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general health of the children of London as the result of the school dental treatment now being systematically
carried out.
For the year 1918-1919 eight additional centres have been sanctioned, making a total of 44 centres,
which will provide facilities for the dental treatment of 90,000 children annually.
Reinspections of Ailing Children.
The measure of success of the Council's schemes for following up and securing treatment for
the children found at inspection to be ailing is given by the results of reinspection. As the primary
inspection is a point and the remedial action is a process, it is obviously impossible to present the actual
position at any given moment in the form of a balance-sheet of profit and loss with a surplus or remainder
to be carried on from year to year. What can be done is to give the proportion of ailing children whose
treatment has actually been commenced at given dates after the first discovery of their defects.
During 1917, 177,742 reports were made upon the re-examinations of ailing children, compared
with 181,035 in the previous year. 21,511 of these reports related to children kept under observation,
but not referred for treatment, 94,660 to children seen six months after their primary inspection,
and 61,571 to children referred for treatment and found not to be relieved at their reinspection in
the previous year and now again reinspected.
It was found that treatment had been commenced or the conditions otherwise satisfactorily
dealt with in the case of 45.3 per cent. of the children reinspected for the first time during the year,
and in 49.1 of those who had not been satisfactorily dealt with at the time of their first reinspection in
1916 or 1917, so that on the results of the year 67.6 per cent. of the children requiring treatment were
eventually receiving it, or otherwise being satisfactorily dealt with. The corresponding figure for 1914
was 75 per cent. The results at first and second reinspections in 1915, 1916 and 1917 may be seen from
the following statement.
Percentage of ailments noted amongst children reported to have been brought under treatment
or discharged as not requiring treatment. Cases noted as requiring observation at first reinspection
are counted as discharged at second reinspection if in the opinion of the examining doctor no treatment
is advisable:—
First Reinspection. Second Reinspection.
1915 51.9 53.7
1916 51.6 52.4
1917 45.3 49.1
This falling off is to be ascribed to war conditions operating through three factors (a) the full
occupation of the parents, including the absence of mothers from home on munition and other work;
(b) the withdrawal of many voluntary workers from the work of following up in favour of voluntary
work connected with soldiers and sailors and munition workers; and (c) the shutting down of facilities
for treatment at voluntary hospitals in consequence of the number of wounded soldiers being dealt
with and in consequence of staffing difficulties.
How serious the last factor has become is shown by the fact that whereas in 1914 22.6 per cent.
of the children obtaining treatment for visual defect went to voluntary hospitals, the proportion doing
so in 1917 was only 6.2 per cent. The opportunities for treatment outside the Council's scheme have,
therefore, owing to war conditions dwindled almost to negligible proportions and a consequent greater
strain has been imposed upon the Council's arrangements.
Somewhat similar difficulties have been experienced in regard to operations for throat diseases,
and the percentage of children found at first reinspection not to have been dealt with for these conditions
has increased from 44.8 in 1916 to 53.0 in 1917.
The Council has done what was possible to cope with these difficulties by endeavouring to fit in
extra sessions for treatment at the centres. It is obviously difficult to start new centres tinder war
conditions, when shortage of materials and labour is so acute, and it is possible that, in localities near
hospitals, the need may be transient, for upon the restoration of peace the facilities at voluntary hospitals
now denied may again become available.
The highest percentage of failure to obtain treatment occurs in cases of dental defect. It is
admitted that there is not, nor has there ever been, sufficient provision either of a voluntary or of a
public nature to deal with the mass of dental defects in children. The scheme of dental amelioration
favoured by the Board of Education deals in the first instance exclusively with younger children. The
cases now under consideration are not those amongst younger children who are subject to the special
inspection of the Council's dental staff, but those of older children for whom inadequate facilities are
provided seen by the school doctors as part of the routine age group examinations. The war, of course,
has seriously hampered the rate of extension of the Council's provision of dental centres, although steady
progress at a reduced rate has been made.
If the dental figures are subtracted from the total results of following up the position is a more
favourable one than has been reported above. It is possible to claim that when dental cases are
excluded some 74 per cent. of the children referred for treatment were eventually being brought under
treatment or discharged as satisfactory during 1916-17.
Special Examinations of Children at Minor Ailments Centres.
The school doctors have attended at ten of the minor ailment centres for a short time after
school hours on certain fixed days for the purpose of inspecting children reported by care committee