Filing Teeth Preparatory to Plugging. [Volume: 2, Issue: 6, January, 1861, pp. 320-322]

820

THE DENTAL, COSMOS.

FILING TEETH PREPARATORY TO PLUGGING.
BY D. VAN DENBUBG.
PERMIT me to offer some suggestions in regard to "filing teeth preparatory to plugging," which the author of "Practical Hints" has hastily
discussed in the December number of the DENTAL COSMOS.
The practice of filing V-shaped spaces between teeth, with the points
of divergence at the gum, I regard as more objectionable than spaces with
parallel walls, since the V-shaped spaces receive food more readily, and it
becomes wedged more firmly in them, and is dislodged with greater difficulty. This, I know, is often denied; but a trial of both will convince
the patient, if not the dentist, of its truth. These V-shaped spaces, also,
perhaps more than any other, (for spaces with parallel walls are more frequently found with a shoulder near the gum,) are likely to permit filed
surfaces to come in contact, and that too at the most dangerous point.
The first objects in filing a tooth are, to give access to the cavity, and
to make a smooth and even surface. But the principal aim should always
be, that the filed surface may not come in contact with another tooth, or
so nearly approach another surface as to endanger it. It is sometimes
difficult between molar teeth, when the cavities are small, to make easy
access to them, without cutting away more of the teeth than is desirable,
if we use the file alone for this purpose. I think a very excellent practice
in such cases is to pass a thin separating file between the teeth, making
just space enough to dress off the fillings and cutting away but little of
the enamel. Then drill the cavity out through the grinding end of the
tooth, and introduce the filling through the cavity itself, bringing up and
finishing one face of it on the grinding surface. This practice avoids impairing the side of the tooth, leaves it in its original shape, and therefore
offers no extra inducement to decay. When two teeth in contact are decayed, it will sometimes be necessary only to open but one cavity through
the end of the tooth, cleaning and filling the other through this opening.
It is sometimes admissible to cut molar teeth with parallel sides, provided a shoulder can be left near the gum. That will prevent the future
contact of the filed sides. But this shoulder should always come out from
the tooth, with a rounded projection, making the outline of the space resemble the letter U. If the V-shaped space opening at the ends of the
teeth is always objectionable, and it surely is, a space of similar shape
opening either upon the palatine or buccal sides of the teeth is almost
equally so. A proportionably large surface of the tooth is flattened, with
nothing to prevent its coming in contact, at some point where it has been
filed, with the adjoining tooth, with a space, if any remains, well calculated to retain whatever lodges in it. The V-shaped opening at the ends
of the teeth, though it may soon bring two filed surfaces in contact near