DIRECTIONS FOR THE mm 0F TIE TEETH, AND KEEPING THE Mouth in a Healthy Condition. BY M. Y. SIMMONS, SURGEON DENTIST, Office, Providence, R. 1. >>»CPKKy hd. fefflfffi. Printer. PROVIDENCES' 1874. DIRECTIONS FOR the jjmotftmfiott of fljc fcdlj, AND KEEPING THE Mouth in a Healthy Condition. BY M. Y. SIMMONS, SURGEON DENTIST, Office, 146 Westminster Street, Providence, S. I, PROVIDENCE: A. Crawford Greene, Printer. 187^ PREFACE. The Author haying, for many years had an extensive practice in Dentistry has long been convinced that his patients, and others needed reliable directions for the preserva- tion of the teeth, and likewise for that care of the mouth which is demanded for its neat and healthy condition. To be of further ser- vice to the one, and with a desire to serve the other class, he has devoted much thought and care in the preparation of the ensuing- pages, fully believing, if his readers will faith- fully follow his instructions, they will not only save themselves much pain, but likewise be more replenished in purse, and have more beauty and cleanliness on that part of the body which often is first to impress the be- holder. REMARKS ON THE TEETH. The mouth is an important part of the hu- man body. In it are the organs of taste and of primary mastication. Decayed Teeth and health are never companions for any long period of time. Not only are the teeth absolutely essential to the proper mastication of food, but in giv- ing beauty to the countenance, and distinct- ness, volume and power to the voice. Every individual, therefore, who regards comeliness as an advantage, and distinct utterance as an accomplishment, will be diligent and prompt in the use of all means needful for the healthy condition of the teeth. Whenever these organs, by neglect or disease, have decayed jam! been lost, every one appreciating their inestimable value will lose no time in having their place supplied. In these modern days, where enterprise is everywhere visible, science has felt its power and art has shown itself in manifold forms. INTRODUCTION. 4 THE TEETH. In no department of labor are the blessings of both science and art more conspicuous than in Dentistry. Now, artificial teeth are inserted in many a mouth, which, in symme- try and beauty, far transcend those given by nature. Teeth of this description are the product of scientific and skillful Dentists. This class is not large, but comparatively small. Many profess competency and skill in the Dental profession, but few by their practice and their patients are diplomated and acknowledged as really qualified for the responsible position. To reach this position is no easy task. Study and labor and long practice only place an individual therein. Had not the author of the following sections had. large experience and practice in his pro- fession, and received from his many patrons the most hearty expressions of their satisfac- tion and gratitude, he would refrain from the task now assumed, of giving instruction on the treatment of the teeth. From many a mouth, in which are teeth which he inserted, will come expressions radiant with perfect satisfaction, in reply to any inquiries as to his skill and competency. He exhibits his works as they are largely running ; and they proclaim his fitness. He sincerely hopes care- ful perusal and faithful practice of what THE TEETH, 5 follows in these pages will be of great bene- fit to all who thus read and practice. FIRST DENTITION. The period of first dentition, or eruption of the primary teeth, is so consequent of con- stitution and health, as precludes the practi- cability of any definite instruction or advice. Infants sometimes have teeth at birth. Instances of such possession, however, are very unfrequent. The central incisors ordi- narily appear, but rarely at the age of three months, often at six,andnotunfrequentlyata 'much later period. The temporary teeth are thus classified : first, the incisors; second, the cuspidati; and third, the molars. These teeth are twenty in number, each jaw, con- taining ten. In the first dentition there is often much irritation and pain, which in most cases, can be quickly relieved by Den- tist or Physician, through the process of scarification. Sucn relief the kind and tender will ever seek not only for the promo- tion of the comfort of the child, but for de- liverance from an untimely grave, now filled by many an infant in consequence of neglect or delay in seeking the necessary aid. When there is much enlargement and inflammation 6 THE TEETH. in consequence of the attempts of the little teeth to protrude, let nature have a little aid from art, and the result will be every way for good. SECOND DENTITION. This period in the life of the child is replete with interest. The gradual absorption of the roots of the primary or temporary, and the quick growth of the permanent teeth, is a phenomenon every way exciting to the cu- rious and inquisitive mind, fond of the study of the human body, which is both fearfully and wonderfully made. Whilst this period is being passed, the child is in a critical con- dition,—so critical, that skillful care aPd in- terposition will only save from consequences the most afflictive and painful. At com- mencement of this period, the diet of children is mostly light, consisting of vegetables ar.d bread. Very little use of the teeth is needed for mastication, but as age increases, and this period is more advanced, heartier food is de- manded, and thus a necessity created for firm- er teeth for needful and healthy mastication, which our benevolent God provides in those which are permanent. So wise and beauti- ful is the eruption of these, that even before THE TEETH. 