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27
of the schools in rotation and enters upon "Dental Cards" the
result of his examinations. The names of children requiring treatment
are noted by the nurse, upon whom devolves the duty of making
appointments and taking such other steps as may be necessary by
following up or otherwise, as will ensure that the dentist's time is
fully occupied in treatment during the sessions at which he attends the
centres. Every effort is made to make dental treatment reasonably
acceptable to the litt'e patients. Local anaesthesia is administered for
the extraction of single teeth when pain would otherwise be experienced.
For the extraction of several teeth appointments are made for a session
when the Assistant School Medical Officer is present, who administers
general anaesthesia—Nitrous Oxide or Ethyl Chloride. The dentist,
so far as time permits, "fills" decayed teeth deserving of preservation,
and scales such teeth as require that treatment. Regulation of teeth
by mechanical appliances and the provision of dentures is an impracticable
proposition under present conditions. The denta' service is one which
allows of amp'c and profitable expansion.
The dental records are kept at the centres for future reference
and entries. When the Juvenile Emolovrrent Committee is in full activity
they will pass with the other records of medical examination and treatment
to that Committee for their guidance.
The present is a favourable opportunity for reviewing the dental
service in the light of experience gained' during the past six years,
i.e., since the establishment of a school dental clinic in Tottenham.
Your Medical Officer is convinced that the system whereby dental care
is begun with school children is entire'y wrong. Just as in the case of
the examination of school children which, imposed as a duty upon school
authorities, revealed the fact that for purposes of prevention of illhealth
it was necessary to go back to a date anterior to birth, so with
regard to teeth it is necessary to keep observation upon them from the
date of their eruption, and attack the earliest manifestations of decav
or irregularity. Thereafter at frequent intervals re-examinations should
be made to ensure that the treatment has been effective, and that no
further attention is necessary. The Board of Education have prescribed
courses of study for health visitors. It is submitted that the course
should include practical tra ning in the use of dental probe and mirror,
and that it should constitute part of the health visitors function to
report upon the condition of the teeth of infants as part of their general
health. The services of dentists should be available for infants referred
to them by the health visitors. Perhaps with the introduction of Nursery