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From the total of 962, there were findings directly of concern to us when general anaethetics were involved
for 52 children. All but two of these required only the knowledge of the condition to ensure a modified
anaesthetic technique, and it was thus possible to avoid a risk which otherwise could have obtained.
The other two, however, would have been put at very serious risk indeed if we had not known of their
conditions, and if the avoidance of this had been the only result of 962 tests over the whole period, / should
still judge all the work and effort involved to have been fully justified.
The first and less serious of these was a six year old little boy due to have all eight deciduous molars extracted
three days after the blood test report showed that he was suffering from a serious iron deficiency anaemia
with a haemoglobin level of only 43%. The extraction appointment was cancelled and the condition notified
to our medical service who acted immediately. The child needed to be admitted to hospital for blood transfusions
and was put onto suitable iron supplements, and was discharged fit three weeks later. The necessary extractions
vxre done when we had reliable information that no risk remained.
The second case was a seven year old boy who, surprisingly, was a hitherto undiagnosed true sickle-cell anemia —
although subsequently we discovered that two siblings had died of this condition before the family came to
England — and it was possible to avoid the child being put at risk of the most dire consequences.
In my report last year on this subject / wrote "It is not, of course, possible to know or even theorise as to
whether or not any serious difficulties with general anaethesia have been avoided by possession of knowledge
gained....That was true when it was written, but / have no doubts that the reverse is now the case.
In addition to the foregoing findings, results of a further 153 tests have been the concern of the medical
service in smaller degree, while not being in any way of significance for dental treatment.
As far as / am aware, we have been the first local authority in the country to have such an established system
of precautionary testing before dental anaesthetics, although it has been usual for some time in the hospital
services if members of these ethnic groups need an anaethetic for surgical procedures.
We have now had a number of interested enquiries from various public services as to our methods and the
results being obtained and / have recently been told that what / believe to be our pioneering work in Haringey
is to be followed in some other places.
Fluoridation
The widespread problems arising from dental decay, either of itself or from its consequences, continue to
cause me deep concern.
The average standard of dental health in our Borough is, to put it no higher, poor: yet it would require
combined resources of our service and the general dental practitioners far in excess of any possible to envisage,
if all necessary treatment were to be provided.
Although some people sincerely feel that there are good reasons why fluoridation of the piped water supplies
is not acceptable, in the capacity in which / serve the Borough / must continue to view the matter from a
purely professional angle and fervently hope that this measure will be brought into effect.
My own feelings are expressed admirably by some words written in the annual report of the Chief Dental
Officer of Sheffield 1969
"Failing to fluoridate the water supplies does not add to our difficulties, it neglects the opportunity of
halving them."