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the Council is therefore making provision for the routine dental inspection of all entrants, whether aged
six or under. This early treatment will lead to the preservation of a large number of important teeth
hitherto lost at an early age, and be of great benefit to the children's future development and health.
Scholarship
children
All children who have obtained scholarships are now dentally inspected and treated when necessary
at the centres. It is, however, important to bear in mind that, inasmuch as these children are 14 or 15
years of age, and have in many cases hitherto escaped dental treatment, the time involved in carrying
out the work is necessarily much greater in each case than the average time spent upon younger children,
partly owing to the greater number of teeth and partly owing to the fact that a proportion of these cases
need root.treatment, a process which in any case is tedious, and frequently involves an unusual number
of visits.
' Secondaiy
schools.
These schools are now included in the ordinary rotas for school dental inspections, and the question
of the treatment of fee.paying students is under consideration.
Attendance
13] ofchildreD.
The attendance of children at the centres has on the whole been good, a welcome feature of postwar
conditions being the interest taken in the treatment by the fathers, who now very often accompany
their children to the centres.
Unqualified
dental
practice.
Dentists attached to London centres frequently complain of the harm that is being done to the
children's teeth and health at the hands of unregistered and, therefore, unqualified practitioners of
dentistry and so.called " dental companies." Not only is the work of these untrained practitioners of
denfistrv extremely bad, but their advice is so harmful as to deter both parents and children from seeking
legitimate skilled dental treatment in future, with disastrous consequences to their health. It is
important to emphasise this matter at a time when legislation is impending.
Juvenile
employees
Under the Education Act of 1918, Messrs. Pascall, a large confectionery firm, have approached
the Council with a view to obtaining routine dental inspection and treatment for their juvenile employees
of the ages of 14, 15 and 16. A scheme has been drawn up which will enable these employees to attend
between 4 and 6 p.m. on one afternoon in each week at the Tooting Dental Centre, where conservative
dentistry will be fully practised.
Many of these employees have already been receiving treatment at the Council dental centres, so
that here commences a most satisfactory advance, whereby children's routine dental treatment is to be
continued up to'the age of 1C.
By a slight re.arrangement of duties, one of the regular centre dentists will be in charge of these
cases, and he will have the assistance of the centre dental nurse.
Maternity
centres.
A number of the London dental centres have had special sessions set apart for the dental treatment
of infants and expectant and nursing mothers. At certain of these centres, moreover, provision is made
for the supply of dentures, which are paid for by regular contribution from the recipients. This plan
has led to the dental treatment and supply of dentures to a large number of mothers, with great benefit
to themselves and the children, and, though not directly in the hands of the Council, every encouragement
has been given bv allowing the use of the dental equinment and so forth.
Dental
treatment of
children in
special
schools.
Up to 1917, it was the practice for a dentist to visit each "special" school for the blind, deaf,
dumb and so forth, for the periodical dental inspection and treatment of the children. The children
attending these schools are now dealt with under the Council's general scheme of dental treatment, and
each school is visited about once a year by the inspecting dentist attached to the nearest centre. Appointments
are made in the usual way for the children to at tend the centres for treatment, but it has been
necessary to make special arrangements, particularly in the case of children attending schools for the
physicallv defective.
Anaesthesia
for dental
operations
upon
children.
The total number of administrations of nitrous.oxide during 1919 was 17,6*25, and the number
of children receiving ethyl.chloride, 13,202 ; it is our experience that ethyl.chloride when administered
by a skilled anaesthetist is a specially suitable and safe anaesthetic for use in these cases, and it may be
here remarked that though, taking the years 1916.1919, no less than 43,837 children have received
ethyl.chloride, no fatality has taken place except in one extremely doubtful case in which a child died
some 10 minutes after the conclusion of the anaesthesia and was subsequently found to be in an extreme
condition of status lvmphaticus undetectable during life, the death being in no way attributable to the
ethyl.chloride used.
Supply of
dentists.
Whereas during the war period the difficulty of obtaining suitable dental surgeons for the centres
was very great, this difficulty has now disappeared, and the number of suitable applicants for dental
posts at the centres has become adequate; in view, moreover, of future developments, it is important
to note that all the great dental schools are now well supplied with students.
Visit from
Board of
Education.
On behalf of the Board of Education an official visit to dental centres throughout the country
was made by Dr. Eichholz and Mr. Norman Bennett.
Mr. Norman Bennett's report is printed in full in the annual report of the Chief Medical Officer
of the Board of Education, pp. 95.106. The summary of his conclusions is as follows:—
(1) Rooms and equipment are generally satisfactory, but are capable of improvement.
Comparatively small additional expenditure would mean higher efficiency and saving of operators'
time.
(2) There is too great divergence in method and thoroughness of inspection. Charting at
the time of inspection should be aimed at as the method for the future.
(3) Treatment is tolerably effective as far as it goes. Failures show the futility of all
systems of treatment which are not thorough, and where reinspection is not practised.
(4) All children should be inspected and treated on entering school, at five years of age
or as soon after as possible. Inspection in nursery schools at three years of age should be
encouraged.