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55
prevent dental caries and one must assume that many factors play
an important part in the cause of the present large amount of this
disease. On the other hand, it is a fact that children of the wealthier
classes and children brought up in institutions suffer less from
dental caries than children attending elementary schools. Apart
from this it is gratifying to note that as each year goes by we are
able to record a larger proportion of fillings to extractions. This
means that more children are accepting treatment before the teeth
are so bad that extractions are inevitable.
In the latter part of his report, Mr. James points out the
necessity for the treatment of children over the age of fourteen.
The County Council are arranging for dental treatment to be
provided for the children of Middlesex attending secondary schools
and in this way part of the need for dental treatment of children
over the age of fourteen will be met.
I am glad to report the success of the session which is now held
regularly once a fortnight for the extraction of teeth under nitrous
oxide gas. I consider this to be a welcome addition to our school
dental service.
In a special examination Mr. James carried out of 898 children,
only eleven were found whose teeth had never been attacked by
dental caries. Mr. James has attempted to show some of the factors
responsible for this condition in these eleven children. His report
does not show that breast feeding is essential in the prevention of
dental caries, for some of these children were bottle-fed in infancy;
nor does it show that incidence of infectious disease causes dental
caries. One factor is of importance, namely, that there was evidence
to show that other members of the family were equally free from
dental defect. This may be due to hereditary influences; on the
other hand it may be due to the fact that other members of the
family have been brought up by similar methods and on a similar
diet.
The report of the School Ophthalmic Surgeon shows keen interest
in the care of children who are suffering from squint and myopia
(short sight). During 1933 children requiring treatment that could
not be obtained at the Eye Clinic were sent to the Western Ophthalmic
Hospital. The hospital admitted ten children for operative
treatment and in addition to this 68 attendances in the out-patient
department were made by Enfield children. This service has been
carried out in the past as purely voluntary work by the hospital.
In view of the satisfactory results that had been obtained and the
increasing number of cases that are being referred to the Western
Ophthalmic Hospital especially for squint, arrangements have been
entered into with this hospital in the early part of 1934 whereby