Page 564 - My FlipBook

562 EXTRACTION OF TEETH.
Second : Teeth of mastication tliat have lost their occhuling teeth
and in consequence thereof are being pushed from their alveoli and are
a source of trouble. As a rule, this refers only to the second or third
molars, and more particularly to the third molar. When it occurs with
other teeth the opposite vacant space should be filh.'d by an artificial
tooth to })revent the extrusion of the natural tooth.
Third : AVhen incurable abscesses originating from teeth in the
upper jaw tend to open into the nasal chamber, maxillary sinus, or
zygomatic fossa, the teeth associated with such abscesses should be ex-
tracted. AVlien diseased teeth are the exciting cause of an incurable ab-
scess in the lower jaw which opens or threatens to open externally on
the chin, jaw, or below the bone into or upon the neck, they should be
removed.
Fourth : Teeth which occupy irregular positions in the arch, that
cannot be corrected so as to become useful or contribute to the gen-
eral symmetry of the mouth, should be removed.
Fifth : Erupting teeth that are retarded because of lack of room
in the jaw, if giving pain, should be extracted or else the tooth that is
preventing the eruption should be removed. A marked example of
this is often found in the eruption of the third molar when all the other
teeth are of good size and are in place. These molars when retarded
cause the greatest distress, sometimes producing serious results, and
must be extracted ; if they cannot be safely removed the second molar
may be extracted, in consequence of which the third molar will usually
be erupted near its place. When an upper third molar is erupting
under the same circumstances there is usually less difficulty, as having
but slight resistance distally it can erupt outwardly or slightly back-
ward, though, should it impinge upon the soft tissues covering the ramus
of the lower jaw, it should be extracted.
Sixth : Teeth so badly diseased that they will not respond to treat-
ment and are a source of discomfort to the patient should be removed,
as they impair the general health.
Seventh : First molars. There has been much discussion regarding
the early extraction of these teeth, many claiming that if the pulp of
one becomes devitalized at an early period of life and it is deemed best
to extract it, the other three should also be removed. No fixed general
rule, however, can be given ; each case must be considered separately.
There are cases where the extraction of all is necessary, and others
where it would be a most unwise thing to do. When the anterior teeth
are fully in position, the bicuspids occluding correctly with their oc-
cluding teeth and the second molars are about to erupt, the case may
then be one for extracting the four first molars, provided it be neces-
sary to extract one of them, or if it be likely that one or more of them