Dentologia

Part Ii. P. 25.)

“The pain called tooth-ache, which Galen very properly considered the most cruel and grievous of all pains that are not mortal, seems clearly to be occasioned by decayed portions of bone, no matter how minute, acting by contact on the nerves of the teeth.--And I firmly believe the pain is never felt until the caries, which always acts from without inwards, has actually met a branch of nerve.

“No species of animal matter, in a state of decay, is so offensive to the vitality of the adjoining substance, whether nerve, or muscle, or membrane, or any part or portion of the living body, as decayed bone. How very small a portion of decayed bone in a tooth is capable not only of causing the most agonizing pains, but also of communicating a fœtor to the breath, is inconceivable by those who have not pursued the inquiry with minuteness: and this offensive matter, when it thus has an opportunity of acting, communicates, through the medium of the nerves, a sympathetic pain to the teeth which are perfectly sound.” (Hare on the Stomach, p. 240.)

In addition to the preceding remarks, I observe, that the tooth-ache is sometimes so severe as to produce alarming derangements of health; while at other times it is merely an annoying sensation, which can scarcely be termed pain. The cavity of the tooth, in most cases, is the original seat of this malady. But as the teeth are supplied by ramifications of those nerves which supply different parts of the face and head, it frequently happens that one or more of those parts may suffer more severely than the tooth itself.

Diseases in the wisdom teeth of the lower jaw affect the ear; and when those of the upper jaw are diseased, the temples generally become affected. The effects of disease in one tooth, from nervous influence, is sometimes felt in the opposing tooth of the other jaw.

No certain treatment can be laid down for the tooth-ache; it must be regulated entirely by a knowledge of the cause, whether arising from decay, the irritation of tartar, the application of cold, or merely as a sympathetic affection. The disease which occasions this malady is insidious in its progress, dangerous and sometimes fatal in its consequences; but the danger more frequently arises from an improper application of remedies, than from the disease itself. Powerful remedies for the tooth-ache, as well as for other diseases, are hazardous in the hands of the ignorant.

(35) And tooth-ache came, the terror of mankind!

“When pains in the teeth show a disposition to change their places with great facility, like all rheumatic affections, they may yield to the most insignificant means, even to the touch of some amulet, applied with an air of mystery and confidence which imposes upon the patient. Every one knows, that in timid people, the presence of a surgeon, in most instances, is sufficient, for a time, to dispel the pain of tooth-ache. It is particularly for these pains that some dentists have a favorite odontalgic elixir, of whose sovereign virtues they are so fond of boasting. These liquors are almost all spirituous tinctures, whose powerfully stimulating action often suffices to suspend the pain.

“In fact, a drop of the tincture of opium, or any one of the essential oils, applied to the part by means of a little cotton, may produce an instantaneous abatement of the pain, but which seldom fails, sooner or later, to return. Frequent successes of this kind, of which marvellous accounts are daily published, have successfully brought into vogue numerous elixirs and various other means, all more or less ridiculous.” (Gerbaux, pp. 80, 83.)

“Doctor Sims, a celebrated practitioner in London, relates that he was such a martyr to the tooth-ache, that he was confined to his house for several weeks together by that malady, but after he avoided taking his food either hot or cold, he entirely escaped it. He was particularly careful not to take soup or any other liquid, of a temperature higher than ninety--eight degrees less than blood heat. He was induced to try this experiment, by reflecting that heat expanded all bodies. When applied to a tooth, therefore, it must diminish its cavity, compress the nerve, and consequently produce pain. However defective this theory may be, the practice of endeavoring to preserve those parts in an equable temperature, will be found to be highly important.” (Duval.--Atkinson’s translation, p. 76.)

(36) To mercy deaf, by sorrowing man accurst.

The following characteristic lines are from the “Address to the Tooth-ache,” by Robert Burns:--

“My curse upon your venomed stang, That shoots my tortured gums alang, And through my lugs gi’es money a twang, Wi’ gnawing vengeance! Tearing my nerves wi’ bitter pang, Like racking engines!

“When fevers burn, or ague freezes, Rheumatics gnaw, or cholic squeezes, Our neighbors’ sympathy may ease us Wi’ pitying moan; But thou--the hell o’ a’ diseases, Ay mocks our groan!

“Where’er the place be priests ca’ hell, Whence a’ the tones o’ misery yell, And ranked plagues their numbers tell, In dreadfu’ raw; Thou--tooth-ache, surely bear’st the bell, Amangst them a.’”

“We were interrupted by Mr. L. He is one of your plain, common sense sort of people, practical, fixed in his own opinions, a little inclined to stoicism, with a dash of savage philosophy, partly affected to hide tenderer feelings, and about six feet and an inch high, without his shoes.

“‘What’s the matter with your face?’ inquired he.

“‘Tooth ache,’ said I, ‘all swelled: keeps me awake, and’----

“‘Try my nitri dulcis and alum pulv.,’ said W.

“‘Curse your nitri dulcis and alum pulv.,’ said L., ‘there is but one cure for the tooth-ache, and that’s a sure one,’

“I looked tremblingly up. He had his great, square fist doubled, as if he held something in his hand. He raised it to his mouth, and screwed around with the motion of a dentist, uprooting some huge, double grinder, with three diverging prongs. My friends were silent. I turned a little pale. He saw what an impression he had made, and with a grin that went to my very soul, added;--

“‘Out with it, you fool, and there’s an end. It’s worth all the nitri dulcis and alum pulv. in the universe.’

“There was a melancholy truth in what he remarked. It sunk into my heart; I made up my mind; and when my worthy advisers left me, I walked around to Mr. ----. There was an awful silence--a moment of intense fear--a slight struggle--an agony--a cry from the heart’s core--I came out the happiest of men.”--(Dreams and Reveries of a Quiet Man, by Theodore S. Fay, Esq. Vol. I. p. 187.)

(37) And stops the fearful progress of decay.

As great disadvantages frequently arise when teeth are decayed, from their crowding against each other, it becomes expedient, with a view to stop the progress of incipient disease, to remove portions from their sides by means of a file; but, if this operation be not performed before considerable parts are decayed, it must not be expected to afford lasting benefit. The incisors and canine teeth may be filed with the greatest probability of success; but the bicuspides and molares have such large surfaces, that caries often extends itself by far too deep before it is observed, to be effectually removed by the file. Little advantage can be expected from filing, unless the whole diseased part be effectually removed.

It is proper to observe, that there are some teeth, which, although attended to at an early period, are but little benefitted by the operation, either from some original defect in their organization, or certain peculiarities of constitution: but this is, by no means, commonly the case; and the instances of its proving essentially serviceable are so innumerable, that it may be recommended with the highest confidence of success.

(38) Performs in nature one substantial use.

The benefits of the operation of stopping the teeth are so truly important, that it is impossible to recommend it too earnestly to the public; for thousands of the most useful teeth, which otherwise would, on account of their painfulness, be sacrificed by extraction, may thus be preserved, not only for many years, but for the remainder of a long life.

The finest teeth are commonly the most highly organized, and therefore become more acutely painful when only a very small portion is decayed. The operation of stopping will always succeed, if performed before the decay has reached the sensible part of the tooth, unless its cavity be superficial, or of a funnel shape, and not capable of being sufficiently deepened for retaining the gold. In such cases, all attempts at stopping it will be fruitless. But if the depth be sufficient towards the sensible part of the tooth to allow of the excavation being made larger, or directed obliquely or otherwise, as may be most eligible for receiving and securing the gold, the caries may be so effectually arrested as to cause no farther uneasiness to the patient.

Continue reading Dentologia free in the Wunder reader →