Page 256 - My FlipBook

lect any detail because we are handling a child, for with
them decay is so much more rapid that any little neglect of
this kind will tell more quickly than it will in the teeth of
adults. The polish should be well made. If we can handle
a child to put in the filling we can at a subsequent sitting
obtain a good polish, and then the filling will be serviceable.
Now, in all of this, gentlemen, I have presupposed that
the children are brought to you sufficiently often that yoti
may follow up the treatment. Not only this', but I have pre-
supposed that the children have been brought to you early
enough so that you have been able to handle thes-e decays
before they are very large, and wJhere this is done we ought
to succeed in the treatmient of these little teeth. But the
difficulty that you will find im'miediately you go out to prac-
tice is that parents will bring their children- to you after de-
cay has progres'sed so far that toothaiche has already oc-
curred. Parents do not realize that decay is going so far;
they may notice that there are decayed spots in the teeth and
be anxiou'9 abouit them, but at the same time: are likely to put
off all effort at treatment until the child has a sleepless night
Wiith toothache, and then bring the child to you. The child
is already tortured with pain ; anything you may do will hurt
the eihild inordinately, and you have the worst po'ssible con-
dition to> begin with. In this case 3"ou are reduced to the
alternative of teimporizing or immediate extraction. The
first effort will be tO' relieve pain, and for the present noth-
ing else should be done. If pos'sible, get the child in a com-
fortable conditiom and then proceed with the treatment at a
subsequent sitting, after the cihild has slept and recovered
its composure. If the pulp is exposed', which will generally
be the ease when the. excavaition is made, you may destroy
it, remove it, and fill the roots, and in this way succeed,
providied rt:ihe child is not too old', provided the
time for the absorption of the roots has not come
around. That miust be looked intO' carefully, but if
the child is broug^ht at am age when the absorption of the
roots has begun there is practically no alternative but to
extract the toioth, or cut away the pulp by the use of cocaine
and fill the remaining portion of the canal, running the risk
of alveolar abscess. I would say it is generally best to ex-
tract the tooth as the only alternative. We are presented

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