Page 253 - My FlipBook

widely as possible, and then use silver nitrate, not in this
case entirely for the purpose of stopping the decay, but for
the purpose of relieving- the sensitiveness. For this pur-
pose I should use it in almost precisely the same manner
that we would for the stopping of the carious process and
depend on it in some measure for this purpos^e. But after
the action of the silver nitrate for a week or ten days,
having- applied it two or three times, we will generally find
that the sensitiveness has been relieved, and then we may
cut out the decay and make a filling. The difficulty with
these decays in the occlusal surfaces is that unless we can
open them very wide they will fill up with food and it will fer-
ment and the decay will againi progresis, notwith-
standing the treatment with silver nitrate. Therefore, this
treatment would be mainly for the purpose of obtunddng
the sensitiveness in order that we may excavate and make
a filling. In this we are running the risk of considerable
disicoloration of the dentine that will, show through the en-
amel. We will not always succeed well with this process';
so'mietimes the sensitiveness will remain and hinder us from
making a sufficient excavation, but the case will be the
better for the use of the silver nitrate in the limiting of the
decay that will occur, even if we do not entirely succeed.
We may repeat this again and again, if the cavity is not
so large as to encroaicli too near the pulp of the tooth.
Remember, of course, the warning I gave you the other
day about using silver nitrate close to the pulp. When
these have been excavated they may be filled readily with
amalgam, or with gold, where we can do that. Where I
had a case that I could handle sufficiently well to fill with
gold I would not want to use silver nitrate and have the tooth
blackened about the margins of my filling, perhaps, but
would excavate and fill the cavity just the same as I would
for an adult. There is no difference w^hatever in the opera-
tion except that we have the child to deal with. Taking
it all in all, amalgam seems to be the best material for filling
this class of cavities.
Proximate surfaces of the deciduous ]nolar teeth are difficult
in the extreme to handle. These little molars are larger
than the bicuspids which come in their place ; when the
incisor teeth come through they are in many cases consid-

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