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MANAGEMENT OF PUTRESCENT PULP CANALS 221

pumping motion of the broach the paste will be thinned and foUoAv
the phenol already in the canal to the apex.
By alternately adding the paste and absorbing the excess phenol
the canal can be filled with a comparatively thick paste. Fill the
pulp chamber with a pellet of dry cotton. Seal the cavity with tem-
porary stopping or cement, preferably for a Aveek or ten days, when
the case will almost invariably return ready for permanent canal
filling. If a shred of vital pulp is encountered in the apical third
it will have been devitalized by the phenol and that without pain or
noticeable soreness.
The Chief Objection to This Form of Treatment is the obnoxious
odor of the iodoform. The deodorized preparations, however, will
not accomplish the desired results. Care should be taken that the
iodoform is kept moist at all times and finally deposited in the foun-
tain spittoon. Each teacher has a different treatment for putrescence
and the student is advised to familiarize himself with all. However
the above is a one-sitting, successful treatment and its trial is ad-
vised particularly where other methods have resulted in pain to the
patient and oft-repeated visits to the dental chair.
In Cases of Long Standing Putrescence, Avhich are generally open
cases, the dentine is thoroughly saturated with poisonous ptomaines,
amido acids and end products. These must be gotten rid of and
the most expedient method is to chemically change these irritating
gases and poisonous liquids into non-irritating and non-poisoning
liquids and solids. This is most successfully done through the use
of formaldehyde. Formaldehyde, however, is very irritating to vital
tissues and should not be brought into contact with them. There-
fore its use is contraindicated in cases of large apical foramen. Also
not indicated in cases where a portion of the vital pulp remains, as
many times intense pain will be induced. To modify the irritating
effects there may be added to a ten per cent solution of formalde-
hyde an equal bulk of either phenol, creosote, or creosol, the latter
being preferable. This should be scaled in the cavity and crown ends
of the canals for twenty-four or forty-eight hours before thorough
broaching of the canals is attempted. Following the removal of the
al)ove treatment the canals should receive a bath first of water and
then of alcohol to carry away in solution the compounds resulting
from the chemical action of the formaldeh.yde.
Animal Fats, which consist of carbon, hydrogen and oxygen, ai-e
liable to be present in abundance in recent cases of putrescence and
should be removed from the dentinal walls as they readily undergo
fermentative decomposition.