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INTHER E N A I S A N e El tic May 1955 tic Published monthly by TICO:-.iIUM A MAGAZINE FOR DENTISTS, DENTAL ASS ISTANTS, AND DENTAL HYGIENISTS ~G\l'f.S 413 N. Pearl St., Albany I, N. Y. Copyright, 1955, Ticonium Annual Subscription, $2.50
'tt-~'\) EDITOR, Joseph Strack CONTRIBUTING ED ITORS Arthur H. Levine, D.D.S. MPRESSIONS Joseph Murray, D.D.S.
May 1955, Vol XIV, No. 5 IS IT LATER THAN YOU THINK? C ON TE NTS by Maurice J. Teite lbaum, D.D.S. Carefully he notes the flaws by Connie Doyle Shown in the pictures of the patient's jaws. IS IT LATER THAN YOU THINK? Ind-dental Items in the News Two extractions and a cy.st, A provocative editorial-article Doctor Superior, still on speaking terms with his office clock, Six alloys needed and three silicates, that can save many practices amI dentists- from going to looked up and murmured to himself, "Is it really that late?" The A bridge up here, he muses, Dentists may favor golf and fishing but, accord smash ...... ec:ho from the office made his deep sigh almost And then two crowns down here he chooses. ~mp~y, th~ee-chair ing to a leading sports columnist, hockey is a den dIslodge the klllgslZe ChIp from his shoulder. The patient asks: "See anything yet?" CHILDREN'S EXODONTICS: THE USE tist's delight. Just about everyone on the New York OF ETHYL CHLORIDE An<:>ther of Doc~or S~perior's. patients had canceled just this Rangers hockey team has lost a tooth on the ice. The dentist smiles, "Yes, a new T .V. setl" "Your child patients will ex perience a great th rill in the mornmg and the lmaglllary ChIp was growing steadily. Once, ... In South Cal'Olina a man was dissatisfied with extraction of deciduous teeth way back ,:hen he began his practice in this small town, the chip his set of dentures and advertised to rent or sell through simple surgical oper was noneXIstent: Pr~ud of his first chair. getting acquainted and THE PATIENT AND THE PROSTHODONTIST ations with absolutely no evi- them. Over 100 people answered the ad. . .. A den.tally e~ucatl?g hIS homespun patients, taking the time to be Mister DuBoise complained that whenever he talked dence of pain or suffering". . . 3 Mississippi school teacher has removed over 1,500 patlent WIth chIldren and to make social contacts, he had, in a his dentures clack-clicked, deciduous teeth in her 40 years as a school teacher. DR. DANI EL F. LYNCH, A.D.A. few short. years, cleared his debts, bought a horne and a mod And that no dentist could get the problem licked. PR ES IDE NT Her instrument was a piece of string and her anes erately pnced car. \\Then his own youngsters begged for a romp So Doctor Stryumph rearranged the teeth in the The second installment of a thetic was a collection of children's stories. . . . A three-par t story about the at home, he found the time. ' back, 53-year-old Frenchman displayed a set of "muscular man who holds the most im As contented as ~ turkey still alive in January, he happily But then Mister DuBoise went click-clack. portant dental post in the molars" by pulling a plough with his teeth. . . . In ~ooked forward to hIS class reunion at a forthcoming dental meet Not discouraged, he tried a new prosthetic trick world ...... 5 Chicago a Boston bull whose bite was worse than mg. It woul~ be great to reminisce with good old George, who Only to have the patient return with a clickety-click. DENTISTRY DURING TH E his bark was fitted with an upper plate.... A Wis had share~ hIS room, and that ball-of-fire, class president Bob. Still undaunted the prosthodontist tried a frontal RENAI SSANCE consin dentist has designed a lower denture with E.verythu:g rolled as smoothly as mercury at the convention attack, The first of two installments metallic molars and bicuspids that have holes on on one of the most fruitful untIl, late III the evening, George mellowed and leaned across T o which Mister DuBoise responded clackety-clack. eras in early dental science. the occlusal and channels along the labial where the table. to confide: "Say, Bob, I doubled my net when I took Finally Doctor Stryumph Another fascinating chapter in the food is forced out. They were designed to cut TIC's exclusive pictorial his- your adVIce about adding a second dental chair. Thanks from Smiled in triumph. and shear food like a meat grinder. ... Did you tory of dentistry...... 8 my heart all the way up to where I used to have hair." He reached in a glass jar and handed the patient know that: One of the best collegiate football "\\That you really need, George," Bob added from sheer broth two rolls of cotton OPERATIVE DENTISTY records. compiled last year was put together by Amalgam-another informative erly. love, as he patted a wave in his own hair, "is a third chair. CarnegIe Tech, whose coach is Doctor Ed Baker, a T hat he had just gotten. chapter in an outstanding ser I tnppled my practice." "What are these for?" asked Mister DuBoise. ies on modern dental proce- practicing dentist? . . . Henry James wrote his Doctor Superior craned forward to bay at the warm trail. "But Said the doctor: "To put in your ears so you won't dures ...... 11 psychological thriller The Turn of the Screw to dis 'where do you guys get the time?" tract his attention from an excruciating toothache? hear the noise." DENTAL WIVES A feature that is always unique, "Simple," Bob explained. "Just divide time between three consistently interesting, and patients and slip back and forth. People are used to assembly unfailingly good ...... 13 Gagging THOUGHTS WHILE WAITING FOR A SILICATE TO SET line production by nmv!" THE FA:\10US DOCTOR PRIME IMMEDI ATE DENTURE SERVI CE . "Then hov:'"do you. ed~cate them-or take on time-consuming, A woman should not embark on any culinary ad " . . . immediate denture dIfficult cases~ conSClentlOus Doctor Superior wanted to know. Fame was a claim of Doctor Prime ventures service is one of the most bene ficial and gratifying services Who could remove three wisdom teeth at the same With a husband who has just gotten new dentures. . "!o~~h cases of patients with low incomes, I channel to spe that the dentist can perform Clahsts, George volunteered. "Let them wrestle with the extra time. for his patient."...... 14 But actually it's nothing you or I couldn't do, T wo heads may be better than one, ~ees . As ~or edu~ation,. I leave that to the coming crop of graduat 1£ we had his three hands instead of our two. Opinions expressed by contributors to mg dentlsts. TImes hke these may not last forever and I'm mak But not in a patient that needs surgery done. TIC magazine do not necessarily reflect DIAGNOSIS the views of the publishers. ing hay while the dollar shines. ' ~Iy city patients had dental education preached in school, so I don't have to waste time The dentist holds the roentgenograms just right T he hostess is ruthless Printed in U.S.A. by explaining." And studies the shadow readings in the light. \\Tho serves steak to guests toothless. C. P. Hoagland Co .. Inc., Somerville, New Jersey Cover artist, Edward Kasper Page Sixteen . -Ak. l Page O ne tic May 1955 May 1955 tic
