Existing dental services.
The need for a
School Dental Care Service.
Nature of Service Proposed.
CHAPTER 11
DENTAL HEALTH
11.1 So far emphasis has been placed on the establishment of basic medical and personal health services. Less attention has ac- cordingly been focussed on the importance of the dental health of the community.
11.2 At present, the dentists in the Medical and Health Depart- ment provide a full dental service for Government officers and their families and Government pensioners. The department also provides simple dental treatment for the inmates of penal institu- tions, specialist treatment for patients in Government hospitals, and emergency treatment for members of the public. All other dental treatment is carried out by private practitioners.
11.3 To introduce a general dental service on a scale com- parable to the Government's medical services would be an extremely costly development, and one beyond the Government's ability at this stage to finance or to staff. Such, however, is the importance increasingly placed by the community on this aspect of personal health that action to promote dental hygiene and proper dental care should be vigorously pursued. Steps will therefore be taken to establish a school dental service and to provide more dentists for the general public.
11.4. When the School Medical Service was reconstituted in 1964, no school dental care service was included because of the shortage of dentists at that time and their reluctance to join a scheme on the terms proposed by the Government. The evidence of dental health surveys by the Medical and Health Department indicates that children do not appear to receive the dental atten- tion necessary during the early part of their lives. In the absence of skilled dental conservative treatment the standard of dental health among children even in spite of the beneficial effects of fluoridation of water is still low, as is borne out from experience of those who come to the notice of the Government dental officers.
11.5 Proposals are made in this White Paper that more dentists be provided for general practice. But to prevent dental decay be- coming too firmly established in young children a limited pro-
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gramme will be instituted to provide a basic dental conservation service at primary school level.
11.6 This scheme will provide participants with regular examinations and simple conservative treatment, including limited orthodontic treatment, but will not include the provision of appliances. Fillings and extractions would be included but the scheme would not be designed to provide emergency treatment, which will continue to be available from dentists in the Govern- ment dental clinics where necessary.
11.7 Experience elsewhere has shown that this service can be carried out effectively by properly trained dental nurses provided they are suitably supervised by qualified dentists. The use of dental nurses to provide routine preventive dental service has been adopted and proved successful for many years in other countries.
11.8 Notwithstanding the priority attached to this development it will take several years to build up the staff needed to operate the scheme. It will not be possible to include all pupils of school age from the start. The Government has therefore accepted the MDAC recommendation that initially the scheme should be avail- able only to children entering primary school in the year in which the scheme starts. Thereafter the scheme will be progressively extended to include children entering primary school in each sub- sequent year. Treatment will be subsidized but not free; an annual charge of $5 will be made in line with that made in the case of the School Medical Service.
a Dental
11.9 To enable the scheme to proceed a dental nurse training Establish- school must be established. It is proposed that this be included ment of in a dental centre to be established at Morrison Hill, next to the Nurse Tang Chi Ngong Specialist Clinic. This will also accommodate a Training school children's dental clinic with 30 chairs, surgeries for the School. dental officers and the Government dental clinic presently in the Wan Chai Polyclinic.
11.10 With the introduction of this service a major step will Dentist have been taken towards improving the dental health of the require- community without significantly increasing the demand for dentists. It is clear however from the MDAC assessment of the present
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