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THE CHILDHOOD PERIOD OF THE PERMANENT TEETH. 275

must be regarded as children and treated accordingly. But the
greater number of these cavities will be found in persons from
fifteen to eighteen years old. These patients will have more self-
control. The teeth are through the gums sufficiently so that the
rubber dam and the separator can be applied without unusual
pain and the conditions for operating are in every way improved.
There are not often found in the general conditions sufficient rea-
sons for temporary treatment. At this age, the patient will gen-
erally not have contracted mincing habits of mastication, unless
caused by the interference of neglected decay of the deciduous
teeth, and malleting will be reasonably well borne. It should be
remembered, however, that our civilized habits of using the knife
and fork for dividing our food and passing it into the mouth, robs
our front teeth of their legitimate function of dividing the food
to such a degree that their peridental membranes are not propor-
tionately as strong as those of the back teeth. Also that the
direction of force required in condensing gold is generally more
or less across the axial line of the tooth, and not so well borne
for that reason. Greater care is therefore necessary in the use
of force. Still, most of these teeth will readily bear the full fif-
teen pounds mallet pressure required in condensing the gold,
when necessary, if carefully applied from the beginning.
Open apical ends of root canals of the teeth during the
childhood period is always a special menace in these operations,
because root fillings can not be made in cases in which pulps are
found exposed or are exposed by any accident in operating. This
should be ever present in the mind of the dentist who attends to
the teeth of children. It is as much his duty to use his influence
in obtaining the opportunity of watching these children in order
that he may do the required operations in good time, as it is to
do the operations well. It is not always an easy matter to con-
vince parents that everything possible has been done when they
bring in the child with a widely exposed pulp at eight or nine
years old and are told that the tooth will probably be lost in spite
of all the dentist can do. A few months earlier a safe operation
could have been made had the opportunity been given. This
education is best and its effect is better when given by the dentist
in his office directly to the parents. The pulps are being removed
from these teeth and root fillings made much earlier than they
should be in hundreds of cases, with the result that abscesses
occur under conditions at the root apices which make them incur-
able. This happens oftener with the upper lateral incisor than
with the central. It is not very uncommon for the upper lateral