Page 274 - My FlipBook

somewhat aroused by the carious process, hyperemia of the
pulp might readily be precipitated by completing the opera-
tion at one sitting. The better way is to make a temporary
filling of red base-plate gutta-percha. The walls of the cavity
shoul(;i be well dried with absorbent cotton (no hot air
drying should be used), and saturated with Eucalyptol to
secure the cohesion of the gutta-percha, and a perfectly tight
filling. The case may then be dismissed for twenty or thirty
days. By this time the sensitiveness will be diminished,
and the danger of hyperemia of the pulp materially reduced,
iand the permanent filling may be inserted. I would cautiCJfi
operators, however, about allowing gutta-percha fillings in
these teeth to go for a longer time. Generally children
who have not been forced into caution by the presence of
highly sensitive cavities are vigorous chewers of food, and
will wear out gutta-percha fillings rapidly. Whenever there
vare reasons for longer delay the gutta-percha filling should
be inspected and, if necessary, renewed.
Often in these cases, if cavities are not deep, there will
be a rapid improvement in the condition of sensitiveness, if
the overhanging enamel is well removed, so as to give full,
free admission of the fluids of the mouth to the cavity. These
will dissolve out much of the acid and other irritating sub-
stances from the decaying mass, diminish their concentra-
tion and reduce the irritation to the dentinal fibrils, par-
tially removing the cause which has aroused the hyper-
sensitiveness. In many cases, those in which decay has
not approached near the pulp, the saturation of the softened
mass with a solution of silver nitrate is very effective. In
this case the cavity may be left open for a month or more.
In this case I regard the risk of some blackening of the
dentin by the silver nitrate as justifiable if by this means
it becomes possible to make a good filling. This remedy
should never be used in deep cavities, because of its liability
to produce intense pain.
In cases in which hyperemia of the pulp has occurred,
and there have been paroxysms of pain at frequent intervals,
a thorough excavation of the cavity should be made. This
may, if the sensitiveness of the tooth and the condition of the
child require, be divided into several sittings, using an anti-
septic and filling with gutta-percha for protection during

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