Read Ebook: The Archives of Dentistry Vol. VII No. 4 April 1890 by Various Eames W H William Henry Editor Stockton C S Editor

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There is one question I would like to ask Dr. Stoddard, which he can answer after I have finished, and that is, how far his body corresponds with the body usually used for the porcelain teeth of the shops? Does it have to fuse at a lower heat, or is it substantially the same?

It seems to me that, going further than this, an effort should be made, before they are entirely lost, to preserve the old formulas that are in the hands of the older dentists. I believe that the most successful manufacturers to-day are manufacturing teeth from the formulas of these men, and if they are available they will be useful to add to our directory, that they may go on record. I think this is a very interesting study, and it is certainly carrying us back to the older days of dentistry in some ways.

DR. ALLEN:--I have in my pocket a tooth which Mr. Dall prepared. He takes one of Ash's inlay teeth, cuts a groove in it and cuts them off in sections.

DR. STODDARD:--In reply to Dr. Meriam's question, the body that we use is Dr. Daniel Harwood's, and is harder than the ordinary bodies. There has been some effort, I believe, to preserve the old formulas. Dr. Preston has presented his to the school, and Dr. Chandler has some which he is preserving.

DR. MERIAM:--I think, seeing this specimen that Dr. Allen has passed around, that some years ago in France a porcelain was made in the form of a pencil, so that the end could be ground and fitted to a cavity, and then cut off and polished. I also believe they use the long teeth used for continuous gum work.

DR. SHEPHERD:--I noticed that some of the specimens, especially a tip for a central, were a little larger than necessary. I would like to ask Dr. Stoddard if the porcelain could be dressed down to give the proper contour to the filling.

DR. STODDARD:--Yes, it can be ground down and polished; and when it is wet in the mouth it looks just as well as English porcelain.

DR. CLAPP:--I have had very little experience in inlay fillings, but I find that the process of grinding in the piece of artificial tooth, when that is used, can be considerably facilitated by cementing the piece of porcelain into the end of a small stick with cements the same as is used by lapidaries who cut precious stones. I would like to ask Dr. Stoddard about the Ash teeth, they being softer and more easily fused than the bodies that we have, would it be possible to take those teeth and pound them up the same as the body is made now, and then use them as the body?

DR. STODDARD:--That never occurred to me, but I think very likely it could be done. The only question it seems to me is in the coloring material, whether it would bleach or not.

DR. MERIAM:--I think we should make a distinction between the Ash ordinary tooth and the Ash Tube tooth. The tube tooth fuses at a lower temperature, and in soldering this tube tooth I found that it would change color and once, for a man with teeth very yellow, I took advantage of that fact and secured a very good match.

DR. CLAPP:--I would like to mention a case that came under my observation a short time ago. It was in the right superior lateral, the mesial portion being turned outwardly a very little. I noticed that there was a slight defect extending a little above and below the enamel, but no decay. I think I examined this tooth two or three times before I discovered that there was a porcelain inlay at that point. On questioning the patient, I learned that it had been put in by Dr. Rollins, eight or nine years ago. I find diamond disks the best for grinding inlays.

DR. MERIAM:--I remember hearing of a dentist standing by the chair of Dr. Perry, in New York, and his showing an operation he had done of that kind; it is now probably seventeen or eighteen years ago. The dentist pointed out that there was a check in his tooth, when it was a tip Dr. Perry had put on.

PRESENTATION OF SPECIMENS.

DR. COOKE:--I wish to present a piece of steel which was sent me by Dr. Wetzel, of Germany. He got it from Geneva. It is very thin, and is a first-rate thing to use for a matrix, &c., and for passing in between the teeth where something very thin is needed.

A method of casting a plaster model where you take a bite and desire to get a model very quickly: First, cast one side, turn the impression over, place a double piece of bibulous paper over the plaster that is to form the tail piece and cast the other side. It comes apart without any trouble, doing away with shellac and oil, and is done with one mix of plaster.

DR. CLAPP:--A bit of vaseline will accomplish the same thing.

DR. COOKE:--I have never tried the vaseline. I have a rather interesting case, an extensive piece of bridge and crown work which the patient received some years ago from a firm who make a specialty of this work. The bridge on the right side had broken away, several abscesses had formed, and the condition of the mouth was far from satisfactory.

DR. SMITH:--Mr. President, right here, after Dr. Cooke's remarks in presenting this case of bridge-work, and knowing that he himself has performed some operations in bridge-work, I would like to ask if the result of his experience places him on record as universally condemning bridge-work.

DR. COOKE:--Far from it. I simply presented that as a specimen of bridge-work as performed in the nineteenth century. It was done by a firm that makes bridge-work a specialty.

DR. MERIAM:--These instruments, I think, have never been made in America. I had them copied by Mr. Schmidt. I present first the set of groove cutters or chisels for molars and bicuspids. I think you will find them about page 122, Appendix to Ash's Catalogue, 1886. They are of the well-known chisel form, and I will send around with them two made on my own curve. I like the Whitten Approximal Trimmers very much as a trimmer and also as a scaler, but I wanted something with a little suggestion of Dr. Lord's added to Dr. Whitten's, and in these the blade is flat and passes easily between the teeth.

