The Operator for the Teeth: Charles Allen 1685
The first English Dentistry Text-book.
Translation to modern English by Dentaljuce, with added sub-headings.
If quoting excerpts, please acknowledge "Dentaljuce".
The Proem
Introduction to the Importance of Dental Health
I understand that it's the responsibility of every individual, particularly those living in a civilised society where personal interests align with the common good, to contribute as best they can to the welfare of the public. Recognising the significance of everyone being aware of the benefits they can gain from my expertise, I am determined to present here what I believe is essential for everyone to know about maintaining and improving their dental health. This might seem trivial to many, but in reality, it's incredibly valuable due to its numerous and significant impacts.
Commitment to Public Welfare and Overcoming Criticism
In doing this, I will fulfil my duty to both God and humanity. As long as my efforts are helpful to others (which they surely will be if applied), that is all I aim for, paying little attention to the critics' opinions of me.
Significance of Dental Health in Overall Well-being
The usefulness of my work will become evident throughout this discourse. Its main goal is to prevent tooth loss, which is critical in food preparation. Without teeth (or without strong digestive aids), proper digestion of food in the stomach is hindered, leading to indigestion and numerous impurities harmful to human health. These can be the root of countless diseases and ailments that not only make life difficult but also significantly shorten it.
Common Perceptions and Consequences of Tooth Loss
This is so true that it has become a common saying among the general public. They often remark that a person with naturally thin teeth is likely to have a shorter life, mainly because such individuals cannot chew their food properly. Additionally, losing teeth can make speech difficult for the individual and hard to understand for others. In summary, the deterioration or absence of teeth is as significant a disability and as prejudicial to a person as any other physical ailment can be.
Section 1
Of the Nature of the Teeth
Understanding Science: Theoretical and Practical Aspects
What people commonly refer to as science, or the understanding of any entity, is usually divided into two parts: theoretical and practical. The theoretical aspect includes the reasons and causes of things, along with the process and method by which they develop into their current state. The practical side focuses only on their properties and effects, as they are in reality, without exploring how they came to be made or thus qualified.
Examples from Philosophy and Navigation
For instance, in physical matters, when philosophers examine the nature of a lodestone, they investigate its origins and trace the causes of its formation back to their sources. They use these findings to explain all phenomena related to the lodestone. Mariners, however, see it simply as a stone that attracts iron and can impart this property to the iron. If unobstructed, it will always align one side towards the north and the opposite side towards the south, which is sufficient for their navigation purposes without concerning themselves with the cause of the magnet's remarkable properties.
Integrating Theory and Practice in Dental Science
Each of these aspects of knowledge, when isolated, cannot provide a complete and satisfying understanding of a subject. Therefore, in discussing my art, I should logically start with its theory, talking about the elements, principles, and rudiments of teeth, which form the subject matter. This would include the reasons for their structure and growth above the gums, and any other causes of their unique nature, before moving on to practical applications.
Postponement of Theoretical Discussion
However, due to certain considerations, I am postponing the theoretical discussion for a more suitable time and will only cover some principal points related to the practical aspect of my profession. In doing so, even though it would suffice to discuss things as we find them, for the reader's satisfaction and out of a genuine desire to help, I will include necessary reasons for a real understanding of what we will discuss. Thus, although this treatise will be incomplete as it lacks many aspects, what it contains will be as useful and beneficial as if it were complete.
Structure and Nature of the Tooth
Following the method I have set, we will next consider the structure and nature of the tooth. Analysing a tooth reveals that its substance is not uniform throughout but consists of two distinct types of material. One is harder, whiter, and of a finer texture, and the other is softer, darker, and coarser. The former constitutes the visible part of the tooth above the gums, while the latter forms its root within the gums.
Composition of the Visible Part of the Tooth
The visible part of the tooth also consists of two different elements: its hard outer layer or enamel and its inner substance. The enamel is like a tough covering that protects the head of the tooth, much like enamel on gold. This natural enamel, which I call the gloss of the tooth, is harder, whiter, denser, and shinier than the inner substance beneath it.
