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PROCEEDINGS OF DENTAL SOCIETIES.

NEW YOBK ODOFTOLOGIOAL SOCIETY.

The New York Odontological Society held a regular monthly meeting, Tuesday evening, March 17, 1885, at the residence of Dr. 0. E. Francis, No. 33 West Forty-seventh street.

The president, Dr. William Jarvie, in the chair.

Dr. J. Morgan Howe. Before the regular order is entered upon I would like to say a word or two. It is known to most of us, probably, that at the last regular meeting we expected to have had the pleasure of the presence of a number of our distinguished friends from Chicago, and of listening to a paper by Dr. Harlan. It is also known that they were detained on the way by a snow-blockade, much to our disappointment. Although the society had the pleasure of entertaining them at dinner the following evening, that is only half the loaf we had expected. I move, Mr. President, that the secretary be requested to communicate with Drs. Harlan, Brophy, Gardner, Ames, and Eeid, expressing the regret of the society that they were unable to be with us at our last regular meeting; and I move that the paper of Dr. Harlan be published in connection with the transactions of that evening.

Dr. Howe's motion was carried.

Incidents Of Office Practice.

Dr. S. Gr. Perry. I have brought with me this evening a cast, showing you at a glance what can be done by over-brushing the teeth. For twenty years the patient has brushed vigorously, using the Oriental Tooth-paste. The grooves were so deep that the pulp of the lower left cuspid was exposed, and that exposure brought him to my office. The pulps of the upper centrals and Jaterals were almost exposed, being just covered with a thin layer of dentine, —so thin and transparent that the rosy color of the pulps underneath was very perceptible.

While I am on my feet I will mention a number of cases that I have had in the last few years of broken teeth, the broken pieces of which I have simply dovetailed and placed back in their positions, using ox^phosphate of zinc. In one lady's mouth I have four such broken outer cusps of bicuspids, two of which have now remained in position for a number of years. Even thin pieces of broken teeth can be dovetailed with the minim burs so as to hold quite well when the cavities which generally underlie them are filled with the oxyphosphate. It is a great comfort to the patient to have a broken tooth replaced and secured in a few minutes. Also, in several instances where natural teeth were broken off completely, I have placed them back on their roots, drilling into the root and setting a post, and then drilling the broken crown and setting it over the post with the oxyphosphate as if it were an oldfashioned pivot tooth. This can be done even when the teeth are broken—as they generally are—somewhat transversely.

Dr. F. Y. Clark. How do you know it was over-brushing the teeth that caused the abrasion mentioned in connection with the cast?

Dr. Perry. I have every reason to believe so, because the man told me he was a vigorous brusher; and he is a right-handed man, as you will see by the cast; the teeth on the left side show more abrasion than those on the right side of the mouth. Would you not think it was done by brushing?

Dr. Clark. Yes, it looks very much like it. I have just received a brush from Dr. B. F. Arrington, of Wilmington, N". C, which is designed to overcome that trouble, and it is believed by many that it will do so if it is caused by brushing. It is intended to brush the teeth longitudinally, and is the most practical brush for the purpose that I have seen.

President Jarvie. These cases that are related here in this way are frequently of more value on account of the line of thought they carry us into than the actual cases themselves are. Dr. Perry suggests that this case is one of mechanical abrasion; and it is evident that other gentlemen in the room believe it is brought about by something quite different. If there is any such thought, this is surely a good time to express it, in order that we may gain something by the case that has been presented.

Dr. Clark. The reason I asked the question is that I had in mind at the time a case that I saw thirty years ago, in the mouth of a person who never used a tooth-brush,—a case of the same kind of abrasion. I cannot account for it; certainly brushing will not account for it in the case I speak of.

Dr. C. E. Francis. I doubt very much that this abrasion is caused wholly by the use of the tooth-brush. I have seen many cases in my practice where teeth were very badly abraded, in which I am satisfied that the brush was not the cause. Only this morning a gentleman came into my office with his teeth cut almost into the pulp-chambers, so that you could see the pulp through the translucent secondary dentine. The teeth were cut away not only on the labial and buccal surfaces, but also on the palatine surfaces, where the brush could not reach them. They were as smooth as glass. It was astonishing to me, and I could not account for this peculiar appearance. I do not think it is due to over-brushing; the gentleman tells me that he brushes his teeth very little; indeed his teeth were badly stained, and quite yellow from extraneous matter. It is unaccountable to me how this peculiar abrasion occurred.

Br. John B. Kieh. I have in my practice a patient whose teeth have been under my care for fifteen or twenty years,—a gentleman who does not use tooth-powder, and who always uses a soft brush* by my direction, and his teeth are denuded in spots all over; different parts of the teeth are worn away, in many cases, as though they had been filed. All of the teeth in his mouth are affected in that way. The abrasion does not follow the track the brush would take, but sometimes takes a different angle. It is a singular case. The process of denudation goes on all the time, and the destruction is becoming so great that I do not know what to do to remedy it. When it is confined to a certain line it can be remedied by cutting away and filling, but this is a case in which I should have to cover the whole crowns of the teeth with gold. Many of the teeth are denuded for fully three-fourths of their length above the gum. This denudation cannot be caused by over-brushing.

