We now give one of his cases of replantation in the words of the author himself:
“On April 10, 1725, the eldest daughter of M. Tribuot, organ builder to His Majesty the King, called on me; she was tormented by violent toothache caused by caries of the first small molar on the right side of the upper jaw; but although she was desirous of having the tooth removed, to be freed of the pain, she, on the other hand, could not, without difficulty, make up her mind, thinking of the disfigurement which its loss would occasion, and thus it was that she was induced to ask me if it would not be possible to put it back again after having extracted it, as I had already done in the case of her younger sister. I replied that this might very well be done, provided the tooth came out without being broken, without any splintering of the alveolus, or great laceration of the gum. The patient, upon this, completely made up her mind. I extracted the tooth very carefully so as not to break it, neither were the gum nor the alveolus injured in any way. I therefore was induced to put the decayed tooth back in its alveolus, and having done this, I took care to tie it to the neighboring teeth with a common thread, which I left in position for a few days. The tooth became perfectly firm, and only caused pain for two days after being replanted.... To better preserve it, I stopped the carious cavity.”[440]
Not without interest is a case of disease of Highmore’s antrum, originating in the following way. A charlatan attempted to extract by means of a common key a canine tooth which had erupted in an abnormal position. He applied the hollow of the key to the tooth and beat upon the handle with a stone. But the tooth, instead of penetrating into the hollow of the key, was driven into the maxillary sinus.[441]
Two important cases of “stony excrescence” of the gums (probably osteomas) are to be found in Chapter XXXII. One of these tumors was removed by the dentist Carmeline after the patient had been tortured with useless operations by surgeons, who, not recognizing the true seat of the evil and mistaking it for a tumor in the cheek, had, over and above all the rest, produced a permanent disfigurement of the patient’s face and a perforation of the cheek that he was obliged to keep closed for the remainder of his life with a wax plug, to prevent the exit of the saliva and of liquid or masticated aliments.[442]
Several important observations on obstinate cases of cephalalgia, prosopalgia, otalgia, and other varieties of pain arising from dental caries are to be found in Chapter XXXIII. In all these cases the removal of the decayed tooth or teeth procured the prompt cessation of pain. Among others worthy of note is a case of violent otalgia caused by the decay of a lower molar, which, however, was itself not painful. This circumstance drew Fauchard himself into error, causing him to believe that the otalgia was independent of the decayed tooth; he therefore merely stopped the tooth to prevent the caries from extending farther. The pain in the ear continued, however, and the patient therefore consulted a doctor of the Faculty of Paris, Coutier, who told her that the decayed tooth might be the cause of the earache, and that, therefore, before undertaking any other cure, she ought to have it extracted. This advice was followed and the earache ceased promptly and completely.[443]
In another case a patient twenty-seven years of age was tormented by violent pain in all her teeth on the left side, in the temple and the ear, as well as in the chin, the palate, and the throat. The doctors and surgeons consulted decided the cause to be rheumatism. The patient was bled not less than four times and subjected to various other methods of treatment (purgatives, clysters, poultices, etc.), but all in vain. She, however, perceiving that one of her teeth was decayed, had it taken out. It was believed that the cause of the malady had thus been found and removed; but an hour later the pain began again with the same violence as before, continuing for some months; after this it ceased of itself. On the return of the pain, later on, in all its former intensity, the patient consulted the very able surgeon Petit, who advised her to see Fauchard, as possibly the malady might have its cause and point of departure in some bad tooth. Fauchard found one of the inferior molars decayed. This being extracted, the pain promptly ceased, not to return any more.[444]
Chapter XXXV contains twelve cases of serious maladies arising from dental diseases. One of these cases was observed in a patient aged fifty-seven years, who in consequence of caries of the last inferior molar on the right lost through necrosis a considerable portion of the lower jaw, including the whole of the right condyle; he was affected, besides, with caries of the temporal bone, in so advanced a degree that the probe could reach the dura mater; he was, therefore, in serious danger of his life, had to undergo several surgical operations of exceptional gravity, and even after recovery remained permanently subject to various disturbances, such as a salivary fistula, paralysis of the lower eyelid, etc. And all this because the surgeons whom the patient had called in had directed all their attention to the secondary facts, instead of suppressing the primary cause of the evil, represented by a dental affection.
A case observed by the surgeon Juton and communicated by him to the author is also a very important one. The patient was suffering with a large abscess on the right side of the lower jaw, accompanied by such great swelling of the cheek that it was impossible to open the mouth wide enough to examine the teeth. Juton proposed opening the abscess immediately, but the patient would not consent. The following day he was sent for in great haste. The gathering had changed its seat, making its way between the skin and muscles of the neck, where it now formed so huge a tumefaction that the patient was in danger of being suffocated. The abscess was now immediately opened, but the swelling of the face still persisted; it was therefore only after a month had elapsed that it was possible to extract the root of the last molar, which had been the original cause of the whole malady. The surgeon observed that the liquid injected into the fistulous opening in the neck issued from the alveolus of the last molar. After the extraction of the root a prompt recovery was effected.[445]
The second volume of Fauchard’s work is entirely devoted to operative dentistry and prosthesis.
Before speaking of the modes of cleaning, filing, and stopping the teeth, the author combats the opinion maintained by some, that these operations are in part useless, in part also dangerous, as having the effect of loosening the teeth, of depriving them of their enamel, and ruining them.