Note (10) — CANTO SECOND.

This deformity generally arises from inattention during the time of shedding teeth. The remedy consists in removing the causes, of which there are many. The first is when the growth of the jaw is insufficient for the new set, and thus forcing them to crowd and overlap each other, by which the central incisors of the upper jaw are pressed forward, and thus forming what has been termed, from its shape, “a rabbit mouth.” In such cases, the extraction of one or more of the bicuspides from each side of the mouth is absolutely necessary, in order to bring the incisors into a regular arrangement, which, after this operation, is easily effected, by the occasional pressure of the thumb and finger, or by a judicious application of silken ligatures.

It is sometimes, however, necessary to apply gold plates, springs, and other mechanical contrivances, to bring them into a regular arrangement.

A second irregularity arises from supernumerary teeth. This takes place, most frequently, in the front teeth of the upper jaw, and thus gives it a most unseemly appearance. In this case it is likewise necessary to have recourse to extraction as soon as possible.

A third irregularity, and one of frequent occurrence, arises from one tooth projecting beyond another. This is easily remedied by removing the projecting part with a proper instrument.

A fourth irregularity consists in the teeth having formed themselves into ragged edges: and a fifth, in their having received fractures from blows or falls. The last two irregularities are principally confined to the front teeth, from their frequent action against each other, more especially when the back ones have been lost; and from being, by their situation, more exposed to accident. These irregularities are likewise remedied by removing portions from their cutting edges. This operation is not only one of the most useful, but it is often absolutely necessary; for diseases of the tongue and cheek are sometimes occasioned by projecting, or badly formed teeth: and it not unfrequently happens, that very useful teeth are extracted, to the future inconvenience of the patient, when the judicious removal of portions only would have answered every purpose; and that a partial loss of enamel from the cutting edges never produces decay, while the natural cavity in the tooth remains untouched, is evident from the well known practice of savage nations, who cut their teeth into various shapes without incurring any disease. When fractures are too extensive to be remedied by the above treatment, various circumstances, particularly the age of the person, must influence the mode of proceeding. If the fracture be of one tooth, and the person has not arrived at the age of maturity, the extraction of the fractured tooth, by giving the adjoining ones the opportunity of approaching each other, will render the defect but inconsiderable. When, however, such accidents occur at an advanced period of life, this kind of treatment can hardly be expected to be entirely successful; but as there is no other means of remedying the defect, unless it be the insertion of an artificial tooth, the earlier assistance is procured, the greater will be the chance of success. A tooth that has been knocked out without injury to its socket, will fasten again, if immediately returned and secured in its place.

Mr. Duval has the following judicious remark on this subject:—“It is from the age of six years to that of fourteen, being the usual period of the second dentition, that the teeth require the greatest care. When there is any disposition to irregularity, they ought to be inspected once or twice a year by the surgeon dentist, who can in almost all cases ensure a regular arrangement.” (page 27.)