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Responsibility of the Private Practitioner
TW ELFTH N A T IO N A L DEN TAL H EALTH C O N FE R EN C E . . . V O LU M E 64, FEBRUARY 1962 • 35/173
Increm ental care program s for children
Kenneth ]. R ya n * D.D.S., Flint, Mich.
Last fall, the Commission on the Survey of Dentistry observed that “ If children’s teeth can be saved now, there is some hope of trimming the national accumulation of dental illness down to manageable size in the future,” and it made four specific recommendations for the development of incremental care programs for children.1 Under this type of program, all six-year-olds would be covered the first year, with new groups of six-year-olds being added each year until all children would be covered through high school. H ow would the programs work? What would be the responsibility of the dentist? H ow would dental auxiliaries be utilized most efficiently? What should be the concern o f the physician in the development of the whole child? These and many other pertinent questions were answered by a panel of experts during the Twelfth National Dental Health Conference, and their papers are presented in the following pages. • M e m b e r , C o u n c il o n D e n ta l H e a lth , A m e r ic a n D e n ta l A s s o c ia tio n . I . A m e r ic a n C o u n c il on E d u c a tio n , C o m m is s io n on th e S urve y o f D e n tis try in th e U n ite d S ta te s. S u m m a ry r e p o r t. W a s h in g to n , D .C ., A m e r ic a n C o u n c il o n E d u c a tio n , 1961, p . 14.
RESPONSIBILITY OF THE PRIV ATE PR A C TITIO N E R
Philip H . Suess,* D.D.S., M.S.D., 'Chicago
The design and initiation of an incre mental dental care program for children is a real challenge to the dental profession but certainly one that has precedents in private practice. There is no question that the clinical experience gained from gen eral practitioners, children’s clinics and certainly pedodontists can contribute the essentials to such a program. It is, however, the direction that is im portant, and I am convinced that dentistry
must take the lead in proving to the pub lic that dental care for the child is the way for improved dental health for the nation. Ambitious as this plan may seem at first appraisal, it is basic in that it pro poses to start with the child and to carry that child through a period of his life when he is most receptive to and influ enced by sound dental procedures. There is no doubt in my mind that a normal, healthy child participating in this type of
36/174 • TH E JO U R N A L O F TH E A M E R IC A N DENTAL A S S O C IA T IO N
program will develop into an excellent dental patient. He will have a full com plement o f teeth, in good repair and in good occlusion. Equally important, he will have a knowledge and appreciation of dental health that is rare today. This, then, is the responsibility of pri vate practitioners: first, to contribute their clinical knowledge and experience to a discussion of incremental dental care for children so that the resulting program may be designed to anticipate for the greater part the clinical demands that may be expected; second, to discuss par ents’ present attitudes toward complete dental care for children offered in private practice today; third, and equally press ing, to discuss the attitude of the public and private school authorities toward dental health education and complete dental care for children. The Commission on the Survey of Den tistry in the United States is convinced that a level o f advancement has been reached in dental practice today that may be utilized in designing and initiating an incremental dental care program for chil dren. I envision this program to be based on the following points: 1. Nodal profiles of dental develop ment and susceptibility such as are used in the works of Arnold Gesell.1 These profiles would be based on those periods of relative equilibrium in the normal progression of the child toward dental maturity. Through the utilization of this approach to clinical dentistry and oral development, the dental practitioner may be able to modify or reduce the antici pated susceptibility to oral disease. 2. The use of auxiliary personnel will allow the dental practitioner to devote himself to more complete and adequate care for the child. 3. The cooperation of the parents will be stimulated by the realization that den tistry not only can anticipate and modify the ravages of dental decay but it can offer an excellent prognosis for oral prob
lems that beset children between 3 and 16 years of age. 4. The school authorities can be shown that such a proposed incremental dental care program is feasible and that it is by far the most efficient method of dental health care and education. It is my intention, therefore, to point out how we can provide complete dental care through an incremental program de void of any restraints except to provide for the child as he deserves. I believe the proposed program should start with the preschool child and certainly by the age of five. W e must strive to place dental care in its proper perspective in regard to the school curriculum. The child at this age level is accompanied by at least one of the parents who can be exposed to dental health information while the child is introduced to the dental environment. Starting with the preschool child will en able the dentist to see the child before extensive dental problems develop in the largest proportion of children. It will bolster the importance of dental care in the minds of parents and it will help in the management o f the child patient. T o start an incremental dental care program with the school age child will only make the transition more traumatic for the child, the teacher and the dentist. The preschool patient would receive a dental prophylaxis, clinical oral examina tion and if necessary a specialized roentgenographic examination. This first den tal experience should be planned at a time when the child is untired and it should be flexible enough so that the dentist may be free to exercise good judgment favor ing the child’s response to the dental en vironment. Attention should be directed not only to the detection o f dental caries but to an examination of all oral tissues. Such oral problems of the preschool child as traumatized deciduous teeth, oral hab its and the normal development of the deciduous dentition should receive ade quate attention.
