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100
Annual Report of the London County Council, 1911.
These results are confirmed by investigations also carried out during the past year on dental
conditions of about 1,500 elementary school children in Kiel. The school doctor noted 12 per cent,
as apparently faultless in regard to the presence of caries. No such healthy dentition was seen in
any child stated to have suffered from rickets. There was only 1 per cent, among the bottle fed and as
many as 21.3 per cent, among the breast fed children who showed mouths free from obvious caries.
These conditions ran through the various other analyses recorded, e.g., of children with very bad teeth,
etc., confirming the observations in the London schools that the tendency to caries is probably
largely a matter of structure of teeth partly due to heredity and to very early infantile conditions.
During the spring of 1911 toothbrushes were distributed among the children of thirteen schools
in the East End. Three of these schools were gone over six months later and the dentist reported
that considerable improvement in the cleanliness of the teeth was noticeable. The schools he inspected
were —
Far ranee-street (B.) School.—300 brushes were distributed on 27th March, 1911, and when the
school was visited on 26th October, 1911, 233 of the boys were still in attendance, 67 had left. Of
these 233 boys 192, or 82.4 per cent., possessed brushes, all of which were in good condition, and most
of them showed signs of recent use. The teeth on the whole were much above the average in cleanliness
as compared with the teeth of the boys in adjacent districts, namely, Poplar, etc., where no
brushes had been provided.
jFar ranee-street (G.) School.—Brushes were distributed to 305 girls on 6th April, 1911, and when
the school was re-inspected on 2nd November, 1911, it was found that 263 of the girls were still in
attendance, and of this number 243, or 92.4 per cent., had their brushes. The teeth of the girls were
exceedingly clean and well kept.
IIalley-street (B.) School.—109 boys received brushes on 29th March, 1911, and 80, or 73.4 per
cent., were produced on 7th November, 1911. The teeth of the boys were on the whole clean ; it was
found that soot was very popular as a tooth powder. Three boys confessed to having lent their brushes
to other members of the family in spite of the warning of the teachers.
Cayley-street (B.) School.—253 brushes were distributed on 3rd April, 1911, and of the boys who
received them there were 218 still in attendance at the school on 9th November, 1911. Of this number
195, or 89.4 per cent., produced the brushes. At this school also the condition of the teeth as regards
cleanliness was on the whole good and much better than the average of adjacent districts.
Some beginnings of treatment have been made. The most notable is the school dental clinic
organised by Miss Margaret McMillan in Deptford. This was opened on 17th October, 1910, and
during 1911 has been subsidised by the Council on the same terms as the hospitals—that is a capitation
fee of 2s. and payment of the dentist's salary. The clinic serves for 63 schools in Deptford,
Greenwich, Lewisham and Peckham, covering a roll of about 45,000 children. The children sent,
however, are limited to the eight year old group. In the first three months of the year inspections of
neighbouring schools were made by Mr. Wallis, who found that the inspections of the school doctors
were insufficient as regards dentistry, only the worst cases being selected. Since then Mr. Benjamin
North, the dentist at the clinic, has given one afternoon a week to school visits. He has examined
3,173 children of the age of eight, 1,634 boys and 1,539 girls, in 37 schools on 33 half days, averaging96
per session. Of these 79.5 per cent, boys and 79.2 per cent, girls needed dental treatment. Four
fifths of the eight year old children require such treatment. The percentages are a little lower in the
poorest schools, possibly due, as Mr. North suggests, to the survival of the fittest, the infant death rate
among weaklings being very high in those districts, and possibly to the use of coarser food. The ill
effects of decayed and sensitive teeth are, however, more marked among the poorer children, and the
mouths are dirtier. Although the dentist examined eight year old children, the numbers at that age
were only about a third of those treated. The school doctors notify many cases at other ages as
requiring treatment, so that out of 2,318 treated 242 were below eight, 1,102 over eight, and 974 eight
years of age. When the school inspection shows any child to require attention its parents are notified,
and if they wish to take advantage of the public service, locally established in Deptford, an agreement
to that effect is signed, and a promise given to pay Is. This may be reduced by the Care Committee
to one penny if the parents are poor, or as workpeople contribute to hospital funds. When the
signed schedules have been returned to the school an attendance card fixing a time for attendance at
the clinic is issued. About ten or eleven attendances are arranged for each session, and about eight
attend, which just affords work as regards the eight year old children. With older children where
much has to be done to each mouth this number would be too great. The cases who attend for medical
treatment by the three doctors who work at the clinic, and cases to be operated on for adenoids or
tonsils, often also require treatment for carious teeth or septic mouths before operation is justifiable.
These cases are numerous and show the utility of dental and medical service being closely associated.
During 1911 they numbered 262 extractions only, 593 fillings only and 1,463 extractions and fillings.
The general work shows that 75 per cent, require some teeth extracting, and that only a quarter
of the cases can have their mouths made healthy by filling the teeth. The new arrangement from the
bdginning of 1912 whereby childrem from six to eight are taken will ultimately greatly reduce the
number of extractions required.