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103
It is apparent from the above figures that only a small proportion of the routine cases actually
receive treatment.
The result of this is, that the mouths of the great bulk of children are left untreated and become
in a progressively worse condition as revealed by the school inspections.
The reasons for the small attendance of routine cases are as follows :—
(1) The following-up of cases is limited to one visit by the Health Visitor, and this is
sufficient.
(2) The payment of 2/6 is an obstacle to the re-treatment of routine cases. Parents
willingly pay the fee for the urgent and special cases, but are not prepared to pay
it in the case of minor defects, which are those which should be dealt with in order
to prevent gross conditions of the mouth.

It is evident from the above table that the alteration in the scheme has resulted in an increase
in the attendance and the amount of work done at the Clinics. Considerable difficulty is now being
experienced in dealing with this increasing amount of work, and, in order to cope with it, one extra
session has been allocated to treatment since April 20th, 1925. A dentist now spends 4 sessions per
week on dental inspection at the schools and 7 sessions per week on dental treatment. However
satisfactory this increase may appear to be from the point of view of providing dental treatment, it
is really work of a character outside the proper scope of a dental scheme as defined by Sir George
Newman in the report quoted above. The dentists are at present engaged in dealing with cases (of
which approximately 50 per cent. are specially referred) of the most neglected and difficult type
requiring many visits before their mouths can be put into reasonable order, instead of the treatment
and completion of a large number of children with minor defects.
The treatment given is therefore very largely of a palliative nature, instead of being preventive
and constructive, in accordance with the principles laid down in the Chief Medical Officer's report.
6. Recommendations.—I beg to submit the following recommendations for the consideration
of the Committee, whereby the scheme may be brought into accord with the principles laid down by
the Board of Education :—
(1) That during the year 1926, all children under 9 years of age (approximately 9,000) be
inspected and offered treatment, together with such special cases (see recommendation 5)
as may attend for treatment at the Clinics.
(2) That during the year 1927, an increase in staff of one dentist be made, this increase in staff
being necessary to deal with the extra work entailed by the influx of entrants to the
schools, the probable increased demand for dental treatment, and especially the need
for regulation of the teeth generally required about the age of 9-10 years.
(3) That provision be made for the addition of dentists in succeeding years until the staff is
sufficient to cope with the dental care of all school children. (Probably 5 dentists in all
would be required for school work.)
(4) That all cases referred from routine school inspections be visited by the Health Visiting
Staff at least 3 times.
(5) That the present charge of 2/6 be operative only in cases specially referred to the Clinics
and not arising out of routine inspection.
(Note.—Every effort should, in the opinion of the dental staff, be made to reduce the
number of special cases—as they are a hindrance to the successful working of
any dental scheme—and to encourage the conservative treatment of early dental
caries.)
(6) That tooth brushes be supplied at the Clinics free or at cost price, depending on
stances.
GEORGE F. BUCHAN,
Medical Officer of Health.
To be presented to the Children's Care Committee at their meeting on 9th December, 1925.