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Special
inspections
Headmasters and headmistresses are required to bring before the school doctor :
(a) any pupil about whose well-being (physical or mental) the parents, care committee,
nursing sister or teaching staff are in doubt.
(b) pupils for whom special educational treatment is suggested.
Re-inspections
Pupils who at previous inspections were referred for treatment or observation are
brought forward for re-inspection as required by the school doctor. This group includes
any pupils receiving school meals, extra milk, or vitamin capsules on the recommendation
of the school doctor.
Parents are invited to be present at all medical inspections (except those of a casual
nature and most re-inspections)
Nurses'
hygiene
examinations
Hygiene examinations are carried out once each term by the school health visitor
but one of these three annual inspections is carried out more intensively and an average
of 20 children an hour are dealt with instead of 50 an hour.
History of
earlier
developments
in dental
inspection and
treatment
School dental service
Interest in the case of children's teeth grew towards the end of the last century. The
British Dental Association, from its incorporation in 1880, pressed for the institution
of frequent examination and, where necessary, treatment of children's teeth. In 1885,
W. M. Fisher of Dundee carried out the first detailed examination of a number of schoolchildren's
teeth, his published results pointing to the urgent necessity for regular
examination and treatment and in 1898 the School Dentists' Society was formed. In
1900 Dr. Wm. Hunter of London insisted on the importance of oral sepsis in general
medicine. His statements about the intensity of scarlatinal angina being proportionate
to the amount of dental sepsis made the subject of prime importance in schools.
Dunfermline and Cambridge were among the leaders in elementary school dental
work. Cunningham of Cambridge in 1908 established a dental treatment centre in that
Borough. Operated in the first instance through local benevolence, the centre was later
taken over by the local authority.
In December, 1905, the School Dentists' Society asked for the appointment of
properly-qualified dental surgeons for all elementary schools so that dental inspection,
advice and preventive treatment might be given regularly from the earliest age. At
that time, in London, both among children and the younger teachers, toothache and
neuralgia were fruitful causes of absence from school. Neglect of the teeth was almost
universal and it was exceptional to find children who used tooth brushes. Only two
children among six thousand had had conservative treatment.
During 1906 dental care was instituted for children over ten years of age in the
Council's schools for the deaf; this was a matter of special educational importance
in connection with the teaching of articulation. In the same year too, Mr. C. E. Wallis
wrote a report to the Council upon the state of the mouths and teeth of the schoolchildren
and was the first detailed dental investigation made of London elementary
schoolchildren. In his report, he said : ' The most striking feature observed is the
neglect of dental cleanliness and absence of any evidence of dental treatment, beyond
a few instances in which teeth have been extracted or broken. Only three of these
245 children possessed tooth brushes, and showed signs of having used them regularly
. . . Bacterial deposits, tartar, remains of food and every degree of malodorousness
and sepsis were evident. Many children were suffering from undue retention of temporary
teeth.' Mr. Wallis then described briefly the results of such foul mouths on the general
health and the undermining of the child's natural resistance to disease. At the same time
Dr. Wm. Hunter at Charing Cross Hospital was showing scientifically that local
concentrated sepsis caused anaemia and that removal of local sepsis cured this and
many other complaints.
After a Sub-Committee on the Medical Treatment of School Children, appointed
by the Council, had made certain recommendations about teeth in 1907, the Council
decided that the problem was one to be dealt with separately from medical treatment.
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