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it must apply with added force to the treatment of children who have
not yet reached school age. In attempting to treat conservatively
the teeth of pre-school children the dentist has to contend not only
with the technical difficulties referred to by the Chief Medical Officer
but with additional difficulties associated with the extreme youth
of the patients. Large numbers of these children, entitled to treatment
under Maternity and Child Welfare dental schemes, are mere
babies between the ages of 2½ and 3½ years, and any treatment of their
teeth requiring the use of the dental engine is attended with obvious
difficulties. Difficulties of treatment are additional reasons for
emphasising the importance of prevention, and while our present
knowledge does not permit us to say that dental disease can be entirely
prevented, it does permit us to say that it can be controlled. The
good teeth of children brought up in institutions illustrate how the
incidence of dental caries can be reduced when errors of diet are
avoided. Mr. F. Breese, L.D.S., Eng., in a paper given before the
Dental Officers group of the British Dental Association a few years
ago, gave particulars illustrating the comparative freedom from dental
caries of 600 children in a large Poor Law Institution. These
children had been under his care for 24 years, and during the whole
of this time he had kept a record of their dental condition. Many
other dentists holding appointments with Institutions have given
similar evidence of the superior dental health enjoyed by these children.
It cannot be said that the law of heredity favours Poor Law children,
nor that before entering the institution their environment is better
than that of the average child—the contrary may, in fact be presumed.
There is no doubt that the main factor responsible for the good
teeth of children living in institutions is the avoidance of those dietetic
errors that Dr. A. Jefferis Turner, M.D., D.P.H., had in mind when
he said in the course of a lecture: "It would almost seem that we
feed our children expressly with the object of destroying their teeth.
Not content with three meals a day, many mothers give biscuits and
bread and butter between meals, at irregular intervals, so that the
teeth are never free from their debris. Fruit is not looked upon as
a regular article of diet to be given at meal times and especially at the
end of a meal, but as a luxury to be given between meals and often
in excessive quantities. And to make things sure, we give them
large quantities of concentrated sugar in the form chiefly of soft
sweets."
With regard to changing habits of diet, it has been truly said that
parents will do for their children what they will not do for themselves
—and, it may be added, many parents will do for babies and young
children of pre-school age what they will not do for older children.
If the simple rules of prevention, which inflict no hardship on the
child and can be applied by rich and poor alike, were advocated with
persistence, conviction and enthusiasm by all interested in dental