TW ELFTH N A T IO N A L DEN TAL H EA LTH C O N FE R E N C E . . . VO LU M E 64, FEBRUARY 1962 • 37/175
All parents would receive dental health information covering dental caries and its control through oral hygiene, diet and preventive dentistry procedures. This ma terial should include the importance of proper professional care of the deciduous dentition and should stress the responsi bility o f the parents to secure complete dental care for their children. Parents should be made aware of the distinction between proximal dental caries and pit and fissure defects. They should be given basic information on nutrition; specific recommendations regarding bubble gum and hard candies should be made. The results o f this first dental health examination would separate all children into two classifications. The caries-free children would be released for one year after they had received topically applied stannous fluoride and adequate instruc tion in oral hygiene by auxiliary person nel. The susceptible children would be placed into an accelerated dental care classification. This group would receive a specialized roentgenographic examination which would help in the detection of dental caries in the deciduous teeth. It would also establish the presence of the developing permanent tooth buds, which would constitute the phase of develop ment on which the first nodal profile is based. The findings of this more extensive dental examination would be compiled with the dentist’s appraisal of the child’s response to the dental environment, and a proposed treatment plan for that child would be developed. This treatment plan would be presented to the parents by the dentist in the presence o f the child. The purpose of this consultation is to deter mine if the child’s dental needs will be completed by the family dentist, the local dental health program or the pedodontist. I do not wish to segregate professional care, but I feel that every child should have the opportunity o f receiving the level of professional care that is necessary for that patient. This certainly cannot be
estimated, but it will become apparent as the child responds to the program. I be lieve that child patients will be able to convince the private practitioner that they are good dental patients and that preserving their cooperation is his most urgent responsibility. This cooperation and the complexity of the treatment plan should determine the referral of patients and not the parent’ s financial ability. On completion of the necessary dental work as prescribed in the treatment plan, the child would be returned to the cariesfree group, and preventive dentistry pro cedures would be completed by auxiliary personnel. The program would proceed the fol lowing year with a new age group enter ing and the previous group being screened for new dental lesions and any deviations from normal oral development. All suc ceeding screening examinations would be based on the previous examination for any given child and would be appraised in light o f the nodal profile for the next phase of development the child is ex pected to pass through. The use of nodal profiles in diagnosis and treatment plan ning is very important, and I believe it deserves the most urgent study because it would establish a basic level of compe tence on which adequate and complete dental care for children could be formu lated. It should not be required or ex pected that every child will conform to the nodal profile, but it should serve to detect the extreme deviation in caries susceptibility and normal oral develop ment. The children that show extreme deviations from normal oral development would be so classified, and professional consultation would be given to the parent so that adequate orthodontic treatment may be secured. Functional problems such as cross-bites of deciduous and young permanent teeth should receive adequate diagnosis and treatment. Provision must be made so that emergency problems, such as traumatic injuries to young per manent incisors, may be treated properly.
