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Little precedent was obtainable for the organisation of such a
centre as this. A scale of fees was suggested which was, of necessity,
experimental at first. This scale bore a relation to the fees in vogue
at the Oxley Street Centre, hospital and local charges, cost of
material and overhead expenses. Eventually, for artificial work, a
scale was evolved, which in maternity cases covered wages and
material; and in other cases, wages, material and overhead charges.
Some discontent is caused among the patients on comparing the fees.
The nursing or expectant mother pays a fee according to one scale;
but the patient who at the time of treatment is neither nursing nor expectant
has to pay a fee approximately 75 per cent, more, although she
may have a family which may be increased. For operative work, as
there is little expenditure for material, the scale suggested bore a
relation to the fees charged in hospitals and locally. While this scale
is adhered to as far as possible, it is pointed out that cases arise in
which one has to exercise one's discretion in estimating the fees to
be charged. Every effort has been made to make the centre entirely
self-supporting, and at the time of writing (July, 1922), as far as one
may gather, practically is so. During the year 17 cases were reported
as being unable to pay the full fee. Of this number 9 were treated
after assessment by Committee.
Table I. gives some indication of the condition of the teeth of
the pre-school child. While only a small number were examined,
the figures sufficiently indicate that a grave condition exists.
Parents lightly consider the value of the temporary dentition, and
difficulty is experienced to induce them to bring their children to
the centre. To cope with this problem dental inspection is essential,
and to carry this out it is necessary that the children be congregated.
Inspection by the dental officer has been tried in the Maternity and
Child Welfare Centres, but this interferes with their normal routine.
Dental inspection, accompanied by the necessary advice and information,
in centre and home, by the Health Visitor equipped with a
mouth mirror might accomplish much good.
Incorrect dietary has much to do with the prevailing dental
conditions. Children are not given a diet that either needs masticating
or is detergent; and the use of the tooth brush is not frequent.