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155
systematic dental check-up followed by any treatment necessary; that in turn should be
followed by revisional checks and treatment if their developing mouths are to be aided to
grow to healthy maturity.
Parents desirous of looking after their child's dental health properly should strive to have
their child accepted for regular dental treatment at either a school treatment centre or a
private surgery. In the preceding sentence ' strive' may be the operative word. Private
surgeries may be unable owing to pressure of work, or unwilling for a variety of reasons,
to accept a child patient and a school treatment centre may be unable to offer regular
dental attention because it has too large a school population for its limited resources.
Most local authorities adopt a policy of a spreadover service for all their schools, which
policy is dependent for its efficiency and effectiveness mainly upon the dental staff available.
However necessary such a policy of spreading the butter' may be for political, financial or
administrative reasons, it is most unpalatable professionally. Where staff is far below
professional requirements, resultant patient-staff ratios render proper professional attention
impossible for large numbers of patients. The service becomes one of haphazard treatment,
much of it pain relief only, instead of systematic dental care and inspection of a number of
patients within the potentiality of staff available. The computation of the potentiality of a
full time dental officer is simple if the assumption is accepted (in fact an over-simplification
and an under-statement) that on average a child can be kept dentally fit by the expenditure
of one hour's professional dental attention per annum. As full-time dental officers with
local health authorities under Whitley Agreement organisation function for 33 hours per
week and have approximately five weeks holiday per annum, working hours per annum are
1,551. On the assumption advanced, a full-time dental officer's potentiality is about 1,500
children per annum. The figure is supported by the British Dental Association and the
reports of many experienced dentists.
In reply to a question in the House of Commons in 1952, the Minister of Education
indicated the desirability of achieving a standard of 1-3,000, which was subsequently
endorsed as ' reasonable ' in a report of the Chief Medical Officer to the Ministry of Education
(Health of the School Child, 1954 and 1955). One must assume that the anticipation was
that approximately 50 per cent, of the 3,000 would not attend the school treatment centre,
but would seek dental attention elsewhere.
This standard was accepted by the Council, which in 1952 laid down as its official policy
to aim at a ratio of one full-time dental surgery for each 3,000 children of school population.
In the Council's nine health divisions the policy gun was aimed and may even have been
fired, but in no division has the target been hit. Present average staff-patient ratio for the
county stands at 1-6,800. The disparity is even more ridiculous in many other local health
authority dental services.
The result of such a meagre spreading of ' dental butter' is that when children are
rendered dentally fit, sometimes after a lengthy and expensive course of treatment, they are
returned to school to wait far too long a period before there is hope of another official
dental check. Without revision within not more than twelve months of the work carried
out, much of the dental treatment given to children is unlikely to prove successful. In many
instances long neglect between treatments must lead to dissatisfaction with and distrust in
the treatment already given. It is thought that the lack of proper revisional treatment
facilities does more to drive dental surgeons away from children's work in local health
authority treatment centres than does the factor of differences in remuneration. No dental
practitioner of quality could view with equanimity and complacency the prospects of
attempting to give a service to six or seven thousand patients per annum, particularly
when a good and co-operative patient is denied revisional treatment until perhaps two or
three years have elapsed. A means will have to be found by which co-operative patients
receive a much higher standard of treatment when their dental well-being is entrusted to the
school dental service. Dentists are trained as individualists and to treat conscientiously the
individual patient. Few dentists apparently gain much satisfaction from contributing to the