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21
The majority of these abnormalities are definitely established and recorded on
the birth cards, but a few need following up by enquiries to health visitors
when their first visits to the home have been made, and also to hospitals where
the babies' conditions have been investigated. No serious difficulty has been
encountered in this follow-up.
The simplified table given above indicates the frequency and nature of
these abnormalities, forty-six of which could be considered major defects, and
includes seventeen stillborn babies and eleven who died soon after birth, so
that there were eighteen babies who survived with a major abnormal condition,
which would probably require treatment.
No particular seasonal distribution was apparent in any of the notified
abnormalities; even had this been so, the numbers in one borough alone would
not be large enough to be statistically significant.
MATERNITY AND CHILD WELFARE DENTAL SERVICE
Under Section 22 of the National Health Service Act, 1946, local authorities
are under an obligation to provide dental care for the priority classes;
that is expectant and nursing mothers, and children not yet at school. School
children are dealt with by the Inner London Education Authority under the provision
of Section 32 of the London Government Act, 1963, and are therefore
discussed under the school health section of this report. The remainder come
under the direct control of the Health Committee, and are dealt with here. As
pointed out by the Ministry of Health, the aim of the 1946 Act is to ensure that
these groups have an absolute guarantee of priority treatment. The dental
service should aim at providing a sound dental foundation for children and at
eliminating the dangers of oral disease to mother and child. It should provide
for the examination of every expectant mother, and the periodical examination
of pre-school children, followedby the provision of such treatment as was found
to be necessary. While the object of treatment should be the conservation and
retention of the natural teeth whenever possible, all forms of treatment should
be available. This should include the provision of crowns, inlays, and dentures.
A local health authority is not fulfilling its duty by referring mothers
and young children to the general dental services for any advice and treatment.
Although the latter are available to the 'priority classes' there is no system
for ensuring that these are given preference over other patients. Also, some
dentists are unwilling to treat small children.
Ideally, all expectant and nursing mothers should routinely attend the
family dentist. However a very large number do not do so. It is for this
group that the Council provides a service. Close co-operation with other
branches of the maternity and child welfare service is essential. Clinic
doctors, midwives, and health visitors are asked routinely to refer these women
for a dental check-up, unless they have a dentist of their own. The function
of the service is both to make them dentally fit and to teach them the essentials
of dental health, so that they will then have the necessary knowledge properly
to care for their children's teeth and gums. It is to be hoped that after
attending a clinic for a year and receiving kindly and considerate dental care,
they will then be willing to look after their own mouths. At this stage they
should be encouraged to seek continual care from the general dental services.
During 1966 a total of 575.5 sessions was devoted to the Maternity and
Child Welfare dental service, which was 18.5 sessions more than in 1965. This
was equal to 11 per cent of all clinical dental sessions worked in Hackney.
The National average was 5 per cent, with a national aim of 9 per cent. Hackney
therefore is amongst the leaders in the field.