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
Catalogue details

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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    The pain is of a dull continuous nature, and heat and cold have not the same marked effect as in myelitis. Firm steady 'pressure on the tooth in this stage relieves the pain because the blood is driven out of the peri-odontal vessels. Percussion of the tooth (with a metal instrument) gives a painful response, whilst cotton-wool or other foreign material in the carious cavity causes no pain. There is usually some accompanying hypersemia and tenderness of the muco-periosteum over the affected tooth. In later stages pressure upon the tooth instead of relieving increases the pain, because exudation from the blood-vessels has occurred and no external pressure can make this return but only increases the pressure upon the nerve endings. If suppuration takes place the tooth becomes very loose in its socket, pus may well up between the gum and the tooth, there is considerable swelling of the muco-periosteum, hyperaemia of the buccal tissues with more or less cellulitis. The pain is intense, throbbing and continuous in character, and does not abate until the internal pressure in the abscess cavity is relieved by perforation into the labio-dental sulcus, or by diffusion into surrounding tissues or organs. The tooth is excessively tender and any pressure aggravates the pain. The condition is usually accompanied by a rise in temperature, loss of appetite, foul tongue, and constipa- tion. Chronic dental myelitis if associated with exposure usually leads to proliferation of the pulp tissue, forming a ‘ polypus 5 which more or less completely fills the carious cavity. This frequently causes loss of function of that side of the jaws—shown by the presence of a film of calculus and detritus covering the masticating surfaces of the teeth on that side. Chronic myelitis not associated with exposure of the pulp, but due to some form of slow continuous irrita- tion, frequently leads to fibroid or calcareous degeneration taking place. The former is usually painless, and the