NATIONAL LIBRARY OF MEDICINE Washington / A TREATISE ON DENTISTRY, EXPLAINING THE DISEASES OF THE T E E T H and GUMS, WITH THE MOST EFFECTUAL MEANS OF PRE- VENTION AND remedy; TO WHICH IS ADDED, DENTITION; WITH RULES TO EE OBSERVED DURING THAT INTER- ESTING PERIOD. JBr B. T. LONGJBOTHOM, surgeon dentist. >>t___________________________________________________ BALTIMORE: - ^ 't • ted qualities, forming a fceptic acid, a£rs v...i more readily on the enamel, thereby getting accefs to the bone, which from its porus nature diffolv- ing, leaves the interior cavity containing the nerve, and other veffels open, which while living and expofed to the air, never fails to occafion the moft excruciating pain: the remedy for which is, aaual or potential cautery ; carefully filling up the cavi- ty with fome malable metal; as gold, filver, or lead leaf, the former to be preferred for cleanlinefs and durability :—this is called plugging or plumb- ing, and will continue its pofition in the tooth, fometimes for twenty or more years. When this cannot be effeaed, and the party will not undergo the momentary inconvenience of having it extracted, care Should be taken to file off any lharp edges * or points, which by repeated contaa may annoy the tongue or furrounding parts. Where this fails, recourfe mult be had to extrac- tion. In all cafes where cauterization is ufed, great care ought to be taken to deaden the * From a negleft of this kind, I have known a cancer on the tongue enfue, which terminated the perfons life: I, myielf, had a patient in Kingfton, who died in confequence of not removing the jagged roots of a decayed double tooth. Children born with teeth are fometimes fimilarly treated, either rounding them with a file or removingthtm altogether, bcin" very apt to wound the lip or under part of the tongue. 20 nerve, for fhould that be but ilightly wounded, muc h pain will enfue. Where tartar has formed in any prodigious quantity, it is not advifable (particularly in varia- ble climates) to remove the whole at one time, as by lofing fo confiderable a clothing, the enamel and neck of the teeth become extremely fenfible to heat, cold, or acids. The Sceptic acid or green Slough alluded to, is to be removed by gentle attrition, and proper dentifrice, or if the enamel is deeply dyed there- with, a weak alcali, or gentle vegetable acid may be ufed difcretionally, but on no account after it has disappeared. CARIES or BE CAT Often proceed from negleaing that neceffary cuftom of daily brulhing the teeth, whereby all ar- tificial bodies are prevented concreting thereon ; it alfo takes place from blows, falls, touching ano- ther tooth and the like, but feldom gives pain un- til (as before obferved) the enamel is gone, and the nerve expofed ; this may often be prevented by filing away the affected part in time, yet even where this cannot be accomplished to anfwer the defired purpofe, care fhould be taken to remove, fufficient to prevent its touching an adjoining tooth as a fimilar decay will enfue : Thus have I beheld a beautiful row of teeth rotted to flumps; and e- miting the moft odious effluvia from no other caufe than inattention to that tooth which firft de- cayed. The French are much in the habit of paff- ing a file between each, fufficient to create a divi- 21 fion for the palling of a tooth-pick. I am aware many will objea to this, from an idea that by re- moving the enamel, we fubjea the bone to prema- ture decay; but daily experience proves it done with fafety, for enamel towards the fides and edges of Teeth is thicker, and will frequently admit this operation, without expofing the fmalleft portion of the bone, but which if it is, feldom decays. The fymptoms of decay is a fhining blacknefs on the furface of the tooth ; the front ones have an opaque fpot, on the infide of the enamel; and the grinders Shew it by a crack on their bafe.