Page 228 - My FlipBook

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^12 THE TREATMENT OF TEETH
remote from the pulp; a small piece of arsenical
paste should then be placed in the bottom of the
hole, which should be filled up with temporary
gutta-percha. This leaves the rest of the cavity
free for the use of obtundents, and precludes the
possibility of the arsenic becoming displaced and
getting on to the gum. It will—even in favourable
circumstances—take about a fortnight for the effect
of the arsenic to travel through the dentine to
the pulp and completely destroy it in these
cases.
It is generally considered that arsenic has
no effect on inflamed pulps, and that inflammation
should always be reduced before it is applied. It
is certainly good practice to relieve an aching tooth
as promptly as possible by appropriate remedies,
and then at the next sitting to apply the arsenic
but there are cases when a tooth resists all the
usual soothing applications, and the application of
arsenic is followed—after usually a period of in-
creased pain— by relief. The writer has often
found that the relief has occurred long before the
pulp is destroyed or even rendered insensitive to
touch. It is considered that the efficacy, as Avell
as the painlessness, of an arsenical application is
greatly increased by making a free exposure. The
writer has only in exceptional cases been able to