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206 OPERATIVE DENTISTRY
capping of pulps in the anterior portion of the mouth as it is better
to remove a number of questionable pulps than to have one die in
the tooth with its consequent discoloration.
The Length of the Time the pulp has been exposed to the irritat-
ing influences is to be taken into account as the shorter the time, of
exposure, the greater the probabilities of success in capping.
The Stage of Hyperemia should be a safe criterion where there
are actual pulp complications, as there will be in almost every deep-
seated cavity. In active hyperemia, from causes other than bacteria,
it is safe to protect the pulp from future irritation and insure its
conservation. However, when the symptoms of passive hyperemia
have developed it is not safe practice to attempt to restore the pulp
to normal and expect permanency.
The Symptoms of Active Hyperemia Avhen the pulp demands
protection and success may be expected are:
First—When the excavated cavity exposed to the air causes a con-
tinued pain not of a throbbing nature and the condition is relieved
by packing the cavity with dry cotton.
Second—When a blast of air from the chip blower causes a quick,
sharp, shooting pain which subsides as quickly as it came.
Third—When the pulp shows the power of accommodation as evi-
denced by tolerating a draft of cold air when the same is gradually
applied.
Fourth—When it is improbable that the pulp has become infected.
Pulps Infected With Bacteria should be extirpated as too large
a percentage of those exposed and capped die and thereby bring re-
proach upon dentistry in general and chagrin to the careful operator.
The time was when the profession attempted to conserve all por-
tions of the pulp found to be vital, even to amputating the coronal
portion and leaving intact the vital stumps. However, this was in
the days of imperfect root canal treatment and filling and about as
many abscesses followed one kind of treatment as the other. But
at the present time the removal of a pulp is attended with such uni-
versal success that the capping of exposed pulps, in general, is un-
warranted, as most pulps are infected at the time of exposure. Even
in the case of an accidental exposure in the preparation of a cavity
neither cavity nor instruments are surgically sterile.
The General Health of the Patient must be considered when
choosing between the conservative or radical treatment of the pulp.
With the same conditions presented, the pulps in the teeth of the an-
emic patient, those wherein the vital processes are at low ebb, or the