, and increased flow of saliva, are the restless and peevish state of the child, the hands being thrust into the mouth, and the evident pleasure imparted by rubbing the finger or nail gently along the gum; the lips are often excoriated, and the functions of the stomach or bowels are out of order. ”

“ If our examination of the mouth discloses anything likely to interfere with mastication the aid of the dentist should at once be sought, but every physician should be so far acquainted with disorders of the teeth as to be able to say, in the majority of cases, at all events, when this is necessary. ”

“ A caries36 of the bone is at all times a disease which is difficult to manage, both on account of the mechanical obstacles which we have to overcome, and the slowness with which the affected parts perform their actions either of disease or recovery. The divisions of this disease have generally been taken from the appearance of the caries, and its extent. We have the dry caries, the worm-eaten caries, the spongy, or carnous caries, &c. and we have the deep and superficial. ”

“ New surfaces for the saliva to work upon are constantly exposed by means of some fifty or sixty exceedingly tiny 'teeth,' which, by the aid of the microscope, will be found at the opening of the mouth, just where the tube-bearing flaps join it. ”

“ If any very acrid material be held in the mouth, as the root of pyrethrum, or the leaves of tobacco, the salival glands are stimulated into stronger action than is natural, and thence secrete a much larger quantity of saliva; which is at the same time more viscid than in its natural state; because the lymphatics, that open their mouths into the ducts of the salival glands, and on the membranes, which line the mouth, are likewise stimulated into stronger action, and absorb the more liquid parts of the saliva with greater avidity ”

“ The teeth divide solid food, the glands which line the inside of the mouth moisten it, the tongue mingles the food, presses it against the palate so as to force out the juice, and then collects the elements in the centre of the mouth, after which, resting on the lower jaw, it lifts up the central portion forming a kind of inclined plane to the lower portion of the mouth where they are received by the pharynx, which itself contracting, forces them into the oesophagus. ”

“ 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. ”

“ 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. ”

“ If the probe slide readily over the bone, it is free from caries, but if it does not so, and yet no inequalities are felt on it, caries has taken place, but it is still smooth: if it feel unequal and rough, the bone is eaten with caries. ”

“ The patient who now takes the soluble preparations of iron, is provided with an instrument to convey the liquid into the pharynx, and prevent any portion of it from coming in contact with the teeth. Those who swallow such a form of medicine, without employing the tube, soon exhibit the consequence in the general discolourization and decay of the mouth. The man, however, gulps his physic, and can rinse out his mouth if the taste be retained ”

“ When the teeth are carious he directs us to scrape them, and [295] apply to them a mixture of the flowers of roses, galls, and myrrh, and to hold undiluted wine in the mouth. When the teeth are slackened by any accident, he directs us to fasten them to the surrounding ones with a golden thread, and then to hold some stringent decoction in the mouth. When in young persons a second tooth appears before the first has fallen out, he recommends us to scarify around the latter and pull it out, and to endeavour to force the other gradually into its proper place. ”