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84 THE TREATMENT OF TEETH

in these cases depend to a great extent on the
production or the non-production of extension for
prevention. If it is admitted that non-extended
gold fillings frequently fail in a comparatively short
time in these places, and extension cannot be pro-
perly carried out, it is surely hardly wise to use
the material that demands the greatest skill, time,
energy, and mental and physical strain to insert.
If the filling is likely to fail owing to non-extension,
it had better be one that is more easily introduced.
If possible let it be one that is supposed, at any
rate, to have a preservative effect on the tooth,
unless the appearance of the tooth demands the use
of gold. An amalgam tilling, with or without a
cement lining, and with or without a gold top or
masticating surface, as the kind of amalgam used
and the circumstances of the case suggest, will
usually be a more practical and satisfactory opera-
tion—all things considered—than any attempt to
make an all-gold filling in these cases. Extension
for prevention as an " academic principle " is per-
fectly sound, but the writer all through these notes
has endeavoured to point out that " circumstances
alter cases."
Insertion of Gold.—To explain methods of packing
gold into teeth, a few typical cases will be men-
tioned. It does not come within the scope of this