CHILDREN’S TEETH

Dominion, Volume 21, Issue 96, 21 January 1928, Page 8

CHILDREN’S TEETH

NEW ZEALAND’S SYSTEM OF TREATMENT

CRITICISED BY DR. H. G. PICKERILL

REPLY BY DIRECTOR OF DENTAL HYGIENE

In a contribution recently published in the London “Spectator,” Dr. H. G. Pickerill, formerly dean of the dental faculty at Otago University, makes a vigorous attack on the system whereby children’s teeth in New Zealand are treated by dental nurses. This criticism has been replied to by the Director of Dental Hygiene, Colonel T. A. Hunter, who has forwarded a letter to the “Spectator,” pointing out that some years ago Dr. Pickerill was one who persistently advocated the provision of free dental treatment for school children by the State, and that the system was one that had won the admiration of many members of the medical and dental professions.

The letter, written by Dr. Pickerill, and which appears in the ‘Spectator” of September 10 under the heading of “Dental Hygiene,” is' as follows: —In your issue of May 21 there appeared a contribution by “Crusader,” under the above heading. The title was surely a misnomer, since your contributor said little or nothing about the hygiene of the teeth. It was apparently a not very enthusiastic attempt to advocate treatment of children’s teeth by unqualified practitioners. Unfortunately, here in New Zealand, we have such a system inaugurated by the Government. Young women of no particular educational standard are “intensively’ trained for two years in a so-called school and then are given State positions as “Dental Nurses,” when they do not carry out the hygiene of the teeth is understood and carried out in America, but are authorised to operate in exactly the same manner as a qualified dentist upon both the permanent and milk teeth of children attending primary schools. They are permitted and have to decide which teeth are to be extracted and which filled, and they administer local anaesthetics for the most . part entirely without supervision. This is not dental hygiene; it is cheap dentistry. It is obviously fundamentally wrong, and is having a most unfortunate effect upon the morale of New Zealand children and parents. In the first place, it is one more responsibility of which the State is relieving the parent. The parents are saying there is no need to worry about teeth or their hygiene; the State will fill up the holes. Secondly, to hope to check the incidence of dental caries by the mechanical means of filling holes as fast as they appear is as futile as it is thoughtless and unscientific. It is not the duty of the State to interfere in treatment; it is the preeminent duty of the State to initiate and carry out prevention. Dental caries can be prevented, but it means care, thought, and sacrifice, and these things being highly unpopular, no politicians will have anything to do with them, much less take active measures to enforce them. On the other hand free (albeit unqualified) dentistry is highly popular and finds ready support. Sufficient is known of the cause and prevention of decay of the teeth to eliminate at least 70 to 80 per cent, of its incidence if the principles were thoroughly taught and enforced. My own investigations and those of others have shown that there are four factors at work, the attacking forces—diet and organisms, and the defending forces the resistance of the surface of the teeth and the quality and quantity of the fluid in which they are bathed by Nature (saliva). . . Colonel Hunter’s Reply.

In his reply, Colonel T. A. Hunter states that the present system has been in operation in New Zealand for six years, but for many years previous to that, the New Zealand Dental Association ' had persistently urged the Government to take up the question of free dental treatment for school children, and in this agitation Dr. Pickerill took an active part. Now he says in the letter referred to, "It is not the duty of the State to interfere in treatment.” When did he alter his views on this subject? Colonel Hunter goes on to say that when the scheme was originally suggested it was naturally enough viewed with a certain amount of misgiving by some of the profession. Dr. Pickerill took advantage of this and organised strong and persistent opposition in the public Press and in other ways. In order to ascertain tlie real views of the profession a full meeting of the executive council of the New Zealand Dental Association was convened. Every branch throughout the Dominion was represented, and Dr. Pickerill, although not a member, was present. The proposal to institute a corps of dental nurses was fully discussed, and by an overwhelming majority the proposal was endorsed, and it was agreed to support the Government: in. bringing the scheme into operation. “Dr. Pickerill’s opposition then ceased,’? adds Colonel Hunter, “and he went so far as to come to me and offer bis assistance. I still have in my possession a letter from him offering suggestions in connection with the proposed syllabus of training for dental nurses. ' His scruples against what he now chooses to call ‘unqualified practitioners’ had disappeared. Later, however, Dr. Pickerill again appeared as a bitter opponent of the scheme.” Colonel Hunter stated that the suggestion that they hoped to' check the incidence of dental caries by the mechanical means of filling holes as fast as thev appeared was an insult to their intelligence. The statement that young women of no particular educational standard were admitted for training as dental nurses was not a fact. A high standard of education was demanded. Tlie opinion of those members of the profession who were best fitted to judge, and who had taken the trouble to investigate thoroughly (which, by the wav Dr. Pickerill had never done) was that’the dental nurses were even better fitted for treating voting children than the average freshly qualified student from a dental school. “Our training school and our clinics throughout the Dominion,” says the colonel, “are open to the fierce light of criticism for the profession and the laitv The New Zealand Dental Association has on more than one occasion pronounced itself in favour of tlie scheme Manv members of both the medical and dental profession have visited us, and all have expressed themselves in admiration of the system. The Chief Dental Officer of the Education Department of Victoria was sent specially to investigate the New Zealand system and after going thoroughly into the matter strongly urged the Victorian Government to institute a similar service,”