Part 3

DR. SMITH:—Mr. President, right here, after Dr. Cooke's remarks in presenting this case of bridge-work, and knowing that he himself has performed some operations in bridge-work, I would like to ask if the result of his experience places him on record as universally condemning bridge-work.

DR. COOKE:—Far from it. I simply presented that as a specimen of bridge-work as performed in the nineteenth century. It was done by a firm that makes bridge-work a specialty.

DR. MERIAM:—These instruments, I think, have never been made in America. I had them copied by Mr. Schmidt. I present first the set of groove cutters or chisels for molars and bicuspids. I think you will find them about page 122, Appendix to Ash's Catalogue, 1886. They are of the well-known chisel form, and I will send around with them two made on my own curve. I like the Whitten Approximal Trimmers very much as a trimmer and also as a scaler, but I wanted something with a little suggestion of Dr. Lord's added to Dr. Whitten's, and in these the blade is flat and passes easily between the teeth.

While I am on the subject, I will show some of Dr. Lord's excavators that I have had made quite small, smaller than he has made himself, and for a simple proximal cavity where only one instrument is to be used, I think they are admirable. Dr. Lord only orders them in hatchet forms. Here are some hoes that I directed Mr. Schmidt to make for me; some of them have been rubbed down thinner.

H. L. UPHAM, D.M.D., _Editor Harvard Odontological Society_.

* * * * *

Send subscriptions to the ARCHIVES to Dr. DeCoursey Lindsley, 321 N. Grand Avenue, St. Louis, Mo.

DISCUSSION OF DR. PARR'S PAPER:

IMMEDIATE SEPARATION OF THE TEETH.[5]

DR. J. G. PALMER:—I do not think I have anything in particular to say concerning rapid separation. I have the separator that Dr. Parr describes in his paper, and I also have a set of Dr. Perry's. The latter is, perhaps, the most nearly universal in its application of any. I cannot say that I agree with the doctor in regard to separating so rapidly in all cases: in some cases it is probably advisable to do it, but I would rather follow the lead of Dr. Faught's paper, and go a little slow. I think going slowly in separating teeth is as useful as it is in some other cases cited in the paper.

DR. C. A. MEEKER:—I have used Dr. Parr's separator for three years, and prefer it to any of the others that I have used.

DR. PINNEY:—Sometimes, when you have a couple of nice little teeth to fill, and you want to get to work and get it done, and you know your patient is going to be so nervous for a week after, if you put rubber between the teeth, that you cannot treat them, it is a great pleasure then to put on your separator and slowly and gradually get those teeth apart, with just one little squeal, so that you can put in your two fillings. This little instrument is one of the best things we have: it does not work in all cases, but it will in nearly all. It should be used carefully; you should not move the teeth in a second, or in a minute, but work carefully with it and you will be surprised to find how many times you can use a separator to advantage. Patients are better satisfied to have their teeth separated in this way, than be compelled to wear rubber or tape, or something of that kind, in the mouth—they say those things tire them.

DR. FAUGHT:—I would like to say a word about that one little squeal that has been spoken of. I do not think we dentists quite appreciate what that one little squeal means. I think it means a feeling of fear and distrust in our patients for years afterwards. I believe also that when we avoid giving pain to a patient, or stop a slight pain, it pays in our dealings with the patient in future years. They never forget it, but we forget them because we see so many of them, but each patient remembers that somewhere in his or her mouth there was one little turn given that caused intense pain, and they remember that _you_ did it. It always causes a feeling of dread when they sit in our chairs again for another operation. I believe that we should, more than we do, try to protect our patients from every annoyance, however slight, even at the expense of a little more time. There are many cases where the use of mechanical separators is unobjectionable, and when it facilitates such work. I wish to call your attention to a method of separating not my own. It is the use of a little piece of tape. I hand a little piece of tape to my patient with instructions how to use it, and in the course of four or five days the necessary space is obtained, and quite painlessly. When they return the mouth is in condition for the operation, and they do not seem to have hurt themselves, and _you_ have not hurt them.

DR. PINNEY:—After you have gained the beautiful space by the use of tape or some other appliance, do you not have sore teeth. One good point in favor of the separator is, that after you get these teeth separated, the pressure of the instrument is so positive that there is no pain whatever during the operation of filling. But when you separate them with tape, the teeth are loose and sore, and a little pressure upon them causes intense pain. The pain is so much greater than that which caused the little squeal in immediate separation, that almost any one would prefer the squeal.

DR. FAUGHT:—I would suggest the use of a little cocaine just before the operation.

