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285
It would appear from records of refusal cases that the number
increases after the age of 10 years. In an attempt to counteract
this the method suggested by Dr. Weaver of the Board of Education
might be tried. Dr. Weaver suggests that parents should be asked
at the time of the first examination of children, to accept regularly
conservative treatment during the whole period of school life, and
that such cases should receive first claim on the services of the
school dental officer on the grounds of economy and efficiency.
Those parents who did not so agree would be given to understand
that their children could only receive such attention as was possible
after the first claims had been dealt with. There would appear to
be no difficulty in explaining such a position to parents and securing
their support, or otherwise, at the time of the first inspection of
their children.
Malocclusion and the Premature Removal of all the Deciduous
Molars.
The majority of the 5 and 6 year old have very carious and
septic teeth which are beyond any form of conservative treatment
and therefore have to be extracted. When the dental officer
examines many of these children he is confronted with two possible
lines of treatment: either to remove an aching tooth and leave the
other carious teeth until they give trouble or to extract all the molar
teeth and so give the patient a clean mouth. In view of the fact
that septic teeth may give rise to a considerable amount of ill-health
the latter method of treatment is to be recommended as the risk
of subsequent malocclusion is not so important as the risk of illhealth
through retained septic teeth.
In 1936 the incidence of malocclusion was 4.99 per cent, of the
total number of children inspected, and in 1937, 3.2 per cent
The information obtained from these surveys does not appear to
support the contention held by some dentists that the premature
extraction of temporary teeth (specially the molars) increases the
incidence of malocclusion in school children. The clinical examination
of cases does, however, suggest that the early loss of thp
deciduous teeth produces special types of deformity. One of the
\ssistant Dental Officers investigated a number of cases in which
all the temporary molars had been lost at an early age and he found
that there was definite evidence that certain types of malocclusion
were associated with the premature extraction of the temporary
molars. The deformities appear more pronounced if seen before
the eruption of the six year old molars. When the molar teeth
are extracted in a child of five years practically all the stress of
mastication is taken by the four canines, which is a very