— Where the pain is periodical, the application of a roafted fig on the infide of the cheek, or bark will fometimes remove it. Perfons having Teeth in this State fhould be careful not to be in extremes, as drinking liquids very hot or cold, biting thread, picking them with pins, cracking nuts, or other hard fubftances; indeed it would be well, were every perfon equally guarded ; for admitting a doubt of their doing harm, none can be of their not doing good. DEC AT jsr DENUDATION Is brought on by mineral exhalations, as may be feen by the Teeth of miners, fugar-boilers, and others fimilarly employed, which are either desti- tute of enamel, and have a rough appearance, or are of a difagreeable yellow colour; here a proper* lotion and foap compofition Should be fubftituted * As every Dentift has for fale mixtures of the kind, and it is natural to conclude each imagines his own to be the beft. To the feversft ccnfurer, I truft I lhall be acquitted in 22 inftead of powder, high feafoned food avoided, aStringent and fweetening medicines made ufe of, to purify the blood, removing with fciffars the points of unhealthy gum, within the interftices of the Teeth. The fmall pox creates the like appear- ance, or indents on the Teeth, as denudational decay. SOCKETS. Thefe occafionally alfo decay, though not fo frequently ; the caufe—obftruaions in the veffels, colds, &c. This moftly occurs to perfons of a de- bilitated habit; thofe more advanced in age are an exception; as from want of thofe nutritious juices, the Sockets become abforbed—warmth is the beft remedy. Where the whole of the Teeth are wanting, the length of the vifage is considerably diminifhed ; evidently, from the lower jaw being permitted to rife two inches at leaft, more than when the Teeth are therein, and come in contaa with thofe oppo- fite. GUMS. Thofe who feek the prefervation of their Teeth, muft by no means neglea that vafcular bo- dy in which they are encompaffed, and on which they may be faid chiefly to depend. This is beft recommending thofe I make. In the interim, as they may not at all times be attainable, I would for the antifeptic loti- on, premife an infulion of Biftort or Tormentil-root, rofes, or fuch like, and for the foap, the pureft of that fort deno- minated Wind/or. 23 done by friaion, from as hard a body as admiffible, giving at all times a preference to a brufh, as cal- culated to enter the interftices. Gums in colour, Should be of a pale vermillion ; firm, elaftic and free from all fcorbutic affeaions, which are the fore-runners of gum-boils, abceffes, excrefcences, callous thickenings, ulcers and fcrofulous. G U M-B OILS Are fecondary difeafes, produced by the Swelled fangs of a decayed tooth : the fymptom— a protrufion of the gum, which Swells and burfts ; when this happens internally, a cure may be per- formed by lancing it to the bottom of the cavity, where the purulent matter refts, neareft the de- pendent part; keeping it open with lint, dipped in tinaure of myrrh, or fome Stimulating balfam, until a granulation takes place, when the mouth fhould be wafhed with a lotion, if matter conti- nues to ooze after this, the tooth muft be extraa- ed ; if it be a ufelefs flump, it would be beft fo to do in the firft inftance, and as inflammation is generally lead on the infide of the mouth, I gene- rally draw inwardly. Where boils are not large, frequent rubbing with the finger will difperfe them. In cafes of this kind, where good teeth have been extraaed, I have known them after being reduced, and the nerve deftroyed, to be returned, but fel- dom with fuccefs. ABCESSES. Attention muft be paid to prevent thefe form- ing an opening, on the external fide of the face, 1-4 as tending to alafling disfiguration; to counteraa it therefore, one is to be made between the gum and the lip ; and in this cafe it is, I am fometimes induced to draw the canini ; which, piercing the maxillary finus, either gives an immediate out- let, or, by a fmall punaure through its bone, ad- mits of one being made for any refident matter.— Where this is done with effea, a pledget of lint kept constantly applied, and changed—ferves to abforb and prevent great portions of the matter being carried to the Stomach ; this complaint often mifleads the patient to attribute it to, and get found Teeth extraaed, a thing wholly ufelefs, unlefs where the laft is adjudged by piercing like the canine, to be a preferable outlet. All fternuta- tories are good in this cafe, as the nofe Should be constantly blown, alteratives alfo are to be taken. EXCRESCENCES Sometimes are very large, and not feldom put on a cancerous appearance. To extirpate them vitriol may be ufed, flightly touching them twice or thrice a day, keeping the Surrounding parts healthy, by a free difcharge of the uncirculating blood ; if this fails, the difeafed part may be removed, with a knife, ftepticks being at hand to prevent too great a bleeding, (the female drug) Agaric, is excellent for this purpofe; and my lotion, or an aftringent fubftitute fhould be given to wafh the parts. I have known tumours removed four or five times before they ceafed to re-appear. Where they a- rife from hollows in the Teeth, thofe Teeth are to be drawn. 