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Most of these 477 extractions of permanent teeth were hopelessly damaged molars of older
children. Many were quite difficult operations where an anaesthetic was necessary and local anaesthetics
were used, as general anaesthesia was forbidden. Arrangements have now been made for
the use of nitrous oxide gas. The extractions are generally done on a Saturday morning. About
4,000 stoppings, nearly all amalgam with cement, were applied, and 87 per cent, to permanent teeth.
This shows the good work of the clinic, as it means about 4,000 teeth made serviceable which otherwise
would soon have been sensitive and lost.
The parents who in most cases accompany the children are always instructed as to the probable
results, and the educational effect of these talks is very useful, as a considerable number return. The
sale of good brushes for 2d. in the schools has been most effective in maintaining healthy conditions in
the mouths after treatment. Of the 2,318 children treated the condition of the mouth when first seen was
noted as : clean 89, fairly clean 873, dirty 1,196, and very dirty 160. The dirty generally had a sensitive
tooth preventing one side of the mouth being used for mastication, whilst the very dirty ones had
septic roots or stumps requiring urgent removal. The dental surgeon at Deptford has tabulated the
cases of decay in the teeth at different ages in both permanent and temporary teeth.

Mr. North thinks it will be necessary ultimately to examine the mouths of all children before
six years of age, and then annually, to save an enormous amount of pain and sensitive teeth and the
retardation which this causes in growth and development.