Page 147 - My FlipBook

Dental Caries as a Pathoiogical Process. ;
Decay of the teeth is a pathological process that stands
to itself. There is no other pathological process to which it
may be compared ; it is different from any other known path-
ological process. In what is known as caries of bone we have
an inflammatory process, followed by suppuration and de-
struction of the tissue, first by absorption of considerable
areas of bone in the inflammatory process, and the extension
or enlargement of the Haversian canals, followed by a sup-
purative process and a destruction of the tissue. In caries
of the teeth we have no such processes as these. There is no
inflammatory process accompanying caries of the teeth. The
dentin contains no Haversian canals, no blood circulates in the
dentin and we haven't anything of the inflammatory or sup-
purative processes connected with caries of the teeth. If we
examined the tissue in the neighborhood of progressive de-
cay no changes appear in the neighborhood, and those
changes which occur in the decayed portion are such as
we find expressed in the solution of the lime salts and the
destruction of the matrix. Then we do not find in the neigh-
borhood of the area of disease a propagation of any such
pathological processes as we find in other diseases. We do
find some changes in the sensory functions. Ordinarily, if
we cut into a tooth that is perfectly healthy in every way we
will find a certain sensibility, a certain amount of sensation
induced by cutting the dentin ; especially we will find this sen-
sation fairly sharp just at the dento-enamel junction, and less
pronounced after passing that point. If we grind a tooth we
will find some sensation in each case, and as we proceed with
the grinding we will find that that sensation is rapidly aug-
mented ; there seems to be something in that process of grind-
ing that causes the tooth to arouse and resist strongly. Now,
in caries we find but little of this. Occasionally we find cases
in which the sensibility seems to be aroused in large degree
they are very sensitive, and in these cases, if we cut into a
sound tooth in the mouth of the same patient, we are very
likely to find the same sensibility we wall find it in all of the
;
teeth of that patient, as a rule. It is only now and then
that we find hyper-sensibility in one tooth and no hyper-
sensibility in the other teeth ; it seems to become a patho-
logical condition aroused in the nervous system of the patient,
by which all of the teeth become more sensitive than normal.
MS