"But my patients are sort of backwoodsish, farm Dentist in the News tion and stability at the time of initial insertion, toothache will be momentarily grateful when the folks," Doctor Superior complained. "They don't but gradual loss of retention and stability should be pain is relieved, but a prosthetic appliance which understand dental nomenclature unless I break it anticipated as healing and resorption of the alveolar restores function and esthetics is a constant daily down in simple terms." bone progresses. reminder of the dentist's skill. The patient's grati "Quit wasting your time," Bob said. "It's not This should be carefully explained to the patient tude is further enhanced by the fact that he did your fault their vocabulary is poor. Try using so that he may better understand why it is necessary not have to go through the embarrassing and brief, technical terms. They won't bother you to reline his immediate denture one or more tirrl'es, inconvenient toothless stage. anymore." or even remake The personal the case at a later satisfaction which "Won't patients be angered by being snubbed d ate. Although the dentist de that way?" immediate den- rives at the com "A few, sure," Bob admitted. "But there will tures have been pletion and sub . always be plenty of patients-and very little time." known to func sequent follow-up Doctor Superior shrank in his tweeds as George tion for a number of an immediate and Bob revealed their incomes. When he saw the of years without denture case is cars they were driving, the splinters called Envy the need for re but a reflection and Ambition mated to beget the tiny chip that lit lining, most cases of the patient's on his shoulder. will require re feelings. Without Mrs. Superior objected to Chair No.2. Objec lining about six a doubt, immedi tion overruled. Photo: Wide World Photos months after the ate denture ser Doctor Superior's practice grew by leaps and Dr. Thomas Michiels, 31-year-ald-stricken dentist, looks initial insertion. vice is one of the bounds, leaping through meals with his family and over a model home with Mrs. Rhea Wallace, 26-year-old A problem m 0 s t beneficial bounding over time-consuming, gentle acts that widow whom he announced he would wed Oct. 30. Two years ago, Dr. Michiels, his wife and Bobby 5, eldest of which occasion and gratifying would have made his patients regard him as a per their three sons, were stricken with polio. Mrs. Michiels ally arises with services tha t the sonal friend. The chip grew noticeably the day died of the malady and Dr_ Michiels was told he could the immediate dentist can per Miss Cheerful, his assistant for seven years, warned never practice again. He i. starting a dental laboratory form for his pati even though he has lost the use of his arms. Mrs. Wallace's denture case is him that he was pushing too hard: "Your family first husband died of polio. that of exceeding ent. The patient misses you and you're missing fun, relaxation, and ly rapid bone benefits in that fellowship." her experience with the two dentists that night at resorption, re he suffers no im One day as Miss Cheerful chatted in her friendly their bridge club. quiring the relin pairment to his fashion to a faithful patient out in the waiting room, Mrs. Newcomer's choice of Doctor Plodder in ing of the case at appearance 0 r Doctor Superior insulted, "Cut the gab and get creased the chip on Doctor Superior's shoulder. frequent i n t e r- general health. busyl" His chip grew when she quit to accept a His family no longer welcomes his nerve-frazzled vals. This is believed to be due to excessive bone The dentist, likewise, benefits, for the practice lower-pay job in a dry goods store. Each of his company. A mutual friend explained how George trimming at the time of surgical preparation of the building potentialities of the satisfied patient is s 4 next five assistants stayed only a few weeks, so he had a heart attack at the chair and that Bob's phy ridges. . Unless there is an abnormality present limitless. decided to operate alone and save an assistant's sician had ordered him to take a six months' rest. requiring a more radical procedure, the operator BIBLIOGRAPHY salary. should be conservative in the removal of alveolar 1 Schlosser, R. 0 .• Complete Denture Prosthesis, Philadel The article, "Why Patients Switch Dentists," Mrs. H. Toothache's case was symbolic of many bone. Resorption will be minimized, since the de phia: W. B. Saunders Co .• 1947, p. 377. based on a survey, lies on Doctor Superior'S desk. 2 Schram, W. R., "Healing of Tooth Sockets Following Ex others. gree of alveolar resorption is in direct proportion traction by Forceps and Surgical Methods," Bulletin North Those figures don't lie: 78 percent of patients who to the extent of bone trimming. western Univ., 30:1-4, 1930. "Just how much money for the needed dental switched dentists did so because of a pleased work in my mouth?" she asked from one of his • Schlosser. op. cit., p . 378. friend's recommendation. Of these "switches," 20 three chairs. • Lisowski. C. S., "A Comparative Study of the Resorption percent were dissatisfied because they disliked the of Alveolar Ridge Tissue under Immediate Dentures," Bulle "Borrelia vincenti," he mumbled to himself, tin Northwestern Univ., 45:11-13, 1945. dentist's personality; 16 percent because of poor "Temporary" Dentures ignoring her question. "Periodontal pockets. Mal work; and the remaining 64 percent because of two occlusion." counts: Failure to explain the specific costs, (who It is incorrect to refer to the immediate denture TV OR NOT TV "Oh, yes," gulped Mrs. Toothache, who can take isn't suspicious of hidden charges these days?); as a "temporary" one. This synonym implies that any insult except that of being proved stupid. and failure to provide a payment plan. only short-term service can be expected of the "About payments?" she tried again. immediate denture and that it will inevitably be Would patients like TV The enormous chip, as Doctor Superior views "Later. Haven't time to explain." He left