Dr. Perry. I think we have all seen cases of abrasion in which brushing is not one of the factors; but I exhibited this case believing that it was one where the wasting away of the tooth-substance might be due to over-brushing, because the gentleman said he had been a vigorous brusher for twenty years; and you see that he is a right-handed man; where he has used the right hand most vigorously is where the teeth are grooved the most. Where the brush does not touch the teeth are not grooved at all. I would not claim that the brush, unaided by the solvent action of an acid, could work this mischief; but I certainly do think, if the brush in this case had been used less vigorously, or had been used intelligently, that these deep grooves would not have been formed.

Dr. Clark. I remember that a number of years ago I worked several hours with a lathe-brush and percipitated chalk, and all the ordinary tooth-powders, upon teeth which I had extracted, and it had no effect upon them other than to leave a smooth, polished surface. If any of you, gentlemen, will try that experiment, I think you will find that several hours' work with a brush and the ordinary tooth-powders will have no effect except to produce a smooth, polished surface. I cannot believe that brushing alone will produce the abrasion of teeth spoken of here, and that we frequently see. I believe one great factor in that destructive process is some agent that is floating around the margin of the gum.

Dr. Perry. Why is it that there is no abrasion, comparatively, on the right side?

Dr. Clark. That seems to be a good argument in favor of your theory. I have four or five teeth in my own mouth that are worn away in that way just above the margin of the gum. This abrasion usually occurs near that point; the grooves take a certain direction, following the line of the gum; and I think it is reasonable to suppose that there is some agent floating around the margin of the gum—call it bacteria or what you will—that causes it. I am not willing to say that injudicious brushing does not accomplish more or less of this destruction, but I am fully satisfied that the brush is not the only factor.

Dr. Kingsley, Dr. Clark says, with reference to abrasion, that he has worked away upon teeth with wheel brushes and powders, and could produce nothing but a polished surface. The effect that would be produced by that operation I think would depend entirely upon the condition of the teeth experimented with. There are teeth in some mouths in such condition that if you should treat them in that way they would be cut away pretty rapidly. There is something besides the brush to be considered in some of these cases. We have all of us seen teeth that at times seemed bordering upon disorganization, really almost to dissolve away, and at later periods the same teeth seemed to have recovered their tone. It is rare that all the teeth in the same mouth show this condition at the same time. It is more commonly one or two, or at most a limited number. I have my doubts if this wasting of surface, even to the extent of grooveforming, is wholly due to local external agents. Nevertheless, teeth in that condition would yield more readily to active brushing than at some other periods. These teeth I believe have been affected by the brush, but I do not think it is the brush alone that causes the wasting away. The transverse lines of the grooves indicate the brush.

I wish to improve this opportunity to do a little bit of tardy justice. You will remember that something like a year ago the matter of crowns being struck up from a single piece of metal was under discussion. I think Dr. Jarvie brought before us an example of crowns which had been struck up in his office from a single piece, and I made some remarks at that time. It seems that after that discussion was published it attracted the attention of Dr. Creager, of Fremont, Ohio, and he sent me a couple of crowns, mounted on a plaster cast, which he said were struck from a single piece, and were copies of what he had done two or three years before; and he wanted me to present them to the Odontologieal Society, as showing that he had done this kind of work before Dr. Jarvie did it. They did not reach me, I believe, until after the Odontologieal Society had adjourned for the summer. I will pass them around now, so that proper credit may be given to the gentleman.

About a year ago my favorite twist drill (I think we all of us find, sooner or later, some one instrument that becomes a favorite) got its point broken off, but it was a better drill after the point was broken off than it was before. I have learned by that, whenever a twisted drill fails to cut, to just break off a little bit of the end, and it will be better than when it was new.

Dr. Abbott. I want to return, for a moment, to the subject of what is called horizontal grooving, or cutting away of the teeth by brushing. Lately it has seemed to me that we see more of this than formerly. I have always contended that it was due, in the first place, to the action of some solvent of the lime-salts, and then the brush cuts away the material that had been softened by the action of this solvent, which is probably some acid. I have discovered still further, I think, that in all these cases the beginning of the difficulty is natural horizontal grooves in the enamel of the teeth themselves. I have two or three cases in my mind, one in my own mouth in particular, which is perfectly conclusive that this natural condition must be the cause, or tends to produce it. A great many incisors are grooved about half the distance from the gum to the cutting edges,—i. e., they have a wavy appearance. As the brush passes across them the bristles are brought into the little hollows or depressions between the waves more emphatically than upon the elevations or waves themselves, consequently cutting away more rapidly. The enamel being thinner in these depressions, it is soon cut through. The dentine being softer and more readily affected by both the acids and the brush, a case of quite extensive horizontal grooving is soon the result. I had a patient in my chair to-day on whose upper front teeth there is certainly not more than one-quarter of the enamel left; it has been almost entirely removed by brushing and the action of acids. The teeth originally had this peculiar wavy enamel that I have spoken of.

Dr. La Eoche. In the case you have just described, did you notice more abrasion on one side of the mouth than there was on the other?

Dr. Abbott. If anything, I think the abrasion on the left side of the mouth was worse than it was on the right. The brush is almost always used the hardest on the left side.

Dr. La Eoche. Could you give any other reason?

Dr. Abbott. No.

Dr. La Eoche. When a person masticates mostly on one side of the mouth, I think you will find the same state of affairs. There is a deposit on the teeth that is natural to almost every mouth, and I have observed that on the side that is used most and brushed most this abrasion occurs. There is a deposit on the side that is not used, which I think protects the teeth from this abrasion. I have one

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