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414 CONSERVATIVE TREATMENT OF THE PULP.

dentimil tissue the exact character of which lias nut been made out.
The writer has observed a multitude of cases in practice when the open-
ing at the point of exposure has become occluded by bony tissue. In
some instances this has occurred in two years, in others after longer
periods. In one instance a lateral incisor became protected by this
formation, but in consequence of mistaken diagnosis of another condi-
tion causing pericementitis, a drill was passed through the new tissue
to the living j)ulp. This new opening healed again. In the same mouth
another incisor also recuperated in the same manner.
In some cases when entire quiescence has been maintained for many
years the pulp will be found not to have undergone any protective
changes.
It is not remarkable, however, that pulps may remain in a state of
quiescence for a long period, when it is considered that in slowly-
advancing caries the pulp will often be exposed for a long time Avithout
the occurrence of any signs of irritation, unless, by the position of the
mouth of the cavity, the pulp has been subjected to the pressure of
food.
It maybe concluded' that, whether the pulp becomes protected by
secondary deposits or acquires complete quiescence, conservative treat-
ment in these cases has considerable advantage over immediate devital-
ization. Still, in this connection in order to avoid embarrassments the
necessity exists for careful selection of subjects to be treated in this
manner, and also for proper analysis of the apparent condition of the
pulp itself. To aid in this discrimination the following summary of
conditions should be held in mind :
(a) Where no previous observable disturbances can be elicited.
(6) Where the tooth has been impressed only by the application of
low temperature.
(c) Where, in addition, reflected pain in related parts has been
observed.
(d) Where the tooth has become much subject to impressions by
heat.
(c) Where continued objective disturbances appear, such as soreness
to touch, or local pain of spontaneous character accompanied by pulsa-
tion.
Classes a, b, and c may be considered as amenable to treatment, and
also, problematically, class d if taken early. Class e must, in view of
the principles stated in this section, be eliminated from the field of con-
servative treatment ; and where cases in the other divisions apparently
amenable subsequently take on disorders coming within this classi-
fication they usually have passed beyond the reach of palliative treat-
ment.