Page 277 - My FlipBook

the roots of the indivickial teeth as perfectly known as their
variations wiU allow.
Lingual pits of the lateral incisors, rarely in the centrals
«ilso, are the only other pit decays that are found at so early an
age. These are not nearly so frequent as those in the first
molars, and, as the rule, occur somewhat later. Occasion-
ally these are found soon after these teeth are in position,
however, and while the gums still overlap the enamel so
much that it is very difficult to get the rubber dam in proper
position without inflicting considerable pain. Nothing can be
done without the dam in place, and this is often the most se-
rious difficulty met within in these cases. The best plan is to
say to the child, "This will hurt for a few minutes ;" force the
ligature down to position, being careful to be successful at the
first effort, and hold it until the pain has abated. When the
cavities have not made great progress the actual excavation
'and filling present no great difficulty. Usually these are not
so sensitive as the pit cavities in the first molars : they are
less in area and the excavation and filling is more quickly
done. Whenever the endurance of the child will possibly per-
mit, these cavities should be excavated and filled permanently
with gold at one sitting. The difficulty in placing the rubber
dam seems to demand this. When patients are older and these
teeth have protruded through the gums sufficiently to render
the placing of the dam reasonably easy, they give but little
difficulty. This cavity is, however, likely to approach the pulp
closely where not apparently very deep, and especial care
must be exercised, a matter that has been emphasized. (Tech.,
p. 69.)
Pit cavities in the second molars begin to occur at from
fourteen to sixteen, and often make rapid progress in highly
susceptible persons. If the student will remember that
these cavities usually appear in very susceptible famihes in
from one to three years after the eruption of the teeth, and
keep in mind the order and time of their eruption, the whole
matter will be materially simplified and the reasons for the
order of their appearance will be readily grasped. They are
the simplest of all cavities to treat, and rarely present any con-
siderable difficulty. It should be remembered, however, that
in occlusal surfaces the whole surface of the fillings is fully ex-
posed to thermal changes by hot and cold drinks and foods,

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