Fig. 82.—Inferior molar tooth and forceps.
Fig. 83.—Elevator.
In raising stumps, so much decayed that the forceps will not hold them, the elevator must be employed; this instrument (fig. 83), straight, pointed, and a little grooved at the point, is thrust down between the alveolus and the tooth; the jaw being then the fulcrum, the elevator is the lever to push forwards the fang; when thus loosened it is easily lifted out. In working with an elevator there is some risk of thrusting the point through the alveolus, and wounding the tongue or floor of the mouth, hence it should always be guided and covered by the left forefinger. In removing the fangs of incisors the narrow forceps are most useful, and should it not be possible to penetrate between the fang and the alveolus, the alveolar border may be included in the grasp of the forceps and brought away with the tooth. The injury thus inflicted is very unimportant and much pain is saved.
After the tooth is extracted the mouth should be well washed with warm water a few times, the attending bleeding being of no importance, except in individuals of hæmorrhagic diathesis, in whom measures should be at once taken to arrest the flow.
To stop a bleeding socket the alveolus must be well cleared of clots, and fragments of sponge, soaked in a solution of perchloride of iron, one part of the salt to three of water, packed into the cavity. A plug of cork is placed between the jaws, and a four-tailed bandage (see page [32]) carried round the head to keep them firmly closed. Should this plan fail, the socket must be cleared again, and the wire of the galvanic cautery pushed well down to the bottom and then heated till it has cauterised the cavity (see page [168]).
Nipple Shields and Artificial Nipples made of flexible ivory, vulcanized india-rubber, &c., are required when the nipple is chafed and excoriated by the child’s sucking, especially if his mouth be attacked by thrush, as is usually the case. When the nipple is sore it should be well washed and dried after suckling, covered with glycerine of starch or plastic collodion and protected by a shield. If much inflamed it may be wrapped in lint dipped in alum water or solution of sulphate of zinc (one grain to the ounce), and deep chinks should be freely rubbed with lunar caustic. The breast should be regularly emptied by the breast-pump if the child’s sucking gives much pain, lest the accumulation of milk in the ducts cause milk abscess.
Plugging the Vagina is employed in cases of rapid hæmorrhage from the womb, &c.
Apparatus.—1. A silk pocket-handkerchief.
2. A dry new fine sponge or pellets of cotton wool.