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TRUE CARIES.
159
smaller cavities were found in both laterals and both The
cuspids.
pulps being alive, it was thought best to fill these teeth with gold,
notwithstanding the consequent disfigurement. This was an extreme
case, yet by thorough attention to the directions as to the care of the
teeth, and perhaps more especially because of the abandonment of
the excessive use of milk, the teeth have never since been stained, and
the fillings are still in good condition, though ten years have passed
and the woman is now herself a mother.
young
Whilst the lower anterior teeth are more or less
protected during
the drinking act, this cannot be said of the molar region. The fluid,
once in the mouth, flows freely over all the posterior teeth ; and it is
along the buccal surfaces of both upper and lower molars that green-
stain plays the saddest havoc. It is unfortunately not uncommon to
find what at first seems to be a small the walls of
cavity, apparent
which, however, will be so thoroughly decalcified that they are readily
FIG. 181. FIG. 182. FIG. 183.

broken down with an excavator. Where this is the case, it is well to
first remove the green-stain with a corundum, and thus be enabled to
determine what is the real limitation of the destruction. Starting with
a small cavity, extension which removes all decalcified structure may
result in a cavity which almost, if not quite, encircles the tooth near
the gum-margin. I have seen the entire buccal surface so destroyed,
with narrow extensions reaching the palatal surface around both ap-
proximal sides. These cavities will often prove most exasperating,
and their successful filling is doubtful unless one can be assured that
future attacks of green-stain will not supervene, which of course is
difficult.
True Caries. Caries may produce surface cavities on any of the
teeth, though I have never seen such a cavity in the lingual surface of
the lower incisors.* It may follow the depredations begun by erosion,
or by green-stain. It may occur in the grooves formed by abrasion
after recession of the gum, at the tooth-neck. It may result from
malformations, which have made crevices where we should have per-
*
Since writing the above, a girl of ten presented with a distinct cavity in-
volving only the lingual surface of an inferior lateral incisor. THE AUTHOR.