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TREATMENT OF DENTAL CARLES. 199
and, therefore, with it the power of limiting decay during the
period of the more extreme susceptibility is greater than with
any other material. This should not, however, lead the zealous
practitioner to undertake the use of gold under circumstances
that will prevent perfect operating. It should be remembered
always that gold is intrinsically better in limiting or curing
caries only because it can be more accurately placed. If the cir-
cumstances are such as to defeat this accuracy of placement,
another material should be used temporarily, in case gold has
been determined upon, until better conditions may be attained.
In the care of families of children, it will happen that con-
siderations of economy will require that a cheaper material be
used. "When this is the case, the facts should receive careful
consideration and a course of action determined. In this the
greatest care should be exercised, and even then it will be impos-
sible to avoid serious error. Many times it has happened that
amalgam was chosen for the molars and bicuspids of families
of children, and when they have grown to adults they have been
greatly chagrined because such a choice had been made for them.
Changes in financial conditions of families, and in the mental
attitude of persons toward such matters, will inevitably bring
some very awkward conditions and relations not appreciated by
the laity.
Under no circumstances can other than gold be used for fill-
ings in the six front teeth, except inlays as indicated elsewhere,
and cement fillings as a temporary expedient under some pecul-
iar conditions. This is to be regarded as a law that can not be
transgressed because of esthetic considerations, except under
conditions under which porcelain inlays may be chosen. But in
the molars and bicuspids, esthetic considerations become less
prominent in proportion as fillings will be hidden from view.
In these, amalgam may be used instead of gold, when required
by the necessity of economy. Formerly, I had been much opposed
to the use of this material in the teeth of children of very sus-
ceptible families for the reason that its power of limiting decay
was so very much below that of gold, but lately, since we have
had more experience with amalgams that neither shrink nor
expand, it is found that the curative power of this material, when
carefully and intelligently used, stands well up toward that of
gold. This gives it a much wider range of usefulness in the
teeth of susceptible young people than formerly.
• Then if, through the necessities of economy, amalgam is
chosen, it should-be limited to certain portions of the mouth, and