38/174 • TH E JO U R N A L O F T H E A M E R IC A N D EN TA L A S S O C IA T IO N
Most management problems d o not arise on the first dental appointment, but they arise when operative work is at tempted on the young permanent teeth. The solution to this problem is not the use of drugs, auxiliary personnel or high speed but it is simply this— a dental ap pointment when the child is untired and receptive to firm, understanding guidance — school time. Clinical experience indi cates that once a child has been exposed to restorative dental procedures, he be comes more responsive and cooperative to dietary control o f dental caries and to preventive dental procedures, such as oral hygiene and topically applied stannous fluoride. Many children will be so influ enced by this dental health experience that they will need only a minimum of operative dental care as they proceed to the phase of development on which the next nodal profile is based— the mixed dentition period. It is also recognized that caries susceptibility is not constant throughout the age period 3 to 16. There is an increasing susceptibility from 3 to 10 and then a decline in caries incidence while the posterior deciduous teeth begin their exfoliation and the young perma nent successors erupt into occlusion. This anticipated reduction in dental caries incidence could be further in creased from what we now experience in private practices through increased den tal health education to parents as well as to children, improved oral hygiene at home and improved nutrition at school and more efficient use of auxiliary per sonnel in preventive dentistry procedures and programs. Increased efforts then can be directed toward the numerous func tional problems that are associated with the eruption and development o f the young permanent dentition. The eruption of the second permanent molars— the phase on which the adult nodal profile is based— initiates the be ginning of the second susceptible period which at present is more devastating than the first, but which is certainly more vul
nerable to the preventive dentistry pro cedures and programs that we have in our armamentarium today. It is at this point on to the termination o f the child’ s par ticipation in the program at 16 years of age that dental health education will have to stress the individual’s responsibility to preserve his oral health into and through out adult life. Consistent return of a child into the accelerated dental care classification should cause the dentist to question the cooperation of the child and certainly that of the parent. I do not wish to imply that the parent has any established obliga tion to complete dental care under the proposed voluntary incremental care pro gram, but I feel that the dental profession should have the legal right to question the cooperation of the child and to place this lack of cooperation squarely in the hands of the parent. Parents’ responsibil ity for the dental care o f their children is not dependent on their financial or edu cational status but is a reflection of their own dental needs and experiences. The responsibility of the parent to place the child in the incremental care program at the proper time is essential to its success and cannot be compromised. The parents must be made to realize that complete dental care begins before the child has developed his first cavity and not after he has experienced a toothache. Every possible avenue of securing the cooperation o f the parents should be pur sued because it is through their assistance that the third problem will be placed in more logical proportion. The cooperation of the public and private school authori ties will be in direct proportion to the degree o f understanding and participa tion of the parents with the proposed dental care program. It is imperative that the dentist have the parents’ support and cooperation in regard to school attendance, because it may well determine how successful man agement and treatment of a given child will be. I f the parents’ responsibility to
TW ELFTH N A T IO N A L DEN TAL H EALTH C O N FE R EN C E . . . VO LU M E 64, FEBRUARY 1962 • 39/177
secure adequate dental care for their children does not solve the conflict be tween professional appointments and school attendance, then the dental pro fession must secure legal authority to pro vide dental care when it is necessary to preserve the dental health of the child. This provision is increasingly more im portant today with the recent tendency to increase federal aid to education. There is no question that local school boards have made great contributions to the improvement of dental health educa tion in our schools. The most recent ad vancement occurred here in Chicago where the sale of all confectioneries and carbonated beverages was banned in the lunchrooms of the public' grammar schools and from some of the public high schools. This represents the efforts of John L. Reichert, M.D., of the Chicago school board to improve the nutrition of our school children, but I am fearful that this advantage has not been pursued to its
fullest by either the dental profession or the medical profession. Where the health of our children is concerned we, as pro fessional men, can ill afford to let an isolated accomplishment such as that made by Dr. Reichert go unpublicized. The program we are discussing today should certainly illustrate to the public, dentistry’s concern for the improvement o f oral health for our children. The in cremental dental care program must be accepted as an integral part of the normal growth and development by the child and his parents, and it should be considered essential to the education and maturation of our children by all school authorities. 55 East Washington Street
P re se n te d b e fo re th e T w e lfth N a tio n a l D e n ta l H e a lth C o n fe re n c e , A m e r ic a n D e n ta l A s s o c ia tio n , C h ic a g o , A p r i l 26-28, 1961. •F o rm e rly , a s s is ta n t p ro fe s s o r o f p e d o d o n tic s , N o r th w e ste rn U n iv e rs ity D e n ta l S c h o o l. I. G e s e ll, A r n o ld , a n d o th e rs . In fa n t a n d c h ild in th e c u ltu re o f to d a y . N e w Y o rk , H a rp e r & B ro th e rs, 1943, p . 1-7.
H O W W O U LD INCREM ENTAL CARE PROGRAMS FOR CHILDREN W O R K ?
Wesley O. Young,* D .M .D ., M.P.H., Boise, Idaho
The Commission on the Survey of Den tistry, after an exhaustive two and one half year study o f the dental profession, has suggested more than 75 actions to im prove the oral health of the public. This panel has been asked to discuss one of the major recommendations in the Com mission’s report, in the chapter on dental health, a recommendation that states and communities initiate programs to assure complete dental care for all children. The Commission’s endorsement of compre
hensive incremental care programs for children is idealistic and visionary, yet realistic and essentially conservative. If acted on, this recommendation could rev olutionize the oral health status of the American public and the practice of den tistry. The report o f the Survey of Dentistry contains three statements relat ing to dental care programs for children.1 These recommendations are that: 1. States and local communities design and initiate incremental care programs for chil
Increm ental care program s for children
Kenneth ]. R ya n * D.D.S., Flint, Mich.
