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47
Secondly, the next line of defence is the maintenance of
cleanliness of the teeth and mouth, obtained by training in the use
of the tooth brush. What is called tooth-brush drill has been
instituted in many schools, and it is claimed that in such schools
dental caries is less prevalent. Unless care is exercised, the use
of the tooth brush by children may do almost as much harm as
good. There can be no doubt that much depends upon the manner
in which the teeth are brushed. The fact is frequently overlooked
that dental caries, in the large majority of instances, commences
in the crown of the tooth, in the part, that is to say, not infrequently
left untouched by the brush. The molars at the back of
the mouth which undergo decay, in the first instance, remain
untouched.
Apart from its effect upon the cleanliness of the mouth, the
institution of a tooth-brush drill in the school would facilitate the
work of the dentist. There is a necessity for a preliminary and
persistent working up of the districts in which a clinic is placed,
and there will always be a residuum of recalcitrant parents who
decline to allow their children's teeth to be treated.
Thirdly, every effort should be made to arrest dental disease
at the very outset, and this aspect of the question is the one which
more particularly bears upon the action of the Committee.
The treatment by conservative methods of all existing disease
in children, both younger and older, may rightly be regarded an
impossible task, and, at present, at least, outside the range of
practical politics; but treatment of dental decay at its earliest
manifestations in the newly erupted teeth of the permanent set,
i.e., between 6 and 8 years of age, has been shown to be quite
feasible, and to be productive of results fully commensurate with
the expenditure incurred. In no disease is it more imperative
to view the actual treatment from the point of view of prevention.
We doubt if the Board of Education will sanction any scheme in
which the treatment is not based on preventive lines. Treatment
must begin from the first moment disease shows itself, and, indeed,