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EXPOSED PULPS. 277

will be no discharge; such cases should be treated in
the manner just described. In operating on teeth

already dead, more delicate manipulation is requisite
to prevent irritation, than on those in which the pulp
is destroyed by the operator. In very many cases of
dead teeth, where there is not a state of actual dis-
ease, there is a strong predisposition to it; and in
these cases, the preparation of a cavity, or the intro-
ducing and condensing of a filling, may produce in-
flammation of the periosteum. When such a condition

is recognized, several sittings may be required to
complete the operation. But it is not always easy to
recognize such a predisposition; yet, whenever it is
suspected, it is well to press the investigation, which
may be. guided by the following rules: ascertain
whether the tooth experiences a different sensation or
any pain, under percussion in any direction; whether
periostitis has ever existed in that or in a contiguous
tooth; whether the parts adjacent to the tooth are in
a healthy state; whether there is a general inflamma-

tory diathesis, or an enfeebled condition. These are
the prominent points in an examination of this kind.
Where this predisposition exists, it may be coun-
teracted by general or local treatment, according as
it depends on general or local causes; but in even-
case, this treatment should be very careful, and it
will, in some instances, have to be protracted. Iu