Stomatology in general practice : a textbook of diseases of the teeth and mouth for students and practitioners / by H.P. Pickerill.

  • Pickerill, H. P. (Henry Percy), 1879-1956.
Date:
1912
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Licence: In copyright

Credit: Stomatology in general practice : a textbook of diseases of the teeth and mouth for students and practitioners / by H.P. Pickerill. Source: Wellcome Collection.

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    whole of the normal pulp tissue may be entirely replaced by a dense fibrous network. On the other hand calcareous degeneration or the develop- ment of ‘ pulp nodules or stones ’ may give rise to con- siderable pain, neuralgic in type and difficult sometimes to locate ; it is more frequently found in patients of a gouty or c rheumatic ’ diathesis (Fig. 22). Since the effective treatment, even palliative, of pain in the teeth (odontalgia) is absolutely dependent upon a correct diagnosis, it is necessary in all cases to determine exactly to what stage the lesion has advanced before attempting to put any form of treatment into practice. The following table may be found useful from this point of view :— DIAGNOSIS OF ODONTALGIA Myelitis. Pain spasmodic, lanci- nating, and induced by stimulation. Pain relieved by de- flation and cold. Pressure on tooth causes no pain. Pressure in cavity causes sharp pain. Small red point of ex- posed pulp may be seen. Percussion causes no pain. No hypersemia, swell- ing, or tenderness of muco-periosteum. Periodontitis. Pain dull and continu- ous. Pain not much affected by cold and not at all by ‘ sucking ’. Pressure on tooth first relieves pain and later increases it. Causes no pain. Pulp either suppurat- ing, gangrenous, or decomposed. Tender to percussion. Muco-periosteum ten- der and reddened. Alveolar Abscess. Pain excessively acute and continuous. Condition too painful to apply either of these. Pressure on tooth causes intense pain. Causes no pain if the tooth be held perfectly firm and still. Pulp cavity filled with decomposing debris and organisms. Percussion cannot be tolerated. All the typical signs of an abscess. Heat, red- ness, pain, swelling, fluctuation, and loss of function. Pain may be referred from one tooth to another, usually to one situated more anteriorly in the same jaw or to the corresponding tooth in the opposing jaw, but never to a tooth