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16
applies also to the secondary schools by arrangement with the Middlesex
County Council.
' 'Owing to changes of staff and consequent unsettled conditions at
the Chesnuts dental clinic, it has not yet been found possible to include
all the age-groups for inspection in the schools in that area, but with the
permanent appointment made last Spring these conditions should soon
be remedied. A certain amount of dental treatment has been given to
babies referred from the Welfare Clinics as in previous years, but under
present conditions only a small number of such cases can be dealt with.
By the proposed additional dental clinic it will be possible to deal conservatively
with the teeth of pre-school children and thus obviate some
of the bad dental condition which is so prevalent in infants when they
first join school. It is of especial importance that whenever possible,
the second temporary molars should be preserved for their full natural
life, not only on account of masticatory value, but as an aid to the normal
eruption of the first permanent molars; early loss of the second deciduous
molar almost always results in a movement forward of the upper and a
tilting of the lower first permanent molars, with consequent contraction of
the arches and crowding of pre-molars and sometimes anterior teeth. This
brings me to the question of orthodontics in the school dental service;
it has been the practice in Tottenham for some years to correct irregularities
in suitable cases with removable appliances; difficulties of cost and lack
of facilities have prevented treatment by fixed appliances being carried
out; also it is doubtful if many of the cases are of a type to benefit by
this method. Cases which specially call for treatment by fixed appliances
are referred to the Eastman Dental Clinic, but this only very rarely
occurs.
"Finally, last year saw a big step forward in the opening of the
well-equipped Lordship Lane Centre.''
Orthopaedic and Postural Defects.—The routine and special
inspections revealed 197 children needing treatment for some form of
crippling defect. Surgical appliances were supplied and repairs and
replacements effected in 208 instances.
The orthopaedic surgeon pays periodic visits to Tottenham for the
examination of children referred to him on account of these defects,