Page 659 - My FlipBook

GENERAL CONSIDERATIONS. . 657

Anesthesia,—For the purpose of allaying pain, the use of anes-
thetics is justified when imperatively demanded, but unfortunately, in
the plantation of teeth the benefits derived are frequently outweighed
by the disadvantages accruing from their use.
Anesthetics are either general or local. An operator would scarcely
be justified in assuming the risks attendant upon the use of chloroform,
ethylic ether, ethyl bromid, or any of the combinations in which these
anesthetics are administered. Nitrous oxid would, in the majority of
instances, be contra-indicated by reason of the shortness of the period
of anesthesia which it induces.
There do not appear to be any records of satisfactory results with
hypnosis. That field is open to the intelligent investigator whose
inclinations lie in that direction. Local anesthesia, therefore, is the
means generally employed. The use of cataphoresis with local anes-
thetics has not as yet been satisfactory for this purpose.
The method adopted has usually been confined to the injection or
other introduction of cocain, the dose being variable, but usually about
5 to 15 minims of a 4 per cent, solution of the hydrochlorid. A seri-
ous objection has been noted to injection through the gum, viz. that
more or less sloughing or destruction of the tissues may result, and this
is very unfavorable for subsequent success. In replantation or trans-
plantation, sufficient anesthesia is often obtained from the wash used in
cleansing the socket ; but in implantation the formation of the new
socket is often an exceedingly painful operation, and in these cases
good results may be had by dipping the instrument with which the
socket is being made, into crystals of cocain, and thus by the friction
of the instrument rubbing it into the parts that are being operated
upon.
The subject of anesthesia may be dismissed with the sole injunction
that its use should be resorted to only in those instances wdiere it is
absolutely necessary. The majority of the cases of plantation are per-
formed with no more pain than is inflicted in filling operations.
The same care should be given to the retention of transplanted
teeth as is given to the retention of replanted teeth. Teeth thus
carefully transplanted, in individuals of good health, often remain as
useful members for a number of years. In the past insufficient atten-
tion has been given to asepsis, and this, coupled with the fact that the
root had not always been properly filled, has not resulted in as much
success as is attained with present methods, and yet transplanted teeth
are known to have remained in a healthy and serviceable condition
for from twenty to forty years.
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