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24
With the present accommodation even the appointment of
an anaesthetist would be no remedy, as no other work could be
done in the same surgery during an anaesthetic session.
Secondly, approximately four sessions weekly, say 184
annually, are given to work which, in the words of the Board of
Education, 'tends to impair the efficiency of the scheme.' I refer
to the treatment of children other than those who attend as the
result of systematic inspection, or, in other words, to the treatment
of 'Casuals.'
If there is one point upon which all school dental officers are
agreed, it is that this continuous granting of treatment to patients
who have previously persistently refused it is thoroughly wasteful,
prevents the best treatment for those who are desirous of receiving
it, and in fact tends to reduce the status of the dental surgeons to
that of the old time 'market place' practitioner.
While it is possible for parents disdainfully to refuse the offer
of correct dentistry and then in their own good time demand and
receive attention, no dental scheme can be truly satisfactory or
produce the desired results. The treatment of the willing patient
will lag behind, annual treatment cannot be given them and the
condition of their mouths will have deteriorated accordingly.
Longer time will be required to restore their mouths to health, and
it becomes progressively more difficult to achieve the satisfactory
results that would accrue from a truly preventive scheme.
I say without fear of contradiction, and with the full support
of my colleagues, that the elimination of these persistent refusals
from the dental scheme is the only way to ensure a satisfactory
service. This policy may, at first consideration, appear somewhat
drastic, but I am convinced that it would result, and speedily, in
such a rapid reduction of refusal of preventive work that the
necessity for so much extractive work would no longer arise.
Even if it were not considered advisable completely to refuse
treatment to those patients for whom it had previously been rejected,
they should certainly not be treated at the same times and preferably
not in the same premises as the willing patients. It cannot
be too strongly urged that a school dental clinic is a place for the
preservation of dental health, and not for the haphazard extraction
of aching teeth.
There is another and not unimportant point that arises in
this connection.
Almost without exception the few complaints that are made
are from this class of parent. As is to be expected, the child that
has not received treatment for long periods has an unhealthy mouth.