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number of these children are found at special schools and close co-operation with the schools is
resulting in a higher uptake of treatment. Frequently social problems are the major obstacle to
overcome.
Shortage and frequent change of staff at some clinics in the Borough has resulted in fewer
children being inspected at schools. The problem is acute in Yiewsley and West Drayton as there is
no dental clinic until the new Health Centre opens. Children from this area must travel to surgeries at
Uxbridge or Laurel Lodge, Hillingdon. It has been our experience that many appointments made for
children from these areas are not kept, possibly because of the travelling problems.
Preventive Dentistry
Much emphasis has been put on preventive dentistry both in the press and on television. This
includes prevention of decay and the prevention of periodontal (gum) disease. Most parents know
the harmful effect that sugar has on the teeth by causing decay. Very few realise that the sticky film
of bacteria on the teeth, dental plaque, is also responsible for inflammation of the gums. This is
usually mild in children but progresses to chronic gum disease in early adult life. Mild inflammation
is frequently found in children at the age of five and in the majority of children in secondary schools.
It can be cured by cleansing the teeth with a toothbrush. Few children do this effectively but dyes
or disclosing solutions, which colour the dental plaque, can be painted on to the teeth to show the
children where they have not cleaned properly. It is sufficient to clean the teeth once a day, if this is
done thoroughly. Our findings show that it is rarely done well.
Techniques for strengthening the teeth with fluoride gels and solutions have been developed
in the United States and Scandinavia; they also complement the strengthening effect of fluoride
which can be obtained in the drinking water. We are able to apply these to children's teeth in the
dental surgery. These developments are very promising but are raising difficulties. No longer are
children only visiting the surgery for fillings and extractions. Many parents are requesting preventive
treatment, often for children who have few or no decayed teeth. Thus the number of children requesting
regular appointments is rising rapidly. The service will not be able to meet these demands without
employing more ancillary help. The dental surgery assistants have been teaching children to clean
their teeth effectively and checking their progress with the disclosing solutions. It seems that this
may be an effective method of reaching large numbers of children and emphasising the message
that healthy gums are as important as teeth free from decay.
In the future we hope to break the cycle of treatment of dental disease by continually repairing
the teeth. This could be done most effectively by fluoridation of the drinking water. The dental health
of children in the Borough is, on the whole, good but this is entirely due to the tremendous amount of
reparative treatment carried out by dentists in the Borough. The majority are, of course, general
dental practitioners. The amount of decay and gum disease does not seem to be decreasing. Regular
detailed surveys of children's teeth will show whether this is a correct assessment. As more parents
realise the importance of regular treatment and the school population increases more strains are put
on the treatment services of both the local authority and the general dental practitioners. We are
competing with other authorities for suitably qualified dentists and the demand far exceeds the
supply.
School dental service statistics are recorded on page 173.
DENTAL HEALTH EDUCATION
Bishop Winnington-lngram School Project
An intensive three week programme of dental health education involving a class of 39 children
aged 9-10 years was carried out at the above school at the begining of October 1972.
The teacher involved in the project had been well briefed beforehand and supplied with all the
relevant literature. The children concerned were mainly from upper middle class families. This was
the first term that the children were being taught by project teaching methods.
For most of the sessions a member of the dental health education unit visited the classroom and
gave a short talk on the topic for the day. One project group would then concentrate on this topic
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