Page 160 - My FlipBook

158 ANTISEPSIS IN DENTISTRY.

AVhilc it is true that there exists a degree of exemption from serious
results, leading to indilTerence and careless management of eases, it is
equally true that infection has resulted in the experience of almost
every operator in dentistry.
Prior to the period Avhen Lister announced that all operations in
surgery should be performed antisej)tically, and made modern surgery
possible, this ignorance was excusable ; but at the present time, with the
accumulated knowledge in bacteriology, it should be impossible for any
dental operator to neglect the procedures under this head considered
absolutely essential for the general surgeon.
The difficulties attending antisepsis in dentistry far exceed those in
other branches of surgery. The dentist is necessarily obliged to meet
conditions hourly that seem to preclude absolute freedom from sources
of contamination. If he were to take the same precautionary measures
now regarded as necessary for the surgeon, he would find practice almost
impossible. While this is true, it does not follow that every eifort
should not be made to approach absolute surgical cleanliness.
The usual methods employed to accomplish this, while valuable to
a limited extent, are by no means equal to what could readily be secured
without consuming much time or patience. The dentist is usually sat-
isfied that he has fulfilled all antiseptic precautions when he has dipped
his instrument in some antiseptic fluid, generally carbolic acid. Little
or no attention is paid to the possibility of infection from rubber-dam,
towels, hands, and the variety of instruments that enter into dental
operations. Some of the latter, as, for instance, the separator, are more
liable to carry infection than the excavator, thq one generally regarded
as most important.
The appliances ordinarily in daily use are the rubber-dam, excava-
tors, broaches, pluggers, clamps, ligatures, separators, drills, hand-
pieces, napkins, and forceps. It is safe to assume that but few of these
will receive any attention beyond ordinary washing. The rubber-dam
is too often used as it is furnished by the manufocturer. If an attempt
at cleanliness is made, it consists in washing the dam in cold or warm
water, this being regarded as sufficient. When it is remembered that
this is passed between teeth and usually forced up under gingival
margins with ligatures, or clamps, frequently lacerating the surface, it
becomes evident that the possibility of infection is always present.
If infection does not occur from the rubber, it is almost certain to pro-
duce a wound in a locality extremely favorable for the growth of patho-
genic germs. The result is innumerable lesions that may extend to
pericemental inflammations. The great increase in the past twenty-
five years of gingival inflammations subsequent to operations in mouths
of more than ordinary health must be partly ascribed to this cause.