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object not only of allaying opposition, but of creating an actual demand for a
healthy mouth as a natural accompaniment of a healthy body as an aid to
efficient school progress.
Staff.—It is sometimes thought that anyone with a dental diploma is thereby
suitable for a dental clinic appointment, and one of the lessons learned is the fallacy
of any such idea. The success of a dental clinic depends almost entirely upon the
suitable selection of the dental surgeon and nurse. However skilful a dentist
may be, unless he can command the confidence and even regard of the children
and parents, he cannot secure the best results. Occasionally the substitution of
one dentist for another has made a change in the output and popularity of a clinic.
It follows, therefore, that the utmost care must be exercised in their selection. It is
found in London that, on the whole, part-time dentists are more satisfactory than
whole time ones except in a few rare cases in which older men have given up general
dental practice for school dental work. Again it is absolutely essential that a school
dentist, besides having a pleasant manner, should have the gift of explaining
treatment to parents in simple intelligible language without the use of technical
terms. Much parental opposition may be overcome by a proper and considerate
explanation of the treatment required.
A point not always evident is that clinic dental surgeons have to supervise the
work of their clinics, and it is, therefore, specially necessary that dentists of experience
and common sense should be appointed to these highly responsible posts,
and not the newly qualified and inexperienced. As regards anaesthetists in dental
centres it is absolutely essential that every anaesthetist so employed shall have
special experience in giving nitrous oxide and ethyl chloride for dental operations
upon children, and it is by no means easy to obtain persons gifted in this respect.
It is also important that the dental surgeon and dental anaesthetist should work
closely en rapport, as it is essential that whatever may be required may be completed
while the child is in a state of complete anaesthesia. This mutual co-operation
obviously precludes a frequent and even a yearly change of anaesthetists, and so
valuable is a really good dental anaesthetist that his services should be retained
for as long as possible.
Co-ordination and supervision of work.—Experience of these clinics soon showed
that co-ordination and supervision of the work by an experienced dental surgeon
was essential. Further, a uniform and uncomplicated method of recording work
done was found to be necessary in order that complaints of malpractice and so forth
might be investigated and dealt with at once. The charts in use in the London
dental centres are made as simple and self-explanatory as possible, and at the same
time there is avoidance of undue clerical work at the expense of necessary dental
treatment.
Output of work.—It is often asked what output should be expected of a dental
surgeon, and after consultation with the senior, most experienced and conscientious
members of the dental staff, it is generally agreed as a broad statement
that one stopping per child per annum is the minimum to be expected, though in
a few centres the quantum approaches an average of three to four stoppings per
child. It is of interest to know that this larger output is derived from the older
and more experienced, who have developed the art of working quickly and efficiently
in accordance with the sessional time available.
Payment for treatment.—The question is often raised as to whether the charges
made for dental treatment act as a deterrent and prevent parents from obtaining
what is required for their children. Much inquiry has been made in regard to this,
whereby an interesting fact has emerged, namely that parents who pay at their
first visit, almost invariably make their children attend until the treatment is completed,
a most valuable: result, and much better than when a mother lets her child
attend once and then fails to re-attend for the completion of the treatment.