- Email: [email protected]
“Dead Teeth”
Editorial Department
373
course, dentistry is a specialty— it is a specialty of the great heal ing art, and not a specialty of medicine as constituted and prac ticed today. And it never can be for the very reasons advanced by the editor of the Boston Medical and Surgical Journal. The criterion on which all such questions are finally decided is the one of extended practical test, and the point may logically be raised as to which system has proved of the greatest value to the people— the one in vogue in America whereby dental educa tion is under the direction of dentists, or the one in certain other countries where medical men dominate the entrance to dentistry. It is always ungracious to make invidious comparisons in matters of this kind, but the verdict of the world at large has been emphatically in favor of the American system. It is the people we serve who have to be considered in these matters, and not the supposed prestige of the professional man, and when it can be shown that better service will come to the people under the pro posed plan than has been given them by the system in operation for more than eighty years, it will be in order to suggest a change— but not till then. “DEAD TEETH” This unfortunate term has been accountable for the loss of many useful teeth, and it should be expunged from our literature. It is the fault of the dental profession that it was ever employed, and it should be the duty of the profession to see that it is elimi nated. Medical men, not familiar with dental structures, natu rally accepted the term at its face value, and it was accordingly logical for them to order such teeth extracted. No physician with any judgment would want anything “ dead” left in his pa tient’s mouth, and if a pulpless tooth were really a dead tooth, there would be no tenable argument in favor of its retention. But a tooth with a good pericemental membrane surrounding the root and attaching it to the alveolar process is by no means a dead tooth.
374
The Journal of the American Dental Association
When the pulp dies, sensation is eliminated from the dentin, which can then be drilled or cut without pain, and this circum stance led to the impression that the tooth was dead. It was a very natural misconception on the part of dentists, and no blame should be attached to them for its introduction. But the blame lies in the fact that this term was permitted to continue even after its fallacy was shown, and when the damage done through its use had been amply demonstrated. Today, physicians quite commonly speak of “ dead teeth” when they mean pulpless teeth, and the distinction between the two should be shown them by every available means. Even without the histologic evidence, which is incontro vertible, the fact that these teeth frequently remain in the mouth for many years without being exfoliated is conclusive proof that they are not dead. A tissue that is dead will not be tolerated for any time by the system. The harm that has been done by the use of this term can never be estimated. Patients, when told that they have dead teeth, are quite likely to begin to feel uncomfortable at once, and the fact that at least some of our ailments have a psychologic basis lends itself conveniently to the general mental demoralization which assails certain people under such circumstances. The term pulpless teeth is not only more accurate histologically, but also much less terrifying to the patient. The message should be carried to the medical profession through every possible medium that, when they speak of dead teeth, they are using a misnomer which is not only unjustifiable but also calculated to work a grave injury to their patients. Medical men are usually genuinely anx ious to serve their patients in the most efficient way, and if they have been led astray by dentists in the use of this unfortunate term, it is high time that dentists do their share in correcting the error, and showing their medical brothers its fallacy. When this term is finally eliminated from medical and dental nomen clature, we shall have a more intelligent mental attitude toward the extraction or the retention of such teeth.
373
course, dentistry is a specialty— it is a specialty of the great heal ing art, and not a specialty of medicine as constituted and prac ticed today. And it never can be for the very reasons advanced by the editor of the Boston Medical and Surgical Journal. The criterion on which all such questions are finally decided is the one of extended practical test, and the point may logically be raised as to which system has proved of the greatest value to the people— the one in vogue in America whereby dental educa tion is under the direction of dentists, or the one in certain other countries where medical men dominate the entrance to dentistry. It is always ungracious to make invidious comparisons in matters of this kind, but the verdict of the world at large has been emphatically in favor of the American system. It is the people we serve who have to be considered in these matters, and not the supposed prestige of the professional man, and when it can be shown that better service will come to the people under the pro posed plan than has been given them by the system in operation for more than eighty years, it will be in order to suggest a change— but not till then. “DEAD TEETH” This unfortunate term has been accountable for the loss of many useful teeth, and it should be expunged from our literature. It is the fault of the dental profession that it was ever employed, and it should be the duty of the profession to see that it is elimi nated. Medical men, not familiar with dental structures, natu rally accepted the term at its face value, and it was accordingly logical for them to order such teeth extracted. No physician with any judgment would want anything “ dead” left in his pa tient’s mouth, and if a pulpless tooth were really a dead tooth, there would be no tenable argument in favor of its retention. But a tooth with a good pericemental membrane surrounding the root and attaching it to the alveolar process is by no means a dead tooth.
374
The Journal of the American Dental Association
When the pulp dies, sensation is eliminated from the dentin, which can then be drilled or cut without pain, and this circum stance led to the impression that the tooth was dead. It was a very natural misconception on the part of dentists, and no blame should be attached to them for its introduction. But the blame lies in the fact that this term was permitted to continue even after its fallacy was shown, and when the damage done through its use had been amply demonstrated. Today, physicians quite commonly speak of “ dead teeth” when they mean pulpless teeth, and the distinction between the two should be shown them by every available means. Even without the histologic evidence, which is incontro vertible, the fact that these teeth frequently remain in the mouth for many years without being exfoliated is conclusive proof that they are not dead. A tissue that is dead will not be tolerated for any time by the system. The harm that has been done by the use of this term can never be estimated. Patients, when told that they have dead teeth, are quite likely to begin to feel uncomfortable at once, and the fact that at least some of our ailments have a psychologic basis lends itself conveniently to the general mental demoralization which assails certain people under such circumstances. The term pulpless teeth is not only more accurate histologically, but also much less terrifying to the patient. The message should be carried to the medical profession through every possible medium that, when they speak of dead teeth, they are using a misnomer which is not only unjustifiable but also calculated to work a grave injury to their patients. Medical men are usually genuinely anx ious to serve their patients in the most efficient way, and if they have been led astray by dentists in the use of this unfortunate term, it is high time that dentists do their share in correcting the error, and showing their medical brothers its fallacy. When this term is finally eliminated from medical and dental nomen clature, we shall have a more intelligent mental attitude toward the extraction or the retention of such teeth.