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mate surfaces usually escape decay, the local conditions as to
form and cleanliness being especially favorable. Often the
proximate surfaces of the front teeth will decay very early,
and those of the back teeth not until later, or not at all. In
other cases, the front teeth escape and the proximate sur-
faces of the bicuspids and molars decay very early. In either
case the decays are very apt to occur in pairs, similarly lo-
cated one upon either side of the mouth.
It not infrequently happens that the mesial surface of the
first molars begin to decay while still in contact with the
second deciduous molar, and this will be the first proximate
cavity. In children of good self-control and endurance these
should be prepared and filled with gold when discovered.

In the reverse conditions in which the teeth are excessively
sensitive and the child very dithcult of control, it is better
to use gutta-percha or zinc phosphate temporarily, await
the shedding of the deciduous molar, and seize the oppor-
tunity when the whole proximate surface is exposed to view
to make the permanent filling. The operator must not be
tempted by these favorable conditions into making this a
simple cavity without due extension for prevention or with-
out cutting the full retention seat in the occlusal surface.
He must form the proximate surface and contact point to
meet with the second bicuspid which will be quickly in po-
sition. A principal point in the treatment will be to determine
what will be the area of liability when the bicuspid is in posi-
tion and include it in the area of the filling. Failure in
either of these directions will be fatal to the future of the
filling.
All that I have said as to the management of the child,
conditions of sensitiveness of dentine, of thermal sensitive-
ness, of pulp exposure, and of the time of extracting when
that is necessary, while speaking of occlusal cavities in these
teeth applies here.
This is the only proximate cavity, in the molars that he-
gins at a very tender age. The second molar is not erupted
until twelve and rarely has a cavity before fourteen or fif-
teen in the most susceptible families. And it is only at this
age that distal cavities in first molars begin to occur. At
this age, however, we may expect cavities in the distal sur-
taces of the first molars and mesial surfaces of the second,

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