Page 46 - An essay on the diseasesof the jaws, and their treatment

24 AN ESSAY ON THE luxation of teeth, or the partial extraction of them by tearing, or dividing the nerve cord or fasciculus of the nerves, with a view to render them free from pain, and subsequently leaving them in their sockets ; all operations performed with an intention of de- stroying the nerve or sensibility of painful teeth, and thus to cure the tooth-ache—all of which not only eifect a sudden destruction of the vitality of the teeth, but arc productive of violent and perma- nent Irritation upon the parts locally as well as generally con- nected with them—such as the application of concentrated acids, by accidental violence, as generally practised, must, of course, be ranked in the same category. I cannot concur Avith Mr. Bell in liis remarks on such accidents, and the treatment which he recommends for adoption. After detailing the effects of retaining teeth that have been partially luxated, and giving instruc- tions regarding the method of securing them in their sockets, he proceeds; — " In cases of total dislocation, where the tooth has been forcibly struck out of the socket, there is generally so much injury inflicted upon the alveolar processes that still less hope exists of its being replaced with any advantage. There is one favourable circumstance, however, which belongs to such a case, and that is, the opportunity which it affords of clearing the socket from any coagula which may have formed there. For this purpose, warm water should be thrown into it by means of a syringe, and after all the blood is thus removed, which may be as- sisted, if necessary, by a pair of small dressing forceps, it should be further cleansed by a small bit of lint rolled round the end of a probe. The tooth having been placed for a moment in warm water, about the temperature of the body, is to be restored to its exact situation, and supported, as before directed, by a liga- ture, embracing one or two teeth on each side of it." (" Anat. Phys. andDis. of the Teeth," p. 184.) Such treatment being based on the notion that the teeth, after their vital connexion with the system is destroyed, can again re- sume their functions as living members of the body, I cannot but condemn as opposed to all sound views of dental pathology. Dr. M'Lellan's case (No. 198 of the Appendix) clearly originated from such treatment in partial luxation. But the most notable example of this mistaken practice on record is that con- tained in the following account of an operation performed on his own person by M. Delabarre, who is one of the most eminent of the Parisian dentists, and certainly the most celebrated writer on dental surgery among the French. " I have per- formed," says he, " upon myself, and also upon several other persons, an analo- gous operation, which consists in extracting a diseased tooth, removing its soft central parts, filling it with gold, shortening its extremity, and then replacing it. After five years, this tooth is now as solid as the rest. Still I do not doubt that it will one day end in being separated from the jaw, for it frequently occasions me very acute local pain, and aggravates the tic douloureux, to which I am subject. This neuralgia always commences at the tooth, and then spreads itself over the whole side of the head; so that I frequently repent of having replaced it." (" Delabarre's Second Dentition," American translation, p. 51.) The naivete of the above statement is really ludicrous. It is evident that M. Dela- barre is a very sincere man, but he is not on that account the less dangerous as a practitioner.