Page 287 - My FlipBook

MANAGEMENT OP PATIENTS. 157
the bucco-lingual breadth of the decay, and in filling these cavities
for those who have this habit well fixed, the necessity for breadth
of cutting in extension for prevention will not be so great,
because cleanliness extends deeper into the embrasures.
We sometimes hear of the brush doing injury to the teeth.
It does not seem possible that the brush, used with water only,
will do injury to the hard tissues of the teeth. In some cases
it has appeared as though the brush might be responsible for
injury to the teeth near the gum margin, but other cases where
the brush had not been used at all are so nearly like these as
to show that the injury had not been done by severe brushing.
Sometimes it would seem that the gum had been torn, lacerated
and caused to recede, particularly from the upper cuspid teeth
on the labial surface. It would seem that we might easily injure
the gums in this position and cause a recession by the too vigor-
ous use of a stiff brush; and yet, again, many cases of appar-
ently the same kind of recession appear where a brush has not
been used. This brings us to doubt whether even this has been
caused by the too vigorous use of the brush. In a number of
these cases it was found that the patient failed to brush these
points. Yet the dentist should have a care about the vigorous
use of a very stiff brush if he saw a tendency to this kind of
recession; in fact, it is not well to use a very stiff tooth brush
in any case; a brush with comparatively few bristles, the
bristles being sufficiently strong, but not so many of them as to
make it very stiff and harsh, is better. Injury by the vigorous
use of such a tooth brush is not to be feared. A few persons
will be met with who state that they use the brush several times
a day for ten or even fifteen minutes. This is too much and
should be moderated. Any one ought to do sufficient brushing
in from two to five minutes.
Mouth washes, tooth powders, etc. What mouth wash
should be used with the brush? What the mouth wash is,
is not important. Plain water answers a good purpose and
is sufficient, but it is often a valuable point to prescribe some
particular mouth wash for this or that person. If it does
no other good, it seems to have an influence in inducing patients
to use the brush. Many persons have more confidence in the
use of some wash of this kind than they have in the mechani-
cal cleaning, and wherever a mouth wash will do good in
this way it should be prescribed. But never prescribe any
tooth powder, or tooth paste, or other mixture that contains
any kind of grit. Dr. W. D. Miller's report of his experimental