Karl Sigismund Hilbert.

The D.D.S. A journal of practical dentistry online

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a pressure of three thousand pounds to
the square inch, after securing a perfect
contact point and the solution is sent on

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T). D. S.



aceo"' ie of this kind and will obviate
the Janger of overlooking any account
when i &siiing a receipt.

Therefore this is the most important
heading in the entire list, and since it
is one which will receive first considera-
tion in reviewing a record it should be
placed first in order.

When the accounts of an entire family
or institution are placed on one page the
fillings should not be outlined on the
diagram of the t2eth bettuise several

-members may have fillings in the same
location. Every skillful operator has a
uniform system of cavity preparation

. and therefore fillings can be satisfactor-
ily designated by the use of initials in-
dicating the surfaces involved. (See
"Surfaces," Fig. 1 and Sample account
Fig. 2.)

Generally in beginning with a new pa-
tient the first operation should be scal-
ing and polishing, extracting roots hope-
lessly diseased, or treating troublesome
teeth. This should be done to prepare
a clean field in which to work. These
headings should therefore appear the
next in order after the date. This plan
of logical sequence is closely adhered to
in the entire list of headings illustrated
in Fig. 2.

As the "Inlay" column is frequently
called into use I would suggest that
porcelain and gold inlays be differenti-
ated by use of initials "P" and "G" re-

The "Combination" heading is intended
for fillings comprising two or more ma-
te:, sis. These may be designated by
their respective initials.

The same principal may be applied to
many of the other headings in the list
iFig. 2).

1 will call special attention to one
other heading and that is "Date of Ren-
dering Bill and of Payment." Each time
i bill is rendered the date should be writ-
ten wth pencil in this column and when
a payment is made the penciled dates
may be erased and date of payment in-
serted with ink. This is a very val-
uahle column because it obviates dis-
putes, economizes space and will serve
as a memorandum in case of litigation.

Should it be desirable, at any time to
record remarks, these may be inserted
in the same line in which the operation
is itemized.

There are three index systems of book-
keeping in vogue, namely: the Station-
ary Leaf, the Loose Leaf and the Card
System. Each of these should be equip-
ped with forms shown in Figs. 1 and 2.
In selecting a system it should be borne
in mind that the greater the volume of
business, the more important becomes
the collection.

The Stationary Leaf has the advantage
in being the cheapest, both in primary
and secondary cost. The main objection
to this system .is that individual records,
in the course of a few years become
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THE J). D. S.

have received a smattering of medical
education. Do you wonder why we
are so looked on?

I am sure it was a great mistake
when dentistry branched out for itself,
and I am afraid the day is far dis-
tant when we are going to shake hands
with our brother medicos and be li-
censed by a medical board, although
I hope the day will soon come.

You ask the question: Why should
a dentist be a physician? First, be-
cause he would have an accurate
knowledge of medical science, and
would be able to cope with many dis-
eases, and recognize many conditions
of which he was ignorant before. Sec-
ond, when he Bees his patient he will
recognize his condition, note the condi-
tion of the heart, pulse, etc., or
whether a contagious disease be pres-
ent. Third, the benefits from the train-
ing he derives and the advantages his
knowledge is to his patients.

The advantages of the physician-
dentist, as I may term him, are as
follows: Being an M.D., he is on a
rank with all medical men, providing
he is a graduate of a regular recog-
nized medical college and a licentiate
of the State in which he practices.

The prestige which goes with the
degree is of value not only in the med-
ical profession, but also in the dental.
One 's knowledge being superior, one's
work and one's fees will be superior.
People will willingly pay more for the
services of one in whom they place
much more confidence.

Are not these sufficient reasons for
a broader medical education? I am
sure that if dentists had the oppor-
tunity and could spare the time they
would mos.t certainly take a medical

In ancient medicine the physician
practiced the dental specialty. In an
old manuscript consisting of over 100
pages a most interesting account of
the anatomy, physiology, medicine,
materia medica, and. therapeutics is
given. The following are examples
of some of the aphorisms given in the
manuscript :

"There are three bones in a man's
body which, when fractured, will

never unite again, and neither of these
exists when a man is born, namely, a
tooth, a knee-pan, and the os frontis.

