Page 211 - My FlipBook

CAEIES AS A WHOLE. ITS CLINICAL FEATURES. 105
pressure of the contact of tooth with tooth as they stand in the
arch in any degree. In the balance of forces which confine the
teeth in normal form and occlusion in the arch, there is a mod-
erate but continuous pressure exerted to hold them firmly one
against the other, which, when conditions remain normal, con-
tinues through life. This is much more than sufficient to take
up any loss of length of the arch around its curve that may be
occasioned by the wear of the contact points. This is often
shown by the quickness with which the teeth anywhere in the
arch will close together when a contact point has been lost by
reason of caries or the reduction of an intervening space where
a tooth has been removed. This wear is produced by the slight
movement of the teeth in their alveoli allowed by the peridental
membrane. It is not equal in all parts of the mouth, but is
greatest among those teeth which do the heavier work in chewing
food, especially the second bicuspid and the first and second
molars. In these teeth it is frequently excessive. The five first
molars, photographs of which illustrate this subject, were each
removed by the author because of injury done to their peridental
membranes by the food which was held by the flattened sur-
faces and crowded against the interproximal gum tissue. The
flat facets shown in the photographs exhibit the amount of
interproximal wear that may be expected to occur frequently in
persons fifty to sixty years old, who have made good use of their
teeth. Many cases may be observed that have become worn as
much as these, or nearly so, in which no special harm has
resulted, and they require no attention. But in a certain number
of these, food that is unusually tough and stringy will some
time be forced between the teeth and not be removed. At sub-
sequent meals more will be forced in, until finally the pressure
of the contact will be loosened and remain so. Then trouble
has begun in earnest, which, if not relieved promptly, will cer-
tainly result in disaster. Within my personal observation,
certain persons have manifested a remarkable unconcern as to
this condition, claiming that they had never experienced any
uneasiness whatever, even when large amounts of gum tissue
had been destroyed by the pressure of food debris. Such cases
are often hopeless when first seen. But when the dentist dis-
covers such cases in time to act successfully, he should express
the necessity for treatment by proceeding at once to do that which
is necessary. Such a course will save his patient from the loss
of the teeth concerned. Others, and much the greater number,
are in constant trouble from the beginning of the lodgments