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MANAGEMENT OF CHILDREN'S TEETH 231
Cavities of Class Three should be lilled with cement with rubber
dam in position. If decay has progressed till angle is lost or par-
tially so, do not build to contour but fill as a Class Three.
Classes Four, Five and Six may be ignored.
Treatment of Exposed Pulps in Deciduous Teeth. Pulp devital-
ization with deciduous teeth should never be attempted. Pressure
anesthesia will not prove successful. Arsenic should never be ap-
plied to deciduous teeth. The risk is too great and is condennied
in every case. If the pulp is exposed and aching, clean out the
debris, flood with Avarm water, dry and phenolize. Apply a pledget
of cotton saturated with oil of cloves for twenty-four hours.
When case returns, dry and again phenolize and apply a paste of
phenolized iodoform over Avhich place a filling.
If the pulp has begun to suppurate, the necrosed tissue should
be cut awa.y and the space filled with a paste made of oil of cloves
and the oxide of zinc powder, over which is placed a filling of tem-
l)orary stopping. The pulp will usually die under this Avithout
further pain.
When the case returns, Avhich should be in about two or three
Aveeks, the canals should be cleansed and filled Avith a paste made
from campho-phenique and iodoform and cavity filled Avith a
plastic filling.
Treatment of Abscessed Deciduous Teeth. Such teeth should be
alloAved or assisted to point externally, as they Avill generally have
progressed almost to the stage of pointing before the dentist is
visited.
As soon as the active stage has subsided, the case should be
given the above treatment for putrescence and filled. If abscess
persists, as Avill occasionally be the case in spite of all methods, a
small hole should be bored in the buccal surface just sub-gingivally
to the pulp chamber, leaving the filling in place.
Inter-Proximal Grinding is of service Avhen filling is out of the
question. This is practiced much after the same method it Avas
used in primitive days Avith the permanent teeth.
The proximal surfaces are cut aAvay so that they are non-reten-
tive to food particles and the sides of the remaining surfaces thor-
oughly exposed to the excursions of food in mastication. AVith
anterior teeth the contact point is thereby moved to near the
gingival line. With posterior teeth the contact point is removed
as far to the buccal as possible by Avidening the lingual end^rasure
vt the expense of both proximating teeth. This method is un-
sightly in the anterior teeth and not altogether Avithout its objec-