Note (34) — CANTO THIRD.
Reading edition
“The pain commonly termed the tooth-ache is one of the most excruciating to which we are liable. It is caused by an inflammation of the membrane lining the cavity. In inflammation, one of the consequences is a swelling of the part, which is generally followed by a diminution of the pain, the degree of which seems to be regulated by the resistance and compression which the inflamed vessels suffer from the surrounding parts. The membrane of the tooth being situated within a cavity which is incapable of extension, there must necessarily exist an insurmountable obstacle to the swelling of the membrane; and this it is which renders the pain so extremely acute. In some few instances, caries will proceed without being accompanied by any sensations; the tooth gradually breaks away, until the whole of it is removed.” (Fox, Part II. p. 25.)
“The pain called tooth-ache, which Galen very properly considered the most cruel and grievous of all pains that are not mortal, seems clearly to be occasioned by decayed portions of bone, no matter how minute, acting by contact on the nerves of the teeth.—And I firmly believe the pain is never felt until the caries, which always acts from without inwards, has actually met a branch of nerve.
“No species of animal matter, in a state of decay, is so offensive to the vitality of the adjoining substance, whether nerve, or muscle, or membrane, or any part or portion of the living body, as decayed bone. How very small a portion of decayed bone in a tooth is capable not only of causing the most agonizing pains, but also of communicating a fœtor to the breath, is inconceivable by those who have not pursued the inquiry with minuteness: and this offensive matter, when it thus has an opportunity of acting, communicates, through the medium of the nerves, a sympathetic pain to the teeth which are perfectly sound.” (Hare on the Stomach, p. 240.)
In addition to the preceding remarks, I observe, that the tooth-ache is sometimes so severe as to produce alarming derangements of health; while at other times it is merely an annoying sensation, which can scarcely be termed pain. The cavity of the tooth, in most cases, is the original seat of this malady. But as the teeth are supplied by ramifications of those nerves which supply different parts of the face and head, it frequently happens that one or more of those parts may suffer more severely than the tooth itself.
Diseases in the wisdom teeth of the lower jaw affect the ear; and when those of the upper jaw are diseased, the temples generally become affected. The effects of disease in one tooth, from nervous influence, is sometimes felt in the opposing tooth of the other jaw.
No certain treatment can be laid down for the tooth-ache; it must be regulated entirely by a knowledge of the cause, whether arising from decay, the irritation of tartar, the application of cold, or merely as a sympathetic affection. The disease which occasions this malady is insidious in its progress, dangerous and sometimes fatal in its consequences; but the danger more frequently arises from an improper application of remedies, than from the disease itself. Powerful remedies for the tooth-ache, as well as for other diseases, are hazardous in the hands of the ignorant.