(b) Shock.—The fact that tooth extraction is a surgical operation, and may be followed by shock, is often overlooked. The amount of shock which follows as a rule is practically nil, but at times, especially in the weak, it may be well marked. This is not taken sufficiently into account when a question arises as to the number of teeth to be extracted at one sitting, and it should be clearly borne in mind that what a strong, able-bodied person, can stand, one of weaker physique cannot bear. The wholesale extraction of teeth at one sitting which is carried out by some operators is not advisable, and the amount of prostration that follows is sometimes very severe.
Syncope at the time of the operation sometimes occurs. Should it supervene during the extraction of the tooth the operator should immediately desist until recovery ensues. Fainting is best treated by bending the head down towards the knees, at the same time loosening anything tight about the neck and applying ordinary salts of ammonia to the nose. In severe cases the patient should be removed from the chair and laid on the floor, and the chest should be exposed and flipped with a towel dipped in cold water. In more severe cases it may be necessary to inject ether or some other stimulant, such as brandy. Fatal syncope following tooth extraction has occurred, and a case which took place at Marseilles in 1881 is mentioned by Tomes.[24] The patient was a female, and an attempt was made to remove a tooth, but was desisted in owing to alarming syncope. A second attempt was made, or rather about to be made, when fatal syncope ensued. Post-mortem examination showed nothing beyond a slight amount of cerebral congestion.
(c) Epilepsy.—In those pre-disposed to epilepsy an attack often commences immediately after the extraction of a tooth. In the event of a fit occurring the patient should be removed from the chair and placed on the floor, the clothes being at the same time loosened, and a wedge of wood or some suitable material placed between the teeth to prevent injury to the tongue.
(d) Hysteria.—Manifestations of this disorder at times follow tooth extraction, but do not call for any special treatment beyond that usually adopted for this disorder.
(e) Septic and infective sequelæ.—Scattered through dental literature will be found a large number of records of septic and infective diseases which have followed the extraction of teeth. In many of these cases it would be difficult to say that the infection was always the result of the operation; in a number of them the actual cause was due to the neglected condition of the tooth which called for extraction. Infection can, however, at times undoubtedly be traced to the operation, and once again attention cannot be too strongly drawn to the fact that antiseptic precautions should be carried out as far as possible.
Suppuration of the socket and its appropriate treatment has already been dwelt upon (page 82). Cases of syphilis having been acquired through the use of infected forceps are recorded, while septicæmia, sapræmia, cellulitis, osteitis, osteomyelitis, periostitis, pyæmia, tetanus, have all been known to follow the removal of a tooth, but the treatment of these conditions hardly lies within the scope of this book.
INDEX.
[A], [B], [C], [D], [E], [F], [G], [H], [I], [L], [M], [N], [O], [P], [R], [S], [T], [U], [W].
| A | |
| PAGE | |
| Abnormality of upper molars, | [26] |
| Accidents under Anæsthetics:— | |
| Forcing out a tooth with a prop or a Mason’s gag, | [88] |
| Passage of a foreign body through the isthmus of the fauces, | [89] |
| Tongue slipping back, | [88] |
| Alveoli of the teeth, disposition of the, | [12] |
| Alveolus, fracture of the, during extraction, | [67] |
| ” ” ” ” treatment of, | [69] |
| ” necrosis of the, following extraction, | [70] |
| Anæsthetics, the use of, during the extraction of teeth, | [56] |
| Arteries, injury to the, in the neighbourhood of the tooth during extraction, | [81] |
| B | |
| Bicuspids, the extraction of lower, | [34] |
| ” ” ” ” misplaced lower, | [51] |
| ” ” ” ” ” upper, | [49] |
| ” ” ” ” upper, | [22] |
| Breaking one tooth in extracting another, | [67] |
| Bruising the lower lips during extraction, | [74] |
