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or even sometimes one before the other. Cases of this kind
require the removal of the temporary lateral incisores.*
The permanent central incisores are very broad ; they oc-
cupy the greater part of the space of the four temporary
ones, and leave scarcely any room for the permanent lateral
incisores ; on which account these latter teeth must grow
very irregularly ; they generally pass through behind, being
forced considerably backwards by the resistance of the cen-
tral incisores and the temporary cuspidati. Sometimes they
pass through edgeways, and now and then they project for-
wards. In any of these cases, the removal of the tempor-
ary cuspidati is absolutely necessary, and unless the operation
be timely performed, the irregularity is with difficulty reme-
died.
The greatest deformity is generally occasioned by the
want of room for the lateral incisores and the cuspidati, and
when too long neglected usually becomes permanent.
When the permanent cuspidati make their appearance,
they generally project very much forwards, and not only
disfigure the mouth, but are very dangerous. I have known
several instances, where, from the accident of a blow, the
upper lip has been cut through. Whenever the cuspidati are
growing thus, the first temporary molares ought to be ex-
tracted.
When the bicuspides appear before the temporary mola-
res have been extracted, they pierce the gums above the
shedding teeth, and may be seen by raising the cheek and
upper lip. The removal of the temporary molares imme-
diately permits them to come down into their right situ-
ation.
In almost all the cases of irregularity which occur in the

* Plate XI. fig. 7.