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preliminary clearance of gross and general dental disease from large masses of patients,
which is all that has been done so far for the school population.
To meet the day-to-day haphazard demand for treatment is not of itself sufficient to
produce dentally fit school leavers. Caries incidence is very high in schoolchildren and only
a limited number of children can be cared for properly by limited staff. If the children of
this country are to receive proper dental attention, there will have to be much fuller use of
the general dental service on their behalf by their parents and the general dental service
will have to be re-organised to meet such need; while the school dental service will have to
be reorganised to give better attention than previously to the patients and children who
trust themselves to that service.
In a school dental service the location of treatment centres is of paramount importance.
The generally adopted method at present of area clinics with potential patients in surrounding
schools would appear to be out-moded.
School-time loss and parental escort problems militate against attendances and many
opportunities for treatment are lost and much administration effort is wasted by rejected
or broken appointments.
If, as far as possible, surgeries were housed in schools, dental education on prevention
and reparative treatment could be given on the spot, with the minimum interference with
the school curriculum and the maximum use of the dental staff and equipment. Frequent
dental inspections or classifications of children en masse are anachronisms: by abandoning
them much time could be saved for all concerned. Every child should have a regular check
up, which could be carried out so easily with proper instruments and under proper conditions
if the surgeries were located in schools.
Mothers, so many of whom in addition to their domestic work are employed elsewhere,
would be relieved of the problem of seeking ' time off'—not to mention the probable loss
of earnings.
An overall shortage of dentists has been repeatedly advanced as the causative factor in
the inadequate service still given to children in dentistry, but the overall shortage is true
only because priority of planning and consideration was given to producing a general
service instead of the priority service for mothers and children. In the overloaded ship of
dentistry the cry of' women and children first' should have been honoured!
To combat the alleged overall shortage of dentists the Government has embarked
(September, 1960) on an experiment, in conjunction with the General Dental Council, in
utilising specially trained dental ' auxiliaries'. To train a dentist takes about five or six
years and the intention of the experiment is to train girls as auxiliaries in two years. It is
intended that after training they will be utilised by local health authorities to provide
certain treatments under supervision for children. The idea is based on the assumption that
much of children's dental treatment is ' simple ' and that, with specialised training in that
section of the work, these girls will be beneficial to the local health authorities' under-staffed
dental services. Unfortunately, the girls' operational activities are restricted by law and in
many mouths they will therefore be unable to give all the treatment required. Who is to be
available to complete the presumably ' difficult' dentistry is not yet clear, nor is it clear how
the differing proportions of ' simple' and ' difficult' can be reconciled with the time,
accommodation and staff factors involved. The practical application of partly trained
dental operators restricted by law will present many problems. The experiment is under
the direct guidance of the General Dental Council and is patterned largely on the New
Zealand Dental Nurse Organisation where ' dental nurses' treat schoolchildren. These
New Zealand nurses concentrate their efforts on the lower age groups commencing at
age 2\ and are confined to a staff-patient ratio of 1-500. As there are not sufficient nurses
at this ratio to cover the entire school population in New Zealand, older children who are
not reached by the dental nurses are farmed out to local general practitioners who receive