her discarded. While it is true that many immediate his shrinking practice, bulges even larger. At this dentures will have to be replaced at some future for another patient. late hour, he is at last convinced that good patient To watch, when waiting palls, Mrs. Toothache had enough. She called com time, the lengths of their periods of usefulness does relations constitute 60 percent of the "tools of not justify the designation "temporary". I know petitive Doctor Plodder and, even though she had trade." On his "time out," he also realizes that his And pay a higher fee-or just to wait longer for an appointment, was flattered of one set of "temporary" dentures which, after superior attitude and his disregard of patients' feel nine years, is still giving the wearer good service by his undivided attention. He answered her ques ings are ammunition for those on the firing line for without relining. Sit staring at the walls? tions in direct, simple terms and explained his pay socialized dentistry. Perhaps he yet has time to There is no phase of dental practice which gives ment plan promptly and clearly. save his practice, but maybe it is later than he more lasting satisfaction to the patient than restora Pleased, she gave Mrs. Newcomer the benefit of thinks. tive dentistry. The patient who pres~ nts with a Ethel Willis Hewitt
Page Two Page Fifteen 'tiC May 1955 May 1955 tic
struction and insertion of full dentures. 'While Childrenls Exodontics: to be performed. The surgical square piece of gauze Immediate the immediate denture patient may experience is placed on the child's face in order to cover the some awkwardness with his dentures initially and mouth and nose, but not the eyes. With the thumb Denture may have to alter his chewing habits, the transition and forefinger, hold the patient's nose and have from natural dentition to dentures is considerably THE USE OF him or her breathe through the mouth. Practice smoother for him. this once or twice so the child will cooperate with Service ETHYL CHLORIDE you when you apply the ethyl chloride spray. Hold the ethyl chloride tube upside down ap by Cyril B. Kanterman, D.D.S. Contra indications by Charles A. Levinson, D.M.D. proximately twelve inches from the gauze and spray There are a number of conditions which con the gauze. Keep reminding the patient to breathe Aside from the introduction of the acrylic resins traindicate immediate dentures: FORMER VISITING ANESTHETIST, FORSYTH DENTAL through the mouth while the nose is held pinched. as denture base materials, the outstanding advance Where the age or the general physical condition INFIRMARY FOR CHILDREN, BOSTON, MASS. While spraying the gauze, make certain that the ment in prosthetic dentistry has been the develop of the patient is such that the extraction of six or ment of immediate denture service to the high meshes of the gauze mask do not become frosted, more teeth plus the surgical preparation of the More dentists should get acquainted with the use as this interferes with breathing. degree to which it is practiced today. Notwith ridges at one appointment is not advisable. 1 of ethyl chloride as an analgesic agent for sllch Inasmuch as the operating time under ethyl standing implant dentures, magnetized dentures, Where extensive bone trimming is necessary. dental procedures in children as the extraction of chloride analgesia is about two minutes, we must and other recent innovations which have yet to pass In the presence of abscessed teeth or a periodontal deciduous teeth, the incision and drainage of an be ever watchful for the symptoms of anesthesia. the test of time and large-scale clinical evaluation, condition, where free drainage is necessary. abscess, and the extirpation of a pulp. Other dental the immediate denture technique holds an import Respirations are the most reliable signs. There Where the patient is not desirous nor apprecia opera tions may be performed and are entirely de is usually a marked change in breathing rate and ant and indisputable place in dental practice. tive of immediate denture service. pendent upon the skill and ability of the operator. rhythm as soon as we start. Coughing and voluntary Immediate dentures are those which are con A trend which I have noticed in my practice and Ethyl chloride is a haloid derivative prepared by holding of breath may be noticeable during the structed before the patient is edentulous, and they those of other dentists with whom I have spoken is the action of hydrochloric acid gas on absolute are inserted immediately following the removal ef early induction period. As the anesthesia becomes that the majority of patients who receive immediate ethyl alcohol. It is a colorless, mobile, very volatile more profound, the respirations become more all of the remaining natural teeth. This technique denture service request it themselves. I feel that fluid having an agreeable odor and burning taste. audible, a little more rapid than normal. Regular, has its widest application in the construction of full this is significant, for it indicates that the laity has Because of its extreme volatility, it is best pre dentures, but it may be used to construct immediate rhythmical breathing is preceded by a deep inhala come to appreciate the value of immediate denture served in hermetically sealed glass or metallic tubes, tion which produces a snoring-like noise. partial dentures and immediate fixed bridgework, prosthesis. and kept in a cool place removed from light and particularly when anterior teeth are involved. The eyeball passes through a period of enhanced The desire of the patient to have this type of fire. It boils at about 55° F. (12.8° C.) and burns activity. As the breathing becomes regular, the treatment is, I feel, an important prerequisite to the with a smoky, green-edged flame_ When liberated eyeball drifts slowly from side to side and may Advantages ultimate success of the case. To every patient who from its container it vaporizes at once, and the become fixed in an eccentric position. The eyelid presents oral conditions necessitating full-mouth One of the oustanding advantages of the imme resultant gas is very inflammable. extractions, I explain the possibilities of immediate Inasmuch as ethyl chloride is a heart depressant, diate denture and perhaps the one reason why more dentures, if they are indicated for that particular individuals are seeking this service is that the pa it is contraindicated in children who have heart case. The patient, however, must be receptive and disorders, lung or kidney conditions, anemia, tient