Two other pelicans and a pair of curved pincers (Ambroise Paré).
Ambroise Paré has recourse to extraction when a tooth is the cause of very violent pain, or when the existence of a carious cavity and concomitant putrefying processes render the breath fetid, and endanger the healthy teeth in its vicinity. If the persistence of a deciduous tooth should cause the cutting of the corresponding permanent tooth outside the line of the dental arch, thus giving rise to deformity, Paré advises laying bare and then extracting the deciduous tooth; for after this the new tooth may be pressed toward the point before occupied by the other, until it assumes its natural position.
Sometimes, when a tooth is too firmly planted, one prefers, says Paré, instead of extracting it, to break off the crown for the purpose of being able to act directly on the dental nerve with appropriate remedies, or to destroy the sensibility of the nerve entirely, by cauterization. This unreasonable and reprehensible method of cure is also quoted, under the denomination of deschapellement, by another French author, a contemporary of Paré—Urbain Hemard—who observes, however, that one rarely had recourse to it; for the pain and shock which are caused by this operation are not less than those caused by extraction.
It very often happens that the patient cannot indicate exactly which tooth it is that gives him pain, his sufferings being so acute as to appear spread over a great part of the jaw. One cannot, therefore, trust too much to the indications given by the patient as to the point of departure of the pain, and must take care not to extract a healthy instead of a diseased tooth.
The extraction of a tooth should not be carried out with too much violence, as one risks producing luxation of the jaw or concussion of the brain and the eyes, or even bringing away a portion of the jaw together with the tooth (the author himself has observed this in several cases), not to speak of other serious accidents which may supervene, as, for example, fever, apostema, abundant hemorrhage, and even death.
In extracting a tooth it is necessary to place the patient on a very low seat, or even on the ground, with his head between the legs of the operator.[306] After having laid the tooth bare sufficiently, if one sees that it is very loose, one may push it out of its socket with a poussoir, that is, with a trifid lever. But if the tooth is too firmly rooted to be extracted with this instrument, one must make use of curved pincers, or else one may have recourse to a pelican. The author notes, however, that much skill is required in using this latter instrument, for otherwise it will almost certainly happen that several good teeth will be knocked out, instead of the one intended to be extracted. In proof of this, he relates the following anecdote, which we relate in the words of the author, that it may not lose anything of its quaint originality:
“Je veux icy reciter une histoire d’un maistre barbier, demeurant à Orleans, nommé maistre François Loüis, lequel avoit par dessus tous, l’honneur de bien arracher une dent, de façon que tous les samedis plusieurs paysans ayans mal aux dents venoient vers luy pour les faire arracher, ce qu’il faisait fort dextrement avec un polican, et lorsqu’il avoit fait, le jettoit sus un ais en sa boutique. Or avoit-il un serviteur nouveau, Picard, grand et fort, qui desiroit tirer les dents à la mode de son maistre. Arriva cependant que ledit François Louys disnoit, un villageois, requerant qu’on luy arrachait une dent, ce Picard print l’instrument de son maistre et s’essaya faire comme luy; mais en lieu d’oster la mauvaise dent au pauvre villageois, luy en poussa et arracha trois bonnes. Et sentant une douleur extrème, et voyont trois dents hors de sa bouche, commença à crier contre le Picard; lequel pour le faire taire luy dit qu’il ne dist mot, et qu’il ne criast si haut, attendu que si le maistre venoit il luy feroit payer les trois dent pour une. Donc le maistre oyant tel bruit, sortit hors de table pour sçavoir la cause et raison de leur noise et contestation; mais le pauvre paysan redoutant les menaces du Picard, et encore apres avoir enduré telle douleur qu’on ne luy fist payer triplement la peine dudit Picard, se tent, n’osant declarer audit maistre ce beau chef d’œuvre; et ainsi le pauvre badaud de village s’en alla quitte; et pour une dent qu’il pensoit faire arracher, en remporta trois en sa bourse, et celle qui luy causoit le mal en sa bouche.”[307] Paré adds in conclusion: “Partant je conseille à ceux qui voudront faire arracher les dents, qu’ils aillent aux vieux dentateurs, et non aux jeunes qui n’auront encore reconneu leurs fautes.”[308]
