1. The human family is subject to a variety of diseases in the teeth,
which generally cause the final destruction or loss of these important
instruments, unless judicious remedies are applied in proper season.
These remedies are administered by the dentist.
2. There are few persons, in proportion to the great mass of the
people, who seem to be aware of the utility of dentistry; for, taking
the United States together, not more than one person in a hundred ever
resorts to the professors of this art, with the view of obtaining a
remedy for any dental disease with which he may be afflicted. The
common sentiment seems to be, that diseases of the teeth, and their
final loss, at different periods of life, are inevitable
inconveniences, to which we must submit with the same philosophy with
which we meet other misfortunes.
3. To enable readers who have never examined this subject, to
comprehend its general nature, we will give a slight sketch of some of
the irregularities and diseases to which the teeth are liable, and, as
we proceed, speak of the remedies applied by the dentist.
4. Two sets of teeth regularly appear, at different periods of life;
one in infancy, and the other, at a later period. The first set
consists of twenty, and the second of thirty-two teeth; the former are
called _infant_, and the latter _adult_; and all these, at the age of
six or seven, are upon the jaws at the same time.
5. At the age just mentioned, the infant teeth begin to give way to
those which lie deeper in the sockets, and which are designed to
supersede the former. As the new teeth advance, the roots of the first
are absorbed; and, after having been thus deprived of their support,
they are easily removed; sometimes, by a slight pressure of the
tongue.
6. In a majority of cases, the whole process is carried on by nature
with the utmost regularity; but, as she is not uniformly successful in
this operation, there is no other period at which the teeth of
children require so much attention and care. Sometimes the second set
rise in the socket without causing the absorption of the roots of the
first. In such cases, the former approach in an improper direction;
and, unless the latter are removed in season, deformity will be the
consequence.
7. When, however, these precautions have been neglected, and the teeth
stand in an irregular manner, they can sometimes be reduced to
symmetry by the dentist, without occasioning much pain. When the front
teeth are too much crowded by reason of the restricted dimensions of
the jaw, the small teeth, situated next behind the eye, or canine
teeth, are extracted, one on each side, to give room to the rest.
8. From the ages of six to fifteen years, the teeth of children should
be examined, at least once in six months, by a dentist, who, if
skilful, can seldom fail of rendering these ornaments of the human
countenance regular, healthy, and beautiful. It is customary in
England and France, for the proprietors of seminaries of learning to
employ a dentist to visit their establishments regularly, for the
purpose of performing such operations, and of administering such
remedies, as their pupils may require.
9. The teeth are composed of very hard bone and enamel. The latter is
a substance exceeding in density any other in the body. It covers the
crown of the teeth, and is thickest in those parts which are most
exposed to forcible contact in mastication; but, in no place, is it
more than the twelfth of an inch in thickness.
10. The most common disease of the teeth is _caries_, or decay, and
almost every part of them is liable to be affected by it, but
especially the sides of those in front, and the crowns of those on
other parts of the jaws.
11. The disease begins its attack either on the enamel or on the bony
portion, and gradually extends itself over the tooth, until it reaches
the nerves which supply its natural cavity. These having become
exposed to the sudden changes of temperature, and to the contact of
extraneous substances in mastication, pain and inflammation are
produced, and the extraction of the tooth very commonly becomes the
only means of relief.
12. All persons are more or less subject to this disease, but some
much more than others; and caries of a peculiar character has been so
often traced through whole families, from one generation to another,
that it is considered hereditary, as much as any other disease to
which the system is liable. In many cases, caries seems to be the
effect of some serious disease which affected the constitution, while
the teeth were in the early stages of formation.
13. Although the teeth of some individuals possess but little
durability, and, when caries attacks them, go on rapidly to decay, in
spite of all the aid which science and skill can afford, yet, there
are comparatively but few instances in which seasonable and judicious
treatment will not arrest the progress of the disease.
