Page 303 - My FlipBook

as age advances, and if these cavities are not extended well
to the gingival, the gingival margin will become uncovered
and exposed later, and come to occupy the central area of lia-
bility to decay. Under such conditions recurrence of decay
along this margin is certain if the susceptibility continues.
When these cavities occur as late as eighteen, or later,
they are not difficult nor uncertain to treat successfully, ex-
cept in the technical sense, and this is confined mostly to the
difficulties in placing" the rubber dam. Good results are very
certain and satisfactory when good judgment is used, and
the technical procedures well carried out. The same may
be said of those occurring in middle life. Those beginning
in the cementum in old age are often very annoying and
present much difficulty. The softening often includes a wide
area that is so situated as to be unusually difficult to keep dry.
Safe cavity walls are difficult to obtain, and pulp exposure
in the canals of the roots, particularly of the molars, is very
liable -to complicate the cases. Foirtunately these cases are
not frequent, but when they occur they require a special study
of the local conditions and the very careful application of
procedures to meet them.
Buccal and labial cavities are, in the aggregate, much

less frequent than cavities of the other classes. In practice
the author has found them very annoying, from the .fact that
they have so often occurred after the case seemed fully under
control. This has been specially true in women. Young girls
quite susceptible to caries have grown up to maturity, other
classes of decay having been kept well under control. They
have married, and, perhaps, in their first or second preg-
nancy, a half dozen buccal cavities suddenly appear and ur-
gently require treatment at a time that is anything but op-
portune, and are therefore especially liable to be neglected.
The circumstances make them very ugly.
Prophylactic measures against this class of cavities can
be rendered more effective than in any other. The surfaces
are so exposed to the brush that they can be perfectly cleaned
most easily. If patients, at the first signs of the coming of
this class of decay, can be induced to use a brush effectively
four times a day, after meals and before retiring at night,
regularly, for a few years, they will escape with only the
cavities already begun. To be effective, however, the brush-
ing must be done regularly.
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