25 CALLOUS THICKENINGS May be treated after the fame way as excref- cences. Frequently bleeding the gums, and remo- ving the tartar, will generally remove them, while friaion from the regular ufed brufh will keep them abfent. ULCERS Of all kinds require the moft attention ; as originating from internal as well as external caufes. Here to prefcribe remedies would be endlefs, as they muft be varied with the diforders ; I will hint only two things, that the more cleanly and early they are adminiftered, the more effea they will have from the adjacent parts being lefs liable to Sympathy. SCROFULOUS May, I think, be claffed among thofe many difeafes (as I have before hinted) generating from uncleanlinefs; thofe who are attentive to the brufhing of their Teeth, feldom being troubled therewith : it Shews itfelf by forming one or more puftules, which fpreading become general to the whole mouth ; often burying themfelves deeply in the neighboring foft parts. Here the phyfician Should be called on for an entire purifi- cation ; after which the lotion will have due effea. Scarification muft be avoided. NERVOUS PAINS in the JAWS, Is the phyfician's province, and need only be noticed in a treatife on Dentiftry, as they have af- D 26 lifted to lead operators aftray ; and to them ami fevere colds, are the barber-dentift's windows in London, and other great cities, indebted for the fine difplay they make of good found Teeth ; it is a pain only known to belong to the jaws, and is thought by Mr. Hunter, to be brought on by af- feaions of the mind. I had a female patient in Jamaica, whofe jaws were at times fo extremely irritated by this complaint, as by caufing the up- per and under Teeth grating againft each other, to create a noife exaaiy fimilar to that made by parrots. I relieved her considerably, by cork, cut in fafhion of the circle which the Teeth formed ; and after by prefcribing change of climate, found She nearly had conquered the difeafe. Sea-bath- ing, hemlock, and blisters below the ear, have been tried with various fuccefs. I think the cold bath has aflifted my praaice in more than one in- ftance ; however the firft thing to be applied is the blifter and following pill; two grains of extraa of hemlock, one of camphor, and one-fourth of a grain of opium, given at night: cold bath in the morning, the blifter to be kept open by perpetual or other ointment, green tea given up, and vale- rian ufed in its ftead, to which add pleafant amufe- ments. Pregnant ladies are very fubjea to a fimilar complaint, but certainly no regular praaitioner would fo far commit himfelf as to be induced to draw a Tooth, while affured the pain proceeded from an obftruaion in the veffels. Let me alfo cau- tion them from giving ftimulatives, the applicati- on of a roafted fig internally will anfwer much better. 27 SWELLED FANGS There is no remedy for but extraaion, altho' in fome inftances they may be returned. INFLAMMATION. Except as noticed under the head of tartar, arifes from colds, warmth therefore is the beft re- cipe. Wafhing the mouth with a lotion, brandy and water, or other diluted fpirit. EXOSTOSIS. This is an overgrowth of the bone, which proceeds from a decayed flump-tooth, protube- rant Swelling, or injured jaw; nothing can be done but by an experienced praaitioner, who will moft likely remove the extraneous bony matter. S C U R VT Is little underftood, what called fo being no more than inflammation arifing from colleaed tartar, and the flagnate juices it creates; and is readily removed by what Dentifts term fcaling.— But real fcurvy is when no tartar is to be feen the gums bleed on the moft trivial preffure, breath foetid, Teeth loofe, alveoli difeafed from irritation, and in the word ftages matter difcharging conti- nually. As this does not always give pain, affift- ance is feldom applied for, until the Teeth either have or are about to drop out of their fockets; which accounts for the little benefit received. 