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TECHNICAL TREATMENT OF THE UNCOVERED PULP. 409
fined to the nerve fibrils distributed about the capillary loops involved,
and thereby induces the reflected manifestations, the nerve fibrils being
in this stage the anatomical element chiefly implicated.
(3) Objective symptoms comprise those manifestations which, after
the subjective ones have continued for some time, become localized in
and about the aflPected tooth. These are : some soreness of the peri-
dental membrane; extreme sensitiveness to heat, accompanied through-
out with dull, heavy pain in the tooth, and at length pulsat-ive
throbs.
This order of statement is the usual sequence in which these indica-
tions appear. They are the result of the extension of the disturbance
to the deeper circulatory elements of the tissue. When this condition
appears on the presentation of a case, or when in the course of the
treatment it becomes apparent, the prognosis usually is rendered
unfavoral)le to recui)eration.
The Technical Treatment of the Uncovered Pulp.
Accidental Exposures.—These, wdiich happen in the preparation
of cavities, if ]>roduced by clean (aseptic) instruments where compres-
sion has been avoided, require but simple treatment. The pain is
relieved by the application of tincture of calendula one part, to four of
water. When the bleeding ceases, the point of exposure should be
antiseptically dressed and capped in the manner to be described.
If the injury has been slight, the cavity may be at once filled with
a metal, having regard to the strength, the placement, and the fixation
of the cap used to defend the part from compression. Here the fixa-
tion may be made by covering the cap with a broad block of gold foil
after adapting this to the margins of the pulp wall of the cavity the
filling may be proceeded with. In case of doubt a metal of less con-
ductivity may be used, such as tin or amalgam. A metal filling is
better in these cases, since the slight thermal irritation tends to the
ultimate recovery. (See Chapter VII.)
Treatment of Recent Exposures.—When the pulp has been fully
uncovered, as previously described, the cavity should be w^ashed clean
with tepid water, be securely protected from the fluids of the mouth
Avith rubber dam, dried, and lightly filled with a pledget of lint sat-
urated with a mild disinfectant. On account of the invasion of the
zone of dentin immediately beneath the caries by bacteria and micro-
cocci, it is recognized that some means of sterilization must be adopted.
This being necessary in the treatment of ordinary cavities, it is evidently
here more demanded. On account of the impatience of the pulp to
medication it is important to be careful in the selection of the sterilizing
agent. The choice should be between hydronaphthol, acetanilid, and
TECHNICAL TREATMENT OF THE UNCOVERED PULP. 409
fined to the nerve fibrils distributed about the capillary loops involved,
and thereby induces the reflected manifestations, the nerve fibrils being
in this stage the anatomical element chiefly implicated.
(3) Objective symptoms comprise those manifestations which, after
the subjective ones have continued for some time, become localized in
and about the aflPected tooth. These are : some soreness of the peri-
dental membrane; extreme sensitiveness to heat, accompanied through-
out with dull, heavy pain in the tooth, and at length pulsat-ive
throbs.
This order of statement is the usual sequence in which these indica-
tions appear. They are the result of the extension of the disturbance
to the deeper circulatory elements of the tissue. When this condition
appears on the presentation of a case, or when in the course of the
treatment it becomes apparent, the prognosis usually is rendered
unfavoral)le to recui)eration.
The Technical Treatment of the Uncovered Pulp.
Accidental Exposures.—These, wdiich happen in the preparation
of cavities, if ]>roduced by clean (aseptic) instruments where compres-
sion has been avoided, require but simple treatment. The pain is
relieved by the application of tincture of calendula one part, to four of
water. When the bleeding ceases, the point of exposure should be
antiseptically dressed and capped in the manner to be described.
If the injury has been slight, the cavity may be at once filled with
a metal, having regard to the strength, the placement, and the fixation
of the cap used to defend the part from compression. Here the fixa-
tion may be made by covering the cap with a broad block of gold foil
after adapting this to the margins of the pulp wall of the cavity the
filling may be proceeded with. In case of doubt a metal of less con-
ductivity may be used, such as tin or amalgam. A metal filling is
better in these cases, since the slight thermal irritation tends to the
ultimate recovery. (See Chapter VII.)
Treatment of Recent Exposures.—When the pulp has been fully
uncovered, as previously described, the cavity should be w^ashed clean
with tepid water, be securely protected from the fluids of the mouth
Avith rubber dam, dried, and lightly filled with a pledget of lint sat-
urated with a mild disinfectant. On account of the invasion of the
zone of dentin immediately beneath the caries by bacteria and micro-
cocci, it is recognized that some means of sterilization must be adopted.
This being necessary in the treatment of ordinary cavities, it is evidently
here more demanded. On account of the impatience of the pulp to
medication it is important to be careful in the selection of the sterilizing
agent. The choice should be between hydronaphthol, acetanilid, and