does not have to face the social embarrassment cooperative before such a case is undertaken. If of being without teeth for even a short period of leukemia, or severe colds. Otherwise ethyl chloride he comes with the preconceived idea that imme can be used in practically all normal children as an time. This is a real economic factor for those in diate dentures are not for him, he is a poor prospect occupations where it is necessary to meet the public. analgesic. It is ideal for children between the for this type of service, even though he may later ages of three and twelve. There is no interruption of function or loss of agree to it. appearance following the extractions and normal facial contours and expressions are maintained. Preparation Tissue Changes Because he has the opportunity to study the pa Before beginning this dental operation the child ]1f tient's dentition before extraction and can make Because of the close relationship between the im should be sent to the toilet. "\Vhile he or she is out, W.L. VINCENT, D.D.S. pre-extraction records, the dentist can duplicate mediate denture and the tooth sockets, the dentist the operating room can be prepared before the CHILDREN'S DENTIST with exactness the size, shape, color, and arrange must keep in mind certain tissue changes which patient enters it. ment of the natural teeth. will eventually affect the retention and stability The paraphernalia necessary on the operating There are other less spectacular though equally of the denture as healing progresses. While it gen table consist of a rubber bite block or mouth prop, important benefits to be gained from the immediate erally takes two to three weeks for the gingival tis a fine piece of mesh surgical gauze four to five inches denture technique. Following surgery, the immediate sue to heal sufficiently for closure of the sockets, the square, and the ethyl chloride bottle. The extrac denture serves as a splInt or pressure bandage, thus sockets themselves are not completely filled in with tion forceps necessary are placed there too, together maintaining the blood clots and protecting the new bone until a much later time. It takes six with cotton pliers, dental mirror, and exodontia sockets from injury and infection. As a result, heal months or longer for regenerated bone to obliterate sponges. ing progresses more rapidly and the patient usually the sockets. The child is seated comfortably in the dental experiences a more comfortable convalescence. Concurrent with the healing of the sockets, resorp chair and the chair is tilted backward to an angle Finally, the wearing of immediate dentures does tion of the alveolus occurs. One of the principal of about 45°. not give the patient an opportunity to develop tissue changes in the alveolar process is marginal improper habits of speech and mastication which resorption of the sockets, together with loss of con How to Do It Pick SMolINskI sometimes arise during the intermediate period tour and a general rounding off of the ridge.2 Thus, The mouth prop is placed in the mouth on the Ll------between the extraction of the teeth and the con- the immediate denture will have maximum reten- opposite side from that on which the extraction is
Page Fourteen Page Three May 1955 tic May 1955 tic
A RESEARCH PROJECT Denta l Wives: Part of the reason, of course, was because her Text and photos by Wide World dental husband usually managed to keep his assist ants with him for many years. \Vhen they even ·Working on a research project in which rabbits tually left it was to be married or to move to another are fitted with braces, Doctor Lucian A. Bavetta part of the country. Perhaps he was just plain (left) and Doctor Joseph G. Schurter give an anes lucky, or perhaps it was because of wise handling, thetic to one of the animals before putting a tiny but usually his assistants seemed to take a very brace on its teeth, at the University of Southern real interest in the office and in the welfare of the California, Los Angeles. Doctor Bavetta is pro dentist himself. fessor of biochemistry and nutrition at the USC Some of this seemed to overflow into the home as dental school, and Doctor Schurter is clinical in well. The dentist's wife had reason to be grateful structor in orthodontics. The brace of bands and to her husband's assistants, and gradually acquired wires is a miniature of that worn by humans. The a knowledge of their lives and problems. Although project is designed to learn more about the straight she saw them but seldom, she liked them and was ening of children's teeth and the varying degrees of interested in their welfare. ease or difficulty with which the teeth respond to There is a wide divergence of opinion in dental braces. To test the doctors' theory that nutrition by Kay Lipke families on this question. A great many dentists may explain the difference, some rabbits have been The broce has been on the rabbit for two like to have the office and the home completely tested during the year the project has been carried and one-half days, during which time it By a curious coincidence, the two letters arrived separate, and a great many dental wives hardly out. Results have been successful but are not con has separated the teeth. in the same mail. One bore the postmark of a town know the names of the women who assist their hus sidered final. up the coast, and the other a community a thousand bands at the chair. miles away. Both comrp.unications were from for Usually this is with the wives' complete approval. mer assistants to the dentist, and both were ad As one very charming Mrs. Dentist expressed it, "I dressed to his wife. don't think I would know my husband's assistant if Eagerly she read the news about the two families: I met her on the street. She is quite efficient, my they were prospering; the children were growing husband tells me, and does an excellent job, but up; Bob had been sick but was better now; Anne she has her life and we have ours. I think it is much was in nurse's training, and so on. better that way." The dentist's wife laughed as she sat there with In a way she is quite right. The line of separa the two letters in her lap, a chain of memories un tion between home and office certainly gives the winding before her eyes. She remembered a Satur dentist a sense of relaxation when he shuts the door day morning during ·World 'Nar II when butter, of his office behind him and later enters his home. eggs, and chickens were almost impossible to obtain. Office conversation does not overlap into the living The doorbell rang to reveal a valued