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(5) The maximum interval before reinspection should be one year.
(6) The same charts should be used to record inspection and treatment, as soon as charting
at the time of inspection becomes general.
(7) Explanations to children and parents, leading to reduction of refusals, can best be
given by dentists, teachers and nurses; individual efforts of members of care committees may
often be valuable, but the system is not a success.
(8) Whole.time dentists are on the whole preferable to part.time dentists, but both have
their advantages and both should be utilised so long as a shortage exists in the profession.
(9) The treatment of simple types of irregularity might well be included in the work of
school clinics ; complex cases involving jaw formation would be outside its scope, but responsibility
for the treatment of such cases should not be entirely shirked by education authorities,
who might make arrangements with special hospitals in the larger cities and towns.
(10) General or local anaesthetics should be employed as a routine measure in the extraction
of permanent teeth; local applications are usually sufficient for temporary teeth unless several
are to be removed.
(11) Methods and efficiency of treatment should be made more uniform throughout the
country, and school dentists should be subject to periodical inspection and supervision by
dental experts.
(12) The value of dental dressers remains problematical. If they should come to be
employed extensively, they should be given a special course of training at a dental hospital.
(13) More thorough instruction to parents and children might be given by school dentists,
but excellent results would accrue from a more extensive system of propaganda work centrally
organised.
(14) Every opportunity should be taken of linking up school dental treatment with dental
treatment before and after.
As regards these conclusions, the following report was submitted to the Central Care Sub.
Committee :—
(1) Accommodation and equipment.—Mr. Bennett has no criticisms of the London Dental Centres
in this regard; on the whole the accommodation and equipment are good. The only centre (Hammersmith)
at which the premises are unsatisfactory, was put up as a temporary structure. The committee
at this centre have taken new premises which appear very suitable for the purpose.
(2) Methods of inspection.—Mr Bennett refers to the question of charting at each inspection session.
Complete and extensive charting is not required, and is not necessary, but extension of the present
plans so as to include such details as will avoid unnecessary and fruitless visits to dental centres should
be adopted and a general scheme by which an indication of the kind of treatment required will be furnished
is now being worked out The main point is that anaesthetic cases should be recorded as such at the
school dental inspection and not left to pay a fruitless visit to a centre merely to receive an anaesthetic
appointment card. There is, however, a great difficulty in this regard if it be known beforehand by the
parent what treatment is recommended by the inspecting dentist, whether involving extractions or
stoppings, as under the more favourable circumstances of examining the teeth in the dental chair at a
centre teeth previously thought saveable may be found to be unsaveable; moreover, if an inspecting
dentist advises one course and a treating dentist another, unnecessary friction and apparent conflict of
opinion may arise, and indeed has, on occasion, arisen. Again, a few weeks' delay between a dental
inspection and attendance at a centre may lead to a dental pulp becoming exposed, and septic, and
consequently beyond the scope of conservative treatment Under the system I propose it should be
possible to indicate at the time of the dental inspection—
(1) Cases definitely needing general anaesthetics
(2) Cases involving slight extractions with local anaesthetics
(3) Cases mainly involving stoppings
By this means the organiser should be able to select a suitable batch of cases so as to occupy the
whole time of each dental treatment session. By this means also the fruitless attendance of children
and parents, and the "R.F.G." (referred for gas) note in the dental register should largely cease to be
made.
(3) Mr. Bennett's statement that reinspeetion and treatment in London do not keep pace with
recurrent caries is correct as regards certain parts of London, in which too many schools are placed on
the rota of the centres. As the number of dental centres increases this difficulty decreases; it is, of
course, the ideal that a rota should be compiled so that each child should be seen once at least in each
12 months.
N.B.—It should not be forgotten that owing to war difficulties the attendance of children has
been much hindered owing to parental employment.
(4) Mr. Bennett suggests that treatment should commence earlier than 6.8, the original age
fixed by the Board of Education itself. This is undoubtedly right, and each child should be inspected
and treated at the earliest possible age. It is important in this connection to emphasise the importance
of appointing dentists of experience and not young men recently qualified and inexperienced in the very
difficult task of managing young children and dealing with difficult parents and guardians.
(6) Methods'of recording treatment.—Mr. Bennett's criticism of non.differentiation in the records
of stopping temporary as opposed to permanent teeth, is based upon the fact that at the centres in
question figures have been used in both cases instead of letters in the case of temporary teeth and figures
in the case of permanent teeth as upon the dental charts themselves. This is now being rectified, and
in future there should be a clear record of the number of temporary teeth stopped as well as the number
of permanent teeth stopped.
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