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APPENDIX B
THE SCHOOL DENTAL SERVICE—A NATIONAL PERSPECTIVE
By virtue of section 80 of the Education Act, 1921, a statutory obligation was placed upon
local education authorities to provide dental treatment for children attending elementary
schools. The service was also permissive in higher education establishments and other
schools.
Ten years earlier, however, the London County Council had entered into an agreement
to conduct an exploratory treatment service at two institutions to provide dental treatment
for 6,000 children for a period of one year ' with a view to accumulating experience as to
how best to deal with the matter ', the ' matter ' in this case being the generally acknowledged
shocking state of dental disease amongst schoolchildren. Prior to the Council's
exploratory service the deplorable state of children's mouths had been frequently commented
upon in many knowledgeable quarters. From its incorporation in 1880 the British
Dental Association has pressed persistently for greater dental care for children. Mr. W. M.
Fisher, a dentist of Dundee, is credited generally with being the first individual pioneer in
this field. He carried out in 1885 the first recorded detailed examination of the teeth of a
number of schoolchildren, and first published results emphasising the urgent necessity for
regular examination and treatment. The deplorable dental dilapidation amongst young
recruits was commented upon strongly by many recruiting and medical officers at the
time of the South African War, but not until Dr. William Hunter of Charing Cross hospital
showed scientifically that dental disease is not entirely a localised disability, did officialdom
begin to sit up and take notice. Hunter insisted, as had many dentists for many years
previously, on the importance of oral hygiene in general preventive medicine. He affirmed
that oral sepsis is a predisposing or causative factor in many systemic diseases and that
through an infected blood stream oral sepsis may set up secondary infections in parts of
the body remote from the mouth. The acceptance of these views by the medical profession
in general and the quite obvious discomfort, disfigurement and distress of so many patients
led, throughout the first years of this century, to a steady awakening to the need for proper
care of the mouth if health is to be preserved. The Borough of Cambridge led the way in
1908 by setting up the first local authority dental clinic in this country. The medical and
official recognition of the undermining of health by dental disease left three obstacles to
be removed before there could be acceptable alleviation of the trouble:
(i) the cost of the service required,
(ii) staff to render the service, and
(iii) the overcoming of public apathy—not' ignorance '—
for with the widespread prevalence of dental disease there are few people so fortunate as
to have escaped a personal realisation of the inconvenience—if nothing more—of dental
disease.
'When fevers burn or agues freeze us
Rheumatics gnaw or colics squeeze us
Our neighbours' sympathy can ease us
Wi' piteous moan
But thee! thou Hell o' a' Diseases!
They mock our groan '
So wrote Robert Burns: the italics are the writer's. Money was forthcoming, staff (at least
in early days) was forthcoming but—' They mock our groanTherein lies the clue to the
stubborn apathy of the public. Many diseases, apart from so-called ' killer' diseases, have
the shadow of tragedy and suffering suspended over them, but dental disease, except
sometimes to the actual sufferer, is frequently the butt of the wit (or the half-wit). ' They
mock our groan ', but to the sufferer dental disease may indeed be the' Hell o' a' Diseases