28 The firft ftep to be taken muft be towards an entire purification of the fyftem, by a correaion of its juices ; bell performed by a regular courfe of Medicine, fea-bathing, and waShing the mouth with falt-water, will then be found beneficial. In nervous fyftcms, the bark taken regularly three times a day, and tinaure of the fame held in the mouth, will prove very efficacious. I have already faid, where a tendency to fcrofulous exifts, Scari- fication is to be avoided. Patience both on the part of the patient and operator is abfolutely ne- ceffary, as repeated operations are likely to enfue and much time elapfe, ere any permanent or appa- rent advantage can be derived, particularly where the gum is to be made re-adhere, which can only be when the phyfician has completed his part, and is done by removing the edges refufing to adhere, and creating a re-birth of gum, which feldom fails to attach itfelf. Any tocth-ach may be mitigated by the care- ful administration of opiate, a few drops of nitre in lpirits, or gently brufhing the Teeth with mixed ether. ABSORPTION Is when the germ defigned to form the Teeth is taken up by the abforbent veffels (or otherwife) as to render the depofit of no effea—no Teeth then appear, or if any, fo deformed as to be Second thereto; if this happens in the firft fet (or milk- teeth) the juices may be fo correaed, as to render the Second more permanent. I have known the fame effeas from other caufes, fuch as mercury given for the worms, the nurfes milk breaft be- 29 ing difeafed, or an inherent venereal. In age it aas or fhews itfelf, expelling the Teeth by de- grees, and then I believe no remedy has been found certainly to cure it, altho' bliftering and the cold- bath have proved efficacious in a few inftances. MERCURY, I have more than once hinted is a moft dread- ful deftroyer of the Teeth ; much caution is there- fore requifite to prevent any remaining particles while taking of it, lodging within their hollows or cavities. In the year 1797, agreeable to the requeft of a medical gentlemen of Kingfton, I ac- companied him to vifit a lady about thirty years of age; on examining her mouth, I found the whole of it with the gums and tongue much Swell- ed, the Teeth inclined to loofen, and her throat fo inflamed, as Scarce to permit her Swallowing neceffary aliment; She fpit considerably, and com- plained of a braffy tafte. Determined in my opinion, I communicated the fame to the phyfician, that mercury had occafioned thefe appearances. We differed in opinion, and he treated it as a fore- throat. A day or two afterwards, he again defired my attendance to draw fome of the Teeth, which he Said were now become fo loofe as to be in hour- ly danger of dropping out. I found her breath offenfively foetid, and therefore more confirmed in my firft opinion that it proceeded from mercury alone, I enforced the not removing Teeth altogether found. Aware that certain animalcuke were occafionally troublefome 3° to both fexes, and induced at times the ufe of a certain ointment or powder, not the moft innocent, I delicately inveftigated but without fucceSs. I was on the point of taking my departure, when calling my eye upon a glove I perceived had re- cently been applied to rub in mercury. The bufi- nefs was elucidated— a favourite little negro for fome days pad had undergone that operation from the fair hand of its miftrefs, covered with the faid glove. By proper treatment this lady overcome eve- ry fenSation of pain, but confiderable time elapfed before either the gums or Teeth recovered their pristine ftate. TOBACCO. The fmoaking and chewing of this herb is frequently introduced from the vehement pain of the tooth-ach, and with moft conftitutions paves the way to a far more dangerous difeafe, than it is intended to remove, by its acrid and internally violent qualities, in the aa of fumigation being inhaled, and the chemical oil which it leaves within the hollows of the Teeth, difpofes them to blacknefs and premature decay; which tho' lefs obnoxious for the prefent, proves a lading enemy to the mouth and itomach. TOOT H-A C H. Human nature fubjeaed as it is to a variety of complaints, appears perfecuted by none fo fre- quently, as by that univerfally known under the 31 name of tooth-ach. None is lefs pitied, none lefs Studied, and in confequence, none more errone- oufly treated. Medical praaitioners, though daily called upon to operate, allow it, (why I don't know) to fiiare no part of their consideration ; but if an un- fortunate wight applies for relief, (which they do Sometimes nine or ten in a day) Doaor Lafts re- medy is had inftant recourfe to, and (if it will) found or otherwife, out it muft come by the