Evening star. [volume] (Washington, D.C.) 1854-1972, 1892-01-30

III r. Js u lSS sSo poAh - Cous0u W
~N~Sh9 "a worm in the tooth;"
VA M/l II he proves by breaking
@9 S it open and exhibiting
~ Ms Il, what looks not unlike q
f-V lD worm, the nerve, or,
A3A 80 more properly. the pulp
GJ Of the tooth. As q
matter OF fact. as all who are posted in dental
pathology know, pain in tooth may be brought
about by any one or more Of a number of dis
eased conditions. So that we may see If we
study what is technically known as dental
pathology (pathos-pain or suffering, and
logos-a discourse) that instead of a single
cause two or more may coexist Still it is not
probable that more than one cause for pain in
the teeth is likely to be present at one time.
Dentists often have their patients exclaim
| when having their teeth operated on: 'Oh. why
do my teeth have nerves in them? What use
are they. anyhow And if the dentist 10 dis
| posed to do more in the way of instruction
| than simply to answer, because they we're
| made SO, he will explain that the portion Of
| the tooth popularity called the nerve, but tech.
nically and scientifically the pulp" is so far
| indispensable to the tooth that he may say,
mo pulp. no tooth" That is. the pulp, SO to
speak, is the germ of the tooth, the tooth
| former or builder.
THE PULP AND IT'S DEVELOPMENT.
| Look at a grain of corn on the cob. We call
1t roasting ear" in the green or immature
state. Later on it gets so hard as to require
| the milestone to pulverize it. Something like
| this grRiu of green corn is the tooth when
first formed. 1t il all pulp. SO to speak,
and is, in the language of physiology, very
| vascular, full Of blood vessels and nerves
| 1t is covered with membrane or membranes
whose function it is to select from the blood cir
| culating SO freely through it such substances
as go to make up the hard part of the tooth
| lime salts. phosphates and carbonates.
| This selective function of membranes is one
| of the most curious and wonderful Of all physi-
| illogical operations. That one membrane
| should be so constructed as to take lime salts
from the blood current and appropriate it to
| the building up of the tooth. while another
| takes from the same circulating fluid the lime
| salts that make bone, and still another takes
| that which makes another tissue, is indeed
mystery. But these membranes which are en-
gagged in tooth building make, it seems to me-
nicer determinations than any others OF the
| tissue builders, for they have to make the hard
| almost hint-like enamel, the dentine, much
softer, but still quite dense, and the cementum,
| or bony substance. which covers the root of
the tooth. SO the pulp goes on tooth building,
making a wall, so to speak, about itself until it
| Is shut in, only leaving a small opening at the
| end of the root, through which the small vessels
| pass which keep up its connection with the
| general circulation.
We can all understand that il this outlet
or inlet were closed the pulp would die as
| thoroughly as an amputsted finger. And we
| can further readily see that if in any way the
pulp should become diseased its chances for
living are less than if it were not SO boxed up
by its dense tooth walls.
COMMON CAUSE OF roorHAcHr
Inflammation Of this dental pulp is by far
| the most common cause Of toothache, and it il
usually brought about by exposure of the pulp
to external irritants. Decay penetrates into
the pulp chamber and at once exposure to air
to particles of food, to changes of temperature,
to fiuids-anything almost in contact with it
sets up irritation.
There is an old Latin phrase, "Ubi irritatio,
ibi fuIus'-where there is irritation to that
part is the flow (of blood. And this is uni
versally true of all tissues. A pin scratches
the surface and at once it reddens, showing an
additional flow of blood to that part So lust
SO soon as the pulp is irritated from any cause
there is an increased flow of blood into the
pulp, coming i'll through the small vessels
which enter the canal at the extremity OF the
root.
We all know what happens when blood flows
into wounded or irritated part-it swels.
So the tooth pulp when irritated swells The
amount OF swelling might be uncomfortable il
II occurred in another organ, as for instance
in the muscles Of the hand or the tongue. But
shut up as Is the pulp in its bony casing the
pain becomes excruciating. What causes the
pain? The answer is, pressure on the nerves
of the pulp by its engorged blood vessels.
This Is a familiar fact and is one of the most
common causes Of neuralgia. Could the tooth
be split probably the pain would cease.
PULP STONE.
One of the most tantalizing of tooth Mains ia
caused by what is known as a pulp stone.
What was said above about the pulp being
tooth builder will be remembered. This build
ing goes on slowly, possibly internationally.
during life, SO that the walls Of the tooth of ar,
old man are much thicker and the pulp much
smaller than in youth In addition to this
| slow decrease Of the size Of the pulp. there is
also an increase of density Of the tooth sub
stance, an old tooth being harder than Young
one. But there Is also sometimes set IN from
causes very obscurely known a formation in
the pulp itself which Is the cause Of great
amount OF suffering. little nodule Of dem
tine related to the pulp somewhat like the
pearl is to the oyster, begins to be formed in
the substance OF the pulp, only it does not have
| to have nucleus, as in the case Of the pearl-a
little spicula of dsntine, Sometimes adherent to
the pulp wall sometimes not, which grows and
grows until the unfortunate tooth posseasor i.
Wild with neuralgia pain. The worst thing
about this disease is that it is fond Of ATTACKING
perfectly sound teeth, or teeth free from decay.
and tina, 1t can only be diagnosed inferentially.
| As for the remedy, there is nothing to do save
to drill in and extirpate the pulp and get rid of
both it and the stone together.
| Grasp one OF your molars, II you have anv
left, firmly with finger and thumb and you will
| AhN W Soh uONc ~ bISutly In Its socket
1t is not tight. as nail in a board for EXAMPLE.
| 1t does not In fact come in direct contact with
| the jaw bone, but an intervening membrane
perldentlum, periosteium, pericementum-any
| one of these names will describe it sufficiently
| well-lines the socket in which the moiar Is
| lodged. This membrane is the seat of disease
sometimes. 1t swells from irritation Of some
sort and the tooth seems suddenly TO have
grown longer. and when the others are shut
against it exquisite pain is the result.
| DISEASE OF THE TOOTH.
Then, again, the root Of the tooth itself In sub.
ject to queer disease called exortosis or ex.
cementoas, and grows larger, sometimes caus-
| ing good deal Of trouble, but chiefly trouble
| when the unfortunate tooth has to be ex.
| tracted, for it - found to be then almost lit
| orally riveted in, the end OF the root having a
bulb on it, effectually preventing extraction
except at the expense Of the bone. which has
| to give way first.
| A troublesome disease, and one sometimes
the cause of a good deal Of pain, 10 recession of
the gums. This leaves part of the root bare
| (the root has no protective enamel covering).
and SO the cementuric becomes sensitive and
painful
Still another cause Of pain In teeth 10 from
wear. They get ground off on their surfaces
| by the daily milestone work they are called on
to perform until the dense enamel disappears
and the dentine is exposed. Then they become
sensitive TO heat and cold, to sweets and sours.