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ANNUAL REPORT OF ORTHODONTIC CONSULTANT.
In submitting this report on the work carried out by the Orthodonic Section of the Dental
Clinic during the year 1933, I feel that a favourable opportunity is presented to me to draw
attention not only to the specific activities of the Section but also to put before you a larger and
more comprehensive view of Orthodontic activity at Dental Clinics. I should like to indicate my
views as to the future possibilities and worthwhileness of the Orthodontic Clinic generally—
possibilities in which I have the profoundest faith and optimism; a worthwhileness which I am
convinced merits the closest attention on the part of Public Health Authorities.
It must be a matter of considerable pride as well as of importance to realise that the
Orthodontic Section of the Heston and Isleworth Public Health Department represents the only
such scheme now in operation which can claim the official recognition of the Board of Education.
At its inception in 1930 and throughout the ensuing three years the Section was of necessity
conducted in co-operation with the Royal Dental Hospital because with such a highly specialised
branch of dental surgery it was essential for the patients receiving treatment to visit the Hospital
and undergo a specialist's examination. The specialists could then submit a report on each case to
the Clinic's Dental Surgeon who had entire charge of the subsequent treatment.
The Royal Dental Hospital.
At this point I should like to say how great is the appreciation due to the Royal Dental
Hospital and the members of its staff who gave their opinions on the cases submitted. Without
their assistance it would have been impossible to establish the Orthodontic Scheme on a satisfactory
basis. I should like, moreover, especially to emphasise the indebtedness of the Clinic to
the Hospital's Medical Registrar, Mr. E. Faulkner Ackery; only by reason of his personal interest
and activities was it possible to interpolate the additional work emanating from the Clinic into the
normal Hospital routine without causing grave inconvenience and delay to an institution already
working at high pressure.
In August, 1932, I was appointed Orthodontic Consultant to the Clinic. I am, therefore,
now in a position to report on the progress of the Scheme, firstly, by reason of my early association
with the organisation of the necessary arrangements carried out at the Hospital, and secondly, by
reason of the very much closer contact I have established in the course of my duties since taking
office with you eighteen months ago.
It is my desire to examine the subject of Orthodontics in school clinics from the angle of
Public Authorities, to consider the point of view of the recipients of the treatment, and to
acknowledge the efforts of those who have contributed so much hard work in bringing the Scheme
to fruition.
Early Misgivings.
I must admit that when I was first approached with a view to co-operation in the formation
of a complete Orthodontic Scheme, I was inclined to the view that here was an attempt to attain
the impossible. It seemed to me then that it would be impracticable to devote such time as
Orthodontic specialisation would demand without interfering seriously with the ordinary routine
dental work of the Clinic.
The pessimism implicit in the foregoing misgivings may perhaps be excused when it is
remembered that had first and foremost determined in my own mind to leave no stone unturned
in order to carry the Scheme to a successful conclusion, should I eventually undertake the suggested
programme. I did not intend to accept the responsibility of fostering so important a
Scheme by merely dabbling on the fringe of the subject.
Furthermore, it was apparent to me at the outset that in order to attain the success I wished
for the treatment of malocclusion would have to be truly comprehensive and not merely selective
as had been—and still is—the case at other Clinics. My goal was to be the assurance of adequate
treatment for all applicants with but a single session per week. And this, I feared, would prove
harder of attainment in practice than in theory.
Doubts Unfounded.
I am, therefore, happy to be able to inform you that as a consequence of my experience
during the past year I realise that my initial outlook was altogether unjustified. I have in fact,
been frankly astounded to find that such a large number of cases can be treated, and treated
adequately, by devoting only one session each week to Orthodontics.
It must be obvious that a very great deal of time and labour has been saved by the discontinuance
of the earlier practice of sending every patient to the Royal Dental Hospital. Also, be
it noted, the cessation of this previously inevitable course has resulted in relieving the parents of
additional costs, and avoiding much loss of time to both child and parent.
The Clinic is now able to deal with every case demanding Orthodontic treatment which
comes to its notice; no patient need be refused. The fact that a large measure of success has been
attained in every case serves to confound another argument sometimes put forward against the
practice of Orthodontics at school clinics, I refer to the alleged inability on the part of the normal
Clinic staff to carry out the essential instructions of the Consultant. The treatment of orthodontic
cases is a speciality; yet I am glad to be able to place on record the fact that my instructions have
invariably been followed to the letter, hereby contributing in no small measure to the steady continuance
of success which has been a feature of last year's work.
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