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22
The employment
of
"Dental
Hygienists."
The question of the training and employment of dental nurses or attendants is
one which is at the present time much to the fore.
The matter has been raised formally, firstly in the following letter from the
Dean of the Royal Dental Hospital of London, School of Dental Surgery, University
of London:—
"The question of training women to act as Dental Nurses to do minor work under the conditions
permitted in the Dentists Act, 1921, Section 1 (3) (c) has been considered by my Committee,
and I have been invited to write and ask whether, supposing such women were trained, there
would be any chance of your Council employing them in your Dental Clinics ? The work they
could usefully be employed upon is auxiliary to that done by the Dental Surgeon, and must be
under his (her) supervision, and would include the carrying out of simple cleaning of the teeth of
children and propagating the principles of Dental Hygiene.
"At the moment we have only heard of one or two centres in which such dressers are demanded
and we feel that it would be unfair to permit candidates to undergo a somewhat lengthy and
expensive training if there is no suitable avenue of subsequent employment.
"Your Committee's consideration of this question would be of very great assistance, and I
shall be glad if you will kindly let me know the result of its deliberations."
Secondly, by the Manor Charitable Trust. A year ago it was agreed that the
Manor Trust should take over as a voluntary service the dental oversight of the
children in two elementary schools, viz., Gainsborough-road school and Berkshireroad
school (Hackney South). The Manor Trust pointed out that there was a
number of "dental hygienists" (or dental nurses) being trained in London at present,
and the Trust is greatly interested in their future. The Trust adopted a proposal to
bear the expense of the experiment, to engage six of these dental hygienists and
with the consent of the Education Committee and the Board of Education to utilize
them in selected schools in London or, failing London, in some other area, where
they would confine themselves entirely to prophylactic and propaganda work.
It will be observed that the letter of the Dean of the Royal Dental School refers
to "dental nurses," while the Manor Trust speaks of "dental hygienists." The
latter is an American term, but the underlying idea is the same. The question is
undoubtedly of importance and merits earnest attention. It cannot be denied that
the issues involved are controversial.
The following is a short outline of the history of the movement:—
1. In America.—Dr. A. C. Fones of Bridgeport, Connecticut, started to train
the first dental hygienists in 1913-14. The work of the hygienists attached to the
Fones Institute consists in dental inspection of children in the schools, recording the
results and giving prophylactic treatment. They work as a rule in pairs and their
portable outfits are easily transferred from one school to another. When the equipment
is fixed up, the hygienists take each class in the school in succession. Charts
are made of each child's mouth, one for the parent and one as a permanent record in
the files, showing the conditions found in the mouth over a period of years. In
Bridgeport the mouths of 20,000 children are cared for by a corps of 26 dental
hygienists, two supervisors and an assistant supervisor (who are also dental
hygienists) and three women dentists.
This system is now fairly widespread in America, and dental hygienists are
trained in many centres. Naturally a movement such as this required careful
regulation because of the possibility of abuse through the tendency of partially
trained persons to take on duties and perform operations which they are not fully
capable of carrying through successfully. Legislation, therefore, had to be brought
about. The enactment setting out the law in America is contained in the Senate
Bill No. 391. This permits any legally incorporated dental dispensary or infirmary
to establish courses of study in oral hygiene for women students, and these may be
graduated in one year as dental hygienists. Any licensed dentist, public institute,
or school authority may employ such licensed and registered hygienists. They may
remove lime deposits, accretions and stains from the exposed surfaces of the teeth,
but they shall not perform any other operation on the teeth or tissues of the mouth.
They may operate under the general direction and supervision of a licensed dentist,
but nothing in the enactment may be construed as authorising any dental hygienist
to perform any operation in the mouth without supervision.