Levant, “among the Mussulmen, to make the little ablution with the face
turned toward Mecca; to rinse the mouth thrice, and clean their teeth
with a brush.” This shows how highly this custom is esteemed among a
people, who formerly were forbidden, according to Menavius, to have a
tooth extracted without permission from the emperor. Let children be
taught by their parents the proper degree of care necessary for their
teeth; they generally imitate them even in their sports:--here the
agreeable lesson will be converted into a useful habit. (_Duval_, p.
75.)
(29) _And blooming health will soon reward it all._
“As soon as the first teeth of a child are completed, they should be
brushed twice, or, at least, once a day, with a soft brush and water.
When children are thus early familiarized to the healthy and necessary
custom of brushing the teeth, it becomes a fixed habit, and they find
it ever afterward absolutely essential to their comfort. In winter, or
in cold weather, the water used in brushing the teeth should be tepid.
It is quite unnecessary to use any kind of powder to the first teeth of
children.” (_Murphy on the Teeth, London_, 1811, p. 118.)
(30) _Restore her hopes, and make her lovely still._
Tartar is more safely removed by instruments than by such chemical
solvents as have been too commonly employed; for, although the injury
they occasion is not at first perceptible, they ultimately disorder
the substance and texture of the teeth. This is not the case when
the operation is properly performed by means of instruments; and is
attended with neither pain to the person, nor danger to the enamel.
The manual operation of cleaning the teeth with instruments, is not
performed with equal skill and delicacy by all who practise it.--There
are, of course, as many different degrees of merit in dentists, as
there are in the practitioners of any other art or science.
(31) _The offspring of an epicurean age._
“But just disease to luxury succeeds,
And every death its own avenger breeds;
The fury passions first from blood began,
And turned on man a fiercer savage--man.”
_Pope’s Essay on Man_, Epistle III.
(32) _And bears them all successively away._
Caries is the most frequent disease of the teeth. The general seat of
it is, on the sides of the front teeth and in the centre and sides of
the back ones. Its progress through all its different stages is easily
marked. First of all, a small dark spot appears on the enamel, through
which the disease quickly passes into the internal structure of the
bone. When this has taken place, the least pressure from chewing any
hard substance is liable to break away portions of the enamel, and thus
the internal part becomes subject to every injury which can arise from
extraneous matter lodging therein. The molares are more subject to this
disease than the front teeth; first, because their indented surfaces
more readily retain any extraneous matter; and secondly, because they
are less in view, and consequently less attended to.
In the enamel of the most apparently perfect teeth, small cracks
may, with a magnifying power, easily be discovered. These, although
unnoticed by the individual, are sufficient to admit disordered fluids,
and to account for many forms of decay. This may likewise account for
decay taking place in the broad surfaces of the molares, where the
points of contraction always produce a depression, and thus afford a
convenient lodgment for acrid saliva and other decomposing agents.
From my own observations I am induced to believe, that caries is
universally caused by the action of external agents; and therefore
cleanliness, and a due regard to the general health, after the proper
offices of the dentist are performed, is the only guard against it. But
some teeth, from their being of less dense structure, are less capable
of resisting the action of decomposing matter, and consequently will
require greater attention to ward off disease.
Mr. Brewster, of Charleston, whose experience, from having been
fifteen years in extensive practice, has given him ample opportunities
of judging, has, in a manuscript with which he politely furnished
me, enumerated the following as the principal causes of decay.
Constitutional softness of the teeth; The use of medicines during
dentition or in after life; The too free use of acids, which, uniting
with the lime in the enamel, destroys its strength; A too slow growth
of the teeth between the time of protruding their points through the
gum, and the full development of their crowns. It will often happen
that the projecting points of the grinding teeth pass through the
gum, and there for a long time remain with a portion of the surface,
comprehending the indentations of the grinding surface, partially
covered with the gum. As there is no union between the enamel and the
gum, fine and soft particles of food insinuate themselves between the
gum and the tooth. This matter decays, and the acid generated thereby
acts perniciously on the enamel, and lays the foundation for subsequent
decay of the tooth. The remedy is simple, and, in most cases,
effectual. It consists in removing the gum from the top of the tooth,
which is performed by a skilful operation, with little or no pain to
the patient. This prolific source of decay I am not aware has ever been
noticed by any writer on the teeth. Another prolific source of decay is
the permitting a new tooth to come in contact with the decaying part of
an old one. The remedy consists in removing a portion or the whole of
the old tooth.