Last fall, the Commission on the Survey of Dentistry observed that “ If children’s teeth can be saved now, there is some hope of trimming the national accumulation of dental illness down to manageable size in the future,” and it made four specific recommendations for the development of incremental care programs for children.1 Under this type of program, all six-year-olds would be covered the first year, with new groups of six-year-olds being added each year until all children would be covered through high school. H ow would the programs work? What would be the responsibility of the dentist? H ow would dental auxiliaries be utilized most efficiently? What should be the concern o f the physician in the development of the whole child? These and many other pertinent questions were answered by a panel of experts during the Twelfth National Dental Health Conference, and their papers are presented in the following pages. • M e m b e r , C o u n c il o n D e n ta l H e a lth , A m e r ic a n D e n ta l A s s o c ia tio n . I . A m e r ic a n C o u n c il on E d u c a tio n , C o m m is s io n on th e S urve y o f D e n tis try in th e U n ite d S ta te s. S u m m a ry r e p o r t. W a s h in g to n , D .C ., A m e r ic a n C o u n c il o n E d u c a tio n , 1961, p . 14.
RESPONSIBILITY OF THE PRIV ATE PR A C TITIO N E R
Philip H . Suess,* D.D.S., M.S.D., 'Chicago
The design and initiation of an incre mental dental care program for children is a real challenge to the dental profession but certainly one that has precedents in private practice. There is no question that the clinical experience gained from gen eral practitioners, children’s clinics and certainly pedodontists can contribute the essentials to such a program. It is, however, the direction that is im portant, and I am convinced that dentistry
must take the lead in proving to the pub lic that dental care for the child is the way for improved dental health for the nation. Ambitious as this plan may seem at first appraisal, it is basic in that it pro poses to start with the child and to carry that child through a period of his life when he is most receptive to and influ enced by sound dental procedures. There is no doubt in my mind that a normal, healthy child participating in this type of
36/174 • TH E JO U R N A L O F TH E A M E R IC A N DENTAL A S S O C IA T IO N
program will develop into an excellent dental patient. He will have a full com plement o f teeth, in good repair and in good occlusion. Equally important, he will have a knowledge and appreciation of dental health that is rare today. This, then, is the responsibility of pri vate practitioners: first, to contribute their clinical knowledge and experience to a discussion of incremental dental care for children so that the resulting program may be designed to anticipate for the greater part the clinical demands that may be expected; second, to discuss par ents’ present attitudes toward complete dental care for children offered in private practice today; third, and equally press ing, to discuss the attitude of the public and private school authorities toward dental health education and complete dental care for children. The Commission on the Survey of Den tistry in the United States is convinced that a level o f advancement has been reached in dental practice today that may be utilized in designing and initiating an incremental dental care program for chil dren. I envision this program to be based on the following points: 1. Nodal profiles of dental develop ment and susceptibility such as are used in the works of Arnold Gesell.1 These profiles would be based on those periods of relative equilibrium in the normal progression of the child toward dental maturity. Through the utilization of this approach to clinical dentistry and oral development, the dental practitioner may be able to modify or reduce the antici pated susceptibility to oral disease. 2. The use of auxiliary personnel will allow the dental practitioner to devote himself to more complete and adequate care for the child. 3. The cooperation of the parents will be stimulated by the realization that den tistry not only can anticipate and modify the ravages of dental decay but it can offer an excellent prognosis for oral prob
lems that beset children between 3 and 16 years of age. 4. The school authorities can be shown that such a proposed incremental dental care program is feasible and that it is by far the most efficient method of dental health care and education. It is my intention, therefore, to point out how we can provide complete dental care through an incremental program de void of any restraints except to provide for the child as he deserves. I believe the proposed program should start with the preschool child and certainly by the age of five. W e must strive to place dental care in its proper perspective in regard to the school curriculum. The child at this age level is accompanied by at least one of the parents who can be exposed to dental health information while the child is introduced to the dental environment. Starting with the preschool child will en able the dentist to see the child before extensive dental problems develop in the largest proportion of children. It will bolster the importance of dental care in the minds of parents and it will help in the management o f the child patient. T o start an incremental dental care program with the school age child will only make the transition more traumatic for the child, the teacher and the dentist. The preschool patient would receive a dental prophylaxis, clinical oral examina tion and if necessary a specialized roentgenographic examination. This first den tal experience should be planned at a time when the child is untired and it should be flexible enough so that the dentist may be free to exercise good judgment favor ing the child’s response to the dental en vironment. Attention should be directed not only to the detection o f dental caries but to an examination of all oral tissues. Such oral problems of the preschool child as traumatized deciduous teeth, oral hab its and the normal development of the deciduous dentition should receive ade quate attention.
