Page 207 - My FlipBook

THE RUBBER DAM. 87

to hold. Generally if one will work carefully and not draw the
ligature too tightly in tying, the ligature may rest upon the
attachment of tlie tissue at the crest of the arch, as shown in
Figure 86, and do no harm. This should always be done with
great care. I have traced incurable disease of the peridental
membranes to this as the initial lesion so many times, much too
many of which were done by myself, that I feel like making this
warning as decisive as possible. Most dentists are much too
careless about doing injury in such ways as this. Many more
have never thought that permanent injury is liable to occur from
ligatures tied on these teeth.
On the bicuspids and molars there is not the same danger
from tying ligatures for the reason that the arching of the
gingival lines does not occur in them. It is generally very nearly
horizontal all around these teeth. Ligatures should not be tied
on any teeth on which any kind of a clamp, matrix or a separator
is to be placed. In case ligatures have been tied for the purpose
of excavating, they should be removed before placing the sepa-
rator. The same rule should apply to any kind of clamp or
matrix. The tendency is to use ligatures more than the necessi-
ties require. Every dentist should make it a rule to avoid them
as much as possible. In no case should the rubber dam be tied
on an incisor and the labial free border of the gum pushed away
with a ligature for the treatment of labial cavities. This should
always be done with the Hatch clamp, described later. Neither
should it be so tied for any other purjiose whatever.
In tying ligatures about the teeth, the first half of a sur-
geon's knot (the upper one in Figure 88) should first be formed
and tightly drawn. In doing this, the ligature should be grasped
as close to the knot as practicable and held close against the
teeth, one end to the mesial and the other to the distal. If the
ligature is over the bicusi^ids or molars, catch the distal end of
it over the end of the forefinger of one hand and force it to the
distal close against the teeth while pulling the mesial end with
the other hand. If the ligature has been well waxed, the first
half of the knot will not slip or loosen ; but it must not be pulled
or disturbed in the least while forming the other half of the knot.
Let the ends fall perfectly loose while forming the second half
and work it up carefully until it is just right and then draw it
tight at a single pull, again keeping the fingers close against the
arch, both to the mesial and distal. A ligature tied in this way
will always be tight around the tooth. It is essential that the
surgeon's knot used should be the true surgeon's knot shown in