| C | |
| Canines, the extraction of lower, | [34] |
| ” ” ” ” upper, | [21] |
| Central incisors, the extraction of lower, | [33], [51] |
| ” ” ” ” ” upper, | [19] |
| Chloride of ethyl, | [61] |
| Chloroform, the use of, during the extraction of the teeth, | [56], [57] |
| Cocaine, mode of employment, | [60] |
| ” toxic effects, | [61] |
| Complications, Difficulties and Sequelæ of Extraction of the Teeth:— | |
| Complications, difficulties, and sequelæ arising during extraction, miscellaneous, | [94] |
| Complications, difficulties and sequelæ arising during extraction under anæsthetics, | [88] |
| Complications, difficulties and sequelæ of extraction of the teeth connected with the jaws, | [67] |
| Complications, difficulties and sequelæ of extraction of the teeth connected with the soft tissues, | [72] |
| Complications, difficulties and sequelæ of extraction of the teeth connected with the teeth themselves, | [63] |
| Coryl, | [61] |
| D | |
| Difficulties, Complications and Sequelæ arising during Extraction, Miscellaneous:— | |
| Epilepsy, | [94] |
| Hysteria, | [94] |
| Septic and infective sequelæ, | [95] |
| Shock, | [93] |
| Uterine pain, | [93] |
| Difficulties, Complications and Sequelæ arising during Extraction under Anæsthetics:— | |
| Tongue slipping back, | [88] |
| Forcing a tooth out with a prop or Mason’s gag, | [88] |
| Passage of a foreign body through the isthmus of the fauces, | [89] |
| Difficulties, Complications and Sequelæ connected with the Jaws:— | |
| Dislocation of the mandible, | [70] |
| Forcing a root into the antrum, | [71] |
| Forcing a tooth into an abscess cavity, | [72] |
| Fracture, | [67] |
| ” treatment of, | [69] |
| Necrosis, | [70] |
| Trismus, | [72] |
| Difficulties, Complications and Sequelæ connected with the Teeth themselves:— | |
| Breaking one tooth in extracting another, | [67] |
| Crowded and irregular teeth, | [65] |
| Fracture of the tooth, | [64] |
| The removal of a neighbouring tooth, | [66] |
| ” ” an unerupted bicuspid, | [66] |
| ” ” the wrong tooth, | [66] |
| Undue resistance of the tooth and alveolus, | [63] |
| Difficulties, Complications and Sequelæ in connection with the Soft Tissues:— | |
| Bruising the lower lips, | [74] |
| Extensive laceration of the gum, | [72] |
| Hæmorrhage following tooth-extraction, | [74] |
| ” ” ” treatment of, | [76] |
| Injury of the arteries in the neighbourhood of the teeth, | [81] |
| Injury of the mandibular nerve, | [74] |
| Pain following tooth extraction, | [81] |
| Wounding the tongue, | [73] |
| Disposition of the alveoli of the teeth, | [12] |
| E | |
| Elevator, | [7] |
| Epilepsy, attack of, following tooth extraction, | [94] |
| Ethyl, chloride of, | [61] |
| Extraction of impacted lower third molars, | [54] |
| ” ” individual teeth, | [19] |
| ” ” lower bicuspids, | [34] |
| ” ” ” canines, | [34] |
| ” ” ” incisors, | [33] |
| ” ” ” molars, | [35] |
| ” ” ” teeth, | [30] |
| ” ” misplaced lower bicuspids, | [51] |
| ” ” ” ” incisors, | [51] |
| ” ” ” teeth, | [46] |
| ” ” ” upper bicuspids, | [49] |
| ” ” ” ” canines, | [48] |
| ” ” ” ” central incisors, | [47] |
| ” ” ” ” lateral ”, | [47] |
| ” ” temporary teeth, | [17], [43] |
| Extraction of upper bicuspids, | [22] |
| ” ” ” canines, | [21] |
| ” ” ” incisors, | [19] |
| ” ” ” molars, | [23] |
| ” ” ” teeth, | [19] |
| ” ” the teeth, general principles of, | [1] |
| ” with forceps, | [14] |
| F | |
| Forceps, holding of, | [6] |
| Forceps, the, | [3] |
| Forcing a root into the antrum during tooth extraction, | [71] |
| ” ” tooth into an abscess cavity during tooth extraction, | [72] |
| ” out a tooth with a prop or a Mason’s gag, accidents under anæsthetics, | [88] |
| Fracture of the alveolus during tooth extraction, | [67] |
| ” ” ” ” treatment of, | [69] |
| ” ” ” tooth during tooth extraction, | [64] |
| Freezing agents, local anæsthetics, | [61] |
| G | |
| General principles of extraction of the teeth, | [1] |
| Gum, extensive laceration of the, during tooth extraction, | [72] |
| H | |
| Hæmorrhage following tooth extraction, | [74] |
| ” ” ” ” treatment of, | [76] |
| Hewitt, Dr., on the toxic effects of cocaine, | [61] |
| ” ” ” ” use of chloroform in operations, | [57] |
| Holding of elevator, | [9] |
