Page 64 - An essay on the diseasesof the jaws, and their treatment

42 AN ESSAY ON THE OF THE TREATMENT OF INFLAMMATION AND SUPPURATION OF THE JAWS. The first and most important indication of treatment in this affection is, to remove from the maxillte and every part of the mouth, whatever cause of irritation may have produced, or may tend to keep up the inflammatory action. This may generally be effected by the extraction: 1st, of every dead root and tooth; 2nd, of every tooth suffering from complicated caries, or every painful tooth ; 3rdly, of every large grinder which is deprived of its antagonist;* and, 4thly, of every other tooth which is loose, irregular, or situated in any part primarily affected, or in any way capable of acting as a cause of irritation and excitement upon any part of the mouth, or which might be in the least suspected to interfere with the exfoliation of the dead parts, or with the complete removal of them.-f- tion being given of the operation of excision of the maxillary bones, which it may be necessary to have recourse to in the advanced stages of the disease ; the aim of the author being solely to give an account of the curative treatment •within the reach of dental surgery. These operations belong to general surgery, and will be found fully treated of in the works of surgical writers. * In regard to the third head, namely, the extraction of every large grinder deprived of its antagonist, the author has been very much misrepresented, having been made to appear as recommending that measure in every case, not only as a means of cure in secondary affections, but as a measure to be adopted for the remedy of the simple defect of the want of such opposing grinders. The author has never in any of his publications recommended the extraction of the grinders or other teeth when their antagonists are lost, except as a part of the treatment of the secondary diseases of the sockets and jaws. The principle on which he proceeds in these cases, in regard to teeth so circumstanced, is the ne- cessity of removing all so\irces of excitement—being the same which sug- gests the extraction of dead and loose teeth. That excitement is the result of the want of antagonist grinders is proved by the fact, that teeth in these circum- stances are gradually protruded along with their sockets. A certain amount of action is necessarily generated by this process, and the action thus pro- duced in a mouth overrun with disease, is very ready to assume the character of irritation. It is on this account that it becomes expedient to provide for its removal. t t This may appear very severe treatment, but it is not really so, especially when considered in connexion with the serious natiu*e of the disease, and the very extensive operation, which is the only alternative, failing curative treat- ment. All the above dental operations consist of measures calculated to second nature, and are, in this respect, based on the same principles as the operations of general surgery for the removal of foreign bodies, sequestra of bones, and certain products of morbid action. In the case of every tooth specified above, it will be found, on minute inspection, that nature has commenced, at one point or