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More people, even now, seek the dentist's aid for the alleviation of pain, or the satisfying
of personal vanity (where a noticeable gap in the front of the dental arch occurs), than do
those with any realisation or intention of positively safeguarding their general health.
Why should this continue to be so—albeit perhaps less so—up to date ? Perhaps because
artificial substitutes for the natural teeth have been so successful; has the substitution led
to indifference to the premature loss of the natural teeth? Certainly all dentists have met
the patient who states he had no peace until he lost all his own teeth and acquired an
artificial set! Has the school dental service been so successful in the virtual abolition of
obvious gross dental defects from schools that this very improvement bolsters the contention
that the school dental service, as given to children to-day, is excessive? Must we have
children's mouths neglected until pain supervenes and distress is obvious to all before the
aid of the dental practitioner is sought? To all of these questions I would say, it would seem
to be so. In spite of some measure of success in reducing obvious distress and in providing
artificial substitutes, dentists and dentistry are still, none the less, in some quarters second
only to mothers-in-law as so-called comic material. The public appreciates the doctor but
to many the dentist is merely a bore; yet he plays an essential part in maintaining public
health. Amidst this cavalier attitude by the public towards their own dental well-being, the
dental profession and officialdom strive to improve and build the public's health. In the
past 50 years the public conscience has been aroused successfully to produce social revolutions
in sanitation, in personal bodily cleanliness and in the personal care of skin, eyes,
ears and hair, but not yet in the personal interest and care of the inside of the mouth and
of the teeth. Lipstick for the girls and beards for the boys are apparently more important
than toothbrushes for the toddlers. Attention is given to the outside of the mouth but the
inside may literally stagnate.
In 1911, in connection with the Council's exploratory scheme already mentioned for
dental treatment of children, lectures on dental hygiene were given in five schools in the
vicinity of each of the two treatment centres by one of the assistant medical officers and
general information on the care of the teeth was disseminated amongst teachers, parents
and pupils by means of pamphlets, etc.
' Lectures and pamphlets, etc.' have continued in ever-increasing volume each year since
then, but have, in the main, aimed rather at dental education than at overcoming apathy.
It is indifference and procrastination, not ignorance, that is the trouble. Dental health
propaganda might be more effective were it in the form of simple advice on maintaining
personal oral cleanliness, rather than education on how the decay spreads in a tooth, or
dismal dissertations on ' dental' diet! A widely publicised slogan such as ' Have a clean
mouth and a frequent dental check-up ' and a lucid explanation of how and where to get
assistance, rather than why treatment should be obtained, might be more effective than
have been all the lectures and pamphlets so far produced. To recommend diet changes,
which mean a social revolution at the domestic table and in the public restaurant—to say
nothing of between meals and school tuck shops—is to flog a dead, or at least an unwilling,
horse. Dentists and dentistry become even more unpopular when the advocated dental
diet—not followed even by dentists themselves—is found by individuals to be apparently
quite unsuccessful in preventing their teeth decaying—even though it may be proved
scientifically to reduce the extent or virulence of the disease. But a simple slogan, e.g.,
' Have a clean face, outside and inside' is easily accepted, and if acted upon would do
much to remove from the teeth the damaging stagnation of any food—sweets included.
The stagnation in the mouth, not the food, is the danger—cleanliness is the cure. Advice
on caries prevention must be as easy of assimilation as is 2 p.p.m. of sodium fluoride in
drinking water, with the same end in view, namely the reduction of dental caries without
the necessity for a social and dietetic revolution.
So far nearly all the effort, thought and expense of a dental health programme has come
from vested interest sources. Dentists and manufacturers of dental toilet requisites have
produced nearly all the manpower, the ideas and the money. Contributions to the effort