This part of the tooth can be compared to the outermost skin layer, as it is bloodless and lacks sensation. It serves to protect the inner tooth from external damage and to enhance the tooth's beauty and strength. The enamel has pores for the expulsion of waste, which vary in shape and size in different people and also differ in thickness, affecting the tooth's colour.
Composition of the Inner Part and Root of the Tooth
The inner part of the tooth, though less bright and solid than the enamel, is more compact and clearer than the root. It contains various types of pores or channels, some of which transport blood from the centre of the tooth to the end via tiny arteries, while others return the blood from the end to the centre through capillary veins. The root of the tooth is the darkest, softest, and most porous part of the tooth, yet it is denser and harder than any other bone in the body.
It has two types of channels with different orientations. Some carry blood through the tooth to the gums, while others transport blood back to the heart from the membrane surrounding the tooth's cavity. In small teeth, the root is a single entity, while in larger teeth, it divides into two, three, or four branches called roots or fangs.
Each of these roots contains a small channel leading up to the head of the tooth, where they converge into a single cavity through which the tooth's vessels pass. Each tooth has its own socket in the jawbone, separated from the others by a thin extension of the bone, with most of the root inside the socket and the rest surrounded by the gums.
Section II
On the Changes in Teeth and Their Remedies
Introduction to Teeth Deterioration and Change
From understanding the nature of teeth, let's now consider the first stages of their deterioration or change. It's important to note that our bodies are designed by nature to constantly lose particles, which mostly leave through skin pores. If these particles, which become waste once separated from the body, are not expelled due to blocked pores, it can lead to fevers and significant disorders in our blood and bodily functions.
Similarly, teeth emit certain substances through their pores. When the expulsion of these substances is blocked due to clogged pores, the teeth become susceptible to various ailments.
Causes of Tooth Ailments
Teeth, being rigid and inflexible, don't get blocked by shrinking or tightening like skin, but rather by external substances entering their pores or a slimy coating forming on their surface. This happens when we eat sticky foods, leaving some viscous parts on the teeth. Combined with tartar from the lungs, heat in the mouth, and a stone-forming juice from saliva glands, this forms a stone-like substance known as dental tartar.
These scales, if not removed, will continuously thicken and eventually cover the teeth entirely, except where they grind against each other.
Effects of Tartar on Teeth and Gums
Understanding how these scales form, let's look at their harmful effects on teeth. The first issue is the blocking of tooth pores, leading to all other problems. This blockage prevents waste particles from leaving, causing them to accumulate and decay inside the tooth. This decay begins with colour changes from white to yellow, then to black, followed by actual decay of the tooth's substance.
Further Complications and Preventive Measures
This harmful substance not only damages teeth but also affects the gums. Some of its particles, after fermenting, pass through the scales and slide between the gums and teeth, destroying the ligaments that hold them together, sometimes reaching the jawbone. This is evident from the soreness and looseness of gums where scales are found, especially if they've thickened considerably.
Sometimes, if the usual exit paths of this corrupted substance are blocked by scales, it is forced towards the tooth's centre. There, it causes severe pain and gradually corrodes the membrane and tooth vessels. Spreading out of the tooth, it then affects the socket, destroying the connections between the teeth, jawbone, and gums. Consequently, teeth often fall out, seemingly intact but yellowed, because the waste didn't stay under the scales long enough to cause more damage.
Maintaining Dental Hygiene
To prevent these issues, keep your teeth clean from tartar and other dirt. If they are already clean, maintain their condition. If not, have them cleaned by a skilled professional, as an unskilled person might do more harm than good, like damaging the film that connects gums to teeth or removing the tooth's enamel. This can lead to the tooth losing its natural shine, turning yellow, becoming prone to pain, and eventually decaying completely. The gums, being loose and damaged, will also deteriorate and separate from the teeth.
Recommendation for Dental Care Product
Once your teeth are clean, you can maintain them with this mixture: equal parts of pearl magistery, coral powder, and dragon's blood, mixed with enough rose water to create a medium consistency, neither too hard nor too soft. I have an excellent toothpaste for this purpose, which, if used weekly, keeps the teeth clean and white. Regular use can even restore lost colour to a considerable extent. This is the same product that I, somewhat improperly, refer to as an "opiat" in my advertisements.
