Page 189 - My FlipBook

EIGHTEENTH LECTURE.

M Faults in the Structure of Teeth.
February 25, 190 1.
\\Faults in structure of teeth and their influence as giving"
opportunity for dental caries have been spoken of so fre-
quently in my lectures that it hardly seems necessary that
we go over that subject at all closely. But I want to say
to you that you should not regard them as causes of decay.
We often speak of them as causes of decay. Here is a
fissure in the occlusal surface of a molar that is deep and
sharp, and in that we find decay begins, and we often speak
of the fissure as being the cause of the decay. It is only a
cause of decay in the sense of giving opportunity for the
beginning of' decay. There * are very many deep fissures
in the teeth of persons immune to decay, and although
the opportunity would seem to be as good as in any teeth,
yet decay does not occur; indeed, the teeth of those im-
mune to decay are as apt to have fissures and faults as
the teeth of those in whom decay is rapid. The band that
we drive onto a tooth carelessly and fail to cement prop-
erly is not a cause of decay, but brings about a condition
that gives opportunity for decay. If the conditions were
not present, if the micro-organisms were not growing in
the mouth, we would have no decay on account of having
driven on that band carelessly so that micro-organisms might
grow between it and the tooth. Therefore, we must not
regard these faults as causes of decay, but conditions giv-
ing opportunity for decay. In that sense they are very
important and we should take a lesson from them as to
the management of our operations; as to the necessity
for smooth finishes ; as to the necessity for removing all
overlaps from about fillings, for these rough points, these
overlaps under which micro-organisms may grow, give the
opportunity for decay. Our object should be to remove
all possible opportunities for decay. The management that
will do this most successfully will be the management that
will be of the greatest benefit to our patients. The inter-
globular spaces which occur as faults in dentin have been
sufficiently explained. When they exist they give oppor-
tunity for micro-organisms to burrow in various directions
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