5. Falling of the teeth, due to absorption of the socket, may be regarded as almost an ordinary consequence of old age; but it frequently occurs under the popular name of scurry of the gums in middle age, although very seldom before the 30th year. True, scurvy, gangrene of the mouth, or mercurial inflammation of the gums, may cause the loosening of the teeth at any age; but there are two other conditions which lead to the same result. In one of these affections, the gums swell, and assume a deep red color, and the inflammation appears to he propagated into the alveoli, producing a thickening of the periosteum, and a consequent elevation of the tooth above its ordinary level. By frequently recurring attacks of this inflammation, the tooth is lifted out of its socket, while the gum retreats from the neck, and leaves a portion of the roots exposed. The tooth thus deprived of its support at length falls, after which the gum heals, and the pa tient is relieved. The remedies indicated are those tending to relieve inflammation of the gum, but they are seldom successful. In the other affection, there is conjoined suppuration of the gums and sockets. and the disease first shows itself by an oozing of pus from behind the edges of the gums when they are pressed. From the absorption of the sockets, and the simultaneous retreat of the gums, the teeth, as in the previous case, at length fall out, if they have not. for the patient's comfort, been previously extracted. Little can be done in the way of treatment in this form of the affection.
6. Painful and difficult eruption of the wisdom-teeth requires a few remarks. The cut ting of these teeth is often accompanied by distressing symptoms, which may be pro tracted for months, or even years, unless surgical aid is called in. The difficulties "arise from the position occupied by these teeth, so close to the joint of the lower jaw, where the mucous membrane is reflected from the gums to the cheek and faeces; combined with the very common condition, that the jaw is not sufficiently elongated backward to allow the dentes sapientice to range in the horizontal series with the other teeth." This mechanical difficulty not only holds back these teeth in their bony bed, but it often pre vents their proper direction of growth. As a consequence of these displacements in the upper jaw, it often happens that when the jaws are brought together, a bit of mucous membrane is nipped and pinched, leading first 'to ulceration and extreme tenderness, and subsequently to cicatrization and stiffness of the parts. From insufficient room in
the lower jaw the crown only partially emerges through the gum. the first cusp coming through it, while the hinder cusps remain covered. This produces a terrible pinching of the mucous membrane over the tooth every time the jaws are brought in contact. Another troublesome symptom, often associated with the painful cutting of a lower wisdom-tooth, is spasmodic but continuous contraction of the masseter muscle, so as to keep the jaws nearly closed, and capable of only slight separation. The most distressing result, however, is the suppuration that often attends the difficult eruption of the tooth. Even in ordinary cases, when none of these complications are present, there is often a good deal of diffuse and erratic pain in cutting a wisdom-tooth. It is unnecessary to en ter into the treatment, which must be left entirely to the surgeon-dentist.
7. Hemorrhage after extraction of teeth has occasionally proved fatal, and is not very unfrequently a troublesome and even dangerous complication of the operation. In most of the recorded cases, there has been distinct evidence of the existence of the hemor rhagic diathesis, or, in other words, of a liability to bleeding profusely from the most trivial wounds. No better local treatment can be recommended than that which was suggested by John Hunter nearly a century ago. "In general, it will be sufficient to stuff the socket with lint, or lint dipped in oil of turpentine. and to apply a compress of lint or a piece of cork thicker than the bodies of the adjacent teeth, so that the teeth in the opposite jaw may keep up a pressure." 3Iatico and saturated alcoholic solution of tannin may be equally efficacious as styptics, but are not superior to oil of turpentine. In some cases, the extracted tooth has been successfully replaced as a plug. The internal administration of astringents, such as tannin and oil of turpentine, should be combined with the local treatment.
8. The subject of tartar on the teeth has been considered in a separate article. TEFF. See MEADOW GRASS.