former assist room. A friendship between the dental assistant ant to the dentist, with her arms filled with home and the dental wife can, on occasion, mix up the cured bacon, butter, eggs, and chickens. Carol, whole business and be disturbing. living on a farm a hundred miles awav, was still However, there is another side of the matter. The researchers at work. An anesthetized rabbit is fitted with a dental brace. The brace looking after her dentist, although she' no longer Life is more pleasant for most of us when it is not is fitted with tiny springs for adjustment to move the teeth apart could don a white uniform and assist him at the in a few days. merely a cut and dried business, all very carefully dental chair. outlined and followed relentlessly. It is certainly Another memory of another former assistant and a rewarding experience when a dental wife and her r eflex is present and active, but if the finger is gence period. good friend. She flew into town for a visit and husband's assistant learn to know and like each p assed quietly and slowly before the eye without Dentists have a wonderful anesthetic in the use dropped by the office for a chat with the "Boss," as other, and more or less form a friendly team touching the lashes or lid, it evidences no reaction. of ethyl chloride if they work with it carefully and she still calls the dentist. His present nurse planned devoted to the welfare of the dentist. . These signs definitely indicate a state of deep with confidence, and use good judgment in its to be away from the office the next day, and the a nalgesia, which is of sufficient depth to permit the administration. Remember, the best dental surgeons girl on a visit begged for the chance to take her o perator to perform the necessary dental operation, are the ones who have early in life learned when place "just for the laughs"-and to prove to herself a fter the gauze mask is removed and the surgical not to do a thing, and not when to do it. Choose that she had not lost her touch in the years she had sponges are in place to prevent the dripping of your cases for ethyl chloride analgesia with good been married and been away. She did a grand job blood into the back of the throat. Make cer tain, judgment. and had a lot of fun doing it. The dentist's wife thought of her husband's pres if you are extracting, to have a firm grip on the Your child patients will experience a great thrill extracted tooth to prevent it from dropping into in the extraction of deciduous teeth through simple ent assistant who had been with him a good many years. She was tremendously fond of her, and ham t he mouth. surgical operations with absolutely no evidence of - pain or suffering. good reason to be grateful to her. They had become After the child awakens from this analgesia opera good · friends. Suddenly, she thought how much Remember, today's satisfied child patient is a tion, excitement may be expected. The operator more interesting life had become for her because future satisfied adult patient, which embraces the a nd his assistants must be prepared for such an she had kept in friendly contact with the vital o ccasion. The child should be treated with the progress of your future professional happiness and young woman who has assisted her husband in h is u tmost kindness and consideration from this emer- success. profession.
Page Thirteen Page Fou r tic May 1955 May 1955 tic
Authorities all agree that it is important to keep The important fact to remember is that the mer the mercury content as low as possible. The greater cury must be removed. And since the more mer the amount of mercury, the more flow. This means cury present in the finished filling, the more flow, the filling will have a greater tendency to change it follows that the less mercury left in the filling the shape under stress of mastication. In mixing the better. This does not mean that the pieces can be filling, the manufacturer's direction concerning the so dry that they do not join each other in a homo amount of mercury should be followed. This will geneous mass. That, obviously, is the other ex insure proper smoothness in the mix. But once the treme. Just h01' much mercury to remoye, is best filling has been started, as much mercury as possible left to the judgment of each operator. should be squeezed out. Trituration time is another factor in the forma tion of an amalgam filling that might haye an effect FOR LIVING Condensing the Filling on the finished product. But recent research4 indi cates that, aside from dimensional change, it has Authorities do not agree, however, on the method little bearing. Specimens were over-triturated and of condensing the filling. Mechanical means of con under-triturated intentionally and then their struc densing the filling have enjoyed long popularity ture was studied. Here is its conclusion: "Varia Dr. Daniel F. Lynch: A.D.A. President with many men. Special points are used in the tions in the mercury content of the amalgam by Joseph George Strack handpiece which act with a trip hammer type affected the appearance of the structure appre action as the motor runs. It is similar to the action ciably, whereas variation of the trituration time Part II of the automatic mallet used for gold foil. Those did not." who favor the mechanical condensation technique Daniel Lynch's early trammg and experience naturally liked them, that they sensed it and recipro claim a harder, denser filling for themselves. They BIBLIOGRAPHY helped to develop many of the talents and skills he cated. That was important information, for it feel that more filling is used in the process, thus in exercises today with such seeming efEortlessness. meant I could devote myself sincerely, enthusiasti 1 Schoonover,!. C., and Souder, 'Vilmer. Research un Den dicating that the filling must be more compact. tal Materials at the National Bureau of Standards. N. B. S. Back in his home town of Waterbury, Connecticut cally, and effectively to causes of benefit to the com Others feel that many of these claims are not jus Circular 497 , Washington, D. C., U. S. Government Printing -where he was born on June 6, 1902-he became a munity, to my profession; that I could exercise, in a tified, that with a material having the plasticity of Office, Aug. 15, 1950. correspondent for the H'aterullry Repuulican while small way at least, qualities of leadership. I sud 2 Gabel, A. B., American Textbook ot Operative Dentistry, amalgam at the time of insertion, the filling is ed. 9, Philadelphia: Lea and Febiger, 1954. still in high school, an experience that taught him denly knew, also, that I would be a success in pushed around more than it is condensed. Doctor 3 Swartz, M. L., and Phillips, R. W., ]. Dental Research to write and to speak clearly and simply. (Read my profession, a success in the nnest sense of A. B. Gabel2 has summed up this point of view: 33: 12, Feb. 1954. any of his published essays or listen to one of his the word: I would be able to use my dental knowl "Advantages of mechanical condensation are very • Smith, D. L., Ferguson, G. 