TW ELFTH N A T IO N A L DEN TAL H EA LTH C O N FE R E N C E . . . VO LU M E 64, FEBRUARY 1962 • 37/175
All parents would receive dental health information covering dental caries and its control through oral hygiene, diet and preventive dentistry procedures. This ma terial should include the importance of proper professional care of the deciduous dentition and should stress the responsi bility o f the parents to secure complete dental care for their children. Parents should be made aware of the distinction between proximal dental caries and pit and fissure defects. They should be given basic information on nutrition; specific recommendations regarding bubble gum and hard candies should be made. The results o f this first dental health examination would separate all children into two classifications. The caries-free children would be released for one year after they had received topically applied stannous fluoride and adequate instruc tion in oral hygiene by auxiliary person nel. The susceptible children would be placed into an accelerated dental care classification. This group would receive a specialized roentgenographic examination which would help in the detection of dental caries in the deciduous teeth. It would also establish the presence of the developing permanent tooth buds, which would constitute the phase of develop ment on which the first nodal profile is based. The findings of this more extensive dental examination would be compiled with the dentist’s appraisal of the child’s response to the dental environment, and a proposed treatment plan for that child would be developed. This treatment plan would be presented to the parents by the dentist in the presence o f the child. The purpose of this consultation is to deter mine if the child’s dental needs will be completed by the family dentist, the local dental health program or the pedodontist. I do not wish to segregate professional care, but I feel that every child should have the opportunity o f receiving the level of professional care that is necessary for that patient. This certainly cannot be
estimated, but it will become apparent as the child responds to the program. I be lieve that child patients will be able to convince the private practitioner that they are good dental patients and that preserving their cooperation is his most urgent responsibility. This cooperation and the complexity of the treatment plan should determine the referral of patients and not the parent’ s financial ability. On completion of the necessary dental work as prescribed in the treatment plan, the child would be returned to the cariesfree group, and preventive dentistry pro cedures would be completed by auxiliary personnel. The program would proceed the fol lowing year with a new age group enter ing and the previous group being screened for new dental lesions and any deviations from normal oral development. All suc ceeding screening examinations would be based on the previous examination for any given child and would be appraised in light o f the nodal profile for the next phase of development the child is ex pected to pass through. The use of nodal profiles in diagnosis and treatment plan ning is very important, and I believe it deserves the most urgent study because it would establish a basic level of compe tence on which adequate and complete dental care for children could be formu lated. It should not be required or ex pected that every child will conform to the nodal profile, but it should serve to detect the extreme deviation in caries susceptibility and normal oral develop ment. The children that show extreme deviations from normal oral development would be so classified, and professional consultation would be given to the parent so that adequate orthodontic treatment may be secured. Functional problems such as cross-bites of deciduous and young permanent teeth should receive adequate diagnosis and treatment. Provision must be made so that emergency problems, such as traumatic injuries to young per manent incisors, may be treated properly.
