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678 MANAGEMENT OF THE DECIDUOUS TEETH.

I^. Acidi arseniosi,
MorphijB acetatis,
Piilv. opii, cid. pars ceq.
Creosoti q. s. to make paste.
Why opium and acetate of morpliia should both he used in the same
prescription is not clear, as their properties are so nearly the same, but
the ]xiste has been satisfactory in devitalizing; j)ulps with no ])ain, or
with a minimum amount. Other formulas may be equally satisfactory.
In occlusal cavities its application is sim})le. Excavate the softened"
dentin as thoroughly as possible without inflicting ])ain, using spoon-
shaped excavators to prevent puncturing the pulp. If the excavation
can be carried far enough to apply the paste directly to the pulp its
action will be more rapid. Dry the cavity, apply a small amount, not
larger than half a pinhead in size, with a small probe and cover it with
a pellet of cotton, or place in the cavity a small pellet of cotton one
side of Avdiich has been touched to the paste. Add enough pellets of
dry cotton to fill the cavity, then a])ply a drop of sandarac varnish, suf-
ficient to saturate at least half the depth of cotton. This is a better
plan than dipping the pellets in the varnish before inserting, because an
excess of the latter is a])t to come in contact with the pulp and cause
pain, or, penetrating between the paste and the pulp, may render the
former inoperative. Temporary stoppings such as Gilbert's, White's, or
Fowler's are excellent for sealing the cavity, but take a little more
time than cotton and varnish. Such temporary stopping should be well
softened by heat to prevent pressure on the pulp in its insertion. A
good plan is to warm the end of the long stick of stopping and press
it into the cavity, using the remainder of the stick as a handle, then
remove the surplus and smooth with a warm instrument.
In approximal cavities extending near or under the margin, the gum
should be protected, before applying the paste, as follows :
Make, by rolling between the fingers, a cylinder of cotton as long
as the width of the tooth and about the size of the lead of a pencil.
Saturate it with sandarac varnish and pack it between the teeth npon
the gum, extending part of it below the edge of the cavity, thus sealing
this portion of the cavity and reducing it nearly to the form of an
occlusal cavity. Paste applied in an approximal cavity so protected
cannot flow upon the gum unless too great a quantity has been used.
The paste should be applied and sealed as in an occlusal cavity.
" Devitalizing fiber " is very satisfactory and may be used with less
fear of its affecting the gum tissue.
The paste may be allowed to remain in the cavity for from twelve
to forty-eight hours. The possibility of the dressing being dislodged, so