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182 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.
point into the interproximal space and pulling it back and forth
while holding it against the proximal surface of first one and
then the other tooth. Usually the practiced hand will discover
any roughness by the drag of the ligature. Often the sharp
edges of a very slight break in the enamel will cut the ligature.
It often happens that a slight decay will be discovered in this
way that has been passed by the exploring tines. In cases where
great precision is required, the teeth should be cleaned thor-
oughly and the rubber dam put on and then the teeth dried for
this examination. In some cases it will be necessary to use the
separator and separate the teeth at some one, or several, points
in order to be satisfied as to the condition. At every point where
the instrument catches or there is a roughness that gives a sus-
picion of decay, a special examination should be given that par-
ticular point. The teeth should be cleaned and dried, and the
whitening, if any, noted, or any color that is off from the normal.
In this way the amount of beginning caries of the enamel may be
determined, but without this cleaning and drying it is almost
impossible to be sure of the extent of the injury or whether the
injury is caries or some other form or roughening of the surface.
Caries of the enamel that has whitened the surface always
needs immediate attention, either in the way of filling or in clean-
ing. Cleaning by the patient, properly directed, may often be
successful in stopping decay in the enamel of the buccal surfaces,
but on proximal surfaces the patient can not, by anything he can
do, prevent the progress of the decay that has once begun. The
only recourse now known to us is the filling of such decays, and it
is much the better plan to fill them very early, while the cavities
may be shallow, not penetrating much into the dentin.
A dark color appearing in pits does not necessarily indicate
decay. It may be simply some dark deposit, and very generally a
dark deposit indicates a condition of immunity; yet it is the
wisest plan to always try such pits with the explorer, for it occa-
sionally happens that a dark spot is covering a decay that is
making progress and should receive attention. As a general rule,
pits should not be cut out nor filled unless there is some tangible
indication of actual softening of the dentin beneath. If there is
caries of the dentin, however, a filling should always be placed at
the earliest practicable moment before great injury to the dentin
has occurred, keeping in mind continually the principal object of
keeping cavities as shallow as possible.
With this brief description of the process of examination for
caries, one who has studied carefully the subject of caries, as