Page 23 - My FlipBook

INTBODUCTION. 3

tion to treatment by filling shown by most recent writers. It is
intrinsically wrong to treat the subject of filling teeth simply
from the mechanical standpoint; it is wrong in that it tends to
produce in the minds of students the idea that filling teeth is a
purely mechanical pursuit. This is far from the proper concep-
tion of the facts. In fiUing teeth, the closest use of our knowl-
edge of the pathology of dental caries and of the local conditions
of its occurrence, and of its recurrence after fillings have been
made, should be put to full use in every case, in order that the
greatest benefit may be derived from filling operations. To state
this in the fullest detail has been a special object.
To this end, studies have been made of dental caries and the
various forms it assumes in its beginnings in the enamel, spread-
ing of colonies of microorganisms on the surface of the enamel,
carrying with them the spreading of beginnings of caries into
the surface of the enamel, and the manner of penetration of the
enamel. These have been carefully illustrated by photographs
and photomicrographs, beginning with the simplest forms, and,
by careful arrangement, proceeding to the more complex through
the different phases. There have been included, so far as seemed
possible by this method, illustrations of the directions of this
spreading and the local conditions which favor it and which
hinder or prevent it. The areas of the surfaces of the teeth rela-
tively most susceptible to the beginnings of caries, as differen-
tiated from the immune or relatively immune areas, have also
been illustrated. On account of the extreme importance in the
practical operations of filling teeth of this particular phase of
the subject, it has been illustrated, with two or three exceptions
only, by photographs and photomicrographs reproduced by the
half-tone method without any retouching or artificial modifica-
tion in any way. To these a few diagrammatic illustrations have
been added.
The fact has been kept prominent that immunity to dental
caries, which may be complete, or which will approach complete-
ness, even in persons, who, as children, were very susceptible to
caries, will become established in early adult life in the larger
proportion of cases in which effective protection has been given
by filling operations, by continuance of active mastication of
food, and reasonable care as to cleanliness. This matter, which
was neglected because of previous misinterpretation of observed
facts, is, with continued observation, assuming greater impor-
tance in dental practice. The systemic conditions producing the
changes in the saliva on which susceptibility and immunity are