Page 206 - My FlipBook

202 OPERATIVE DENTISTRY

Through the General System.
Potassium Bromide in 5-grain doses three times a day for forty-
eight hours previous to a sitting at the dentist's will do much to
remove the nervousness caused by the fear of the intended visit and
serve to minimize the pain to be endured.
Nitrous Oxide when properly administered is of great value and
efficiency. It should be combined with oxygen or compressed air in
proper proportions. So combined and administered, it may be given
for a protracted period, long enough to prepare one or more sensi-
tive cavities without pain to the patient and in most cases with no
danger to health or life.
Somnoforme. Somnoforme when administered through a special
apparatus is one of our most efficient means of rendering the patient
semi-conscious and practically immune from any pain of dental opera-
tions. In the administering of this as well as other anesthetics for
analgesia, all of the rules pertaining to the administration of the
same anesthetic for major operations must be observed as the same
danger to life exists.
Chloroform Slowly Administered and only to the first stage of
anesthesia is a most valuable means of dealing with severe cases.
This is particularly true of the A. C. E. mixture (alcohol, chloroform
and ether, equal parts). The primary effect is to paralyze the sen-
sory nerves, as the ends of the fingers, the skin and mucous mem-
brane in general and this is true in the tooth's pulp with the fibers
ending in the odontoblastic layer of cells wherein abundant sensitive-
ness has been developed.
The Method of Administration is quite the same as that for any
other operation except that it is not carried past the first stage of
anesthesia. All that part of the preparation of the cavity not pro-
ducing pain is carried out, after which the dental chair is tipped
back to as recumbent a position as will admit of operating. A nap-
kin is then spread over the lower part of the face, leaving the eyes
uncovered. The chloroform, or better the A. C. E. mixture, is added,
first slowly a drop or two at a time and carried to the point where
the patient feels a tingling sensation in the finger tips or expresses
the fact that they begin to feel the effects of the drug. The anes-
thetic should never be crowded or confined while the patient can
smell the chloroform, but can be pushed more rapidly when the ol-
factory nerves have been paralyzed, so that the sense of smell is lost,
and it is not long thereafter until the dentine can be excavated pain-
lessly. As soon as the operator begins to operate the assistant should