When diseases of the teeth will no longer succumb to treatment, extraction is necessarily the last resort. Unsightly gaps, of course, result from this operation, gaps which in the upper jaw are especially noticeable when the upper lip is short. In any case, the contour of the mouth and the general expression of the face undergoes a marked change. The loss of teeth not only effects an unhappy change in the appearance, but too often occasions discomfort and ill-health, the latter being caused by the inability to properly masticate the food, which sooner or later must impair the digestive organs.

     Dentists are now able to remedy, to a large extent, these defects, replacing the missing teeth by artificial ones. These artificial teeth are now made with such fidelity to Nature, both in the matter of color and form, as often to escape detection. A dentist who has both mechanical skill and artistic judgement will supply his patients with artificial teeth which fit as snugly as if they were part of the jaws and in appearance are life-like, harmonizing with the age, complexion and individual type of the wearer. Teeth so manifestly artificial as to arrest the attention of the beholder are almost as unprepossessing as the lack of teeth. That the artificial teeth must be practically useful in mastication goes without saying.

     The length of time that should elapse between the loss of the natural teeth and the insertion of the artificial set should be regulated by the condition of the gums after extraction. As soon as they have entirely healed and before the facial muscles have had time to alter perceptibly in expression, the mouth is ready to receive the new set.

     Various mineral products are used in the manufacture of artificial teeth. The dentist adapts the material to individual cases, the different materials being more or less acted upon by the fluids of the mouth, which vary according to the individual.

PIVOT TEETH- Whether the artificial set be complete or partial, the same amount of care must be bestowed upon its manufacture and adjustment. Partial sets often consist of "pivot" teeth. When a root from which a decayed crown has been removed remains intact, it is often used as a support for a pivot tooth. An artificial porcelain crown is selected to match the natural tooth in color and form and is then accurately adjusted to the root by means of a gold pin, one extremity of which is inserted into the open canal in the root, while the opposite end is let into the artificial crown. Such teeth form excellent substitutes for the original. While less troublesome than teeth attached to plates, they are also less durable.

CROWN TEETH- Sometimes a "crown" tooth is used in preference to a pivot tooth. For this purpose the root is again used as a support for either a porcelain or gold tooth. In this instance, however, the root is capped with gold and either a gold or porcelain tooth is soldered to it.

BRIDGE WORK- Another process in mechanical dentistry known as "bridge work" is used when several teeth are missing. A number of porcelain teeth are soldered to a "bridge" of gold, silver, gum, rubber, or celluloid, which is then attached at each end to a root. As a rule, bridge work is not very durable, especially if the supporting roots be widely separated.

CASTS OF THE MOUTH- An impression for the plate is obtained by introducing unset plaster of Paris, beeswax or some other modelling compound into the patient’s mouth and pressing it forcibly upon the guns and other parts upon which the plate is to rest. After remaining in the mouth a short time it is removed and into the mould thus obtained, plaster of Paris is poured; this, when it becomes hard, gives a perfect facsimile of the gum. This model serves as a basis in fitting the artificial set.

CLASP PLATES- Sometimes, when but a few teeth are missing, a clasp plate is preferred to bridge work. The teeth are fastened to the plate as in bridge work, but it is secured at each end by clasping a band round one or more sound teeth. These teeth, however, through the friction naturally caused by the clasps, soon become decayed. The process is usually resorted to when a partial set is required for the lower jaw. More or less difficulty usually attends the adjustment of teeth in the lower jaw.

SUCTION SETS- when too many teeth are missing to render any of these processes practicable, a complete artificial denture or suction set is advisable. These sets are held in the mouth by suction, there being an air chamber in the center of the plate. These plates are made of the various materials already mentioned. Gold plates, while the most expensive, are considered the best and lightest, since they allow the plate to be made thin. Sometimes the teeth are affixed to a gold plate with rubber, an arrangement which somewhat diminishes the weight of the plate. Silver, though occasionally used, is unpopular because it easily tarnishes. Continuous gum is generally made on a platinum base, the gum being baked on platinum. This is effective in appearance, though it has the disadvantage of being heavy. It is especially desirable for the lower jaw. Rubber is, perhaps, oftenest used because of the readiness with which it takes coloring matter, though plates made of it are thick and heat the roof of the mouth in an uncomfortable way. Celluloid is the cheapest of all materials and at the same time the least desirable. Unless economy is a prime necessity, it should never be chose.

THE COMPOSITION OF ARTIFICIAL TEETH- Varied and complicated are the processes to which artificial teeth are subjected during manufacture. Their chief ingredient is feldspar, a mineral employed also in the manufacture of pottery, though used only in a highly purified form in dentistry. Kaolin, a variety of clay, likewise used in making porcelain, is sometimes employed, but it is inferior to feldspar. Rock crystal, the purest form of silica or quartz, enters also into the composition of artificial teeth. The coloring materials used are gold, platinum and titanium, each of which, in a certain form, gives the tone required to produce a natural appearance in porcelain teeth. The fine gloss of the enamel is obtained by furnace heat, the ingredients being united in unlike proportions for the body of the tooth and enamel. Heat is also used in the development of the colors. The teeth are attached to the supporting plates by small platinum pins. Careful manufacturers take into consideration the fact that the natural teeth are not usually regular and symmetrical in form. The difference in the various outlines of the teeth of one class may be slight, yet it is perceptible. Then, too, the color is by no means uniform. The age of the patient is an important matter for consideration. There is sometimes a failure on the part of the dentist, when fitting elderly people with teeth, to observe the law of harmony in which case the effect is anything but pleasant. Men and women advanced in years, with dental equipments that would better suits youths or maidens, are sorry sights to behold, though unfortunately, not uncommon.

Those wearing artificial teeth should themselves heed the changes which age works in the general contour of the face and from time to time have renewed the teeth they wear. Not only changes in the face but recession of the gums and other unhappy conditions render this necessary. A set of artificial teeth that becomes too loose for its wearer is practically useless. It is a hinderance to distinct articulation and to the proper mastication of food, to say nothing of its appearance. A duplicate set is often an advantage. Teeth sometimes break away from their moorings, in which case the reserve set proves a boon.

CARE- The necessity for keeping the plate of artificial teeth clean cannot be too strongly urged. After each meal they should be removed, cleaned with a stiff brush and thoroughly rinsed in water. Once a day soap or a strong solution of bi-carbonate of soda may be used. Many wearers remove the teeth at night, but there is no need for this if they fit comfortably. If removed at night, there may be difficulty in adjusting the plate in the morning, since the gums when free tend to expand. However, if the practice is continually followed, the gums gradually become accustomed to it and adapt themselves to the plate.

EXTENSION OF DENTAL SURGERY- The dentist’s province has been extended. Broken jaws, cleft palates and similar conditions were formerly considered cases for the surgeon, but they have now become specialties for treatment by the dentist. The most approved methods, causing as little discomfort to patients as possible, are employed by them.

Butterick Publishing Co., The Delineator, Vol. XLVII, June 1896, p. 734.

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