Chapter Xxv Contains Some Observations on “_well-Authenticated Cases_”

of regeneration of permanent teeth in individuals of ages varying from fifteen to seventy-five years. We will here give two of them by way of curiosities:

“In the year 1708 Mademoiselle Deshayes, now the wife of M. de Sève, residing at Paris in rue de Baune, and who was then fourteen years of age, had the first large molar on the right side of the inferior jaw extracted by me, because decayed and causing pain. The following year she returned to have her teeth cleaned by me, and whilst doing this I observed that the tooth extracted had been wholly regenerated.”

“In the year 1720 the eldest son of M. Duchemin, player in ordinary to the King, who was then sixteen years old, came to me to have the second large molar on the left side of the lower jaw extracted. It was very much decayed. I drew it, and a year and a half after the tooth was completely regenerated.”

In Chapter XXVIII the author relates twelve cases of dental irregularities corrected by him with satisfactory and at times even surprising results. We here refer, in Fauchard’s own words, to the last two of these cases, not because of their being the most important, but because from them it is evident that Fauchard was not the only dentist who undertook such corrections, although he was perhaps the only one who, in certain cases, carried them out with a rapid method.

“In the year 1719 M. l’abbé Morin, about twenty-two years of age, whose countenance was greatly deformed from the bad arrangement of the incisors and canines, consulted various colleagues of mine as to the possibility of correcting the irregularity of his teeth. Some found the thing so difficult that they advised him to do nothing at all, that is, not to risk any attempt. He came to me by chance one day whilst another dentist was with me. We both examined his mouth with much attention. Now, as this dentist was my elder, and I believed him to have more experience than I had, I begged him to give me his opinion as to the best method to follow in this case, in order to insure success. Whether it be that he would not give me advice, or that he was not in a position to be able to do so, the fact is, that his answer was not such as I could have wished. I therefore felt myself obliged to tell him that I hoped to put this gentleman’s teeth in order within three or four days. My colleague was not aware that this could be done so quickly; urged by curiosity, he returned when the time I had indicated had elapsed, and found, not without surprise, M. Morin’s teeth reduced to perfect order.”

“Several years ago the wife of M. Gosset, Reviseur des Comptes, sent for me to examine the teeth of her daughter, then twelve years of age. I found the lateral incisor on the left side of the lower jaw strongly inclined toward the palate in such a manner as to constitute a real disfigurement. Interrogated by the mother as to the possibility of remedying this, I replied that it could easily be done in eight or ten days, with the method of threads, if the young girl were only sent every day to my house. As, however, the young lady received instruction from several masters who came to her house each day, my proposal was not accepted, in order not to distract her from her studies. This induced me to say to the mother that, if she were willing, I would put the crooked tooth into its natural position in a few minutes. Surprised at so short a time being demanded for the operation, she consented to my performing it immediately. Making use of the file, I began by separating the tooth from the neighboring ones which pressed upon it, slightly diminishing the space it ought to have occupied. This done, I straightened the tooth with the pelican, placing it in its natural position, to the great astonishment of the young girl’s mother and of other persons present, who told me they had many times seen similar corrections that had been carried out by the late M. Carmeline and others, never, however, with this method or in so short a time. As soon as I had reduced the tooth to its normal position I fixed it to those next to it by means of a piece of common thread, which I left there eight days; and during that time I made the young girl rinse her mouth four or five times a day with an astringent mouth wash. After the tooth had become firm, it would not have been suspected that it had ever been out of its normal position.”

In Chapter XXX the author gives an account of five cases of dental replantation and one of transplantation. This last operation was carried out on a captain who had the upper canines on the left side decayed and aching; he inquired of the author if it were possible to draw it and replace it by another person’s tooth. Having received an affirmative reply, the officer sent immediately for a soldier of his company to whom he had already spoken on the subject. This man’s canine was found by Fauchard to be too large; nevertheless, for want of better he extracted and transplanted it, after having diminished it in length and in thickness. This it was not possible to do without the cavity of the tooth remaining open, and for this reason, when, after about two weeks’ time it had become quite firm, he stopped it. But the stopping immediately caused such insupportable pain (which circumstance astonished the writer not a little) that he was obliged to take it out again the following day, on which the pain ceased directly. Fauchard saw this patient eight years afterward, and was assured by him that the transplanted tooth had lasted him six years, but that its crown had been gradually destroyed by caries. The root had been extracted by a dentist, not without considerable pain.