"To extract a tooth without pain.
Take some newts, by some called liz-
ards, and those nasty beetles which
are found on ferns in the summer-
time. Calcine them in an iron pot,
and make a powder thereof. Wet the
forefinger of the right hand, and in-
sert it in the powder, and apply it
frequently to the tooth, refraining
from spitting it off, when the tooth
will fall away without pain, it is

Bleeding and local applications,
such as poultices and counter irritants,
are frequently alluded to. The exact
date of the manuscript is not known,
but it was probably written about the
end of the fifteenth century. So you
see, the early physician practiced this
specialty also.

Dentistry is one of the oldest pro-
fessions, dating from the time when
people were placed in front of the
temples in order that they might gain
relief. All dqwn through the different
ages, literature has been contributed
by the different observers.

Dental surgery has always been as-
sociated with education and scholarly
men, and not with mere mechanics
or tonsorial artists.

Our literature of the present cen-
tury is elegantly written and illus-
trated with beautiful pictures, giving
in detail the different oral deformi-
ties, and the modes of treatment by
surgical or mechanical means. In our
own United States there seems to have
been in 1he last fifty years a very
rapid growth and high degree of de-
velopment in dental science, as com-
pared with other countries. The per-
centage of qualified persons practic-
ing dentistry is fully as large as those
in other similar cailings of life. It is
stated that after five years only about
20 per cent, remain in practice, and
that the qualified and successful aro
only about 5 per cent.

Dentistry as a science and art is a
noble calling and is worthy of the best
efforts and of the finest minds. —
C. W. Knowles, Dental Digest.


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THE D. D. S.

Please mention The D. D. S. when you write to advertiser*.


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A Journal of Practical Dentistry
Operative and Mechanical

Vol. I


No. 3


AtS. W. Cor. Fifth and Jefferson Sts., Dayton,

Ohio, on the 20th day of each alternate


Subscription price - 50 cents per year.

Address all communications to THE D. D. S.
Dayton, Ohio.


Man never got a much better mes-
sage than that which told him he
would have to earn his bread by the
sweat of his brow. The record of
events preceding the delivery of that
message proves that he could not ap-
preciate the good things when they
were his for the asking; and the long
record of events following the receipt
and application of it proves that he
has been able to appreciate the things
he had to work for, when he did the
right sort of work in the right way.
The chief trouble about man and man-
ual labor has its root in the unfortu-
nate fact that a great many men — I
am almost tempted to say a majority
of men — begin wrong by making no
attempt to find out what is the right
sort of work for them to do; and keep
on in the wrong by not doing their
work in the right way. There are
thousands of persons in the world to-
day who are clinging to the rocky
sides of steep mountains and making
vain attempts to reach coveted sum-
mits, who ought to be working away in
the pleasant and fruitful valleys below,
content with what was intended for
them and not trying to rise in the
world by getting a seat on the hilltop.

— Selected.

* *


We will be pleased to furnish Bpace,
without charge, to any dental society
that may have matters for publication.
Such matters should be forwarded by

the proper officer in time to reach us
by the first of the month on which
publication is desired.


The last page of The D. D. S. is re-
served for WANTS and FOR SALE
advertisements. This page is at the
service of our subscribers, and we in-
vite them to use it without cost as
often as they wish to do so. If there
is an office for sale, or location want-
ed; if there is need of a position or an
assistant; if there are any dental
books, dental magazines, instruments
or appliances that are not in use and
that might be desired by some other
member of the profession, advertise
them. If a sufficient number Of re-
sponses are not secured the first time,
try again.

This service being free, we can
assume no responsibility for such ad-
vertisements, and all correspondence
relating to it must be done direct.
When replies are to be sent in our
care, sufficient postage for forwarding
should be included with the copy. The
latter must be received in this office
by the first of the month on which
publication is desired. Address all
communications to The D. D. S., Day-
ton, Ohio.


