TEETH. 



ternal or internal furface of a tooth ; upon tlie l>ody or the 

 fang of a tooth ; or it may affert every part ot it. 



As to caufcs, the caries may proceed from fuch as are 

 properly called external, as a fiiTure ; a wearing away of 

 the enamel ; fordcs adhering to the teeth ; tartar ; a detach- 

 ment of the glims ; a violent effort to bite, by which the 

 apex of the fang, or the bottom of the fockct, is contufcd ; 

 the ufe of mercury ; cofmetics ; the application of acids, 

 efpecially thofe which are termed mincrj ; dentifrice powders 

 containing alum ; cold damp air ; fmoking, or chewing 



tobacco, &c. 



Sugar has been imagined to he hurtful to the teeth ; but 

 probably without real foundation. General de Beaufort 

 ate every day for forty years a pound of fugar, and lived 

 to the age of fevcnty. After death, his vifcera were found 

 free from difeafe, .ind his teeth found. (Anecdotes de 

 Medccine, torn. ii. p. 35.) Plenck put a healthy tooth 

 into fome fyrup diluted with water, and kept it there two 

 months, at the end of which time it was taken out, and 

 found to have undergone no change. Doftrina de Morb. 

 Dentium, p. 52. 



The internal caufes are fcurvy, rachitis, fcrofula, &c. 



In relation to the particular nature of caries of the teeth, 

 there are two fpecies ; one termed humid, which quickly 

 deilroys the tooth afFeftcd with it ; the other is the di-y ca- 

 ries, which advances (lowly, lafts a long while, is altogether 

 indolent, and cannot be palliated by any known remedy. 



The effefts of caries are fetor of the breath; repeated 

 attacks of tooth-ache ; infeftion of the neighbouring teeth ; 

 and not unfrcqueutly the correfponding tooth on the oppo- 

 fite fide of the mouth becomes alfo affedled with caries, as 

 feveral authors whimfically fuppofe, from nervous fympathy. 

 In the fituation of the difeafed tooth, efpecially, over the 

 carious fang, the gum is moft. commonly attacked with a 

 parulis, or epulis. Sometimes chronic ophthalmy originates 

 from the irritation of the difeafed fang (Journ. de MCd. 

 tom. xxxvi.) ; or elfe a fiftula of the gums or cheek, or an 

 ozaena of the antrum Highmorianum. Even a locked-jaw 

 has been known to arife from carious teeth. Truka Com. 

 de Tetano, p. 151. 



In refpeft to figure or form, the following fpecies of 

 caries may be eftablifhed. 



1. Caries foraminofa, or a carious canal, which runs from 

 the external furface of the crown, and penetrates the fub- 

 ftance of the tooth. 



In the treatment, it is proper to clean out the carious 

 canal with a needle, and by injefting a fluid into it. Then 

 it is to be burnt with a heated needle ; and, laftly, elofed 

 with wax, maftich, gold, or lead. 



2. Caries of the whole crown or body of a tooth. When 

 the middle of the crown of a tooth is eroded in fuch a man- 

 ner, that the caries is wider fuperficially than it is more 

 deeply, then the gold, or lead, or whatever is ufed for filling 

 it up, cannot be retained in its place. 



In this circumftance it becomes neceffary to burn the 

 carious furface with a fuitable inltrument ; or to deftroy it 

 with cauftic applications ; or to apply antifeptics. 



But when, notwithttanding all thefe means, the caries yet 

 fpreads, the tooth ought to be extrafted, in order to re- 

 move the pain, prevent the occurrence of other difeafes, 

 and not incur the rifk of the tooth breaking in pieces in 

 the attempt to take it out at a later period, vvhen it may be 

 excavated and rendered too thin. 



3. Caries maculofa. If the fuperficial fpot only appear 

 upon the external furface of the tooth, it may be removed 

 with a file. 



4. Caries ftriata. Whfn the caries occurs in the form 



of a longitudinal black (Ireak, it is cither in the middle of 

 tlie crown, or on the lateral margins of the tooth. This 

 cafe may be oecafioned by the teeth being placed too clofely 

 together, and alfo by the ufe of cofmetics. It admits of 

 being taken off with a file. 



5. Caries of tlie fang of a tooth. The body of fuch a 

 tooth is fometimes found. The tooth, however, is fre- 

 quently painful, the cheek of the affeAed fide, and the 

 gum near the painful tooth fvvell, and an abfcefs is formed, 

 which is lefs common in the other fpecies of caries. 



The cure requires that the tootli ftiould he drawn out as 

 foon as the inflammation has fubfided, It is reckoned dan- 

 gerous to perform the operation while the parts are much 

 inflamed. 



6. Internal caries of a tootli. In this complaint the 

 tooth is painful, and exhibits a leaden colour, and if it be 

 fliaken with an inflrument the pain is confiderably ex- 

 afperated. Thus the difeafed tooth may be detefted ampngfl 

 many which are healthy, even when feveral of them are 

 thought by the patient to be unfound. 



The cure requires the tooth to be extrafted. 



7. Caries of all the teeth. This afHiftion is fometimes 

 induced by the fcurvy, and rachitis. The radical cure is 

 of courfe impoffible ; but the progrefs of the caries can be 

 checked by the internal ufe of antilcorbutic medicines, the 

 remedies againft rachitis, and by giving affa-foetida. 



Externally, antifeptic wafhes may be ufeful. 



Plumhatio dentis is the fiUing of the carious cavity with 

 thin fheet-lead, tin, or gold. Gold is preferable to lead, 

 which is apt to be afted upon and diffolved by acid food, 

 and may therefore produce the faturnine colic ; but, on the 

 other hand, lead is more cafily introduced into the tooth, 

 and it can be more firmly fixed there. Some dentiils give 

 the preference to tin. 



The operation is proper, if the carious tooth has a narrow- 

 entrance. It can only be performed on the incifors, canine 

 teeth, 'and firfl grinders, which are furnifhed with but one 



The operation is contraindicated, when the orifice of the 

 caries is wider than its bottom, as the lead cannot then be 

 retained. Alfo, when pain and inflammation are prefent, 

 the introduflion of the lead muft be deferred until thefe 

 fymptoms have fubfided. 



The inftruments for this operation are, 



1. The introduftor. 



2. The perforator. 



3. The planatorium. 



4. The file. 



5. The plates or leaves of gold, about three or four times 

 as thick as thofe commonly met with. 



As for the operation itfelf, 



1. A thin plate of lead, tin, or gold, is to be put into 

 the hollow of the tooth, by means of the inltrument called 

 the introduftor. 



2. The lead or gold is to be gradually compreffed more 

 and more clofely, fo that it may fill up well the (ides of the 

 cavity. This is to be done with the planatorium. Then 

 fome holes a»e to be drilled in the metal with the perforator, 

 and thefe are to be filled with lead. Laftly, the place is to 

 be rendered even and fmooth with the file. 



The lead, for fome days after the operation, proves r.-ither 

 difagrccable to the tongue ; but, in a ihort time, the patient 

 is habituated to it, and he experiences no longer any fuch in- 

 convenience. 



Sometimes pain and inflammation follow ; in which cafe, 

 the lead muft be taken out for a few days with a pointed 

 ioftrument. 



8 There 