The too free use of mercury; The accumulation of tartar; Neglect of
cleanliness by suffering the particles of food to remain between the
teeth after meals; Irregular living, or any other cause which occasions
a disordered stomach; Extremes of heat and cold; All Acids, whether in
fruits, powders, or lotions; Metalic toothpicks; Injudicious dental
operations; Most of the nostrums administered for tooth ache.
“I propose,” says Mr. Bell, “to substitute for the word caries, the
term gangrene of the teeth, which expresses the real nature of the
disease. It may be defined--mortification of any part of a tooth,
producing gradual decomposition of its substance. It usually attacks
the crown of the tooth; sometimes, though rarely, the neck; but I
believe it scarcely ever makes its first appearance on the root.
It invariably shows itself on the external surface of the bone,
immediately underneath the enamel, and its existence is, in many
cases, first indicated by an opaque spot on that substance, occasioned
by partial breaking down of its crystalline structure; in others,
its presence is shown by the discolored bone being seen through the
semi-transparency of the enamel.” (_Bell on the Human Teeth_, p. 118.)
I have made the foregoing quotation from the work of Mr. Thomas Bell,
with whom I once conversed personally on the doctrine contained
therein, for the purpose of expressing my entire dissent from the
opinion held by most of the writers on this subject, in relation both
to the local origin, and the immediate cause of caries, or dental
gangrene. Some of these writers divide the disease into two kinds,
which they distinguish by the names external and internal caries;
while others inculcate the doctrine so hostile to all my experience
and observation, that caries commences, as Mr. Bell says in the
passage quoted, on the surface of the bone, under the enamel, and
that the disease becomes visible through the semi-transparency of the
enamel, which itself is destroyed by being broken away by mechanical
violence. Now I must aver, that after a constant and extensively
diversified practice of nineteen years, both in Europe and America, I
have never known a solitary instance of this disorder which was not
evidently occasioned from external causes on the surface of the tooth,
penetrating first through the enamel, if on the body of the tooth, and
then assailing the bony structure.
There are teeth that are faulty, both in their enamel and organization;
owing, probably, to constitutional or hereditary peculiarities which
have not, as I am aware, ever been satisfactorily explained by any
author.
As to the cause of caries, I published my opinion many years ago,
first in London, and afterwards in this city, and have seen no cause
to espouse a contrary opinion. I consider the immediate and exciting
cause of dental decay to be always external to the tooth itself, and
to consist of certain corrosive menstrua, to which these organs are
exposed from bodily disease, improper aliments, powerful medicines
and the thousand other sources of acrid filth and destructive poisons
that become concentrated in the mouth and deposited upon the teeth.
These procuring causes of caries may indeed derive their origin from
constitutional diseases acting upon the system at various periods of
life, but whatever internal defect of structure a tooth may derive
from original organization, how much soever it may be predisposed to
take a diseased action under favorable conditions, still, the tooth
never decays till externally affected by putrescent, or corrosive, or
disorganizing matter, which breaks up its structure.
That such has been my uniform opinion, will be seen from the following
extract from the work on the stomach and digestive organs, published by
Dr. Thomas Hare, Fellow of the Royal College of Surgeons in London, in
1821.
“The theories concerning the cause of decay in the teeth which seem
to have met most attention, are those referring it to an undue degree
of compression exerted by the irlateral surfaces on each other, and
to a putrefactive fermentation of extraneous matter lodging in the
interstices. The former has been ably set forth by Mr. Bell, of St.
Thomas’s Hospital, in the Medico-chirurgical Transactions; the latter
was published about two years ago, by Mr. Parmly.” (page 269.)
(33) _A dream forgot, a tale of other years._
Dr. Fitch alleges the following three modes in which disordered teeth
contribute to the production of that distressing disease--the dyspepsy,
or indigestion.
“First, by preventing a proper mastication of the food.
