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13. SOBRE OS DENTES

            MY DEAR LAURA, –To-day I am going to say a few words about the teeth, their structure, and their hygiene.

            Human teeth, whether incisors, cuspids, or molars, are composed of four distinct substances. The exterior of every tooth is divided, anatomically, into crown and fang, the crown being the portion above the gum, and the fang the portion below. The outside of the crown is covered with a hard compact substance called enamel, which sometimes, especially on the molars, or grinding teeth, wears away, exposing the second layer or body of the tooth, that is, the dentine, otherwise called ivory. This material extends also into the fangs or roots of the tooth. It is not bone, for, alike in chemical composition, in structure, and in appearance, it differs from the ordinary osseous tissue in other parts of the body. The enamel which covers the upper part of the dentine ceases at the neck of the tooth, that is, at the part meeting the gum, and below this is replaced by a substance called cement, a thin crust of which surrounds all the ivory of the fang. In the interior of the tooth, beneath the dentine, is a cavity, and this cavity contains the fourth element of the tooth, the dental pulp, soft in consistency, and highly vascular and sensitive, being supplied with nutrition and feeling by means of small

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arteries and nerves which penetrate to the centre of the tooth through narrow channels in its fangs or roots.

            The rewards and penalties of heredity manifest themselves perhaps more strikingly through the teeth than through any other organs of the body. Scrofula and specific disease announce themselves from generation to generation by means of deformed, brittle, or discoloured teeth. Early decay and loss of the molars betray feebleness of constitution and vitiated blood, and may indicate some such particular expression of debility as tubercle in the lungs or analogous disease of the bony tissues. Apart, too, from the special heredity of the individual, all civilised races suffer more or less from dental disease and decay, and this phenomenon is traced by our best authorities to the abundant use made by such races of cooked food, and, in particular, of hot food. Hot meats and drinks are undoubtedly injurious to the teeth, and the taste for them is purely artificial, since we see animals, taught by natural instinct, invariably refuse food at a high temperature, and I believe the same observation has been repeatedly made in regard to savage men. If you give a plate of steaming hot soup or bread and milk to your oat or dog, he will not partake of it until it has cooled, and will wander about it wistfully, sniffing now and then at it, until satisfied that its heat has sufficiently subsided to allow him comfort in his repast. But the temperature at which he finally consents to eat it would disgust his master, and would cause him to consign the dish again to the cook with orders to have it “made hot”.

            Nothing, in fact, is worse for tooth, bone, hair, and complexion than our civilised and luxurious custom of daily swallowing hot food at all our meals. We begin the day with hot coffee or tea; at lunch, hot soup, hot

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joints, hot potatoes, hot puddings; the same at dinner, and maybe, to wind up with, more hot coffee, or even hot “grog.” And the worst of it is, that because habit is second nature, and is bequeathed to us through long generations, we like all these things so much as to esteem cold or cool viands and beverages positively insipid and comfortless. Among all civilised nations, Americans have the worst teeth, and consequently resort the most commonly to dentists and to dental operations; and Americans are precisely the people who eat most hot dishes, and who alternate them most ingeniously with icy-cold drinks. Even if we cannot induce ourselves to forego hot foods, we can at least refrain from mixing the use of ice with that of fire, and from alternating mouthfuls of steaming potage or fricassée with sips of glacier-cold champagne.

            Then, again, teeth otherwise good are often destroyed, especially in childhood and early age, by over-feeding, by unsuitable food, and by the immoderate use of medicinal drugs, and in particular, by preparations of iron and mercury. Strong acids also damage the teeth by attacking the enamel, corroding it and softening it, and thus denuding the ivory. A tooth which has lain for twenty-four hours in a wineglassful of mineral acid becomes so soft outside that it may be dented by the simple pressure of the finger-nail. Persons who habitually take acid drinks usually suffer from decay or caries of the teeth. Such is notoriously the case with the French peasantry in certain districts of Normandy where large quantities of cider are consumed. Hence, acids should never be used as dentifrices, because, although they may momentarily whiten the enamel, they assuredly and inevitably destroy it in the long run. Tooth-powders and toilette lotions for the mouth should be either alkaline,

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astringent, antiseptic, or wholly inert. Alkalies neutralise the acidity of the products of decomposition and fermentation arising from the organic alimentary matters accumulated in the interstices of the teeth or elsewhere in the buccal cavity. If these products be allowed to remain, they will, by the precipitation of insoluble salts, cause the deposit of tartar on the surface and about the neck of the teeth, and ultimately lead to the retraction of the gums, their inflammation and atrophy, and to the loss of the teeth by loosening or decay. The nature of the dietary regimen has an incontestable influence on the condition of the teeth. M. Préterre, laureate of the Faculty of Medicine of Paris, and surgeon-dentist to the civil and military hospitals of that city, expresses his opinion in regard to this question in the following words: –

            “The accumulation of tartar on the teeth varies according to the nature of the alimentation. This deposit is abundant on the teeth of persons living in towns and eating largely of meat: it is, on the contrary, found in very small quantities on the teeth of country folk who subsist chiefly on fruits and vegetables.” – (Practical Treatise on Diseases of the Teeth.)

