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. NILES:—I am very glad to hear Dr. Reilly speak as he does. It is
perfectly consistent with the accepted theory of decay. Decay does
not progress where moisture and oxygen are excluded; therefore a
cavity thoroughly dried out and hermetically sealed is good treatment
and sound in theory. Nature has formed a covering to the nerve, and
although nothing but the matrix of that covering may remain, I would
not tear it away if an attempt is to be made to save the nerve. I
would retain it with its odontoblastic connections with the pulp. I
believe it is the only reasonable theoretical and practical course
to follow. Let the nerve alone; nature has provided a covering, why
should it be torn away? If there is any irritation, it is very easily
removed. In my opinion, a pulp is never inflamed to an extent that
needs treatment when it is free from soreness by percussion. If there
is inflammation at all in the pulp there will be periosteal disturbance
to give warning; but if the periodental membrane is not inflamed, it
may be concluded that the pulp is free from irritation; provided, of
course, it has never been painful or previously inflamed.
DR. REILLY:—I would like to relate my experience with cases of this
kind which have been right under my eye and care for some two and
one-half years. When I first began to fill my babies' teeth, I made it
a point that they were not going to be frightened. The eldest is six
years old, and has been under treatment for nearly three years, and
during that time she has never experienced any pain in the chair, and
she will come to my office any time with confidence,—in fact she seems
to like it. Her teeth are very poor, and in the first ten cavities I
did not do any excavating whatever. I practically did not remove any
decayed dentine. I simply stuck in fillings wherever there was a cavity
and depended entirely on dryness, and I have had good results from it,
with no dead pulp up to the present time. After the first dressing of
cement I endeavor to remove carious dentine.
DR. TAFT:—Did you use a rubber dam?
DR. REILLY:—No, sir. The teeth were too short and it could not be done
without causing some pain. My principal object was to avoid pain.
DR. WERNER:—Did you put in any gutta-percha fillings?
DR. REILLY:—Yes, sir. I put in some at first; then cement, and I have
used copper amalgam in crown cavities.
DR. GILLETT:—It seems to me that the case which Dr. Reilly has related
is merely the ordinary temporizing with children's teeth, the object
being to save them pain, and the case would be somewhat different with
adult teeth in which there has been a large amount of decay, and when
we expect to do permanent work. I do not see how that decayed, diseased
matrix can be non-irritating, as Dr. Niles claims.
DR. NILES:—If it was irritating you would have inflammation.
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