DR. JENNISON:—I do not like to disagree with my friend, Dr. Parr, because he has given us a great many valuable things. I have not had much experience in the use of separators, for the reason that I cannot get my patients to submit to them. The moment I put one on and begin to turn the screw, the patient exclaims: “Take that off; I cannot stand it,” and I am compelled to take it off. Then in the use of the separator, I am always fearful of crushing the enamel, which I think is a very important thing to consider. With regard to separating immediately, it would be very desirable if we could do it under all conditions, or even under some conditions. I would like to see a separator of some sort for immediate use, and I have no doubt Dr. Parr can devise one, having plates not made of metal, and which will do the work of separating teeth without possible injury to the enamel. That, to my mind, is a very important point, and I agree with the essayist of the evening most emphatically that it is best to go slow in this matter. It has been said that teeth are sometimes so situated that you cannot pass anything through between them for the purpose of gaining space. When I find teeth in that condition, I introduce a piece of rubber dam; you can always get that in, and leave it there until the next day, and then I am usually able to put in something else, such as a bit of wood, which I generally use. I take time to separate. After I get space, if the teeth are still sensitive, I fill with gutta-percha and leave it for a few days, and soon the soreness is all gone.

DR. J. A. OSMUN:—I think it always best to be perfectly frank with your patients. If you must inflict pain, tell them you are going to do it, and why, but that you will be as careful as you possibly can, and you will find they will stand an immense amount of pain, and be satisfied when you are through.

DR. ADDLEBURG:—If you speak to the patients and tell them the operations will be painful, but that by inflicting pain you can serve them better, in most cases they will allow you to apply the separator, and they say it is much preferable to the old way of separating. I have some patients who will not allow me to use it, but most of them prefer the separator. Ladies especially say they prefer it, rather than have something between their teeth, when going into society; they would rather bear the little pain than the annoyance. I have used it for two years. After the teeth are separated I find them to be obtunded to such an extent that there is little pain in excavating and filling.

DR. EATON:—I want to add a word in favor of quick separation. For the last four or five years I have followed the practice of quick separation. If the separator fits property, and you use it with care, it does not cause much pain. As soon as you find you are inflicting pain, stop and rest a minute or two, and then you will be able to gain a little more space. The separator should not extend up to, or impinge upon the gum. A little gutta-percha under the bows of the separator will tend to keep it out of the gum and will also steady the separator. In some cases, where it is very difficult to keep the separator on the teeth, the placing of a little gutta-percha on the bows will overcome the difficulty, and the separator will stay in place, you can gain all the space required, and then the teeth are held firmly while you perform the operation of filling. Another thing: I have a number of dead laterals in my patients' mouths which I cannot account for in any other way than by slow separation. The pulps were not exposed at the time of filling, and yet a few months afterwards I found them dead. I believe the blood vessels were strangulated by holding the teeth in one position for so long a time.

DR. PALMER:—I fear I did not express myself very clearly in regard to the different separators. I have frequently used Dr. Perry's separators, and have taken them off and put on Dr. Parr's; and I want to say, that while I do not find Dr. Parr's separator universal, as claimed, it is more nearly so than any other: and I can do with it what I cannot do with any other. But I have failed to find any patients like those Dr. Pinney speaks of, who prefer the separator to slower methods of separating. Many ask me never to use one again. I have found best results from using pieces of rubber and keeping them there until sufficient space is gained. I think the difficulty in Dr. Eaton's case was that the teeth were not kept sufficiently solid: if they had been held firmly, the difficulty would not have occurred.

TEETH A COMBINATION OF CONES.

At the usual monthly meeting of the Manchester (Eng.) Odontological Society, on December 10th, Mr. W. A. Hooton showed a collection of bones and specimens of ancient implements and pottery recently discovered in a limestone cavern at Deepdale, near Buxton, including remains of a brown bear, Celtic ox, deer, wild boar, fox, sheep, horse, and other animals.

The skull of the bear, which was in fine preservation, was found imbedded in a mass of stalagmite more than a foot thick. The specimen was an old one, and the teeth had been subjected to very rough usage, being excessively worn down and many of the pulp cavities exposed. The canines had all been fractured and afterwards worn smooth, with the exception of the right upper, which was of full length and encircled by a band of erosion. There was no trace of the second premolars.

The skull of a Celtic ox (_bos longifrons_) showed portions of skin in a petrified condition still adherent, and there was also half the lower jaw of a calf.

In the clay were found portions of a stag's antlers of great size, somewhat softened by exposure to moisture.

Although no human bones have so far been met with, the signs of man's presence were conclusive, and that probably during the ancient British and Roman periods. One antler had been divided, and the tip smoothed and sharply-pointed; another was shaped, apparently for use as a spear head; and close at hand a small carved bone ornament, much blackened, and some bits of bronze were found.

We know that fires were made in the cave, for fragments of charcoal are preserved in the stalagmite.

The specimens of pottery are unfortunately much broken, but examples of Romano-British and also of Samia ware have been identified by Prof. Boyd-Dawkins, also pieces of hand-made pottery.

