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the control group than in the Wick centre group. Yet, looking at the figures as a whole, it is difficult
to resist the conclusion that the Wick children were in a better dental condition as a result of dental
treatment than the control group.
But the test of "treated and sound," though satisfactory up to a point, fails in that it discloses
nothing of the condition of those children not in this category, that is, "treated but not sound."
The children in this group range from those with perhaps one slight cavity in a permanent molar
or even a developmental crevice, up to those with many carious teeth. It seemed to me that
this group might provide some useful data expressed in terms of teeth requiring treatment.
In order to arrive at a basis of comparison, I have expressed the carious teeth in terms of so
many per child and have given the index figure of the temporary and permanent teeth separately.
Taking the total number of teeth, which includes those with slight cavities, saveable teeth and
unsaveable, all grouped together, it will be seen that the index figure of teeth carious per child
is not very striking. In the case of the temporary teeth the number per child in the Wick centre
is greater than in the control group, being 0.85 per child in the former against 0.50 per child
in the controls. In the permanent dentition there is a more favourable figure for the Wick children,
the index figure per child being 0.84 against 1.07 in the controls. But when the carious teeth are
segregated into two groups, saveable and unsaveable, the figures are interesting. There is comparatively
little difference between the Wick children and the controls as regards saveable teeth,
but a very definitely smaller figure per child of unsaveable teeth in the permanent dentition, for
while the Wick children have only 0-06 unsaveable permanent teeth per child, the controls have
0.33 per child. Can one justifiably deduce from these figures that the favourable ratio of dentitions
treated and sound " in the Wick children is corroborated by the figures provided by an
investigation of the amount and degree of caries present in the two sets of children ?
Total temporary teeth carious—
Wick centre 259 (0.85 per child)
Control 318 (0.56 per child)
Total temporary teeth carious but saveable—
Wick centre 112 (0.24 per child)
Control 90 (0.24 per child)
Temporary teeth carious and unsaveable—
Wick centre 147 (0.31 per child)
Control 170 (0.45 per child)
Total permanent teeth carious—
Wick centre 386 (0.84 per child)
Control 400 (1.07 per child)
Total permanent teeth carious but saveable—
Wick centre 358 (0.8 per child)
Control 287 (0.77 per child)
Total permanent teeth carious and unsaveable—
Wick centre 28 (0.06 per child)
Control 123 (0.33 per child)
I am of opinion that these figures, though taken by themselves they might not justify any
decisive pronouncement, yet, takenin conjunction with the "treated and sound" figures, strengthen
the view that the Wick children have a better dental condition than the controls.
It is too much to expect that any dental supervision and treatment, however thorough,
will suffice to retain the temporary teeth in a sound condition throughout their functional lifetime.
Treatment of these teeth is at best a patching up which needs to be done at short intervals and
even then it is rarely that they will last out their normal span. The real test of school dentistry
is the condition of the permanent dentition. It must take a considerable period for caries in a
permanent tooth to attain a degree which makes it unsaveable. The very much smaller incidence
of such teeth in the Wick group is significant for it shows that while the attendance at the Wick
clinic may not have diminished greatly the liability to caries, yet the intensive and regular treatment
has borne fruit in that the number of unsaveable teeth is greatly reduced. In 460 children
there were only 28 unsaveable permanent teeth, while in the 372 control children the number of
such teeth was 125.
The last test applied to the children was the condition of the gums and mouth generally.
Many conditions affect the cleanliness of the mouth, so that a clean mouth may not necessarily
denote a high degree of personal hygiene, or a dirty mouth a neglect of hygiene measures. Irregularities
of the teeth, caries leading to abscess formation or to disuse of that side in eating
because of pain, are a common cause of a dirty mouth. Similarly, a clean mouth may be due to a
high degree of vigorous mastication and a diet rich in coarse, fibrous foodstuffs needing efficient
chewing. Since the main feature of the Wick clinic has been the service of a dental hygienist carrying
out prophylactic cleaning as a routine part of the treatment, it might seem reasonable to
interpret the condition of the gums in terms of the personal oral hygiene of the children concerned.
1 think one should be very cautious in drawing such conclusions.
The figures of the two sets of children are not highly significant. There is, however, in all
three groups a more favourable condition of the gums in the children treated in the Wick centre