7 temporary teeth give warning that they will soon disappear, a tooth on each side of the maxilla makes its appearance, to show that others of a like permanent character are soon to be their companions. The permanent teeth, with the exception of the bicuspids in size, are in advance of the temporary. The number of these is, usually, thirty-two. Cases, however, have been re- ported in Anatomical Journals, where per- manent teeth have succeeded each other even to the fourth set; but the phenomenon of even a third, is very seldom seen. Sometimes in the permanent teeth, those called “ Wis- dom ” are peculiarly in need of dental care and those experiencing trouble or pain from them, should at once, seek this care from the most skillful in the profession. IRREGULARITY OF THE TEETH. The teeth, as they appear in the child, bear close affinity to other parts of the human body. Sometimes the human body is un- seemly, but most generally all its members are most beautiful for their perfect symmetry and gracefulness. The teeth, as they come forward in the child, do so with general uni- formity and order, and are in their appropri- 8 ate position. When they are irregular, the instance is a rare exception to the general order. The primary molars, being the first of the permanent set, the ten anterior teeth are necessarily restricted to that part of the arch assigned to the first set. If, in consequence of their breadth, there is not room for their admission, irregularity is certain to follow. The treatment by the Dentist of this irreg- ularity must be governed by the indications of nature. When the irregularity is great, complicated and perplexing, a large amount of skill in the operator is demanded, and like- wise a large amount of fortitude on the part of the patient is indispensable, that there may be the necessary perseverance in submis- sion to the means employed for the correction of the irregularity. Every irregularity in the teeth should be seasonably corrected. The eighteenth year should never come before the crooked should be made straight, and the rough smooth. Beyond this age, there have been instances of regularity being given to the teeth by the skillful Dentist, but these instances are un- frequent. THE TEETH. THE TEETH. 9 THE PULP OR NERVE OF TEETH. The pulp or nerve is an exquisitely sensi- tive, highly vascular suhstance, in color re- sembling the roan or red grey. When ex- posed by a cavity in the tooth, by reason of its excessive tenderness and delicacy, inflam- mation and most acute pain are at once pro- duced. There are two main nerves, called Superior and Inferior Dental, which run through the body of each jaw, and from which branches or twigs proceed, one of which enters each tooth. Many individuals have suffered great pain in a sound tooth, and have been unable to satisfy themselves as to the cause. It is here explained as being produced by one of the twigs of a decayed tooth remote from the seat of pain. THE TOOTHACHE. Those afflicted with this suffering express themselves variously, yet nearly all at length adopt the same description of their sensation, and call their pain, “ the horrid toothache.” When it comes to the horrid, it is easy to go to the Dentist. This excruciating torture is commonly pro - 10 duced by irritation or inflammation of the pulp or nerve of the tooth. The pain is sometimes periodical and of short duration at other times it is prolonged, dull, deep- seated, throbbing, or lancinating. Some- times the pain is restricted to an individual tooth, at other times it effects several teeth ; and at other periods it extends through one side of the face, affecting most severely the entire head. When the nerve alone occasions the pain the remedy is often simple and easy of appli- cation. A small lock of'cotton immersed in Creosote, or Camphor and Morphine, or Par- egoric, or Oils of Cloves or Cinnamon, and put into the cavity and about the aching member, will usually impart almost instant relief. When there is ulceration, a more powerful remedy becomes imperative. It may be known when toothache is caused by acute inflammation of the investing membrane, because this pain is attended first by dulness of sensation and next by throbbing soreness and tumefaction of the gums, and sometimes by the swelling of the cheek, indicating the formation of an alveola abscess. At this crisis the course is plain. The remedy is only in the hands of the well-practiced dentist and the sooner applied the quicker the relief. THE TEETH. THE TEETH. 