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153
Reasons for Refusal of Treatment.
Apart from those receiving bone-fide private treatment, the
main reasons for non-acceptance of treatment would appear to be
as follows:—
(i) Indifference of Parent.
These represent a comparatively small minority. Any
efforts to assist are as a rule resisted—even medical examination
is disliked. Except in the case of relief of pain, very
little can be accomplished.
(ii) Difficult Home Circumstances.
The above represent quite a substantial proportion of the
total. The child is often found to be living with an elderly
relative, owing to the fact that the parents are either
"separated" or both at work. These children are sometimes
brought to the Clinic by a friend or elder child for relief of
pain. Such patients are usually quite amenable, though it is
difficult to enforce regular treatment.
(iii) Lack of appreciation on the part of Parents as to the
value of early treatment.
The latter is more commonly manifest with reference to
the temporary dentition. After "refusing" at the time of the
school inspection, the child is later brought to the Clinic
when in pain, requesting "extractions" but "no fillings."
After a suitable explanation many parents show a favourable
reaction and accept the requisite treatment.
(iv) Fear of the Dentist's Chair.
Patients in this category are by far the most difficult to
deal with, as their condition is largely psychological and they
will often endure prolonged agony rather than present themselves
for treatment. In such cases contact can sometimes be
made through successful treatment for a friend, or a chance
meeting with the parent. Once confidence has been established
the sufferer may attend of his own volition and
becomes amenable to treatment. Should parental control be
entirely lacking very little success can be expected with these
cases.
The foregoing remarks are intended to illustrate some of the
difficulties encountered in dealing with "recalcitrant" cases. In
View of the social issues involved progress in winning over such
children is bound to be slow, and therefore no large scale
improvement can be hoped for in the immediate future.