Page 98 - My FlipBook

94 THE TECHNICAL PROCEDURES IN FILLING TEETH.

made a close contact, it is necessary to separate them, or lift
them a little apart in order that we may finish the filling to the
full mesio-distal breadth of the tooth and restore the contact in
correct form, preserving the full breadth of the interproximate
space. This is necessary to the maintenance of the health of the
interproximate gingivae, the gums, the peridental membranes
and the teeth. If the contact of the filling with the proximating
tooth is not made in correct form, food will be held between the
teeth and will be crowded upon the interproximate gum tissue,
causing inflammation and absorption, and finally injure the gums
and peridental membranes, perhaps causing incurable disease and
final loss of the teeth. Or, by forming a pocket in the gum
tissue about the gingival margin of the filling, in which debris
undergoes fermentative decomposition with acid formation,
recurrence of decay is caused which destroys the filling and the
tooth. These considerations, derived from careful clinical obser-
vation, render it imperative that we make provision for finishing
proximate surface fillings to very exact form by first separating
them sufiiciently to give room to do this work.
In all ordinary cases the separation of teeth to gain room for
finishing is done best by the use of the Perry separator. This in-
strument simply catches the two teeth by their necks and lifts them
apart by turning a screw. The separation required is done with the
least pain possible, is done at once, and without causing especial
soreness of the teeth. Generally the separator should be applied
before the filling is begun and the teeth separated sufficiently at
once. Occasionally, and especially with the molar teeth, when
the teeth are very firm, they are difficult to move sufficiently.
If in such cases the separator is forced very tight, the instrument
springs instead of separating the teeth, B.ut when it is
allowed to remain and the filling is proceeded with, it is found
that when the filling has been built and is ready for finishing the
continuous spring force of the separator has caused them to yield
sufficiently. "We should make note of this and be careful
not to force the separator too hard upon the single-rooted
teeth, for if we attain the full separation required at once we will
find when the filling is completed that we have separated the
teeth much more than was necessary. All of this you will learn
intimately by observation in the infirmary.
When the separator is applied, if the bows do not rest firmly