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from other sources have been relatively small. An annual practising (registration) fee is
collected from dentists by the General Dental Council (formerly Dental Board of the
United Kingdom), and a portion of the sum collected is expended on dental health education
material. This in turn is distributed free or at low cost to public bodies interested or
involved in dental care programmes. In like manner some industrial organisations set
aside sums of money to expend on the same objects, a few actually producing quantities of
posters, films, etc., many of them of a very good and expensive standard. Such activities
from the dental profession and manufacturers, while highly praiseworthy, may possibly
be suspected by some people as a measure of self interest, and it could be said that the task
of overcoming public apathy to dental care is one to be tackled by the Government, as has
been the case in other fields of preventive medicine. True, an advisory and co-ordinating
committee on dental health education has been set up by the Ministry of Health, but this
committee has no fund at its disposal and no remit to produce anything except comment.
Were the Government prepared to embark on a widespread drive to alert the public,
particularly young people, to the advisability of having clean mouths, much money and
effort might be saved ultimately in the National Health Service. Some changes in the
present general dental service organisation would be required to produce a better children's
service, by diverting dentists' efforts to treatment for the younger section of the community.
The main change necessary to achieve this end would be the curtailment of the free or
assisted National Health Service to persons above a certain age, as is done, for instance, in
New Zealand, where all persons over 16 years of age pay for their own dental treatment,
thus intensifying the drive on children's dental care which, under 16, is free in that country.
It is not, however, suggested that this change would be a popular one!
In the initial planning and organisation of the dental section of the National Health
Service, emphasis was placed by all concerned, and particularly by the dental profession,
on the advisability, nay necessity, of establishing first a ' priority dental service ' for mothers
and children. The decision was taken, however, to have as part of the National Health
Service a comprehensive dental service for all. This decision was pressed forward in spite
of the warnings of the dental profession that the number of dentists available was not
sufficient to meet the foreseeable demand. A ' priority dental service ' was included in this
comprehensive service and the duty of administering this most important section of the
dental service was placed upon local health authorities. The Ministry of Health undertook
the administration of the general dental service and of the hospital dental service and by
offering to the dental profession remuneration on a scale of fees basis, an average aggregate
far beyond salaries payable by local authorities, satisfactory recruitment for the priority
dental service became virtually impossible. In the free-for-all for staff local health authorities
cannot, without disrupting their entire salary and wage gradings, compete with the
Ministry of Health and in the free-for-all for treatment, adult patients on higher scale of
fees are more likely to be successful in obtaining it than are children for whose treatment
payment is often less. The ' school dental service', which had been in steadily expanding
existence prior to the advent of the National Health Service, suffered grievously after the
appointed day (5 July, 1948) while a priority dental service for expectant and nursing
mothers and for pre-school children failed to materialise. Local health authorities to-day,
if they are able to run any dental service for mothers and pre-school children, do so in an
extremely meagre form. The ' priority dental service' so far has gone, with other good
intentions, to help pave that famous road; if in fact it has not already arrived at the road's
termination.
At the time public dental schemes, particularly those for schoolchildren, were initiated,
two factors were present, widespread obvious gross dental neglect and the personal cost
involved in seeking private treatment. Against that background a strong and relatively
efficient school dental service was growing and working; working so effectively that, in the
years immediately prior to 1948, in many schools grossly neglected mouths and acute
dental distress had been virtually eliminated. Frequent dental inspections were carried out
by dentists, followed in the vast majority of cases by treatment of the children found to be