The Archives of Dentistry, Vol. VII, No. 12, December 1890Various
Science
The Archives of Dentistry, Vol. VII, No. 12, December 1890
Various
Dentistry -- Periodicals
Idiosyncracies of persons have much to do with lesions of the teeth,
but there are often other causes also. A patient comes from some other
operator, and ignorant of what has been done, he is apt to be misled.
All causes which are not directly associated with the trouble, if first
eliminated, the diagnosis is much easier. The prejudice and ignorance
of the patient must be considered. A previous condition should be
studied, and its influence at the present time weighed that we be not
led to error. We must not be influenced by mere probabilities. Teeth
once affected are quite likely to be mistaken as the cause of trouble
again.
_Discussion_—DR. OTTO ARNOLD:—Instinct is a pretty good guide in
difficult diagnosis.
DR. R. D. JENNINGS:—Physicians know very little about the teeth.
DR. M. H. FLETCHER:—Pulp stones are often the cause of lesions very
difficult of diagnosis.
Dr. L. E. Custer, of Dayton, O., read a paper upon "Chloride of Methyl."
Since Dr. B. A. R. Ottolengui introduced the ether spray for obtunding
sensitive dentine there have been a number of such agents introduced
for the same purpose.
There has been considerable confusion regarding the action of volatile
agents for sensitive dentine. Dr. Ottolengui in previous paragraph
first used ether, supposing it to dehydrate further than alcohol or
hot air; but it does not, because it has no affinity for water and
because it produces cold, which opposes vaporation of the dentine's
moisture. Dr. Curtiss in using nitrous oxide is led to the belief that
it obtunds because it dehydrates. But that is a mistake, for the same
reason as for ether. When these agents obtund sensitive dentine, it is
because they reduce the temperature far below normal, and the crown
of the tooth being easily isolated, it is not difficult to reduce the
temperature so low as to render it entirely void of sensibility.
Chloride of methyl being an ether quite low in the series, volatilizes
at 74° Fahr. between ether and rhigolene, and is capable of reducing
the temperature to 40° below zero, if necessary. It volatilizes with
considerable rapidity with the warmth of the hand, and so does away
with any blast apparatus. Is not as inflammable as ether. Is not a
solvent of caoutchouc, and so it may be conducted through a rubber tube
to the tooth and its flow regulated by a thumb-screw. It volatilizes
quicker than ether, so that the surrounding parts are not saturated.
Its objections are that it is a general anæsthetic and at the present
time rather costly. It is all that Dr. Rhein claims for it, and is to
be preferred as a cold-producing agent for sensitive dentine.
But the more experience we have the better we can control our patients
by a sort of personal magnetism, and dehydration will answer our
purpose without resorting to such dangerous methods as the reduction of
temperature.
_Discussion_—DR. C. R. BUTLER:—General anæsthesia is probably
slightly produced, which accounts for part of the effect.
Public-domain text, read in full here on John Shaqi.
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