Instruments

Traduction par Malcolm Bishop (Grande Bretagne)

 

Up to the beginning of the 20th century, the decision as to whether to restore a tooth or not was not an easy one to make. The main reason for this was the difficulty of obtaining a clear view of the inside of the mouth, even in full daylight. Several authors commented on, and regretted, the shadows thrown by the hands on the teeth. Moreover, the probes and diagnostic instruments did not progress much during the 18th century, not really becoming fully functional until during the 19th century, when the probes became finer, and at the same time the mouth mirrors introduced at the beginning of that century no longer resembled miniature hand mirrors.

Following the identification of the tooth that was carious and responsible for giving pain, files were for a long time all that were available to enlarge the cavity before rasps (‘rugines’) could be brought into play. These files improved access to caries situated at contact points, albeit at the expense of healthy enamel, and also separated the teeth, simultaneously removing or at least reducing the sharp edges which might injure the lips or the tongue. Their employment was often controversial. It should be noted that in the first half of the 20th century, despite the improvements brought in by rotary instruments, the catalogues still offered patterns of files, even if more and more complex in design, for the separation of teeth or smoothing roughness.

The scrapers or rasps, in reality multi-functional instruments, could also be used for smoothing the teeth. But from the second half of the 19th century, improvements in the manufacture and quality of steel allowed for the making of enamel chisels and of excavators, much better suited to the opening up of cavities and the removal of caries. These instruments were used throughout the 20th century.

We have found that from the 18th century some authors suggested using drill bits or even reamers adopted directly from the workshops of jewellers or ironmongers, to function as little trephines to gain the best access, via a carious cavity, to the pulp chamber and root canals. It was necessary to give these instruments a to-and-fro motion and/or a rotary movement, using the thumb and forefinger, foreshadowing the actions required by the hand drills that were to come. Meanwhile, mechanisation generated fully rotational systems.

It would appear that the early types of instruments which were common to other fields of work are not very numerous in dental museums. Perhaps they finished their lives in a general toolbox?