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Community Dental Service as Demonstrated at Children’s Dental Clinic, Cook County Hospital, Chicago
1260
The Journal of the American Dental Association
people that knowledge which will pro health and preventing disease is so gi tect them from preventable diseases gantic that it challenges our best efforts and, perchance, premature death. With and calls for many personal sacrifices; this object in view, the dental depart but the results will more than justify ment has prepared several hundred the time and energy expended. Dentistry has much to offer that will short, readable newspaper articles which will be sent to any paper that will benefit the citizens of Ontario, and the provide the necessary space. Motion pic people look to us for leadership in con tures, slides, posters and pamphlets are nection with this new public health also available, and members of the pro movement. To some it is given to read fession in all parts of the province history; to a few it is given to teach should be willing to give public ad history; to us it is given to make history. dresses pointing out the means whereby May we be willing to accept our oppor an individual can protect himself from tunities and measure up to our respon the ravages of dental disease. sibilities so that in after years it cannot I am glad to have this opportunity tobe said that we were remiss in our duty. speak to the dentists of Eastern Ontario. Our activities will differ to some ex We are all engaged in an altruistic en tent, but we will all be engaged in a deavor to protect the citizens of this work which will never become monot province from disease and injury. onous, for new avenues of helpful serv Health is most important, from both the ice will ever open before us and we standpoint of the individual and that of can always look back on a past of use the state. The task of preserving ful work well done.
COMMUNITY DENTAL SERVICE A S DEMONSTRATED A T CHILDREN’S DENTAL CLINIC, COOK COUNTY HOSPITAL, CHICAGO By M. H. KILLIP,* D.D.S., Chicago, Illinois
M
UCH has been said and written carried on by a few loyal dentists and concerning the development of a number of laymen, who gave their dental education in Chicago and time and money in order that the poor Cook County, but little does the pro children of our city might secure free fession at large realize the great re dental service. Realizing that this sponsibility and untiring effort that has could not be the solution of a com been produced by members of the munity problem, this committee called Public Service Committee of the Chi on public officials to aid them in estab cago Dental Society in developing this lishing a free dental clinic. dental health program. After a number of conferences and For many years, this work has been much effort on the part of a few men connected with the committee, an ap♦Dental Supervisor.
Department o ] D ental H ealth Education
1261
propriation for a clinic was made by the operate with less expense than if it Cook County Board of Commissioners. were run as a private institution. The clinic is equipped with the latest It was also decided that such a clinic, financed by public fund and run as a and best furnishings that can be secured. county institution, should be connected It consists of a large receiving room, with the county hospital. A building examination room, a main operating was found suitable for the clinic, and in clinic with eight complete units and the fall of 1923, Cook County’s first specially built children’s chairs, steriliz
F ig .
1.— C o o k C oun ty C h ild ren ’s D ental C linic, C o o k C oun ty H ospital.
free dental clinic was opened to the public. The budget passed by the county commissioners for the first year was approximately $40,000 and each year the board has voted a new budget of $25,000. The general running ex penses for the year are taken out of the general hospital budget. By being con nected with a large institution such as the county hospital, a clinic of this type can secure many advantages, and
ing room, retiring room, play room, opeiators’ and nurses’ quarters, and of fices. More equipment will be added to the main operating clinic as soon as a larger appropriation is made. In order to take care of those chil dren who are most deserving, and to eliminate all those who are able to pay for their work, a representative of the County Agent department examines each case before the child is admitted as a patient. I f there is any doubt as to
1262
The Journal o f the American D ental Association
the circumstances of the family, an in vestigator is sent to the home and a report is made before further action is taken. Only a limited number of patients can be taken each month and many are refused treatment or are sent to other
brought by either parent or the nurse, those sent by the board of education, and those from other dispensaries. The Juvenile Court sends many of the mother’s pension cases and the boys from the Cook County school located at Riverside.
F ig . 2.— Section o f M ain O p eratin g C lin ic, C o o k C ou n ty D en tal C linic.
clinics or dispensaries for treatment. There are four sources by which chil dren are admitted to the clinic; namely, the County Health Department, County Agent, Juvenile Court, and the County Hospital. The County Health Depart ment brings children from the rural dis tricts. Their nurses have certain days assigned each week and the children brought by them are given preference on those days. The County Agent ad mits children from the city who are
The operating staff is composed of graduate licensed dentists. Each oper ator is a full time civil service employee and is first recommended by the Public Service Committee to the Civil Service Commission. There is no limited serv ice for the operators, but they must adapt themselves to children’s work and devote their entire time to the clinic. A registered supervising nurse is in charge of that department, and is under the direct supervision of the Illinois training school.
