A History of Dentistry from the most Ancient Times until the end of the Eighteenth Century

by Vincenzo Guerini

When the teeth show blackish stains, Celsus advises such stains to be scraped away, and the teeth afterward to be rubbed with a mixture of pounded rose leaves, gall-nuts, and myrrh, and the mouth to be frequently washed with pure wine. It is necessary besides, says the author, to keep the head well covered, to walk a great deal, and to partake of no acid food.

“If by effect of a blow or other accident some of the teeth become loose, it is necessary to bind them with gold wire to the neighboring firm teeth, and besides to keep in the mouth astringent substances, for example, wine in which the rind of pomegranates has been boiled, or into which some burning hot gall-nuts have been thrown.”

“When in a child a permanent tooth appears before the fall of the milk tooth, it is necessary to dissect the gum all around the latter and extract it; the other tooth must then be pushed with the finger, day by day, toward the place that was occupied by the one extracted; and this is to be done until it has firmly reached its right position.”

“Now and again it happens that when a tooth is pulled out its root remains in the socket; it is then necessary to extract it at once, with the forceps adapted for the purpose, called by the Greeks rizagra.”

The last book of the work of Celsus treats chiefly of fractures and dislocations. In the first chapter the position and form of the bones of the whole human body are described, although not very exactly. Speaking of the teeth, the author says: “The teeth are harder than the bones, and are fixed, some on the maxilla (lower jaw) and some on the overhanging bone of the cheeks.”[126]

“The first four teeth, being cutting teeth (incisors), are called by the Greeks tomici. These are flanked on both sides by one canine. Beyond this there ordinarily exist, on both sides, five grinders, except in the case of those persons in whom the last molars, which commonly are cut very late, have not yet appeared. The incisors and the canines are fixed with one single root; but the molars at least with two, some even with three or four. In general, the shorter the tooth, so much the longer is its root. A straight tooth commonly has a straight root, a curved tooth has it generally curved. The root of a temporary tooth produces in children a new tooth, which usually pushes out the first; sometimes, however, the new tooth appears either above or below it.”

In the seventh chapter Celsus treats of fractures in general, but in particular of those of the lower jaw.

“To reduce a fracture of this bone, it should be pressed in a proper manner, from the inside of the mouth and from the outside, with the forefinger and thumb of both hands. Then in the case of a transverse fracture (in which case generally an unevenness in the level of the teeth is produced), it is necessary, after having set the fragments in place, to tie together the two teeth nearest to the fracture with a silk thread, or else, if these are loose, the following ones. After this, one should apply externally, on the part corresponding to the lesion, a thick compress, dipped in wine and oil and sprinkled with flour and powdered olibanum. This compress is to be fixed by a bandage or by a strip of soft leather, with a longitudinal slit in the middle to embrace the chin, the two ends being tied together above the head. The patient must fast the first two days; then he may be nourished with liquid food, but in small quantities, abstaining, however, completely from wine. On the third day it is necessary to take off the apparatus, and after having fomented the part with the steam of hot water, to replace it. The same is to be done on the fifth day, and so on, until the inflammation has subsided, which generally happens from the seventh to the ninth day. After the symptoms of inflammation have vanished, the patient may take abundant nourishment; he must, however, abstain from chewing until the fracture is completely consolidated; and, therefore, he will continue to nourish himself with soups and like food. He must also entirely abstain from speaking, especially during the first few days. Fractures of the jaw commonly heal from the fourteenth to the twenty-first day.

“In luxations of the jaw (Chapter XII) the bone is always displaced forward; but sometimes only on one side, and sometimes on both sides. When the dislocation is only on one side, the chin and the whole jaw are found deviated toward the part opposite to the luxation; and the similar teeth of the two dental arches do not correspond; but instead under the upper incisors will be found the canine tooth of the dislocated part. If, however, the luxation is bilateral, the chin inclines and projects forward; the lower teeth are farther in front than the upper ones, and the muscles of the temples are tightly stretched. The reduction of the luxation must be performed as quickly as possible. The patient having been made to sit down, an assistant holds the head firmly from behind; or else the patient is made to sit with his shoulders against a wall, with a hard cushion between this and his head, whilst the assistant holds the head against the cushion, and so keeps it steady. Then the operator, after wrapping his two thumbs in linen cloth or strips, that they may not slip, introduces them into the patient’s mouth and, applying the other fingers on the outside, firmly grasps the jaw. Then whilst lowering the back part of the latter, he shakes the chin and pushes it upward and backward, seeking to shut the mouth, and in this way making the jaw return to its natural position.