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In addition to the Bridgeport Institute there are other pioneer establishments
in the United States that merit description. The Rochester (New York State)
Dental Dispensary was founded in 1915 by Mr. George Eastman, who has furnished
$1,800,000 for the purpose. At this dispensary, the education of the parents and
children is regarded as being of even more importance than treatment. In 1916 a
school for dental hygienists was erected for the purpose of educating young women
to do prophylactic work in the public schools or in private dental offices.
The Dispensary Authorities direct the prophylactic work which is done in the
public schools by squads of licensed dental hygienists in charge of licensed dentists.
The squads are provided with portable equipment consisting of chair, cabinet,
engine instruments, sterilisers, etc. All the prophylactic work—cleaning of the
teeth—is done in the schools. The " squad " visiting a school varies from six to
fifteen operators, depending on the size of the school. (Note.-—It must be borne in
mind that American schools are far bigger than schools in this country.) It is
claimed that the benefits of the work are noticeable in the improved health of the
children, and that Rochester occupies a unique position with reference to this work.
Another famous American institution is the Forsyth Dental Infirmary for
Children, Boston. The clinics here were in full operation in 1915. The aim of the
institution is "to render serviceable the carious teeth of children; to teach the
principles of mouth hygiene, and to make every effort to determine wherein lies
prevention." Young women receive instruction in oral hygiene and render services
in children's dentistry. Apparently, however, the public elementary and other
schools of Boston are not open to the visits of the dental hygienists from the Forsyth
Infirmary, and it is stated that in certain other cities where dental hygienists are
trained, the school authorities have not thought it desirable to permit their activities
within the schools.
It has been necessary to set out in some detail the movement in America, for,
undoubtedly, the urge at the present time taking place in London is due to the
establishment in London of a replica of the Rochester (N.Y.) Dental Dispensary, in
connection with the Royal Free Hospital.
2. In New Zealand.—Owing to the shortage of dental surgeons throughout the
Dominion and the fact that the population is a very scattered one, it was decided,
about 1920, to train young women to perform the necessary treatment which at the
outset was to be confined to work on the milk dentition of the younger children.
The dental nurses are specially trained by the Health Department solely for Government
school dental work. The salaries of these trained dental nurses are less than
half of those paid to dental surgeons. The training includes a two years' special
course. They work without the continuous personal supervision of dental surgeons
and they perform all operations usually carried out by the latter, including
extraction and fillings. It is stated that their work has been successful and it is
understood that, although they were primarily intended to work solely upon the
milk dentition of younger children, the scope of their work has since been extended
to cover similar operations upon the permanent teeth of older children.
The conditions in New Zealand are, of course, exceptional, but such a scheme of
dental practice by partially qualified persons would not be legal in this country.
3. In England and Wales.—During the war, and before the operation of the
Dentists Act of 1921, there was a shortage of trained dentists and the Board of
Education approved the employment of " dental dressers," who were able to assist
the school dentist in his work. This was in accordance with the recommendations
of the Departmental Committee appointed by the Lord President of the Privy
Council in 1917. Such dental dressers were allowed to carry out inspection, fillings,
extractions, etc., under the supervision of a dentist. Eight education authorities at
one time or another took advantage of the Board's approval, viz : Sheffield (3 dental
dressers), Derbyshire (5), Shropshire (4), Liverpool (5), Abertillery (1), Bristol (1),
Nottingham (1) and Preston (1).
The Dentists Act of 1921, however, placed restrictions upon the work which
might be carried out by dental dressers or nurses, and the conditions defining the