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28 PATHOLOGY OF THE HARD TISSUES OF THE TEETH.

the crowns will have to be made rather flat and the cusps short
in order to prevent raising the bite excessively, especially if
this must be done after the teeth have come into full occlusion.
These caps should be regarded as a temporary expedient.
When the child is older the time will come when the teeth may
be permanently filled with gold and the repair made permanent.
In the bad cases, requiring considerable gold building, this
should not be attempted before the person is eighteen or twenty
years old. The pulp is so near the occlusal surface that it will
be much endangered if this building of gold with sufficient
anchorage be undertaken earlier. In the meantime a careful
guard must be kept to see that decay does not begin on the axial
surfaces along the gingival margins of these caps and cause
trouble. Caps put on in this way at from seven to ten years of
age, even if they reach fully under the free margin of the gum at
the time they are placed, will be some distance from the free
margin of the gum after a few years. If decay occurs, a new cap
may be made to cover it.
It is the duty of every dentist having families in his charge
to see to it carefully that these atrophied molars are taken care
of in this way, or some similar way, very early. After the patient
has grown older and the teeth have come further through the
gum, other devices may be used if thought necessary.
Some cases may be successfully treated by grinding away
a considerable part of the injured enamel and thus gain a smooth
surface that will be kept clean by the excursions of food in masti-
cation. This may often be employed advantageously after con-
siderable decay has occurred. For little children it should be
done little by little, having them come to the office frequently for
this purpose. Particularly this should be the case if any sensi-
tiveness has developed.
Incisors and cuspids. The treatment of incisors and cuspids
should be along different lines. In a very large proportion of
these cases, no treatment whatever is necessary, for these teeth
are not much inclined to decay because of atrophy. Yet, some-
times decay does occur, and if the atrophy is confined pretty
closely to the incisal edge, it may usually be treated by grinding
away. Often the atrophied portion may be ground away so that
the tooth will look fairly well. It will be a little bit short, but
the inclination will be to protrude further through the gums
and increase its length in that way. If necessary, other teeth
in the neighborhood may be ground also, shortening them a little,
and in this way the esthetic in appearance may be satisfied.