The Roots of Pressure Anesthesia and its Contemporary Similarities.

For decades dentists have faced the challenge of achieving profound anesthesia in the presence of a severe tooth ache. Frequently this challenge was more acute when the tooth or teeth in question were mandibular molars. Over a 125 years ago this clinical dilemma was managed by using cocaine, both directly on an exposed dental pulp and often times using a solution of such injected directly into the pulp. Both clinical applications were considered as achieving "pressure anesthesia" sufficient to permit pulp extirpation. This historical perspective will focus on both the origins of this approach and its contemporary counterparts.

Inventing ways to salvage a tooth with extensive caries approximating the pulp (Intradental Purulence Evacuating Valve).

Tooth retention has always been the major goal of all dental professionals when possible. In the mid 1800s this attainment was a major challenge due to problems in dealing with deep caries and the potential for exposed and infected dental pulps. Although the diagnostic skills of the clinician during that era were not as honed as they might be today, they were still cognizant of dealing with compromised pulp tissue and its elimination from the root canal when necessary, however demanding. This historical perspective will present a rather unique way in which Dr. Josiah Foster Flagg opted to manage these types of clinical challenges.