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96
various dates during the last six months of the year. There was one resignation
of a full-time dental officer early in the year and some months elapsed
before this post could be filled.
At present the orthodontic clinic is worked seven sessions per week and
it is intended that this shall be increased to a full-time service should the
scope of the work justify it, but it is too soon yet to know when this may be.
A new dental clinic was opened in August at Cornwall Road, N.15. It is
an extension of an existing clinic. Very little space was available and
consequently the rooms are smaller than usual, but the equipment is very good.
At the time of writing we have nine dental surgeries in full use, one of
these being shared between the orthodontist and a part-time dental officer.
This is our whole accommodation and so far, with existing staff, it has not
been possible to provide annual inspections for all children in all parts of
the Area, though there should be some improvement in this respect in 1955,
provided we can keep all the surgeries in full operation without any closing
due to changes in staff."
Details of the work of the dental officers are included in the tables
at the end of this Report.
Rheumatism Supervisory Centre
The Rheumatism Supervisory Centre has now been in operation since
August 1951, under the overall direction of Dr. I.M. Anderson, Consultant
Paediatrician, Prince of Wales's General Hospital, with the close co-operation
of the local Public Health and Area Health Departments.
The total number of cases seen in each year are tabulated below under the
appropriate headings. Taking Tottenham first it can be seen that the number
of children attending for the first time has declined in each year. There
are several reasons for this.
Firstly, the number of children referred was larger in the first year
because previously no such special provision had been made for children who
had had rheumatic fever. Some of these children were not acutely ill but
merely required supervision. Once this catchment had been made the numbers
automatically declined. As can be seen this applies to children with congenital
heart disease as well as rheumatic heart disease.
There can be little doubt however that there has been a substantial
decline in the number of children newly developing rheumatic fever. This
trend has been noticeable in national statistics for many years but seems to
have accelerated recently. Thus it can be seen that the number of children
admitted to hospital for rheumatic fever has declined from 33 to 19 to 15 in
each year since 1951. This decline is confirmed by the clinical staff at the
Supervisory Centre who have noticed the same thing in other areas.