Page 250 - My FlipBook

TWENTY-FOURTH LECTURE.

Treatment of Caries of Children's Teeth—Continued.

The latter part of my last lecture was devoted to pre-
senting the plan of treatment of caries of children's teeth
by silver nitrate. Before passing that I want to speak of
some of the oibjections to this miethod of treatment. The
first objection is that it makes the teeth very black and
this adds to the disfigurement caused by the necessary cu^-
ting. For this reason it is a very objectionable practice
from the esthetic standpoint, and yet, with all of its objec-
tions it is often the best we can do. Parents will object
to the discoloration) of the teeth in many cases; yet^
if the child is' very sensitive, we can scarcely do better
than to use this niietihod. The teeth can be made to look
very much better by other methiodis of treatment, how-
ever, methods that will be more painful to the child.
IVe may excavate the cavities and fill zvith cement. Where
we can succeed in making the necessary excavation, this
should be preferred, but to fill with cement at all successfully
we must excavate the cavities quite thoroughly. In filling
these little teeth with cement I should not insist upon ex-
tensions of the cavity—extensions for prevention—but
should simply remove the decay, cutting away the over-
hanging margins of enamel somewhat and making the fill-
ing without any considerable efifort at extension of the cav-
ity. Unfortunately, the cements are not very reliable and
in miany cases they will wash out from these little teeth
very quickly ; in some other cases, again, they seem to stand
quite well. I have in a good many instances seen cement
fillings, put in early, stand until the teeth were shed. But
whenever cement fillings are used the child should be seen
frequently and the fillings renewed if they waste away.
Extensions of decay beside the filling will also require treat-
ment. W^e need to watch these little teeth much closer
2^8