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filling the carious cavity is also to be ranked as a measure of
prevention, inasmuch as the condition is at once prevented
from spreading. The question of treatment is thus linked
up with the means of prevention. The alternative to filling
a decayed tooth is to extract it. This should rarely be necessary
provided the teeth have been carefully looked after.
Unfortunately this counsel of despair is too often the only
treatment adopted. The teeth of children should not be
extracted unless there is severe toothache, or serious overcrowding
of teeth, or else the doctor is satisfied that the
presence of the decayed teeth is injuriously affecting the
child's health. The consequence of extracting the first teeth
is to prevent proper development of the lower jaw, and consequent
overcrowding of the permanent teeth. What, then,
is to be done with decayed teeth in childhood?
The treatment should be essentially conservative, that is
to say, it should aim at taking the decay at its earliest stages
and preserve the teeth.
The first of the permanent teeth appears in or about the
seventh year of life, and it is to the preservation of the
important permanent teeth that the attention of the dentist
should be directed.
The problem confronts the educational authorities as to
how best to deal with dental caries, now that they have legal
powers and some financial inducement to do so. The matter
has already been approached in some districts by the appointment
of special school dentists. Is there any need for a
school dentist in Ilford? From the experience of the School
Medical Inspector practically nothing is done by parents at
present to treat dental caries. There are some three or four
qualified dentists practising in Ilford, and there is reason to
think that their time is already fully occupied in the treatment
of adults. Possibly one or two of them could give part
of their time to the treatment of school children. The