294 DENTAL PATHOLOGY. 



exists on this subject, both among professional therapeutists and the masses 

 of the people, and shall feel myself amply repaid if I have set people think- 

 ing in an intelligent way about this great and all poAverful agent — Heat. 



DENTAL PATHOLOGY. 

 BY A. H. TREGO, D. D. S. 



Dr. Parmele, in the April number of the Eeview, says: " The most fre- 

 quent cause of the death of the dental pulp (nerve) is from medicaments 

 aiDplied by the dentist." 



It must be admitted that procrastination on the part of the patient is 

 the primary cause; after which the injudicious use of medicaments com- 

 pletes the " slaughter of the innocents." Another frequent cause is the un- 

 skilful use of instruments; as also packing the filling in immediate contact 

 with the exj)osed, or partly exposed pulp. 



Thorough knowledge o± the anatomical and chemical structure of the 

 teeth, with judgment as regards age, development, and other variable circum- 

 stances, are absolutely necessary toward constituting a " competent dentist." 



All operators, however, are liable to expose the point of a pulp in exca- 

 ting cavities of any considerable size or to meet with extremely sensitive 

 dentine immediately over the pulp. It is either of these cases that Dr Par- 

 mele alludes to. The remedy he leaves the ordinary reader and unedu- 

 cated dentist to guess. Great care is necessary to avoid these sensitive 

 points until the other parts of the cavity have been cleansed, after which 

 mild narcotics or styptics should be used to allay inflammation. If, now, 

 the dentine is sufficiently healthy and the pulp but little exposed, a safe 

 operation may be effected by " capping" and filling. 



The "fatal cases" are produced by the ignorant and indiscriminate use 

 of cauterants, alkalies or acids "to obtund pain." Any one at all acquainted 

 with therepeutics and chemistry ought to know that chemicals of that char- 

 acter will devitalize and destroy anything like flesh and blood with which 

 they come in immediate contact. Hence the correctness of Dr. Parmele's as- 

 sertion. However, arsenic, creasote, carbolic acid, iodine, chloride and oxy- 

 chloride of zinc, etc., etc., are indispensable in a well regulated dental ofiice ; 

 but, one application of anj^ one of them to an exposed dental pulp renders 

 extirj)ation absolutely necessary to the health of the tooth and comfort of 

 the patient. I know there are operators who oppose this theory, who as- 

 sert and believe that "when the nerve is destroyed the tooth necessarily 

 becomes discolored and dies." 



These same operators "obtund pain" (?) by use of the aforesaid chemi- 

 cals, and the last thing before fillingthey cover the ]3artly decomposed pulj) 

 with cotton saturated with creasote "to ^jrevent the tooth from aching." 

 If they have any knowledge of anatomy, what would they think of a sur- 

 geon who woukl attempt to hermetically seal such a powerfully decomposing 



