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40 THE TECHNICAL PROCEDURES IN FILLING TEETH.

loosened up with scalers and removed with a strong stream of
water. In very many cases the teeth should be cleaned with a
rubber disk and powdered stone and washed clean with a jet of
water before anything is done toward excavating cavities. In
all cases the field of operation should be made clean as the first
procedure.
The use of water while removing calculus is impera-
tive. The field of operation requires to be repeatedly washed
with strong jets of water, in order to do both operator and
patient justice. This is necessary in order to remove blood and
debris that the next step of the operation may be seen. It is
necessary to impart a sense of cleanliness and comfort to the
patient. It is necessary to the removal of particles of loosened
calculus from about the necks of teeth.
In excavating cavities water should be used freely in
any portion of the operation that is done before placing the rub-
ber dam. In many cases it is desirable to open cavities and do
the rougher parts of the excavating before the dam is applied.
During such part of the operation as may be done without the
rubber dam the cavity should be frequently washed with strong
jets of water of the proper temperature for the purpose of
removing all debris from the cavity and from the mouth of the
patient.
Before placing the rubber dam water should be used
to free the necks of the teeth from micro-organisms, even
in the most cleanly mouths. A thin scaler should be passed
around all of the surfaces, loosening up any gummy substance
adhering to them, and this should be washed away with a strong
jet of warm water. If the case is not especially cleanly there is
greater necessity for this proceeding, provided, of course, that
this has not been done preparatory to some previous operation
'
at the same sitting.
The object of this care is especially to prevent pushing a
mass of micro-organisms and debris under the free margin of
the gum by the rubber and the ligature. Often the gums are
more or less bruised by this procedure, and if at the same time
a mass of debris containing many active micro-organisms is
crowded into the soft tissue and held there for a considerable
time, the micro-organisms will take hold of this injured tissue
and cause very inconvenient soreness, or actual suppuration.