Page 138 - My FlipBook

118 Curative Treatment of Caries.
out ever experiencing any ill effects : nor can any danger ever
attend its proper application.
Whenever the nerve of a tooth can be preserved, it should
not by any means be destroyed.
Very often in the artificial exfoliation of teeth much decay-
ed, the nerve will be exposed before the disease can be per-
feclly extirpated ; and if such teeth be now stopped with any
metal, without the leaden cap, pain will certainly follow and
compel the patient to have the teeth extracted but
; if the
nerve be first covered with the lead, the operation is usually
successful; indeed, we may say, that it is rarely unsuccessful,
if skillfully performed. The lead seems to act as a direct se-
dative. We have often exposed the nerves of teeth, and even
wounded them so as to make them bleed, before we could extir-
pate the disease, and yet when treated as above, no pain has
followed. We have often been asked,— How can a tooth be
filled when the nerve is exposed, so that the metal may not
press upon it, and cause pain? The reason is this:—The
ceiling or roof of the cavity of a molar tooth, is convex, or
rather oval, and it projects considerably into the cavity, while
four cornua run a little towards the grinding surface : conse-
quently, we can proceed much farther with our instruments,
directly in the centre of a tooth, towards the nerve, than a
little to one side, without exposing it, and it is at one or more
of these cornua, where the nerve is usually exposed.
The practice of capping the nerves of teeth, was introduced
and recommended by Mr. Koecker, several years ago, and is
truly a valuable improvement in dental surgery.
Lead leaf may also be used, but great care must be takenlhal
the pressure applied in forcing the plug, do not indent the leaf
so as to press upon the nerve, in which case pain will cer-
tainly follow. The plate of lead being thicker and more un-
yielding, obviates this objection. Koecker and Snell recom-
mend the nerve to be cauterized, previously to the operation
of plugging. We think the practice a good one; but its prop-
er application will require more (act and ingenuity than most