DENTAL PATHOLOGY. 295 



agent in an}^ other part of the human organism? Would he not be guilty 

 of malpractice ? 



Aside from theory, practice proves that in a large majority of cases 

 where pulps are "treated" and left in intense suffering and alveolar abscess 

 is the inevitable result. 



It is an established scientific fact, that a tooth not otherwise injured receives 

 all necessary nourishment and vitality from the peridontium after the pulp 

 has been extirpated and the channel properly filled. Also, that after ulcer- 

 ation and alveolar abscess have occurred, the surrounding parts may be 

 restored, and the tooth rendered permanentl}^ healthy and useful. 



After years of experiment and comparing notes, the leading authorities 

 of the profession are unanimous as regards the modus operandi of devitaliz- 

 ing and extirpating dental pulps ; as also of the necessity of filling the cavity 

 with some substance that will render it absolutely impervious to moisture 

 or gas, either by percolation or imbibition from the surroundings. 



To devitalize a pulp : First, excavate the superficial decay and foreign 

 substance usually found in decayed teeth, dry the cavity and apply "nerve 

 paste," (arsenic and creasote), immediately on the pulp, by means of a small 

 tuft of floss, cover this with cotton saturated with Sandarac varnish. Be 

 sure to exclude ail air and moisture, and not get any of the paste on the 

 gums or lips. 



!Never apply arsenic while peridontitis exists. Leave the nerve paste in 

 from ten to forty-eight hours, as circumstances demand ; then remove it and 

 cut away as much superfluous dentine as the condition of the pulp admits. 

 JS"ow apply creasote for from three to ten days, usually five to seven days ; 

 exclude moisture and air as before. Fungous growth of pulp may be treated 

 similai-ly. As little arsenic and creasote as possible should come in contact 

 with the bony structure of the tooth, as they will soon destroy it. 



Arsenic "devitalizes," creasote "tans," or causes the pulp to "slough." 



1 prefer carbolic acid and iodine for fungus, abscess and necrosis, but use 

 it sparingly in contact with the dentine, as it is liable to discolor the tooth 

 by continued use. Never use cauterants in the cavity after the pulp is 

 removed, except for abscess, necrosis, etc. 



"When the pulp has been made insensible it can be readily extirpated. 

 Eemove all of the pulp — to the apex of the fang, have the cavity thor- 

 oughly cleansed and free from inflammation, and as a final dressing before 

 filling the fang, wash it out with a tuft of floss saturated with equal parts 

 of tincture of belladona and aconite root. . Tepid water, by means of a 

 syringe, should be freely used in cleansing all cavities. 



Until a few years ago the leading dentists considered gold the only 

 proper material with which to fill " pulp canals." They roll a cone to sup- 

 posed size, having it semi-solidified, and then guess how far to drive it in. 

 Having everything in readiness, they dip the cone in creosote and insert 

 it. If periostitis or abscess follows they attribute it to "'exostosis," or to 

 the patient "taking cold." A majority of cases treated in this way result 