Dr. Shaw said that what had been exhibited by Mr. Hooton referred us back to that almost eternity of the past when the limestone was formed in which these caves are now found—a time before the appearance of vertebrate animals. And even when, inconceivable ages after it was formed, the limestone had risen from the shallow seas and became a part of the dry land, these caves must have been formed in it at a date so remote as to be almost incomprehensible to our mental grasp. And they had undoubtedly been, from a time of which we have no record down to clearly historical times, the homes of animals—man included. Many of these animals have, in only comparatively recent times, become extinct. In many of these caves, however, are to be found remains that show they have been the homes of animals now only to be found in hot climates, but were able to roam far north of their present habitations at that period when this island formed part of a great continent which was connected with Africa, and possessed an altogether different temperature than at present. The ruder kind of pottery to which Mr. Hooton referred are probably of Neolithic origin. In regard to the ornaments and better class of pottery found in these caves, it shows they have been at some time inhabited by a race greatly superior to the ancient riverdrift and cave-men, and their still later Neolithic inhabitants; and there can be no doubt they were the places in which the Celtic and Roman element sought refuge at the time of the fierce Saxon invasion.

Referring to the inferior jaw of a wild boar in which there was, at the extreme posterior portion, a fully-formed molar tooth which had not yet erupted, and consequently, had not any of its cusps in the slightest degree worn down by mastication, he (Dr. Shaw) said that he had read a paper some years since before the Manchester Microscopical Society, in which he had vaguely hinted at a theory which he had not since had time to work out, but which he would now distinctly state and leave it to younger men to consider. Mr. Hooton had also exhibited a most interesting specimen of a young, partly-formed and unerupted horse tooth in which also there had not been any wearing down of the cusps. He (Dr. Shaw) had several specimens of the same sort. Now, this molar horse tooth was in reality a combination of five teeth with projecting cones of various heights. As soon as the tooth appeared in the mouth these cones began to be worn down in mastication, and the tooth eventually presented a flat surface with alternate layers of enamel, dentine and cementum, so arranged that the occlusion formed a veritable mill for grinding the food. Although the molars of the bear and boar are not made up in the same way as those of the horse, the wearing down can be seen to have taken place in the teeth of the bear and the boar exhibited; and if gentlemen will kindly examine this unerupted tooth at the extreme posterior portion of the inferior jaw of the boar, it will be seen what this animal's molars are like when first formed, and before they are put to any use. _They are ummistakably made up of a great number of cones._ Therefore, it was his (Dr. Shaw's) opinion that, while in the primitive manner dentine and eventually teeth first appeared there were no signs of cones, when this form did, in the long process of time, make its appearance, it became a starting point from which has been derived, by a great variety of combinations, the forms of the teeth of the higher animals.

THE TACOMA DENTAL SOCIETY.

We are in receipt of a copy of the constitution and by-laws of the above Society, which indicates that the dentists of the new State of Washington are abreast of the times.

“The object of this Society shall be to cultivate the science and art of dentistry, to promote among dentists mutual improvement, social intercourse and good feeling, and to collectively represent and have cognizance of the common interests of the dental profession in our city.”

We take pleasure in giving to our readers the code of ethics of this new Society as being something new and original.

CODE OF ETHICS.

The members of the Tacoma Dental Society in the fulfillment of their duties to the profession, to the public and to each other, declare and accept as binding the following code of ethics as embracing such principles of honor, fairness and gentlemanly bearing as every gentleman of honor and self-respect should most willingly adopt.

ARTICLE I.

SECTION 1. It is the duty of every dentist to maintain the honor, respectability and good name of the dental profession, and by a manly and dignified bearing, by studious habits and mental improvement, as well as by a conscientious earnestness in the employment of his skill for the welfare of mankind, to aim at securing a general recognition of the worthiness of the dental profession to rank among the honored and learned professions.

SEC. 2. He should so practice his profession that the community will esteem it above the art of a mere mechanican and above traffic wherein shrewdness and cunning are an essential part of the stock in trade.

SEC. 3. He should therefore regard it as unprofessional and beneath the dignity of his calling to offer the products of his skill in competition at fairs, or to make sale of his services as does the shop-keeper of his goods, or resort to public advertisement such as cards, hand-bills, posters, or signs calling attention to peculiar styles of business, lowness of price, special modes of operating, or to claim superiority over neighboring practitioners, to go from house to house soliciting or performing operations, or to do other similar acts; but nothing in the above shall be so construed as to prevent any member from inserting simply his or her name, occupation and place of business in the public prints, or giving notice in the same of his removal, absence from or return to business, or issuing appointment cards with his fee bill thereon.

ARTICLE II.

SECTION 1. It is the duty of a dentist to treat the members of his profession—not excluding those who are his competitors—with the honor of a gentleman and the honesty of a true man; and when he has occasion to examine the operations of a neighboring practitioner, to do so without criticism.

