Page 58 - My FlipBook

44 METHODS OF FILLING TEETH.

of teeth with insufficient space. The man does not live who
filling
can fill as perfectly in a narrow crevice as he could in an approximal
.surface fully exposed by the loss of a tooth. It follows logically that as
much space should be obtained as is possible without permanent
injury.
There are several reasons why a perfect filling cannot be made
where the space is very slight, but the chief one is that gold should be
built out so far beyond the true surface, and over all borders, that the
final finishing will cut down to a perfectly condensed part of the gold.
For this reason, where teeth are forced apart with steel separators, it
often happens that the fillings when finished show pitting, or at best
will not take a mirror-like polish, which should be made on all, but
more especially upon those in approximal surfaces.
There are two kinds of cavities which require considerable space.
These are very small, and very large cavities. To fill a tiny cavity
through a narrow crevice is to court failure, while it is simply impos-
sible to reach into all parts of large cavities, in long bicuspids, without
considerable room. In the latter, all that part which is most inac-
cessible is improperly filled, but being also out of sight is not seen
by the patient, and not looked at too closely by the dentist, who
thinks he cannot afford the time required for properly separating teeth.
If it is important to fill a tooth at all, it is important to fill it well,
and to fill it well the cavity must be accessible. This can only be ac-
complished by separating as widely as is consistent with safety. The
cases where teeth can be forced as far apart (with the patient's con-
sent) by using a separator, as by the old-fashioned system of wedging,
are so few, that to buy a separator seems to me to throw away money,
for I refuse to insert gold with insufficient room for thorough work.
Where the patient is easily hurt, if there is no hurry, the teeth may
be painlessly forced apart with tape. The patient should be supplied
with this and directed to change it, increasing the number of thick-
nesses from day to day until the space is adequate.
The rubber wedge is the most positive, and at the same time the
most painful, usually making the teeth so sore to the touch that they
must be allowed to rest for several This necessitates the re-
days.
moval of the wedge and the insertion of a piece of gutta-percha.
This is placed between the teeth cold, trimmed just thick enough to
slightly wedge when pressed in. With a warm burnisher the surplus
is then removed on each side, and the soreness will subside
very rap-
the teeth meanwhile The main to
idly, being kept apart. objection
rubber is the to slide or under the This
tendency up against gum.
be a bit of the to extend
may usually prevented by allowing wedge
beyond the cutting-edges of the teeth. Sometimes it is well to apply
the dam, smear the teeth with sandarac, and then the
lightly place