Page 275 - My FlipBook

the intervals. The excavations must finally be made com-
plete, however, in every case, removing every particle of
softened dentin before any attempt at permanent filling is
made. It should be determined definitely whether or not
icaries has actually reached the pulp. If it has not, the case
may safely be regarded as simple hyperemia, and even though
there may have been very severe paroxysms of pain, the
chances are favorable for recovery by simply keeping the
cavity well filled with gutta-percha for several weeks or
months. It is difficult to prevent children hurting these
teeth by temperature changes. Parents should be instructed
to withhold hot and cold foods and drinks, and if the weather
is cold to keep them well housed, or especially guarded
against breathing cold air through the mouth when out of
doors.
Accidental exposure of the pulp zvhile excavating^ if donq
according to rules given,* while adding another serious com-
plication, does not greatly add to the danger. After the ap-
plication of 1-2-3, o^ o^^ o^ cloves, the exposure should be
capped with oxyphosphate of zinc. To make a successful
capping it is required that all decayed material be removed
from the cavity. Then take a bit of ordinary writing paper
and cut a piece that will cover the exposure and overlap well
in every direction, or in this class of cavities it should cover
the whole pulpal wall, and fit fairly well. Having tried thig
in place and found it right, flood the cavity with oil of cloves,
1-2-3, o^ other equally non-irritating antiseptic. Then prepare
some oxyphosphate of zinc, mixing rather thin and spatulat-
^ng well, watch it carefully, continuing the spatulation, until
stiffening is just beginning, so that a globule may be held on
ithe bit of prepared paper. At this moment dry out the cavity
•and at once introduce the paper with the globule of cement
directed toward the exposure, and very gently tap it into
position, so as to spread the cement over the whole of the
pulpal wall of the cavity, and cover the exposure without
unnecessary pressure. Leave this without disturbance of
any kind for fifteen or twenty minutes, or until assured that
the cement is well stiffened. Then place a good gutta-percha
filling over it and allow this to remain for one or two weeks
or months before making a permanent filling.
Technical Procedures in Filling Teeth, page 137-
263