4. Stopping of the carious cavity. Dionis does not enumerate this operation among those intended for the preservation of the teeth. At that period, this operation was performed solely with a view to preventing the penetration into and the retention within the carious cavity of alimentary substances, and the disadvantages caused thereby. The carious process, says the author, often ceases altogether, and the pain then generally ceases also. However, as the residual cavity often becomes troublesome in various ways, among others by making the breath offensive, it is better to stop it. For this purpose, gold or silver leaf is generally made use of; but this mode of stopping is not durable, because gold or silver in leaf is apt to become loosened and fall out. It is therefore preferable, says Dionis, to make a stopping with a piece of gold or silver corresponding in size and shape to the cavity.[391] Many, he adds, prefer lead as a stopping, on account of its softness, whilst others simply use wax.
5. The use of the file. The indications given by Pierre Dionis for using the file do not differ from those we find in other authors. Dionis warns, however, against using the file to level down a tooth which has become lengthened through the loss of its antagonist, for after a certain time it would again project above the level of the others.
6. Extraction. This operation, says Dionis, ought not to be performed too lightly, but only in those cases in which it is really necessary; that is, when a tooth is the cause of insupportable pain and its crown is almost entirely worn away; when nothing remains of a tooth but its root; when a tooth is so loosened in its socket as to leave no hope of its again becoming firm; when supernumerary teeth or irregularly planted teeth give rise to inconvenience or deformity; and lastly, to remove deciduous teeth that have become loosened. The opinion that if the loosened milk teeth be not promptly extracted they cause the permanent teeth to grow irregularly, is, however, considered by Dionis to be a prejudice.
Dionis strongly doubts whether a tooth that has been extracted and replanted can really take root again, as had been affirmed by Dupont, Pomaret, and other authors. This shows that Dionis had had no experience on this point.
7. The application of artificial teeth. These teeth, says Dionis, are generally made of ivory, but may also be made of ox bone, which is less liable to turn yellow than ivory. He does not mention the use of hippopotamus tusks, but we learn from him that one Guillemeau made artificial teeth with a composition of his own invention, which was obtained by fusing together white wax and a small quantity of gum elemi, and then adding ground mastic, powder of white coral and of pearls. This fact is, as everyone can see, most important, for it constitutes the first step toward the manufacture and use of mineral teeth. Dionis tells us that the teeth made of Guillemeau’s composition never became yellow, and that it was also very good for stopping decayed teeth.[392] It would seem, therefore, that it could be used as cement is now used.
The Guillemeau of whom Dionis speaks is probably Jacques Guillemeau, the author of a book now no longer to be found, which was translated from the French, first into Dutch, and afterward into German. Crowley, in his Dental Bibliography, only quotes the German edition, published at Dresden in 1710, the title of which runs thus: Der aufrichtige Augen und Zahnarzt.[393]
Jean Verduc, also a Frenchman, relates a case of the surgeon Carmeline,[394] analogous to that of Denis Pomaret, in which a sound tooth which had been extracted by mistake was immediately replanted and took root again, becoming quite firm. However, Verduc does not speak of replantation as a special method of cure, but merely refers to the above case incidentally in speaking of the extraction of teeth. He considers this operation a most dangerous one, and advises not having recourse to it except in cases of utmost necessity. Notwithstanding this, Verduc gives us to understand that teeth were drawn with sufficient ability by most of the operators of the time, and precisely because of this he omits describing the manner of performing the operation. According to Verduc, the drawing of teeth is often of little or no advantage against toothache.[395] In proof of this assertion he relates the case of a hypochondriac, who little by little had as many as eighteen teeth extracted, without, however, getting the better or the wiser; but as this case does not prove anything at all, one is disposed to think that Verduc, in relating it, had the intention of being humorous.
Monsieur de Lavauguyon. To another French surgeon, Monsieur de Lavauguyon, also a contemporary of Dionis, belongs the merit of having declared useless, in the greater number of cases, the practice, at that time general, of separating the gums from the tooth before proceeding to the extraction of the latter. He says that this is only necessary when a tooth, either because broken or because its crown emerges too little above the gum, offers an insufficient hold for the pelican.[396]
Our historical survey has now reached the end of the seventeenth century. Embracing at a glance the whole of this last period of time, we remark, among many facts of minor importance, some events which, in the history of the development of dental art, stand out in strong relief. Such are the replantation of teeth used as a special curative method by Dupont and others; the method of plugging in cases of alveolar hemorrhage, the credit of which is due to Rivière and to Tulpius; the description of the maxillary sinus given by Highmore; the rational treatment of affections of the antrum, inaugurated by Meibom, Cowper, and Drake; the researches into the microscopic structure of the teeth, brilliantly initiated by Leeuwenhoek, who discovered the dentinal tubuli; the use of models introduced by Purmann into the workmanship of prosthetic pieces; the employment of hippopotamus’ tusks in making artificial teeth, first recommended by Nuck; and the invention of Guillemeau, which was the first step toward the use of mineral teeth.