'V., and Schoonover: "Micro lectures: all of his material is characterized by edge beneficially beyond the limits of my own prac structure of Dental Amalgam," l.A .D.A. 47:305 (Sept.) 1953. slight and from the practical standpoint, if all other clarity, brevity, and simplicity.) tice. That was the beginning of my interest in the factors are carefully controlled, it will show few He is blessed with a natural intellectual curiosity, organizational activities of dentistry-local, state, favorable results." and thus was bound to become a well-informed per and national societies and associations-the frame This does not mean that one can be slipshod son. In fact, he gained much of his interest in pro work within which the dentist can best and most while inserting a filling. It merely suggests that fessional education and its methodology from this condensing pressure (which should be four to six inherent love of learning. Probably the most fun pounds), whether mechanical or digital, can pro damental decision he ever made was to study den duce equally good results. tistry-every aspect of it that he could-to learn as Doctors M. L. Swartz and R. W. Phillips3 made much about it as his mental and physical resources a comparison of four commonly used methods of permitted. When he completed high school, he handling the filling just before insertion but imme began his dental studies at the Baltimore College of diately after squeezing out the mercury. They Dental Surgery (University of Maryland), and re analyzed the filling made from the following pro ceived his Doctor of Dental Surgery degree in 1925. cedures. First, each piece added had more mercury He also undertook an important collateral edu expressed until the final piece was almost com cation. While attending the university, he spent pletely dry. Second, each piece of filling had the his summer vacations ringing doorbells to sell sub same amount of mercury expressed. Third, a maxi scriptions to the Pictorial Review. Thus he liter mum amount of mercury was expressed from the ally did work his way through college, but the entire mass, except that each piece was softened experience of selling, of meeting and talking with just befl9re insertion. Fourth, a maximum amount thousands of strangers, probably was more impor of mercury was expressed from the entire mass but tant, more significant, in preparing him for his no attempt was made to soften each piece. Their future as a leader in his profession. analysis showed that "no correlation could be noted " . .. AND I, HUBERT HOTCHKISS, DOCTOR OF "I had a wonderful time trying to increase the DENTAL SURGERY, BEING OF SOUND MIND, circulation of the Review and build up my college between the physical properties of residual mercury HEREBY SAY TO ALL MY RELATIVES GATHERED content and the specified method of packing." The HERE TO HEAR MY LAST WILL AND TESTA fund as well," he recalls. "I had a wonderful time authors concluded that as far as the finished filling MENT, 'THIS IS GOING TO HURT A LITTLE.''' because I was learning one of the most priceless is concerned it does not make much difference things a person can learn-how to meet and deal which method of squeezing out the mercury is used. with people. I learned, too, that I liked people, Mead Dental Hospital
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easily make contributions to his profession, his col that is to teach. The students at our dental schools Operative Dentistry-Part VI: amalgam. Improved methods of handling and high leagues, and his fellowmen." today are a preview of the new dentistry that is on standards for dental materials have made it the In 1925 and 1926 young Doctor Lynch interned the way five years, ten years from now. It is an giant of dental practice it is today. at the Fifth Avenue Hospital in New York City, exciting preview, for these young people constitute Amalgam-No.1 As an inexpensive material, easily handled, which well on the way to specializing in oral surgery. Fol a wonderful group of individuals. I am happy to will resist the stresses of mastication fairly success lowing his internship, he spent more than two years be associated with them." He smiles broadly-and by Arthur Levine, D.D.S. fully, it has no equal. Some men consider it supe at famed Mayo Clinic in Rochester, Minnesota, this man knows how to smile. "Just being around rior to a gold inlay. Certainly, it is superior to a where he supplemented his fellowship work at the them keeps me young; I don't even look my age poor gold inlay. Men like Hollenback and Korn Amalgam is the most widely used filling material clinic with courses at the University of Minnesota. when I'm with them. They keep me moving feld, outstanding authorities on amalgam restora in the world. According to physicists 1. C. Schoon physically, mentally, and professionally- just trying tions, have worked tirelessly to demonstrate that an over and Wilmer Souder 1 of the National Bureau not to faU too far behind them." amalgam filling can be as beautiful, as efficient, and Mead Dental Hospital of Standards, "More restorations are made from as lasting as the best gold inlay. amalgam than from all other materials combined." It was in the summer of 1928 that he reported at Official Assignments An alloy is the combination of two or more Mead Dental Hospital, Washington, D.C., where he By far the bulk of general practice today is devoted But educator Lynch has been no ivory-tower metals. An amalgam is the combination of a metal began his practice, and where he still practices, to amalgam fillings. More dentists spend more academician. He has loved people too much to or metals with mercury. The alloy, therefore, is along with such distinguished colleagues as Doctor time on amalgam than on any other material. It confine his activities to the classroom. He had the dry part of the filling before the mercury is Sterling V. Mead, Past President of the American is, without question, the backbone of restorative joined the American Dental Association, the Dis added. It is supplied by the manufacturer