11 DECAY OF TEETH, AND THE CAUSE. The causes of decay in teeth are many. Some of those which are prominent and principal will be mentioned. The first and most common is hereditary or constitutional. When consulted by a young person who has teeth largely decayed, in reply to my inquir- ies, I find, in a majority of cases, that either one or both of th® parents were in the same condition of the child. Another cause of decay in teeth is in neg- lect of their cleanliness. While eating, par- ticles of food will find their way into the cre- vices of the teeth, which soon become acid, and corrode the enamel, and will soon be visible in an opaque or dark speck. This decay sometimes shows itself in a dark-brown or black or whitish color, which first appears on the outer surface of the dentine, and pen- etrates towards the centre of the tooth, and from thence quickly to the nerve, when the alarm is given by excessive pain. A third cause of decay in teeth is in the use of extremely hot and cold drinks. Those which are hot work decay in one way, and those which are extremely cold in another. A fourth cause is in the use of improper 12 THE TEETH. preparations for cleansing the teeth, and like- wise of improper tooth picks. Some teeth are so beautifully organized that decay is unknown to them; whilst others are so soft and carious, that by neglect they are lost in early life. Persons having an hereditary or constitu- tional tendency to decayed teeth, can be es- sentially aided in their preservation by fre- quent consultation with those who make dentistry their constant study, and whose knowledge and experience qualify them to advise. The most eminent in the profession should by such individuals be sought. TIC DOULOUREUX. This disease has received in modern times the name of Neuralgia. Its pains are often excruciating in the extreme. Individuals suffering from it have often expressed to the anthor of these pages, that in all their pains, none in severity and acuteness were like what were experienced when they were the victims of Neuralgia. The nervous system is sometimes completely prostrated by the dis- ease. Though various remedies are used, yet they all at times are unavailing, and relief has not come until all the decayed teeth were THE TEETH. 13 removed. Individuals afflicted with the mal- ady, to save themselves prolonged pain, should early submit their teeth to the exam- ination of the discriminating and skillful den- tist, who will give the necessary advice and recommendation of the course to be pursued. Drink water, that has passed through lead pipes, may poison the blood, and produce the most malignant form of Neuralgia. FILLING TEETH. No department of the profession is more difficult or decisive of the skill of the dentist than this necessary and important operation. It is one thing to insert gold in the tooth, and quite another thing technically to fill it and have the operation a decisive and enduring benefit. In no branch of the profession is there the opportunity for deceit and wrong as here. Individuals having occasion for this service should be very careful never to entrust themselves to any other operator than one whose skill has been tested by repeated trial. Many a tooth which might have endured for years with skillful filling, has been quickly lost, in consequence of the operation being performed by an inexperienced, or ignorant, or careless, or indifferent operator. A sue- 14 THE TEETH. cessful operator, one whose works prove a real benefit to the teeth, and which command the respect and gratitude of his patients, be- comes such only after years of patient study and experiment and practice. So very diffi- cult is it to succeed in this department, and be acknowledged as expert and reliable, that but few attain to this eminence Thoroughness must characterize the operation, or the tooth had better have been left untouched. The cavity of every tooth to be filled has to be treated with skill before the gold is introduced, and then the packing is to be skillfully per- formed, that all mositure and air may be ex- cluded. A tooth scientifically and properly filled, not only ceases to become painful, but continues for years doing all the service of one that is sound. We advise our patients not to defer the operation of filling till ad- monished by pain of the necessity of care. The operation at incipient decay, prior to any painful sensation, is uniformly advised, as the tooth then is stronger and more likely to be enduring. Every one valuing the preservation of teeth, should select a competent' and skillful dentist, and submit to a careful examination two or three times annually. In this way his careful and practised eye will quickly detect THE TEETH. 