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24 PATHOLOGY OF THE HAED TISSUES OF THE TEETH.
any undermined enamel, and the cavity thus formed filled with
oxyphosphate of copper. In any case, oxyphosphate fillings
should be examined as often as once in three months to see that
they are doing well and to mend up any failures. In this way
these teeth can often be tided along and serious decay prevented
until such time as permanent operations can be made.
Those cases in which the condition of the occlusal surface
is still worse and in which decay seems to start in spite of the
effort to prevent it in this way, a gold cap may be made to cover
in the entire exposed part of the crown. After grinding down the
more prominent points that will cause the cap to interfere with
the occlusion, an impression should be taken in modeling com-
pound. This may be taken in the little impression cups used
in crown work. Often these may be cut down considerably to
decrease their bulk, which, in the mouth of the little child, is a
serious objection. The arrangement should be made to obtain
a very sharp impression very quickly. To this end, the softened
modeling compound should be placed in the cold cup and allowed
to partially stiffen. Then the surface should be warmed quickly
over a Bunsen or alcohol flame and quickly conveyed into the
mouth and pressed over the tooth. It should be held in position
for several minutes, if practicable, so that the mass may become
hard enough not to be drawn or marred in its removal. By this
plan a very sharp impression can be obtained. From this a gold
cap can be formed to cover in the occlusal surface of the tooth
and may be cemented in place. There should be no attempt
to make a full gold shell crown. It should only overlap the axial
surfaces sufficiently to hold it in place. A renewal later, when
it can be slipped further over the tooth, should be expected in
many of the cases. The gum will cover much of the crown at
the age of seven or eight years, and the child will be very sensi-
tive about any pushing away of the soft tissues.
Sometimes it will be impossible to place these without some
interference with the occlusion. This will not be of much impor-
tance if the interference is not very considerable, for the occlu-
sion is quickly accommodated by movement of the teeth in early
childhood. Special attention should be given to the intercusp-
ing of these caps that the teeth may not be caused to slide out
of position during the process of shedding the deciduous teeth.
(See article on the intercusping of the first molars in Manage-
ment of Children's Teeth.) These caps can often be improved
by filling in deep grooves and by some broadening of the occlusal
surfaces of the models before they are swedged; and, in doing
this, the intercusping can be studied and arranged. Generally
the crowns will have to be made rather flat and the cusps short