Section III
On the Decay of Teeth and Their Remedies
Introduction to Advanced Tooth Decay and Its Management
In the previous section, we considered the early stages of tooth decay, where the teeth undergo minor changes but their substance, form, and proportion remain intact. This is merely an alteration, a state where teeth are under attack but can still be saved. Now, we will discuss teeth that are fully decayed, where the goal is to prevent their complete destruction.
Effective Measures for Moderately Decayed Teeth
For teeth that are not too far gone, prompt action can still be effective. The first step is to clean the outside of the teeth, then remove any decayed parts within using a suitable instrument. After scraping, thoroughly rinse the teeth with a suitable liquid to remove any remaining debris. If the tooth is hollow enough for filling, it should be filled with non-corrosive, taste-neutral materials that are durable enough for regular use.
Managing Severely Decayed Teeth
If the tooth is uniformly decayed without any cavity, it must be kept clean, especially after meals, to prevent decay from spreading to other teeth. My advice is to keep even severely decayed teeth, as long as they don't cause pain, because their roots help maintain the alignment and stability of the other teeth. However, if they are in very bad condition and cause pain, it's better to have them removed to avoid damaging the gums and affecting healthy teeth.
The Risks and Considerations of Tooth Extraction
Tooth extraction, while common, is often misunderstood and can be quite dangerous, especially from the lower jaw. It requires great care and should not be done rashly.
Section IV
On Tooth Replacement
Introduction to Tooth Replacement Options
When decayed teeth are beyond saving, or have been extracted due to intolerable pain, don't lose hope. The loss is significant but not irreparable. Natural teeth can be artificially replaced, and when done well, these replacements are indistinguishable from natural teeth in colour, firmness, and proportion. Properly fitted, they support the adjacent teeth, making the entire jaw stronger.
Benefits of Artificial Teeth
Artificial teeth offer many benefits, such as stabilising the other teeth and improving appearance and speech. However, they must be well-made for these advantages.
Natural Tooth Transplantation
Besides artificial methods, there's a natural approach involving the transplantation of healthy teeth from another person's mouth. This method, while challenging, is feasible, as demonstrated in the case of a lady who had a double tooth mistakenly thought to be two separate teeth. The tooth was reinserted after extraction and became firm again with appropriate treatment.
Ethical Considerations and Animal Alternatives
Despite this successful case, I don't recommend this method due to its inhumanity and complexity. A better alternative is using animal teeth, such as from dogs, sheep, or goats. The procedure involves carefully extracting the animal's tooth and replacing the patient's tooth with it, securing it firmly in place. With proper care, this transplant can integrate well with the gums and jawbone, becoming as stable as natural teeth. This can be considered a natural restoration or renewal of human teeth.
Section V
On Toothache, Loose Teeth, and Gum Decay, and Their Remedies
Understanding the Causes of Toothache
Toothaches can be caused by many different factors. To understand them better, it's important to consider the blood vessels that supply the tooth. The primary vessel is an artery that brings warm, nutrient-rich blood from the heart. This blood initially forms the tooth and continues to nourish and repair it. The artery branches into numerous small vessels that distribute blood throughout the tooth. Excess blood is then returned to the heart through tiny veins.
Effects of Blood Flow Disruptions on Tooth Pain
When the artery is dilated due to an excess of blood, it can block the vein, disrupting blood circulation. This leads to swelling and pain in the tooth, which continues until the blood's abnormal state changes or the small arteries in the tooth's root stretch enough to discharge the excess blood into the gums, cheeks, and lips, causing swelling.
If the vein is blocked at the start of this disorder, rapid blood flow can stretch the artery's walls, allowing thinner blood components to accumulate at the tooth's root. This accumulation can become infected, causing severe and lasting tooth pain. In such cases, bleeding the gums can be an effective part of the treatment.
Impure Blood and Its Effects on Dental Pain
If the blood in the brain, responsible for producing animal spirits, is impure and not sufficiently filtered, it can cause headaches, dizziness, or, when it reaches the nerves, pain in various body parts, especially the teeth. This pain is caused by the discharge of harmful humour between the tooth's membrane and vessel sheath, leading to constant agony until it is expelled.
