"Is tin foil poisonous? If not, why are our brethren so reluctant to use it? Is it nauseous? If not, why not employ it? Will it not preserve the teeth when properly used? Then why not encourage the use of it? Does its name signify one too common in the eyes of the people, on account of its daily use in the tin shops, or do patients murmur when the fee is announced, because it is nothing but tin? Is it not better than amalgam, although the patient may believe it less costly? Eleven good plugs, twenty-nine years old, in one mouth demonstrates that tin will last as long as gold in many cases." (F. A. Brewer, _Dental Cosmos_, 1863.)

"So much tin foil is used for personal and domestic purposes that the following is important: Ordinary tin foil by chemical a.n.a.lysis contained 88.93 per cent. of lead; embossed foil, 76.57 per cent.; tea foil, 88.66 per cent.; that which was sold for the pure article, 34.62 per cent. Tin foil of above kind is made by inclosing an ingot of lead between two ingots of tin, and rolling them out into foil, thus having the tin on the outside of the lead." (Dr. J. H. Baldock, _Dental Cosmos_, 1867.)

The author used tin foil for filling the teeth of some of his fellow-students at the Ohio College of Dental Surgery in 1867.

"Amalgam should never be used in teeth which can be filled with tin, and most of them can be." (Dr. H. M. Brooker, Montreal, 1870.)

"I have used tin extensively, and found it more satisfactory than amalgam. Dentists ignore tin, because it is easier to use amalgam, less trouble. This is not right. If your preceptor has told you that amalgam is as good as tin, and he thinks so, let him write an article in its defense. Not one dentist in ten who has come into the profession within the last ten years knows how to make a tin filling, and only a few of the older ones know how to make a _good_ one." (Dr. H. S. Chase, _Missouri Dental Journal_, 1870.)

"Among the best operators a more general use of tin would produce advantageous results, while among those whose operations in gold are not generally successful an almost exclusive use of tin would bring about a corresponding quantum of success to themselves and patients, as against repeated failures with gold. The same degree of endeavor which lacked success with gold, if applied to tin would produce good results and save teeth. A golden shower of ducats realized for gold finds enthusiastic admirers, but a dull gray shower for tin work is not so admirable, even though many of the teeth were no better for the gold as gold, nor so well off in the ultimate as with tin." (Dr. E. W. Foster, _Dental Cosmos_, 1873.)

In 1873 Dr. Royal Varney said, "I am heartily in favor of tin; it is too much neglected by our first-cla.s.s operators."

"Tin stops the ends of the tubuli and interglobular s.p.a.ces which are formed in the teeth of excessive vascular organization; if more teeth were filled with tin, and a smaller number with futile attempts with gold, people would be more benefited." (Dr. Castle, _Dental Cosmos_, 1873.)

"If cavities in teeth out of the mouth are well filled with tin, and put into ink for three days, no discoloration of the tooth (when split open) can be seen." (W. E. Driscoll, _Dental Cosmos_, 1874.)

"Tin makes an hermetical filling, and resists the disintegrating action of the fluids of the mouth. If an operator can preserve teeth for fifteen dollars with tin, which would cost fifty dollars with gold, ought he not to do so? Upon examination of the cavities from which oxidized plugs have been removed, these oxids will be found to have had a reflex effect upon the dentin; the walls and floors will be discolored and thoroughly indurated, and to a great degree devoid of sensitiveness, although they were sensitive when filled. Tin is valuable in case of youth, nervousness, impatience, high vitality of dentin, low calcification, and low pecuniosity." (Dr. H. Gerhart, _Pennsylvania Journal of Dental Science_, 1875.)

"Tin Foil for Filling Teeth." Essay by Dr. H. L. Ambler, read before the Ohio State Dental Society. (_Dental Register of the West_, 1875.)

"Some say that if tin is the material the cavity must be filled with, that it must be filled entirely with it, but advanced teachings show differently." (Dr. D. D. Smith, _Dental Cosmos_, October, 1878.)

