Page 168 - My FlipBook

METHODS OF FILLING TEETH.
154
minute openings in the dentine, thus closing them and covering up
the living matter, which the excessive heat from the friction may also
serve to devitalize. Thus a crust is formed over the responsive
tissue, so that it is shielded. Fortunately, if the use of a very soft
brush be adopted, the sensitiveness will rarely recur within six months
or a when the remedy may be Where carious
year, applied again.
action has actually begun, a superficial softening having supervened,
the is different. It is at this time that the tooth
procedure slightly
will ache after the use of acids or sweets, etc. and an irritation of
,
the matter has occurred. Touch the with a
living probably part
saturated solution of nitrate of silver, and allow this to remain for a
few days. This will discolor the tooth, and, whilst effectual in allay-
is a It must therefore be removed with a
ing pain, disfigurement.
corundum, or with a polishing-point and pumice. This will at the
same time take away the softened dentine from the surface, and the
sensitiveness will again be noticed, though in a lesser degree. The
burnisher must consequently be resorted to, and persisted in till no
softness appears on the surface. This may leave a deep groove, but,
with women, will be preferable to an
especially unsightly gold filling.
Of course, where greater progress has been made, so that a distinct
cavity is produced by the removal of softened dentine or decay, a
is unavoidable.
filling
This sensitiveness at the neck may also occur on the molars ; and
here we do sometimes find it along the palatal as well as the buccal
side. It may also result where attrition has worn down the masti-
cacing surfaces till the interzonal layer of dentine becomes exposed.
This is a good place for the free use of the nitrate-of-silver treatment.
The dam is to be and the
applied, if possible, parts touched with the
saturated solution, which is allowed to" dry. I have treated teeth in
this sometimes
way, renewing it two or three times at successive sit-
tings, until by the blackening of the surface I was assured that a
heavy deposit coated the parts. These teeth not only ceased to be
sensitive, but I have noticed that even where carious action had
begun, the surface being softened, the caries has been aborted. I
have also seen teeth which I had treated in this way five years pre-
viously come into my hands again, when, mistaking the discolora-
tion for nicotine stains, I have to cleanse them. In
proceeded every
such case the patients have returned within a week, complaining
that the sensitiveness had returned.
The condition which I have been should never be mis-
describing
taken for erosion, an error which might be* made with the anterior
teeth. Yet the distinctions are well marked. With erosions we
almost always have the enamel involved. I might say always, for the
exceptions are only where the erosion, starting upon the enamel, may