“Secondly, by the ulcerated and putrid matter which passes from the
teeth and gums, along with the aliment, to the stomach.
“Thirdly, the irritation produced by diseased teeth, being often so
great as to disturb the healthy functions of the system, and of the
stomach in particular.” (_Fitch on the Teeth_, p. 308.)
(34) _Most justly damned to everlasting fame!_
“The pain commonly termed the tooth-ache is one of the most
excruciating to which we are liable. It is caused by an inflammation
of the membrane lining the cavity. In inflammation, one of the
consequences is a swelling of the part, which is generally followed by
a diminution of the pain, the degree of which seems to be regulated by
the resistance and compression which the inflamed vessels suffer from
the surrounding parts. The membrane of the tooth being situated within
a cavity which is incapable of extension, there must necessarily exist
an insurmountable obstacle to the swelling of the membrane; and this it
is which renders the pain so extremely acute. In some few instances,
caries will proceed without being accompanied by any sensations; the
tooth gradually breaks away, until the whole of it is removed.” (_Fox_,
Part II. p. 25.)
“The pain called tooth-ache, which Galen very properly considered the
most cruel and grievous of all pains that are not mortal, seems clearly
to be occasioned by decayed portions of bone, no matter how minute,
acting by contact on the nerves of the teeth.--And I firmly believe the
pain is never felt until the caries, which always acts from without
inwards, has actually met a branch of nerve.
“No species of animal matter, in a state of decay, is so offensive to
the vitality of the adjoining substance, whether nerve, or muscle, or
membrane, or any part or portion of the living body, as decayed bone.
How very small a portion of decayed bone in a tooth is capable not
only of causing the most agonizing pains, but also of communicating a
fœtor to the breath, is inconceivable by those who have not pursued the
inquiry with minuteness: and this offensive matter, when it thus has an
opportunity of acting, communicates, through the medium of the nerves,
a sympathetic pain to the teeth which are perfectly sound.” (_Hare on
the Stomach_, p. 240.)
In addition to the preceding remarks, I observe, that the tooth-ache
is sometimes so severe as to produce alarming derangements of health;
while at other times it is merely an annoying sensation, which can
scarcely be termed pain. The cavity of the tooth, in most cases, is
the original seat of this malady. But as the teeth are supplied by
ramifications of those nerves which supply different parts of the face
and head, it frequently happens that one or more of those parts may
suffer more severely than the tooth itself.
Diseases in the wisdom teeth of the lower jaw affect the ear; and when
those of the upper jaw are diseased, the temples generally become
affected. The effects of disease in one tooth, from nervous influence,
is sometimes felt in the opposing tooth of the other jaw.
No certain treatment can be laid down for the tooth-ache; it must be
regulated entirely by a knowledge of the cause, whether arising from
decay, the irritation of tartar, the application of cold, or merely
as a sympathetic affection. The disease which occasions this malady
is insidious in its progress, dangerous and sometimes fatal in its
consequences; but the danger more frequently arises from an improper
application of remedies, than from the disease itself. Powerful
remedies for the tooth-ache, as well as for other diseases, are
hazardous in the hands of the ignorant.
(35) _And tooth-ache came, the terror of mankind!_
“When pains in the teeth show a disposition to change their places with
great facility, like all rheumatic affections, they may yield to the
most insignificant means, even to the touch of some amulet, applied
with an air of mystery and confidence which imposes upon the patient.
Every one knows, that in timid people, the presence of a surgeon,
in most instances, is sufficient, for a time, to dispel the pain of
tooth-ache. It is particularly for these pains that some dentists have
a favorite odontalgic elixir, of whose sovereign virtues they are so
fond of boasting. These liquors are almost all spirituous tinctures,
whose powerfully stimulating action often suffices to suspend the pain.
“In fact, a drop of the tincture of opium, or any one of the essential
oils, applied to the part by means of a little cotton, may produce an
instantaneous abatement of the pain, but which seldom fails, sooner or
later, to return. Frequent successes of this kind, of which marvellous
accounts are daily published, have successfully brought into vogue
numerous elixirs and various other means, all more or less ridiculous.”
(_Gerbaux_, pp. 80, 83.)
