Page 385 - My FlipBook

EXTRACTION PREPARATORY TO INSERTION. 381

number to be removed ; second, the firmness of their
attachment; third, the patient's power of endurance
;
and fourth, the manner in which the immediate parts
are affected. Where the number to be removed is
considerable, and the attachment feeble, or not very

firm, and the patient's power of endurance good,
the extraction may be as rapid as is consistent with
efficiency. In many such cases, from three to six
teeth may be removed, without any relaxation, by
the operator, of his hold on the parts with the left
hand. This is generally practicable with the front
teeth of the lower, and frequently with those of the
upper jaw ; but it is not proper to remove more than

three or four of the molar teeth, without respite, even
when they are quite loose, or have but a feeble
attachment in the socket. The gum should, of
course, be well separated previously to the operation.
Only so many teeth should be removed at one sitting
as the nervous system will allow without too great a
shock. In many instances, however, it is practicable
so far as this is concerned, to remove at once all the
teeth in the mouth. In the extraction of a large

number those most easily removed should be first
taken, so as by degrees to bring the patient to the more
severe operations. If there is a manifest hemorrhagic
diathesis—a disposition to bleed freely from the capil-
laries, as well as from the larger vessels—but two or