Page 219 - My FlipBook

PREPARATORY TO FILLING 203

dentine may be completely dried up and hardened
varies considerably in different cases. Sometimes an
application of twenty-four hours is sufficient, some-
times a much longer time is needed. If the desired
result is not obtained, the application should be re-
peated, and so on, until a hard floor is produced.
The thickness of the floor must be considered, for
it is no use attempting this method when the soft
floor is so thin that the pulp is practically exposed,
and a pulp that has once been irritated may fail to
completely recover, no matter how thick the floor may
be. A pulp that is well covered with soft dentine,
and has only become sensitive to heat and cold or
has only ached for a few minutes owing to pressure
of food in mastication, will often give no further
trouble, but a pulp that has ached badly is always
a doubtful case if its preservation is attempted.
The following case may be mentioned as an illus-
tration of the value of treating soft dentine.
In the year 1894 the writer discovered two large
cavities in the mesial approximal surfaces of the
two upper centrals in the mouth of a schoolgirl,
aged about fifteen years. Each of these cavities
contained a mass of thoroughly softened dentine,
the complete removal of which would probably
have exposed the pulps. The cavities were suf-
ficiently excavated to admit of temporary fillings