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. BRIGGS:—Rules have their exceptions, and when I make the statement
that I do not believe in capping pulps, I still claim the privilege
of having certain exceptions. It seems to me that in all the cases of
actual exposure, the question of capping the pulp is merely one of
expediency for the purpose of keeping the tooth along. You do not wish
to destroy the pulp at that time, perhaps, because it is a young tooth;
or perhaps you dread the trouble and inflammation which is likely to
ensue from the use of arsenious acid at that time, or possibly the
patient is going away. In those cases I have had no trouble in putting
a dressing in, which has kept the tooth quiet for a long time, but I
always expect that sooner or later I will have a dead pulp to attend
to. In fact, the most of the pulps that I have capped to preserve,
are pulps that are not exposed, but are protected by a thin layer of
dentine, perhaps decalcified, but which I could easily make aseptic.
Many cases of pulp stones are the result of putting a filling too near
the pulp, which is irritating and causes a formation. In those cases
I remove the irritant and put in a dressing. That dressing is made by
mixing the oxide of zinc with an antiseptic which has some anæsthetic
property—say some essential oil; then covering that with a thin layer
of copper plate, and then putting a hard filling over that. There is
always an uncertainty about it, and four, eight or even twelve years
is not always time enough to prove the success of capping the pulp. It
may be that after twelve years you find a pulp stone formed that will
give all the trouble and exhibit all the symptoms of neuralgia. If your
tooth is fully formed, it is better to get the pulp out of the way and
to fill it properly, and have a good, healthy tooth. It has been said
this evening that the office of the pulp is to form the tooth, and when
the tooth has been fully formed its usefulness is, to a greater or less
extent, over, and the tooth can do good service without it, and this
opinion I agree with.
Perhaps right here would be a good place to mention something which I
intended to speak of later on, under the head of "Incidents of Office
Practice." We have, all of us, more or less trouble from applying
arsenious acid, and I have lately found that where the pulp is exposed,
I can, by wiping a 20 per cent. solution of cocaine over the surface,
inject without pain a twenty per cent. solution of cocaine, and
after a few moments remove the pulp entirely, also without pain. My
brother and myself have operated several times on such cases lately
with satisfaction to ourselves and our patients. I say several cases,
because we have disposed of some old cases which had resisted the
arsenious acid and had been hanging along waiting for "something to
turn up."
Public-domain text, read in full here on John Shaqi.
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