            Astringent and antiseptic tooth-washes and powders exercise a beneficial effect in hardening and preserving the gums, and counteracting the results of fermentative action; inert powders, such as chalk, pumice-stone, cuttle-fish bone, etc., produce a mechanical effect only. Of all compositions sold as tooth-powders or “elixirs,” those containing alum or tartaric acid should be the most sedulously avoided. M. Préterre says of such compounds: –

            “If one were to try to invent a preparation for the express purpose of destroying the teeth in the shortest

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time possible, nothing better could be imagined than a mixture containing acidulated tartar of potass and calcined alum!”

            Recently prepared fine charcoal, especially areca-nut charcoal, which is somewhat scarce in commerce, forms one of the best dentifrices known, because of its whitening and deodorizing properties. Moreover, it acts mechanically as well as chemically, and cleans the surface of the enamel by friction without scratching it, as harder substances are apt to do. Here is a formula for charcoal tooth-powder which you will find very good: –

Areca-nut charcoal.......................................... 5 ounces.

Cuttle-fish bone............................................... 2 ounces.

Raw areca nuts pounded.................................. 1 ounce.

Pound and mix. Two or three drops of oil of cloves or of cassia may be added if a perfume is required.

            For general use the following tooth-powder is excellent: – Powdered bark, half-an-ounce; myrrh, a quarter of an ounce; camphor, one drachm; prepared chalk, one ounce.

            Camphorated chalk, which combines antiseptic qualities with the virtues of an inert powder, is an admirable dentifrice for daily needs. The camphor should be in the proportion of one-twelfth part to the chalk basis.

            Soap dentifrices should be avoided. Almost all of them tend to make the teeth yellow.

            Among liquids for cleansing and preserving the teeth, no preparation is better than the following: –

Camphor (powdered)................................... ½ drachm.

Lump sugar..................................................... ½ ounce.

Triturate to a fine powder and add: –

Dry blanched almonds.................................... ½ ounce.

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Beat up the whole into a paste; then make an emulsion with: –

Distilled water....................................................... ½ pint,

very gradually added. Or again, camphor julep, thus composed: –

Camphor ....................................................... 1 drachm.

Rectified spirit .................................................  20 drops,

triturated, and diluted with: –

Distilled water .....................................................  2 pints,

strained through linen, is an excellent antiseptic tooth-lotion. In case the gums are spongy, tender, or disposed to recede from the teeth, the following compound will be serviceable: –

Tannin ..........................................................  ¼ drachm.

Tincture of myrrh ................................  6 fluid drachms.

Spirit of horse-radish .....................................  2 ounces.

Tincture of tolu ....................................  2 fluid drachms.

Shake and stir until complete solution.

            If the teeth become brown by discoloration of the enamel, so that inert powders fail to cleanse them, a little lemon-juice may be permitted, applied on the tooth-brush, or by means of a rag. But it must only be used very rarely, and the mouth should be well rinsed with pure soft water afterwards. Apples, or the inside of orange-peel, may be effectively used in a similar way. Mineral acids, seductive on account of their bleaching properties, must be avoided with the most conscientious determination, for the reasons I have already stated; and if much vinegar be taken with food, the teeth should be cleansed after meals.

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            As a lotion for rinsing the mouth, weak solution of borax may be beneficially used at night, and the teeth may be afterwards rubbed with a moderately soft brush and some neutral powder, such as camphorated chalk or orris-root. Finely pulverized pumice-stone may be employed occasionallyfor preventing the formation of tartar; but it should be sparinglyused, and preferably by means of a cambric rag or a small piece of soft wood, the teeth being afterwards brushed in the ordinary way, and rinsed with water. Remember always that it is quite as necessary to clean the teeth at night as in the morning. Never go to bed without having thoroughly purified the mouth and teeth from the results of the day’s repast. Be careful, too, in cleaning the teeth, to pass the brush well behind the front teeth, both in the upper and lower jaw. It is at the back of the incisors that tartar is most apt to accumulate, in the morning, after completing the brushing operation, wash out the mouth with a tumbler-full of tepid water, with which a few drops of tincture of myrrh have been mixed. I may add here that the quality of the water used for drinking purposes and for rinsing the mouth is not without its effect upon the teeth. Water containing calcareous substances appears to exercise a disastrous influence on the teeth. It is to the habitual consumption of such water that M. Préterre attributes the dental disease and premature decay common among the inhabitants of Pycardy, Holland, Champagne, and other districts supplied with silicious and chalky springs.

            Never allow a decayed or hollow tooth to remain neglected, even though it does not cause pain. If it cannot be filled with gold or other stopping, have removed; the administration of nitrous oxide (laughing gas) is now so easy and even pleasant a process that no

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one need dread the dentist’s chair. The presence of a decayed, and therefore decomposing, tooth in the mouth, is not only unsightly, but it is a continual danger for sound contiguous teeth; it infects the breath, impairs the digestion, and deteriorates the general health.

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