View report page

68
(7) Methods of following.up.—Mr. Bennett expresses the opinion that "following.up" would
best be done by nurses. The proportion of children inspected and needing treatment who fail to appear
at the dental centres remains at a higher figure than is desirable. The total bulk of the work is so large
that the school care committees in general are not quite able to keep pace with it, and much of the work is
thrown upon the organiser, who endeavours on the spot to persuade those parents who attend the inspection
to agree to treatment, but the indifferent parents or those unable to attend are in many cases not
effectively dealt with.
The reduction in the amount of leakage could be effected by a large increase in the number of
trained voluntary workers willing to undertake dental work, or failing that, by an increase in paid staff.
The position is at present unsatisfactory.
(8) Whole.time and part.time dentists.—In London both plans are in operation, and on the whole
I think no hard.and.fast rule should be made. It is desirable that part.time dentists should give at
least three sessions a week to the work.
(9) Abnormality in position of teeth.—This question has been before the Sub.Committee and is
now being considered by the Royal Dental Hospital.
(10) Ancesthesia.—Mr. Bennett's recommendations are in the main carried out and more "gas"
sessions are being provided at each centre. Ethyl.chloride spray should be provided at every centre
for local anaesthesia and local injection apparatus if required by the respective dentists.
(11) Discrepancy in type of dental treatment.—Mr. Norman Bennett does not refer to London
at all in this respect, but to certain provincial clinics in which there is no dental expert to supervise
and co.ordinate the work of the clinic dentists. In London the centres are frequently visited by the
Council's dentist and the work co.ordinated and supervised. London is the only Education or Public
Health Authority by which skilled dental supervision is provided.
(12) The question of dental dressers does not arise in London.
(13) Instructions and propaganda are largely undertaken in London, and Mr. Bennett refers
with approval to the dental talks to mothers given in London schools. They should be extended especially
in connection with factories, such as Pascall's, and secondary schools where the teeth of the children are
particularly bad, and where it is not unusual for large numbers of children to receive most unsatisfactory
and sometimes dangerous forms of treatment at the hands of advertising dental companies, etc., as shown
in the recent Government Committee Report. The question should be considered as to giving regular
dental lantern lectures in training colleges and also to school nurses and teachers as well as assistant
organisers who visit the parents in their homes. Mr. Wallis informs me that in America use is made of
certain films illustrating the work of Dr. Fones, of Connecticut, by which it is claimed that the incidence
of dental decay is diminished. Mr. Wallis is endeavouring to learn further particulars with regard to
these films.
(14) Linking up school dental treatment with dental treatment before and after.—Wherever possible
joint undertakings with maternity centres for dental treatment are established in London. Such arrangements
exist at the Holloway, Lissonia, Bethnal.green and Fulham centres, and at the St. George's
dispensary. The question of dental work in continuation schools is being borne in mind in connection
with the scheme under the Education Act, 1918. Co.ordination between dental and medical treatment
is already to a considerable extent carried out at the centres, but it should be made an essential that all
adenoid and tonsil cases should have their teeth rendered healthy and their mouths freed from dental
sepsis before operation.
Following up.
Attendance
of organisers
at Treatment
lentres.
Under all the schemes of treatment organised by the Council it is provided that an organiser of
children's care work shall be in attendance at the hospital or centre both for the purpose of regulating
the attendance of the children and with the object of communicating to the school care committees the
result of treatment, failure to continue attendance, and any adjustments or following up required in the
home in order to complete, confirm or expedite the cure of the children.
There was some alleviation of the difficulty in obtaining the help of voluntary workers, which was
so acutely felt during the war ; this was in part met, as in 1917 and 1918, in certain schools (about 35
in number) by utilising the services of the school nurses. The re.inspection figures show that in several
of these schools the proportion of cases that had received no treatment and still required it was below
20 per cent.
A comparison of the figures shows that the results obtained in these schools were better than
those found in London schools generally, e.g. :
London schools. Selected schools,
per cent. per cent.
Cases marked off at first re.inspection 41.6 49.7
Cases marked off at second re.inspection 31.9 30.3
Total percentage completed 73.5 80.0
Voluntary
arrangement
at Guy's
Hospital.
For some years an organiser, and more recently two organisers, have attended at Guy's Hospital,
although the arrangements at the hospital are not within the Council's scheme. The plan is
found to work extraordinarily well, benefiting the children, and being of great assistance both to the
hospital and to the children's care (school) committees in their respective spheres of work.
The following account of the work, prepared by the Council's organiser for presentation to the
Hospital Committee, gives a good idea of the benefits accruing from the arrangement.
The London County Council assistant organisers of children's care committee work are now
attending in four of the out.patient departments of the hospital. In addition to the ear, nose and throat