We believe that the matter of sup-
plies used by the dentist is of interest
equal to that of the methods by which
they are employed, and we will en-
deavor to introduce in these pages
from time to time such new materials
and devices as may be developed, as
well as all standard specialties.

We will, however, allow representa-
tion to none but reliable goods, which,
to the best of our knowledge, will give
satisfaction to the users.


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THE D. D. S.

Porcelain and Crown and Bridge Work

K. C Brashear, M.D., D.D.S.


When we are studying a tooth for
the purpose of selecting shades, the
patient should be in an upright po-
sition. I have noticed that if the
patient is reclined so that the light
strikes at an angle the teeth seem
much lighter than they really are.
This study should be made early in
the operation before the teeth have
been allowed to dry, as this always
bleaches. In handling the shade
guide we should remember that the
body in an inlay will be much thinner
than the specimen in the guide, and
consequently much lighter, hence a
darker color should be selected than is
desired in the inlay. — J. O. Wells,
Dental Digest.


Amalgam dies have become very
popular in the construction of gold
and porcelain inlays, copes for crowns
and for building up teeth that have
decayed far below the gum margins
with gold.

Take an impression with pink base-
plate gutta-percha in the following
manner: Moisten the tooth and cav-
ity with glycerin. Soften the gutta-
percha over an alcohol flame, being
careful not to blister it, and force it
into the cavity with a broad instru-
ment. The glycerin will prevent the
gutta-percha from sticking in the cav-
ity. Flow a stream of cold water over
the gutta-percha to harden; carefully

remove and if the margins are per-
fect mix a small quantity of plaster,
build it to a pyramid on a glass slab,
and invest the impression by forcing
it down in the soft plaster with an in-
strument, being careful to have the
plaster well up around the margins.
When the plaster is hard, mix the
amalgam. I prefer to use alloy in the
form of shavings, or copper amalgam.
The latter is better, as it can be used
several times over by warming it until
the mercury appears on the surface
when it is mixed thoroughly in a
mortar. Carefully pack the amalgam
around the impression until it is well
covered and then roll up a piece of
unvulcanized rubber, about the size of
a thimble, and wrap several thick-
nesses of rubber tape around this.
Place it over the amalgam, insert in
a vise, and squeeze out the excess mer-
cury. Leave it under pressure three
or four hours or over night. Then
break away the plaster, remove the
guttapercha, and you will find a clean
cut and polished die which is easily
mounted in the swage and makes a
perfect matrix. — O. J. Hadley, Dental

* *


To most dentists the making of a
matrix for the jacket-crown is a
much-dreaded proposition. My idea
is to make this matrix of platinum
wire which is a little heavier than the
ordinary platinum wire used in the
electric furnace. The idea of prepar-


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THE D. D. S.


ing the matrix lor the crown is to
wind the tooth with platinum wire in
much the same way as a sailor would
wind tie end of a rope. This gives a
cone-shaped matrix of platinum which
is corrugated on the outside and on
the inside as well An impression is
then taken in plaster or in modeling
composition, pour up with any suit-
able investment material. The im-
pression material is removed, leaving
a spiral cone of platinum on the
model, which can then be built up
with porcelain and baked in the
usual way. The model may be placed
on the articulator and the piece broken
off so that it can be tried into the
mouth. — G. L. Hutchinson, Dental


In using platinum as a material
for matrices, it is well to have it of
at least two thick nesses — one the com-
mercial, which is supposed to be 1-
2000 of an inch in thickness. This
can be annealed and oiled and folded
together, and with a good set of rolls
can be reduced to probably one-half
its thickness, and is much better for
small inlays than the heavier gage.
Various methods for annealing have
been suggested. One very good way
is in the furnace, heating it up to
2,000 degrees or more, then allowing
it to cool gradually. Another very ex-
cellent way is the oxyhydxogen blow-
pipe, which heats it very rapidly and
very hot, and is more convenient on
account of the saving of time, while
the result is equally as good.

