Page 200 - My FlipBook

196 OPERATIVE DENTISTRY
and result in the obliteration of the dental tubuli by the deposit of
calcific matter termed ''tubular calcification." When this is the
result all sensation may be absent.
Exposure of Cementum through gum recession is another excit-
ing cause of hypersensitive dentine aggravated by allowing the ac-
cumulation of sordes about the exposed cementum.
Abnormal Oral Secretions often produce hypersensitive dentine
and may be particularly looked for in the convalescent stages of
fevers, as well as in dyspepsia, neuralgia, pregnancy, pulmonary tu-
berculosis and acute rheumatism.
Hypersensitive Dentine is found in poorly calcified dentine in-
cluding the teeth of the growing child; teeth that have not been
erupted for more than a few months; the teeth of those who follow
indoor lives, particularly if they are under a heavy mental strain,
as well as anything which may produce nervous irritation or debility.
The Varying" Temperaments of Patients must be studied and un-
derstood to best cope with the problem of hj^persensitive dentine.
The suffering is actual upon the part of some, while there are those
who magnify every pain and seem to be able to stand nothing and
make as much fuss about a pin stick as it would be possible for them
to make were they thrust through Avith a bayonet. The operator must
separate these classes and vary the methods. He must understand
the actual conditions and, by kind words of encouragement and a
positive procedure, stimulate the nervous to withstand the necessaiy
pain. This can only be done when the operator has full control of
his own feelings, seeing to it that his temper is not ruffled, for, hav-
ing lost control of himself, he has no control over the patient.
Highly-Wrought, Nervous Temperament is, by nature, sensitive
to impressions, especially augmented by environment or occupation
and calls for the most skillful management of both patient and teeth.
People of this type are generally of a high order of intelligence and
when handled by a master hand prove a most desirable clientage.
Patients of This Temperament aaIII permit being hurt for a shoi-t
time provided something definite has been accomplished. They should
be advised at times as to the coming pain, and for what purpose it
must be inflicted, as the forming of an angle or the flattening of a
Avail, explaining, when done, that that which had been intended has
been accomplished. Thej' will stand for no awkwardness or fumbling
but admire exactness and precision and are the class Avhich will re-
ward the dentist most liberally for painstaking efforts and actual
achievements. This class make the day long but they serve to stim-