We now give one of his cases of replantation in the words of the author himself:

“On April 10, 1725, the eldest daughter of M. Tribuot, organ builder to His Majesty the King, called on me; she was tormented by violent toothache caused by caries of the first small molar on the right side of the upper jaw; but although she was desirous of having the tooth removed, to be freed of the pain, she, on the other hand, could not, without difficulty, make up her mind, thinking of the disfigurement which its loss would occasion, and thus it was that she was induced to ask me if it would not be possible to put it back again after having extracted it, as I had already done in the case of her younger sister. I replied that this might very well be done, provided the tooth came out without being broken, without any splintering of the alveolus, or great laceration of the gum. The patient, upon this, completely made up her mind. I extracted the tooth very carefully so as not to break it, neither were the gum nor the alveolus injured in any way. I therefore was induced to put the decayed tooth back in its alveolus, and having done this, I took care to tie it to the neighboring teeth with a common thread, which I left in position for a few days. The tooth became perfectly firm, and only caused pain for two days after being replanted.... To better preserve it, I stopped the carious cavity.”

Not without interest is a case of disease of Highmore’s antrum, originating in the following way. A charlatan attempted to extract by means of a common key a canine tooth which had erupted in an abnormal position. He applied the hollow of the key to the tooth and beat upon the handle with a stone. But the tooth, instead of penetrating into the hollow of the key, was driven into the maxillary sinus.

Two important cases of “stony excrescence” of the gums (probably osteomas) are to be found in Chapter XXXII. One of these tumors was removed by the dentist Carmeline after the patient had been tortured with useless operations by surgeons, who, not recognizing the true seat of the evil and mistaking it for a tumor in the cheek, had, over and above all the rest, produced a permanent disfigurement of the patient’s face and a perforation of the cheek that he was obliged to keep closed for the remainder of his life with a wax plug, to prevent the exit of the saliva and of liquid or masticated aliments.

Several important observations on obstinate cases of cephalalgia, prosopalgia, otalgia, and other varieties of pain arising from dental caries are to be found in Chapter XXXIII. In all these cases the removal of the decayed tooth or teeth procured the prompt cessation of pain. Among others worthy of note is a case of violent otalgia caused by the decay of a lower molar, which, however, was itself not painful. This circumstance drew Fauchard himself into error, causing him to believe that the otalgia was independent of the decayed tooth; he therefore merely stopped the tooth to prevent the caries from extending farther. The pain in the ear continued, however, and the patient therefore consulted a doctor of the Faculty of Paris, Coutier, who told her that the decayed tooth might be the cause of the earache, and that, therefore, before undertaking any other cure, she ought to have it extracted. This advice was followed and the earache ceased promptly and completely.

In another case a patient twenty-seven years of age was tormented by violent pain in all her teeth on the left side, in the temple and the ear, as well as in the chin, the palate, and the throat. The doctors and surgeons consulted decided the cause to be rheumatism. The patient was bled not less than four times and subjected to various other methods of treatment (purgatives, clysters, poultices, etc.), but all in vain. She, however, perceiving that one of her teeth was decayed, had it taken out. It was believed that the cause of the malady had thus been found and removed; but an hour later the pain began again with the same violence as before, continuing for some months; after this it ceased of itself. On the return of the pain, later on, in all its former intensity, the patient consulted the very able surgeon Petit, who advised her to see Fauchard, as possibly the malady might have its cause and point of departure in some bad tooth. Fauchard found one of the inferior molars decayed. This being extracted, the pain promptly ceased, not to return any more.