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their children every six months for any necessary following-up,
and many do so. The difficulty of the problem is keenly felt, since
there is little doubt that if a satisfactory solution is possible, much
of the work, now necessary in the school clinics, would be prevented.
During the year an endeavour has been made to obtain the
attendance of unmarried girls, since for these work may be carried
out that will prevent the usually wide extractions found necessary
when treating maternity cases. It was found, however, that the
higher scale of fees applicable to these patients, acted as a deterrent
to their attendance, and it was recommended that the lower scale
of fees which applies to maternity cases, apply to these. As a result
of the Council's acquiescence, the attendance has been greater, and
it has enabled more to be done for the individual.
In many cases of pyorrhœa dealt with, cultures have been made
from the apices of teeth, and these usually show infection by the
streptococcus longus group. While many patients do not actually
complain of ill-health, many show signs of general debility, and
many present arthritic symptoms. Cases are healed by scaling,
appropriate gum treatment, and excision of pockets, others by
extraction. As a result some patients report considerable benefit,
others a persistence of general symptoms. Many cases where
conservative methods were applied report recurrence of the oral
condition, due in part, no doubt, to lack of personal care. But where
once the alveolus becomes infected it is difficult to cure the oral
condition, clear up the general symptoms, and save the teeth. It is
hoped that vaccine treatment may be available for these cases
shortly.
During the year 14 maternity and 4 tuberculosis cases, being
unable to pay the full fee were assessed, the total reduction in the
fees being £37 11s. 6d.
Although local economic conditions react adversely, it is gratifying
to be able to report that the Centre has made steady progress
during its 20 months' existence, no doubt due in great part to the
advertisement of past patients. The evening session, held weekly
for those unable to attend during the day, has proved a success,