Page 468 - My FlipBook

214 THE TECHNICAL PEOCEDUKES IN FILLING TEETH.

the case for a few weeks to see that this gi'ows up and tills the
space. Often some stimulation of the tissues every two or three
days by the application of stimulant remedies, such as oil of
cloves, will aid in this regeneration of lost tissue.
Years ago, when the use of the separating file was common
in finishing fillings, many dentists cut proximal surface fillings
flat and made similar conditions to that formed by worn con-
tacts. The separating file was a legacy, carried over from the
use of that instrument in connection with non-cohesive gold
filling operations before the discovery of the cohesive property
of this metal ; and, naturally, its use continued for a considerable
time. Very many otherwise excellent fillings were lost by recur-
rence of decay to the gingival of fillings so made. There is yet
some of this, and often dentists are careless about separating
teeth and making the contacts of the proximal surfaces in cor-
rect form. When this is found and collections of food debris
in the interproximal space occur, the only recourse is to remove
the filling and make a new one in correct form. There is no
operation done in dentistry of which patients, who have been
worried in chewing food, express a higher degree of appreciation.
A caution should be expressed regarding a class of cases
in which this treatment will fail. These are found when the
arch has been broken by the loss of one or more teeth, leaving
two or more of the molars without support against forward
movement. It is well known that the constant tendency in such
cases is to close the gap formed by the loss of teeth. The back
teeth will move forward and to a lesser extent teeth to the
mesial of the gap will move to the distal. This is often seen
in the falling together of teeth that have lost their contacts by
caries. This will always occur unless the teeth in the opposite
jaw — the occluding teeth — have cusps in such form as to pre-
vent the movement. Suppose the upper second bicuspid is lost;
the upper first molar will move forward unless the cusps of the
lower teeth so interlock with the cusps of the upper as to prevent
it. This well observed fact of the tendency to movement and
its method of natural prevention gives a strong hint that should
be used in the treatment of some of these cases. Occasionally,
this movement of the teeth after an extraction will change the
relations of the proximal surfaces to each other and cause food
to fill the interproximal space. Then the case should be studied
with the view of so strengthening a certain cusp, or certain cusps,
as to prevent the movement, or even to drive the tooth that has
moved, slightly back to its normal position.