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a post would, in my opinion, be definitely bad economy. For the production of all the appliances
which are required in connection with the increased number of treatments, the present arrangements
at the Clinic are quite adequate. I have at no time suffered any inconvenience or delay in
this direction.
In regard to the taking of X-ray photographs where such are necessary, I consider that the
present arrangements at the West London Hospital are quite satisfactory.
Facial Appearance.
I think you are fully aware of my answer to the so-called "æsthetic objection" to the
practice of orthodontics, viz:—that the prime concern of orthodontia is the provision of a perfectly
functioning mouth, and that only after this has been achieved can there be permitted to arise the
question of facial appearance per se.
The true orthodontist must be first and foremost a preventer of disease, and secondly (for
psychological and aesthetic reasons) a curer of facial deformities; he must never be a mere beauty
specialist.
The fact that both aesthetic and psychological considerations have nevertheless a definite
bearing on the problem is, however, particularly well borne out by a case which was brought to my
notice last year.
A boy of 16 years of age had left school having, through influence, secured a clerical
situation. He duly commenced his work which, it so happened, consisted of interviewing the
firm's clients throughout the day. After the lapse of a week, however, the employers intervened
as it had become only too apparent that the unfortunate youth could not hope to succeed at the
particular duty which had been allocated to him—his deformity not only made him painfully selfconscious
but his appearance was obviously repugnant to those with whom he came in contact.
The lad was, therefore, tactfully yet firmly informed that unless he took immediate steps
to improve his facial appearance he could not be permitted to continue in his situation. It should
be noted, incidentally, that this intervention of commerce came as a result of experience and not
from a priori dictates.
Now it appears that this boy had in fact come before the Orthodontic Clinic some three
years previously, and after some delay in obtaining the parents consent, he had been sent to the
Royal Dental Hospital for examination. Before the treatment prescribed there could be commenced
the boy gained a scholarship, and so graduated to a secondary school, thus passing out of
the jurisdiction of the Clinic. During the time he attended the higher grade school no orthodontic
treatment was sought because it would have interfered with his school hours and also because his
parents failed to appreciate the gravity of his condition. The models and skiagram which appear
on the next page show the boy's condition before he gained his scholarship, and at the end of his
first week of employment.
I believe this to be by no means an isolated example of the tragedy liable to a tend an
untreated orthodontic condition, and its import lies in the fact that it illustrates the " commercial "
danger of malocclusions. It must not be overlooked that although this boy obtained his situation
through influence a week's work nevertheless proved his unfitness for the post, and his prospects
in commerce were thus blighted almost at the start. Children suffering from malocclusions who
are obliged when seeking situations to make personal application to employers will in nine cases out
of ten be foredoomed to utter failure.
Facial deformities due to malocclusion are likely to prove not only an actual barrier to
commercial success, but the very realisation of their presence must perforce result in a profound
psychological repression on the unfortunate individuals in question.
The attitude of the employer I do not criticise—dental hygiene is to-day most rightly taken
well into consideration by many employers of labour.
I would add that I have since taken this boy on as a patient at the Royal Dental Hospital,
and treatment is now being carried out. But—and here is a point I wish to stress—the final result
can hardly be as successful as if a proper and complete treatment had been undertaken whilst he
was still attending your Borough school.
I regard this case as a vivid illustration of the imperative need for parents to realise their
responsibility for ensuring that their children shall receive early attention in order that a satisfactory
cure shall result from treatment completed before the school leaving age is reached.
The National Outlook.
The continued success of the weekly session scheme, and the experience gained during the
past year of the readiness with which the Section can undertake treatment of a steadily increasing
number of cases, clearly indicates to me the entire fitness of the scheme for extension on National
lines as an integral part of ordinary school dental work.
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