Page 65 - An essay on the diseasesof the jaws, and their treatment

DISEASES OF THE JAWS. 43 All the teeth and roots which constitute the causes of the dis- • ease should be removed, if possible, at the same time—for a re- moval at different intervals will greatly diminish and protract the salutary result of the treatment.* This, however, may frequently be deemed impossible, and the dentist must content himself with their removal at different periods. Any treatment, however, without the removal of them altogether, at least in a short space of time, will only be an injurious palliation, and occasion a relapse of the disease, sometimes more violent than the first attack ; for the remaining affected teeth will keep up the morbid action, and either lessen or totally prevent the healthy inflammation of the whole mouth, but especially in the parts most extensively affected. other, the process for throwing it off as an offending body—thus furnishing an indication which cannot, without risk, be overlooked, even in comparatively healthy mouths. But since the introduction of the Inhalation of Ether, the mere pain of an operation can no longer be regarded as a barrier to its endurance, even by the most timid. In most instances, the ether is neither asked for nor required in the extraction of a single tooth, but, in those more serious cases, in which the mouth contains many stumps and roots of teeth, there are comparatively few patients who have not a strong desire to be put under its influence. Of all the parts of the body, the mouth is the least suited to prolonged surgical operations under the influence of ether, because it is by that organ the substance is administered : consequently, the inhalation of ether is almost precluded in the operations of general surgery on the mouth and jaws. But, as the opera- tions of dental surgery are of a nature to admit of interruption, and may be divided into several stages, or evea, if necessary, into different sittings, this agent can always be made use of by the dentist, unless when contra-indicated by some peculiarity of constitution or condition of body. From this circumstance it also happens, that the chances of evil effects from the use of ether by inhala- tion are very much diminished, as it is never necessary to prolong the adminis- tration of the vapour after the state of insensibility has been induced; and, indeed, if no impediment occur, such as the forcible shutting of the mouth, an operation extending to the extraction of many stumps may sometimes be com- pleted before the patient recovers from the effects of a single dose. It is to be hoped that the immunity from pain, which may now be enjoyed by the' use of ether, may prove of signal service to scientific dental surgery, as contra-distinguished from that school which regards the extraction of dead and decayed teeth in the light of killing the goose that lays die golden eggs. * From neglect on this point, the above treatment is liable to fall into dis- credit. Cases have come within my knowledge, in which all the teeth have been successively extracted, without any mitigation of the disease. It is obvious, that the mode of applying a remedy is as necessary to the securing of its proper effect, as is its possessing the right nature and properties. Tlie unsuccessful result of half measures, and dental operations, such as extraction, undertaken oa no fixed principles, and often at the suggestion and under the direction of the patient himself, is exhibited in several of the cases contained in the Appendix.