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140
Annual Report of the London County Council, 1910
oven offered them pennies to have the teeth treated. The children were sent to the hospitals in twos
and threes so as not to excite any hostility on the part of the authorities. At the end of 12 months,
out of 71 boys marked as urgently in want of treatment, 17 had gone to an institution and not a
boy had been sufficiently treated. No teeth had been stopped and only a few extractions carried out.
A similar result held for the girls and infants. This shows that even in a school surrounded by hospitals
and dispensaries, with dentists attached, it is practically impossible to obtain dental treatment without
special arrangements.
The Age for
Commencing
Treatment.
It would scarcely be possible to treat all the children in the schools at once; the best way is to
begin with one age group and then follow up. When it was proposed last summer to conduct medical
inspection of an extra age group of children, between their eighth and ninth birthdays, this age was
suggested as suitable also for dental work. It is not the ideal age, but was suggested as a compromise
between medical and dental inspection. The results of medical inspection show that only one-eighth
of the mouths are noted compared with the results obtained by a dentist, so that this inspection
may be put on one side so far as dentistry is concerned. The utility of any first dental
examination in the school is very doubtful, because as nine out of ten children in most
schools will require treatment, they would probably be examined more effectively, cheaply, and with
less disturbance to work, at the centre in the dentist's chair. This would have to be done
in any case, so that examination for the first time in the school is superfluous. Examinations
carried out at the "Michael Faraday" School, at the "Blackfriars," at schools in Deptford, and at the
Stockwell College Practising School show that the group 8-9 is too late for the best preventative work.
By that time a large number of the first permanent six-year-old molars are decayed beyond the reach
of the treatment which could be afforded by any school clinic. Probably soon after the seventh birthday
is the best time for most children to be seen by the dentist. The septic or necrosed remains of
temporary teeth are then easily removed and incipient cavities or vulnerable points in the six-yearold
molars can be treated without undue expenditure of time. The ideal plan seems to be to march
all children in relays to the school dentistry about the time of their transfer from the infants' to the
upper school.

The leaving class "L.C." in the above table refers to a class of backward delicate girls, who,
being within a year of leaving school, have a special curriculum to make the most of their abilities.
Though many are merely backward from previous ill-health some are of inferior mental calibre, and,
although it does not appear numerically, the oral sepsis present and frequent hypoplastic enamel noticed
pointed to conditions of ill-health in early life. Superior protrusion or projecting upper teeth, of the
type associated with Continental caricatures of English women, was present in 13 of the 250. This
is more than double the frequency of the ordinary elementary schools, and is scarcely likely to be
due to error from small numbers. It was not explicable by nasal obstruction, and Mr. Wallis states
that he had noticed a bad habit of keeping the upper teeth closed on the indrawn lower lip, which
might account for it. The upper incisors, which in the manufacturing districts are so often affected
in young girls, were only carious in seven cases, and none of these were less than 12 years of age.
A similar observation has been noted in other London schools. Dental propaganda conducted here by
lantern lectures to the teachers and students and to the parents caused numbers to become interested.
Qualified and
Unqualified
Dental
Treatment.
Lists of qualified dentists in the district were drawn up to aid the parents, and a tactful notice,
signed by the head mistress, caused many to seek treatment. Within six months 87 of the 237 cases found
to need attention had obtained treatment. Qualified private dentists treated 48 per cent., the dental
hospitals 12 per cent., and in spite of warnings unqualified practitioners treated 40 per cent.
Careful notes were made when these cases were again inspected, and it was found that the
treatment generally given had been unsatisfactory in the case of the unqualified practitioners.
The fees charged were often excessive and frequently stoppings had been done and fallen
out in a day or two. One girl paid £2 for five stoppings which had all fallen out within
a week. Little or no attention had been paid to small cavities although it is on the treatment of
these that permanent preservation of the teeth depends. Extractions which presented difficulty
were either avoided or else the teeth were broken off and the roots left in the iaws. Several of the