15 any germ of decay, and his ready and skillful hand apply at once the appropriate remedy. The old adage, “ an ounce of preventive is worth a pound of cure,” will thus be con- firmed, and the patient be saved the endu- rance of pain and expenditure of money. A variety of substances have been employed in filling the teeth, but having tested them all with great care, we are decidedly of the opinion that gold is the best material yet dis- covered. DESTRUCTION OF THE NERVE. The nerve of the tooth, as before expressed is exceedingly tender, and when slightly dis- eased or exposed, easy of irritation and pain- fully sensitive. It can, in most cases, be de- stroyed without pain by the use of Creosote and Arsenious acid. This should be used with great caution. The most effectual, safest, and generally economical course is to consult a competent dentist. TIIE USE OF ANAESTHETICS IN THE EXTRACTION OF TEETH. The employment of proper Anaesthetics by a competent and learned dentist, while con- cealing from the unfortunate individual re- 16 THE TEETH. quiring the extraction of teeth, knowledge of the pain attending it, is without injury to the constitution and health. Improper Anaes- thetics are very injurious ; and even those which are proper, when injudiciously applied are harmful. Wisdom, therefore, strongly admonishes such as desire to be insensible to suffering when submitting to the extraction of teeth to place themselves in the hands of a dentist of established skill and eminence, who will so administer Anaesthetics that all consciousness of pain will be lost, the opera- tion scientifically be performed, and every in- jurious effect be avoided. Sulphuric Ether, Chloroform and Nitrous Oxide Gas, are the Chief Anaesthetics em. ployed for overcoming the pain in the ex- traction of teeth, or when any dental or sur- gical operations are performed. Ether and hloroform should be administered after long abstinence from food, and never on a repleted stomach, as their effects is to produce nausea. With Nitrous Oxide the effect is otherwise. The administration does not effect the stomach in the least, and besides creates a pleasant and agreeable sensation. In my own prac- tice, 1 administer either of the Anaesthetics specified, and always with great prudence and care, and at the same time to the satisfaction 0f7r.Tr -,0+1-OT1+C, THE TEETH. 17 EXTRACTING TEETH. Much medicine prescribed by the faithful physician is exceedingly loathsome to the pa- tient, and frequently is long deferred after the ordered hour has passed, so dreaded is the nauseating dose. So with the individual having a decayed or aching tooth, there is a dread when thinking of the only remedy, and often delay in the application of the same. Notwithstanding all this, health and quiet both to self and others sternly demand imme- diate extraction. Whenever teeth are so de- cayed as to be unfit for filling, every consid- eration urges their immediate extraction. CLEANSING AND POLISHING THE TEETH. Many individuals are entirely neglectful of their teeth, and the consequence of their neglect is the collection in and about them of what mars their beauty and works their de- struction, and may occasion entire physical prostration. The many evils of this neglect should ever be admonitory of attention and proper care. The gums sometimes become spongy and ulcerated. When such is the the case, there 18 THE TEETH. should be no delay in seeking a reined}". The cause of such affliction should be removed at once. All dead and loose teeth should know the power of the dentist’s instrument, that mechanical irritation may be subdued. The other teeth should be freed from all tartar or decomposition, or other irritating foreign matter. In the removal of the tartar, great care should be practised to avoid injuring the enamel of the teeth. Many teeth have thus been destroyed b}r ignorant or careless den- tists. When this compound is suffered to collect without hindrance, an inflammation ensues, which is succeeded by the suppura- tion of the gums and alveola process, which cause the teeth to loosen and then to fall from their position, besides giving a most fetid odor to the breath, which engenders dis- ease. It will hence be apparent that no small im- portance is connected with the cleansing of the teeth, and of having them polished after the likeness of nature. The following prescription may be of ser- vice",when the gums are in a state of inflam- mation : Tincture of Myrrh 1 ounce. “ “ Peruvian bark “ “ “ “ Kino “ “ THE TEETH. 19 BRUSHING THE TEETH. What a little thing this is, and yet how very important. Important to appearance, to health, and to teeth preservation. Were this duty promptly performed, the necessity for a common demand on the skill of the den- tist, detailed in the preceding section, would in a great measure cease. We hope all our patients, and indeed every one, will attend to this matter, and especially young ladies, who would avoid having the purpose of a young gentleman to propose, who, at a distance, has been smitten, changed on a near approach and the discovery of teeth unbrushed and foul—the fearful index of inattention else- where, all needful to make an attractive and happy home. Give good attention to your teeth, and then the inspiration will be, “ Her mouth, as she smiles is clear As moiT.ing roses, newly washe