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30
Sale of tooth
brushes,
etc.
In addition to the routine work of dental inspection and treatment carried out in London,
arrangements have been made for supplying at cost price tooth brushes, tubes of tooth paste and small
tablets of permanganate of potassium for making an antiseptic mouth wash when required.
Selection of
age groups
for dental
inspection
and
treatment.
It is becoming generally recognised that the age group 6.8 is really too advanced and that the
earliest age possible should be selected if the temporary teeth are to be kept healthy and the
permanent teeth treated on the first sign of caries; first permanent molars erupted at 5 to 5½
may be already extensively carious by the time the child is dentally inspected at perhaps 6 to 7 years
of age.
Secondary
schools.
Reference is made on page 31 to the arrangements under section 18 of the Education Act, 1918, for
the inspection and treatment of scholarship holders in secondary and trade schools.
Physically
defective
children.
a scheme has been prepared for treating these children at the dental centres, ana careful regulations
have been drawn up to ensure that each child is thoroughly examined before any dental treatment
or administration of an anaesthetic takes place. It is intended that each child shall be conveyed to and
from the dental centres in one of the Council's ambulances accompanied by the school nurse.
The supply
of dentists.
Difficulty was experienced in 1918 in obtaining experienced dentists to replace those called up
for naval or military service. The success of a dental centre is of course largely dependent upon the
dentists engaged. Frequent changes of dentist are undesirable, and though for the successful working
of a centre the question of the annual renewal of the appointments is considered by the Council, it
is, as a general rule, the practice to reappoint the dentist if possible.
Dental
scholarships.
With a view to increasing the supply of dentists for school dental work a letter has been sent to
head teachers of secondary girls' schools pointing out the suitability of this work for women and its
advantages as a career for them. The use of scholarships for the purpose should ultimately lead to an
increase of available trained dentists.
Dental
anaesthetics
The use of ethyl chloride for dental anaesthesia continues to give great satisfaction, and though
nearly 14,000 administrations have taken place during the last few years, no cause for alarm of any
kind has occurred ; the gain in duration of anaesthesia is such that practically every case is finished at
one sitting, and this is not possible when nitrous oxide is used. The disadvantages of ethyl chloride in
skilled hands may be regarded as almost negligible ; there is merely a tendency to sickness which is
preventable by proper preparation beforehand ; moreover, recovery from the anaesthetic is somewhat
more protracted than is the case with nitrous oxide. Owing to the growing proportion of older children
now attending the centres the original fortnightly anaesthetic session has proved insufficient and additional
anaesthetic sessions will be needed in future.
Unregistered
and
unqualified
dental practitioners.
A special investigation was carried out by Mr. Walls at the Stockwell Practising School where
some of the parents were known to have been attracted by the advertisements of dental companies
trading in the South London District. Out of 87 girls at this school who received dental treatment,
as the result of recommendations by the school inspecting doctors. 48 per cent. were treated by qualified
and registered dentists, 12 per cent. were treated at hospitals, and 40 per cent. went to unqualified and
unregistered practitioners. All the above were inspected with a dental probe and mirror, and it was
found that while the 40 per cent, who had been treated by unregistered dentists had been mulcted in
fees often in considerable excess of those charged by the properly qualified dentists, the quality of the
stopping work done was shameful to a degree and many children declared that their stoppings fell out
soon afterwards. Oral sepsis, too, had been passed over as of no account, and where the extractions
required presented any considerable difficulty the teeth were either broken or left in situ with their
pulp chambers open and full of septic material, leading to the infection of glands of the neck and general
toxasmia. Another serious result of treatment of this kind is that children have been so frightened that
great difficulty arises in persuading them to have their teeth attended to again. The children referred
to were as a rule of 13 and 14 years of age, and therefore at that time, not admissible under the Council's
dental scheme. A certain proportion had, however, obtained treatment at the Stockwell Centre
and the condition of their teeth was in strong contrast with that of those treated by unregistered
Welfare
centres
(mothers and
infants).
An important development of the Council's Dental scheme has been its association with the
work of Infant and Mothers Welfare Centres in various parts of London. Although the Council is not in
any way responsible for the dental work performed on others than school children, the mutual association
brought about by the use of the school treatment centres by the welfare centres is of great advantage
to both parties.
A good example of this association is to be seen at the Lissonia Centre, where on one weekly
session, mothers and infants are seen and treated, the Council allowing the use of the dental equipment
for these cases. The serious state of oral sepsis of many of the expectant and nursing mothers calls for
extensive extraction operations upon septic and necrosed unsaveable teeth and roots. At this welfare
centre a small charge is made by the Committee for all work done, and where provision of dentures
is undertaken the necessary fee is arranged for by a system of instalments.
Medical and
dental
treatment—
General.
The total number of children attending treatment centres as new cases during the year was
143,539. The returns of numbers treated are less than were expected mainly owing to the air raid
menace in the early part of the year, and later to the influenza epidemics. It may be mentioned that
the numbers fell below the weekly averages of the year to the following extent in certain periods :—
January 26th (2 weeks) 409 ; February 9th (2 weeks) 275 ; April 20th (2 week's) 243 ; July 7th (2
weeks) 219; November 23rd (4 weeks) 891, the figures stated representing the average defect each
week. The maximum intensity of the influenza epidemic is clearly reflected in the low numbers for the
period ended November 23rd.