roots. Many are the objeaions to this cruel procedure, the operation occafionally is of fo difficult a nature, that the moft fkilful dentift may be Scarcely ade- quate to the talk. PoSfibly the parts are fo inflam- ed, as to render the neceffary preffure infupporta- ble ; or what is Still more likely, there may be no occafion at all, for the removal of a Tooth. To feparately point out all the diforders whence tooth-ach may arife, would alone fill a larger trea- tife than I purpofe this to be; fuffice it, that to thoSe already deScribed, I add fuch as are moft likely to occur. The firft will be that termed jympathetic, and is generally felt in a found double tooth, cauSedf by a decayed one in another part, which being plugged, or otherwife preferved from the aaion of external air, will bring relief to its fufpeaed neighbour; or drawing the decayed tooth will moft affuredly. INFLAMMATORY TOOTH-ACHS Are moftly attendant upon youth ; and will ac- cordingly be noticed in Dentition, but as it alfo attacks adults, it is proper to obferve, when peri- 0M odical, it is rendered fo by codivenefs, which, if removed, generally brings a cure, if afterwards it continues, it may be imputed to cold, in which cafe warmth is to be adminidered, dudioufly not making it a partial one, that is, differing one ap- plication to be thoroughly cold before another is applied. ELECTRICITY In gentle Shocks, has been prefcribed, but is very judly direaed to be ufed in the early part of the complaint; or like partial heat they become injurious. Wherever Suppuration is neceffary the fig or bread and milk poultice will bed effea it. I never hefitate to lance the gums where Scrofu- lous does not exid, it is at all times beneficial.— The Teeth caufe alfo another pain, in which eve- ry part as low as the bread, aaually fympathifes, and fo refembles that occafioned by rheumatism, as to have obtained the name of rheumatic tooth-ach. Not any thing but the extraaion of thefe Teeth, will convince the party fo affliaed, that tooth-ach is the caufe, nay, perfons long poffeffing it, will infid the pain is not lod with the extraaion, but ufually it difappcars with the caufe. Extraaing of a Tooth befide another, by expofing of its bony part may give pain. Cariated bone from extrac- tions long pad, will raife imaginary tooth-ach— Concealed matter, exodofis, dentition, lod ena- mel, loofenefs, fraaures, gums receding, extra- vasation, obdruaions, and many other things, will give pains, for which no Tooth need be drawn. 33 ^ One kind of tooth-ach particularly deferves notice, as, to indifferent obfervers, it both comes and goes without any apparent caufe ; it begins by an impreflion on the Spirits, pain in front of the head and gums, fwells the face to didortion, brings on a great difcharge of faliver, while all the Teeth are in a thorough found date; with many it returns at regular, though didant intervals. I impute it to an overcharge in the veffels, which by creating a tenfion in the pituitary and other membranes, negative or obdrua a proper circula- tion of the fluids, and though repeatedly entreated to extraa a tooth, for the purpofe of giving eafe, never would accede. Cooling purgatives, abfti- nence from grofs diet, and a tolerable fized Wider, if it' will rife on the nape of the neck, may almoft ever be depended on for a lafting remedy. P I C K I N G the TEETH Is of infinite ufe, and fhould be more gene- rally encouraged ; but never performed with a lefs yielding body than a quill. SUPERNUMERARY TEETH Are fuch as exceeding the number of a fet, projea, croud, and disfigure that agreeable regu- larity, fo pleafing to the eye—they tend to make us lifp, cut the tongue while fpeaking, and fee! at certain periods,- a fenfation the moft unplea- fant. E 34 Thefe we are indebted for to the inattention of our parents, guardians, or others, to whofe care we are entrufted in early life; and who, un- lefs their charge complains of pain, leave nature to difcharge the firft Dentition, in which originates the caufe; or employing a praaitioner, deny him that continued accefs, fo neceffary to enfure ef- fea. Some few feminaries indeed and private fa- milies, are attended regularly at dated periods. I, myfelf, have had many, which I attended once in each month, when every child's mouth was exami- ned. This becomes neceffary about the fixth year, though all children ought to be taught the necefli- ty of ufing a brufh from their third or fourth.