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156 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.

care in brushing you may avoid other cavities in similar positions,
for this is a part of the tooth that you can clean, and, if you do
it well, you will stop all of the tendency to decay in these sur-
faces." These surfaces are in positions that can be reached
and can be cleaned perfectly with the brush and water without
other aids. Caries will not begin on well-cleaned surfaces of
the teeth. If there is any one fact regarding decay of the teeth
that is well fixed by careful clinical observation, it is this one.
Of all the surfaces of the teeth, the buccal and labial sur-
faces are cleaned with the brush the easiest and most per-
fectly. To do this properly, however, the brush must be used
so that the teeth will be well brushed fully to the free margins
of the gums. Proximal surfaces or fissures can not be perfectly
cleaned with a brush. The cleaning of the lingual surfaces is
mostly for the purpose of preventing disease of the gums. One
can run around all of these surfaces with a motion very nearly
lengthwise the arch with an ordinary tooth brush. Only the
lower second and third molars will need a diagonal motion.
There are very few persons who need other than the ordinary
straight tooth brush. A cheap tooth brush is generally the best
tooth brush, because it is small, there are not so many bristles in
it, and they will get in between the teeth better.
The frequency of using the brush is an important item.
This should be regulated somewhat by the needs of the particu-
lar person. Some persons do not need to use a brush. On
account of our artificial manner of preparing food, we do not
make that use of the teeth that Nature seems to have intended.
If patients form the habit of using the brush, they will, once the
habit becomes fixed, prefer to do it. It is necessary, however,
for the dentist to watch them carefully until this becomes a fixed
habit. In persons where the susceptibility to caries is not great,
moderate use of the brush is sufficient; in fact, many persons,
if they use the brush once a day, will do well and will perhaps
have no necessity for using it more frequently, but the habit
of using the brush after each meal is the best. This is sufficient
to keep off calculus and keep the gums in condition; but where
we use the brush as a prophylactic against caries of the teeth,
and especially where the tendency to caries is very considerable,
the brush ought to be used as often as four times per day — after
each meal and at night before retiring. This frequency is neces-
sary to prevent the formation of colonies of microorganisms,
or microbic plaques in positions reached by the brush. If it does
not entirely prevent proximal decay, it will materially lessen