Causes and Remedies for Loose Teeth and Gum Decay
Loose teeth often result from gum decay, which can be caused by many of the same factors as toothaches and tooth decay. Excess blood from the teeth can overwhelm the gums' veins, leading to bleeding and gum tissue decay. The waste products from the teeth can also erode the gums. Additionally, tartar and dirt on the teeth can harm the gums.
To prevent these issues, keep your teeth and gums clean. If your teeth are already loose and your gums have decayed, seek help from a professional. General remedies are not sufficient here, as treatment must be tailored to the specific cause and condition, which is best understood by a specialist.
Anatomical Considerations
I could have mentioned that the tooth's artery originates from the carotid arteries, the vein from the jugular, and the nerve from the fifth pair of nerves, but this information is either already known to those familiar with anatomy or would be meaningless to those who are not, without a detailed explanation of these vessels. This level of detail is beyond the scope of this section.
Section VI
On Children's Teeth
Introduction to Children's Dental Development
So far, I have discussed teeth concerning adults and older children. In this final section, I'll concisely and clearly explain what is necessary to know about the growth and change of teeth in young children, which is a matter of great importance as it often affects the lives of infants.
Early Stages of Dental Growth in Infants
A child is born without teeth and remains toothless until about five or six months old. At this time, the primary teeth in each jaw start to emerge, with no set order. Sometimes the upper teeth appear first, and sometimes the lower teeth do. After these initial teeth, the rest follow in both jaws: the four additional incisors, the four canine (or dog) teeth, and the first eight molars, which are the double teeth.
Emergence of Larger Teeth
Then, the four largest teeth, which can be called Quadruple Teeth and are about three times larger than the smaller teeth, appear. Following these are the eight last teeth, which can be termed Treble Teeth. However, the timing of their appearance varies considerably, with the last four often not emerging until around twenty or twenty-one years old. These are sometimes called Wisdom Teeth, as it's believed that by this age, a person should have full use of their rational faculties, though how often this is true is debatable.
Teething and Its Challenges
The eight incisors and four canine teeth typically come in during the first year; the eight double teeth in the second year; and the four quadruple teeth, along with the first four treble teeth, in the third year. During the eruption of these teeth, especially the four quadruple teeth, children often suffer from fevers and significant health changes, which can severely weaken them and sometimes even be fatal. This usually happens due to a lack of assistance in easing the teeth through the gums.
Professional Perspective on Children's Dental Care
I consider the knowledge of children's teeth as an essential part of my profession. Therefore, I feel obligated to improve, expand upon, and make this knowledge as beneficial as possible for preserving the lives and health of children and preventing the various ailments they suffer due to the emergence and shedding of their teeth. Based on my experience and understanding, here is what I recommend:
Recommendations for Managing Teething Discomfort
Firstly, those caring for children should pay close attention to when the child's teeth start causing discomfort. Signs of teething include the child's irritability, excessive crying, drooling (often referred to as drivelling by nurses), and swollen gums. When you notice these symptoms, regularly wash the child's mouth with the following mixture: Boil seven or eight fresh figs in a pint or more of whey until they soften. Then strain the whey and the figs' substance through a cloth. Take half a pint of this liquid, add half an ounce each of Honey of Roses and syrup of violets, and three or four spoonfuls of plantain water. Mix these ingredients well and store them in a closed bottle.
Application of the Teething Mixture
The best way to apply this mixture is by using a stick of licorice, beaten at one end to resemble a small, brush-like comb. Dip this licorice stick into the mixture and gently wash and rub the child's swollen gums with it, doing this at least five or six times a day. Continue this treatment until you see the gums turn white over the emerging tooth, which indicates significant pain in that area and that the tooth is about to break through the gums. At this point, use a lancet or a very sharp pen-knife to carefully make two intersecting cuts at the centre of the white area, down to the tooth beneath. Keep using the mixture until the tooth becomes visible above the gums. Follow this method for each emerging tooth, identifiable by the symptoms described above.
