I do sometimes think it better to wait for awhile, as the teeth cannot be put into the sockets as in the upper, but, as in the case I instanced just now, when it has been necessarry to insert at once, the teeth usually fit very well.

I have generally recommended a mouth wash of Condy's fluid or permanganate of potash, until the gums have well healed.

I should like to say here that, notwithstanding the very extraordinary case which Mr. Spence Bate mentions in the paper from which I have already quoted, of a woman who went mad after the extraction of a number of teeth, I believe that it is very rare for any untoward results to follow that operation. I cannot call to mind any other that I have heard of, although many times I have known patients to regret exceedingly that the stumps were not removed. I have never known a case during the nearly twenty years I have been connected with the profession of regret being expressed or any trouble ensuing after the removal. All my experience has been entirely the other way.

It will, no doubt, be felt by some that it must be somewhat inconvenient to be obliged to get the cases done so quickly, especially if several of them be in hand at once. It is inconvenient sometimes, but the result is worth the inconvenience and trouble. But if a judicious selection of teeth be made, there is so little fitting required that a case is very quickly got out of hand. I have in many instances cut the sockets in the model and put the teeeth all in order in ten minutes or a quarter of an hour from the taking out of the models, and given to my assistant to wax up and vulcanize at once.

Mentioning the fact of putting the teeth in order reminds me of one thing which I had almost forgotten to say, it is this-If men undertake to supply artificial teeth they should either see to the arrangement of them themselves or get an intelligent assistant who can see the patient's mouth and receive instructions in the surgery and then arrange the teeth artistically. How seldom do we see Nature's

irregularities copied, and how often do we see, much to our disgust, rows of teeth "set up" as regularly as the keys of a piano and the edges as even as if smoothed with a file? So frequently teeth are put into the mouths of elderly patients as perfect as we could wish to see at the age of blushing sixteen.

The depots provide us now with a marvellous assortment of teeth ready to hand, such as we can scarcely wish or imagine to be surpassed; but the hand and eye and brain of the dentist are all needed to so arrange and adjust them that they may be life-like, instead of obviously artificial. "The height of art is to conceal art" is a motto which every dentist should remember.

A little chipping of the corners, roughing slightly the polished surface, staining if necessary, and many other little devices which will occur to the mind in practice, go a long way in making our work satisfactory to ourselves and pleasing to our patients.-London Dental Record.

ARTICLE II.

PROSTHETIC DENTISTRY.

BY JAMES B. HODGKIN, D. D. S.

What is the condition of prosthetic dentistry in this country at the present time?

Although this question has been often answered in papers and reports of investigations read before dental societies, in discussions of the same, and in articles published in our journals, it is proposed again to call attention to it, and to continue to do so until the profession is induced, if possible, to remedy existing faults in that direction, which,

in some cases, come very near being, if they are not, crimes. The broad statement is made in the beginning, that while operative dentistry has, in the treatment of decayed teeth and diseases of the oral cavity, made giant strides and almost incredible progress, so far as both science and art are concerned, in the last thirty or forty years, prosthetic dentistry has, in both these respects, rather retrograded, than advanced, with the mass of practicing dentists. It cannot be truthfully denied that praise and credit for the former, as well as blame for the latter, belong to the dental profession; and it is a duty incumbent now, as it always has been, on its members, to remove the just cause for this blame.

The true cause for this seems to lie, and doubtless does lie, in the fact that in prosthetic dentistry the great study, as a general rule, has been to produce the cheapest possible substitutes for the natural teeth and oral tissues lost by the ravages of decay and disease. In this effort both art and science have been sacrificed to cheapness and ease of manipulation. In the face of the rule that "the beauty of art is to conceal art," there are comparatively very few cases in which artificial teeth in the mouth cannot be detected as such at a glance by the most casual observer. The teeth themselves are caricatures of the natural organs, not adapted in color, shape or arrangement, to the physiognomy of the wearer, while in the formation of the plates to which they are attached, no attention is paid to the restoration of the original and natural form and appearance of the face.

But this offence against art and esthetics is not so grave as that which, in the pursuit of cheapness, or in supplying the demand on the part of the mass of the people for cheap dental plates, is regardless and reckless of the pathological effects of some of the cheap materials used for that purpose.

It is very interesting to any one who has the inclination (I was going to say, and time; but if the inclination exists, the time can be found) to investigate this subject, having before him its conditions forty years ago, with the sub

stances since proposed for the material used for "bases" (to use a modern term) for artificial teeth at that time, and the consequent different manipulation required for each substitute. Gold was then the material for dental plates, platinum being used very rarely, while in many cases temporary plates were made of silver. The latter metal, however, was objectionable even for temporary plates, on account of its ready conversion into salts of silver in the mouth.

The two former have to this day held their places as being entirely unobjectionable, in a hygenic point of view, for any form of dental appliance, even though the gold should be alloyed with silver and copper down to an 18carat quality. It is universally admitted that these two metals and porcelain do not produce any deleterious effects on the oral structures and tissues, nor on the system generally. With the exception of pure block tin and a very few alloys formed into plates by casting, all the substitutes offered for these are more or less injurious, either locally or generally, or both.

While some alloys composed of base metals, as, for instance, Blandy's cheoplasty, have gone entirely out of use, on account of the chemical changes they undergo in the mouth, no metal or alloy formed into plates by casting, however unobjectionable in that respect, has come into general use, because of the uncertainty of making a good casting and the skill and experience required to overcome that difficulty. One of these causes, viz., the skill required, connected with the great cost of the material, and consequent high price to the patient, has driven out of general use artificial dentures made of gold or platinum, with porcelain, or of porcelain alone; but the fact still remains that they are the best, in every respect, that can be worn. They have to that extent been transplanted by the vegetable bases which have become so popular within the last twenty-five or thirty years, on account of cheapness and ease of manipulation.

The principal of these are India-rubber (caout-chouc) and cellulose, compounded with other substances to give the former hardness and color, and the latter plasticity under heat, and color. The compounds of these so formed and most used, are hard rubber, or vulcanite and celluloid. The former alone will be spoken of, as it has, since the expiration of the Cummings patent, been rapidly taking the place of the latter, on account of its greater ease of manipulation and its greater durability, and is now so generally used that it may be safely said that there are comparatively few artificial dentures made with any other material. It is admitted by all that the introduction and adoption of this material for dental bases has not been an advance step by the profession, either as regards art or science. It has certainly lowered very much the artistic standard of work in prosthetic dentistry. In a scientific point of view, it has been, in the opinion of a great many of the most prominent members of our profession, productive of serious injury by its effect on the mucous membrane of the mouth and subjacent tissues; so serious that its use has been condemned and its abandonment urged. These opinions, based upon careful observation of facts, have been frequently expressed, since 1869, and can be found on record in the proceedings of dental societies and associations all over the country.

The list of those expressing these opinions is long, and but few will be named. These are Drs. Taft, Atkinson, Chase, Watts, Walker, Cutler. Allen, Eames, Cushing, Morrison, Crouse; all so well known that their names have become familiar as household words in the profession.

The character and symptoms of the pathological conditions (known commonly as rubber sore mouth) produced by the use of rubber plates, have been from time to time described in the proceedings of Dental Societies and Associations, and vary from slight irritation of mucous membrane to ulceration of soft tissues and necrosed bone, with discharge of blood, ichor and pus. One of the worst characteristics of this disease is, that in its progress from simple