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fortable position for the child to bite and soon there is a tendency
for one of the canines, usually an upper one, to move lingually,
distally, or labially, which allows the jaw to swing to one side and
produce a "cross-bite," with interlocking of incisors. It would
seem that a certain amount of malocclusion could be prevented by
extracting the two lower canines at the time the molars are removed,
or by stoning off the tips of the canines. The results of this investigation
emphasise the need of orthodontic clinics as a part of the
school dental service. The types of irregularities described are of
course sometimes found in dentitions which have not been mutilated,
and it is possible that some cases of malocclusion in which
the premature extraction of the teeth has been thought to be the
cause, may not in fact have been the etiological factor. Further
investigation is, therefore, necessary with controls in cases where
irregularity exists but with all the teeth present; those in which
the molar teeth were removed in early life but with no subsequent
malocclusion, and lastly where there has been premature extraction
of the temporary teeth and irregularity is present.
Attendances and Charges For Treatment.
The total number of attendances for the year was 19,225 as
against 14,749 in 1936. The charge for treatment up to August
29th, 1937, was 8d. per attendance and 2s. for each "gas" administration.
It was considered that the attendance fee did in certain
cases create a difficulty for some of the indigent parents, who
although they were entitled to free treatment were too reticent
about their straightened circumstances to acquaint the dental clinic
of their position, and paid when they could not afford it, while
others may have adopted the extreme attitude of not consenting to
treatment because they could not pay the fee and did not wish to
disclose their inability in regard to payment. In the light of this
information it was decided to have a flat rate charge of Is. for one
year's treatment (dating from the day of the first attendance).
The fee for each "gas" administration is 2s. as before. Whilst
the initial fee of 1s. is higher than the attendance fee previously
charged, it is in the ''long run'' cheaper for the parents since each
child makes at least two attendances for completion of treatment.
It is the opinion of all the dental officers that this charge has
already resulted in an improvement in the attendances and the
considerable increase during the last quarter of 1937 would suggest
that parents appreciate the new system of payment.
The sum of £590 18s. 8d. was received in payment for treatment,
and £4 1s. 9d. was received from the voluntary box contributions.