Page 50 - An essay on the diseasesof the jaws, and their treatment

28 AN ESSAY ON THE — For proof of this assertion I have only to refer the medical reader to a careful examination of the parts, which will evince the fact; for it will be found that, in a hundred jaws containing roots or stumps, without one single exception, the parts contiguous to the roots exhibit some marks of disease or mortification ; unless, indeed, the teeth have been broken after the death of the subjects from which the teeth are taken. In all preparations of the maxillse, which contain stumps or roots, the gums will always be found more or less inflamed, and the sockets either wasted away by gradual absorption, or in a state of mortification, and often spongy, perforated, &c.* Where the expulsion of the roots of teeth has been left to the slow process of nature, a total destruction of the alveoli is the inevitable con- sequence ; and not unfrequently, very considerable portions of the bony structure of the jaw will perish through the diseased action. When, however, a tooth or teeth have been timely extracted, not more than the extreme process of the alveoli is generally absorbed. extends over the whole of these parts; and a strong effort appears to be made to effect the expulsion of the decayed teeth, now become dead and offending bodies." — " Principles of Dental Surgery," page 94. This was written in 1826, when, I may say, the author stood alone in advo- cating these opinions. Since then, many of the American dentists have given in their adherence to his principles, and one or two of the writers on Dental Surgerj', in this country, have signified their belief in them in theory, but I do not know a single English or Continental author who shows his conviction of their truth by acting up to them in practice. Indeed, I am inclined to think that, with few excep- tions, the dentists in this country would be ready still to dispute even the theore- tical truth of these principles. For their benefit, I add the following quotation — from the clinical lectures of Sir Benjamin Brodie: " The cause in which the dis- ease [suppuration in the antrum] originates is generally a diseased tooth, which by and bye gives rise to tooth-ache. The inflammation on which the tooth-ache depends then terminates, as [ it always does, in the death of the pulp of the tooth. \ Then the whole tooth dies, and is now like a portion of dead bone, or any foreign — substance, stuck in the jaw." " Medical Gazette," vol. xv., page 347. * M. Chassaignac's observations, in regard to an analogous state of parts, con- firm this statement. At a meeting of the Academic des Sciences he remarked tliat, " in preparing the lymphatics of the head and neck in young subjects, he liad often met with an anatomical change of structure of interest in regard to the effects of irregularities of the teeth. The tooth examined in the alveolus presents no alteration but the maxilla, being completely denuded, is found perforated witli : several small holes, in the neighbourhood of the root of the tooth. If this dis- eased lamina of bone be removed, the fang of the tooth is generally found diseased and surrounded with pus. This intra-alveolar caries must often escape observa- tion during life, and is, doubtless, in many instances the cause of tlie enlargement of the maxillary glands, and of certain purulent collections in tlie same region." " American Journal of Dental Science," 1846, p. 326.