Page 78 - My FlipBook

METHODS OF FILLING TEETH.
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of having them cohere. I have frequently met prominent men who
I have asked these
have admitted using non-cohesive gold. invariably
men why they ever prefer it to cohesive gold, and the replies have
always been either evasive or unsatisfactory. The best answer ever
offered to me is that non-cohesive gold may be used where a cohesive
would be an in the buccal
gold filling impossibility, as for example,
surface of a molar in the lower jaw, where the cavity extends so far
below the gum-margin that the dam cannot be employed. It is
claimed that a good gold filling can be made in such a situation if
non-cohesive gold be used. I believe that this is possible, but I also
believe that it is possible only in the hands of a limited few who have
attained to extreme skill in the manipulation of the non-cohesive
I think that as a for the a of
golds. practice many large percentage
failures would be the result, while the same men could produce admir-
able and sufficiently permanent results with other material than gold.
A use which I was taught to make of non-cohesive gold is to place
it against the walls of cavities, finishing with cohesive foil ; the idea
being that non-cohesive gold can be better made to adapt itself to the
walls, and that thus a more nearly water-tight filling will be produced.
where so we
This I think must be condemned, especially by doing
would occupy, with non-cohesive gold, that part of the cavity upon
whose shape we depend for the retention of the whole mass of the
While there will be some cohesion between the
filling. underlying
layer and the superincumbent portion which is made with cohesive
I am certain that a can be made where cohesive
gold, stronger filling
gold is used throughout. I have removed so many fillings, taking
out first a solid piece, and then picking out the remainder in crumbs,
that I believe the has been relied
practice upon by many. My removal
of such has been because of discolored show-
fillings usually margins,
ing where caries had crept in and was undermining the fillings.
My opinion, then, of non-cohesive gold is that in practice we have
so little, if any, need for it, that the dentist may discard it almost in
ioto. In the colleges, however, its management should be taught, for
the student who learns to fill with non-cohesive foil will have acquired
of manual make him in
a. degree dexterity which will quickly expert
the use of cohesive gold. Too many have neglected to learn in this
way, and the cohesiveness of gold has enabled many inexpert men to
which look
practice dentistry, palming off upon patients fillings may
bright and smooth to the inexperienced eye, but -which in a few months
become rough, in which condition they are a menace to the safety of the
teeth.
Of the manipulation of cohesive gold much could be written. It
is my purpose here only to point out the more important facts, and if
possible to draw attention to a few points of faulty working, upon