The problem of child dental care.

IN the United Kingdom facilities available for child dental care are among the best provided by any country. This, however, is all that is comforting about our present situation. The sheer quantity of dental treatment required by our child population is so great that we cannot adequately cope. What is more, unless we have universal fluoridation within the next five or ten years and unless we rapidly speed up the training and utilization of dental auxiliaries, our ability to cope with the problem of child dental health is unlikely to improve during the next 30 years. There are many facets of child dental care but over¬ whelmingly our problems are concerned with treating the ravages of dental decay and correcting misfitting or irregular teeth. These two treatment problems are very different and are best considered separately. The problem of dental decay Dental decay is not akin to the ' one off' diseases or to those for which there is a natural process of repair. Neither is it akin to any of the chronic metabolic disorders. It is in many ways unique in that it affects one site on a tooth at a time. In most people this is a continual process, which begins almost as soon as the deciduous teeth appear. Wave after wave of attacks occur up to about the age of 35 years, when the impetus is almost spent. In our community, not all teeth succumb. There appears to be an individual ceiling of attack which usually is reached by 35 years and sometimes earlier. On average only 25 teeth out of the total of 52 (that is 32 permanent and 20 deciduous teeth) ever succumb. The burden of this attack, however, falls heavily on the very young. In the average individual, almost half of the 25 teeth ever likely to decay throughout life have decayed by 12 years of age and about 75 per cent of them have suffered attack before the age of 15 years. These figures are for the average child; some suffer infinitely more than this. In my clinic it is not uncommon to find children with all their deciduous teeth decayed by three years, or children of 12 years with 21 decayed teeth. The problem is easy to define. In a large proportion of children the burden of treatment needed is beyond their emotional capacity. Indeed it is often beyond the emotional capacity …