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Staff Efficiency.
In Mr. I. Cohen, the School Medical Service has a dental surgeon who has proved invaluable
in the furtherance of orthodontic treatment. His understanding of the subject, both practical
and theoretical, is of a high order. I should like to offer Mr. Cohen my personal thanks for the
very efficient manner in which he has attended to my instructions and supervised the work. He
has offered me every facility for progressive and intensive Orthodontic treatment of the many
patients coming through his hands. This, in conjunction with his willingness at all times, proves
him indeed a valuable servant of the Borough.
From the other members of the Clinic Staff, both professional and clerical, I am glad to be
able to report not only a service of technical efficiency, but also a sympathetic appreciation of the
problems encountered in the administration of Orthodontics at a School Clinic. Throughout the
year I have observed the most friendly co-operation to exist between all members of the Staff.
The National Viewpoint.
I regard the particular activities of the Orthodontic Section of the Clinic during the past
year as very valuable material when judged from the broader viewpoint of Clinic Orthodontic
work as such. From the problems encountered and overcome by the Section there has, in my
opinion, become available a wealth of practical experience which should prove of more worth in
aiding the evolution of a possible National Orthodontic Scheme than any amount of erudite
theories, however academically corect the latter might be.
Proof has been obtained, for example, that the work of the Section has served as invaluable
propaganda amongst the parents of the children attending the Borough schools It is, of course,
an a priori necessity to obtain the consent of the parents before the child may be treated, and, simple
as this sounds, there is no need for me to remind you that it is a procedure fraught with considerable
difficulty. The idea, so firmly fixed in the minds of many parents, that cases of malocclusion
or irregularities should be left alone for Nature to cure, is one of the hardest hindrances which
have to be overcome.
Since the Clinic has effected so many successful (and to the lay mind " spectacular ") cures,
the barriers of indifference and prejudice are slowly breaking down. Indeed it has been brought
to my notice on more than one occasion that the parents of successful cases have eventually given
their ungrudging approval and appreciation of services rendered. Time will show whether this;
greatly to be desired orientation of outlook on the part of the parents may be the prelude to a
larger and more National conversion to the acceptance of the Orthodontic Scheme for this country.
If feasible, and I sincerely believe it is, the inauguration of Orthodontic Clinics throughout
the land will, in my opinion, bestow a direct and far-reaching benefit on the people of England.
The results in this pioneer Borough are most encouraging and at the close of 1933 I look forward
with confidence to the eventual extension of the Scheme on National lines.
Objections Encountered.
At this stage I think it is only fair to draw attention to the two main objections which are
put forward by the opponents of the Orthodontic Clinic. These objections are :—
1. The treatment will involve loss of time for ordinary dental practice.
2. The treatment takes too much thought of appearance, i.e., the aesthetic principle
predominates.
Now I think that you will admit that objection No. 1, whilst being perhaps inevitably
encountered in the theoretical and preliminary stages of the institution of an Orthodontic Clinic,
will not have much validity in the light of practical experience such as has been afforded by last
year's proceedings of this Clinic. I have already pointed out that the efficient way in which the
Clinic have been able to handle a large number of cases throughout 1933 (and this with but one
session per week), has occasioned me much pleasurable surprise. I have in fact found that the
normal function of the Dental Clinic is in no way interfered with by the Introduction of an
Orthodontic Scheme.
The Aesthetic Problem.
Objection No. 2, viz : that the protagonists of Orthodontics incline to attach too much
importance to the improvement of appearance, involves rather deeper problems. In brief, I
maintain that the Orthodontic view is that health rather than appearance should always be the aim,
but that nevertheless appearance is a factor in life demanding considerable attention.
My primary object in the treatment of all cases has been to render the individual a clean
and healthy mouth, to equip the child with a normal and hygenic denture which will carry it
through life without attracting innumerable allied complaints.
The psychological effect of a more normal as opposed to a more abnormal denture is perhaps,
more profound than one may at first imagine. But it should be obvious to anyone that the
abnormal denture provides a very large loophole for the development of inferiority complexes in
the unlucky patient. These complexes will be strengthened by the undeniable fact that on leaving
school the child will discover that dental malformations are a very real handicap to a career.
Employers nowadays pay quite an amount of attention to dental condition, and rightly so.
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