Pennsylvania Association of Dental Surgeons. [Volume: 2, Issue: 1, August, 1860, pp. 25-32]

PROCEEDINGS OF DENTAL SOCIETIES.

31

Dr. Garretson said, that as a mechanical difficulty to be overcome,
saliva was the great drawback to operative dentistry, and thought it
would be well for the profession to give more attention to this particular
subject. It was most vexatious to work in a very wet mouth, while it
was a positive pleasure to operate in a dry one. All must admit that it
is very difficult to make a successful operation when the work has to be
performed under water. This is due to several causes, it being extremely
difficult to put in fillings, under such circumstances, that would be perfectly solid. Again, if the saliva is very acid, a certain amount will,
during the operation, be absorbed by the open-mouthed tubuli bordering
the cavity, and this acid, breaking down its equivalent portion of dentine,
would of course destroy the integrity of the operation. He, however,
overcomes the last difficulty by a very free use of Labarraque's solution, made weak, sponging out the cavity every few minutes, and giving it
to the patient occasionally to hold in the mouth. He thought this practice eminently worthy the attention and imitation of members. He alluded
to the sialagougic effect of napkins placed in the mouth, and remarked
there were cases where it was much better to do without them. Patients,
he thought, should be given some directions in the management of these
napkins when used. Some persons by the constant movement of the
tongue making it an impossibility to keep them in position. It would
also be a good idea to prepare patients for operating by directing them
occasionally to place a napkin between the lip and gum, commencing a
week or more before the visit. Decoctions of Privet, made icy cold and
held in the mouth a few moments before operating, would be found invaluable. Hie alluded to certain medicinal agents which influence the secretions,
and broached the idea that their exhibition under some circumstances
might be admissible. When there was no probability of finishing an
operation before becoming wet, he never attempted the adhesive mode of
working the gold, but used cylinders, pellets, etc.
Dr. Buckingham referred to the difference in the quantity of saliva
secreted in twenty-four hours, as given by different physiologists. Dr.
Carpenter, for instance, says: "It is calculated by Bidder & Schmidt,
that the average in man is about three and a half pounds daily; and
high as this estimate seems, yet it is based on data apparently satisfactory. "
He thought it true that caries is often due to vitiated saliva, induced
by some constitutional derangement. Saliva is also a fluid that rapidly
runs into decomposition, and as a consequence the chemist finds it
almost impossible to analyze.
He has found that the salivary secretions are always greater immediately after eating, and particularly noticed this in the case of a fellowpractitioner, for whom he operated immediately before eating without
inconvenience from saliva, but afterwards the flow was so excessive as to