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.
The dose of carbolic acid water (Aqua Acidi Carbolici).
of the glycerite, dissolved in distilled water, enough to make the mixture measure a pint, the dose is to
Impure carbolic acid is employed for disinfectant purposes. Ointment of carbolic acid (Unguentum Acidi Carbolici) - carbolic acid, lard,
Sulpbo-carbolic acid, C6H4 (OH) (S02OH)= C6H6S04, is produced by the action of sulphuric acid on phenol, and is considered to be a very efficient antiseptic and disinfectant. The addition of acids, particularly sulphuric, to crude carbolic acid of different strengths, increases its antiseptic and disinfectant properties, and considerably increases its solubility. Twenty-five per cent. of crude carbolic acid, mixed with an equal quantity of concentrated crude sulphuric acid, gives the best results, and renders it a cheap and effective disinfectant and sterilizer.
Aseptol, crude sulphophenol (sulpho-carbo orthoxyphenyl-sulphurous acid), is a syrupy rose-colored volatile liquid with a strong odor, and a non-irritant action. It readily dissolves in every proportion of water, alcohol and glycerine. Although it is more acid than carbolic acid, yet it is less caustic, and directly combines with bases. It is non-toxic, anti-fermenting, anti-putrid, and its disinfecting properties are more energetic than those of carbolic and salicylic acids. It can readily be combined with the essential oils. It is recommended as a substitute for carbolic acid.
Sulpho-carbolate of zinc (Zn(C6H5S04)2H20) combines the virtues of zinc salts and carbolic acid, and is used internally, in diarrhoea, and externally, in aqueous solution of from three to six grains to the ounce, as a dressing for wounds and ulcers, and an injection in gonorrhoea.
Carbolic acid being antiseptic, styptic, escha-rotic, stimulant and sedative, or narcotic, is a valuable agent in dental therapeutics. It has been employed as an application to carious dentine, to obtund sensibility and arrest putrefactive changes in the devitalized structure, and to coagulate the albuminous elements at the end of the dentinal tubuli.
But it is now generally conceded that there are other agents which are more permanent in their action as antiseptics, and hence carbolic acid, it is claimed, should not be introduced into root-canals permanently, as silico-fluoride of sodium, boro-glycer-ine, aristol, oil of cloves, cassia, cinnamon, myrtol, etc., are far more powerful, with better stimulating, antiseptic and disinfectant properties, and do not possess the coagulating property of carbolic acid, nor clog a delicate canal or destroy the tissues to which they are applied. Carbolic acid relieves odontalgia when applied to the surface of an exposed and painful pulp. It is also invaluable in the treatment of alveolar abscess; and in combination with iodine or other agents it is often employed with beneficial effects in the treatment of periodontitis. When employed in the treatment of alveolar abscess, as an antiseptic, although the discharge of pus may be increased for a short time after its application there is soon manifested a decided diminution in the quantity secreted. When applied to a suppurating pulp it arrests putrefaction, and induces a healthy action without irritation. It is also a valuable antiseptic application in ulcerations of the mucous membrane of the mouth, gangrenous conditions and mercurial stomatitis; for such purposes it is combined with glycerine and other agents. Applied to exposed pulps, it forms, by its escharotic action, an eschar, which some regard as conducive to the recovery of the organ, while others regard the quiescent state it produces as an indication of the degeneration of the pulp, and hence prefer to use it in a diluted form, for the same object, objecting to its employment in its pure state, on account of its escharotic or caustic action.
It is also useful as a styptic in case of superficial hemorrhage from the gums after the extraction of teeth, especially in combination with other agents. A preparation known as phenol sodique is often employed for such a purpose.
Oil of cloves, when added to an equal quantity of carbolic acid, will disguise, to some extent, its taste and odor. It can also be perfumed by adding to 1 part of carbolic acid 3 parts of oil of lemon and 100 parts of alcohol (36 degrees). Carbolic acid is also employed to check the hemorrhage resulting from the application of leeches to the mucous membrane of the mouth. When applied to an ulcerated surface, it should be repeated, as pus is formed or fungous growths appear; and having formed an eschar when applied to an exposed pulp, it should not be repeated until the eschar is detached from the surface. It has also been employed in the form of hypodermic injections, for the relief of neuralgia.
Carbolic acid is also useful as a local anaesthetic. Combined with glycerine (1 part to 12 of glycerine), it will stimulate the mucous secretion, and hence has been applied to the palate in cases of deficiency of this secretion to promote the suction of upper dentures.
When properly diluted with alcohol, it renders soft and spongy gums firmer and less tender.
It will also correct fetor of the breath arising from carious teeth, smoking, etc., acting as a deodorizer.
In all fetid discharges from the mouth, throat, etc., carbolic acid, combined with glycerine or an aqueous solution, may be used with advantage. The pure acid is employed for bathing cavities in teeth, preparatory to the introduction of the filling material, for its effect on sensitive or softened dentine and low organisms, although other agents prove more effective as germicides. Carbolic acid, combined with glycerine and rose water, forms an antiseptic mouth-wash; and when prepared chalk is added to the combination, it forms a tooth-paste.