Permanent tooth

“ It is certainly possible, by a strong mental effort, to keep pain in subjection during a dental operation. A firmly fixed tooth, under a bungling operator, may be wrenched from the jaw without pain to the patient, if he will only determine not to feel. ”

“ It is, however, impossible to examine the molar teeth satisfactorily during life. Far less frequently an incisor tooth becomes loosened; more often it loses its glistening appearance and looks dull and yellowish. ”

“ But it is a safe plan to have the teeth looked over at least twice a year, for you may have broken a tooth without knowing it, and by the time a decayed spot is large enough to cause pain, or has made a hole that you can feel with your tongue, it has advanced much farther than it should have been permitted to do. ”

“ It depends, in many cases, on a humorous fluxion of a hot or cold nature which flows into the alveolus, forcing the tooth outward, loosening it, and causing the patient so much pain on the slightest pressure being exercised on it, that he cannot dare to bite with it in the least. If, however, the tooth is corroded, hollowed out, or pierced to the root, the pain is so strong, when the patient drinks—particularly if the liquid is cold—that he seems to have had a stab with a stiletto inside the tooth. ”

“ It is no rare thing, also, in these days, not only for unprofessional persons, but also for medical practitioners, to fall into errors of this kind, especially because, in similar cases, the wisdom tooth, having but a limited space in which to erupt, is in the habit of filling the void left by the second molar, where it meets with less resistance. ”

“ The teeth are thus nourished like other parts of the body. The exposure of the delicate pulp to the air, due to the decay of the dentine, gives rise to the pain of toothache.
Surrounding the cavity on all sides is the hard substance known as the dentine, or tooth ivory. Outside the dentine of the root is a substance closely resembling bone, called cement. In fact, it is true bone, but lacks the Haversian canals. The root is held in its socket by a dense fibrous membrane which surrounds the cement as the periosteum does bone. ”

“ It is necessary, therefore, to avoid acting like the ignorant and foolish barbers, who in their temerity do not observe any of the above-mentioned rules, and therefore very often cause the patients great injuries, the least among which is the breaking of the tooth, the root being left in the socket, or else the taking away, together with the tooth, of a piece of the maxillary bone, as the author often happened to see. After the extraction the patient must rinse his mouth with wine, or with vinegar and salt. ”

“ 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 an incision to touch the rising tooth, will cause no more pain than a simple scratch of the gum, and usually will give speedy relief. ”

“ Then they fall to with their spades, cutting the flesh away from the lower part of the tooth and loosening it, and completing the extraction by main strength, very much after the fashion of a dentist, but by means of the falls instead of forceps. Often the loop slips off of the tooth suddenly, letting down the men who are swaying away on the falls, and starting shouts of laughter. Or the whole strip of teeth may come together, held together by the gums. When the teeth have all been drawn the jaw is sawed into slabs for convenient use, for the jawbone is very hard and close-grained. ”

“ When one wishes to apply an artificial crown to the root of a natural tooth, one files away the part of the root that emerges above the gum, and even more if possible. One then removes, with proper instruments, all that is decayed in the root itself; after which one stops the root canal with lead and fits the base of the artificial tooth to the root in such a manner that they correspond perfectly to each other. One drills one or two holes in the tooth through which to pass the ends of a thread, which serves to fasten it to the natural teeth on each side of it, as described above. ”

“ It is not always necessary to have teeth extracted when they ache. The nerve, or the investing membrane of the root, may be diseased, and the tooth still be sound. In such instances, the tooth should not be extracted, but the diseased condition may be remedied by proper medication. There are many sound teeth, that become painful, as already mentioned, which are unnecessarily removed. ”

“ A moment's reflection will show the folly of extracting teeth to make room for those out of alignment, and modern dentistry has
proved that such extraction will defeat the object for which it is undertaken, viz., the restoration of the perfect denture. A man who will extract a tooth in regulating may be foolishly clinging to the old tradition, that was spoken of just now, that the unfortunate child had inherited large teeth from one parent, and small jaws from the other. ”

“ It very often happens that the patient cannot indicate exactly which tooth it is that gives him pain, his sufferings being so acute as to appear spread over a great part of the jaw. One cannot, therefore, trust too much to the indications given by the patient as to the point of departure of the pain, and must take care not to extract a healthy instead of a diseased tooth. ”

“ The front teeth are called incisors because they are used to cut the food. The back teeth are named molars because they are used in grinding the food.
Fig. 32 —Photograph of teeth not kept clean, showing how germs and a sour substance called acid eat holes in them and thus cause decay and toothache.
Toothache.—Toothache is a common ailment, and yet it can be entirely prevented. A tooth does not ache until it has a hole in it. The tender nerve within gives us warning that it is being hurt. The dentist can stop the ache and mend the tooth so that it will not ache again. ”

“ 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. ”

“ Were the teeth to be without this power, the animal would run a great risk of dying from hunger, the injured tooth not being able either to do its own work, or to aid its companion of the opposite jaw. Either tooth alone would be as useless as a single blade of a pair of scissors.
There is another notable characteristic of these incisor teeth. If you will examine the incisors of any rodent, whether it be a rat, a mouse, a rabbit, or a beaver, you will see that the tips are "bevelled" off just like the edge of a chisel. This shape is absolutely necessary to keep the tooth in working order. ”

