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1000 ABRASION AND EROSION OF THE TEETH. ;

density, were finished as evenly and smoothly, the one with the other,
as if done on the lapidary's wheel.
Fig. 533 was made trom the cast of a case in my own practice, and
represents the teeth as I first saw them. The patient was sufficiently
intelligent to give what seemed to be a very reliable account of its prog-
FiG. 533.

A Case of Erosion (drawn from tlie castl: B, silhouette from a perpendicular line through the left
centrals, upper and lower, showing the loss of substance.

ress. A little more than three years before, she had noticed slight cups,
which caused her some solicitude, appearing on the labial surfaces of
the upper central incisors, near the gums. These were observed to
widen very slowly, but seemingly very steadily, toward the cutting edge
and laterally. About six months later the same condition was seen on
the lower centrals, and the lesion seemed to progress more rapidly than
the erosion of the upper teeth ; so that at the end of the first year the
loss of substance appeared to be about equal in depth. At about this
time the erosive process was seen to be making its appearance on other
teeth. Her dentist was then consulted, and she was told that the
trouble resulted from the use of a stiff toothbrush which she employed.
Very much against her will, she abandoned the brush for a year.
During this time the erosion made more rapid progress than before,
and the .sensitiveness of the eroded surfaces, already quite considerable,
increased greatly ; so that, in addition to the marred appearance of the
teeth, the hvper8e.sthesia became a source of great annoyance, occasional
exacerbations occurring, during which exquisite suffering resulted when-
ever the eroded surface.^} were touched. Finding that the abandonment
of the u.se of the brush did not retard the erosion, she again resumed it
but, on account of the great sensitiveness of the eroded surfaces, she was
ever after compelled to avoid them in cleaning het teeth. The erosion
continued steadily, and at the end of the third year was as represented
in the illu.stration. At this time intense hyperse.sthcsia of the pulps had
occurred in the central incisors above and below. The sensitiveness
was so extreme that the patient could not be induced to submit to any
manipulation whatever. I therefore gave an anse.sthetic and removed
the pulps of the four centrals, which had the effect of rendering the
patient fairly comfortable. Before cutting into the teeth the outline of
the former pulp-chamber was distinctly seen in what seemed to be the