University of the Pacific School of Dentistry - Chips Yearbook (San Francisco, CA)

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Your professional opinion must dominate your patient, or the patient will dominate you, which means unsatisfactory re- sults for both parties concerned. Co-operation is vitally nt to sary, bntiti is often imperative that you put aside this means and use plainer methods to demonstrate your ideas on how work should, and must be done, to accomplish desired ends. The young practitioner often sets his hopes too high, botl, financially and mechanically. It is quite true that the embryo dentist must forget many things learned at college, and acquire worldly ways, but if he bears in mind the fact that simplicity, both in mechanics and finances, accomplishes results where com- plexity of aims fail, his way will be easier and his lot more desira- ble. If you find that business is rushing past your door, don't be discouraged. Do the very best that is in you, and in the end you will win out. Remember this, a satisfied patient is better than ten electric sings advertising your presence, and every good piece of work you turn out has a string attached to it, with your name on one end and an enthusiastic booster on the other. One other matter that I would like to impress upon you is the necessity of having a plain talk with your patients on oral hygiene at the conclusion of a sitting. Many people fail to ob- serve the little necessary details of cleanliness about the mouth that would prolong the life of your work and save themselves expense and pain. This talk, supplemented with instructions on the use of toothbrush, fioss silk, mouth washes and the like, never fails to produce an effect upon the patient which is most desira- ble. In concluding my words 'of advice, allow me to compliment you on the results of your work. Unquestionably the accom- plishments of your class will be a standard for students to come, and it is with pride that I look back to you as the men who were my first Freshmen May every success that dentistry affords be yours, and when the road seems rough and the way hard, keep smiling, don't worryg work. PERICEMENTAL ANESTHESIA. Q-Peridental or Intraosseous Anesthesia., jackson H. Smith, Graduating Class of 1912. Local anesthetics, of late years have been utilized more and more, in surgical procedures, which formerly demanded the ad- ministrations of a general anesthetic. In the use of any local anesthetic, the maximum effect can be realized only by careful attention to the details of the method of injection. In no case is diligent care more necessary than in that of pericemental anesthesia-the technique of which I am about to describe, according to instructions received by students of dentistry at the College of Physicians and Surgeons. 31

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MY LAST WORD TO THE SENIORS. Dr. B. Rosen. Three years ago, you, the present Senior Dental Class, were with fear and trembling entering upon your college career. , The road to a degree in your chosen profession seemed endless, blocked by innumerable obstacles, and in fact an apparently overwhelming task. i The first week of college was one that meant a great deal to each student, the memory of which will linger long after your many experiences, while at college, will have been forgotten. The practical and instructive talks of Dr. Anderson and Dr. Southard caused you to stop and think, to realize the seriousness of your position, and the responsibilities connected with it. The inspiring and sterling advice of Dr. Boxton and Dr. Morffew made you all the more deetermined to succeed, and you attacked the work before you with strength and vigor which pointed but one way-success. After recalling these incidents, let us con- sider a few of the practical and essential details that every stu- dent 'should be acquainted with. My object is not to preach a sermon on ethics, neither is it to moralize on dentistry. I sim- ply want to give the advice that has proven to be correct, at least it has for me. First and most important is the loyalty that you owe to your Alma Mater, and I appeal to you not to forget in future years that the basis of your success was laid by the instructors of the College of Physicians and Surgeons. A man must live, and eat to live. This statement is, in- deed, a true one, and is worthy of considerable attention, as the average graduate has an abnormal appetite. To have our ex- istence, it is necessary to produce something worth while in exchange for the necessities of life. Right here let me say that one of the mistakes in the pres- ent method of professional education is the omission of a course in business instruction. Many a practitioner, excellent in his line, has failed, merely because he did not possess the knowledge of tactful, reasonable, business methods. Not that I advocate the advertising means of making money, but, my object is to call to your attention the fact that a reasonable compensation for your efforts is a just due. Putting the matter plainly, your fees will be exactly in accordance to your ability, to produce the goods. If you have confidence in yourself, not over-conii- dence, but a substantial knowledge of your profession, you can set your price on whatever you do, and demand of your patient conditions that otherwise would be impossible. 30

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After adjusting the high-pressure syringe and supplying it with a needle, which has been previously prepared fby selecting a needle with the thickest point obtainable and grinding off of the needle to within three-eighths of an inch of the re-enforce- mentj, fill the syringe with two per cent solution of novocaine and adrenalinf' and lay syringe aside in readiness. The mouth and field of operation should now be cleansed with an antiseptic solution and the surface of the gum overlying the root is thoroughly dehydrated, and dryness maintained by proper placement of cotton rolls. p A pellet of cotton is now dipped into the novocaine solution Cwhich has been left in the mixing glass for this purposej and applied to the gum tissue, thus rendering the cutting of a semi- circular flap, almost, if not entirely, painless. Q V The flap of the gum is now turned back and a rose bur Cidentical in size with that of the needlej is used in the engine to make a hole of sufficient depth to accommodate the needle. The syringe is now used, and, upon applying considerable pressure, the novocaine solution may readily be diffused through- out the alveolar process, which contains lymph channels that facilitate this diffusion. I P The injection is made rather slowly and a period of time is required before the full physiological effect of the anesthetic is apparent. This period of time will vary with the thickness and compactness of the alveolar process. ' The successful anaesthetization of the part greatly depends upon allowing sufficient time for the proper diffusion and action of the anaesthetic solution throughout the spongy alveolar pro- cess. This method of anaesthesia may be used for the preparation of cavities in hyper-sensitive teethg for extirpation of dental pulpg for the amputation of the apex of a root, when deemed necessary Cfollowing septic pericementitis, chronic alveolar ab- scess, etc.i, and, in fact, for any surgical procedure where the operation is confined to the alveolar process and its contents. The amputation of the apex for apical thirdj of a root is accomplished after the preceding method of anaesthesia, by en- larging the opening with a larger Alveolitis bur, but upon ar- rival at the apex of the root, a dentate or crosscut fissure bur is employed by alternate lateral movements to cut through the root, at the junction of the apical third with the middle third, after which the apex is extirpated and the ragged stump made smooth with small, cylindrical, finishing stones. The cavity is washed with sterile water and then dehydrated, after which tincture of iodine is applied and the cavity allowed to heal by granulation. It is understood in this operation for the amputation of a root-apex, that the pulp has been previously extirpated and the root canal thoroughly filled with gutta percha or cement. 32