The maternal management of children, in health and disease

by Thomas Bull

THEIR MANAGEMENT AND PRESERVATION.

IRREGULARITY OF ARRANGEMENT AND POSITION.—Every parent ought to have the mouth of her child inspected occasionally, during the advance of the permanent teeth, that any irregularity in their position or arrangement may be prevented. And it is equally her duty to see to it, that she choose a competent person to do this, since great mistakes are not unfrequently made in this matter, and which themselves become the source of evils far more serious than those they are intended to obviate. "I have known," says Mr. Bell, "no less than eight or even ten firm teeth forcibly removed from the jaws of a child at once, when there was not the slightest reason to apprehend any evil result from their being left alone." Here there was a most cruel, because unnecessary, infliction of pain, as well as great hazard incurred of seriously injuring the permanent teeth by interfering with the secretion of their enamel. And besides all this there is another and yet greater evil, for, if the temporary teeth be removed, before the permanent ones are so advanced as to be ready to occupy their situation, the arch of the jaw will assuredly contract, and when, subsequently, the permanent teeth are fully formed, there will not be room for them to range in their proper situation. Thus the operation which was intended to prevent irregularity becomes the cause of its occurrence, and that in its very worst form, producing a want of accordance between the size of the teeth and that of the jaw.

The eye-teeth generally occasion most anxiety to a parent, from the prominent position in which they present themselves; but in the majority of cases nothing but time is required to reduce them to their proper station. But, whatever may be the peculiarities of each individual case, the dentist will decide what may be required; only, I would again repeat, do not neglect the occasional inspection of the mouth at this age, if you regard the future comfort and appearance of your child.

THEIR PRESERVATION.—The preservation of the teeth requires attention to several points; the first and principal of which is, to enforce the habit in the child of thoroughly cleaning the teeth by means of water and a brush night and morning, and rinsing out the mouth after each meal. The brush should not be very hard, as it will not only be more difficult to clean the interstices between the teeth, the part in which the tartar[FN#24] is most likely to be deposited, but by its friction, will occasion the gradual absorption of the gum and the exposure of the neck of the teeth. The hair of the brush should be firm and elastic, and not too closely set.

[FN#24] A sort of calcareous substance, which becomes deposited at the roots of the teeth, from a want of proper attention to cleanliness; and, if allowed to remain, will destroy first their beauty, and then the organ itself.

TARTAR.—If there is a tendency to the formation of tartar, then it will be necessary to have recourse to some tooth-powder. Tooth-powders, however, must be chosen with care, as many of them are composed of substances highly injurious to the teeth. "Many of the tooth-powders which are offered for sale, with the promise of rendering the teeth beautifully white, perform, for a time, all that is promised, at the expense of permanent and irremediable injury to the teeth; for they often contain a quantity of tartaric or other acid, which effects a gradual decomposition of the enamel."[FN#25] Prepared chalk is one of the simplest and best tooth-powders.

[FN#25] Bell on the Teeth.

The following form, also, may be used with advantage:—

Prepared chalk, three ounces;
Orris root, powdered, half an ounce;
Powdered myrrh, half an ounce;
Cuttle fish, powdered, one ounce;
Essential oil of cinnamon, four drops.—Mix.

The best preservative, then, against the formation of tartar, is to see that the child cleans his teeth thoroughly night and morning with the brush, powder, and water, and also (if possible) that he rinses out the mouth after each meal.

If the gums should be tender, irritable, and bleed (as is frequently the case when an individual gets out of health, or the tartar accumulates) the mouth may be washed night and morning with a tumbler of tepid water, containing from ten to twenty drops of the tincture of myrrh, and the same quantity of spirits of camphor; or the following form may be used:—

Alum, one drachm and a half;
Tincture of myrrh, two drachms;
Camphor mixture, five ounces and a half.—Mix.

ACIDS.—The use of acids to the teeth cannot be too strongly deprecated: they decompose their substance, and lead to their rapid decay. Hence the whiteness produced by acid tooth-powders and washes is not less deceitful than ruinous in its consequences. As has been just observed, they perform all that their vendors promise, causing the teeth, for a little while, to become very white and beautiful in their appearance, but, at the same time, injuring them irremediably: the enamel becomes gradually decomposed, the bone of the tooth exposed, and its death is the inevitable consequence.

It is therefore of great importance when acid medicines are ordered for children that they should be taken through a glass tube, to prevent their coming in contact with the teeth. From a want of this precaution, I know a lady (and there are many such instances) who once had as sound and fine a set of teeth as any one could boast of, but from this cause has had nearly the whole of the upper row destroyed. She was in delicate health: it was judged requisite that she should take for a considerable time (with other medicines) sulphuric acid; but the glass tube was not thought of, and the consequences followed which have been described.

CALOMEL.—This medicine, as it is frequently given, alone, or in the little white powders, in infancy and childhood, by mothers and nurses, is productive of serious and indeed irremediable injury to the teeth. "The immoderate use of mercury in early infancy produces, more perhaps than any other similar cause, that universal tendency to decay, which, in many instances, destroys almost every tooth at an early age. It is certainly not unimportant to bear this fact in mind, in the administration of this sovereign remedy, this panacea, as many appear to consider it, in infantile diseases."[FN#26]

[FN#26] Bell on the Teeth.

HEAT AND COLD.—The teeth are exceedingly apt to suffer from sudden variations of temperature. Fluids, therefore, should never be taken into the mouth so hot or so cold as to produce the slightest pain; and, for the same reason, the water with which the mouth is cleansed should in winter be always warm or tepid. When ices are taken, the precaution of placing them in the centre of the mouth, so as to prevent contact with the teeth, should be carefully observed.

There are many other causes which might be mentioned as tending to induce decay of the teeth, but their consideration here is purposely avoided.

It is hoped that enough has been said to draw the parent's attention to the subject of the teeth, to prevent their neglect, and yet at the same time to induce a cautious management.