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MANAGEMENT OF CHILDREN'S TEETH. 243
ing the arch and making room for itself. These are usually
easily removed if the conditions are recognized. They produce
very much less trouble than the roots of incisors. Recently a
student brought me a lower first and a lower second bicuspid,
which he had just extracted, to ask an explanation regarding a
singular growth on the proximal side of the apex of the root of
each one of the teeth. Upon examination, I found each of these
to be the apical half almost entire of the roots of a deciduous
molar, or possibly of the distal root of each deciduous molar
that had remained in the jaw and had become attached in this
way. One of them was slightly movable, and therefore was
attached only by the fibers of the peridental membrane, though
the attachment was very firm. The other was immovable and
was evidently attached by cementum. No history of any difficulty
from these retained bits of roots was discoverable. Occasionally
the root of a cuspid will be found — a long root — being thrown
out under the lip in the same way as the incisors. This root is
occasionally so long that its end will be too high to pass out under
the lip and the labial side of it will appear in the opening.
Occasionally an abscess will occur at the end of the root of a
temporary molar before the enamel of the crown of the bicuspid
has been completed, and, in that case, the pus may break into
the enamel organ and destroy it, or a part of it, so that the
enamel of the crown of the bicuspid will never be completed.
Then it will come through as an imperfectly enameled tooth. I
have observed a number of these cases, one in my own family,
where a,n abscess occurred very early at the root of a temporary
molar, in which there was a good deal of swelling and a good
deal of pus. I suspected at the time that there would be injury
to the bicuspid, and when the bicuspid presented the enamel
was imperfectly formed, not having been completed. This has
occurred a number of times under my personal observation.
Sometimes these injuries closely resemble atrophy in appear-
ance, but are readily distinguished from that class of injury by
being confined to one or two teeth. But it is only occasionally
that we get injury from alveolar abscess that has occurred quite
early at the root of a temporary tooth.
Not very infrequently the failure of absorption of an
abscessed temporary molar will hold back and delay the eruption
of a bicuspid ; and it is often difficult to determine the cause of
this delay satisfactorily without an X-ray picture. This, how-
ever, will show the condition clearly enough to complete the
diagnosis. These cases illustrate the peculiar value of keeping