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320 THE MICRO-ORGANISMS OF THE HUMAN MOUTH.

or inflame tlie gums, thus facilitating or making possible the
colonization of pyogenic bacteria. A small degree of suppura-
tion will always be found in such cases ; it may, under certain
circumstances, extend to the pericementum and lead to abscess-
formation.

h. Abscess-Formation resulting from Impeded Eruption of Wisdom-
Teeth.
The affection which Arkovy calls abscessus alveolaris diffusus
must, in my opinion, as far as it is caused by those ditficulties
accompanying the eruption of wisdom-teeth, also be assigned to
this group.
It is immaterial in these cases whether the disease be seated
in the gums,* or in the pericementum, or in the periosteum, or
finally in the bone itself. The invasion of the bacteria is in every
case made possible by the diminished power of resistance of the
soft tissues, caused by long and continued irritation.
The infection by pyogenic microbes, so often accompanying
impeded eruption, occasions not only profuse suppuration and
abscess-formation in the region of the lower jaw, wdiich are ac-
companied by pronounced general symptoms, but also often leads
to general infection (septicaemia, pyaemia), with fatal result.
Various fatal cases of blood-poisoning occasioned by the im-
peded eruption of lower wisdom-teeth have been cited on page
289 et seq.
The inflammation existing in the pericementum, or in the
gums, or in both simultaneously, manifests itself first by swell-
ing, redness, and accompanying soreness of the gums, which in
the mildest cases are circumscribed, in more pronounced cases
involving a large part of the mucous membrane of the corre-
sponding side of the mouth after inducing severe secondary
angina.
The appearance of suppuration is always a bad omen, in my
judgment calling for the immediate extraction of the tooth. I
have- invariably found the formation of pus to begin on the

* The difficulties connected with the eruption of wisdom-teeth usually lead to
periosteal abscesses, while those arising from suppurative periostitis are generally
sub-periosleal. (Arkovy, page 281.)