After the teeth have been cleansed with a tooth-brush and powder, the mouth must be thoroughly rinsed several times. Scented mouth-washes have been in use for ages. Many persons are of the opinion that rinsing the mouth with an antiseptic wash is sufficient for the cleansing of the teeth, especially as many manufacturers of these mouth-washes advertise this as being the case. But this is not so. The mechanical action of the tooth brush and the powder is the main point ; the use of antiseptic mouthwashes can merely aid the mechanical cleansing. An appropriate mouth-wash is one which is absolutely harmless to the teeth, to the mucous membrane, and to the body in general. It must be sufficiently antiseptic in its effect, and must have an agreeable taste and a pleasant odour. Many of the mouth washes on the market do not fill these requisites, and are therefore often injurious. An absolutely harmless mouth-wash consists in a simple solution of cooking-salt in Ivarm water (one thimbleful of salt to a tumblerful of water). In order to rinse the mouth properly, the water must be forced between the teeth, and also be used as a gargle.
The teeth should be cleansed in the manner here stated morning and night. Cleansing at night is of the greatest importance, in order to prevent food deposited between the teeth from putrefying during the night when nothing can be done to remove it. The cleansing of the teeth in the morning is necessary to remove the mucus which has accumulated on the teeth over night. After each meal the mouth should be rinsed with warm water.
In case of toothache, a dentist should be consulted. The causes of tooth ache are so varied that it requires a certain degree of medical education to recognise the exact cause and apply the proper remedy. Remedies advertised in newspapers should be strictly avoided, for even though they may seem efficacious in some cases, their effects are rarely permanent. The trying of all kinds of remedies really amounts to no more than a useless waste of time, during which the pain merely becomes aggravated. Only a trained dentist is able to give prompt relief.
The most frequent disease of the teeth is dental decay (caries), the cause, nature and development of which have been described in the foregoing. When the enamel is broken in a small spot, the decay quickly invades the bone, and spreads to all sides until the enamel is undermined. Although the enamel may remain intact for the time being, the decay steadily progresses until suddenly a large portion breaks away, disclosing a cavity. It is, therefore, necessary to have one's teeth regularly examined by a dentist, so that such carious spots may be discovered as early as possible, and the progress of the decay arrested before pain sets in. When the carioims process
involves the pulp of the tooth (the so-called nerve), it gives rise to pain. At first there is a transient sensation of pain when drinking cold fluids or eating sweets. Gradually the pain becomes prolonged, occurring without any special outward cause, and, unless treated, it may last for months. The pain indicates that the pulp is inflamed in consequence of the entrance of suppurative bacteria. When the pulp is destroyed, the pain generally ceases for a time. Only for a time, however ; for the decay advances further and further, gradually destroying the tooth until the entire crown breaks down. Food remnants are readily deposited in the mouth of the cavity, pressing upon the disintegrated contents, which thus are forced into the root cavity. These food remnants are accompanied by bacteria, which cause suppuration, and give rise to a so-called " inflammation of the root-membrane." For a time this condition may cause no annoyance, but sooner or later it will give rise to severe throbbing and piercing pain. That side of the face on which the sick tooth is situated becomes swollen, and pus accumulates around the base of the tooth (see Fig. 416). Near the tip of the root the pus usually breaks through the bony tooth-cells and gums, and is discharged into the mouth. This may result in a dental fistula which continuously secretes pus. The pus may also break through the cheek to the face. This latter condition gives rise to a so-called " cheek fistula," which never heals without leaving a disfiguring scar.
When a tooth aches, the mouth cannot be thoroughly cleansed, and the affected side does not take any part in chewing. This causes tartar to form also on the sound teeth. The tartar adheres principally to the neck of the tooth, from where it extends downward between the tooth and the gum, causing an insidious suppuration which frequently involves the jaw-bone also. This condition leads to destruction of the bone, and the tooth gradually loses its support and falls out. Owing to a large deposit of tartar inter vening between the tooth and the gum, the latter no longer adheres closely to the root of the tooth, which is then merely supported by the tartar. Finally, both tooth and tartar break down. In order to avoid this condition, tartar deposits should be removed in time, and the gums strengthened by massage and thorough cleansing.