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SCHOOL DENTAL SERVICE
Mr. G.C.H. Kramer, Principal School Dental Officer, reports as follows:-
"The year has brought both disappointment regarding the level of routine inspections in schools
and satisfaction that it at last became possible to introduce the precautionary blood-testing of
certain groups of patients before the administration of general anaesthetics.
The general pattern of the service provided again followed that of previous years and. staffing
difficulties notwithstanding, the average and total 'productivity' were well maintained, with a small
but pleasing increase in teeth saved and reduction in those extracted.
The relevant figures are set out in full at the end of this report, but comment on certain aspects
is necessary.
Inspection and Treatment
The number of pupils on the school rolls as at 31st December was 35,952, a mere 140 more than a
year ago. Routine dental inspections in schools occupied 144 sessions, 40 fewer than in 1968,
during which 12,452 children were examined for the first time in the year, and a further 3,849 were
first examined in the clinics. Together, these 16,301 on whom a check on the dental status was
possible represent only 45.3% of the school population: worse even than the low level of 53% the
previous year which was itself unsatisfactory. However the more recent figure does include a
higher proportion of children in primary schools who, because of their age. are more at risk of dental
decay and less likely to have established routine treatment with the 'family dentist'. Being
unable to meet the whole of our duty, to inspect, we have used inadequate resources quite deliberately
for those in greatest need. In addition to the insufficient number of surgeries and/or dental officers
in some parts of the Borough where the demand is heaviest, we have had the continuing mal-distribution
of schools-to-clinics necessitated by the building of the new Stuart Crescent health centre in Wood
Green.
Of the total of 18,498 children first or re-examined in the year, treatment was required by 11,305 or
61.1% — as compared with 64.4% in the previous year.
/ am afraid that the reduction is by chance and not statistically meaningful, but should very much
like succeeding years to show that this was the beginning of a trend towards a better level of dental
health among our child population.
One thing which figures of the past several years have convinced me is being achieved, albeit
very slowly, is that we are arousing greater interest in obtaining treatment. The numbers rendered
dentally fit who then, at the usual sort of interval such as six months approach their clinic for
re-inspection and necessary treatment, is increasing. In some ways we are making a rod for our
own backs in creating an even greater demand, but perhaps / can be forgiven for feeling pleased
if our message is getting over.
Whatever slight improvement may have occurred, it does little to reduce the appalling amount of
treatment needed by our children, and only in future fluoridation of the water supplies can / foresee
a real answer to the problem.
Blood Testing of Certain Ethnic Groups
Recent years have brought increasing awareness that blood abnormalities found among people from
certain overseas countries, of whom there are many resident in the Borough, may present a threat
to life or health when a general anaesthetic needs to be administered for any purpose. As well
over one thousand are administered each year in our dental service, it would be less than reasonably
careful if no account was taken of the risk and steps taken to avoid danger to our patients.
Children suffering from the most severe types of these abnormalities may be expected already to be
known to us, unless they have very recently arrived in England, because of the effect on health
already having been recorded. If any such information came to the notice of the Health Department,
it would be passed to the dental clinic responsible for that particular patient through the 'Dental
At Risk' register which contains details of patients with any defect needing to be noted on the
dental record card as a permanent warning. However, it is always possible that a small number
of even serious abnormalities remain unknown, and it was certain that less serious and obvious
conditions were to be found deserving of particular care, and use of a modified technique if general
anaesthesia was necessary.
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