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24 THE TIGHTENING OF LOOSE TEETH

In the case of natural teeth that are to be substi-
tuted, drilhng should be done and fixation secured by
split pins, as in the lower jaw.
If artificial tube teeth are to be applied, they should
be previously cemented and fastened in the mouth,
together with the retaining appliance.
In cases of projecting teeth and retroversion of the
jaw, it is sometimes difficult to introduce both ap-
pliance and tube teeth at the same time.
In this case the teeth should be fastened to the
pins, but after the retaining appliance has been
inserted.
The tube teeth should be ground on the palatal
surface, in order that they may be enabled to pass
the processus alveolaris.
For rendering the drilling of upper teeth less
painful, apply cocaine, painting it on the nasal
mucous membrane.

Fixation of Loose Bicuspids and Molars.

In cases where the anterior or posterior bicuspids
are loose, and there are gaps in the teeth, strong pure
gold collars should be put round the teeth, and the
interdental spaces connected by strong soldering and
strengthening wire. Case, Evans, Bryan, and Thiersch
have devised useful appliances of this kind.
If there be caries on the grinding surfaces of molars
and bicuspids, inlays should be made and soldered
together.