The Natural Cycle of Children's Teeth
Once all the teeth have emerged (except for those that appear around the age of twenty-two), they remain firm and strong until the child is about six or seven years old. At that point, most of these teeth start to loosen and eventually fall out. The treble teeth (wisdom teeth) usually don't change, and the quadruple teeth rarely do, but the incisors, canine teeth, and double teeth always do. Sometimes these teeth fall out entirely, and then the secondary (permanent) teeth take a long time to grow in.
Shedding of Baby Teeth
More commonly, only the top part of these baby teeth comes off, leaving the remainder as the base for the new tooth. This process is similar to a young plant's growth cycle, where the upper part withers in the winter and falls off in spring due to its loose texture and the dilation of its sap-carrying vessels, which allows for the absorption of larger, undigested particles unsuitable for the plant's nourishment. These particles, being irregular and inactive, stop moving when cold compresses the plant, causing that part to lose nourishment and dry up, followed by a new sprout from the remaining part.
Compression and Change in Young Teeth
Similarly, when young teeth are exposed to cold air while still tender and soft, they undergo changes. Those teeth that are more susceptible to change and exposed to harsh conditions (due to their size and location) are compressed, causing their substance to become denser, and the spaces between their parts to narrow. This compression is caused by the erratic movement of some of the smallest particles in the teeth, which, due to their instability, disrupt the structure of the rest. The veins and arteries in the teeth become extremely compressed, blocking the flow of blood, which is often impure in children, as indicated by their common illnesses and feverish tendencies. This impurity in the blood causes it to coagulate within the teeth.
Reconciliation of Contradictory Observations
If you ponder my explanation about the agitation and stagnation of children's blood in their teeth being caused by its impurities and inconsistent composition, you might initially think I'm contradicting myself, like the satyr who criticised the traveller for blowing hot and cold with the same breath. However, upon closer examination, you'll find that this explanation, like the fable, can be logically reconciled.
Blood Flow and Blockage in Tooth Development
The blood from the living part of the tooth tries to move into the other part, but is blocked by the narrow passages and resistance from the condensed blood. This blockage forces the blood to exert pressure on the area between the dead and living parts of the tooth.
Separation and Growth of New Teeth
Gradually, this pressure loosens the connection, eventually separating the living tooth from its dead portion. The gap that forms allows the living part of the tooth to grow and develop a new head, which emerges above the gums, pushing out the old tooth and becoming a complete tooth in its place.
Challenges in New Tooth Emergence
However, if the dead part of the tooth clings too tightly to the gums, hindering the growth of the new tooth, it may remain underneath too long. Residual fragments between the old and new parts can corrode the new tooth, causing it to emerge already damaged. To prevent this, baby teeth should be removed as soon as they become loose. Sometimes, the new part of the tooth grows so rapidly that it is obstructed by the strong attachment of the old tooth to the surrounding area. This can cause the new tooth to grow in the wrong direction, either inside or outside the gums, leading to misalignment.
Corrective Measures and Tooth Alignment
To correct this, the excess tooth should be removed, and appropriate measures taken to align the new tooth correctly. This is relatively easy if addressed early, but becomes more challenging if the surrounding teeth are too close, requiring either the new tooth to be adjusted or the adjacent teeth to be repositioned.
Care in Tooth Removal and the Value of Expert Advice
When removing a baby tooth, great care must be taken not to damage the underlying permanent tooth. Finally, it's important to understand that not everything can achieve the same level of perfection, and there are always exceptions to general rules. My assertions about improving certain conditions are generally applicable and not absolute for every case. I commit to dealing honestly with everyone and only promise what I can deliver. Anyone seeking advice on matters within my expertise can visit my chamber for free consultation at any time.
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Gentlemen,
Although I have shared in this paper only that which aligns with my experience and the best of my understanding, I acknowledge that I may have overlooked many aspects and made several errors in addressing my topic. However, considering that I am the first, to my knowledge, to write on this subject, and taking into account my current situation, I hope you will be inclined to overlook my shortcomings. If you find what I have written to be of value, I plan to revise, clarify, and expand this modest treatise in a future edition to make it more comprehensive. In the meantime, I suggest you make the best use of the information provided here. I remain, your very humble servant,
Charles Allen
FINIS
The price is Six-pence