by extraction such teeth as are in the way, and by mechanical contrivances, known as regulating plates, to apply pressure in such a manner as will move the misplaced tooth or teeth into their normal position, and retain them there for some time afterwards. Such plates are constructed on the same principles, and of the same materials, as the bases of artificial sets, which will come to be treated of afterwards. It not unfrequently happens that nature, if left to herself, effects a wonderful improvement in cases of dental irregularity. This is frequently observable where it is the upper canines which are misplaced. These teeth when appearing, as they often do, outside and much above the necks of the adjoining teeth, occupy a long time in descending, and in certain cases the anterior portion of the maxillary arch seems to enlarge sufficiently to afford space for their almost perfect arrangement during this period. The same thing occurs, but to a less marked extent, in the case of other teeth ; in general, however, nature requires to be assisted by art in some way, as has been above indi cated, where the irregularity exists to any great amount.
Diseases of Teeth.—The teeth being living organisms are, like other structures in the animal body, subject to disease. Some of the diseases bear a close resemblance to mere chemical decomposition, such as occurs in dead or inorganic matter, and at a certain stage of some dental affections a pro cess of the kind does no doubt occur ; but this is so mixed up with, and accompanied and preceded by vital action, that to consider it as a mere chemical or physical lesion would be pathologically incorrect. Various arguments have been advanced by its advocates in support of the chemical theory of dental caries ; but however ingenious or specious these at first sight appear, they fail to explain many phenomena in the origin, the period of occurrence, and the stages and progress of this disease, unless the vital element in its nature be also taken into account. Dental caries, or decay of the teeth, may briefly be described as consisting in a previous imperfect development, or in the access of some morbid action interfering with the nutrition or vitality of their tissues, thus rendering them liable to any destructive agencies to which they may be subjected, by which they become disorganized, disintegrated, and broken down, leaving the sensitive pulp exposed, whereby acute pain is occasioned, especially when the destruction of the protective tooth substance has been rapid. Sometimes the process of decay is insidious and unobserved. Its advent is then supposed to have been sudden, and its progress more speedy than has really been the case. This, however, in many instances arises from the condition of matters being overlooked until the enamel, which resists destruction longest, being undermined and falling in, reveals for the first time the cavity existing un derneath. Pain, probably also for the first time, is then experienced from exposure and irritation of the dentinal pulp, and toothache, as it is termed, is produced. Necrosis, or death of a whole tooth, is another lesion to which these organs are liable. This may result from either acute or chronic inflammation in the tissues connecting them with the jaw, or from a blow, or from any other cause leading to their vascular supply being cut off. The necrosis may involve the whole tooth, or it may be partial as, for example, where it is limited to one fang of a multiple fanged tooth. In these cases there may be no breaking down of texture, but the tooth becomes discoloured, loosened, extruded, and at last detached from its socket, from which after a time, and generally after considerable uneasiness, it drops out. Exostosis, or a morbidly increased growth of certain parts of a tooth, being in almost every instance confined to the cement substance described as covering the fang or root, is an affection somewhat obscure in its outward symptoms. It is generally a consequence of previous disease of the tooth, leading to chronic inflammation of the textures covering the fang and lining the socket (or alveolus) in which it is implanted. This leads to a deposi tion of new material in the cement till that substance appears in nodular masses attached to or surrounding the apex of each fang, and sometimes uniting several of such fangs into one. The presence of this additional and in creasing bulk of hard tissue within the inclosing socket produces pain of a severe and somewhat anomalous charac ter by pressure on the adjacent nerves, which is often mis taken for neuralgia or tic of a less unaccountable origin. It further acts within the unyielding bony socket referred to as a means of rendering removal of the tooth much more difficult, owing to the bulbous extremity of the enlarged fang acting like a rivet in its fixation. Generally, however, the teeth in which exostosis occurs have been too long the subjects of irritation and decay not to be suspected when obscure pain of a less localized nature exists in their vicinity; and not unfrequently there is found round the necks of teeth or stumps so affected a red and tumified con dition of the gum, sufficiently indicative of the state of matters below to warrant their extraction. Alveolar abscess, or gum boil, as it is popularly denomin ated, is a localized inflammation going on to suppuration, and generally confined to the tissues surrounding the apex of a tooth fang. The pain usually commences with a feel ing of tenderness and enlargement or lengthening of the whole tooth. The gum becomes swollen and tender over the whole depth of the root, generally to a greater extent on the outer side of the jaw. The face also becomes swollen, and the glands in the neighbourhood of the jaw feel enlarged and tender. The pain is not commonly con tinuous, but rather remitting in its character, sometimes ceasing altogether only, however, to be followed by an in creased attack, while its repeated exacerbations night and day lead in many cases to very considerable constitutional disturbance. After a time the purulent matter secreted makes its way to the surface, sometimes finding an escape alongside of or through the pulp cavity of the fang, and very frequently, as the name given to the disease indicates, by pointing and discharging itself through the gum. Occasionally, instead of pointing on the surface of the gum, the matter takes a more indirect course and points on the surface of the cheek, bursting and leaving an open sore there which seldom closes until the tooth or stump has been extracted. At an early stage of this disease fomenta tions and other modes of relieving inflammatory action do good, but evacuating the matter by means of incisions or extraction of the offending tooth are the only reliable remedies at a later period.
Teething.—What is termed dentition, although in its widest sense properly including the development of the teeth within, as well as their subsequent appearance through, the superimposed tissues, is generally restricted in its application to the latter division of this process, more especially as it occurs in connection with the temporary or milk set, during the period of early infancy. The genesis, increment, and evolution of these organs involve so much of what is purely physiological, and would entail the discussion of so many points of a histological nature, that only the latter stages of evolution or cutting of the teeth can be referred to here. Regarding this occurrence, the most vague and contradictory opinions have been enter tained. Erroneous notions of its nature, and of the exact manner in which to account for many of its phenomena, have been and still are promulgated. A number of morbid affections incident during infancy are set down as clearly attributable to the tooth s penetration of its inclosing
tissues, and considered by many authorities as of every day
