Page 265 - My FlipBook

teeth ofif, but it will not stop the erosion unless, as I say, the
whole surface liable to erosion is cut away.
Now, that is about all I can say as to the treatment of
erosion I will add only this—watch it carefully and let it alone
;
so long as the mutilation of the teeth is not excessive. Do this
with the hope that the erosion may cease. I think about half
of the cases of erosion that I have been al:)le to follow have
ceased to progress before the teeth were very much muti-
lated. And it is on this observation that I say—let it alone
heroically and watch it. It does not go so fast but that you
can apply the remedy, either filling, if you choose that, or cut-
ting off and crowning, at any time afterward that it may seem
necessary, and w^e always will have this hope that it may cease
to progress before the teeth are too badly mutilated.

Thermal Sensitiveness.

The consideration of thermal sensitiveness more properly
belongs to Prof. Peck, but it is so closely interwoven with the
management of cases in practice that I wish to- speak of it for
a few moments myself. Thernnal sensitiveness is a peculiar
painful sensation brought about by taking cold water into the
mouth; a pain in the teeth caused by changes of temperature.
This is peculiar to the teeth ; no other tissue in the body, no
other organ, showing a like resistance to thermal changes.
It is manifested by a sharp pain, the character of which you all
know from personal experience, lasting for a moment and
passing away. This is normal. Under certain conditions this
becomes a hypersensitiveness to thermal changes ; it becomes
augmented and becomes a pathological condition. The ac-
tual condition in this case is a hyperemia of the pulp. I have
studied this very carefully and I find that there is an injury
to the walls of the veins, particularly, and to some extent
to the arterioles of the pulp, by which they become very
much dilated ; indeed, each manifestation of pain in this way
is brought about by a dilatation of the blood vessels of the
pulp and a forcing of an extra quantity of blood into the
pulp. Now, as this becomes a pathological condition the
walls of the vessels become so injured that they are more
readily expanded than in the normal condition, and every
slight change of temperature produces a paroxysm of pain,
253