60 ON THE REMOVAL OE THE 



family, had at an early period of life the first 

 molars removed, also an upper anterior bicuspid. 

 As to the propriety of removing this last tooth, I 

 gave no opinion, having no history of the case ; all 

 I can see is, that she has not a bad tooth in her 

 head at the age of eighteen. The other children, 

 with the exception of the youngest, have had at- 

 tempts made to save the first molars — some of them 

 have been refilled by myself since the children came 

 under my care. Other teeth have also been attacked 

 with caries ; in my opinion, owing in a great mea- 

 sure to the want of proper care and cleanliness, which 

 they have not received, owing to diseased and tender 

 teeth being present in the mouth. The youngest 

 boy has had the first molars removed by me; I 

 may say they were very much diseased, and that I 

 expect the result will be as fortunate as in his 

 sister's case, where the first molars were removed. 



There is no form of arch which derives more 

 benefit from this operation than the rabbit or 

 Y-shaped arch. This arch can seldom retain the 

 full number of second teeth without irregularity 

 taking place, but by the removal of the permanent 

 first molars before the bicuspides are fully developed, 

 or have articulated the upper with the under, these 

 latter teeth will in a measure recede, and the eye- 

 teeth will take up their normal position in a more 

 rounded form and curve than if the anterior bicus- 

 pides had been removed. In this form of arch, in 

 addition to the removal of the first molars, it is 



