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themselves, and it is thought that the prophylactic work of the dental hygienists
in the schools would operate in the direction of overcoming these natural fears in
regard to dental treatment.
The effect of the entry of dental hygienists into the schools would also have to
be considered upon several classes of individuals now engaged in the work including
the teachers, organisers, and care committee members, school dentists, school nurses
and school doctors.
The effect upon the teachers.—The teachers at present carry out important
propaganda work, they are charged with the duty of hygienic instruction and in some
schools instruct the children in the care of their teeth by tooth brush parades and
tooth brush drill, etc. Some teachers are enthusiastic, others less so. In at least
one school in London where the head teacher is a super-enthusiast in the cause of
dental hygiene there is a hundred per cent, efficiency. If this could be reproduced
in every school the whole problem would be at once solved without the advent of
dental hygienists. Would the teachers welcome this further invasion of the schools ?
The question cannot be answered with certainty. On the ground of disturbance of
school work, however, it is almost certain that there would be opposition in many
places. It is probably the anticipation of this opposition which has prevented the
dental hygienist from obtaining entry to the schools even in certain cities of the
United States in which they received their training.
The effect upon organisers and care committee members.—The dental hygienists
would naturally usurp to some extent the functions of organisers and care committee
members but especially that of the organisers, as they would be the natural accompanists
of the dentists at the inspections. Would the care committee members
welcome them ? Probably yes, if it could be shown that they are more effective
in propaganda and if their prophylactic work could be shown to result in the prevention
of decay. Incidentally it may be mentioned that it is the organiser and not the
centre nurse who at present accompanies the dentist because the following-up of
defect is in the Council's system carried out by the voluntary care committees and not
by the paid professional staff.
The effect upon the school dentists.—It is possible that, obeying the professional
instinct, the school dentists themselves would prefer not to be placed in the invidious
position of aiding a system not acceptable to the profession at large, although
the Council of the School Dentists' Society has declared itself not inimical to the
employment of dental hygienists on the Fones plan.
The effect upon the school nurses.—The school nurses are the practical educators
in habits of personal hygiene, including the hygiene of the mouth. Under a scheme
initiated by Sir Cyril Jackson, who provided prizes for individual excellence in oral
hygiene in schools, the school nurses acted as judges and much early educational
work in this connection was carried out by them. As in the case of attendance at
the dental centres, it may appear that if there is a place for dental hygienists in the
schools it would be better, by training the school nurse, to combine in one individual
the care of all aspects of personal hygiene than to multiply the different specialists
and classes of persons visiting the schools.
The effect upon the school doctor.—The school doctor at present takes a very prominent
share in the propaganda work, especially as over 80 per cent, of the parents
attend the inspection of the entrant children. Indeed in various ways so much
propaganda is carried on that it is possible that the people who are not converted
remain aloof from conviction rather than from ignorance. The dental hygienist,
however, would in no way interfere with the school doctor's work.
In the above considerations the propaganda side of the dental hygenist's work
has been chiefly borne in mind, but the very important question of the prophylactic
side of the work has not been given so much attention. If it can be shown that by
the practical attention to oral hygiene—cleaning and polishing the teeth of the
children in school, detecting at an early stage the beginning of caries, bringing home
to the children their individual remissions in care, etc.—a considerable prevention
of caries takes place and a considerable expenditure upon treatment is avoided, and