| ” ” the forceps, | [6] |
| Hysteria, attack of, following tooth extraction, | [94] |
| I | |
| Impacted lower third molars, the extraction of, | [54] |
| Incisors, the extraction of lower, | [33] |
| ” ” ” ” misplaced lower, | [51] |
| ” ” ” ” ” upper central, | [47] |
| ” ” ” ” ” ” lateral, | [47] |
| Incisors, the extraction of upper, | [19] |
| Individual teeth, the extraction of, | [19] |
| Injury of the arteries in the neighbourhood of the tooth during extraction, | [81] |
| ” to the mandibular nerve during tooth extraction, | [74] |
| Instruments, | [3] |
| Irregular and crowded teeth, difficulties during extraction through, | [65] |
| L | |
| Laceration of the gum through tooth extraction, extensive, | [72] |
| Lateral incisors, the extraction of misplaced upper, | [47] |
| Lips, bruising the lower, during tooth extraction, | [74] |
| Local anæsthetics, | [59] |
| Lower bicuspids, misplaced, the extraction of, | [51] |
| ” incisors, misplaced, the extraction of, | [51] |
| ” ” the extraction of, | [33] |
| ” teeth, the extraction of, | [30] |
| ” third molars, impacted, the extraction of, | [54] |
| M | |
| Mandible, Dislocation of the, during tooth extraction, | [70] |
| Mandibular nerve, injury to the, during tooth extraction, | [74] |
| Miscellaneous complications, difficulties and sequelæ, | [93] |
| Misplaced lower bicuspids, the extraction of, | [51] |
| ” ” incisors, the extraction of, | [51] |
| ” teeth, the extraction of, | [49] |
| ” upper bicuspids, the extraction of, | [49] |
| ” ” canines ” ”, | [48] |
| ” ” central incisors, the extraction of, | [47] |
| ” ” lateral ” ”, | [47] |
| Molars, impacted lower third, | [54] |
| ” the extraction of lower, | [35] |
| ” ” ” upper, | [23] |
| N | |
| Necrosis of the alveolus following tooth extraction, | [70] |
| Nitrous oxide, the use of, during the extraction of the teeth, | [56], [57], [58] |
| Nitrous oxide with air, the use of, during the extraction of the teeth, | [56], [57], [58] |
| O | |
| ”Oblique rooted” molars, | [26] |
| Operations requiring a long anæsthesia, | [57] |
| Order of removal of teeth, | [59] |
| P | |
| Pain following tooth extraction, | [83] |
| Passage of a foreign body through the isthmus of the fauces, accidents under anæsthetics, | [89] |
| Points in the anatomy of the teeth and jaws, | [11] |
| Position of the operator and patient, | [10] |
| R | |
| Removal of a neighbouring tooth during extraction, | [66] |
| ” ” an unerupted bicuspid ” ”, | [66] |
| ” ” teeth, the order of, under anæsthetics, | [59] |
| ” ” ” with straight elevator, | [15] |
| ” ” the wrong tooth during tooth extraction, | [66] |
| S | |
| Screw, the, | [9] |
| Septic and infective sequelæ following extraction, | [95] |
| Sequelæ, difficulties and complications arising during extraction, miscellaneous, | [93] |
| Sequelæ, difficulties, complications and, arising during extraction under anæsthetics, | [88] |
| Sequelæ, difficulties, complications and, of extraction of the teeth connected with the jaws, | [67] |
| Sequelæ, difficulties, complications and, of extraction of the teeth connected with the soft parts, | [72] |
| Sequelæ, difficulties, complications and, of extraction of the teeth connected with the teeth themselves, | [63] |
| Shock following extraction, | [93] |
| T | |
| Teeth, general principles of extraction of the teeth, | [1] |
| ” which require extraction, | [1] |
| Temporary teeth, the extraction of, | [17], [43] |
| Tongue slipping back, accidents under anæsthetics, | [88] |
| Treatment of fracture of the alveolus during tooth extraction, | [69] |
| Treatment of hæmorrhage following tooth extraction, | [76] |
| Trismus, treatment of, | [72] |
| U | |
| Undue resistance of the tooth and alveolus, | [63] |
| Upper bicuspids, misplaced, the extraction of, | [49] |
| ” canines, misplaced, the extraction of, | [48] |
| ” central incisor, misplaced, the extraction of, | [47] |
| ” lateral ” ” ” ” ”, | [47] |
| ” teeth, the extraction of, | [19] |
| Use of anæsthetics during the extraction of the teeth, | [56] |
| Uterine pain following tooth extraction, | [93] |
| W | |
| Wounding the tongue during tooth extraction, | [73] |
| Wound resulting from removal of a tooth, | [16] |