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244 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.
accurate records of cases. A severe alveolar abscess may occur
early at the root of a deciduous molar, be relieved by discharge
of the pus, or the removal of the offending tooth, and be forgot-
ten. When the bicuspid takes its place with imperfect enamel,
no one knows what has occurred. If there is a record of the prior
condition and the treatment, the two incidents become properly
connected as cause and effect. A number of cases have occurred
in the author's practice in which necrosis, as a result of these
abscesses, has brought away the permanent tooth with that por-
tion of bone immediately surrounding it. These things lead one
to believe that the sufferings of children with these conditions
are not sufficiently appreciated. It is certain that the little ones
are much too often neglected.
The absorptive process seems to be very fickle in its begin-
ning and in its progress, and there are many cases of variation
from the normal. In some of these, the absorptive process seems
to be hurried and it will be completed before the normal time so
that a temporary tooth will drop away before the permanent
tooth has come forward, and the child may be without a tooth
for a year or two ; whereas, in the normal process, when the little
tooth drops away, the permanent tooth should present at once.
These cases are not so frequent, however, as delayed absorption.
Delayed absorption of roots occurs quite often, so that the com-
ing tooth will be deflected from its position. If the absorption
of a root of a lateral incisor or cuspid is delayed, the coming tooth
will generally strike its lingual surface and be deflected to the
lingual. Deflections to the labial are more likely to occur from
other causes, but deflections to the mesial or distal, the tooth
making room in the arch for both itself and the retained decidu-
ous tooth, are occasionally seen. In case of the bicuspids, the
crowns are normally between the spreading roots of the decidu-
ous molars, and in case the absorption is delayed, generally the
coming bicuspid is simply held back. In the upper jaw it may
escape from between the spreading buccal roots and be deflected
to the buccal, so that the tooth will come out to the buccal of
its normal position in the arch. In the lower jaw they may be
deflected either to the buccal or to the lingual, but they are more
generally simply delayed, held back by the lack of absorption
of the roots. Indeed, the absorption of the roots of the tem-
porary teeth does not seem to be especially stimulated by the
coming of the permanent teeth, for they are often absorbed
when there is no permanent tooth to come. "When that happens,
the absorption occurs in accord with a process of nature, and