50 ON THE REMOVAL OF THE 



in the following remarks, is the systematic removal 

 of the four perm^anent first molars in over-crowded 

 arches^ especially when attacked by caries. 



Before entering upon a consideration of the 

 reasons, which in my opinion justify this practice, 

 I wish it to be distinctly understood, that I am far 

 from advocating any officious interference with 

 nature. So long as the teeth in question, though 

 affected by caries, appear capable of being saved, or 

 the arch, though limited in extent, seems likely to 

 expand sufficiently to accommodate the full number 

 of teeth, so long I advocate non-interference I add 

 the latter condition in conformity with a fact 

 noticed by Mr. Saunders in one of his works — 

 namely, that in the arches of many children the 

 eye-teeth are often cut very prominent, but do not 

 in all cases continue so, since, as the jaw developes 

 itself, they frequently fall into their normal position. 



The practice, as I have said, which it is my 

 object to advocate in the present communication, is 

 the systematic removal of the four permanent first 

 molars whenever the arch has a decided tendency to be 

 over-crowded, and especially when the teeth in question 

 are affected by caries. 



A strong argument for the removal of these 

 particular teeth in the case of over-crowded 

 arches, may be derived from the observations of 

 Mr. Fox, and, since his time, of many other writers, 

 that of all the teeth of the second set, the first 

 molaxs are in most cases the least durable. 