"Frail teeth can be saved better with tin than with gold. I never saw a devitalized pulp under a tin filling." (Dr. Dixon, _Dental Cosmos_, May, 1880.)

"Tin may be used as a base for proximate fillings in bicuspids or molars, in third molars, in children's permanent molars, in the temporary teeth, and in any cavity where the filling is not conspicuous." (Dr. A. W. Harlan, _Independent Pract.i.tioner_, 1884.)

"Tin in blocks, mats, and tapes is used like non-cohesive gold foil, but absence of cohesion prevents the pieces from keeping their place as well as the gold." ("American System of Dentistry," 1887.)

This is virtually saying that there is cohesion of non-cohesive gold, and that for this reason it keeps its place better than tin. It has always been supposed that there was no cohesion of layers of non-cohesive gold, and as the tin is used on the non-cohesive plan, therefore one keeps its place as well as the other. We claim that generally in starting a filling, tin will keep its place better than cohesive or non-cohesive gold, because it combines some of the cohesiveness of the former with the adaptability of the latter.

"Tin will save teeth in many cases as well or better than gold. Put a mat of tin at the cervical wall of proximate cavities in molars and bicuspids, and it makes a good filling which has a therapeutic effect on tooth-structure that prevents the recurrence of caries, probably because the infiltration of tin oxid into the tubuli is destructive to animal life. Where the filling is not exposed to mechanical force, there is no material under heavens which will preserve the teeth better." (Dr.

Beach, _Dental Cosmos_, 1889.)

"I extracted a tooth in which I found a cavity of decay which had extended toward a tin filling, but stopped before reaching it; on examining the tooth-structure between the new cavity and the tin filling, it was found to be very hard, indicating apparently that there had been some action produced by the presence of the tin." (Dr. G.

White, _Dental Cosmos_, 1889.)

"Pure tin in form of foil is used as a filling and also in connection with non-cohesive gold." (Mitch.e.l.l's "Dental Chemistry," 1890.)

"Tin ranks next to gold as a filling-material." (Essig's "Dental Metallurgy," 1893.)

"Tin is good for children's teeth, when gold or amalgam is not indicated. It can be used in cavities which are so sensitive to thermal changes as to render the use of gold or amalgam unwise, but it can only be used in cavities with continuous walls, and should be introduced in the form of cylinders or ropes, with wedge-shaped pluggers having sharp deep serrations, thus depending upon the wedging or interdigitating process to hold the filling in the cavity." ("Operative Technics," Prof.

T. E. Weeks, 1895.)

"Tin for filling teeth has been almost superseded by amalgam, although among the older pract.i.tioners (those who understand how to manipulate it) tin is considered one of the best, if not the very best metal known for preserving the teeth from caries. In consequence of its lack of the cohesive property, it is introduced and retained in a cavity upon the wedging principle, the last piece serving as a keystone or anchor to the whole filling. Each piece should fill a portion of the cavity from the bottom to the top, with sufficient tin protruding from the cavity to serve for thorough condensation of the surface, and the last piece inserted should have a retaining cavity to hold it firmly in place. The foil is prepared by folding a whole or half-sheet and twisting it into a rope, which is then cut into suitable lengths for the cavity to be filled." (Frank Abbott, "Dental Pathology and Practice," 1896.)

"Forty-three years ago, for a young lady fourteen years of age, I filled with non-cohesive gold all the teeth worth filling with this metal; the rest I filled with tin. Three years after that there was not a perfect gold filling among the whole number, and yet the tin fillings were just as good as when made. The explanation as to why the tin fillings lasted so much longer than the gold ones was, that there must have been something in the tin that had an affinity for the teeth and the elements that formed the dentin, by which some compound was formed, or else it must have been in the adaptation." (Dr. H. Gerhart, _Dental Cosmos_, January, 1897.)

CHAPTER IV.

At the World's Columbian Dental Congress, held in Chicago, August, 1893, the author presented an essay on "Tin Foil for Filling Teeth."

