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190 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.
At present it seems unwise to discuss the subject at length.
Its development belongs to the journals rather than to books.
It must be understood that treatment by filling should be
supplemented and supported, in all cases of considerable sus-
ceptibility to caries of the teeth, by fairly vigorous and healthful
chewing of food and by artificial cleaning with the brush in the
hands of the patient. For this purpose, careful training of the
individuals should be seriously undertaken by the dentist with
the same care that he would bestow upon any operation he per-
forms for their relief. This should be pursued to the minutest
details of the motions of the brush necessary to do the best work
in each particular case. Examinations should be made at inter-
vals to see that regular and correct habits become fixed, so that
important points will not be neglected by errors in handling the
brush. This work will prove prophylactic in a high degree. It
should entirely prevent the formation of the gingival third buc-
cal and labial cavities. Even in cases of marked whitening of the
enamel in several teeth, my experience shows plainly that the
decay of the enamel can be effectively checked in any case in
which the enamel has not been penetrated. The brush and water
are all that are needed, but these must be correctly used to be
effective. Thus far, prophylactic work done in this way will be
successful. If coupled with careful watching for special periods
of increased susceptibility, frequent examinations, or a special
effort directed to treatment locally to prevent injury to the teeth,
great good will be done.

Treatment of Dental Caries by Fillings.
ILLUSTRATION: FIGURE 167.
After decay has once begun in the dentin of a tooth, the only
treatment that has thus far been found effective in preventing
its progress or in curing the decay has been the complete removal
of all of the carious area and the filling of the cavity with metal,
or with some substance that is durable. Thus far, gold holds the
first place for filling teeth, amalgam the second place, and
recently porcelain and gold inlays are demanding important con-
sideration. There are a few persons who would also give tin an
important place. Besides these there are in use gutta-percha
and the cements; these latter more especially for temporary
fillings. In this treatment we would seem to be violating some of
the general principles of physiology and pathology. Certainly
we can not place any of these substances in the soft tissues with-