:Y—3

Dental Services

The dental service is directed by a European Dental Officer and two Maori dental nurses. Further expansion has taken place during the year under review, and a record of 10,134 operations were carried out. During the last quarter of the year an increased amount of conservation work has been done, and the number of fillings has exceeded the number of extractions for the first time in five years. All of the schools on Rarotonga, Aitutaki, Mauke, Atiu, and Mangaia were visited during the year. Preschool children and adolescents continued to receive urgent treatment, and admissions to hospital were also examined before discharge. The dental clinic was moved to more suitable accommodation during the year, and establishment of a clinic at Aitutaki is being completed. Equipment was increased during the year. Cadets were selected from Aitutaki and Mauke for training at Rarotonga, where there are at present five cadets. The training period covers three years, the first two being spent at Rarotonga, and the third at one of the outer islands, where the cadet gains practical experience, A final revision course at Rarotonga completes the training period, after which the cadet is returned to his home island, from which he will be brought to Rarotonga at intervals for a three months' refresher course. Training is directed towards conservative and preventative dentistry, and it is hoped that this will control the increasing incidence of dental caries. In addition, extraction technique is taught. The dental health education programme which commenced in 1947 has been continued, films, posters, and pamphlets, both in Maori and English, being displayed and distributed. Comparative statistics for the last five years are as follows :

Nutritional The Cook Islands can be divided into two nutritional areas : (а) The Northern Group. —Here the diet is predominantly based on fish, sea foods, and coconut products, supplemented by imported carbohydrates such as flour and rice and limited amounts of locally grown carbohydrates such as breadfruit, banana, and coarse taro. By means of composting and the use of fish manure, a certain quantity of vegetables is being grown at one or two islands in the Group. (б) The Lower Group.—Here the diet is predominantly carbohydrate, being based on locally grown taro, kumara, and banana and imported flour and rice. A limited quantity of fish, pork, and poultry is available for special occasions. The chief source of animal protein is imported tinned beef. Citrus fruits, tomatoes, and pawpaws are available during most of the year v and are extensively consumed. There is evidence of malnutrition amongst the poorer section of the community in the Lower Group, especially amongst those outer-island people who have migrated to Rarotonga and have no arable land. There is also an increasing tendency to rely on imported bread, sugar, and tinned beef. Talks and films regarding diet have been given throughout the Group, and some interest in diet is being aroused. A comprehensive system of training in growing new types of food and in preparing them has been commenced by the Education Department, and this example is being reflected by a marked increase in the cultivation of

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— 1944-45. 1945- 46. 1946-47. 1947-48. 1948-49. Extractions 1,533 1,713 828 2,482 2,335 Fillings 1,382 915 489 1,893 2,743 Miscellaneous : Prophylactic 38 239 1,622 2,266 5,056 and other treatments, cleaning, scaling, &c. Total operations 2,953 2,867 2,939 6,641 10,134