14. When the teeth are but slightly affected with caries, especially
on the sides, a cure may be accomplished by the removal of the decayed
portion. This is effected, by the most approved dentists, chiefly with
small cutting instruments. Formerly, the file and the saw were
employed for this purpose; and, by their indiscriminate and
injudicious use, many teeth were ruined, and the art of dentistry
itself brought into disrepute.
15. Notwithstanding the injuries which have been inflicted by the
improper application of the saw and file, in some instances they are
indispensable; and, in the hands of the scientific operator, they need
not be feared. They are especially useful in preparing the way for the
employment of other instruments; for, in some cases, the affected part
can with difficulty be reached by any other means. But filing the
teeth for the purpose of improving their appearance, or for rendering
the sides more accessible to the tooth-pick and brush, seems to be
reprobated by the most intelligent part of the profession.
16. When the caries has penetrated far into the tooth, and, in its
removal, a cavity of suitable form and dimensions can be produced, it
is filled with some substance, with the view of protecting the bone
from the action of extraneous agents. The dentist is careful to
remove every particle of the decayed portion, and to render the cavity
perfectly dry by repeated applications of lint or raw cotton, before
he attempts to fill it.
17. Gold is the only substance which possesses sufficient solidity to
withstand the ordinary friction of mastication, and which, at the same
time, is capable of resisting the chemical action of the substances
that come in contact with it; yet lead and tin are frequently
employed; and many have been made to believe that they answer as good,
if not a better purpose, than gold itself. The durability of these
metals, however, can never be depended upon, and they ought not to be
employed, where the tooth is capable of resisting the mechanical force
required to fill it properly with gold.
18. The metal is prepared for the use of the dentist by the
gold-beater, in the manner described in the article which treats upon
the business of the latter. The leaves, however, are not beaten so
thin as those designed for the common purposes of the arts. The
portion to be applied is cut from the leaf, and, after having been
twisted a little, is forced into the cavity. The metal is rendered
perfectly solid by means of instruments adapted to the purpose.
19. This operation, properly performed under favorable circumstances,
generally renders the tooth as serviceable, to the end of life, as if
it had never been diseased. The hopes of the patient, however, are
sometimes disappointed by the unskilfulness of the operator, or by the
general unhealthiness of the mouth, arising from tartar, other decayed
teeth, or want of care in keeping them free from the lodgment of
particles of food.
20. It is a common practice to have teeth extracted, when they are
affected with pain; but this operation is not always necessary. In
many cases, the nerve can be paralyzed, and the tooth plugged. By
these means, teeth which, under the ordinary treatment, would be
prematurely sacrificed, are often retained, for years, in a
serviceable state.
21. The next most destructive affection to which the teeth are liable,
is the accumulation of _tartar_. This is an earthy substance,
deposited from the saliva, and is more or less abundant in different
individuals. This deposit is extremely troublesome, and generally does
much injury to the mouth, even before those who suffer from it are
aware of the mischief.
22. The tartar on the teeth of some individuals, is of a black or
greenish color, and very hard; on those of others, brown or yellow,
and not so firm. When it is first deposited, it is soft, and can be
easily removed with a tooth-brush; but, if suffered to remain, it soon
becomes indurated, and gradually increases in thickness about the neck
of the teeth. The gums become irritated and inflamed. The sockets are
next absorbed, and the teeth, being left without their natural
support, either fall out, or become so loose, that they can be easily
removed.
23. From this cause, old people lose their teeth, when, in many cases,
they are perfectly sound; but comparatively very few are aware of the
origin of this deprivation, or suppose that these valuable instruments
can be retained in old age. The loss is attributed to the deleterious
effects of calomel, or is imagined to be an evil inseparable from
advanced age.
24. The affection of the gums, arising from causes just mentioned, is
frequently called scurvy, and, like caries, produces fetor of the
breath; but, when these two diseases are combined, as is frequently
the case, they render it extremely offensive. Besides, the effluvia
arising from these diseased parts give rise to many maladies which
terminate fatally, if a remedy is not applied sufficiently early to
save the patient.
