Page 211 - My FlipBook

operate with accuracy. We speak of these as child move-
ments because they are so common in children. They seem
hardly to be voluntary movements ; involuntary movements,
as it were, but continuous. Other conditions, general nerv-
ousness, sensitiveness that cannot be well overcome, all of
these things contribute to the difificulties of making fillings,
and make it necessary, upon occasion, that we make fillings
that are not the best ; the conditions will not allow of the best
operations. I would hardly regard these as permanent fill-
ings, and yet they do a service in protecting for the present,
with the hope that conditions will be so improved that better

operations may be made later. These are more properly fill-
ings made for temporary purposes, but valuable. A filling
that will protect and prevent depth of cavities, even if it does
not prevent the broadening of cavities, is valuable in protect-
ing the deeper portions of the tooth and the pulp of the
tooth, and later may be made broader and made to protect
the area of liability and rendered permanent in a second
operation. I should say a permanent filling should last a
lifetime, practically. A filling that is made broad enough to
protect the area of liability, is properly seated, properly con-
densed, should stand. I say they should stand because they
have in the past. None of us will be able to operate with that
perfection that will make every filling really a permanent
filling, but a very large percentage of fillings should be per-
manent in this extended sense of lasting a lifetime, or until
the natural processes of wear have practically removed them,
and usually when that is the case a refilling is not needed.
I have seen a good many cases where proximate fillings
had been made and the wear of the teeth had been excessive,
in which practically the whole filling had been removed by
the process of wear.
The conditions under which fillings are least likely to
be permanent, even when well placed, are important for us
to consider. More fillings will, fail when made for children
than when made for adults, even when just as well made, and
we all know the conditions are such that they are not likely
to be as well made. And in my observation of dentists in
their practice, and in my observation of their operations as
they have come to me, it seems certain that they do not as a
rule operate as well for children as they do for adults. It

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