Page 368 - My FlipBook

230 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.
special study of the local conditions and the very careful appli-
cation of procedures to meet them.
Cavities of this class are, in the aggregate, much less fre-
quent than cavities of the other classes. In practice the author
has found them very annoying from the fact that they have so
often occurred after the case seemed fully under control. This
has been especially true in women. Young girls quite suscepti-
ble to caries have grown up to maturity, other classes of decay
having been kept well under control. They have married, and,
perhaps, in their first or second pregnancy, a half dozen buccal
cavities suddenly appear and urgently require treatment at a
time that is anything but opportune, and are therefore especially
liable to be neglected. The circumstances make them very diffi-
cult to handle.
Prophylactic measures against this class of cavities can be
rendered more effective than in any other. The surfaces are so
exposed to the brush that they can be perfectly cleaned most
easily. If patients, at the first signs of the coming of this class
of decay, can be induced to use a brush effectively four times a
day, after meals and before retiring at night, regularly, for a few
years, they will escape with only the cavities already begun. To
be effective, however, the brushing must be done thoroughly and
regularly. Only the brush with water is needed.
CAEIES IN CASES OF RECESSION OF THE GUMS.
ILLUSTRATIONS: FIGURES 168-171.
Caries occurring in the cementum in cases of recession of
the gums on the labial surfaces of one, two or more teeth in
mouths otherwise healthy, is not very uncommon. They are
always unsatisfactory cases with which to deal. It appears quite
certain that the recession of the gum gives the opportunity for
the caries, and as the recession of the gum is often progressive,
so is the area involved in caries enlarged. Many cases of reces-
sion of the gum occur without caries that, to all appearance, are
of precisely similar nature. This recession of gum is a very
singular phenomenon. Often there seems to be no pathological
condition present and thus far very little has been accomplished
in the endeavor to limit it, much less to cure it and obtain a
regrowth of the lost tissue.
But in this place we are interested chiefly in the manage-
ment of caries that is liable to begin in the cementum uncovered
by the recession of the gum. In many instances this is a broad,