On some severe forms of disease arising from the retention of decayed teeth / by J.C. Clendon.

  • Clendon, J. Chitty (John Chitty), 1809-1870.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: On some severe forms of disease arising from the retention of decayed teeth / by J.C. Clendon. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    cavity and pressing on its softened parietes cause a slight pain, and the patient instinctively avoids biting on it in future. The decay extends ; and soon a minute orifice, per- haps not larger than a needle’s point, opens through the softened ivory into the pulp cavity : hot or cold fluids, or a draught of cold air, entering by this orifice, give rise to pain, which will presently subside, to be renewed perhaps daily, until in a little while, air entering freely, sets up inflamma- tion in the pulp, or, as it is erroneously termed, the nerve of the tooth. This pulp, a specimen of which I exhibit in its entirety, is the remains of the matrix in which the whole of the ivory of the tooth was formed, the portion remaining as pulp being intended to nourish the tooth up to a certain period of life. Small as it appears, it is made up of an artery, vein, absorbent vessels, and numerous filaments of the fifth pair of nerves, held together in a uniform and apparently inseparable mass by cellular tissue. These together form what is popularly con- sidered and called the nerve of the tooth ; and into this pulp, so constituted, blood is continually passing through a small foramen at the extremity of the root. Aretaeus, nearly two thousand years ago, described tooth- ache as a disease the cause of which is known only to God ; and altnough, since that period, comparatively few people have passed through life without experiencing it, I believe there are fewer still who could give any more satisfactory account of the immediate cause of their suffering. I consider the pain to arise from the free admission of air to the pulp, which so alters the condition of the venous blood that it cannot readily be returned by the vein ; while fresh blood being continually brought in by arterial action, congestion of the pulp ensues. Now, inflammation may, and generally does, occasion severe pain in any part of the body, even when the tissues are highly elastic and distensible: how much more must it do so when it takes place in a small canal of dense unyielding ivory, the distended vessels within which, press on the sensitive nerve-filaments, giving rise to a sharp, throbbing, or lancinating pain, simultaneous with each contraction of the left side of the heart. This—the congestion, swelling, and pain of the pulp—is what I call true toothache, and is very acute; it seldom commences before the twelfth or fifteenth year, and rarely occurs after thirty-five; the temporary teeth, and the six uppei and lower front teeth of the permanent set, are sel-