TEETH, DISEASES OF THE. The teeth like other organs of the body, are subject to a variety of diseased conditions. For practical purposes they may be divided into-1. Disorders attending dentition or the cutting of the teeth ; 2. Diseases of the teeth themselves ; 3. Diseases of the gums and alveolar processes.
Diseases of Dentition.—The eruption of the temporary or milk-teeth is a natural process after birth [DENTITION, DISEASES OF; and TF.ETII, NAT. Hist' Div.]. The order in which the milk-teeth appear after birth is subject to considerable variations. Although dentition is a natural process, It is frequently attended with morbid conditions. Prior to the appearance of a tooth the gum above it increases in breadth, becomes swollen, and in hot to the touch. There is an increased flow of saliva, which comes out of the mouth ; the child thrusts whatever may be placed in its hands into its mouth. It is more fretful than usual, has sudden fits and starts in its sleep. Thu cheeks are flushed, the bowels are irregular, and its food is often thrown off its stomach. It not unfrequently happens that a dry cough is present, and sometimes even severe derangement of the nervous system.
In the treabsent of these symptoms little more is needed than to regulate the state of the bowels, and to prevent the child overloading its stomach with milk. It should not be put to the breast after every time it Is sick, but cows' milk, with a little water and sugar, may be substituted for its mother's milk. When convulsions occur and evidently arise from the irritation of the gums, a free incision of the gum over the pressing tooth will often give great and immediate relief. Whenever in fact the imitation has proceeded en far as to produce obvious Inflammatory symptoms, recourse may be had to lancing the gums. In this operation care should always be taken to divide the gum down to the surface of the pressing tooth.
Sometime* instead of inflammation of the jaws there is an excessive hardness or induration of the gums. In this case there is great irri tability and make/mesa, with other symptoms of derangement of the which can only be removed by dividing the indurated gnms_ freely down to the pressing tooth.
During the presence of the milk-teeth, they and the gums arc subject to the same dixesees ns the permanent teeth in after life. They are however subject to one form of disease which is peculiar to children, and which is called encrust oris. It is in fact an ulceration attended with a death of parts similar to what is called phagmdena in other organs of the body. The ulceration commences in this case at the free edge of the gums and extends to the alveoli and other parts of the mouth. The surface of the cheek lying in contact with the ulcerated gums becomes involved in the same disease, so that the surfaces of the two ulcers are in contact. The teeth loosen and in some cases become black from necrosis. The surface of the ulcer is of a pale yellow or straw colour, with here and there a red point raised above the surface, and which bleeds on being touched. This disease spreads in some cases till the cheek is perforated, but it more frequently happens before this takes place that the patient either sinks from exhaustion or haemorrhage from the ulceration of some large vesseL The treatment in these cases must be both constitutional and local. The bowels should he kept open, and tonic medicines (iron and quinine). with a liberal diet, must be given. Locally, the nitrate of silver should be applied, and the mouth should be washed out with a lotion con taining chlorate of potash. This latter salt has also been strongly recommended as an internal remedy.
The milk-teeth disappear as they came, at various ages. They are succeeded by what are called the permanent teeth. The number of these is thirty-two. Twelve of them, however, belong to the first act, as they are never superseded. So that the true view of the case appears to be, that the first set of teeth consists of thirty-two, of which twenty disappear under the name of milk-teeth. and are followed by twenty others, which are called, with the other twelve, permanent teeth.