20. It is a common practice to have teeth extracted, when they are affected with pain; but this operation is not always necessary. In many cases, the nerve can be paralyzed, and the tooth plugged. By these means, teeth which, under the ordinary treatment, would be prematurely sacrificed, are often retained, for years, in a serviceable state.
21. The next most destructive affection to which the teeth are liable, is the accumulation of tartar. This is an earthy substance, deposited from the saliva, and is more or less abundant in different individuals. This deposit is extremely troublesome, and generally does much injury to the mouth, even before those who suffer from it are aware of the mischief.
22. The tartar on the teeth of some individuals, is of a black or greenish color, and very hard; on those of others, brown or yellow, and not so firm. When it is first deposited, it is soft, and can be easily removed with a tooth-brush; but, if suffered to remain, it soon becomes indurated, and gradually increases in thickness about the neck of the teeth. The gums become irritated and inflamed. The sockets are next absorbed, and the teeth, being left without their natural support, either fall out, or become so loose, that they can be easily removed.
23. From this cause, old people lose their teeth, when, in many cases, they are perfectly sound; but comparatively very few are aware of the origin of this deprivation, or suppose that these valuable instruments can be retained in old age. The loss is attributed to the deleterious effects of calomel, or is imagined to be an evil inseparable from advanced age.
24. The affection of the gums, arising from causes just mentioned, is frequently called scurvy, and, like caries, produces fetor of the breath; but, when these two diseases are combined, as is frequently the case, they render it extremely offensive. Besides, the effluvia arising from these diseased parts give rise to many maladies which terminate fatally, if a remedy is not applied sufficiently early to save the patient.
25. The obvious remedy for diseases arising from tartar, is the removal of their cause. This is effected by the dentist, with small sharp cutting instruments of a suitable form. To prevent the tartar from accumulating again, and to restore the gums to a healthy state, nothing more is generally requisite than the daily use of a stiff, elastic brush, and the occasional application of some approved dentrifice or astringent wash. Sometimes it may be necessary to scarify the gums, or to apply leeches to them.
26. The operations of dentistry, mentioned in the preceding part of this article, are those which relate to the preservation of the teeth; and, if performed in a proper manner, and under favorable circumstances, they will, in most instances, prove effectual. But, as few persons resort to the dentist, until the near approach of deformity, or until they are impelled by pain to seek relief, a great proportion of dental operations consists in inserting artificial teeth, and in extracting those which are past recovery.
27. When a tooth has gone so far to decay, that it cannot be cured by stopping, it should not be suffered to remain in the mouth, lest it infect the rest. Front teeth, however, when the roots remain sound, and firmly based in the sockets, ought not to be extracted, as upon the latter artificial teeth can be placed with great advantage. In such cases, the removal of the crown only is necessary.
28. The instruments commonly employed in extracting teeth, are the key, or turnkey, the forceps, the hook, and the graver, or punch. These are supposed to be sufficient to perform all the operations of this kind which occur in practice; and, although many attempts have been made to invent others which might answer a better purpose, yet those we have mentioned, in their improved state, are likely to continue in general use.
29. It seems to be a common opinion, that any one can pull teeth, who has a turnkey, and sufficient physical strength to use it; accordingly, blacksmiths, barbers, and medical students, are the chief operators in this line of dental surgery. The many fatal accidents which must inevitably be the consequence, such as breaking the tooth or jaw-bone, are considered matters of course. These, however, seldom happen with skilful dentists; and it is to be regretted, that the latter are not always employed, where unskilfulness may produce such serious consequences.