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.
To obtain the best results from peroxide of hydrogen, it should be kept in a cool place, tightly stoppered, and when required for use as much as desired should be poured from a large bottle into a small receptacle, and only the quantity to be used at a time be exposed to the light. For injection, a small glass or rubber syringe should be used, as contact with metal destroys its utility.
As a test for peroxide of hydrogen, Dr. Chas. Mayr suggests a paper saturated with a mixed solution of iodide of potassium and dithionate of soda. The peroxide of hydrogen liberates the iodine in the iodide of potash, but this liberated iodine is immediately seized by the dithionate of soda and a colorless solution is the result. But if enough of the peroxide is applied the blue spot will appear, because more iodine is liberated than can be used in oxidizing the dithionate of soda to tetrathionate of soda; to make the reaction more pronounced still, a little starch-paste is added. By this paper one drop of peroxide of hydrogen of 12 volumes of oxygen, produces a blue spot in 20 seconds; with six volumes in from one to two minutes ; and with four volumes no blue spot is produced, only possibly a blue rim.
Of peroxide of hydrogen, gr. iij to gr. v, containing six times its volume of oxygen, or two per cent. In operations on mucous membrane, a strong solution of peroxide of hydrogen - twelve per cent. - greatly facilitates by decolorizing the blood and by its cleansing, styptic action.
Peroxide of hydrogen is a valuable remedy in dental therapeutics, especially in the treatment of alveolar abscess, alveolar pyorrhoea, ulcerations of oral mucous membrane, gangrene or cancrum oris, fungous growths, bleaching discolored teeth, putrescent pulps, stomatitis, etc., etc.
A twenty per cent. solution has been recommended for the arrest of hemorrhage, after tooth extraction, by Mr. Bennett.
Dr. A. H. Prince's method of treatment, in the case of alveolar abscess, illustrates the properties of peroxide of hydrogen. "The septic abscess is caused to heal by one application made in the following manner: After removing the pulp and passing a broach through a canal of the root into the abscess cavity a drop of the liquid is injected by means of Farrar's syringe. The cavity of the crown is then immediately closed with softened gutta percha, before which, under pressure of the finger, the liquor is driven into the abscess cavity. Upon coming in contact with the pus in the fetid cavity, the liberated gas permeates it throughout, and by the continued evolution of the gas the cavity is emptied of its contents, which boil out at the fistulous opening so thoroughly mixed that the appearance is that of foam or froth ; while the remnant thus removed is rendered so thoroughly antiseptic that the healing process proceeds uninterruptedly." Dr. A. W. Harlan has successfully employed the peroxide of hydrogen, in connection with iodide of zinc solution and other agents, in the treatment of alveolar pyorrhoea.
Dr. Harlan's treatment is as follows: First pack the pus pockets with iodoform and eucalyptus, iodoform and oil of cinnamon, or thoroughly syringe with a one to three grain solution to the ounce of water of chloride of alumina, a method which will relieve the suffering and reduce the swollen gums to their normal size. In three or four days the sanguinary deposits may be removed, and the edges of the alveolus scraped or chiseled off. The pockets are then syringed with peroxide of hydrogen, and, after drying the gums, injected with one, two or three drops of a solution of iodide of zinc, grs. xii to the ounce of water. On the fourth day the gums are carefully dried, and a fine cone of cotton or bibulous paper moistened with peroxide of hydrogen, gently pressed into each pocket. If any effervescence occurs, it denotes the presence of pus, when each pocket should be again injected with the iodide of zinc solution. In chronic cases, after syringing with the peroxide of hydrogen, a stronger injection of the iodide of zinc (grs. xxiv to the ounce of water) is made, and in very bad or hopeless cases even a stronger solution of the zinc (grs. xlviii to the ounce of water); and when the gingival margins present a ragged border or cone-shaped slit, pure granular iodide of zinc is applied to such edges. The injection into the pocket is repeated every fourth day. In some cases constitutional treatment is also required. Peroxide of hydrogen has also been successfully used for bleaching discolored teeth, first adjusting the rubber dam and repeatedly washing out the cavity with the peroxide of hydrogen, and then carefully drying with the hot-blast syringe. A small quantity of chloride of alumina is then placed in the cavity and moistened with peroxide of hydrogen and allowed to remain for five minutes, and then washed out with a clear solution of soda; biboras.
Antiseptic and Stimulant Mouth Wash.
For use in Alveolar Pyorrhaea, etc., etc.
Dr. Chas. B. Atkinson.
Hydrogen perox. . . Tinct. calendulae . .
For Alveolar Pyorrhaea.
Dr. A. W. Harlan.
Hydrogen perox. . . Hydrarg. bichlor. . . gr.1/2. M.
Inject into pockets until they are free of all foreign matter.