Page 319 - My FlipBook

GANGRENOUS TOOTH-PULPS AS CENTERS OF INFECTION. 291

seven years old, followino; an abscess caused bv a carious tooth,
will be found in the Dcidal Cosmos, vol. xvi, page 614. About
one-half of the ramus of the left side was removed through the
mouth, after enlarging the fistulous openings.
Sclimid ^'"^ gives a full report of a case of partial necrosis of the
left half of the lower jaw following upon traumatic septic (gan-
grenous) pulpitis. The patient had bitten a foreign body into
the cavitv of an inferior left molar. The followins' morninof the
left cheek was so swollen that he was not able to open his mouth.
After a long, severe ilhiess, with varying symptoms (intense
swelling, recurring abscesses, temperature 40° C, pulse up to
120, insomnia, discoloration of the skin, diarrhoea, etc.), not less
than seventy pieces of necrotic bone were thrown off.
I am of the opinion that in this case a part of the septic tooth-
pulp was forced through the foramen apicale by the pressure of
the foreign body bitten into the pulp-cavity, and that the infec-
tion was brought about in this manner.
As is well known, diseased teeth very often occasion severe
diseases of the nasal cavity and maxillary sinus. Such cases are
too well known to every physician and dentist to necessitate the
enumeration of special cases here.
Ritter ''"''' has of late described sixteen such cases, and thereby
essentially strengthened the belief that by far the most cases of
diseases of the maxillary sinus and many of the troubles in the
nasal cavity are due to diseased teeth.
Galippe^^ also mentions the general disturbances that may arise
whenever a secretion of matter in the mouth becomes general and
profuse, as is the case in pyorrhoea alveolaris. " We have seen
patients afflicted with fever, stiffness, loss of appetite, severe dis-
turbances of the alimentary canal, insomnia, subicteric discolor-
ation of the skin, etc."
Odenthal's ^^^ investigations have lent probability to the view
that the centers of infections formed by decayed teeth manifest
their deleterious influence in a manner hitherto but little sus-
pected.
Ungar^*- had previously communicated a case in which a
tubercular ulceration of the gums, followed by a swelling of the
ymphatic glands, had formed around a badly decayed cuspid.