Care Of The Teeth - Duty Of Dentists
( Originally Published Early 1900's )
There is, perhaps, as much oversight or neglect by the average dentist, in the matter of cleansing the teeth, in the ordinary cases that come to his care, as in any other particular in practice. How often it is that teeth that. have been recently filled will exhibit upon their surfaces more or less of foreign matter, usually salivary calculus! This is sometimes removed from the exposed surfaces, while it is permitted to remain in considerable quantities beneath the margin of the gums.
When the care of a set of teeth and the mouth is committed to the dentist, the first step, so far as treatment and manipulation is concerned, is to render all the teeth thoroughly clean, removing every particle of foreign mat-ter, and polishing the surfaces as perfectly as possible ; giving particular attention to all rough and abraded places. The gums should be rendered healthy and freed from all irritants. In proper and systematic treatment this should precede the operation of tilling. Still, in some cases, it will be necessary that all go on together, but the rule should be that thorough cleansing precede the operation of filling.
Cleaning the teeth and making the mouth healthy is as important as, and, indeed, more so in some respects, than the operation of filling decayed teeth.
If the profession could feel the full importance of this, better success would attend the operation of filling.
He who neglects the condition of the mouth in respect to health and parity, and simply fills teeth, irrespective of these conditions, does both himself and patient great injustice. Such operations, however well performed, are far less efficient than they would be if the mouth were kept clean and free from disease. Nor is it enough that the month be made healthy and pure, but it must be kept so, if the work of the dentist is to be of permanent service. And in order that this good condition of the mouth be maintained the patient should have a clear understanding of its importance, and of the means by which it is accomplished, and be made to feel that it is mainly dependent upon himself. It is the duty of the dentist, not only to fully impress this fact upon the mind of his patient, but also to give him all needed information as to the means to be used.
In order that the mouth be kept in proper condition, it should be examined thoroughly once in from four to twelve months ; with some as often as every four months ; with others once in twelve months will suffice. The dentist who has the best interest of his patients at heart, and a just appreciation of his own reputation, cannot afford to dismiss them indefinitely, or until the patient finds something breaking down, or is admonished by the pain of some active disease.
It is very often that quite faulty filling in mouths kept healthy and clean seem entirely to arrest decay of the teeth in which they are; while in mouths that are neglected, impure, and diseased, the most perfect fillings utterly fail to save the teeth for any considerable time.
Were dentists as careful in this matter as they ought to be, there would be far less of failure in operating upon the natural teeth than is at present realized ; and the appreciation of the service of the dentist would be much greater, and his reputation of a higher order than at present, a result to be greatly desired.
Toothpicks. At the temperature of the mouth, only a few hours is sufficient to induce a putrefactive change of particles of food left between the teeth. They should be removed with the quill or wooden toothpick, or with floss silk. Silk is preferable, as it can be passed between teeth that stand in contact, and effectually cleanses the surface that cannot be reached by the pick or the brush. If this be too expensive, linen threads, such as are used by shoemakers, may be substituted.
Toothbrushes should be used with great thoroughness every night and morning, and, if practicable, after every meal. Great care should be taken, however, to select brushes not too harsh and stiff, as they may do much harm to the gums. On the other hand, if brushes are too soft, the teeth will not be well cleansed.
Powders should always be used, as by their help the sticky mucus is more thoroughly removed and the surface kept smooth and polished. The chalk of which they are most h made, has also an affinity for the acids, thereby protecting the teeth. Soap is very cleansing, and may be always used to advantage. Most of the powders before the public may be considered reliable. The chalk and orris, of which they are chiefly made, are so cheap that there is no inducement for adulteration.
Washes for the teeth and gums may he used, but care should be taken to avoid those which are astringent. Such may be used to advantage in case of diseased gums, but in a state of health the teeth and gums need to be cleansed, not medicated.