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133
such service outside the general dental services provided under the
Act and that this was to be followed by any necessary treatment.
Of a local authority dental officer's time, not less than 9% is to be
devoted to the care of mothers and pre-school children and, as
previously stated, this percentage is considerably short of the fulltime
equivalent of one dental officer. We are therefore faced with
the serious question whether to invite expansion of demand without
being able to cope with consequent treatment or whether to
concentrate what resources are available on the school population
to the detriment of the priority classes which are in equal, if not
greater, need of effective early preventive treatment than the
school child. Although the compromise decision giving the fullest
possible service to the younger school child has been stated elsewhere,
this in no way detracts from our acute consciousness of the
inadequacy of the service at both extremes of this age group. The
problem therefore simply hinges on how far the resources of the
service can and ought to be stretched without decrease in overall
effectiveness.
Statistical analysis of treatment during 1968 shows a marked
increase in total attendances and treatment output per session but
it would be unrealistic to view this as a substantial increase of the
impact the service has made on the community as a whole.
Although the statutory requirements quoted define the scope of
the service, there are other aspects of community dental care
which must not be ignored, namely, the mentally handicapped,
the non-ambulant old people and children in the authority's care
in training centres. Whilst the needs of the latter may be satisfied
within a future school dental service, their care meanwhile is
assured from a different source but the problems of the other two
groups remain. We have to face the fact that the introduction of
a geriatric dental service cannot be entertained until all other problems
are solved. Bearing in mind the unknown factors regarding
adults in training centres, I examined, in 1968, the trainees at the
Blackwall Lane and Park Vista training centres. The findings,
which were statistically analysed, revealed a fairly serious situation.
It would seem that treatment, in the first instance, should be via
the general dental services provided under the National Health
Act but, with the I.L.E.A.'s consent to the use of school dental
service facilities subject to certain conditions, a further avenue is
opened for cases untreatable in general dental practices. However,
dental health education and supervision are now established.
Without retrogression, the dental service for mothers and children
during 1968 was maintained despite the considerable gap
between what the community needs and what we have been able
to give it."