H.—3l.

PART VII.—DENTAL HYGIENE.

I have the honour to submit the following report on the work of the Dental Division for the year ending 31st March, 1938 : - School Dental Service. The programme for extending the School Dental Service to all primary schools within the next three years is proceeding according to plan. Reference was made in the last annual report to the increased activity in connection with the training of school dental nurses and to the preparations that were being made to train a greatly increased number. With the additional accommodation at the training-school at Government Buildings, and with the Ministerial residence at Tinakori Road in use as an annexe to the training-school, a greater number of dental nurses is now being trained than ever before. The instructional work is not without its difficulties, since, of necessity, many of the facilities are of an improvised and temporary nature. In the meantime, good progress is being made with the erection of the new training-school in Wilbs Street, Wellington, although it is not likely to be ready for occupation in 1938, as was originally expected. Only one new school dental clinic was established during the year under review—namely, at Addington, Christchurch. This, however, was in the nature of a reorganization, as the pupils had previously been under treatment at another clinic. The number of treatment centres is 253, of which 145 are main centres and 108 are sub-bases. Particulars of these are given on another page. Negotiations are in progress for the establishment of a considerable number of new clinics during 1938. Twenty-two new clinics have been authorized at centres which were not served before, and fourteen existing centres will be reorganized, and their scope extended, by the appointment of additional stafE. Details of these are given in another section of this report. In order to facilitate the control of the clinics which are to be established during the next few years the existing dental districts are being reorganized, and a new one created, with headquarters at Hamilton. This district will include the South Auckland, East Cape, and Taranaki Health Districts, and the Auckland and Wellington dental districts will be reduced accordingly. The statistical section of this report shows that the work of the School Dental Service has been well maintained during the period under review. The total number of operations shows an increase over the previous year—namely, 759,873, as against 725,069 for 1936-37. The number of patients under treatment at the end of 1937 is 320 less than at the end of 1936, 89,483 as against 89,803. This, however, is only an apparent decrease. The explanation is that through a combination of circumstances —namely, the sudden influx of five-year-old entrants in 1936, the time lost through the poliomyelitis epidemic in the early part of 1937, and shortage of staff —there has been a lag in bringing new entrants under treatment. Consequently the loss of patients through pupils passing out of Standard IV has exceeded, temporarily, the gains from the enrolment of new entrants for treatment. With the augmenting of the field staff in the near future this difficulty will be gradually overcome, and it is expected that the accumulated new entrants will have been brought under treatment by the end of 1938. An unfortunate phase of this struggle on the part of a depleted stafE to keep pace with commitments is that fewer children of pre-school age are being enrolled. But this, too, is a temporary phase, which will be rectified in due course when the field staff has been sufficiently strengthened. The number of schools under treatment shows a decrease of 61, from 1,629 last year to 1,568. This is due, in the main, to the closing of small schools and their consolidation at larger centres, a procedure that greatly facilitates the work of the School Dental Service. During the difficult period from which the Service is now emerging the principle of six-monthly revision has been strictly observed. Indeed, it was decided that revision must take precedence over the treatment of new entrants. This decision was based on the belief that it was better to maintain for the maximum period the children who had already been made dentally sound, rather than undertake fresh commitments with no certainty of being able to maintain regular supervision. The justification for this is now to be found in the fact that by the judicious use of relieving staff the arrears of new entrants are steadily being overtaken, while the vital principle of six-monthly revision has not been sacrificed. Staff of Dental Division. On the 31st March, 1938, the professional staff of the Division, disposed as under, numbered 17 dental officers, 2 trained nurses (matrons), and 188 school dental nurses. In addition, 108 student dental nurses were undergoing training, and steps were being taken to appoint a further 76 :—

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Dental j School Dental Student Dental Officers. Nurses. Nurses. Director .. .. .. .. .. 1 District staffs— District Dental Superintendents .. . . . . 4* Staff of school dental clinics — Auckland Distriot .. .. .. .. 2f 55 Wellington District .. .. .. .. • • 60 Canterbury District . . .. . . 1 42 Otago District . . . . .. .. .. 24 Wellington dental clinic and training-school for dental nurses 9 6} 108§ On leave .. .. .. .... .. .. 3 _ _ 17|| "" 190|1 108 * The Dental Superintendent of the Otago District is also in charge of the Central Clinic, Dunedin. "f Native Dental Officers working among Native schools in Bay of Plenty and East Coast districts. J Includes two trained nurses—viz., the Matron of the Wellington Dental Clinic, and the Matron of the Denta Nurses' Hostel. § Of this number, forty-seven will shortly complete their training and will be drafted for service in the field. The appointment of seventy-six additional student dental nurses has been authorized and is being proceeded with. || These numbers include one dental officer and twenty-two dental nurses employed temporarily to augment the permanent staff. The latter are mostly married ex-dental nurses who have been re-engaged in a temporary capacity.