Ulcers of the tongue are frequent, and are commonest at the sides from friction with a decayed tooth. The tooth should be removed, and the treatment advised for ulcers of the lip adopted.
Cracked Tongue exhibits a series of irregu lar furrows, often of some depth, running over the surface of the tongue. They are very pain ful, and interfere with speaking and eating.
Any digestive disorder which may be the cause should be properly treated, and the borax - and - glycerine wash mentioned above used freely.
Cancer may have its seat in the tongue. It is usually of a sort akin to that of the lip, pre sents similar characters, and demands similar treatment—removal by operation.
Tumour under the is the name applied to a form of tumour under the tongue, which consists of a sac filled with a gelatinous sort of fluid. The tumour may be so large as to affect speech and even push the tongue upwards or to the side. It is associated with the duct of the gland under the tongue, and is supposed to be due, sometimes, to the blocking of that canal. A surgeon should be consulted for its removal.
Warty Growths are also formed on the tongue. The acetic acid, as used for similar growths on the lips, may be tried.
Injury to the Tongue is frequently caused by accidental bites. The teeth may even be driven deeply into the tongue by a fall. It is best to leave the tongue alone in such a case, and to permit nature to heal the wound. Bleed ing may be controlled by pressure over the part.
Inflammation of the Gums is common in children during the period of teething. It is con sidered in the section on DISEASES OF CHILDREN. Simple inflammation may occur in grown- up people. The part of the gum affected is dark red, congested, and very tender. A brisk purge and hot application to the part will relieve; but often nothing is equal to free lancing, which permits the excess of blood to escape, and thus immediately gives relief. A commoner thing in elderly people is that condition in which the gums become spongy, soft, constantly painful, and liable to bleed at the slightest touch. They separate from the teeth, which become loose in consequence.
In a very large number of cases the inflamed and spongy gums are produced by the irritation of decaying stumps or small pieces of rotting teeth, or the tartar that forms on the teeth in elderly people. With their removal the inflam mation disappears.
The treatment should be directed as much to the general bodily condition as to the condi tion of the gums. Sluggish action of the bowels and liver will maintain the bad state of the mouth. Free use of purgative medicines should therefore be made, to unload the digestive organs, and astringent washes and gargles used for the mouth, those of chlorate of potash, borax, or tannic acid being best, while a tooth brush should be used daily with camphorated tooth-powder, the gums being well rubbed.
is usually due to the irritation of a decayed tooth. Beginning in the socket of the tooth it works its way outwards. The more deep-seated it is, and the greater difficulty it has in coming to the surface, the more intense will be the pain. Usually it is evident from the swelling of the guru that a gum-boil is being produced. Sometimes when it is deep seated, at the end of the fang of the tooth, there is no apparent swelling. In such a case, that sup puration is going on at the end of the tooth is ascertained by firmly pressing the tooth down into its socket. This procedure will give rise
to severe pain if an abscess be forming at the root of the tooth, and will thus indicate the seat of mischief.
The treatment consists in the use of hot applications, in the removal of the decayed tooth, and in letting out the matter where it comes to the surface. If the tooth that is the source of irritation be not removed, or otherwise properly treated, the gum-boil is liable to recur again and again.
Toothache is due to decay of the substance of a tooth—dental caries, as it is called. It has been pointed out (p. 196) that the crown of a tooth consists of a cap of very hard substance called enamel, covering the dentine, which forms the main bulk of the tooth, and is not so hard as the enamel. Now the enamel is a very re sisting substance, though it is brittle, and so long as it is perfect the tooth is not liable to the carious disease. Sometimes, however, the enamel is imperfect, and the dentine becomes exposed, and the process of softening and break ing down begins. The dentine may be attacked through so small an opening in the enamel that the tooth appears to he perfectly sound, while it may be completely decaying within. The decay seems to be due, in the first instance, to a chemical process, whereby the salts of the ena mel and dentine are removed by acids produced in the month. The acids are not produced by the glands of the mouth, nor are they normal constituents of any of the fluids of the mouth. They are produced by the decomposition of par ticles of food that lurk in recesses about the teeth. Certain parts of the teeth more easily retain portions of food, which may in time, owing to decomposition, obtain the power of attacking them; notably in the furrows between the cusps or points on the surface of the large grinding teeth will food remain, as well as round the neck, and between the teeth. Again, some parts of the teeth are more exposed to attack than others, any parts, for example, from which the enamel has been worn away. Teeth which are too much crowded, therefore, will have more surfaces than usual pressed upon and rubbed, and so overcrowding is a frequent cause of bad teeth. It ought, also, to be remembered that the teeth share in general states of the body, and that a long period of ill-health may, indeed quite commonly does, very materially affect their resisting power and make them easy victims to decay. A person often bears the marks of a long illness in irregularities of the teeth. When the dentine has become exposed it begins to soften, to become more or less discoloured, and to break down. As the affection passes inwards the pulp is reached, the intimation of which is that toothache begins. At first it may be that the tooth is affected only now and again, when hot or cold things are taken into the mouth. The pulp contains blood-vessels and fine filaments of nerves, and when the irritation reaches it inflammation will readily arise, of which sensi tiveness and aching are the signs. Suppuration of the pulp may arise, and if the matter cannot escape above, it forces its way down the fang, at the end of which, in the socket of the tooth, the matter collects, forming a gum-boil. The in flannnation and swelling also loosen the tooth, and raise it to some extent in its socket.