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POINTS OF ATTACK IN SOFT TISSUES OF THE MOUTH. 321

distal side of the tootli ; a bent probe passed under the fold of
the gum eaters a pocket filled with pus, from which more or
less pus exudes on pressure. If extraction is delayed, twenty-
four hours may suffice to bring about complete trismus, by
which the operation is extremely complicated, or for the time
being made impossible. Even in such cases, however, I have
seen all the swelling subside and the trismus and its accom-
panying symptoms disappear without any interference on the
part of the dentist. Very commonly, the suppuration not
remaining confined to the pericementum causes secondary peri-
ostitis and osteitis, involving a large portion of the angle and as-
cending ramus of the jaw. The bone becomes infiltrated with
infectious sanious matter, which in this stage may readily be
absorbed in sufficient quantities to occasion general poisoning,
or it may make its way to the surface, usually at the outer angle
of the jaw (fistula), or the inflammatory process may extend
through the fossa pterygoidea, orbita, etc., to the brain, giving
rise to a fatal meningitis. The process is accompanied by ex-
tensive swelling of the submaxillary region, and sometimes
(seldom) by profuse suppuration or even gangrene of the gums.
The tooth itself finally becomes exceedingly loose through
destruction of the alveolus, and its extraction is accompanied by
the discharge of a large quantity of bloody, stinking pus. After
the extraction the wound should be thoroughly syringed with a
1-200 solution of sublimate.

c. PijorrhaxL alceolaris.
A disease of probably parasitic nature, which, next to decay of
the teeth, has attracted more attention among dental surgeons
than perhaps any other disease of the human mouth, and which
every dentist has abundant opportunity of observing in his
practice, is the so-called Riggs's disease, pyorrha?a alveolaris
(loculosis, blennorrhoea gingivae, periostitis alveolo-dentalis, in-
fectious arthro-dental gingivitis, phagtedenic pericementitis, ex-
pulsive gingivitis, symptomatic alveolar arthritis, etc.), a chronic
suppurative inflammation of the periosteum, with more or less
severe inflammation of the gums and necrosis of the alveolar
process of the diseased teeth.
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