An “ulcerated tooth” begins as an inflammation in the socket of a tooth, and, if near its deepest part, causes great pain, owing to the fact that the pus formed can neither escape nor expand the unyielding bony wall of the socket.
This explains why an abscess near the tooth is so much more painful than a similar one of soft parts. There may be no cavity in the tooth, but the tooth is commonly dead, or its nerve is dying, and the tooth is frequently darker in color. It often happens that threatened abscess at the root of a tooth, which has been filled, can be averted by a dentist’s boring down into the root of the tooth, or removing the filling. It is not always possible to locate the troublesome tooth, from the pain, but by tapping on the various teeth in turn with a knife, or other metal instrument, special soreness will be discovered in the “ulcerated” tooth. The ulcerated tooth frequently projects beyond its fellows, and so gives pain when the jaws are brought together in biting.
Treatment. The treatment for threatened abscess near a tooth consists in painting tincture of iodine, with a camel’s hair brush, upon the gum at the root of the painful tooth, and applying, every hour or so, over the same spot a toothache plaster (sold by all druggists). The gum must be wiped dry before applying the moistened toothache plaster. Water, as hot as can be borne, should be held in the mouth, and the process repeated for as long a time as possible. Then the patient should lie with the painful side of the face upon a hot water bag or bottle. The trouble may subside under this treatment, owing to disappearance of the inflammation, or to the unnoticed escape of a small amount of pus through a minute opening in the gum. If the inflammation continues the pain becomes intense and throbbing; there is often entire loss of sleep and rest, fever, and even chills, owing to a certain degree of blood poisoning. The gum and face swell on the painful side, and the patient often suffers more than with many more serious diseases.
After several days of distress, the bony socket of the tooth gives way, and the pus makes its exit, and, bulging out the gum, finally escapes through this also, to the immediate relief of the patient. But serious results sometimes follow letting nature alone in such a case, as the pus from an eyetooth may burrow its way into the internal parts of the upper jaw, or into the chambers of the nose, while that from a back tooth often breaks through the skin on the face, leaving an ugly scar, or, if in the lower jaw, the pus may find its way between the muscles of the neck, and not come to the surface till it escapes through the skin above the collar bone. Pulling the tooth is the most effective way of relieving the condition, the only objection being the loss of the tooth, which is to be avoided if possible.
If the pain is bearable and there are no chills and fever, the patient may save the tooth by remaining in bed with a hot water bottle continually on the face, and taking ten drops of laudanum to relieve the pain at intervals of several hours. Then many hours of suffering may be prevented if the gum is lanced with a sharp knife (previously boiled for five minutes) as soon as the gum becomes swollen, to allow of the escape of pus. The dentist is, of course, the proper person to consult in all cases of toothache, and the means herein suggested are to be followed only when it is impossible to obtain his services.