London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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in the schools contributory to the various centres and during the year 2,492
inspection sessions have been held by the 68 inspecting dental surgeons. As a
general rule children in the age groups examined by the school doctors, viz., entrants,
children aged 7 and 11 and leavers, are not inspected by the dentist; but, in connection
with certain of the centres, where the inspection of the schools on the rotas
is completed in less than one year, it is the practice for the dentists to inspect
children of all ages. It is intended that the scheme shall be extended so that by the
conclusion of the next three years, children of all ages in all the schools in London
will be inspected by the dentists at least once a year.
The number of children inspected by the school dentists during 1934 was
273,672, compared with 275,213 during 1933. The number found to require treatment
was 176,509 or 64.5 per cent. Table IV, group IV, at the end of this report
shows the number of children of the various ages inspected, as well as the details
of the treatment given at the hospitals and centres included in the scheme.
The total number of children treated was 138,140 compared with 133,835 during
the year 1933, an increase of 4,300. Included in the total is the number of children
(3,710) from the schools allocated to the Eastman clinic who were treated at the
clinic and 22 scholarship cases, as well as 488 cases dealt with at Berkshire-road
school. The 1933 figures were compiled on a similar basis. In addition to the
above there were 7,023 children from unallocated schools treated at the Eastman
clinic. The number of sessions including general anaesthetic sessions held during
the year was 18,211, compared with 18,713 during the previous year. It will be
seen that, although some 500 sessions less were held, there were 4,300 more cases
dealt with during the year. This is accounted for by the reduction in the number
of sessions devoted to general anaesthetics, and it may be noted that there were
66,424 administrations of general anæsthectics, compared with 69,683 during 1933.
This reduction has been effected by the more general use of local anaesthetics,
especially in the treatment of the older children. Of recent years a considerable
change of outlook towards the use of local anaesthetics in dental therapy has taken
place throughout the dental profession.
Efforts have been and are being made to use local anaesthetics more generally
in the school treatment centres in suitable cases, and most of the dental surgeons
have now adopted the practice with very good results. Moreover, the extraction
of one or two teeth on the spot under a local anaesthetic saves another visit to the
centre for gas treatment; and, apart from this economy of time, the child is not
subjected to the nervous anticipation of further treatment, and the work is completed.
During the year 31,945 local anaesthetics were given. The aim of the
school dental service is conservative in character, and as a general principle every
saveable tooth should be preserved. It is indicative of the progress of the dental
scheme in London that year by year the number of saveable teeth is increasing,
whilst the number of unsaveable teeth is decreasing. This is shown in the following
table by the steady increase in the number of fillings undertaken, save for the
slight setback in 1933, and the decrease in the number of extractions.

Table 7.

1931139,723132, 237393,579

A problem that is ever present is that of the "casual" case—that is the child
whose parents do not take advantage of the facilities offered at the school inspections,
and who is only brought forward by the parent when acute toothache is the cause.
Casual cases.