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that there is 110 cheaper or so efficient a method of attaining this result, then the
dental hygienist in some form must be provided. Some of the American reports are
enthusiastic and the rapid extension of the dental hygienist movement in America
would hardly have taken place unless the opinion was widely spread and strongly
held that their work is good. On the other hand the same opinion might be held
of our own system in England of which the results can by no means be held to be
negligible. A letter which has been received by one of the Council's officers from the
Director of one of the pioneer training schools for dental hygienists in America suggests
caution. He states: "You ask as to the results. I think that the hygienist does
some valuable work and that there is a great field for her in certain places. I do not
think, however, that the hygienist will ever prevent decay of the teeth. I believe
the cause of decay is of a more fundamental nature. Statistics indicate this since in
spite of all our hygiene and reparative work, dental decay still exists to the extent
of 95 to 98 per cent."
The Council considered that the Dean of the Royal Dental Hospital School of
Dental Surgery should be informed that the Council would not. at present contemplate
the employment of dental nurses or dental hygienists as permanent officers in the
Council's school dental service. It was considered worthy of trial to accept the
services of the six dental nurses offered by the Manor Charitable Trust and the Council
agreed to give facilities for this experiment, their work to be confined to propaganda
and prophylactic work.
Subsequently the Eastern Clinic was opened on 17th November, 1930, and
with the consent of the Manor Trust three of the six dental nurses were appointed at
this clinic to whom the Council agreed to assign the dental care of a neighbouring
school (Prospect-terrace) on the same lines of voluntary service followed by the
Manor Charitable Trust in the two Hacknev schools alreadv mentioned.
The Council is bound by law to make a charge for treatment. The charge to the
parent is fixed at 2s. for a major ailment, and after a fortnight's free treatment 1s.
for a minor ailment until discharge. No charge is made for refraction which is
held to be a form of " further inspection." Spectacles are paid for by the parents
but assistance is given in necessitous cases by the London Spectacles Association
working in conjunction with the school care committees. Concessions art
allowed whereby for " slight treatment " of dental cases a charge of 1s. only is made
and the school care committees are empowered to remit the charge altogether in any
case where necessity is pleaded. The number of " slight cases " in which the charge
was reduced for dental treatment was 10,897. The total amount recovered from
parents during the year was £11,723 3s. 2d. By an arrangement with the Hospital
Savings Association vouchers are accepted in lieu of payment of charges and the
Fund pays to the Council the sum of £1,000 a year. The average cost per case has
been worked out as follows for the current year:—Refraction and eye disease,
6s. 3d. ; ear, nose and throat defect, 17s. 2d.; minor ailments, 7s. 9d; X-Ray
treatment of ringworm, 25s. 8d.; dental treatment, 7s. 2d. Notices setting out
these costs are exhibited in the centres for the information of parents who desire to
pay in full. Scholarship holders in secondary schools are treated on the same terms
as elementary school children, but fee-paying pupils in these schools are required
to pay the full charge as set out on the exhibited notices.
Charges for
medical
treatment.
Stammering Children.
There are now eight centres for stammerers, a new centre at Amberley-road
school (Paddington, N.) having been opened in August, 1930. During the year 320
children attended the centres ; of these 29 were discharged cured, 55 as provisionally
cured, and 48, many of them greatly improved, left for various reasons. It is only
quite recently that it has been realised that stammering is not due to an organic
defect of the speech apparatus but should be classed as a nervous disorder, in many
cases a disorder of the whole personality, affecting behaviour, temperament and
outlook. In the child and to a greater degree in the adult the effects of this disorder
are very noticeable. The sufferer may be irresponsible and unstable, irritable or
excitable. He is often quick tempered or unruly, or, on the other hand, moody and
reserved.
Report by
Dr. E. J.
Boome.