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TREATMENT OF DENTAL CARIES. 195

broader sense, in that it gives the natural use of the tooth; a
tooth that was sensitive, a tooth that the patient avoided chewing
upon, is brought again into full use. That full use tends to the
health of the part and the whole side of the mouth. Patients
often, on account of one sensitive cavity, will avoid the use of
that side of the mouth, chewing entirely upon the opposite side.
Then disease is likely to run riot upon the disused side. In this
way a single filling, by allowing full usage of the teeth, may serve
to protect and guard the whole side of the mouth against future
decay and against disease of the gums and peridental mem-
branes. In this sense the prophylactic effect of the filling is wide
and important. It is also important in a broader sense again than
this, for, by giving the full use of the apparatus of mastication,
it contributes to the general health of the person; the food is
more perfectly masticated, is placed in a better condition for
digestion, and the whole physical man is benefited by the opera-
tion.
What should be considered a permanent filling? What do
we mean by permanent? This question might be answered in
various ways. Possibly many dentists would regard a filling as
permanent if it afforded a reasonable protection for eight or ten
years, or four or five years. This would hardly be the highest
idea of a permanent filling. There may be different degrees of
permanence. Under some conditions I should regard a filling
that protected the teeth for two or three years as doing good
service under the circumstances, particularly in making fillings
for children, where the conditions under which the operation is
performed are very unfavorable. The child movement, to say
nothing of the difficulties of self-control in the child, is such that
operations are difficult. We sometimes find the equivalent of
child movement in those who are no longer children, a condition
of the nervous system in which there is continual movement of
the person. This becomes so annoying that it is almost impos-
sible to operate with accuracy. We speak of these as child move-
ments because they are so common in children. They seem hardly
to be voluntary movements ; involuntary movements, as it were,
but continuous or very frequent. Other conditions, such as gen-
eral nervousness, sensitiveness that can not be well overcome,
etc., contribute to the difficulties of making fillings, and make it
necessary, upon occasion, that we make fillings that are not the
best, because the conditions will not allow of the best operations.
These should hardly be regarded as permanent fillings, and yet
they do a service in protecting for the present, with the hope that