“Doctor Sims, a celebrated practitioner in London, relates that he was
such a martyr to the tooth-ache, that he was confined to his house for
several weeks together by that malady, but after he avoided taking his
food either hot or cold, he entirely escaped it. He was particularly
careful not to take soup or any other liquid, of a temperature higher
than ninety--eight degrees less than blood heat. He was induced to
try this experiment, by reflecting that heat expanded all bodies. When
applied to a tooth, therefore, it must diminish its cavity, compress
the nerve, and consequently produce pain. However defective this
theory may be, the practice of endeavoring to preserve those parts
in an equable temperature, will be found to be highly important.”
(_Duval.--Atkinson’s translation_, p. 76.)
(36) _To mercy deaf, by sorrowing man accurst._
The following characteristic lines are from the “Address to the
Tooth-ache,” by Robert Burns:--
“My curse upon your venomed stang,
That shoots my tortured gums alang,
And through my lugs gi’es money a twang,
Wi’ gnawing vengeance!
Tearing my nerves wi’ bitter pang,
Like racking engines!
“When fevers burn, or ague freezes,
Rheumatics gnaw, or cholic squeezes,
Our neighbors’ sympathy may ease us
Wi’ pitying moan;
But thou--the hell o’ a’ diseases,
Ay mocks our groan!
“Where’er the place be priests ca’ hell,
Whence a’ the tones o’ misery yell,
And ranked plagues their numbers tell,
In dreadfu’ raw;
Thou--tooth-ache, surely bear’st the bell,
Amangst them a.’”
“We were interrupted by Mr. L. He is one of your plain, common sense
sort of people, practical, fixed in his own opinions, a little inclined
to stoicism, with a dash of savage philosophy, partly affected to hide
tenderer feelings, and about six feet and an inch high, without his
shoes.
“‘What’s the matter with your face?’ inquired he.
“‘Tooth ache,’ said I, ‘all swelled: keeps me awake, and’----
“‘Try my _nitri dulcis_ and _alum pulv._,’ said W.
“‘Curse your _nitri dulcis_ and _alum pulv._,’ said L., ‘there is but
one cure for the tooth-ache, and that’s a sure one,’
“I looked tremblingly up. He had his great, square fist doubled, as if
he held something in his hand. He raised it to his mouth, and screwed
around with the motion of a dentist, uprooting some huge, double
grinder, with three diverging prongs. My friends were silent. I turned
a little pale. He saw what an impression he had made, and with a grin
that went to my very soul, added;--
“‘Out with it, you fool, and there’s an end. It’s worth all the _nitri
dulcis_ and _alum pulv._ in the universe.’
“There was a melancholy truth in what he remarked. It sunk into my
heart; I made up my mind; and when my worthy advisers left me, I walked
around to Mr. ----. There was an awful silence--a moment of intense
fear--a slight struggle--an agony--a cry from the heart’s core--I came
out the happiest of men.”--(_Dreams and Reveries of a Quiet Man, by
Theodore S. Fay, Esq._ Vol. I. p. 187.)
(37) _And stops the fearful progress of decay._
As great disadvantages frequently arise when teeth are decayed, from
their crowding against each other, it becomes expedient, with a view
to stop the progress of incipient disease, to remove portions from
their sides by means of a file; but, if this operation be not performed
before considerable parts are decayed, it must not be expected to
afford lasting benefit. The incisors and canine teeth may be filed with
the greatest probability of success; but the bicuspides and molares
have such large surfaces, that caries often extends itself by far too
deep before it is observed, to be effectually removed by the file.
Little advantage can be expected from filing, unless the whole diseased
part be effectually removed.
It is proper to observe, that there are some teeth, which, although
attended to at an early period, are but little benefitted by the
operation, either from some original defect in their organization,
or certain peculiarities of constitution: but this is, by no means,
commonly the case; and the instances of its proving essentially
serviceable are so innumerable, that it may be recommended with the
highest confidence of success.
(38) _Performs in nature one substantial use._
The benefits of the operation of stopping the teeth are so truly
important, that it is impossible to recommend it too earnestly to the
public; for thousands of the most useful teeth, which otherwise would,
on account of their painfulness, be sacrificed by extraction, may thus
be preserved, not only for many years, but for the remainder of a long
life.