25. The obvious remedy for diseases arising from tartar, is the
removal of their cause. This is effected by the dentist, with small
sharp cutting instruments of a suitable form. To prevent the tartar
from accumulating again, and to restore the gums to a healthy state,
nothing more is generally requisite than the daily use of a stiff,
elastic brush, and the occasional application of some approved
dentrifice or astringent wash. Sometimes it may be necessary to
scarify the gums, or to apply leeches to them.
26. The operations of dentistry, mentioned in the preceding part of
this article, are those which relate to the preservation of the teeth;
and, if performed in a proper manner, and under favorable
circumstances, they will, in most instances, prove effectual. But, as
few persons resort to the dentist, until the near approach of
deformity, or until they are impelled by pain to seek relief, a great
proportion of dental operations consists in inserting artificial
teeth, and in extracting those which are past recovery.
27. 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.
28. The instruments commonly employed in extracting teeth, are the
key, or turnkey, the forceps, the hook, and the graver, or punch.
These are supposed to be sufficient to perform all the operations of
this kind which occur in practice; and, although many attempts have
been made to invent others which might answer a better purpose, yet
those we have mentioned, in their improved state, are likely to
continue in general use.
29. It seems to be a common opinion, that any one can pull teeth, who
has a turnkey, and sufficient physical strength to use it;
accordingly, blacksmiths, barbers, and medical students, are the chief
operators in this line of dental surgery. The many fatal accidents
which must inevitably be the consequence, such as breaking the tooth
or jaw-bone, are considered matters of course. These, however, seldom
happen with skilful dentists; and it is to be regretted, that the
latter are not always employed, where unskilfulness may produce such
serious consequences.
30. In the cut, at the head of this article, is represented a dentist,
about to extract a tooth for a lady, who may be supposed to be in a
state of alarm at the sight of the instruments; but he, having thrown
his right hand, which holds them, behind him, shows the other
containing nothing, with the view of allaying her fears. The manner in
which teeth are extracted, needs no description, since it is an
every-day operation in all parts of the world.
31. One of the chief sources of income to this profession, is the
insertion of artificial teeth; for, although few are willing to expend
much to prevent the loss of their teeth, many will incur great expense
in supplying the deficiencies, after they have occurred. So perfectly
and neatly is this operation performed, by some dentists, that it is
difficult to distinguish between teeth which are natural, and those
which are artificial.
32. The materials for artificial teeth were formerly found chiefly in
the teeth and tusks of the hippopotamus, and in the teeth of some
domestic animals; but, within a few years, a mineral composition,
called porcelain, has come into great repute, since it is very
beautiful, and is entirely proof against the most powerful acids.
33. Surgical operations upon the teeth were performed in ancient
Greece and Rome, many of which were similar to those of the present
day. The extraction of teeth must have been practised at a period of
antiquity to which the records of medicine do not reach. The operation
is recommended by Hippocrates, who describes many of the diseases to
which the teeth are liable. He also mentions the practice of fixing
the teeth by means of gold wire, and gives several formulas for making
dentrifices.
34. Celsus, a Roman writer on medicine, who flourished about the
beginning of the Christian era, seems to have been the first author
who described the method of extracting teeth, and the first who
notices the removal of tartar by means of cutting instruments, as well
as filling carious teeth with lead and other substances, with the view
of preventing further decay. Soon after this period, false teeth, of
bone and ivory, were introduced. Actius, a writer of the fourth
century, is the first who mentions the operation of filing the teeth.
35. The return of barbarism to Europe, nearly extinguished the
knowledge of dentistry. As a branch of surgery, however, it was
revived by the Arabian writer, Albucasis, in the tenth century; but,
for many hundred years after this period, it received but little
attention from men of science, the operations of surgery being
confined chiefly to the barbers.
36. The first modern work on the diseases of the teeth was published
at Lyons, in 1581. This was followed by many other publications on the
same subject, in the succeeding century. In the year 1700, it began to
be required in France, that all persons who intended to practise
dentistry in that country, should undergo an examination, to test
their qualifications. From this period is dated the establishment of
the dental art as a distinct branch of medical practice.
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