Page 417 - My FlipBook

THE CHILDHOOD PERIOD OF THE PERMANENT TEETH. 265
Further consideration in a general way will be given to the
evils resulting from the early loss of the first molars in connec-
tion with the consideration of caries of these teeth.
Caries op Permanent Teeth During the Childhood Period.
The first molars and the incisors are particularly liable to
caries during the childhood period. The first molars suffer
much the oftenest. The fact that these teeth take their places
very quietly to the distal of the deciduous molars without the
dropping away of any of the deciduous teeth to announce their
coming, serves to conceal their eruption. Parents generally do
not know of the presence of these teeth, or do not realize that
they are permanent teeth. They are, therefore, more frequently
neglected than any other teeth.
First permanent molars. The lower first molars are usually
the first of the permanent teeth to be attacked by caries. The
decay is almost always in the central pit of the occlusal surface,
but occasionally in the buccal pit also. Cavities in a similar
position in the upper first molars begin soon afterward. This
is so common and the effects of this early beginning of decay
in these teeth are so grave, that it requires special consideration.
These teeth are the first of the permanent teeth erupted and are
usually through the gums by the middle of the sixth year of the
child's life. In this, however, there are pretty wide variations
which have been noted. They are often deeply decayed by the
eighth year and generally require fillings by that time in fami-
lies in whom there is considerable susceptibility to caries. There
are no other teeth that are so often lost from inattention at the
proper time as these. There are no other teeth easier to protect
by proper attention correctly timed. The early loss of the first
molars is from occlusal decays in about ninety-five per cent of
cases, and these are the easiest cavities to manage when taken
in time. They are also the most important of the molar teeth.
They are the largest, strongest and most effective in mastica-
tion. For several reasons, which have been given above, their
loss causes more derangement of the masticatory apparatus
and of facial expression than any other, not even excepting the
incisors, for these have not so prominent a function in the gen-
eral development. If these latter are lost early or late, the loss
is replaced artificially. The form of the face and the expression,
which would otherwise be marred by shrinkage to fill the space,
is prevented ; and mastication is not seriously deranged. How-