Department o f D ental H ealth Education
An educational program is carried on from the time the child is admitted as a patient until the work has been com pleted. Each operator handles the pa tients assigned to him as though he were conducting a private practice. Tooth brush drills are started as soon as the child becomes acquainted, and health
1263
months he returns and there is no further work needed, another card is given with instructions to return in six months. In this way, the clinic keeps in touch with the patient for about a year from the time he is first examined. About 70 per cent of the children re turn for reexamination after three
F ig . 3.— T ooth bru sh d rill, C o o k C oun ty D en tal C linic.
talks are given as the work proceeds. The children are given appointment cards and urged to keep their appoint ments and be there on time. It is suprising to note how quickly these children, many of them coming alone after the first time, learn to carry out the routine and how few fail to keep their appointments. When a patient’s work has been com pleted, he is given a card with instruc tions to return in three months for reexamination. If at the end of three
months, and about 60 per cent return after the six months’ period. In this way it is hoped to so train the child that when he is dismissed from the clinic, he will realize the necessity of visiting a dentist at regular periods. An average of about 300 new pa tients are admitted each month and over 200 return for reexamination. We are at present taking care of between 1,800 and 1,900 appointments each month. The purpose of this clinic is not to care for a quantity of patients, but to pro
1264
The Journal of the American Dental Association
duce quality of work in the number handled. Each operation is done with as much care and skill as is possible. All fillings are properly contoured, carved and polished. A great number of treatments are made in both per manent and deciduous teeth, and they are carried out under the most septic conditions and followed by the use of roentgen rays. Each operator works with the idea of giving the patient the best service possible. The question of preventive dentistry has often arisen wherever we have demonstrated our clinic. With the con dition of the mouths that are presented to us, it is hard to accomplish much in the way of preventive dentistry. It often is hard for us to do reparative dentistry successfully. Unless a tooth is hopeless or injurious to the health of the patient, we try to save it, even if for only a short time. SCH OOL D E N T IS T E M P L O Y E D IN D A L L A S T h e school b o a rd o f D allas, T e x a s, has recently m ade an a p p ro p ria tio n w h ich allow s f o r the em ploym ent o f a dentist to w o r k in the schools. H e is to survey a ll o f the schools, do em ergen cy w o r k and instruct the tw enty-seven physical education teachers as to the fundam entals o f dental health and m ethods o f fo llo w u p in ord er that they, in turn, m ay carry the message to the student b od y . In ad d ition to g iv in g lectures, the
dentist w ill see that teachers and la y p eople are supplied w ith pam phlets and other m a terial o n dental health. F L O R I D A L IC E N S E S D E N T A L H Y G IE N IS T S F lo rid a has recen tly passed a la w licensin g dental hygienists. T h is makes a list o f tw enty-seven states in w h ich the hygienist is licensed to practice. H aw aii also licenses dental hygienists. A P P O IN T M E N T
OF
DENTAL
IN T E R N
T h e R ile y H osp ital, Indianapolis, Indiana, has recently appointed D r . Starz H . G rau as dental intern on the same basis as the m edi cal intern. F IE L D N O T E S * D r . M a r y H . W e stfa ll has been appointed state chairm an o f the O ral H ygiene C om m it tee o f the Indiana State D ental A ssociation. D r . Sherman D avis, p rofessor o f chem istry at Indiana U niversity, d u rin g A ugu st and Septem ber lectured on ora l hygiene at the various cou n ty teachers’ institutes. In this w ay, about 8,000 teachers received instruc tion on the fundam entals o f dental health. N inety-seven g irls, representing sixty-nine counties in Indiana, attended the hom e eco n om ic sch ool h eld in con ju n ction w ith the state fa ir . T h e g irls received tw o weeks’ in struction in the various phases o f h om em a k in g and in matters o f health. T h e health w o r k was under the direction o f D r . A d a E. Schw eitzer, d irector o f the C h ild H ygien e D iv isio n o f the Indiana State B oard o f H ealth. ♦The D epartm en t o f D en tal H ealth E d u ca tio n w ill b e g la d to re ce iv e Items o f new s a lo n g the lin es o f ed u ca tio n in d en tal o r g e n e ra l health.
