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110
"No case has been included which has been treated, and no case not established
as a deformity. Therefore, in infant departments the incidence of abnormality is
low, although the trained eye can see that deformity will occur later in all probability.
Again, the omission of treated cases causes a low incidence of gross deformity in
the higher grade schools. The accepted text books state that in physical and mental
defectives, oral deformity is rife, and may be classed as a stigma. While this is
not yet absolutely proved, the figures appear most strikingly to confirm the presence
of this oral and dental stigma. Shortage of calcium probably has no direct influence
on decay and deformity; but where general oral sepsis is still rife the incidence
of deformity is very high. Additional and most important causal factors are
associated with nasal obstruction, adenoids and tonsils; with mouth breathing,
induced by the flaccid tonelessness of the non-chewing child suffering from oral
sepsis; and with individual habits, such as finger sucking or the use of a
"dummy."
"The first and most striking fact shown by the table is the very high percentage
of deformity—no less than 30 per cent, of the children examined in a representative
area—even somewhat higher in grade than the rest of the county, show some deformity.
Fully 18 per cent, of our children have R.N., retro-normal mandibles,
with the usual corollary of projecting upper front teeth; fully 8 per cent. have
misplaced teeth (L.V.); almost as many have crowded mouths (C.R.); these three
deformities account for the bulk of the deformed mouths, while a large number
follows with various defects, one of which—open bite (when the incisors fail to meet)—
is utterly disfiguring, though any dental deformity classified here may relegate a
child for life to a dreaded inferiority.
"The problem of the treatment of deformity must be faced upon these
lines:—
"A. The parents must be brought to realise that milk teeth are as important
as permanent teeth. Attention must be paid to tuition of the future mothers of the
race, that when their time comes they may know what is a right diet for the expectant
mother—good teeth and good bones go together in the unborn and newlyborn
child.
"B. Both knowledge and teaching are at present incomplete. So that it is
most important that signs of decay in milk teeth, should receive early attention. The
Council admits to its treatment any child registered at school; for those not so
placed it cannot provide, this is the sphere of the maternity and child welfare
authorities.
"C. When these measures fail, treatment must be given for simple, orthodontic
deformity, other than treatment by extraction, the only means at present of
combating deformity. Here a word of thanks may be given to the great voluntary
hospitals, dental schools, institutions and departments, where many of the worst
cases of deformity are treated—these institutions would treat more but their accommodation
is overwhelmed and the waiting lists are all too long.
"In paragraph A above is given the reason for instruction; a beginning has
been made by the Consulting Dental Surgeon with intensive propaganda in the
schools by giving weekly (or more often) simple lectures upon dental health and dental
disease; audiences of parents, elder scholars and Care Committees have been
gathered and arrangements made by the Principal Assistant Organiser, Miss Deverell.
In some cases the children have written essays on the lectures. It is almost invariably
the experience that head teachers have been at great pains to instil methods of
dental hygiene into their charges, and in many schools the intimate structure of
the teeth was perfectly understood. It is hoped that this tentative effort may be
completed by organised propaganda against that which was described last year
as the chief scourge of child life—dental disease.