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Malocclusion or irregularities predispose the individual to dental disease. This is a hard
and undeniable fact, without any psychological complement; subsequent general ill-health assuredly
comes the way of the unfortunate possessor of irregular dentures. Crowded teeth spell decay—
that should be plain to all.
Surely it must, therefore, be obvious that objection No. 2 cannot be put forward in any
good faith. Public Health demands a healthy mouth for every child and this is the Orthodontist's
primary concern. Aesthetic results are not denied importance—they are given secondary
consideration.
Treatment and Benefits.
I have during the past year endeavoured wherever possible to employ the least amount of
apparatus consistent with the Orthodontic treatment determined, and then only the simplest types
of appliances. A prime consideration here is the matter of expense, but there is also the fact that
my aim is always to prevent rather than cure. For this reason I consider it most desirable to
treat the cases by judicious extraction at the right time, trusting in the powers of Nature to complete
the preventitive process. This, I am convinced, tends to promote a healthy condition
generally.
All the appliances so far employed are of the removable variety, fixed apparatus is
discouraged not only on account of its relatively higher cost but also because of the much greater
time required for its adaption.
If malocclusion can be treated by early attention, more serious after-developments are
definitely less probable. Again, if deciduous teeth are unsaveable, the employment of splint plates
subsequent to extraction goes a long way to prevent the travelling of other teeth and so avoids
overcrowding at a later stage.
Amongst the numerous ills attendant upon dental malformation is that of mouth-breathing,
with all its undesirable consequences. In fact with certain forms of malocclusion mouth-breathing
is a concommitant complaint. The ills by which the mouth-breather is imperilled are many and
serious, and the great importance of early corrective Orthodontic treatment cannot be more clearly
emphasised than in such cases. Remove the malocclusion and make normal lip-approximation
possible and you remove the chief incentive to mouth-breathing. Normalise the denture first; then
the breathing can be regularised by instruction.
Future Developments.
In looking forward to the coming year's work, there would appear to be every reason to
suppose that the satisfactory results obtained by the Orthodontic Section to date will continue. I
have already drawn attention to the useful propaganda effect that the Scheme has achieved, and the
progressive enlargement of a sympathetic understanding outlook on the part of the parents will
do much to ease the way for earlier and more complete treatment of suspect and developing cases.
This will mean more patients to deal with and more treatments to carry out, but I have every
confidence that those concerned will be ready and willing to handle as many cases as may come
their way.
The necessity for the installation of an X-ray apparatus at the Clinic has become more
urgent, and I consider that the Council should give the matter their earnest attention. I know
that the question of expense is no light one, but I would point out that such apparatus has several
applications in other branches of the Clinic's activities, in which, indeed, it may in truth be as much
needed as it is in the Orthodontic Section.
In conclusion it seems to me that the experience gained from the working of this pioneer
Orthodontic Clinic is of an entirely promising nature and warrants the assumption that the
practice of Orthodontics in school Clinics throughout the country is wholly desirable and
emminently practicable. My personal convictions carry me further, and I am convinced that a
National Scheme is an absolute necessity to conserve the health of the Nation. If such a Scheme
receives the recognition and approval of the Board of Education and is eventually adopted, the
Nation as a whole will then be indebted to you in a very large degree. You have already incurred
the gratitude of the Dental Profession both for your original conception of the pioneer scheme at
this Clinic, and for making it possible for the preliminary plans to be put into practical operation.
I look forward to the time when the Orthodontic Section of the Heston and Isleworth
Dental Clinic will be acknowledged by similar clinics throughout the land not only as the leading
spirit in such work but also as the continued model of success for all centres.
ORTHODONTIC CASES.
I now append details of the treatment of some typical forms of malocclusion which have
been encountered at the Clinic.
It should be borne in mind in looking at these illustration that in each case the age given is
that at the commencement of treatment.
H. R. EVANS, l.d.s., r.c.s., eng.,
Orthodontic Consultant.
Orthodontic Demonstrator, Children's Department, Royal Dental Hospital.
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