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The percentages shown in the above table are (1) children with sound teeth, (2) children with slight
dental caries, (3) children with severe dental caries.
The one almost consistent manifestation observed in the table is the steady improvement, with
exception for 1918, in the number of children at twelve years of age who have teeth free from caries
and the diminution in the proportion of children at that age who exhibit severe dental decay. It is
significant that the greatest advance in this respect has occurred during the past two years. Although
the worst cases of dental caries are not now met with so frequently as formerly among the older
children, owing to the fact that special pressure is put upon bad cases to attend the treatment centres,
the immense problem that remains to be solved requires our courage to be braced up to the highest pitch.
Forty-six dental centres have been provided and are working at full pressure, and although the numbers
of children at the older ages with serious dental caries have been halved since provision for treatment
began to be made, yet forty per cent. of the children leaving school still have obvious dental caries.
Now dental decay is held by all to be a preventable disease, and it is clear that in order to cope
with this great mass of trouble, all the aid that can be given by education and the practice of hygiene
must be pressed into the service. Not by treatment of the worst cases but by prevention at the
outset will success finally be achieved.
The interesting suggestion was made by Dr. Wheatley, the county medical officer of Shropshire,
that the compulsory change in diet during the war might have caused an alteration in the condition
of the teeth of children entering school in that county. It appears that from 1910 to 1914, 95 per cent.
of the Shropshire entrants were returned as presenting dental decay and that in 1919-20 only 56 per
cent. were found to have carious teeth. If this great alteration were due, as Dr. Wheatley suggests, to
a cause which was universally operative in the country, it would be expected that the medical officers
of other authorities would find the same result; but the London figures certainly lend no support to
the theory. It is suggestive that while the pre-war figures in Shropshire bore no resemblance at all to
the London figures, those of 1919 approached most nearly, and could be considered comparable, to
the London figures.
In this connection attention might be drawn to the London report for 1916, where the figures
setting out the condition of the teeth of the entrant infants bear no relationship to the figures of any
year before or since. The condition of the teeth of the entrant children in this year appears in the table
to be extraordinarily bad, and the result would be inexplicable to anyone who was not aware of the fact
that throughout this year alone, in all the series of years set out, was the practice of inspecting ailing
children only, and not all children, carried out. A revolutionary transformation in a statistical figure
like this suggests an alteration of method, rather than a change in the facts themselves, and one
cannot be too careful in applying to the whole of a population, figures which are derived from a specially
selected group. Such an error was committed by those who argued that, because in hospital patients
suffering from other complaints ten per cent. were found to give the Wassermann reaction for syphilis,
therefore, 10 per cent. of the whole population was tainted with this disease.
11,447 children in the age-groups were referred for treatment for "adenoids and tonsils" either
separate or combined. This number was 5.5 per cent. of all those examined and is an improvement on
the corresponding figures of the two previous years, as 6.1 per cent. were referred for treatment in 1919,
and 6.2 per cent. in 1920. It is thought that there were fewer catarrhal conditions during 1920, affecting
the children and that this accounts for the improvement. The numbers of boys and girls suffering
from these conditions are practically identical, with the exception that older girls seem to be more prone
to enlarged tonsils alone than boys, but entrant infants suffer more from both these conditions than
older children and there is a steady diminution of the incidence throughout school life.
Adenoids
and tonsils
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