Page 404 - My FlipBook
P. 404
;
256 PATHOLOGY OF THE HAED TISSUES OF THE TEETH.
decay has progressed for a considerable time and food has
lodged, that the gums are out of the way. One of the difficulties
of the treatment by cutting is that we will come upon the gums.
Another difficulty is the proximity of the pulp of the tooth.
The pulps in the deciduous molars are large and we are liable
to encroach upon the pulp too closely if the cavities are too large
to cut out in the way mentioned. Of course, where we can control
the child to prepare these cavities and make fillings, even though
we can not make much extension, it is still the better method to
make fillings rather than cut away the surfaces, and for this
purpose I should say that there is nothing better than a good
amalgam filling, if well put in and polished properly afterward.
This matter of care in putting in these fillings, however, is just
as important as it is in the teeth of adults. We should not neg-
lect any detail because we are handling a child, for, with them,
decay is so much more rapid that any little neglect of this kind
will tell more quickly than it will in the teeth of adults. The
polish should be well made. If we can handle a child to put in
the filling, we can at a subsequent sitting obtain a good polish
and then the filling will be serviceable.
Thus far it has been presupposed that the children are
brought to the dentist sufficiently often that he may be able to
follow up the treatment. Not only this, but it is supposed that
children have been brought to the dentist early enough so that
he has been able to handle these decays before they are large
and, where this is done, one ought to succeed in the treatment of
these teeth. But the difficulty that confronts one in practice is
that parents too often bring their children after decay has pro-
gressed so far that toothache has already occurred. Parents do
not realize that decay is going so far ; they may notice that there
are decayed spc4s in the teeth and be anxious about them, but at
the same time, are likely to put off all effort at treatment until
the child has a sleepless night with toothache. The child is
already tortured with pain ; anything one may do will hurt the
child inordinately and one has the worst possible condition to
begin with. In this case we are reduced to the alternative of tem-
porizing or immediate extraction. The first effort will be to
relieve pain, and for the present nothing else should be done.
If possible, the child should be made comfortable, and the treat-
ment continued at a subsequent sitting, after the child has slept
and recovered its composure. If the pulp is exposed, which will
generally be the case when the excavation is made, you may
destroy it, remove it and fill the roots, and in this way succeed,
256 PATHOLOGY OF THE HAED TISSUES OF THE TEETH.
decay has progressed for a considerable time and food has
lodged, that the gums are out of the way. One of the difficulties
of the treatment by cutting is that we will come upon the gums.
Another difficulty is the proximity of the pulp of the tooth.
The pulps in the deciduous molars are large and we are liable
to encroach upon the pulp too closely if the cavities are too large
to cut out in the way mentioned. Of course, where we can control
the child to prepare these cavities and make fillings, even though
we can not make much extension, it is still the better method to
make fillings rather than cut away the surfaces, and for this
purpose I should say that there is nothing better than a good
amalgam filling, if well put in and polished properly afterward.
This matter of care in putting in these fillings, however, is just
as important as it is in the teeth of adults. We should not neg-
lect any detail because we are handling a child, for, with them,
decay is so much more rapid that any little neglect of this kind
will tell more quickly than it will in the teeth of adults. The
polish should be well made. If we can handle a child to put in
the filling, we can at a subsequent sitting obtain a good polish
and then the filling will be serviceable.
Thus far it has been presupposed that the children are
brought to the dentist sufficiently often that he may be able to
follow up the treatment. Not only this, but it is supposed that
children have been brought to the dentist early enough so that
he has been able to handle these decays before they are large
and, where this is done, one ought to succeed in the treatment of
these teeth. But the difficulty that confronts one in practice is
that parents too often bring their children after decay has pro-
gressed so far that toothache has already occurred. Parents do
not realize that decay is going so far ; they may notice that there
are decayed spc4s in the teeth and be anxious about them, but at
the same time, are likely to put off all effort at treatment until
the child has a sleepless night with toothache. The child is
already tortured with pain ; anything one may do will hurt the
child inordinately and one has the worst possible condition to
begin with. In this case we are reduced to the alternative of tem-
porizing or immediate extraction. The first effort will be to
relieve pain, and for the present nothing else should be done.
If possible, the child should be made comfortable, and the treat-
ment continued at a subsequent sitting, after the child has slept
and recovered its composure. If the pulp is exposed, which will
generally be the case when the excavation is made, you may
destroy it, remove it and fill the roots, and in this way succeed,
