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TREATMENT OF HYPERSENSITIVE DENTINE 203

hold to the nostrils a large-mouthed bottle of the anesthetic to pro-
long the stage of anesthesia reached. At no time should the patient
be sufficiently under the influence of the anesthetic to be unable to
converse coherently or intelligently answer the questions put to him.
It must be remembered that any anesthetic has its dangers, par-
ticularly when its use is abused, but the above method can be recom-
mended as comparatively safe. One writer reports its use in over
20,000 cases without ill effects. It is true that a large per cent of
the cases Avherein death has resulted from the administration of
chloroform or ether have occurred in the first few breaths, as we
believe due to a strong mixture used at first or before the nerve
filaments of the air passages have been anesthetized.
If a few breaths administered as above, by the open method, proved
fatal, literature would be replete with long accounts of druggists,
physicians, dentists and others having met death by smelling of
opened bottles of these drugs.
Rapid Breathing as a means of producing peripheral anesthesia
should receive consideration, not only for hypersensitiveness of the
dentine but for other minor dental operations as the use of hypo-
dermic needle, lancing of abscesses and extraction of teeth. The
anesthetic effect is brought about by superoxidization within the tis-
sues caused by charging the blood with an abundance of oxygen.
This Method Is Employed by instructing the patient to take
deep, long breaths as rapidly as possible and continue the same until
a sense of dizziness is brought on, when from thirty to sixty seconds
of the anesthetized condition will be found available for operating.
Mechanical Conditions.
The Mechanical Conditions under Avhich the cutting of dentine
is done is a gi'eat factor in the amount of pain produced.
Sharp instruments which cut without pressure upon the contents
of the tubuli cause much less pain than dull ones even with hand
instruments. With rapidly revolving engine burs this is also true
to say nothing of the heat produced by the friction caused by rub-
bing surfaces which are worn away rather than cut, which is the
chief source of pain in the use of burs.
The Cutting Should Be Done as much as possible at a right angle
to the long axis of the tubules rather than to follow their course with
pressure towards the pulp or in a line with their long axis.