The platinum which has been
doubled and passed through the rolls
for the purpose of reducing the gauge
is glased on the surface which comes
in contact with the steel rollers, while

the other side has a frosty or velvety
surface. The frosted surface should
be placed in contact with the tooth,
the glazed side in contact with the
porcelain, as it strips from the inlay
more easily than the frosted side.—
Western Dental Journal.


There should be plenty of space for
porcelain to get the required strength
to withstand the force of mastication
as we are entirely dependent upon its
bulk for strength. Also consider the
condition of the teeth to serve as
abutments, their number and situ-
ation, the curve of the arch and most
important, the length of bite. — O. M.
LeOron, Dental Brief.


The clasp should be as wide as pos-
sible not to interfere with the acclu-
sion or impinge upon the gum tissue,
as the narrower the clasp, the closer
it hugs the tooth; and the closer it
fits, the more mechanical abrasion it
causes; and the more abrasion, the
more injury it does. The clasp
should be sustained by frictional con-
tact at a few points only. — Dr. H. J.
Goslee, Dental Brief.


As we all know, the more dense we
can pack the body the less shrinkage.
In building up a large molar crown
to be finished with one baking, I have
been pleased with the following ex-
periment: Having the pins gripped
firmly in the proper holder, I eut a
strip of sheet steel — of the thinnest
sort, such as we use for matrices-
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THE D. D. S.

and pinched this together around the
cap with a small screw vise. Then I
oiled the inner surface of the matrix
to prevent the porcelain from adher-
ing. I was then able to pack the body
of the crown very quickly and firmly,
absorbing the moisture that was
pressed to the surface from time to
time with blotting paper. I built high
enough to allow for prominent cusps,
then released the vise hold upon the
matrix. The spring steel let go, leav-
ing a fine general contour and smooth
surface. Then, after having cut away
enough of the plaster teeth adjoining
to allow about one-sixth for shrinkage,
the tooth to be was placed in the
articulator and cusps carved to shape.
Any required special forms of contour
were added with a, brush. I am sure
that I got less shrinkage and a con-
siderable saving of time by this

I may add here that it seems to me
that I get a good final surface with
soft spunk, dry or slightly moist, upon
the nearly dry surface of the body. —
Garrett Newkirk, American Dental


In backing teeth, too much care
cannot be expended in producing as
good a fit as possible. The pinholes
in the metal should not be enlarged
unnecessarily, as this is often the
cause of a tooth cracking in the fir-
ing, owing to the solder running
through between the tooth and the
backing. The metal should always be
kept flush with the edges of the tooth
all around. This is most essential in
bridge work, as backings have often
to be relied upon for linking up. An-
other point in favor of the metal be-
ing flush is, that in the mouth, should

the incisive edges of a natural and
an artificial tooth meet, there is less
chance of fracture, since the backing
undoubtedly takes up a certain
amount of the strain. On the other
hand, where there is a margin of
metal almost an eighth of an inch
from the cutting edge, the artificial
tooth is, in my opinion, positively
weakened. — Cosmos.


One of the most important items
in crown and bridge work is that your
backing fit the tooth perfectly, es-
pecially in the case of porcelain-faced
crowns. How many of us have spent
a quarter of an hour in burnishing a
backing, and then found that it was
far from being a fit? By a very sim-
ple device I have found that both
time and patience can be saved.

Having ground the tooth at the
back to the desired shape — which is
invariably oval — take your Melotte's
moldine and tray, dust the tooth with
French chalk, and press it firmly into
the moldine; draw away the tooth,
and you will have an impress of tooth
with the pinholes left by the pins.
Take two pieces of steel, iron, or cop-
per wire of about the same gage as
the platinum pins, and insert them
into the holes left by the pins of the
tooth; pour the fusible metal; when
set, draw away the die and you have
a tooth-back with pins in position.
Dust with French chalk and take the
counter-die. You can now strike up
the backing with no fear of breaking
the tooth. By this method — which
does not take more than three min-
utes — you secure a perfect backing,
and it will take only one-third the
time that it takes to bend up and
burnish. — Cosmos.

