Page 109 - My FlipBook

EROSION OF THE TEETH. 47
casts of this have been made about one year apart, watching its
progress. The picture presented here is from the first cast
taken, and the erosion at that time had been noticed only about
one year. It has not gone deeper since, but has spread consid-
erably more toward the incisal.
Flattened areas. The tendency seems evidently toward the
flat form, which is prominently presented in Figure 53. This
case was from a man about sixty years old, a laborer. He had
apparently taken no care of his teeth, and claims that he never
used a brush in his life. This case presents very remarkable
peculiarities in the triangular patches of enamel remaining on
the upper right central and lateral, and the lengthwise cutting
of the lower left lateral. The gums were in very good condition.
Figure 54 presents another case which, while it looks similar,
is really quite different. This occurred in a man about sixty-five
years old, and had been seen and watched for a number of years
by one of our most intelligent practitioners. The course of the
erosion was very rapid, occupying but between three and four
years. In this the erosion began near the center of the labial
surfaces and spread more rapidly toward the incisal than toward
the gingival, and the incisal edge was soon invaded. The proxi-
mal surfaces also began to lose material and the centrals spread
apart. In this case there was not the perfect smoothness of
surface usually seen in cases of erosion, and it reminded me
very much of a case described by Dr. Kirk, in which he thought
there was an inclination to softening upon the surface, although
there was no actual softening discernible. The teeth in this
case, Figure 54, gave a great deal of trouble from sensitiveness,
but artificial crowns placed upon them are doing very well.
The next case, Figure 55, is somewhat similar in its nature.
This case was brought in to me for advice by the dentist in charge,
and when I first looked at the mouth at a distance of a few feet,
my impression was that the upper incisors were retained decid-
uous teeth, but closer inspection dispelled this idea at once. The
gentleman was about twenty-eight years old, and the normal
wear where the lower teeth had occluded against the lingual
surfaces of the upper incisors was unmistakable, showing that
it had not been very long in progress. The teeth were so sensi-
tive that the patient was greatly annoyed, and was seeking relief.
The teeth were cut in such a way as to cup them out slightly upon
the labial surfaces. The proximal surfaces were wasting per-
haps as much as the labial surfaces, but were cut pretty squarely,
almost as though they had been filed. The teeth showed no traces
of scratches of any kind, but they were not as smooth and glossy