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232 PATHOLOGY OF THE HABD TISSUES OF THE TEETH.
crushing a small crystal on a glass slab and adding a single drop
of water. Apply this to the area of decay with a thin end of an
orangewood stick and saturate the entire area thoroughly. If
possible, place the patient in the direct rays of the sun for ten or
twenty minutes. In that time an intense black color should be
obtained, such as is shown in Figures 169, 170, 171, which were
photographed directly from the mouth after this treatment and
have had no retouching. If direct sunlight can not be obtained,
use the best daylight obtainable and continue the exposure for an
hour or more. Many of the cases treated in this way do very
well indeed, and it is very easy to follow up a further recession
of gum by a repetition of the treatment. It must be distinctly
understood that the silver nitrate without the precipitation by
light is valueless. It is dissolved out and disappears. It is only
the insoluble black precipitate that is effective and the decayed
tissue should be filled with it completely and to the greatest depth
possible.
Esthetic Considerations.
There would seem to have been sufficient consideration else-
where of questions of esthetics in the treatment of caries of the
teeth without a separate mention under that head. Yet there
are some points not touched upon, or perhaps that have not been
made sufficiently clear.
The point that gives offense most often in this regard in
the treatment of caries, is making gold fillings that are so large
as to overlap onto the labial surfaces of the incisor teeth. When
this occurs, it is usually made necessary by the burrowing of
decay, and the injury to the appearance of the teeth can not be
remedied by the ordinary methods of operating. Porcelain inlays
may be used in these cases, but their use in young people, in
whose teeth the carious process is still active, is not, as yet,
to be trusted as sufficiently permanent under these conditions.
Therefore, we are limited to making the best appearance possible
under the conditions. This best appearance is best subserved
by making the necessary show of gold in the most perfect tooth
form possible. A mass of gold appearing in an incisor that has
not the form of the natural surface of the tooth is inexcusable.
Such a presentation adds the insult of bad taste in operating to
the injury of the loss of the part of the tooth.
On the other hand, if the building of the filling to the form
of the tooth has been artistically done in all of its details, there