Dr. Sexton cites the readers of the Record to eight cases of otalgia resulting from diseased teeth. I have no doubt but a majority of the dentists before me to-day have met with almost that number of cases in practice every week; nor do you find it a difficult thing to render prompt relief, and that, too, in a large majority of cases, without the use of the forceps. And I believe that I am warranted in saying that in at least three-fourths of the cases met with in our practice, we find the reflex pain in the ears due to exposed living pulps, and not to "dead teeth in the jaws."
That diseased teeth do cause reflex trouble, not only in the head, but frequently in more remote parts of the body, is a fact well-known to every competent dentist. I am glad that Dr. Sexton has at last discovered the fact, that diseased teeth do frequently cause reflex pain in the ears, and in other neighboring parts, and that alveolar abscesses very often cause catarrhal affections of the maxillary sinus and of the nasal passages, and that diseased teeth will endanger the general health. It is to be regretted, however, that the doctor has found it necessary to charge this unfortunate state of affairs to the ignorance of dental practitioners, who are in no way responsible for but few of the many cases met with in practice, for there can be no doubt but a very large majority of the teeth causing the troubles above referred to have never received any treatment whatever at the hands of dentists, and because Dr. Sexton has discovered that in certain cases pulpless teeth (or dead teeth as he calls them), has caused the ailments above referred to by Dr. Sexton, there can be no doubt. Every dentist of any considerable experience can enumerate such experiences by the score, and the medical profession has only been too slow to recognize the facts discovered by Dr. Sexton.
The only difficulty with these medical gentlemen is, that they have drawn very erroneous conclusions from the important discoveries they have made. Their limited knowledge of the minute structure of the dental tissue, and the source from which each derives its life, is manifested by the erroneous statements upon which they have based their arguments, and then after arguing from false premises, Dr. Sexton says: "In regard to the treatment of pulpless teeth, the practice in vogue seems the reverse of procedures founded on well-established surgical principles." And in an editorial of the same issue we are informed that the treatment of diseased teeth is carried, to what "the medical minds regard as a dangerous extreme."
That some members of our profession have been over zealous in their efforts to save all diseased pulps alive, there can be no doubt. We will occasionally meet with an enthusiast in our profession who will say, "I have no use for forceps, I never extract teeth." I have heard that statement made on the floor of the Iowa State Dental Association.
That incurable diseased teeth should not be tolerated in the jaws does not admit of discussion. Good common sense ought to settle that question. And again, there are extremists who never devitalize diseased pulps, no matter how badly exposed, but "doctor them up," and stupify them, and then bury them in a living grave. Much evil has grown out of this practice.
Some one has said that to cap a badly exposed pulp is to create a slumbering volcano, and he might well have added that such volcanoes have but a limited time to slumber. Gentlemen, there are in our own country ten thousand volcanoes belching forth—not pure molten lava—but impure gases and putrescent matter of the most sickening character. The craters to these volcanoes are not found on the mountain top, but they are found in human mouths—in the antrum of Highmore, in the nasal passages, and externally on the face, neck, or even on the chest.
When the pulp of a tooth is dead and confined within its bony walls an outlet is sought, and must be affected for the escape of impure gases arising from the decomposing pulp and for the putrescent matter associated with it. When thus confined its only way of escape is through the dental foramen, and into tissues adjacent thereto. The pressure thus brought to bear upon the bony walls surrounding the apex of the root will in time perforate it at its weakest point, and the poisonous matter is forced through the opening thus formed and into the soft tissues, which soon yield to the pressure, and the imprisoned mass of corruption is liberated. The pain and swelling now subsides, but a dangerous nuisance has been created. The channel formed from the apex of the root to an external opening will not close while it is used for the passage of foul matter and gases that will flow unceasingly from the pulp canal.
The remedy of course is to remove the cause, and assist nature in affecting a cure, and to do this the pulp chamber must be opened, its contents removed, the canals cleansed and disinfected, the abscess healed, and the roots filled to the exclusion of all fluids and purulent matter. But how often this is not done. How many thousands of suffering mortals are to-day dragging out miserable lives because of these drainage tubes emptying themselves into the oral cavity—into the maxillary sinus or into the meatus of the nose. Such an abiding nuisance in the mouth cannot long exist without ruining health. But how few of the unfortunate sufferers realize the cause of their nervous irritability, their loss of appetite, their feeling of lassitude, their lack of energy, and their general prostration. And here let me say, that but few, in comparison to the number of these unfortunate sufferers seek relief at the hands of the dental practitioner. The patient is neither sick nor well, but debilitated and "good for nothing." The family physician is consulted, nervines and tonics are administered, but to no avail. The septic matter is vitiating the air that is breathed, and poisoning the food that is eaten. The saliva that is poured into the mouth from the various glands must mingle with this poisonous matter and carry it into the stomach.
Sanitary means are being employed in all our cities at the present time, in view of the cholera scourge that it is feared will sweep over our land the coming summer. Our physicians wisely talk and write about the baneful influences of impure water, about miasma arising from the decomposition of vegetable matter, and about unwholesome food, and it would be well if the public would heed their timely warnings. And as dental practitioners, I feel that we, also have an important duty to perform, in enlightening our patients, and the public so far as we are able to do so, in the direction I have above indicated.
The subject is of paramount importance, and as the opportunities come to us in every day practice, let us not fail to impress upon the minds of our patient (when we find it necessary to do so), the fact that a clean mouth is essential to health.