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THE D. D. S.



Frank M. Casto, M.D.,D.D.S.


The frequency of deformity in the
dental arches, particularly «that con-
dition known as contracted arch, in
conjuction with obstructed respira-
tion, due to reduction in the respir-
atory space within the nasal cham-
bers, and in the naso-pharynx, has
been very forcibly impressed upon me
during the past few years in my work
in the hospital dispensary and dur-
ing the examination of children for
admission to a day nursery.

If we consider the mechanical
forces active in the production of the
contraction, we cannot fail to realize
the importance of taking into account
the frequent coincidence of these two
conditions. This surprising fre-
quency can hardly be considered pure
accident, but is suggestive of a prob-
able relation between the two con-
ditions. This probability is advanced
almost to a certainty, when from a
physiologic standpoint we consider
the mechanics of the muscle forces
incident to the nasal obstruction and
the resulting mouth-breathing.

During quiet nasal respiration the
lips are closed, the teeth of the oppos-
ing jaws are in contact, and the
tongue closely applied to the palatal
vault and to the inner aspects of all
the teeth. In this position the muscle
forces are in a state of equilibrium,
by which the teeth are maintained in
their proper relations one to another.

The muscles of the tongue on the
one hand and those of the lips and
cheeks on the other, exert equal pres-
sure upon each side of the dental

In the presence of nasal obstruction
and the resulting mouth-breathing,
the mandible is depressed, increasing
the tension of the tissues and muscles
of the cheeks, the lips are parted and
the tongue separated from the roof of
the mouth and from contact with the
aspects of the teeth. In this position
the normal equilibrium is disturbed
and unequal forces are brought to
bear upon the teeth and the dental

The logical result of this disturbed
equilibrium follows. From lack of
support on the inside and increased
pressure from without, the tendency
of the bicuspid and molar teeth is
inward. Simultaneously pressure is
brought to bear upon the anterior
teeth, as a direct result of a lateral
contraction, and in the absence of
normal restraint from the lips, the
anterior teeth advance and result in

When we further consider that
these forces are active, even in mod-
erate degrees of obstruction, for at
least one-third of the twenty- four
hours, the strength of this power be-
comes evident, while in those cases
where nasal respiration is impossible,
and the disturbing force is contin-
uously active, we are brought to re-
alize even more forcibly the strength


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THE D. D. S.

of the distorting power with which
we have to deal.

Under these circumstances all ef-
forts directed toward correcting the
oral deformity will be constantly an-
tagonized, both during the period of
active treatment and subsequent to
the removal of all appliances from
the mouth. The result under these
circumstances will in many cases be
failure to attain a permanency, the
extent of return of the original con-
dition depending upon the degree of
the nasal obstruction and the age of
the patient, it being greater in cases
of marked stenosis and in young chil-

Nasal Examination Recommended.
— This brief consideration of the
state of affairs existing in many
cases of contracted dental arch, in-
dicates the importance and value of
recognizing the probable coexistence
of intra-nasal deformity and ob-
struction in many, if not in all cases
of dental irregularity.

I believe from the standpoint of
the rhinologist, that it is not going
too far to state that thorough intra-
nasal examination is indicated and
should be required in all cases pre-
senting oral deformity, and that the
time has come when all who under-
take the correction of irregularities
of the teeth should be familiar with
the anatomy of the nasal chambers
and with their gross pathological
changes, and should possess a working
knowledge of the signs and symptoms
of these conditions. For it is only
by aid of this knowledge that we shall
be able to detect their presence, to
note the frequence of this coinci-
dence, and to realize the importance
of their relation.

It is not too much to expect the
competent practitioner of dentistry to

be able to test the functional capac-
ity of the nose in patients presenting
for treatment, and to question the
patient or parent concerning possible
disease within the nose. Such data
can be gathered in a very few min-
utes, and, properly used, will quite
accurately determine for or against
the necessity of preliminary treat-
ment at the hands of the nose and
throat specialist.

The occurrence of even a single

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