in the Dental Association; Doctor Mark Burton, Past dentistry. In the light of repeated statements that trict of Columbia Dental Society, and other profes form of fillings of varying coarseness and contains President of the District of Columbia Dental So the country would have an insufficient number of sional groups at the start of his career. A short silver, tin, copper, and zinc. Today about forty-five ciety; and Doctor Sterling G. Mead, son of the dentists to handle all the dental needs of the popu time after he began to practice in the nation's capi approved alloys are available for the profession. clinic's founder. Young Lynch was enthusiastic lation if everybody appeared for treatment, the role tal he was elected to his first official position in den about his post at the hospital, for it probably was of the amalgam filling becomes increasingly im tistry-secretary-treasurer of the District society, a Four Requirements the best equipped dental hospital in the world. portant. post he held until election to the presidency of the The American Dental Association has estab The dental hospital has every possible facility Civilized living gallops along at a fast rate. The group. By 1936 he had become so well-known in public demands better products at lower cost. Pa lished the following requirements for an alloy used and service for the care of the mouth, the extraction dental circles that he was designated the official in amalgam fillings : (1) thorough amalgamation of teeth, and all other surgical operations of the tients accept miracle drugs as a matter of course. representative of the United States Goverment at In treating trench mouth Doday, one stiff dose of in three minutes; (2) absence of granular or sandy mouth. It has an X-ray dep Page Six Page Eleven May 1955 his first look at international dentistry, and broad tic ened his whole professional horizon. The follow ing year he was chosen for his first majQr national tion of teeth: "The hand must be used with much this must chiefly bee don with a thred of gold or role-Secretary of the Research Commission of the moderation in the drawing out of a tooth; for the silver; or for want of either, with a common thred A.D.A., a position he held for a decade. jaw is oft-time dislocated by the too viol.ent .draw of silk or flax. . . . " He took on other important posts, gained other ing out of the lower teeth. A tDoth whIch IS fast Pare also describes a new method of replacing vital experience. A commander in the Dental in, and is plucked out with one pull, oft-times lost teeth, transplantation, a questionable practice Corps, United States Naval Reserve, with two years break's the jaw, and brings forth the piece together introduced in Pare's time. During the last quarter of active duty in World War II; a member of the therewith." Pare knows also very well how pos of the eighteenth century and the first quarter of Reserve Consultants Board to the Surgeon General sible it is to extract the wrong teeth: "But judg the nineteenth century, it was much in vogue, hav of the United States Navy; a member of the former ment must be used, and you must take special care, ing caught the fancy of the fashionable world. "I Armed Service Medical Advisory Committee to the least you take a sound tooth for a pained one; for heard it reported by a credible person, that hee saw Secretary of Defense; and consultant to various oft-times the patient cannot tell, for that the bitter a Ladie Qf the prime Nobilitie, who instead of a Army, Navy, and Air Force medical and dental ness of pain by neighborhood is equally diffused rotten tooth shee drew, made a sound tooth, drawn units and the U.S. Public Health Service, he has a over all the jaw. Therefore for the better plucking from one of her waiting-maids at the same time, to solid and total grasp of the dental programs in the out a tooth, observing these things which I have bee substituted and inserted, which tooth in process armed forces and in civilian agencies of the govern mentioned, the patient shall be placed in a low of time, as it were taking root, grew so firm, as that ment-knowledge that has made it possible for him seat, bending back his head between the tooth shee could chaw upon it as well as uplOn anie of the to protect and promote the interests of dentists and drawer's legs. I would have a tooth-drawer expert rest. But as I formerly said, I have this but by dentistry in those areas of government service, and and diligent in the use of such toothed instruments; hear-say." A paltry sum sufficed to induce some to talk the language of military and civilian admin Doctor lynch, at right, receiving a medal and honorary member poor devil to have his healthy, handsome teeth ship in the Argentine Odontological Association from President for unless one know readily and cunningly how to istrators and policy-makers who shape those dental Oprile, at Chicago, February 1948. In the center is Doctor Sterling use them, hee can scarce so carrie himself, but that extracted and set in some rich patient'S mouth in and allied programs. V. Mead. hee will force out three teeth at once, oft-times leav place of the latter's own painful or discolored teeth. His long experience, training, and knowledge in ing that untouch't which caused the pain." Teeth were not filled but filed, especially the so many fields of dentistry have given unusual au front ones: "If the hole bee on the one side be forced to take the suggestions seriously. He an It is interesting to note that Pare speaks of replac thority to his views. ,Vhen he states that voluntary tween two teeth, then shall you file away so much dentistry, and voluntary dentistry alone, can and nounced his candidacy in 1952, determined to win ing only the "fore-teeth" which "mooved, broken or of the sound tooth, as that you may have sufficient will solve the problems of poor dental health in ejection to the greatest dental post in the world. stricken out of their places by som violent blow, libertie to thrust in your wier doing anie harm." the United States, members of the Congress-many which c '! !