— The anterior Teeth claim our fird regard; indabi- lity is the Symptom, and as thofe to replace them, are larger in common than the firft, it is not only proper to withdraw thofe, but the adjoining ones on each fide, thus having no refiftance to con- tend with, an even birth enfues, and by encou- raging at proper intervals the like arrangement, equally throughout, a permanent, beautiful, and regular fet may be procured. Where this has been negleaed, they may be drawn in moft in- stances Safely, and where required, may be direa- ed to the wifhed channel by ligatures of filk, plates formed of filver, preffure frequently repeated, or by three or four other modes peculiar to thoSe who praaife them. I have met fome jaws inade- quate to contain within the proper eircle the per- taining Teeth, in which cafe the Tooth of wifdom would often incline defertion where it did not, and all were found alike, that moft irregular is the one ufually removed. Mr. Hunter points out the bi- 35 cufpides, but for myfelf in young fubjects a dif- eafed Tooth would be my aim, as from the flexi- bility of the parts, there is little doubt of the va- cancy being Supplied by the yielding Teeth on each fide filling up the fpace. REPLACING OP a TOOTH. This I think is beft done with fuccefs in wrong extraaions, and with moft fecurity when the operator does not let the agitation occafioned by the accident, deprive him of attention, to put it right in place and figure ; the blood if poflible, Should not be permitted to coagulate, but if fo, broken. Should the Tooth have fallen, or other- wife acquired dirt, it muft be removed by warm water. I have been fortunate in fabftituting, of TRANSPLANTING TEETH, But by no means encourage a defirc thereto. It is a fpecies of innoculation and therefore dan- gerous ; circumspection is absolutely neceffary. I have procured them rather fmaller at one time than the focket they were intended for, and at another rather large, yet in both inftances Suc- ceeded, the latter time by reducing with a file. I have inferted dead Teeth alfo with fuccefs ; but fincerely believe their adherence to be owing en- tirely to the nicety with which they fitted. I would! advife all voting praaitioncrs to avoid and decline thefe performances, left an unlucky occurrence mould prove an injury to their praaice. 36 However, if they are induced thereto, let an able phyfician be their affiftant, to regulate the fydem, abate fever, &c. &c. until the Tooth proves firmly rooted. The operation of having living Teeth trans- planted, would more effeaually and frequently be anfwered, did thofe whe undergo it pay that attention it demands; but forry I am to fay, tho* many are found defirous to poffefs beauty, health, and eafe ; few are willing to bedow that regard fo requifite for their attainment. The firlt prudent caution is, to make fure as poflible that the par- ties are in proper date of health, and that no re- mains of mercury exid in either fydem. The Tooth then fixed in that pofition it is intended to remain, (without force, which by caufing it to prefs improperly, the periodeum frequently origi- nates difeafe) let filk, fea-weed, or a white thread waxed, be tied as high on the neck of the adjoin- ing Tooth as poflible, then fadened on the body of that tranfplanted, and then (as in the fird in- ftance) to the neck of that tooth on the other fide: thus making, as it were, its two neighbours fup- port it firm to the bottom of the Socket; this Saf- tening Should, (if not inconvenient) be permit- ted to remain until decay removes it, for by fub- jeaing the Tooth to instability at too early a period, adhefion, if not totally deftroyed, will be longer taking place : the patient fhould be tenacious to give as little motion as he can to a Tooth of this fort, until perfuaded it is equal thereto, neither fhould he by fitting in a draught of air, rifque the catching cold. I have heard and read of double- tceth being tranfplanted, but cannot fay I give it 37 credit, the improbability ever appeared to me too obvious to need a trial. { DRAWING. The impreffed apprehenfion exhibited by ma- ny while getting a Tooth extraaed, is not only miSplaced, but unlefs under the hands of a very fkilful Dentift, may be attended with the ferious confequence of drawing a wrong one ; breaking that intended to be drawn, or otherwife injuring the mouth. Neither patient or operator fhould be timid or in hafte—moft