During the discussion of the subject, the following opinions were elicited:

Dr. E. T. Darby: "I have always said that tin was one of the best filling-materials we have, and believe more teeth could be saved with it than with gold. I have restored a whole crown with tin, in order to show its cohesive properties; the essayist has paid a very high and worthy tribute to tin."

Dr. R. R. Freeman: "I have used tin foil for twenty-five years, and know that it has therapeutic properties, and is one of the best filling-materials, not excepting gold."

Madam Tiburtius-Hirschfield: "I heartily indorse the use of tin, and have tested its cohesive properties by building up crowns."

Dr. A. H. Brockway: "I am a strong believer in the use of tin, on account of its adaptability, and the facility with which saving fillings can be made with it."

Dr. Gordon White: "After having used tin for nine years, I claim that it is the best filling-material that has been given to our profession."

Dr. C. S. Stockton: "Tin is one of the best materials for saving teeth, and we should use it more than we do."

Dr. James Truman: "I use tin strictly upon the cohesive principle, and would place it in all teeth except the anterior ones, but would not hesitate to fill these when of a chalky character."

Dr. Corydon Palmer: "For fifty-four years I have been a firm advocate of the use of tin, and I have a filling in one of my teeth which is forty years old."

Dr. William Jarvie: "I rarely fill a cavity with gold for children under twelve years of age that I want to keep permanently, but use tin, and in five or ten years, more or less, it wears out. Still, it can easily be renewed, or if all the tin is removed we find the dentin hard and firm.

The dentist is not always doing the best for his patients if he does not practice in this way."

Dr. C. E. Francis: "I have proved positively that tin foil in good condition is cohesive, and my views have been corroborated by dentists and chemists."

Dr. James E. Garretson: "Tin foil is cohesive, and can be used the same as gold foil, and to an extent answers the same purpose."

Dr. C. R. Butler: "Tin is cohesive and makes a first-cla.s.s saving filling."

Dr. W. C. Barrett: "Tin is as cohesive as gold, and if everything was blotted out of existence with which teeth could be filled, except tin, more teeth would be saved."

Dr. L. D. Shepard: "Tin possesses some antiseptic properties for the preservation of teeth that gold does not."

Dr. W. D. Miller: "I use tin foil in cylinders, strips, and ropes, on the non-cohesive plan, but admit that it possesses a slight degree of cohesiveness, and when necessary can be built up like cohesive gold by using deeply serrated pluggers."

Dr. Benjamin Lord says, "It is said that we know the world, or learn the world, by comparison. If we compare tin foil with gold foil, we find that the tin, being softer, works more kindly, and can be more readily and with more certainty adapted to the walls, the inequalities, and the corners of the cavities.

"We find also that tin welds--mechanically, of course--more surely than soft gold, owing to its greater softness; the folds can be interlaced or forced into each other, and united with more certainty, and with so much security that, after the packing and condensing are finished, the ma.s.s may be cut like molten metal.

"I contend moreover that for contouring the filling or restoring the natural shape of the teeth, where there are three walls remaining to the cavity, tin is fully equal to gold, and in some respects even superior; as tin can be secured, where there is very little to hold or retain the filling, better than gold, owing to the ease and greater certainty of its adaptation to the retaining points or edges of the cavity.

"It will be said, however, that tin fillings will wear away. The surfaces that are exposed to mastication undoubtedly will wear in time; but the filling does not become leaky if it has been properly packed and condensed, nor will the margins of the cavity be attacked by further decay on that account.

"Altogether, I believe that we can make more perfect fillings with tin than we can with gold, taking all cla.s.ses of cavities; but it must not be understood that it is proposed that tin should ever take the place of gold where the circ.u.mstances and conditions indicate that the latter should be used. Of course, the virtue is not in the gold or the tin, but in the mechanical perfection of the operation, and tin having more plasticity than gold, that perfection can be secured with more ease and certainty.