Page 354 - My FlipBook

216 PATHOLOGY OF THE HAHD TISSUES OF THE TEETH.
being especially favorable. Often the proximal surfaces of the
front teeth will decay very early, and those of the back teeth
not until later, or not at all. In other cases, the front teetb
escape and the proximal surfaces of the bicuspids and molars
decay very early. In either case the decays are very apt to
occur in pairs, similarly located one upon either side of the
mouth.
A mesial cavity occurs occasionally in the first permanent
molar while it is in contact with the second deciduous molar
and it requires treatment very early. This is presented fully
under the heading "Management of Children's Teeth," and need
not be considered further here.
This is the only proximal cavity in the molars that begins
at a very tender age. The second molar is not erupted until
twelve, and rarely has a cavity before fourteen or fifteen in the
most susceptible children. And it is only at this age that distal
cavities in first molars begin to occur. At this age, however,
we may expect cavities in the distal surfaces of the first molars
and mesial surfaces of the second, and cavities are liable to
occur in the proximal surfaces of the bicuspids almost as rapidly
as they take their places. When this occurs, the teeth melt away
with great rapidity and the most heroic and painstaking operat-
ing in respect to minute details and the full inclusion of areas
of liability will be required to protect them until the coming of
immunity relieves them of danger. All tinkering with tem-
porary fillings should be avoided to the utmost, and yet cases
will occur in which temporary fillings must be resorted to, to
bridge over periods of extreme sensitiveness. But the time of
their use should be confined to the shortest possible limit. At
this age, the failure of effective use of the teeth in chewing food
quickly brings with it sensitiveness and thickening of the peri-
dental membranes, and it is of the utmost importance to have
the patient using the teeth vigorously again in order that fillings
may be made without inflicting unbearable pain, and also on
account of the necessity for the greatest possible cleanliness.
Often temporary fillings made with this special end in view,
together with the arousing of the proper effort on the part of
the patient, will accomplish the desired end quickly, or within
a month or two, and then the case may be regarded as under
control and the necessary fillings leisurely and effectively made.
Many dentists push their young patients too strongly. That is,
they make their sittings too frequent and too long. When the
patient is suffering pain, extreme sensitiveness, or failing in