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14 —
CAUSES AND RELIEF OF DENTAL PAIN.

L
injection made of about \ 2 minims on the external and
I minims on the internal side of the alveolus, the aim of
the operator being to surround the tooth with a /one of
anaesthesia, and for this purpose at least two punctures
are necessary; the point of the syringe should be
inserted about 3 mm. from the free edge of the gum

adjacent to the tooth to be removed; the needle should
be inserted quickly and the injection made very slowly,
the syringe being held in position for some seconds after

the requisite quantity has been injected. When the gum
becomes blanched, and not till then, the anaesthesia may
be regarded as complete.

Hypodermic Injection of Adrenalin and Eticaine.
^o Beta-eucaine .... gr. ^

Aq. ad. ..... . gr. % f00
Adrenalin chloride
.
.
iT\xvij.
To be freshly prepared or used from an " ampoule."
Hypodermic injections into the gums should not be
made

(1) In inflammatory or suppurative conditions of the
mouth.

(2) In cases of alveolar abscess. In such cases the
application of cotton-wool soaked, in 10 per cent, novo-
caine for some five minutes will much alleviate the pain

of a dental extraction.
The local anaesthesia that can be produced by freezing
the gums with a spray of ethyl chloride is frequently very
useful in the case of readily accessible single-rooted teeth,
but it must be borne in mind that it has a great tendency

to cause the teeth to become brittle owing apparently to
the freezing of their " organic" matter, with the result
that they may be very readily broken during the attempt

at extraction and thus lead to much difficulty.