The Journal of the American Dental Association
people that knowledge which will pro health and preventing disease is so gi tect them from preventable diseases gantic that it challenges our best efforts and, perchance, premature death. With and calls for many personal sacrifices; this object in view, the dental depart but the results will more than justify ment has prepared several hundred the time and energy expended. Dentistry has much to offer that will short, readable newspaper articles which will be sent to any paper that will benefit the citizens of Ontario, and the provide the necessary space. Motion pic people look to us for leadership in con tures, slides, posters and pamphlets are nection with this new public health also available, and members of the pro movement. To some it is given to read fession in all parts of the province history; to a few it is given to teach should be willing to give public ad history; to us it is given to make history. dresses pointing out the means whereby May we be willing to accept our oppor an individual can protect himself from tunities and measure up to our respon the ravages of dental disease. sibilities so that in after years it cannot I am glad to have this opportunity tobe said that we were remiss in our duty. speak to the dentists of Eastern Ontario. Our activities will differ to some ex We are all engaged in an altruistic en tent, but we will all be engaged in a deavor to protect the citizens of this work which will never become monot province from disease and injury. onous, for new avenues of helpful serv Health is most important, from both the ice will ever open before us and we standpoint of the individual and that of can always look back on a past of use the state. The task of preserving ful work well done.
COMMUNITY DENTAL SERVICE A S DEMONSTRATED A T CHILDREN’S DENTAL CLINIC, COOK COUNTY HOSPITAL, CHICAGO By M. H. KILLIP,* D.D.S., Chicago, Illinois
M
UCH has been said and written carried on by a few loyal dentists and concerning the development of a number of laymen, who gave their dental education in Chicago and time and money in order that the poor Cook County, but little does the pro children of our city might secure free fession at large realize the great re dental service. Realizing that this sponsibility and untiring effort that has could not be the solution of a com been produced by members of the munity problem, this committee called Public Service Committee of the Chi on public officials to aid them in estab cago Dental Society in developing this lishing a free dental clinic. dental health program. After a number of conferences and For many years, this work has been much effort on the part of a few men connected with the committee, an ap♦Dental Supervisor.
Department o ] D ental H ealth Education
1261
propriation for a clinic was made by the operate with less expense than if it Cook County Board of Commissioners. were run as a private institution. The clinic is equipped with the latest It was also decided that such a clinic, financed by public fund and run as a and best furnishings that can be secured. county institution, should be connected It consists of a large receiving room, with the county hospital. A building examination room, a main operating was found suitable for the clinic, and in clinic with eight complete units and the fall of 1923, Cook County’s first specially built children’s chairs, steriliz
F ig .
1.— C o o k C oun ty C h ild ren ’s D ental C linic, C o o k C oun ty H ospital.
free dental clinic was opened to the public. The budget passed by the county commissioners for the first year was approximately $40,000 and each year the board has voted a new budget of $25,000. The general running ex penses for the year are taken out of the general hospital budget. By being con nected with a large institution such as the county hospital, a clinic of this type can secure many advantages, and
ing room, retiring room, play room, opeiators’ and nurses’ quarters, and of fices. More equipment will be added to the main operating clinic as soon as a larger appropriation is made. In order to take care of those chil dren who are most deserving, and to eliminate all those who are able to pay for their work, a representative of the County Agent department examines each case before the child is admitted as a patient. I f there is any doubt as to
1262
The Journal o f the American D ental Association
the circumstances of the family, an in vestigator is sent to the home and a report is made before further action is taken. Only a limited number of patients can be taken each month and many are refused treatment or are sent to other
brought by either parent or the nurse, those sent by the board of education, and those from other dispensaries. The Juvenile Court sends many of the mother’s pension cases and the boys from the Cook County school located at Riverside.
F ig . 2.— Section o f M ain O p eratin g C lin ic, C o o k C ou n ty D en tal C linic.
clinics or dispensaries for treatment. There are four sources by which chil dren are admitted to the clinic; namely, the County Health Department, County Agent, Juvenile Court, and the County Hospital. The County Health Depart ment brings children from the rural dis tricts. Their nurses have certain days assigned each week and the children brought by them are given preference on those days. The County Agent ad mits children from the city who are
The operating staff is composed of graduate licensed dentists. Each oper ator is a full time civil service employee and is first recommended by the Public Service Committee to the Civil Service Commission. There is no limited serv ice for the operators, but they must adapt themselves to children’s work and devote their entire time to the clinic. A registered supervising nurse is in charge of that department, and is under the direct supervision of the Illinois training school.