SEC. 2. And when called upon to counsel concerning the utility of any operation, it becomes him to excuse any perceived faults which may justly be excused, and to make no attempt to undermine the confidence of a patient in a reputable practitioner, or by under-bidding, attempt to secure patronage that might go to another dentist.

SEC. 3. He should esteem it enough for honorable rivalry that the patient of another practitioner should from voluntary preference seek his professional skill. In short, he should treat every professional brother as he would his own brother in the flesh engaged in the same calling, or as a father would a SOD whose success he would not hinder.

ARTICLE III.

SECTION 1. A dentist should make his own personal advancement in the literature and practice of his profession his chief aim, and be determined to win success on the ground of merit. He should always employ his best skill, and should endeavor to instruct his patients candidly, knowingly and conscientiously in relation to their welfare as connected with their teeth.

SEC. 2. He should consider it also his duty to regard the needs of the poor in rendering gratuitous service, or by making such operations as are needful to health and bodily comfort available at rates within their means, ever regarding the wide difference between benevolently reducing the price to the _known poor_ and selfishly reducing the price to gain patronage that might go to another dentist.

OFFICERS AND MEMBERS.

F. P. Hicks, _President_; W. E. Burkhart, _Vice-President_; A. J. Gustaveson, _Treasurer_; A. McCulley, _Secretary_; E. G. Case, C. Van Winter, W. S. Conn, W. Chamberlain, —— Lamson, I. A. Chapman, J. R. Kennedy, L. Eaton, W. H. Johnson.

IOWA STATE DENTAL SOCIETY.

The Iowa State Dental Society will hold its twenty-eighth annual meeting at Dubuque, Iowa, May 6th, 7th, 8th and 9th, 1890. For purpose of observing a great clinic and hearing read papers by the most noted writers in dentistry, all are invited to come. The officers are: Dr. F. M. Shriver, President; Dr. C. J. Peterson, Vice-President; Geo. W. Miller, Secretary; Ben Price, Treasurer. Executive Committee: Jesse M. Ritchey, C. J. Peterson, C. Thomas. Membership Committee: J. S. Kulp, J. J. Littler, A. B. Cutler. Publication Committee: Geo. W. Miller, T. A. Hallett, J. B. Entrikim. Vice-President Peterson is Superintendent of Clinics.

ILLINOIS STATE DENTAL SOCIETY.

The twenty-sixth annual meeting of the Illinois State Dental Society will be held at Springfield, beginning Tuesday, May 13th, and continuing four days.

GARRETT NEWKIRK, _Secretary_.

MISSOURI STATE DENTAL ASSOCIATION.

MEXICO, MO., March 15th, 1890.

DEAR DOCTOR: We wish to call your attention to the next meeting of the Missouri State Dental Association, which will be held at Pertle Springs, July 8‒9‒10‒11, 1890.

No effort will be spared to make this meeting one of the largest and most interesting in the history of the Association.

The American Dental Association will meet in Missouri next August, and it is especially desirable that we have a large attendance at our next meeting so that we may make proper arrangements to receive the members of the American Dental Association in a manner that will reflect credit upon the dentists of Missouri.

Now is the time to make your plans so that you may be able to be with us, and we earnestly solicit your presence.

Fraternally yours.

_Executive Committee._

KANSAS STATE DENTAL ASSOCIATION.

The nineteenth annual meeting of the Kansas State Dental Association will be held at Hotel Throop, Topeka, Kansas, commencing Tuesday, April 29th, and continuing four days. An interesting program is assured, and the clinics will be a special feature. The hotel is first-class in every particular, and has granted a reduced rate. One and one-third fare has been granted by the railroads, on the certificate plan. Members of the profession cordially invited.

C. E. ESTERLY, _Secretary_.

Lawrence, Kansas.

FORTY-SEVENTH ANNUAL CONVENTION OF THE MISSISSIPPI VALLEY ASSOCIATION OF DENTAL SURGEONS.

CINCINNATI. OHIO.

The Society met at Lincoln Club Hall, and was opened by prayer by Dr. James Leslie. Dr. J. R. Callahan then delivered an address. He said—“As I look back over the records of the past doings of this Society, I can see where its founders builded better than they knew. I imagine this Society in its earliest days had more to do with bringing dentistry to its present high standing than most of us give her credit for doing. * * * In the very beginning they put the seal of their disapproval on charlatanism, amalgam fillings, advertising, derogatory remarks about one another in regard to poor ability, etc.; in fact it is hard to find anything that the most advanced of us to-day condemn, that they did not speak of in no uncertain tone forty-six years ago. Many are the good things done by this Society in early days; it has sown seed that has produced an hundred fold; many of the dental societies of to-day are offsprings of this old mother association. Not the least among the good fruits of this Society are the _Dental Register_ and Ohio Dental College. * * *