“ This is met, as is characteristic in rodents and grass eaters, by the development of first high-crowned, then permanently growing molars. In acquiring the permanently growing tooth, some of the irregularities of the crown are lost, others which are deep-seated enough to affect the tooth even to the root are maintained, so that especially the external and internal infoldings become a persistent part of the tooth, having been impressed into the dental papilla. ”

“ Finally, if the patient can no longer bear the pain, the tooth is extracted and in this the suffering person has two choices. One method is to knock the tooth out. One end of a piece of bone or hard wood is placed against the base of the tooth and an obliging neighbor taps the other end sharply with a stone axe. ”

“ When a tooth has gone so far to decay, that it cannot be cured by stopping, it should not be suffered to remain in the mouth, lest it infect the rest. Front teeth, however, when the roots remain sound, and firmly based in the sockets, ought not to be extracted, as upon the latter artificial teeth can be placed with great advantage. In such cases, the removal of the crown only is necessary. ”

“ The fractured molar tooth appears to have belonged to the inferior maxilla on the right side; the crown is destroyed; a part of the cavity of the root remains. The body is compressed transversely, and presents a double curvature, which renders its anterior and exterior aspects slightly convex; the posterior and interior gently concave; these surfaces are all uniform, with the exception of the interior or mesial aspect, which presents a longitudinal rib or ridge, one-half the thickness of the long diameter of the tooth ”

“ A tooth must not be sacrificed excepting when it is loose and attacked by incipient necrosis, so as to leave no hope of arresting the putrefactive process. It is then our duty, says Heurn, to remove the tooth without causing much pain. For this purpose, after the tooth has been separated all around from the gums, it must be raised somewhat from the alveolus; then it must be sprinkled with powder of euphorbia, or a paste made with flour and the juice of the tithymalus must be applied around it, taking care, however, to cover the neighboring teeth with wax. ”

“ At this age the marrow is very considerable and the tooth being small in proportion, it is easy to raise the tooth without injuring it, because it has as yet no root and the opening at the base of the crown is very large. The tooth being raised and the marrow thus laid212 bare, if it is irritated in any way the animal gives signs of the most acute pain. I have often made this experiment, always easily done, on account of the want of thickness of the osseous layers which then form the sockets. ”

“ When the dislocation is only on one side, the chin and the whole jaw are found deviated toward the part opposite to the luxation; and the similar teeth of the two dental arches do not correspond; but instead under the upper incisors will be found the canine tooth of the dislocated89 part. If, however, the luxation is bilateral, the chin inclines and projects forward; the lower teeth are farther in front than the upper ones, and the muscles of the temples are tightly stretched. ”

“ The hard parts of a tooth commonly enclose a central pulp-cavity into which projects the pulp, a papilla of the dermis including blood-vessels and nerves. As long as growth continues the outer layers of this pulp become successively calcified and added to the substance of the dentine. In young growing teeth the pulp-cavity remains widely open, but in mammals the general rule is that as a tooth gets older and the crown becomes fully formed, the remainder of the pulp becomes converted into one or more tapering roots which are imbedded in the alveolar cavities of the jaws. ”

“ A clear view of the tooth and its surroundings can be obtained during the whole period of removal.
(2) Force can be applied with greater advantage.
(3) The alveolus can be easily embraced by the fingers, or by the finger and thumb of the left hand.
(4) In removing the tooth from the socket a slight backward movement can be employed.
One disadvantage of shape fig. 29 is that it is difficult to employ much inward movement, and therefore, for teeth lying inwards, namely, with the crown directed towards the tongue, hawk’s-bill-shaped forceps cannot easily be used. ”

“ As the tooth wears, the surface, besides the external enamel layer as in an ordinary simple tooth, shows in addition a second inner ring of the same hard substance surrounding the pit, which adds greatly to the efficiency of the tooth as an organ for biting tough, fibrous substances. ”

“ Come what may, they must keep up at an equal rate the wear and tear of the incisors, and the internal growth of the pulp beneath, which is always pushing the tooth forward. This dull continuous work might otherwise have a terrible result, which you would never suspect. It is very disastrous for a young lady to lose a front tooth, as it is called, for it sadly spoils a pretty face; but for a rodent such a loss is much worse ”

“ When a tooth aches, and it is thought well to extract it, because medicaments are of no use, the gum must be detached all around, and then the tooth must be shaken until it is well loosened, it being very dangerous to draw a firm tooth, as this may sometimes give rise to a dislocation of the lower jaw. And greater still is the danger in regard to the upper teeth, as this might cause a shock to the temples and eyes. ”

“ If we are mouth-breathers, our jaws will grow out of shape, so that our teeth are crowded and irregular and do not meet each other properly in chewing. Pressure upon the roots of the teeth, from meeting their fellows of the opposite jaw in firm, vigorous mastication, is one of the most important means of keeping them sound and healthy. Whenever a tooth becomes idle and useless, from failing to meet its fellow tooth in the jaw above or below properly, or from having no fellow tooth to meet, it is very likely to begin to decay. ”

“ When one or more teeth have appeared in an irregular position and offend the walls of the oral cavity or else the tongue, the excision (resection) of the tooth or teeth must be performed with a pair of strong pincers, whose shape must vary according to whether the teeth are situated externally or internally with regard to the dental arches. But as after the resection there will almost always remain some points or sharp irregularities, which by their presence would continue to irritate the soft parts, it will be necessary to remove these irritating prominences by means of the file. ”