Note (12) — CANTO SECOND.

There are instances, and those not a few, when relief can be afforded by no other means than by extraction; for this operation I prefer the improved forceps, in all cases where they can be safely applied, as being the best and safest instruments that can be used; but if the tooth is so much decayed as to render it likely to break where the points of the forceps embrace the tooth, I uniformly use a small key instrument, with the improvement I made on it many years ago, which is now in very general use, in England and in this country.

In order to do myself justice, I shall here make a short extract from Mr. Snell’s work, lately published in London, the author of which, in speaking of the instrument, forgot to make mention by whom the improvement was made. “The moveable bolster,” says he, “when in apposition to the gum, retains its relative situation, and the fulcrum of the instrument moves upon it; this I consider one of the most important improvements of the key instrument; its superiority over the old one is so evident, as to need no farther explanation.”—(page 100.)

On the subject of this improvement, Dr. Thomas Hare, of London, as early as 1821, in his celebrated treatise on the “Stomach and Alimentary Organs of the human body,” thus speaks: “The instruments hitherto in use for the extraction of teeth, have, to my apprehension, been deficient of that neatness and convenience for adaptation, which every operation on the human frame so justly demands. Besides his finished qualifications as a dentist, therefore, it gives me great pleasure to notice the merits of Mr. Eleazar Parmly, in contriving an instrument, admirable for its simplicity, which completely sets aside these obvious disadvantages.” (Pages 295, 296. London Edition, 1821.)

I make the following extract from Mr. Koecker’s work, to show that many persons have an unwarrantable antipathy to extraction; and that parents are frequently more in fault than their children, when resistance is made to the necessary performance of operations on the teeth. A want of decision on the part of parents, often subjects the child to serious injury, and the operator to many inconveniences, not the least of which is loss of time, which might be wholly avoided, if parents would send their children to the dentist with directions for his government, or submit them entirely to his management, when placed in his hands for the benefit of his advice or operations.

It is the case of a child about ten years of age. “I discovered,” says this writer, “several of her teeth to be carious, and proposed to remove the caries with a file, and to extract the first four large grinders, in order to prevent a recurrence of the disease, which had arisen from some irregularity of the teeth, owing to their crowded state.

“The poor child was greatly alarmed at this advice. Her eyes filled with tears, although her sisters, who were more familiar with the operation, where whispering her to be of good cheer. The affectionate mother was much grieved at the discovery, and the struggle between her good sense on the one hand, and her parental anxiety on the other, was so affecting, that I proposed another plan, by which I should be able to save all the teeth of her daughter. But to this proposal she would not consent, declaring that she was convinced my first advice was the best, and adding that she and her daughter would submit to the operation first proposed; desiring only a little time for preparation.

“About a week afterwards the little girl called upon me in excellent spirits; and after expressing her sorrow for not having submitmitted to the operation immediately, stated that her reluctance had principally resulted from the alarm of her mother, who had continued, ever since I last saw her, to express her wish that the operation should be performed, but had not courage enough to agree to its performance. She, the daughter, therefore, had at last resolved to come to me, without the knowledge of her mother; and having acquainted me with the circumstances, she sat down with sparkling eyes and a smiling countenance, and said: ‘Now, if you please, sir, I am ready!’

“I shall not attempt to describe my feelings on this occasion; but merely state, that, in less than five minutes, the four permanent first large grinders, the largest teeth in her mouth, were wrapped up in a piece of paper, and she went away with them in her hand, rather dancing than walking, to surprise and relieve her anxious mother from fear and apprehension.

“I leave to parents, and particularly to mothers, to judge of the mother’s feelings for so amiable a daughter.”

“It is remarkable,” says Mr. Fox, “but not less true, that there is scarcely any pain to which the human body is subject, that is so much under the influence of fear and hope, as the tooth-ache. This is experienced by almost every patient, and as constantly observed by every surgeon, by the pain generally leaving that individual who is under the immediate expectation of having the tooth extracted.

“Empirics are not wanting, who take advantage of this circumstance, and pretend to cure tooth-ache by certain charms and nostrums: indeed, at the moment, they appear to be successful, from the passions of fear or hope causing a temporary suspension of pain.

“The burning of the Antihelix of the ear, in order to relieve this complaint, must be ranked amongst the above methods of cure; it is one not worthy of notice, had it not been formerly a very popular remedy, and lately recommended in a periodical publication.

“The slightest knowledge of the distribution of the nerves to the teeth must convince every one, that a division of any part of the ear cannot separate the connexion that subsists between the teeth and the principal branches that go to the brain; and, therefore, no more benefit can be derived from this formidable operation, than may be attributed to the influence of fear.” (Fox on Human Teeth, Part II., p. 38.)