This section is from the book "Dental Medicine. A Manual Of Dental Materia Medica And Therapeutics", by Ferdinand J. S. Gorgas. Also available from Amazon: Dental Medicine.
Antiseptics are medicinal substances which possess the power of arresting the process of putrefaction, and they embrace such drugs as organic (vegetable) acids, inorganic (mineral) acids, the former, such as carbolic, salicylic and benzoic acids being applicable to tooth structures, and tooth tissues; while the latter, such as nitric, sulphuric, hydrochloric, boracic and chromic acids, are restricted to the treatment of tooth-tissues; also, the iodides, which include the tincture of iodine, iodoform, iodol, potassium iodide, aseptol, aristol; also the mercurials, such as the bichloride and biniodide of mercury; also such oxidizing agents as peroxide of hydrogen and permanganate of potash; also the essential oils, such as cajuput, cassia, peppermint, cloves, thyme, turpentine, caraway, mustard, eucalyptus, juniper, gaultheria, cinnamon, eugenol, sassafras, pennyroyal, valerian, etc.; also the wood and coal-tar derivatives, such as creasote, hydronaphthol, resorcin, lysol, etc.; also heat. The methods of using antiseptics in dental practice are by irrigation, disinfection, and as antiseptic dressings. Irrigation consists in washing out cavities in teeth, applications to inflamed and infected surfaces, syringing abscesses, and the use of mouth washes or lotions, diluted aqueous solutions or antiseptic agents being considered preferable to concentrated solutions for such purposes.
Disinfection consists in the destruction of micro-organisms and the products of fermentation and putrefaction in carious cavities, pulp-canals, gangrenous pulps, etc.
Antiseptic dressings or applications are in the form of powders, solutions and pastes, or mixed with filling materials, such as the preparations of zinc. When acids are used as antiseptics, they must be so diluted as to deprive them of their caustic properties or action, and the mercurials, such as the bichloride, must be in such weak solutions as will prevent toxic effects on the system. Different antiseptics are required according to the anatomical structure of the part on which they are to act, and also its physical condition, as the inflammation present may be either acute, or chronic, or the tissue be in a septic or putrescent state ; hence, each condition demands a particular class of antiseptics. The strength of the antiseptic employed will also depend upon the condition of the tissue or structure at the time of application. Dr. W. D. Miller has established the relationship of micro-organisms to the etiology of dental caries, and also shown that all fermentative and putrefactive processes of the dental pulp and oral mucous membrane are conditioned by the presence of living bacteria. From recent experiments made by Dr. Miller on the comparative value of antiseptics for sterilizing cavities, etc., he concludes that bichloride of mercury, "which usually ranks as the king among antiseptics," and gave uniformly good results in one method he employed, fell considerably short of the striking action shown by the trichloride of iodine, and he further remarks that "we have consequently reasons to hope that the trichloride of iodine may prove a valuable remedy in the treatment of diseased conditions of the teeth and mouth, and that the five per cent. solution is one of the most active agents at our demand for disinfecting carious dentine. Of carbolic acid, he says, while it is a very active antiseptic agent, it falls considerably behind the bichloride of mercury and trichloride of iodine in its penetrating power. Of lysol and tri-chlorphenol, he says that the results were very similar to those obtained by carbolic acid. Of peroxide of hydrogen, he says, that although it is an excellent sterilizer for thin layers of carious dentine, it fails when applied to thicker ones, as antiseptics applied to cavities of decay on cotton naturally retain their power but a few hours; pledgets of cotton saturated with carbolic acid and placed in large cavities near the gums, lose their antiseptic action in twenty-four hours. Of chloride of zinc, he thinks that although it penetrates the tissue quite rapidly, yet its antiseptic power is inferior to that of many other available antiseptics, and that the pain attending its application to the nearly exposed pulp, more than counterbalances any slight advantage it might otherwise have over carbolic acid.
Hydronaphthol showed considerable penetrating, antiseptic and consequently preservative action. Iodoform he considers to be one of the most worthless antiseptics, and that this fact has not been revealed long ago is in part due to the circumstance that it is nearly always employed in conjunction with some other material, such as carbolic acid, oil of cloves, etc.
The essential oils, pyoktanin, benzoic acid, alcohol, thymol and resorcin, all fell far short of the standard of efficiency maintained by other antiseptics for sterilizing carious cavities. He found that thymol and salicylic acid manifested an evident preservative action upon the dental pulp, but the effects were confined to a small portion of the pulp. Of the two, thymol gave the better results. Of the aniline colors, methyl violet and methylene blue, neither, he says, has the slightest preservative action, nor did they penetrate the pulps to a depth of more than a quarter of an inch. Campho-phenique, he says, appeared to penetrate the pulp-tissue about as rapidly as carbolic acid, and moderately hardened the tissue, giving to it antiseptic properties by the absorption of the solution, but not equal to that imparted by carbolic acid alone.
The antiseptics Dr. Miller found to be preeminently active in preventing decomposition of pulp-tissue, were: bichloride of mercury, cyanide of mercury (?), trichlorphenol, sulphate of copper, carbolic acid, oil of cloves, chloride of zinc, campho-phenique (?), hydronaphthol (?).