Page 264 - My FlipBook

though the surface eroded is so very sensitive ; at least, I have
never seen but one case in which thermal sensitiveness had
been aroused to any considerable degree, and that is the case
of the first cast that I presented to you. In that case the lower
central incisors became hyperemic, became extremely sensitive
to thermal changes ; the teeth were so sensitive that I could
hardly approach the young woman, hardly look at her, without
bringing a tremor, and I finally had to give her an anesthetic
and take the pulps out of those two teeth. But in the others,
although the erosion had entered what had been the pulp cham-
ber, they were sufficiently protected, and when the pulps were
removed from the two lower teeth it was found that the others
were not sensitive to thermal changes. Generally we will not
fear the exposure of a pulp by erosion. There is no other con-
dition that I know of that so certainly secures the pulp against
exposure in the wasting away of tooth substance as erosion.
What shall we do for erosion? That is the question.
Well, as a general rule, I should say, let it alone heroically.
We know of no means of stopping it or preventing its progress,
except the one of cutting out the surfaces and making fillings.
I have tried this thoroughly, and I want to say this in regard
to it—the filling that you place will protect only its area of
surface, nothing more. The erosion, if it is spreading, will
continue to spread and cut alongside your filling just the
same as if the filling had not been placed, and the only way to
stop an erosion by a filling, if it has begun upon the labial
surface of the tooth, is to remove the whole of the labial sur-
face and replace it with gold. Now, I should say, don't do
this unless the mutilation by the erosion makes the teeth look
worse than the filling would do. Where that is the case it is
all right to cut away and make the filling. In this worst case
that I have presented to you from my own practice, the whole
of the labial surfaces were cut away to the gingivae and filling,
made, which, so long as I had the opportunity to observe the
case, was successful, but it was a horrid mouthful of gold.
If it had been in the time of crowns (it was before we made
crowns by the modern methods), I should have put crowns
upon the teeth instead ; it would have been very much better,
and very often that is the better plan in the treatment of ero-
sion in cases where it is destroying the teeth. Filling, how-
ever, will prevent the increase of depth and prevent cutting the
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