The Archives of Dentistry, Vol. VII, No. 12, December 1890Various
Science
The Archives of Dentistry, Vol. VII, No. 12, December 1890
Various
Dentistry -- Periodicals
DR. CLAPP:—I had occasion yesterday to cut off two central incisors
for a lady eighteen years of age. The pulp chamber was entirely
obliterated, entirely filled. I imagine that the pulps near the apex
of the root are still alive, and it seems to me that the presence of
the pulp is a great advantage to the teeth as long as they are in a
healthy condition, and I must say that I hesitate to destroy pulps. As
Dr. Taft says he has not destroyed the pulps in half a dozen teeth in
four years, I do not believe that my proportion is greater than that in
eighteen years.
I would like to inquire of the Society its opinion of the advisability
of removing softened dentine over the pulps that would be undoubtedly
exposed by the removal of such softened dentine.
DR. BIGELOW:—I do not rise to relate any experiences in capping pulps,
but there is one question that has come up in my mind many times that
I would like to have answered, if possible, by some of these gentlemen
that believe in capping, and practice it regularly. We were taught in
the school that in an inflammatory condition we might expect to find
heat, pain, redness, swelling—we might expect to find one or all of
these symptoms in an inflammatory condition of the tissue. It is said
of the bones, that an inflammatory condition might exist and yet have
neither swelling, redness, nor pain, but there might be heat. Now the
question that comes up in my mind is, how are we to know, really, when
the pulp is in an inflamed condition, and what treatment to give it
before capping? Very often patients come to us with teeth that have
been aching, and there is perhaps a swelling of the pulp and a certain
redness; I say swelling—the throbbing generally indicates a swollen
condition, in which cases the pulps are evidently inflamed; but what I
would like to know is, how are we going to tell whether these pulps
are in an inflamed condition or not? I would like to know the proper
treatment for an inflamed pulp. In cases where I have attempted to
subdue the inflammation, I have not had great success.
DR. SMITH:—In the absence of all symptoms, I should conclude that
there was no inflammation.
DR. BIGELOW:—I don't know whether all the symptoms were absent or not,
and that is just the point; there may have been heat, but not knowing
positively there was an increase in temperature, an inflammatory
condition might exist, and we might work blindly.
DR. SMITH:—I know of a prominent physician who treated a woman for the
"Grippe" when her real trouble was fatty degeneration of the liver. He
worked as near to the symptoms as he could get, but he diagnosed the
case wrong. He is a prominent, eminent physician, and I simply speak of
it to show the uncertainty of symptoms in a diagnosis. So in this case,
there might be inflammation, but if there was an absence of all the
symptoms, I should conclude that there was no inflammation and should
treat it accordingly.
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