Page 291 - My FlipBook

and cavities are liable to occur in the proximate surfaces
of the bicuspids almost as rapidly as they take their places.
When this occurs the teeth melt away with great rapidity
and the most heroic and painstaking operating in respect to
minute details and the full inclusion of areas of liability will
be required to protect them until the coming of immunity
relieves them of danger. All tinkering with temporary fill-
ings should be avoided to the utmost, and yet cases will oc-
cur in which temporary fillings must be resorted to, to
bridge over periods of extreme sensitiveness. But the time
of their use should be confined to the shortest possible limit.
At this age the failure of effective use of the teeth in chew-
ing food quickly brings with it sensitiveness and thickening
of the peridental membranes, and it is of the utmost im-
portance to get the patient to using the teeth vigorously
again in order that fillings may be made without inflicting
unbearable pain, and also on account of the necessity for the
greatest possible cleanliness. Often temporary fillings
made with this special end in view, together with the arousing
of the proper effort on the part of the patient, will accom-
plish the desired end quickly, or within a month or two, and
then the case can be regarded as under control, and the
necessary fillings leisurely and effectively made. Many
dentists push their young patients too strongly. That is,
they make their sittings too frequent and too long. When
the patient is suffering pain, extreme sensitiveness, or failing
in mastication, it is better to make the sittings short and fre-
quent until comfort is restored and conditions obtained
which permit of effective mastication. Then put the patient
to vigorous work with the teeth, if possible, upon extra
tough or hard foods, giving them vigorous exercise three
times per day. When this has been continued for a few
weeks the sensitiveness will be so diminished that effective
operating can be done without great pain. Sufficient time
should be given between sittings—a week or more—to allow
the hyperesthesia aroused by the one operation to pass away
before the next. In this way the operations can be contin-
ued to a finish with a continuous improvement of conditions.
Definite plans of management with these ends in view are of
the utmost importance in these extreme cases of hyperes-
thesia with notable impairment of mastication.
27Q