praaitioners in their own houfes have a chair, the back of which may be accommodated to that height requi- fite to reft the party's head. Extraaion is difficult or eafy, as circumftances render it, but at all times may be performed by the common turnkey instrument, to which, as generally in uSe, I Shall ' confine my direaions. Each instrument has a va- riety of claws, you will felea that beft adapted, and before it is applied, enwrap the lever or end of the key, in writing paper folded to its Shape, fo as to break or foften that preffure neceffarily ufed upon the gum, which for a hazard of adhering, muft be carefully lanced around the Tooth, the claw being properly applied as near to the focket as poflible, regarding it be not on the focket itfelf, gradually turn the key with increafing force, and your purpofe will be effeaed. The back or dou- ble Teeth are beft drawn inwardly, as may be feen by their pofition. The incifores require a much larger claw than any, and the paper considerably thicker, by which means you take a firmer grafp 38 on the bony part beneath the gum, and draw it nearly in its own axis, or fay perpendicularly, if the jaw is narrow; thefe, like the molares, will draw eafieft on the infide. It is Seldom that any hemorrhage enfues, if it does, gentle fteptics will not avail—let a pledget of lint be dipped in oil of turpentine, and tightly compreffed upon the wound, the root agaric or cork cut in fhape of tlie root re- moved, placed within the focket, and held firmly down by the oppofite Teeth, will alfo ftop it effec- tually. I never knew any fcrieua eonfequences take place from a bleeding of this kind, unlefs where ignorance to ftop it was the occafion. In a few instances I have had the edges or Small portions of the alveoli adhere to the Tooth, but this is unwor- thy notice, if we reflea nature difpofes them to decay; whenever deferted by the Teeth, fhould a point of bone appear, it may be filed ; or Ihould a (till more Serious cafe occur, remedy is offered under the head of EXFOLIATION. This is when a Tooth or portion of bone in- clines, or Shews a diSpofition to leave the place it was originally deftined to Supply, and as fuch por- tion of bone may be out of light, and perhaps un- thought of, by reafon of its injury being received long before in drawing, a blow, or fome other caufe and protemporary readhered: innocent Teeth are imagined to create the pain, although found, it is then only to be known by defcription und preffure on the part, thefe together discovering it to be a Splinter, the gum fhould be lanced there- 39 to, and with die foflip's pliers, or other indru- ment, die extraneous piece removed, aftringent tinaure or lotion then applied, a few days, will Serve to heal the parts. STUMPS. The extraaing of thefe, like thofe of Teeth, will be found difficult or otherwife, but for the mod part eafy, as if properly lanced they may be removed by a fimple application of the finger nail, or raifed by a diff fharp pointed indrument, the bed lever for which, you will find to be the fird finger of your left hand, attention is to be paid to the indrument, led by flipping it wounds fome other part. Where confiderable force is neceffary, as will Sometimes occur with the double or treble fanged molares, the turnkey may be ufed ; nor is it neceffary always that the dump be feen, provi- ded it be fenfibly felt by the indrument applied.— Where artificial Teeth are purpofed to fupply the vacancy, it becomes advifeable to retain the dump if it be a found one, as with a golden pevit a new crown can be grafted thereto, in all refpeas re- fcmbling the former Tooth. Where dumps are retained from other motives, fuch as fear, or with a view to prevent the falling of the jaws, their ca- vities ought at all times to be fecured by plugging, which negatives putridity or decay. RABBIT MOUTH Proceeds from the circle of the Teeth being too confined, and is remedied by drawing that 4° Tooth of lead value, if all the Teeth are found, one of the cufpidatus; perhaps a filver plate, and the Teeth kept Shut, with moderate preffure feve- ral hours in the day, may remedy the defea : It alfo proceeds from another caufe, viz. the under- jaw projeaing forwards, fo as to permit a confide- rable body to be admitted between, in which cafe the plate mud be reverfed and made to throw the upper-teeth outwards. I have tried dicks acrofs the mouth, but they are very troublefome. bwl