Page 616 - My FlipBook

614 EXTRACTION OF TEETH.

5o'), niul 558, showiiiii^ wlicre teeth have been carried away with the
tiiherosity). If it is a siin])le fracture the parts can be forced into phice
and they will in a short time reunite. J)Ut it" the i)arts are torn h>ose it
will be of little use to try to rei)laee them ; the best course is to trim
away the ragged cdg(!S, using the curved scissors for this purpose.
After such a fracture it is possible that hemorrhage may occur from
rupture of the superior dental artery. This is sometimes difficult to
control. One of the best remedies, however, is to tightly pa(!k the parts
with medicated gauze. This application must be left in for a few days
and then be carefully removed. It is sometimes well to take out only
part of the gauze at a time, the loosened portions being cut off with a
pair of curved scissors. Hemorrhage after extraction usually ceases in
a short time, and then there is no occasion for treatment ; when, how-
ever, the adjoining parts are much inflamed, or the patient is in an
anemic condition, or the case is one of hemorrhagic diathesis, special
treatment will be necessary.
Hemorrhage of extraction may be divided into two classes, arterial
and capillary. When arterial, it is nsually located in the socket of
the tooth, and may usually be stopped without much difficulty by taking
a twist of absorbent cotton, shaping it into a thin tapering roll, and
thoroughly packing the socket. Before inserting the cotton tampon,
it should be rolled in tannic acid until the fibers will hold no more,
then the cotton is to be packed tightly into the alveolus with a dental
plugger. In packing the cotton it is well to begin at one end and
crimp it upon itself until the socket is entirely filled. A narrow strip
of iodoform gauze when packed in the same way makes a good plug,
and the more rapid healing of the parts afterward and freedom from
any offensive odor makes it a more satisfactory tampon than the tannic
acid and cotton plug, though the styptic quality of the latter makes it a
more efficient hemostat. The plug in a few cases may require retention
in position by compression. This is accomplished by holding a few
folds of muslin or similar material over the plug, closing the mouth
and binding the jaws together with a few turns of a Barton's bandage.
(See Figs. 559 and 560.) The 25 percent, ethereal solution of hydrogerf
dioxid in small quantity on cotton packed into a bleeding socket is a
most efficient styptic, and will effectually control severe hemorrhage
after extraction. Care must be exercised not to use the solution in
excess, as it may cause injury to adjacent parts.
Where hemorrhage occurs from the surrounding tissue, as in patients
in an anemic condition or in cases of hemorrhagic diathesis, the case
usually falls into the hands of a general practitioner for systemic
treatment, but the local treatment usually employed by physicians in
these cases is often unsatisfactory, many using: Monsel's solution of