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EXPOSURE AND REMOVAL OF THE DENTAL PULP. 137

Gutta-percha is too soft for permanent fillings in any positions
that are exposed to the stress or friction of mastication. In
some cavities, where it will not be exposed to wear, it will do
most excellent service. It is especially to be recommended for
fillino- cavities in the buccal surfaces of the teeth of old people,
especially those that are in large part in the cementum, and
extend beneath the free margin of the gum.
It is often useful as fillings in the temporary teeth for chil-
dren. By renewing it from time to time these teeth may be
made useful until removed in the shedding process. However,
children often wear it out of cavities rapidly, and it needs to be
very frequently renewed.
Gutta-percha is also very useful in the treatment of sensitive
dentin, and in cavities of teeth with hyperaemia of the pulp. It
is tolerated in both of these conditions better than any other
filling material, and, if well put in, will generally stand long
enough to accomplish good results. But to do well in either of
these classes of cases, it must be made to cohere to the
walls of the cavity. Otherwise it is liable on account of its
softness to slight movement in the ca\ity, and to admit moisture.
In that case the condition, especially of sensitive dentin, is liable
to be made worse instead of better.
Exposure and Removal of the Dental Pulp.
Exposure of the dental pulp.—The pulp of a tooth may
be found exposed by caries so that it lies naked and in view ;
it may have been reached by the extension of caries but remain
covered by a softened carious mass of dentin ; it may become
exposed by accident during the preparation of a carious cavity ;
the conditions may require that an intentional exposure be made
through a carious cavity that has nearly reached the pulp, or
that an intentional exposure be made, there being no carious
cavity.
The first and second cases are so similar that they may be
treated of together, only noticing differences of manipulation as
they occur. In both, the supposition is that the pulp is to be
destroyed and removed. In the first procedure the problem is
the preparation of the cavity for the treatment of the exposed
pul[>, and with the least pain and inconvenience to the patient.
The requirement is that the cavity be opened by the removal