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NITRATE OF SILVER. 295

is not so reliable as tannic acid, gallic acid, etc., on account of
the coagulum or clot formed by it, being soluble in an excess of
albumen. It is also employed to obtund the sensitiveness of
dentine, especially where the cause is mechanical abrasion ; also
in aphthae, mercurial stomatitis, ulceration of the gums, salivary
fistula, alveolar abscess. For obtunding sensitive dentine, the
stick form (one end of a stick inserted into a quill, or fused on
the end of a platinum wire) is employed; or the end of a silver
wire may be immersed in nitric acid, and applied to the sensitive
surface, taking care to limit its action to the part on which it is
to act. When applied to sensitive dentine, it acts on the gelat-
inous portion of the tooth, destroying its vitality to the extent of
the combination which takes place. The objection to its use in
such cases is the discoloration it causes.
Dr. C. N. Peirce recommends saturating blotting paper with a
40 per cent, solution of nitrate of silver for application to chil-
dren's teeth, as it cauterizes the soft issues and acts upon the
hard in a satisfactory manner, without danger or staining the
fingers ; asbestos paper or felt may also be saturated with the
nitrate of silver for use in the mouth. Dr. Kirk recommends
thin asbestos felt, as being better than paper. Before saturating
the asbestos felt, it should be heated to redness over a Bunsen
burner to burn out any organic matter with which it may be ac-
cidentally contaminated.
Dr. Black recommends nitrate of silver as useful in the treat-
"
ment of caries of the teeth " under some certain conditions ;
mostly in deciduous teeth, but occasionally in the permanent
teeth also. His method is as follows : In the case of broad, shal-
low cavities in children's teeth, a full exposure of the decayed
area as practicable, is made, and then the outer portion of the
carious material only should be removed. Then the rubber dam
is adjusted, the decayed area dried, and some pulverized nitrate
of silver is laid upon the carious area, with just enough of water
to dissolve it, and insure the saturation of the whole of the
softened dentine. This should remain from five to fifteen min-
utes, the longer time if the patience of the child will allow,
the surplus removed with absorbent cotton, and the cavity lightly