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180 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.
above and below, and also of these surfaces of the teeth, should
be made with a mouth mirror. In doing this, it is well to include,
or to make a separate movement for, the examination by the eye
of the occlusal surfaces of the teeth. Finally the lips should be
raised and the cheeks retracted, wliile the patient closes the teeth
for the examination of the occlusion, whether it is normal or
abnormal. From this point a close scrutiny should be made of
any suspicious points on the mucous membranes that indicate
the death of the pulp of a tooth, or trouble arising about the
gingival margins of the gums or the necks of any of the teeth.
In this first examination careful note should be made of any dis-
colorations of the teeth, and whether these discolorations indicate
the death of a pulp or are due simply to some deposits upon the
teeth. Any suspicious places upon the gum tissue should be gone
over with the finger, and the sense of touch noted. One who is
careful to do this in the examination of patients will soon find
that the sense of touch will indicate disease about the alveolar
process and apices of the roots of teeth, which does not appear
to the eye, or will give further information when disease is
apparent to the eye. Often a blind abscess will exist at the root
of a tooth and there will be no appearance to the eye to indicate
it, whereas the sense of touch will indicate it very clearly after
some practice. Again, the condition as seen on the gums may
give evidence of some slight irritation, while the sense of touch
will reveal an extensive absorption of the alveolar process.
The patient will probably have mentioned having come for
a particular purpose that will direct an examination for some
particular thing, but this should be put aside until this general
examination has been made. However, if it should at any time
appear that the patient has come in an emergency and is the
patient of another practitioner, only such examination should be
made as will properly direct the treatment immediately required.
The patient should then be referred back to the dentist who cares
for the case. Otherwise we suppose the care of the case is to
be undertaken. If it is on account of dental caries that the
patient has called, it will generally be best to examine for caries
at this point, but in doing so it is just as well to have in view
atrophy, erosion, or any other of the defects to which the hard
tissues of the teeth are liable, such as white spots, pits in abnor-
mal positions, etc. In examining for caries, the three explorers,
a pair of rights and lefts and one with single curve, the mouth
mirror, foil pliers, cotton or spunk, or both, the water syringe
and warm water should be at hand. Any deposits upon the sur-