The treatment of toothache, short of extrac tion of the tooth, is seldom very satisfactory if the pulp has actually been attacked. One of the best applications, however, is carbolic acid. But it is difficult for anyone, not accustomed, to apply it properly, and it is liable to be so clumsily employed as to burn the mouth and tongue very severely. A small camel-hair pencil should be used, the hairs being cut rather short. It is moistened with the acid, care being taken that there is not enough on the brush to run, and the cavity of the tooth is to be well cleaned out by pushing the brush well into it and turn ing it about. The brush is to be removed, cleaned, and reapplied with some fresh acid, the person being permitted to wash the mouth with warm water after each application, to re move excess of acid. When the pain has been soothed, a small piece of cotton, moistened with carbolic acid, is to be pushed well down into the tooth, and it may be covered over with a pieced cotton soaked in a solution of gum mastic or benzoin. Creasote may be used in the same way. If a tooth be simply sensitive from expo sure of the dentine, a mouth-wash of two tea spoonfuls of bicarbonate of soda to a glass of water is recommended to be used several times a day to allay the pain.
Neuralgia is often mistaken for toothache. The main distinction is that neuralgia comes and goes, and specially that it very often returns at the same hour each day. Pregnant women are specially liable to this form of pain in the teeth. Teeth are often extracted in the hope of relieving pain, when it is neuralgia that is the affection and not toothache ; and the extrac tion gives, at best, only temporary relief. Yet many people are reduced to such desperation by the constantly recurring pain that they will sacrifice one tooth after another, and often several at once. Neuralgic toothache is best treated by the person taking some ordinary opening medicine to begin with, and then pur suing for some time a system of tonic treatment with quinine and iron, or the phosphorus pill recommended on p. 169, and at the times of re currence of the pain the quinine and salicylate powders recommended on p. 170 for neuralgic headache.
Stopping Decayed can now be done in the way of arresting the decay of teeth, and in repairing those already decayed. This is effected by scraping away the decayed and decaying parts of the tooth and filling up the cavity with some kind of cement, or with gold or an amalgam. The kind of filling of which cement may be taken as an example is valuable, because it does not conduct heat or cold so much as a metal. A tootb,formerly sensi tive to hot or cold liquids taken into the mouth, will be protected by such a filling. On the
other hand, a metallic filling, which readily con ducts heat, would not render such a tooth less, but rather more, sensitive. The want of per manency of cement is its disadvantage, and the metallic substance is in this respect superior to it. So that the nature of the material with which a tooth should be stopped is largely de pendent upon the tooth itself.
The best time for stopping teeth is before the pulp has been in any way attacked. In fact, the sooner any decay present in a tootl. i discovered the better, and the sooner, after the discovery, steps are taken to arrest the decay, the more likely is a successful result attainable. For if the tooth be attended to early, a compe tent dentist may restore it to an almost perfectly satisfactory condition. There is, therefore, a very sufficient reason why those who can afford it should consult a dentist periodically, to have their teeth inspected and, if need be, repaired. It should always be remembered that it is far preferable to have the natural teeth stopped, if possible, than to have artificial teeth, which are a frequent source of annoyance.
Anyone who wears plates of artificial teeth should always remove mem az night, and should never go to sleep with them in the mouth; they are liable to slip off and pass back into the throat. Before a plate is fitted to either the upper or lower jaw, all stumps should be removed, and all roots as well, unless they are filled with some preservative filling. The decay which occurs in roots covered by a plate is of a peculiarly poisonous kind, and sooner or later produces serious digestive and blood disorders.
Bleeding after Extraction of teeth is sometimes troublesome, and even dangerous. The cavity left by the removal of the tooth should be well cleaned out. This may be done by means of a camel-hair pencil moistened with tincture of steel, which tends to produce con traction of the blood-vessels. A small piece of cotton steeped in the tincture is then pushed hard down into the bottom of the cavity, and one small piece of cotton after another is packed tightly in after it, till the cavity is filled up to the level of the top of the gum. A little pad of lint may then be placed on the top in such a way that the opposing teeth will press it firmly into the hollow when the mouth is shut. If the bleeding is not so severe as to require all this, cleaning out the cavity and touching it with tincture of steel, and then the sucking of ice for a short time, may arrest it, or merely placing a small roll of lint or wool over the cavity and shutting down the upper jaw on it, so that it is pressed on to the bleed ing part.