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cases. 249
CASES.
Tt would be endless to give histories of cases, exemplj l\
ing each symptom of Dentition. I shall only relate a few

the cheek, producing more or less inflammation, while in the other it
irritates and annoys the tongue ; in either case it is necessary that the
tooth should be removed ; and in doing this great caution must be ex-
ercised, for if the tooth is broken, and the fangs remain in the mouth,
they may give rise to very serious symptoms, and to great bodily suf-
fering.
Another position in which the lower wisdom tooth presents itself
is with the crown coming forwards against the back of the second
grinder. "When this occurs, and there is want of space at the back of
the jaw, the fangs being placed in the opposite direction, instead of
passing downwards, produce great pressure upon the jaw bone ; in
many instances violent inflammation has arisen, leading to the for-
mation of abscesses, and to -the destruction of a portion of the jaw
bone. The remedy is to extract, if possible, the wisdom tooth ; but, if
this cannot be effected, then the second grinder should be removed ;
and the pressure being by this means taken off, the inflammation
may possibly subside, but no treatment will avail until this has been
done. (1)
The two following cases are recorded in the Medical and Surgical
Journal for 1841.
A lady, 29 years of age, sought advice on account of a painful
tumour on the cheek, which had existed for several months. On exami-
nation, it was found to arise from the wisdom tooth projecting hori-
zontally outwards, and lodging in the substance of the cheek. So soon
as the mouth could be opened sufficiently wide the tooth was extracted,
and the patient quickly recovered.
A gentleman, 45 years of age, had suffered from an ulcer on the
side of the tongue, near its base. For this the patient had been sali-
vated, which only made it worse. It was afterwards found that the
wisdom tooth on that side projected inwards, and had occasioned the
nicer on the tongue ; the tooth was removed, and the ulcer healed in a
few days.
Many persons have pain and swelling of the gum while the wisdom
teeth are being erupted ; in some a simple incision of the gum, reaching
down to the tooth, will give relief, or it may be necessary to remove a
small portion of the gum. Unless the part is very much inflamed, this
operation really causes very little pain, for naturally the gum is not
(1) See Des Anomalies Dcntaires, par A. M. Forget. Paris, 1859 ; also
Translations of the above in Dental Review for 1860.