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INTENTIONAL EXTENSION OF CAVITIES. n

practice to insert pin-head fillings in such positions. It would be safe
to say that the sulcus in a bicuspid should always be opened to its full
extent, even when caries appears in but one pit. There may be a few
cases which might rightfully be excepted, but, as stated, the rule is a
safe one. From this dogma it follows that it is improper ever to insert
two in the crown of a one in the at one
fillings bicuspid, pit extremity
of the sulcus, and one at the other end. The patient is thus made to
believe that he receives two when but one is needed, and
fillings, truly
would serve better than two, since the between is weak.
space
In considering molars we perhaps should be less dogmatic, though
in the inferior we would still be on the safe side,
jaw erring it erring
at all, when we cut out the crossed sulci. I heard a professor in a
dental college once, in a lecture, instruct his class somewhat differ-
ently upon the point as here stated. He said that he had frequently
filled lower sixth- year molars, placing one filling at each corner of
the cross, and one in the center, charging five dollars Had
apiece.
this gentleman made a single filling of the whole, charging twenty-five
dollars for his he would have been more scientific, more
operation,
honest, and yet have received the same fee. A man may regulate his
fees as he chooses, but he cannot his for
rightfully arrange fillings
effect, at the expense of durability.
It is necessary here to dilate a moment upon this subject of enlarg-
ing the cavities in the lo'wer molars, especially those of the sixth year.
We are usually asked to fill them in the mouths of children. The
has no that there is a at
parent suspicion cavity all, and when the
child returns home with a tremendous surface of gold showing, the
that the dentist has
mother calls at the next visit, charging perhaps
"
bored a hole in the tooth." This is the opportune time for edu-
cating the family. A candid explanation should be made, stating
that while it would have been possible to fill the tooth with only a
small amount of it would have needed in a few
gold, surely refilling
years. To those who must have an incentive for doing conscientious
work, aside from the gratification of knowing that the most skillful
course has been pursued, it may be said that these talks with parents,
and patients generally, are sure to redound to the benefit of the
operator.
The general rule of cutting out the sulci of course helds also with
the superior molars, but here it is often best to insert two fillings.
There is commonly found a deep pit in the anterior portion of the
crown, a less deep one existing posteriorly, with a sulcus extending
well over into the surface. 18 shows the crown of a
palatal Fig.
molar built
superior properly filled, the anterior cavity (a) being up
so as to be free from ramification of the sulci, and the posterior
This
civity (3) having been cut so as to include the palatal groove.