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512 PYORRHEA ALVEOLARIS.
As a general rule the first step of the operation consists in a careful
and thorough scaling of the teeth. It is essential that the use of bulky-
sealers be avoided—first, for the reason that they rarely reach the
deepest portions of the deposits
475.
second, that if they do, they cause
more or less laceration of the gum,
which should be kept as free from
injury as possible. The instru-
ments employed for this purpose
by a majority of operators are the
set known as Cushing's scalers
(Fig. 475). Their mode of appli-
cation and their position relative
to the root are shown in Figs. 476,
Cushing's scalers.
477. No instrument with a draw
cut can remove these deposits with the same thoroughness as
one operated with a push cut. With proper guarding it is
improbable that these instruments should do harm to the
vital parts beyond the calculus. Great care should be exer-
cised in the use of pushing instruments to avoid forcing the
dislodged particles into the deeper tissues. The scaling is a
tedious operation, but one which should be persisted in until
the root of the affected tooth is absolutely smooth. The scal-
ing is alternated with a washing out of the pockets with 3
l^er cent, pyrozone or hydrogen dioxid, which washes out the
detached particles of calculus and disinfects the parts. " When
the gums are tumid and interfere notably with the scaling pro-
cess, applications are made of a solution of trichloracetic acid
1:10 upon cotton tents ; this checks oozing, shrinks the gum,
giving a better view of the parts, and tends to soften the de-
posits." ^ " It not infrequently happens that the teeth have
suffered such extensive loss of their retaining structures that
the operation of scaling tends to still further loosen them. In
these cases the correction of mal-occlusion and splinting the
teeth should be attended to before proceeding farther with the
operation. The teeth should be ligatured to their fellows,
and the excessive occlusion corrected by grinding away the
points of contact with corundum wheels sufficiently to relieve
the teeth of strain and to permit the fixing of a metallic splint
by means of which the teeth may be held firmly, during and subsequent
to the scaling operation." ^
Splints for these cases are usually swaged metallic caps made of
1 E. C. Kirk. ^ H. H. Burchard, International Dental Journal, August 1895.
512 PYORRHEA ALVEOLARIS.
As a general rule the first step of the operation consists in a careful
and thorough scaling of the teeth. It is essential that the use of bulky-
sealers be avoided—first, for the reason that they rarely reach the
deepest portions of the deposits
475.
second, that if they do, they cause
more or less laceration of the gum,
which should be kept as free from
injury as possible. The instru-
ments employed for this purpose
by a majority of operators are the
set known as Cushing's scalers
(Fig. 475). Their mode of appli-
cation and their position relative
to the root are shown in Figs. 476,
Cushing's scalers.
477. No instrument with a draw
cut can remove these deposits with the same thoroughness as
one operated with a push cut. With proper guarding it is
improbable that these instruments should do harm to the
vital parts beyond the calculus. Great care should be exer-
cised in the use of pushing instruments to avoid forcing the
dislodged particles into the deeper tissues. The scaling is a
tedious operation, but one which should be persisted in until
the root of the affected tooth is absolutely smooth. The scal-
ing is alternated with a washing out of the pockets with 3
l^er cent, pyrozone or hydrogen dioxid, which washes out the
detached particles of calculus and disinfects the parts. " When
the gums are tumid and interfere notably with the scaling pro-
cess, applications are made of a solution of trichloracetic acid
1:10 upon cotton tents ; this checks oozing, shrinks the gum,
giving a better view of the parts, and tends to soften the de-
posits." ^ " It not infrequently happens that the teeth have
suffered such extensive loss of their retaining structures that
the operation of scaling tends to still further loosen them. In
these cases the correction of mal-occlusion and splinting the
teeth should be attended to before proceeding farther with the
operation. The teeth should be ligatured to their fellows,
and the excessive occlusion corrected by grinding away the
points of contact with corundum wheels sufficiently to relieve
the teeth of strain and to permit the fixing of a metallic splint
by means of which the teeth may be held firmly, during and subsequent
to the scaling operation." ^
Splints for these cases are usually swaged metallic caps made of
1 E. C. Kirk. ^ H. H. Burchard, International Dental Journal, August 1895.
