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The out-patients' room of every hospital has large numbers of patients suffering from anæmia
and chronic stomach troubles, and a certain number of patients in adult life who become victims of
pulmonary tuberculosis probably reach this through debility, the result of chronic gastric disorder,
resulting from want of teeth, and continual absorption of putrefying matter.
Large numbers of young adults seen as candidates for our London teaching appointments have
lost their useful grinding teeth, so that there is an extensive destruction of teeth going on quite early
in life, affecting the individual's prospects; seriously damaging their wage-earning capacity, and even
reducing some to a condition of semi-invalidism.
The remedies for this are to be applied in early life, during the period of eruption of the permanent
teeth, that is, for practical purposes during the whole of school life. These remedies are preventative,
i.e., educational, which it is the duty of the educational authority not to neglect, but which duty is at
present practically untouched, and curative by observation and treatment of the beginnings of disease
in the teeth.
Abroad, dental hygiene has a place in the school management. New York has recently started
regular dental examinations of the children, and in Brussels a dental service has been in force since
1875. In Germany at Darmstadt, Wiesbaden, Mulhausen, and Strassburg, regular inspection of the
teeth takes place, and Professor Jensen of Strassburg has described in a series of annual reports, the
school work done there. At Ulm this year a dentist has been appointed whole time, and in Prague six
school dentists have been set to work. The children are inspected and the dental condition recorded
on a card; in cases requiring it the parents are notified to bring their children to the school dental institution
where regular treatment is carried out. The District Inspector in discussing the report pointed
out that there was a saving in attendance, as the time taken up in examination and treatment at the
institution was less than that previously lost through absences for toothache.
It is improbable that the English public are yet sufficiently educated to appreciate a dental
inspection of school children, and to follow it up by treatment; without this it would be in great measure
a waste of time.
The measures then to be immediately undertaken are prophylactic and educational, and fall well
within the scope of an educational authority. The very great importance of the subject requires
impressing on parents and teachers, both in school and evening classes.
The teeth of the child are affected by health in infancy, and even by the mother's health before
birth. Their evolution is delayed by rickets, which it will be shown later affects a great proportion
of our London school children. Food nowadays is too fine, too much milled and machined, and some
coarse fibrous material is always required as an element in children's food. If there are to be school
meals, tough fibrous vegetable material should occasionally form part of the meals.
The subject of "teeth" would form an admirable object lesson. The softening of the teeth by
vinegar and by acid foods such as pickles, the use of chalk to neutralise these things, and to polish the
teeth, and finally the necessity for the tooth brush, are subjects to be impressed on the scholars.
The majority of parents either could not or would not purchase tooth brushes. Each child
at school should have its own tooth brush numbered and hung on a rack, and might be made to use
it twice daily with great advantage.
These suggestions are not put forward except from the consideration that it is extremely important
that this matter should be followed up in a practical way. It would be a great advantage if
the Council now added a dental surgeon to the medical staff, to make observations and supply suggestions
for this branch of hygiene which is so extensive and important, and which requires an amount
of expert knowledge which only a qualified dental practitioner can possess.
PHYSICALLY DEFECTIVE IN ORDINARY SCHOOLS.
The physically defective still in the elementary schools, omitting squint, harelip, cleft palate,
and a few very minor defects, the effects of various troubles seen in the ordinary schools, have been
considered by Dr. Rowntree. He took 14 schools representing an attendance of i4.098 children, and
found 105 cases with noteworthy defects and who had not been transferred to cripple schools.
Paralysis of various types 30
Tuberculous diseases 16
Congenital malformations 16
Rickets 31
Accidents and fractures 6
Spinal curvatures (marked) 3
Acute bone inflammations 3
105
Paralysis.—7 (4 girls, 3 boys) were cases of cerebral paralysis, 3 having both limbs on one
side affected and 4 having the arm only, in 3 cases the right arm affected. In two cases the teachers
were using great efforts to teach the children to write with deformed and atrophied right hands and
neglected the education of the service of the serviceable left hands.
21 (9 girls, 12 boys) were cases of old infantile palsy. In most of these cases apparatus had been
provided (irons), but in several cases these appliances were so heavy and uncomfortable that they had
been discarded. 2 cases in boys were pseudo hypertrophic paralysis.