Page 180 - My FlipBook

178 EXAMINATION OF TEETH.
mal surface of cacli tootli. Tliis movement should be made from the
inner as well as from the outer aspect. In this manner the instrument
will be brought into contact with every accessible portion of the inter-
proximal surfaces.
Then the sulci are explored and thi; haccal (ind Unf/ual surfaces
examined.
The inspection is thus conducted from tooth to tooth. Next the lines
of apjxirent contact are critically tested with the mirror for evidence of
slow changes of structure as shown l)y discoloration or rapid alterations
shown by a milk-like appearance of the tooth surface.
Finally, all approximal surfaces which could not be explored are
silked. To do this the floss is wrapped upon the index finger of the
left hand, and with the right is drawn between the contact surfaces
Avith a sliding lateral movement. Care should be exercised that no
injury be done to the gingival margin of the interproximal space by
suddenly and forcibly driving the floss into contact with it. This acci-
dent may be effectually avoided by a proper guarding and supporting
of the fingers by contact with the adjacent teeth. Practice gives
facility in determining by means of the silk the state of the parts in
contact with it.
In the inspection of previous stoppings, all margins, particularly
those beneath the gum, should be critically inspected.
Lastly, doubtful situations should be noted for subsequent examina-
tion to be made after separation.
(The tests for pulp exposures are considered in Chapters VII. and
YIII.)
The order of examination is best conducted by beginning at the
median line of each quarter of the denture, progressing posteriorly with
one line of observation and returning to the place of beginning with
another line of observation.
The Chart Record.—The chart record should at the same time be
carried on by the principal, or better an assistant, with the view of
securing a complete record of each derangement, for guidance and for
reference. The details of the record are indicated in a simple manner
by symbols which are illustrated by Fig, 148, and explained by the glos-
sary. These symbols may be combined, where required, to give fuller
expression.
From this temporary record im])ortant operations when executed
may be transferred to a permanent record.
The constitutional condition and the texture and apparent resistance
of the teeth to caries and attrition ; the inherited tendency to diseases of
the teeth ; the chemical reaction of the mucous and salivary secretions ; the
state of the general heath ; the condition of the mucous membrane of the