View report page

114
I wish to draw particular attention to the figures relating to
fillings inserted and extractions carried out. It will be noted that
the number of teeth extracted reached the large total of 7,893
—the highest yet recorded in the Enfield School Dental Service—
while the number of fillings, although it remains high, is less than
the corresponding number for any of the three previous years.
Children attending the clinic as "specials" on account of pain
or sepsis have tended to increase during recent years, and there
can be no doubt that the time necessary for the treatment of
these children is responsible for the reduction in the amount of
conservative work carried out during the year under review. The
aim of the school dental service is "to secure that as many children
as possible leave school without the loss of permanent teeth, free
from dental disease, and trained in the care of the teeth." Large
numbers of children attending the clinic as "specials" have,
in previous years, been offered conservative treatment which has
been refused, and it is obvious that the main purpose of school
dentistry will not be advanced if an increasing amount of time is
devoted to extracting teeth for children whose parents only value
the school dental service as a means of relief from pain. In order
to cope with the problem presented by large numbers of "casuals"
it has been suggested that when parents apply for treatment for
their children after first refusing it, such treatment should not be
given until after the next routine inspection, and then only if a
promise is made that treatment will in future be regularly accepted
as offered by the dentist. It would be incorrect to assume that
this procedure would result in children being left in pain, as many
dentists in Enfield will perform extractions for a fee well within
the means of most parents. Occasional sessions for emergency
work are unavoidable, but when the time devoted to such work is
found seriously to affect the general educational scheme of
conservative dentistry a policy of restriction is necessary. On
account of the steady increase of " specials " treated during recent
years, as shown in the following table, it is submitted that some
such procedure as the one indicated should now be adopted in
Enfield.
Number of
Year. Specials treated.
1935 616
1936 1,054
1937 1,514
1938 1,638
In all Public Health work great emphasis is rightly laid on
prevention, and the enormous amount of dental disease that prevails
makes this emphasis particularly important in school dentistry.
There are three rnain avenues of approach to the ideal of prevention.