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102 Preventive Treatment of Caries.
in larger and better formed, on account of the increase of room
for their devclopement.
When it is deemed proper to pursue either of the above
methods of treatment, the four corresponding teeth should be
removed for reasons that will soon be given. One thing of
great importance remains to be mentioned.—The first perma-
nent molares are not to be extracted till the second permanent
molares have so far advanced in their formation, that there be
no danger of injury to them by the operation. (See page 41.)
When the second molares are about to cut the gum, is a proper
time for their removal.
" Irregularities of the teeth, and a crowded state of the teeth
are the chief predisposing causes of their diseases, and seldom
fails even in the most healthy constitution to destroy the best
set of teeth, unless properly attended to.
"By an early and judicious application of the necessary
preventive treatment, I have never failed to obtain such a set
of healty and beautiful teeth, as might be preserved to the end
of life.
" As it is often necessary to extract some of the permanent
eet, at an early period, in order to give sufficient room for the
rest, it is a matter of great importance to know which teeth
should be extracted for this purpose.
"Those teeth which are the most subject to disease, least
important, and the removal of which would afford the most
relief to the whole set, are the proper ones to be extracted.
As the loss of the incisores and cuspidati greatly disfigures the
set, they ought always to be preserved if possible. I have
hardly ever seen a case in which it was necessary to extract
any of them, with a view to give room to the rest, where early
attention had been paid to the state of the teeth. The pre-
servation of the bicuspides should also be a matter of con-
sideration.
"The first molares are the most predisposed to decay, and
are so situated as to afford, by a timely removal, sufficient
room for the anterior teeth, as well as the second and third