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66 METHODS OF FILLING TEETH.

has been and an examination of this
great, palatal portion after the
is nearly completed shows that it is not full enough.
filling Crystal
can be built on here more than
gold readily any other.
its makes
The second good quality, plasticity, crystal gold espe-
cially useful over nearly-approached pulps. It is frequently instructive
for a dentist to have his own teeth filled. He then discovers, much
to his surprise perhaps, that certain methods produce pain, which, as
the dentist, he may have thought to be painless, or where patients
have complained, he may have attributed the cause erroneously. I
'have been astonished to find that the mallet will cause excru-
myself
over a ; pain, too, of a character which
ciating pain particular spot
showed that the pulp itself was disturbed. It is my opinion that
where a pulp is nearly approached, that point of the dentine which is
thinnest, becoming more resilient, yields slightly under the force ofthe
mallet, thus producing pressure, which shocks the pulp. Therefore,
when a patient complains of a distinct pain from the mallet at a specified
point, and at that point only, or more than elsewhere, I now attribute
the disturbance to the above- described cause, and continue the filling
with crystal gold, using hand-pressure until, having built a sufficient
thickness of metal over the thin portion of dentine, I find that the
no to the mallet-stroke. For similar
pulp longer responds painfully
reasons small cavities may best be filled with crystal gold, using hand-
whenever the tooth is sore from
pressure, wedging. Still, except in
the smallest cavities, I should prefer to make the extreme outer sur-
face of heavy foil, as will be described.
Another most important usefulness of crystal gold is that its plas-
allows the to work with less of fracture
ticity operator danger along
weak walls or in deep undercuts. A more resistant form of gold,
as a in such an undercut, may crack or even break the
acting wedge
enamel. I have seen a whole corner forced off with a corkscrew plug-
which was used to drive a
ger, being pellet ahead of it. I think it
could have been well filled and preserved by the use of crystal gold.
This accident occurred at a clinic, and caused the operator much
but from an educational it furnished a better
chagrin, standpoint
than if it had not
object-lesson happened.
The third quality, that of not balling up, brings me to a description
of the right and of the wrong way to use crystal gold. While it is true
that it will not ball up if properly used, it is also true that it will so
act in unskillful hands. The great danger with this material is the
temptation to use too large pieces. The inexperienced may think
that, being plastic, it may be crowded into a large cavity and then
condensed afterward. I have seen this method advocated at a college
clinic by one of the instructors. It is a mistake. In the majority of
such cases, when the mass is condensed, it will be found that it can be