London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1912

[Report of the Medical Officer of Health for London County Council]

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Report of the County Medical Officer—Education.
this is the most suitable age for conservative treatment. It is intended that continuous observation
shall be maintained during school life over those children already inspected or treated at the centres,
and consequently the schools in the areas supplying each centre will be revisited and the children further
treated as may be required.
Dental treatment.—The general principle adopted is that each child's mouth shall be made
absolutely healthy and free from sepsis. This involves the stopping of all teeth, whether temporary
or permanent, that can be saved, and the extraction of such unhealthy teeth or roots as are beyond
the scope of ordinary conservative treatment. No countenance is given to the mere extraction or stopping
of an odd tooth here and there. If the mouth is not rendered healthy and free from sepsis the gain to
the health of the child may be little or nothing.
Anœsthetics.—Nitrous oxide or ethyl chloride are given in cases where a large number of extractions
or specially difficult teeth have to be removed. The general experience tends to show that an anaesthetic
day in each week is required at all the centres in order to avoid a cumulative list of "waiting
cases," many of whom are suffering from enlarged or perhaps tuberculous glands which cannot heal
so long as the mouths remain septic.
General remarks on the dental centres.—The plan of adapting existing homes or institutions for
dental treatment purposes has answered admirably, the essentials sought for being a well-lighted room
suitable for a surgery, with a recovery room immediately adjacent, and a third room, some distance off
and therefore out of hearing, to be used as a waiting-room. No centre can be worked satisfactorily
which is limited to two rooms alone. In addition, the surgery is always located in such a way as to
enable the children who have been treated to leave the centre without being seen by those awaiting
treatment. This is a point of great importance, as nothing demoralises a room full of waiting children
more than the crying face of a child who has perhaps had some teeth extracted.
Equipment of the centres.—The sum of £50 allowed by the Council for this purpose is sufficient so
long as strict economy is exercised, and at the present time the requirements have been so standardized
that little or 110 difficulty arises on the score of expense. All the centres are well and economically
equipped. The accompanying table gives under the necessary headings details of attendances and
nature of work carried out.

Return of Dental Treatment for Year Ended 31st December 1912.

Centre.No. of sessions a week.No. of children attended.No. of attendances.No. of teeth or roots extracted.No. of stoppings.No. of other operations, e.g., scalinc, immediate regulation. application of AgNO3, etc.No. of general anæsthetics.
Nitrous Oxide.Ethyl Chloride.Other general anaesthetics.
Fulham, from 4.6.1246959703,1563571,2084621379
Poplar Hospital41,2671,6583,5564732,64672420922255
St. George's Dispensary51,8642,2795,1959413,5273041348732
St. Marylebone Dispensary, from 10.9.1233356271,164189638494140-

The school doctors in addition to their work of examination of school children re-inspect all cases
referred for treatment at the inspection. By this means the doctor is able to ascertain whether
treatment has been obtained and the extent to which it has been successful or otherwise. If treatment
is still required steps are taken to follow up the case and to induce the parents to obtain the necessary
medical attention. In cases where the parents refuse to act and there is strong evidence that the
child's health is seriously affected as the result of neglect, the National Society for Prevention of
Cruelty to Children is informed of the circumstances in order that legal proceedings may be taken
under Section 12 of the Children Act.
As a rule the cases referred for treatment in one term are re-inspected during the following
term and those found to be still in need of treatment are submitted to a second re-inspection in the
term succeeding that in which they were first re-inspected.
During the year under review 41,015 children were thus re-inspected, and with regard to
23,344 of these children full particulars of the results of re-inspections are shown in the AppendixThese
23,344 children were all re-inspected in the third term of the year, and from that time onwards
the results of re-inspections are being kept in classified form. The tables in the Appendix
summarise the defects under five headings showing separately the ailments for which provision has
been made, under the Council's scheme for treatment, at the various hospitals and centres.
Refraction.—This group includes defects in vision, strabismus, nystagmus, etc.
Minor ailments.—These include minor complaints provided for by the Council's scheme, e.g.,
slight conjunctivitis, discharging ears, minor diseases of the skin, etc.
Ear, nose and throat.—The complaints comprise cases of enlarged tonsils, adenoids, and diseases
of the ear which are not suitable for treatment as minor ailments.
Teeth.—This class includes cases of defective teeth found by the school doctor, but not those
found by the dentist.