The Archives of Dentistry, Vol. VII, No. 12, December 1890Various
Science
The Archives of Dentistry, Vol. VII, No. 12, December 1890
Various
Dentistry -- Periodicals
DR. REILLY:—I would like to state a little experience that might cover
Dr. Clapp's case partly. Some time ago a young lad came to my chair
whose father had great difficulty in getting to go to a dentist's
office. There were two enormous labial cavities in the central
incisors. I did not attempt to excavate at all. I had been cautioned
before that it would be hazardous to try it, as he was a fearful little
fellow to get along with, and his teeth were very sensitive. I simply
wiped out the cavities as well as I could, getting them dry without
causing pain, and filled them with gutta-percha. He came again a few
weeks ago, and the dentine was all there, much harder, as I remember
it, than it was on the first visit. I removed it the last time and
filled them without any trouble. Now, I do not think it is any risk
to leave decalcified dentine in the bottom of a cavity, providing it
is tightly sealed; but, as Dr. Eddy says, I should depend more on the
drying process than on the use of antiseptics.
DR. WERNER:—Dr. Reilly brought up a very important point. Much less
excavation than is generally done is necessary for the absolute
control of decay, and that all excavation that gives pain is, in
one sense, unscientific. It is only necessary, from a mechanical
standpoint, to retain metallic fillings, but I think some day we will
have a plastic filling that will require very little excavation—simply
the wiping out of the cavity and the thorough removal of the actual
decayed portion, leaving all that has sensation—treating the cavity
antiseptically, and when in an aseptic condition, fill it with this
plastic filling. The surgery of to-day is very much modified. Muscles
and bone are not cut away as they were forty, or even twenty years
ago. To-day ivory is inserted and made useful in the place of bone,
and why should not tooth substance that has sensation be preserved? We
have to cut it away simply because we have to shape the cavities to
retain the metallic fillings; that is, we treat mechanically instead of
therapeutically. In the near future I hope we shall know better than to
cut away that which should be saved. I have a very hard little patient
whose parents wish me to save his teeth but not to give him pain, and
the little fellow will not stand any excavation. His teeth are being
preserved at the only disadvantage of having to have a great many
temporary fillings.
DR. SMITH:—I do not quite understand the logic of Dr. Reilly's
conclusions. I may misunderstand him. He tells of a case coming to him
where he did not see fit to excavate; he placed in that cavity some
gutta-percha; the gutta-percha after being in a while was removed and
the cavity excavated. Now, how did he know the depth of decay at the
first sitting? and not knowing the depth of the cavity, how did he know
that decay had not gone on in that cavity?
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