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"Arising out of the inspection by the Board of Education in 1926, opportunity
was taken of the opening of the new "Prunella" centre in the East End to try out
a special scheme embodying the following suggestions:—
A special
dental
scheme at
the Prunella
Centre.
"(a) That the centre should be used principally for the treatment of very
early dental defect, and only to a minor extent for the relief of pain or the treatment
of advanced cases. Children whose parents refused treatment to be excluded from
the scheme of treatment and not reinspected. (b) That certain administrative
changes should be made chiefly in the manner of notifying parents of dental defect
among their children, and for the keeping of dental inspection records in more
adequate detail. (c) That the Inspecting Dental Surgeon should treat only children
coming from the schools visited by her. (d) That children found to require only
extraction under gas as treatment for their diseases should be given a direct appointment
(the parent being willing) for an anæsthetic session, so saving one visit to the
centre. (e) That cases requiring slight treatment be charged less than those requiring
advanced treatment.
"It was found, at the end of the first year that:—
"(a) The children showing early defect at 6 years of age, could be dealt with
easily and effectively, if treatment were accepted. On the other hand, the centre
was not kept adequately supplied with children, if the child was excluded whose
parent refused treatment. However, the door was never bolted and locked, and
many cases came in for treatment, driven by toothache. Nevertheless, evidence
accumulated that the condition of the elder children was becoming worse. This
part of the scheme was for these reasons, dropped, and reversion made to the normal
methods—the open door and persuasion.
"(b) A new card was designed, recording directly in some detail, the dental
condition of a child on inspection ; direct gas appointments were given. This involved
fewer children being inspected per inspection session. The changes have
worked well, and as by slight modification an increase in inspections per session has
been secured, they have been continued.
"(c) This has been found practicable as far as "Prunella" centre is concerned,
and is being continued there. It is found that people in London generally are
inclined to visit the nearest centre of choice rather than the centre officially treating
the school attended, and it is administratively impossible to ensure treatment being
given by the inspecting dentist. Even on the fringe of the Prunella area, parents
will seek another centre. Prunella, in its turn, treats patients which should perhaps
be treated at Wapping. A water-tight compartment system in relation to the
centres is, therefore, in London, impracticable.
"(d) Direct gas appointments have been given at inspections, and this method
works fairly well. It is difficult, however, to explain fully, in a crowded hall, how
to prepare a child for an anaesthetic, and to demonstrate the teeth that must come
out. For the present this system is being continued.
"(e) Modifications in the Council's charges had already been instituted, and
for fillings of an easy type a charge of one shilling is now made. This has been
adopted not only at Prunella, but throughout the county.
"It is now an axiom that the best way of attacking the problem of dental
decay is to concentrate on the child of 6 years of age. In conjunction with Miss
K. M. Fry, therefore, investigation was made into the state of the first permanent
molars, probably the most important human teeth, among children aged 7 years.
These teeth erupt at about the sixth year.
The first
permanent
molars.
"Of 197 children examined by Miss Fry, 101, or 50 per cent., showed healthy
teeth; 85 children, or 42 per cent., had these very important teeth slightly decayed,
but saveable; while the remainder showed either a mixture of saveable and unsaveable
teeth, or else unsaveable and hopeless decay. Only 8 of a possible 788 teeth
had failed to erupt into place. It appears then, that from the point of view of the
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