Page 222 - My FlipBook

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2o6 THE TREATMENT OF TEETH
and run no risks of future annoyance, but at
once to anaesthetise or destroy the pulp and remove
it. When admissible, it is preferable to completely
anaesthetise the pulp, and remove it painlessly, rather
than destroy it Avith arsenic.
This is what is known as pressure anaesthesia.
A solution of cocaine is applied to the exposure by
means of a small ball of absorbent cotton-wool
the cavity is then filled with a piece of unvulcanised
rubber rolled up into a ball, and gentle pressure is
applied to the rubber by means of a broad-faced
plugger or ball-ended burnisher. At first the pres-
sure must be very gentle to avoid causing pain ; in
about a minute it may be gradually increased
(reducing it if it hurts the patient), and in about
two minutes considerable pressure may be made
without giving pain, it may then be continued for
about another minute, when it will generally be found
that a fine probe can be passed to the apex of the
root painlessly. As soon as this can be done the
pulp should be extracted. Cocaine has been used in
aqueous solution, in chloroform, in alcohol, and in
a mixture of alcohol and formalin. The writer uses
cocaine and formalin. He places a few drops of
formalin on a glass slab, and adds sufficient cocaine to
produce a saturated or slightly super-saturated solu-
tion. It does not seem to matter how minute the