That pulpless teeth and roots may be treated, filled, and preserved in health in a majority of cases, is a settled question. Every well-informed dentist knows that to be a fact, the distinguished Dr. Sexton and the able editor of the Medical Record to the contrary notwithstanding.—Iowa State Med. Reporter.
[ARTICLE III.]
DEAD TEETH IN THE JAWS.
TRUMAN W. BROPHY, M. D., D. D. S.
In reply to Dr. Sexton on this subject, Dr. Brophy makes these pertinent remarks in the journal of the American Medical Association:
Dr. Sexton says: "The retention in the jaws of teeth which are diseased, have become irredeemably sensitive to thermal influences, or deprived of adequate periosteal nourishment through calcareous formations about the roots, very frequently gives rise to nervous diseases about the head. I am convinced that these reflected nerve influences manifest themselves much oftener since dentistry has come more extensively into practice during the present generation, and greater efforts are made to retain defective teeth in the jaw."
That diseases of the teeth are often the center from which pain is reflected to the eyes, ears and other parts, all experienced clinical observers must admit. But that these pathological conditions of the teeth, from which reflected pain has its origin, can be and are successfully treated and cured with rare exceptions, as effectually as any other diseases, is a fact too well established to be set aside.
It is not possible to describe in this letter the method by which the various diseases of the teeth are treated, but suffice it to say that "teeth which are diseased from death of the pulp or from caries" do not "become irredeemably sensitive to thermal influences." In proof of this statement, many thoroughly educated medical men, practicing the specialty of dental surgery, will testify.
"Teeth deprived of adequate periosteal nourishment, through calcareous formations about the roots, very frequently give rise to nervous diseases about the head." To this statement I assent, but dissent as to the remedy not mentioned but implied, i. e., the removal of the teeth. If the calcareous deposits mentioned have destroyed so much of the pericementum and the alveolar processes as to render the teeth very loose; if, indeed, the teeth have lost their bony support and are retained by means of a remnant of pericementum only, they cannot, of course, be restored to permanent health and usefulness, and their removal is, therefore, indicated. Teeth in this condition "frequently give rise to nervous diseases about the head."
On the contrary, if the calcareous deposits have not destroyed the pericementum and alveolar processes to a very great extent, the condition is amendable to intelligent treatment and cure. In answer to the assertion that "Reflected nerve influences manifest themselves much oftener since dentistry has come more extensively into practice during the present generation," I would say, that with equal propriety it might be said that reflected nerve influences manifest themselves more frequently since gynæcology has come more extensively into practice. To attribute the obvious increase of nervous diseases during the present generation to diseases of the teeth is a statement not only "sweeping," but "overdrawn." Much harm is no doubt done by some of the modern appliances "for retention in the mouth of substitutes for absent teeth," and the unhealthy state of the gums and contiguous parts, established and maintained by the presence of these substitutes, unquestionably give rise in many cases to reflected pain.