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as well as decay. Periodontal or gum disease is responsible for the loss of a
very large number of teeth in adulthood, much of this disease beginning during
childhood. Unfortunately, there is a tendancy to concentrate statistical efforts
on recording fillings, with no credit being given for periodontal treatment.
This tends to dampen the spirits of all but the most enthusiastic dental officer.
The same few also spend time applying topical fluoride solutions and prophylactic
pastes, which in addition to fluoride toothpastes, help to prevent tooth
decay. However, all of these measures taken together are not nearly as effective
as the safe, simple and cheap process of fluoridation of the public water
supplies; and none of the very short supply of dental manpower is required for
the latter.
ORTHODONTICS
A very experienced full-time orthodontist joined in April 1969, and has
resulted in an increased number of orthodontic sessions and attendances. He
has also deputised for the P.S.D.O. on several occasions. At first glance, the
casual observer might wonder why, if this is the case, should there have actually
been a slight fall in the number of new orthodontic cases commenced and
orthodontic appliances fitted. An experienced orthodontist diagnoses cases
early enough to treat large numbers of children by removing crowded teeth early
in life and allowing the rest to straighten by themselves without appliance
therapy. These cases are not counted as orthodontic patients for statistical
purposes hence the reason for many attendances but few appliances. Treating
children without appliances has many advantages. It means that children only
need make a few visits for diagnosis and then extraction of teeth, as opposed
to visits every two or three weeks over a period of about eighteen months to
two years, at a time when they can ill afford loss of academic time, i.e., in
the age group 10-14 years. In addition it saves children the cost of travelling
to the surgery, and is cheaper for the service as no expensive appliances have
to be made. Nevertheless there is a hard core of children who do need, and
have appliance therapy. With a view to greater efficiency and service to the
community the orthodontist tours the Borough in order to visit some surgeries
together with the dentist normally working there, and sees groups of children
who have been brought in especially for the purpose. He makes a diagnosis,
and where possible advises the ordinary dental officer how to treat the child.
If more complex treatment is required an appointment is made for the child to
visit the orthodontist at his surgery. This again is a service much appreciated
by patients and by their dentists. Most children see the orthodontist at John
Scott or Shoreditch, each clinic serving half of the Borough.
The orthodontist has also played a part in the school dental inspection
programme. This has helped to give him an overall picture of the state of
children's mouths in this Borough, and has also enabled him to provide early
diagnosis for large numbers of children, before crowding of their teeth advances
to a stage where prolonged therapy is required. As a sign of close working
relationship with the local General Dental Practitioners, several refer their
own patients to the orthodontist in order to give them the benefit of this
highly specialised service.
DENTAL HEALTH ACTIVITIES
Dental health talks by a dental auxiliary were offered to primary schools
when the results of school dental inspections were communicated to each head
teacher. Most heads asked for such a talk. The actual number of sessions was
less than in the previous year as of course it was during 1968 that the massive
Wealthy Teeth for Hackney' campaign was held. By the end of the year a flood
of applications had been received for the dental health puppet show which was
due to tour Hackney schools at the beginning of 1970.