38/174 • TH E JO U R N A L O F T H E A M E R IC A N D EN TA L A S S O C IA T IO N
Most management problems d o not arise on the first dental appointment, but they arise when operative work is at tempted on the young permanent teeth. The solution to this problem is not the use of drugs, auxiliary personnel or high speed but it is simply this— a dental ap pointment when the child is untired and receptive to firm, understanding guidance — school time. Clinical experience indi cates that once a child has been exposed to restorative dental procedures, he be comes more responsive and cooperative to dietary control o f dental caries and to preventive dental procedures, such as oral hygiene and topically applied stannous fluoride. Many children will be so influ enced by this dental health experience that they will need only a minimum of operative dental care as they proceed to the phase of development on which the next nodal profile is based— the mixed dentition period. It is also recognized that caries susceptibility is not constant throughout the age period 3 to 16. There is an increasing susceptibility from 3 to 10 and then a decline in caries incidence while the posterior deciduous teeth begin their exfoliation and the young perma nent successors erupt into occlusion. This anticipated reduction in dental caries incidence could be further in creased from what we now experience in private practices through increased den tal health education to parents as well as to children, improved oral hygiene at home and improved nutrition at school and more efficient use of auxiliary per sonnel in preventive dentistry procedures and programs. Increased efforts then can be directed toward the numerous func tional problems that are associated with the eruption and development o f the young permanent dentition. The eruption of the second permanent molars— the phase on which the adult nodal profile is based— initiates the be ginning of the second susceptible period which at present is more devastating than the first, but which is certainly more vul
nerable to the preventive dentistry pro cedures and programs that we have in our armamentarium today. It is at this point on to the termination o f the child’ s par ticipation in the program at 16 years of age that dental health education will have to stress the individual’s responsibility to preserve his oral health into and through out adult life. Consistent return of a child into the accelerated dental care classification should cause the dentist to question the cooperation of the child and certainly that of the parent. I do not wish to imply that the parent has any established obliga tion to complete dental care under the proposed voluntary incremental care pro gram, but I feel that the dental profession should have the legal right to question the cooperation of the child and to place this lack of cooperation squarely in the hands of the parent. Parents’ responsibil ity for the dental care o f their children is not dependent on their financial or edu cational status but is a reflection of their own dental needs and experiences. The responsibility of the parent to place the child in the incremental care program at the proper time is essential to its success and cannot be compromised. The parents must be made to realize that complete dental care begins before the child has developed his first cavity and not after he has experienced a toothache. Every possible avenue of securing the cooperation o f the parents should be pur sued because it is through their assistance that the third problem will be placed in more logical proportion. The cooperation of the public and private school authori ties will be in direct proportion to the degree o f understanding and participa tion of the parents with the proposed dental care program. It is imperative that the dentist have the parents’ support and cooperation in regard to school attendance, because it may well determine how successful man agement and treatment of a given child will be. I f the parents’ responsibility to
TW ELFTH N A T IO N A L DEN TAL H EALTH C O N FE R EN C E . . . VO LU M E 64, FEBRUARY 1962 • 39/177
secure adequate dental care for their children does not solve the conflict be tween professional appointments and school attendance, then the dental pro fession must secure legal authority to pro vide dental care when it is necessary to preserve the dental health of the child. This provision is increasingly more im portant today with the recent tendency to increase federal aid to education. There is no question that local school boards have made great contributions to the improvement of dental health educa tion in our schools. The most recent ad vancement occurred here in Chicago where the sale of all confectioneries and carbonated beverages was banned in the lunchrooms of the public' grammar schools and from some of the public high schools. This represents the efforts of John L. Reichert, M.D., of the Chicago school board to improve the nutrition of our school children, but I am fearful that this advantage has not been pursued to its
fullest by either the dental profession or the medical profession. Where the health of our children is concerned we, as pro fessional men, can ill afford to let an isolated accomplishment such as that made by Dr. Reichert go unpublicized. The program we are discussing today should certainly illustrate to the public, dentistry’s concern for the improvement o f oral health for our children. The in cremental dental care program must be accepted as an integral part of the normal growth and development by the child and his parents, and it should be considered essential to the education and maturation of our children by all school authorities. 55 East Washington Street
P re se n te d b e fo re th e T w e lfth N a tio n a l D e n ta l H e a lth C o n fe re n c e , A m e r ic a n D e n ta l A s s o c ia tio n , C h ic a g o , A p r i l 26-28, 1961. •F o rm e rly , a s s is ta n t p ro fe s s o r o f p e d o d o n tic s , N o r th w e ste rn U n iv e rs ity D e n ta l S c h o o l. I. G e s e ll, A r n o ld , a n d o th e rs . In fa n t a n d c h ild in th e c u ltu re o f to d a y . N e w Y o rk , H a rp e r & B ro th e rs, 1943, p . 1-7.
H O W W O U LD INCREM ENTAL CARE PROGRAMS FOR CHILDREN W O R K ?
Wesley O. Young,* D .M .D ., M.P.H., Boise, Idaho
The Commission on the Survey of Den tistry, after an exhaustive two and one half year study o f the dental profession, has suggested more than 75 actions to im prove the oral health of the public. This panel has been asked to discuss one of the major recommendations in the Com mission’s report, in the chapter on dental health, a recommendation that states and communities initiate programs to assure complete dental care for all children. The Commission’s endorsement of compre
hensive incremental care programs for children is idealistic and visionary, yet realistic and essentially conservative. If acted on, this recommendation could rev olutionize the oral health status of the American public and the practice of den tistry. The report o f the Survey of Dentistry contains three statements relat ing to dental care programs for children.1 These recommendations are that: 1. States and local communities design and initiate incremental care programs for chil