While I am on the subject, I will show some of Dr. Lord's excavators that I have had made quite small, smaller than he has made himself, and for a simple proximal cavity where only one instrument is to be used, I think they are admirable. Dr. Lord only orders them in hatchet forms. Here are some hoes that I directed Mr. Schmidt to make for me; some of them have been rubbed down thinner.

Send subscriptions to the ARCHIVES to Dr. DeCoursey Lindsley, 321 N. Grand Avenue, St. Louis, Mo.

DISCUSSION OF DR. PARR'S PAPER:

IMMEDIATE SEPARATION OF THE TEETH.

DR. J. G. PALMER:--I do not think I have anything in particular to say concerning rapid separation. I have the separator that Dr. Parr describes in his paper, and I also have a set of Dr. Perry's. The latter is, perhaps, the most nearly universal in its application of any. I cannot say that I agree with the doctor in regard to separating so rapidly in all cases: in some cases it is probably advisable to do it, but I would rather follow the lead of Dr. Faught's paper, and go a little slow. I think going slowly in separating teeth is as useful as it is in some other cases cited in the paper.

DR. C. A. MEEKER:--I have used Dr. Parr's separator for three years, and prefer it to any of the others that I have used.

DR. PINNEY:--Sometimes, when you have a couple of nice little teeth to fill, and you want to get to work and get it done, and you know your patient is going to be so nervous for a week after, if you put rubber between the teeth, that you cannot treat them, it is a great pleasure then to put on your separator and slowly and gradually get those teeth apart, with just one little squeal, so that you can put in your two fillings. This little instrument is one of the best things we have: it does not work in all cases, but it will in nearly all. It should be used carefully; you should not move the teeth in a second, or in a minute, but work carefully with it and you will be surprised to find how many times you can use a separator to advantage. Patients are better satisfied to have their teeth separated in this way, than be compelled to wear rubber or tape, or something of that kind, in the mouth--they say those things tire them.

DR. PINNEY:--After you have gained the beautiful space by the use of tape or some other appliance, do you not have sore teeth. One good point in favor of the separator is, that after you get these teeth separated, the pressure of the instrument is so positive that there is no pain whatever during the operation of filling. But when you separate them with tape, the teeth are loose and sore, and a little pressure upon them causes intense pain. The pain is so much greater than that which caused the little squeal in immediate separation, that almost any one would prefer the squeal.

DR. FAUGHT:--I would suggest the use of a little cocaine just before the operation.

DR. JENNISON:--I do not like to disagree with my friend, Dr. Parr, because he has given us a great many valuable things. I have not had much experience in the use of separators, for the reason that I cannot get my patients to submit to them. The moment I put one on and begin to turn the screw, the patient exclaims: "Take that off; I cannot stand it," and I am compelled to take it off. Then in the use of the separator, I am always fearful of crushing the enamel, which I think is a very important thing to consider. With regard to separating immediately, it would be very desirable if we could do it under all conditions, or even under some conditions. I would like to see a separator of some sort for immediate use, and I have no doubt Dr. Parr can devise one, having plates not made of metal, and which will do the work of separating teeth without possible injury to the enamel. That, to my mind, is a very important point, and I agree with the essayist of the evening most emphatically that it is best to go slow in this matter. It has been said that teeth are sometimes so situated that you cannot pass anything through between them for the purpose of gaining space. When I find teeth in that condition, I introduce a piece of rubber dam; you can always get that in, and leave it there until the next day, and then I am usually able to put in something else, such as a bit of wood, which I generally use. I take time to separate. After I get space, if the teeth are still sensitive, I fill with gutta-percha and leave it for a few days, and soon the soreness is all gone.

DR. J. A. OSMUN:--I think it always best to be perfectly frank with your patients. If you must inflict pain, tell them you are going to do it, and why, but that you will be as careful as you possibly can, and you will find they will stand an immense amount of pain, and be satisfied when you are through.

DR. ADDLEBURG:--If you speak to the patients and tell them the operations will be painful, but that by inflicting pain you can serve them better, in most cases they will allow you to apply the separator, and they say it is much preferable to the old way of separating. I have some patients who will not allow me to use it, but most of them prefer the separator. Ladies especially say they prefer it, rather than have something between their teeth, when going into society; they would rather bear the little pain than the annoyance. I have used it for two years. After the teeth are separated I find them to be obtunded to such an extent that there is little pain in excavating and filling.

