Page 247 - My FlipBook

its struggles and its cries. Just there is the difficulty, and it
is practically the only difficulty, so far as making fillings is
concerned. We may do it in these little teeth just as well as
in the adult teeth; there is nothing in the condition of the
tissues of the teeth that will hinder making these fillings,
and if the extensions are made sufficient to protect the area
of liability tO' decay, fillings will stand just as well. Now, I
haven't seen so many fillings made for these little people as
for grown-up folks, by any means, but I have seen enough
of them made of gold to be sure of what I say.
The general rule is that we cannot make metallic fillings
for these little folk we will have to resort to other methods.
;
In many of these cases we cannot reasonably make the proper
excavation. These teeth are as painful as the teeth of older
people, and our sympathy for the child will prevent us from
doing that which seems necessary to be done. Mothers will
object to the proceedings. We must temporize in our treat-
ment of these cases. How cam we temporize to advantage?
becomes the question
In this consideration there are certain peculiarities that
are important for us to consider. We may say that by the
end of the third year {m speakmg now of the incisors and
cuspids particularly), the growth of the jaws and the develop-
ment of the permanent teeth above their roots has begun to
carry these little teeth slightly apart; at least, the effect of
the growth will prevent these teeth from dropping together
if the contacts are cut away. And as the child grows older
the tendency is for these little teeth to stand apart. Now
this we can take advantage of in the treatment, a thing that
we cannot do with the permanent teeth. We can cut them
apart freely, make spaces between them, and these spaces
will be self-cleaning and remain permanent ; that is, after
about three vears old. One of the best methods of treatment
of little decays that have started in the proximate stirfaces
is to file them out, or partially file them out. Take a chisel or
excavator and chip away the undermined enamel make the
;
cavity as broad as possible in that way; then take a jeweler's
file and file them flat from labial to lingual, not the full depth
of the cavity, if it is of considerable depth, but leave the de-
cayed material where it is ; do not attempt to remove it ; it is
this that is particularly painful to the child. I like to cut
235