Page 404 - My FlipBook

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Treatment of Complicated Caries.

The treament of complicated caries, is a matter of con-
siderable nicety, so as to preserve the tooth, and not by our
operations excite pain and active inflammation of the nerve
and lining membrane. For in a majority of cases, if we at-
tempt operations upon a tooth whose nerve is exposed with-
out a previous preparation of the nerve, we shall excite in it
active inflammation, and be compelled to extract the tooth.
There are three ways in which the lining membrane of a
tooth when exposed, is now treated by surgeon-dentists.
The first consists in destroying the vitality of the nerve and
lining membrane, by the use of some of the concentrated
acids, or caustics, or the actual cautery, (red-hot iron) as
for instance, the nitric, sulphuric, or muriatic acids, the caustic
potash, orthe argentumnitratum, (lunar caustic) andsomeof the
essential oils, &c. &c. These are introduced into the tooth,
and applied to the nerve, so as to destroy its vitality. But as
it was observed by Mr. Hunter, page 149, these very often
fail, and the dentists have then at times, used the actual cau-
tery, introducing into the tooth a piece of platina or iron
wire heated to redness : but this also often fails.
Attempts to destroy the inflamed nerves of teeth, espe-
cially the molar and bicuspid, are not only very painful, but
most usually ineffectual. If we succeed in destroying the
nerve, the tooth is often rendered almost useless.
I here subjoin a case of an unsuccessful attempt to de-
stroy the nerves of a diseased tooth, which came under the
observation of my friend Mr. Eleazar Parmly of New-York,
who referring to the subject remarks* : "In a front tooth

* Parmly. Disorders and Treatment of the Teeth. Pages 52, 53, 54, 55.