Page 57 - My FlipBook

CONTROL OF MOISTURE.
43
Sometimes the only necessity for using a napkin is the fact that the
is oversensitive and nauseated the dam.
patient easily by If there is
danger of moisture arising between the teeth, a piece of rubber-dam
just large enough to cover the two teeth and immediate vicinity may
be placed without inconvenience to the patient, and then the napkin
in combination with this will all for a short time.
keep perfectly dry
Where I use a napkin in the upper jaw, I simply fold a large nap-
kin once, so as to a doubled and this back behind
present edge, pass
the tooth to be filled, holding it with the mouth- mirror. This is less
annoying to the patient than any other method, and will keep a crown
cavity dry long enough to insert gold. I have filled the posterior
approximal surfaces of wisdom-teeth in this way, producing permanent
gold fillings. This, however, is the most difficult place for using a
napkin, owing to the fact that the muscles offer tremendous resistance.
Chloro-Percha and other Devices Moisture. Chloro-
for Controlling
percha may be made to serve a very useful purpose at times. A case
may arise where it is impossible to apply a clamp to a festoon cavity,
which is nevertheless so small that it could be filled if
quickly only
kept dry ; a napkin will not serve, for, though it might be made to
dam up the saliva, there is often a weeping of mucus from the mem-
brane overhanging the cavity, and this is sufficient to prevent the in-
sertion of a cohesive gold filling. If the gum be wiped as dry as possi-
ble, and then smeared with a thin coating of chloro-percha, the cavity
may be filled successfully by a skillful, rapid operator.
There is a device of which I have made frequent use, but which I
believe is now difficult to obtain. It consisted of a sort of clamp, which,
however, was not needed, and concaved disks of pipe-clay. It is
well known that a fresh clay pipe will stick to the lips. These disks,
made of the same material, could be placed over the orifice of the duct
of Steno, and would adhere, shutting off that supply of saliva for an
hour or two. In many cases they prove most useful.
Many use Japanese bibulous paper for damming up saliva. Its
is that like the disk it adheres to the
advantage over the napkin clay
mucous membrane, but it absorbs moisture more rapidly. For short
operations, however, it is frequently a good plan to make a stiff roll
of this paper and stuff it between the cheek and alveolar process, thus
covering the opening of the duct.
There are little rolls of cotton which are now sold for this same pur-
pose, and are useful.
Wedges vs. Separators. I have the boldness to assert that steel
separators have worked more harm than good to the profession. I
have no doubt that in the hands of the most skillful, and used with
discriminating judgment, they have saved much time for this limited
class ; but in the practice of the many the result has been too often the