DR. EATON:--I want to add a word in favor of quick separation. For the last four or five years I have followed the practice of quick separation. If the separator fits property, and you use it with care, it does not cause much pain. As soon as you find you are inflicting pain, stop and rest a minute or two, and then you will be able to gain a little more space. The separator should not extend up to, or impinge upon the gum. A little gutta-percha under the bows of the separator will tend to keep it out of the gum and will also steady the separator. In some cases, where it is very difficult to keep the separator on the teeth, the placing of a little gutta-percha on the bows will overcome the difficulty, and the separator will stay in place, you can gain all the space required, and then the teeth are held firmly while you perform the operation of filling. Another thing: I have a number of dead laterals in my patients' mouths which I cannot account for in any other way than by slow separation. The pulps were not exposed at the time of filling, and yet a few months afterwards I found them dead. I believe the blood vessels were strangulated by holding the teeth in one position for so long a time.

DR. PALMER:--I fear I did not express myself very clearly in regard to the different separators. I have frequently used Dr. Perry's separators, and have taken them off and put on Dr. Parr's; and I want to say, that while I do not find Dr. Parr's separator universal, as claimed, it is more nearly so than any other: and I can do with it what I cannot do with any other. But I have failed to find any patients like those Dr. Pinney speaks of, who prefer the separator to slower methods of separating. Many ask me never to use one again. I have found best results from using pieces of rubber and keeping them there until sufficient space is gained. I think the difficulty in Dr. Eaton's case was that the teeth were not kept sufficiently solid: if they had been held firmly, the difficulty would not have occurred.

TEETH A COMBINATION OF CONES.

At the usual monthly meeting of the Manchester Odontological Society, on December 10th, Mr. W. A. Hooton showed a collection of bones and specimens of ancient implements and pottery recently discovered in a limestone cavern at Deepdale, near Buxton, including remains of a brown bear, Celtic ox, deer, wild boar, fox, sheep, horse, and other animals.

The skull of the bear, which was in fine preservation, was found imbedded in a mass of stalagmite more than a foot thick. The specimen was an old one, and the teeth had been subjected to very rough usage, being excessively worn down and many of the pulp cavities exposed. The canines had all been fractured and afterwards worn smooth, with the exception of the right upper, which was of full length and encircled by a band of erosion. There was no trace of the second premolars.

The skull of a Celtic ox showed portions of skin in a petrified condition still adherent, and there was also half the lower jaw of a calf.

In the clay were found portions of a stag's antlers of great size, somewhat softened by exposure to moisture.

Although no human bones have so far been met with, the signs of man's presence were conclusive, and that probably during the ancient British and Roman periods. One antler had been divided, and the tip smoothed and sharply-pointed; another was shaped, apparently for use as a spear head; and close at hand a small carved bone ornament, much blackened, and some bits of bronze were found.

We know that fires were made in the cave, for fragments of charcoal are preserved in the stalagmite.

The specimens of pottery are unfortunately much broken, but examples of Romano-British and also of Samia ware have been identified by Prof. Boyd-Dawkins, also pieces of hand-made pottery.

Dr. Shaw said that what had been exhibited by Mr. Hooton referred us back to that almost eternity of the past when the limestone was formed in which these caves are now found--a time before the appearance of vertebrate animals. And even when, inconceivable ages after it was formed, the limestone had risen from the shallow seas and became a part of the dry land, these caves must have been formed in it at a date so remote as to be almost incomprehensible to our mental grasp. And they had undoubtedly been, from a time of which we have no record down to clearly historical times, the homes of animals--man included. Many of these animals have, in only comparatively recent times, become extinct. In many of these caves, however, are to be found remains that show they have been the homes of animals now only to be found in hot climates, but were able to roam far north of their present habitations at that period when this island formed part of a great continent which was connected with Africa, and possessed an altogether different temperature than at present. The ruder kind of pottery to which Mr. Hooton referred are probably of Neolithic origin. In regard to the ornaments and better class of pottery found in these caves, it shows they have been at some time inhabited by a race greatly superior to the ancient riverdrift and cave-men, and their still later Neolithic inhabitants; and there can be no doubt they were the places in which the Celtic and Roman element sought refuge at the time of the fierce Saxon invasion.

THE TACOMA DENTAL SOCIETY.

We are in receipt of a copy of the constitution and by-laws of the above Society, which indicates that the dentists of the new State of Washington are abreast of the times.

"The object of this Society shall be to cultivate the science and art of dentistry, to promote among dentists mutual improvement, social intercourse and good feeling, and to collectively represent and have cognizance of the common interests of the dental profession in our city."

We take pleasure in giving to our readers the code of ethics of this new Society as being something new and original.

CODE OF ETHICS.

The members of the Tacoma Dental Society in the fulfillment of their duties to the profession, to the public and to each other, declare and accept as binding the following code of ethics as embracing such principles of honor, fairness and gentlemanly bearing as every gentleman of honor and self-respect should most willingly adopt.

SECTION 1. It is the duty of every dentist to maintain the honor, respectability and good name of the dental profession, and by a manly and dignified bearing, by studious habits and mental improvement, as well as by a conscientious earnestness in the employment of his skill for the welfare of mankind, to aim at securing a general recognition of the worthiness of the dental profession to rank among the honored and learned professions.

SEC. 2. He should so practice his profession that the community will esteem it above the art of a mere mechanican and above traffic wherein shrewdness and cunning are an essential part of the stock in trade.

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