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.
Arsenious acid is also employed in dental practice to obtund the undue sensitiveness of dentine, but less frequently now than in past years, as its action is due more to devitalizing energy than to a chemical action, such as a true escharotic produces, as it is capable of being absorbed through a considerable thickness of dentine, the result of which would be the death of the pulp. Arsenious acid, if it is employed for obtunding the sensibility of the dentine, should be suffered to remain in the tooth but a very short time - from one to three hours - and every particle of it carefully removed. As there are many agents which prove effective for such a purpose, it is much better to refrain from the use of arsenious acid as an obtunder of hypersensitive dentine.
When arsenious acid comes in contact with the soft tissues of the mouth, the result of careless application, its irritating effects become apparent in from twelve to twenty-four hours, beginning with a slight soreness and some congestion. Small ulcers then appear which increase in depth, but are not attended with much pain, unless the agent penetrates to the periosteum. In such case the parts involved eventually become quite dark in color, and sloughing occurs to some extent, and in severe cases necrosis of bone may result, a condition which is known as arsenical necrosis. Dr. Faught suggests the following treatment: "Wherever practicable, the soft tissues should be curetted. Scarify freely, and then touch the wound with muriated tincture of iron; then cauterize it with carbolic acid or iodine, and, if need be, stimulate further in a few days with another application of the same." Dr. J. A. Johnson recommends in the treatment of arsenical stomatitis, the use of peroxide of hydrogen, and as a mouth-wash every hour, sulphate of zinc gr. ijss, water or a solution of glycerite of tannin, and, internally, iodide of potassium, five grains, three times a day.
For Devitalizing Pulps of Teeth. Dr. Flagg. Acidi arseniosi . . . gr.j Morphinae acetatis . . gr.ij Acidi carbolici . . . gtt.iij. M. Fiat massa. Signa. - The proper quantity to remain 12 to 24 hours.
Dr. Pierce. Acidi arseniosi . . . gr.x Morphinae sulphatis . gr.xx
To make a thick paste. Signa. - To remain 24 hours for adults; 10 hours for children.
Dr. Garrettson. Acidi arseniosi . . . Morphinae acetatis . . aa gr.x
To make a thick paste. Signa. - To remain 24 hours for adults 10 hours for children. If a very irritable condition is present, sulphate of atrophia may be substituted for morphia.
Dr. Hollander. Acidi arseniosi . . . gr.xij Morphinae acetatis . . gr.ij Olei caryophylli . . . gtt.iv
Ut fiat pasta.
Acidi arseniosi . . . gr.v Acidi tannici .... gr.x Tincturae aconiti . . . q.s. To make a thick paste. Signa. - To remain 24 hours.
Dr. T. I). White. Acidi arseniosi . . . gr.ij Morphinse sulphatis . gr.j
Fiat massa. Signa. - To remain from 12 to 24 hours.
Acidi arseniosi . . . gr.xx Morphina: acetatis . . gr.x Creasoti......q.s.
To make a thick paste. Signa. - To remain 12 to 24 hours for adults; 8 to 10 hours for children.
Acidi arseniosi . . . gr.x Morphinae acetatis . . gr.xl Creasoti, vel acidi carbolici ......q.s.
To make a thick paste. Signa. - To remain 12 to 24 hours.
Dr. E. C. Kirk.
Acidi arseniosi . . .
Cocaini hydrochloratis. aa gr.xx
Menthol cryst .... gr.v
Glycerini.....enough to make a stiff paste. M.
Use the desired quantity, and secure it with a lead cap covered with gutta percha.
Acidi arseniosi . . . 1 part Cocaine hydrochloras. 4 parts
Lanolin......5 parts. M.
To remain 24 hours.
For Painless Devitalization.
Acidi arseniosi . . . gr. 1/60 Olei caryophilli . . . enough to make a paste. M. Or a pledget of cotton may be saturated with the oil of cloves and the arsenious acid taken up on this and applied to the pulp.
Absorbent cotton . . (crosscut fine.)
Acidi arseniosi . . . gr.v Acidi tannici .... gr.ij Morphinae acetas . . gr.x Acidi carbolici (ol.) . q.s. for a thin paste.
Reduce the cotton by cutting and cross-cutting to a soft fine fuzz, then incorporate it with the above mixture; dry and separate into small pieces for convenient application.
Devitalizing Pulps of Teeth.
Acidi arseniosi . . . 3j
Hydrochlorate of cocaine ......3 ij
To make a stiff paste. Signa. - Apply a small quantity to the exposure on a little square of gummed paper about 1/16 of an inch in size; this should be covered with a pellet of cotton saturated with liquid vaseline and the cavity filled with soft gutta percha, or paste of oxyphos-phate of zinc. This application should remain 48 hours in the case of an adult; 24 hours in case of a patient under 21 and more than 12 years of age; and 8 to 12 hours in case of a patient under 12 years of age.