Department o f D ental H ealth Education
An educational program is carried on from the time the child is admitted as a patient until the work has been com pleted. Each operator handles the pa tients assigned to him as though he were conducting a private practice. Tooth brush drills are started as soon as the child becomes acquainted, and health
1263
months he returns and there is no further work needed, another card is given with instructions to return in six months. In this way, the clinic keeps in touch with the patient for about a year from the time he is first examined. About 70 per cent of the children re turn for reexamination after three
F ig . 3.— T ooth bru sh d rill, C o o k C oun ty D en tal C linic.
talks are given as the work proceeds. The children are given appointment cards and urged to keep their appoint ments and be there on time. It is suprising to note how quickly these children, many of them coming alone after the first time, learn to carry out the routine and how few fail to keep their appointments. When a patient’s work has been com pleted, he is given a card with instruc tions to return in three months for reexamination. If at the end of three
months, and about 60 per cent return after the six months’ period. In this way it is hoped to so train the child that when he is dismissed from the clinic, he will realize the necessity of visiting a dentist at regular periods. An average of about 300 new pa tients are admitted each month and over 200 return for reexamination. We are at present taking care of between 1,800 and 1,900 appointments each month. The purpose of this clinic is not to care for a quantity of patients, but to pro
1264
The Journal of the American Dental Association
duce quality of work in the number handled. Each operation is done with as much care and skill as is possible. All fillings are properly contoured, carved and polished. A great number of treatments are made in both per manent and deciduous teeth, and they are carried out under the most septic conditions and followed by the use of roentgen rays. Each operator works with the idea of giving the patient the best service possible. The question of preventive dentistry has often arisen wherever we have demonstrated our clinic. With the con dition of the mouths that are presented to us, it is hard to accomplish much in the way of preventive dentistry. It often is hard for us to do reparative dentistry successfully. Unless a tooth is hopeless or injurious to the health of the patient, we try to save it, even if for only a short time. SCH OOL D E N T IS T E M P L O Y E D IN D A L L A S T h e school b o a rd o f D allas, T e x a s, has recently m ade an a p p ro p ria tio n w h ich allow s f o r the em ploym ent o f a dentist to w o r k in the schools. H e is to survey a ll o f the schools, do em ergen cy w o r k and instruct the tw enty-seven physical education teachers as to the fundam entals o f dental health and m ethods o f fo llo w u p in ord er that they, in turn, m ay carry the message to the student b od y . In ad d ition to g iv in g lectures, the
dentist w ill see that teachers and la y p eople are supplied w ith pam phlets and other m a terial o n dental health. F L O R I D A L IC E N S E S D E N T A L H Y G IE N IS T S F lo rid a has recen tly passed a la w licensin g dental hygienists. T h is makes a list o f tw enty-seven states in w h ich the hygienist is licensed to practice. H aw aii also licenses dental hygienists. A P P O IN T M E N T
OF
DENTAL
IN T E R N
T h e R ile y H osp ital, Indianapolis, Indiana, has recently appointed D r . Starz H . G rau as dental intern on the same basis as the m edi cal intern. F IE L D N O T E S * D r . M a r y H . W e stfa ll has been appointed state chairm an o f the O ral H ygiene C om m it tee o f the Indiana State D ental A ssociation. D r . Sherman D avis, p rofessor o f chem istry at Indiana U niversity, d u rin g A ugu st and Septem ber lectured on ora l hygiene at the various cou n ty teachers’ institutes. In this w ay, about 8,000 teachers received instruc tion on the fundam entals o f dental health. N inety-seven g irls, representing sixty-nine counties in Indiana, attended the hom e eco n om ic sch ool h eld in con ju n ction w ith the state fa ir . T h e g irls received tw o weeks’ in struction in the various phases o f h om em a k in g and in matters o f health. T h e health w o r k was under the direction o f D r . A d a E. Schw eitzer, d irector o f the C h ild H ygien e D iv isio n o f the Indiana State B oard o f H ealth. ♦The D epartm en t o f D en tal H ealth E d u ca tio n w ill b e g la d to re ce iv e Items o f new s a lo n g the lin es o f ed u ca tio n in d en tal o r g e n e ra l health.