>ti . " F, . .. t fo rfillng fl>f r.tt A.D.A.?" Naturally, he liked to hear that, but he regarded such comments as gracious, overly kind Each dentist must admit, amenities-until so many friends and strangers alike For when we poets get our bills, became more and more insistent. Then, when some of the top men of the pwfession also pressed him, Brother, we remit! stressing his unusual experience in all aspects of CHAP. dentistry and emphasizing his obligations to the When teeth were filed. The first obturators. profession which had done so much for him, he was Nancy Talbert __--I Page Ten Page Seven , , - ,ie May 1955 May 1955 tic A Pictorial History: Part V-Dentistry in the Renaissance-No. 1 by Curt Proskauer, D.M.D. I n the middle ef the fifteenth century, printing and bettles ever the windews, a brush hanging Leenarde da Vinci, greatest genius ef the Renais ing, and applicatien ef cupping-glasses (the last with mevable type was invented, eutmeding the [rem the wall, and a heavy eperating chair. Later sance, had ne influence en eral anatemy. His netes was intreduced again 350 years later, at the begin expensive handwritten cedices. This inventien pre on we shall find similar "effices" depicted in seven and drawings, though produced earlier than the ning ef the twentieth century, by the eminent Ger meted the disseminatien ef science and knew ledge teenth and eighteenth centuries paintings. writings ef Vesalius and Eustachius, remained man surgeon August Bier.) These metheds, Pare ameng a wider pepulatien and much accelerated Theugh this beeklet is extremely impertant frem unknewn until the beginning ef the twentieth declares, "absolutely belong te the Physician." the revival ef the arts and sciences-what we call the the point ef vic,' of dental history and bibliog century. At the end ef the fifteenth century he \'\There these varieus remedies prove ef ne avail, Renaissance-that had begun in Italy a hundred raphy, it consists mainly ef passages extracted from describes the anatemy ef the jaws and teeth and "if the pain bee net asswaged with these, yeu shall years befere. eld Roman and Arab medical works. Twe great accompanies this descriptien with the first accurate com te narcoticks, which may stupefie the nerv." Dentistry alse had a kind ef renascence at the anatomists, hewever, Andreas Vesalius (1514-1564) drawings, executed with the highest artistic skill. He recemmends hyescyamus, epium, campher, and beginning ef the sixteenth century. In 1530 a beek and Barthelomeus Eustachius (1520-1574) did suc In ene drawing the skull is divided dewn the mid papaver, to be put inte the teeth. He relates his in the German vernacular was published in Leipzig ceed in threwing new light en oral and dental dle, in twe ethers the skull is seen frem the right own experience: "I beeing ence troubled with under the title Artzney Buchlein wider allerley anatemy. In his velumineus De humani cOl'paris side befere and after remeval ef the external wall grieveus pain in this kinde, fellewed the ceunsel kmnckeyten vnd gebrechen der tzeen ("Beeklet ef fabrica (1543), Vesalius described and pictured cor covering the sinus maxillaris. These are the first of a certain eld weman, and laid garlick rested Remedies Against All Kinds ef Diseases and Infirmi· rectly, en excellent weodcuts, the form and number drawings te display the maxillary air sinus, usually under the embers te my pained teeth, and the pain ties ef the Teeth"), and became knewn as the Zene ef eight teeth en each side ef the human jaw, male and unjustly asseciated with the name of Nathaniel ferthwith ceased. The same remedie used te ethers Artzney ("Remedies fer the Teeth"), the title ef and female. This ended the contreversy raging Highmore, the English physician, whe described treubled with the like affect, had like success. Mere seme ef its many later editiens. The beek was a between the varieus groups ef physicians as to the and depicted it enly in 1651, mere than 150 years ever, sem think it available if it bee put inte the systematic, cemprehensive menograph, the first proper number ef teeth (accerding te the fellew later. auditerie passage. . . . But if the teeth bee hel werk in werld literature cevering the dentistry ef ers ef Aristetle, females sheuld have fewer teeth \'\Thereas Vesalius and Eustachius advanced den lewed, and that the patient will net have it pull'd the era. It became very pepular ameng surgeens, than males) Vesalius adds sarcastically: "Since tal science, the French surgeen Ambroise Pare out, there is ne speedier remedie, then to put in barber-surgeens, and laymen, and is regarded as a ne ene is prehibited from ceunting the teeth, it is (1520-1590) opened a ne" era in the practice ef caustick medicines, as eil of vitriel, aqua fortis, and landmark in the general histery ef dentistry. Its ebvious that it is as easy fer anyene te test this dentistry. He says: "Of all pains, there is nene also a het iron (cautery); fer thus the nerv is title-page shews a dentist practicing his prefessien, assertion as it is te say it is false." which mere cryelly termenteth the patients than' burn't in sunder, andleseth it's sens." \Ve see that extracting teeth with leng, slender pincers. He is Twenty years later, in 1563, Eustachius wrete the the Teeth-ache. 'We see teeth by daily experience Pare fully understeed the rele the pulp plays in standing sidewise and behind the patient, bent first menegraph en the anatemy ef the teeth, his to bee eaten and hollewed, they are pained as if toothache. slightly ferward, in the regular pese fer mandibular fameus LibeUus de dentibus; it treated net enly the yeu thrust in a pin er bedkin, the bitterness of the For pyerrheea he recemmends "If the teeth grew extraction; the patient is sitting in a centracted anatomy but alse the embryology and physielegy pain is such." Pare advises: "In the bitterness ef lees by the decaying gums the use ef wch things attitude. The "dental office," scantily furnished, ef jaws and teeth. These twe anatemists contrib pain wee must net presently run te Teeth-drawers, as fasten the teeth." Further: "If they becem lees consists of a high door, a heavy woeden ceiling, a uted enermeusly te the develepment ef dental and er caus them presently to ge in hand to pluck them by a fall or blew, they must net bee taken ferth, but long bench against the back wall, a shelf with jars eral science 1vhile the far mere admirable werk ef out. First consult a Physician, who may prescribe restered and fastened te the next that remain firm, remedies according te the varietie of the causes." fer in time they will bee confirmed in their seckets." Such physicians' remedies Pare lists as diet, bleed- Pare alse gives exact instructiens for the extrac- ~------f . . I , .. ".. - ..JliA1~(1.... . ~ -' ;: .~.. ::; .:: :.. ~ --;'.: ~: ", . . a dentist practicing his profession ..." A contribution of Leonardo do Other drawings by do Vinci. Early dental anatomy. Illustrations of instruments from the works of Vinci. A pioneer book on dentistry. Ambroise Pare. Page Eight Page Nine