Page 279 - My FlipBook

of softened material should be removed, and if the pulp be ex-
posed in so doing-, deal intelHgently with the conditions
found. This is the only safe line of treatment in any cavi-
ties whatsoever.
Pit cavities in the occlusal surfaces of the bicuspids ard
much less frequent than in the molars, and when there has
been reasonable watchfulness they may be filled when small.
They are therefore easy of management. They begin to
occur at from fourteen to sixteen. These, however, should
be filled early, for if neglected the burrowing of decay is
pretty certain to undermine the marginal ridge and a por-
tion of the enamel of the proximate surface. By this ex-
tension the simple pit cavity is converted into the more com-
plicate occluso-proximate cavity, which greatly increases the
difficulty of treatment. For this reason you should be es-
pecially watchful of the pits in bicuspids in the children of
very susceptible families and fill them upon the first appear-
ance of softening. This watchfulness is especially neces-
sary in these teeth for the reason that the pits are so gen-
erally small and the beginnings of decay very much hidden
until considerable burrowing has occurred. Careful exam-
ination of the proximate surfaces of these teeth for decay
should always be made before filling these pits to see whether
or not they may need treatment. The proximate surfaces
decay much more frequently than the pits, and in the treat-
ment of these the pit fillings previously made must always
be removed in cutting occlusal anchorages.
When examining for pit and Assure cavities in children of
families highly susceptible to caries, the least showing of the
beginning of caries should not be allowed to pass without im-
mediate treatment. These decays are too often allowed to
burrow deeply before treatment is instituted. Sometimes they
will even reach the pulp of the tooth before making any no-
ticeable showing upon the surface. The carious material is
white, the surface of the enamel is complete, except the pit or
fissure. It may show through the enamel as a grayish area, or
the decay cannot possibly be detected except by the
fine-
pointed explorer. All such occurring in susceptible children
demand immediate attention.
This condition must be differentiated sharply from the
conditions so often found in older persons, in which these pits

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