The finest teeth are commonly the most highly organized, and therefore
become more acutely painful when only a very small portion is decayed.
The operation of stopping will always succeed, if performed before
the decay has reached the sensible part of the tooth, unless its
cavity be superficial, or of a funnel shape, and not capable of
being sufficiently deepened for retaining the gold. In such cases,
all attempts at stopping it will be fruitless. But if the depth be
sufficient towards the sensible part of the tooth to allow of the
excavation being made larger, or directed obliquely or otherwise, as
may be most eligible for receiving and securing the gold, the caries
may be so effectually arrested as to cause no farther uneasiness to the
patient.
“There is no object connected with dental surgery of more importance
than that of stopping. There is none better deserving the attention
of the student, nor is there any in which the dentist may more
successfully display his professional skill. Were we to judge,
indeed, from the almost innumerable cases of failure which occur, we
might conclude that the uncertainty of the operation was so great
as essentially to diminish its utility and importance. These cases,
however, generally occur under the management of ignorant persons, who
are alike incompetent to the mechanical and the surgical part of the
operation, and who are equally incapable of choosing a proper time for
its performance.” (_Snell on the Teeth_, p. 151.)
“If properly done,” says Dr. Fitch, “this is one of the most useful
operations in dental surgery; and if practicable, it bears the
preference to any other operation for the cure of diseased teeth. It
should be an object of solicitude in every case, when we are called
upon to extract or file the teeth, to obviate both operations by
plugging them, if in any way expedient or practicable.” (_Fitch on the
Teeth_, p. 398.)
“I have no hesitation in affirming this to be one of the most important
and useful operations that can be performed.” (_Sigmond._)
“By the beautiful and useful operation of stopping or plugging
teeth which are greatly decayed by caries, they may be preserved
for many years; in most instances during the remainder of life: and
not unfrequently, from ten to twenty teeth may be preserved by this
operation in the same individual.” (_Koecker._)
(39) _And pointing to the portal of the tomb._
“We have a most humiliating reflection, in observing the powers of
renovation which are enjoyed by the inhabitants of shells, some of
which, after their testaceous coverings have been broken, whether
on the edges, in holes, or in cracks about the middle, no matter
where--possess the power of directing, from their secretory vessels, a
sufficient quantity of calcareous matter and animal gluten to repair
the injury effectually;--whereas man has not the power of directing
a single particle, either of earthy or glutinous matter, from his
secretory system, to repair a small deficiency of enamel, which is
literally a modification of porcelain shell, and the loss of which
makes every accession of cold actually distressing.” (_Hare on the
Stomach_, p. 277.)
(40) _A shining panoply of orient pearls._
The chief object of attention in artificial teeth is, that the
substance be durable, and not liable to change color. Human teeth and
those of small animals have been heretofore supposed to answer the best
purpose, while teeth cut from those of the sea horse have ranked next
in importance; but lately, they have been formed with great success
from certain materials known to the manufacturers, and have been
variously denominated, according to the taste of the artist--silicious
pearl teeth--mineral teeth--porcelain teeth--incorruptible, and
terro-metallic. Under these titles, teeth of various degrees of
excellence are now made, both in Europe and this country, and from
their great beauty, cleanliness, durability, and unchangeableness in
regard to color, will no doubt be generally adopted. They certainly
possess some advantages over any other substitute for original teeth.
Of the various methods which have been devised for fixing artificial
teeth, the most successful is, that of fastening a new tooth by means
of a pivot to a sound fang. When thus fastened, the tooth may be worn
for a considerable time without producing any inconvenience. The next
method is, to adapt a tooth to the aperture from which another has been
extracted, and to fasten it to the adjoining teeth. A third method is,
to supply the place of teeth by means of a gold plate, to which the
substitutes are firmly affixed, the plate being fitted to the gums, and
supported by means of springs. A fourth mode of supplying teeth, by
which whole sets may be provided and worn with great convenience, is to
prepare gold or ivory frames, fitted closely to the gums, on which the
teeth are firmly arranged, and, by means of springs, made to perform
all the most essential functions of original teeth.
(41) _Like Him who fills unnumbered worlds with joy._