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139
with subsequent irregularity and decay, might often readily be checked
by a very slight degree of treatment of the temporary teeth, and instruction
could be given to mothers in questions of diet and other factors
towards the prevention of decay as distinct from its early cure when
present: while dental treatment of expectant mothers or of nursing
mothers would not merely improve their own health and through them
the health of the child, but would alter their attitude towards the whole
question of the care of the teeth. Such direct and indirect instruction
would cause a gradual decrease in the proportion of school children
needing dental treatment on admission to the elementary school, and
general economy of effort as well as improvement in health and physique
would result. The importance of the extension of instruction in this
direction is shown by the fact that recent research suggests the likelihood
of the quality of a child's teeth being settled even before birth by the
diet of the expectant mother. Similarly, the fact that rickets, a disease
almost entirely of infancy and early childhood, is responsible for much
of the decay seen in the permanent teeth of the 6 or 7-year-old child,
shows a need for extending preventive measures back to the early life
of the young child.
The treatment of children under school age and the instruction
and treatment of their mothers does not fall within the province of the
Education Committee, and proposals will be set out below for a portion
of the dentists' time to be offered to the Public Health Committee for
work under their Child Welfare Scheme, dealing with mothers and
expectant mothers and with infants up to the age of 5. A corresponding
proportion of the salaries of dentists and of the expenses of the clinic
would in that event be debited to the Public Health Committee. That
Committee might very probably decide to devote a portion of the dental
services thus allotted to them to their tuberculosis as well as to their
maternity and child welfare arrangements.
(5) Only 44 per cent of the 6-year-old elementary school children
in Croydon needing dental treatment actually obtain it. In some towns
this proportion is as high as 70 or 80 per cent. The low figure in
Croydon may be in part due to the type of the population, but it is
no doubt in large part the result of apathy due to the ignorance
of parents as to the urgency of the need for treatment. Such
ignorance can be dispelled toy dentists, nurses, teachers, and care committees.
It is suggested below that the proportion obtaining or accepting
treatment would be materially increased it the dentists had the
opportunity of addressing the parents of children undergoing inspection
(as distinct from re-inspection), at the time of his visit to the school, and
of pointing out the reasons why treatment should be provided promptly.
Owing to the brief nature of the inspection of each child and the large
number of children to be inspected at any given session, it is not practicable
for parents to be present during the course of dental inspection at
school. It is, however, suggested that a ten minutes' talk to the parents,
at the end of the session, should be regarded as part of the dentist's
normal programme of inspection, and suitable arrangements should be
made with head teachers for the parents to attend at the end of a session
for that purpose. At the same time the details of the machinery for
following up and urging treatment will receive attention.
(D). Proposals for Development of Dental Scheme.
The suggestions are, briefly:—
(1) To make the fullest possible use of the present dental clinic.
(2) To introduce systematic annual re-inspection, extending its
scope year by year.
(3) In due course, to commence dental inspection at 5 instead of
at 6 years of age.