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DENTAL PERIOSTITIS. 291

of blood to the part, and the surroundings being such
as to prevent free expansion of the capillaries, and
other small vessels, ramifying this membrane, these
walls are pressed upon in proportion to the force of
this determination.
This effort at expansion will occasion, especially in
those teeth having very conical roots, quite a per-

ceptible elongation, and this more particularly occurs
when active inflammation supervenes, which is the
sequence of the state of irritation, to which reference
has just been made.
After active inflammation has occurred, pressure or
percussion upon the affected tooth, usually causes
great pain; to such an extent, that sometimes the
slightest contact even by the tongue is intolerable.
This condition varies much in degree, in different
cases, dependent largely upon the predisposition, and

susceptibility to exciting causes of irritation and
inflammation, together with the character of these
exciting causes, whether concentrated in action to a
mere point, or more extensive in their sphere of
operation.
Oftentimes only a very small portion of the peri-
osteum of a tooth will be affected ; it may be confined

to the immediate vicinity of the point of the root, or
to one side, or to the periosteum near the margin of
the alveolus and the border of the gum.