Page 282 - My FlipBook

152 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.
pletely so as to remove the irritants in the decaying mass. When
the cavity is prepared, it should not receive a metallic filling,
but a temporary filling of gutta-percha, which should be a tight
filling. The walls should be dried first, as dry as absorbent cot-
ton will make them; they should then be moistened slightly with
eucalyptol, so that the gutta-percha will adhere and make the
filling tight. This is the best treatment, for gutta-percha is the
best nonconductor we have with which to make these temporary
fillings. A gold filling at such a time would be contra-indicated,
because it so readily conducts thermal changes. Time should
be allowed for the sensitiveness to disappear before making any
other operations upon the tooth, and, if the condition is severe,
all operations in the mouth should be omitted until that tooth
shall have recovered; or, at least, any operations that are not
absolutely necessary at the time.
This condition often ends in death of the pulp from stran-
gulation, which leads to infarction. To-day the tooth may be
extremely sensitive to thermal changes ; to-morrow the pulp
may be dead and this sensitiveness may have disappeared com-
pletely. The sudden disappearance of this thermal sensitiveness
marks certainly the death of the pulp, and when the pulp of a
tooth has died under these conditions, it is of extra importance
that it be removed as quickly as possible. There is more blood
than normal in the pulp at the time of its death and the blood
globules are very liable to be broken up and the hemoglobin set
free in solution. This may penetrate the dentinal tubules in
every direction, a red color appearing through the enamel. Such
a tooth is likely to become very dark in time, and it is especially
difficult to bleach it. Early removal is also important for the
reason that pericementitis, and possibly alveolar abscess, may
soon develop after the pulp has died. This condition of thermal
sensitiveness will come up' continually in the cases in practice,
and require treatment along with the other items in the manage-
ment of conditions in filling operations.