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It is not yet certain exactly how much benefit in the way of protection from
tuberculosis can be expected from B.C.G. vaccination of school children. The object of
the vaccination of the non-reactors to the tuberculin skin test is to produce in them
a controlled primary focus of attenuated infection, with consequent development of
acquired resistance, instead of allowing them to risk the dangers which are inseparable
from natural, uncontrolled exposure to Infection by virulent tubercle bacilli in large
numbers. The evidence suggests that B.C.G. vaccination probably affords a useful degree
of protection to supplement all the other measures employed in the prevention and control
of tuberculosis. The Medical Research Council has extended its thanks to all who helped
and co-operated in the scheme.
REPORT ON THE WORK OP THE SCHOOL DENTAL SERVICE
by
S.Maxwell Young, L.D.S., R ,C .S .
During 1955, the main obstacle in the road to a thoroughly efficient and comprehensive
dental service has been the shortage of staff. There has not been at any time
more than three full-time dental officers, including the Senior Dental Officer, and very
strenuous efforts have had to be made to keep open as many clinics as possible with
temporary part-time officers. This arrangement, apart from making any long-term planning
impossible, has created much administrative difficulty, such as the engagement of dental
attendants, the curtailing of orthodontic work, transferring of patients and the opening
and closing of clinics. Nevertheless, all the clinics, with the exception of Maybury Road,
have been functioning during the year (Table A), and there has been a remarkable spreadover
of service for the whole of the Borough.
Hitherto, the Maternity and Child Welfare Service has been on what one might call a
"chance passer-by" basis,, that is to say, the onus of requesting dental treatment was left
to the mother-to-be or the toddler's parent; this was obviously unsatisfactory, as in the
former patient's case, the request, when it did come, often came too late in pregnancy to
be of any real good, and in the latter case, treatment was more often sought only as a
relief from pain. In March, therefore, a pilot scheme was instituted at West Ham Lane
(and later at Grange Road and Forest Street), whereby all expectant and nursing mothers
and all toddlers who attended for routine medical examinations were given appointments
to the dental clinic, where they were inspected and offered treatment if this was found
to be necessary (Table B). In this way, much pain and sepsis was avoided by early treatment
and the frightening effects of emergency treatment of toddlers was obviated. Most of
the dental treatment of the expectant and nursing mothers was done during the evening
sessions at West Ham Lane, of which there were five or six each week.
It may not be out of place here to outline the basic policy of the Borough's dental
service, so that the results achieved may be seen in their correct perspective. Were
there a full complement of staff (i.e., 10 full-time officers, as recommended by the
Ministries), then a comprehensive service could be offered to all the patients for whom
"he Authority is responsible, but as there has not been even half this number at any one
"ime, it is obvious that some form of selective service has to be substituted. How then
to deploy the available forces, so that they will do the most good? It was decided, therefore,
to offer comprehensive treatment to primary school pupils only, after routine
inspections had shown that they were in need of it. No school child was to be refused
treatment for the relief of pain and where a secondary modern, technical or grammar
school pupil requested comprehensive treatment at a clinic, this was, as far as possible,
to be given.
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