H.—3l.

If defects are found the practice of the School Medical Officer is to notify the parents of their existence, the choice of medical attendants being left entirely to the parents. If the parents are unable for financial reasons or are too apathetic to obtain the necessary advice and treatment, it is the duty of the School Medical Service to see that it is carried out. A great number of operations for minor defects are carried out at the public hospitals throughout New Zealand. In cities the percentage of treatment obtained is from 80 per cent, to 90 per cent, of the number recommended for it, but in the country where facilities are fewer it is much less. It is the aim of the Service to secure the interest and co-operation of the parents, as it is realized that only in this way can the work be made effective. In pursuit of this aim parents are invited to be present at the examination of their children, an opportunity of which the majority avail themselves. Milk-in-schools Scheme. —This scheme, which provides for the issue of pasteurized milk to schoolchildren free of cost, was inaugurated early in 1937. It provides for the issue to each child of half a pint of high-grade milk which is pasteurized, bottled, and consumed through a straw. The source of supply is closely inspected, and the whole process of treatment and distribution closely supervised to ensure a high hygienic standard. Approximately 157,000 school-children are now in receipt of milk under this scheme, which reaches 55 per cent, of the school population. Extensions of the scheme are in immediate prospect which will include another 18,000 children, bringing the number to whom milk is available up to over 68 per cent, of the school population. Health Camps. —A successful feature of the work for the benefit of delicate and undernourished children has been the establishment of health camps. The great improvement in physical and mental vitality of the children attending such camps affords evidence of their value. Health Education. —To improve the standard of health education in the district periodical lectures on the health of children are given to teachers, parents, and the general public, as well as short addresses on the care and health of the body to children in the schools. School Medical Officers are responsible for the medical examination of all candidates for entrance to the teaching profession, approximately one thousand being seen each year. A short series of lectures to the students of training colleges in the four chief towns are given annually. (/) Division of Dental Hygiene. This Division undertakes the dental treatment of school-children. It has as its Director a registered dentist, and is staffed by dental surgeons mostly on the administrative and instructional side, and by dental nurses. The latter are specially trained by the Department to undertake the treatment of children's teeth. Their training covers a period of two years' intensive study, specially adapted for the work they have to perform. After qualifying they are appointed to take charge of the school dental clinics established by the Department of Health throughout the Dominion. The law restricts the operation of State dental nurses to service under the Department of Health. Each dental clinic serves a certain group of schools, and the duty of the dental nurse is to render the younger children of these schools dentally fit as far as possible and maintain them in that condition. The treatment is largely standardized, the work of the dental nurse being limited to the treatment and filling of deciduous teeth, the filling of permanent teeth when the pulp is not involved, extractions with local anaesthetics, and prophylactic treatment. The work is organized on certain definite lines, and both the operative work and the organization are subject to frequent inspections by the supervising dentists. In attacking the problem of dental caries the policy of the Department is a preventive one, In order to prevent the development of extensive dental caries all efforts are, in the first place, concentrated on the youngest children in the schools —that is to say, on the children in the infant classes, whose ages are from five to eight years. These children are then kept under dental observation as they progress through the school, being re-examined as far as possible every six months. Whenever the written consent of the parents is given, the attendance of children at this clinic is a matter of school routine. The attendance of children under school age —that is, from two years and a half to five years —is encouraged. It enables the operators to detect and remedy the defects earlier in contact with the parents. Additionally a great deal of propaganda work is carried out in the form of leaflets, coloured posters, children's stories, exhibits, talks to parents and children, competitions, &c. The School Dental Service was inaugurated in 1921, and was steadily developed until 1931, when, owing to the general financial stringency, the establishment of new clinics was postponed for the time being. Local extension has been carried out, however, within the limitations of the staff available, and at the present time some one thousand six hundred schools are officially linked up with the Service, and 90,000 children are under regular and systematic dental supervision and treatment. During the last two years the expansion of the Service has been resumed, and a greatly increased number of nurses has been accepted for training, with a view to making the service available for the children of all the primary schools in the Dominion within the next three years. The number of school dental clinics at the present time is 253, of which 145 are main-treatment centres and 108 are sub-bases. The number of dental nurses in the field is 190, and the number at the training-school is 153, of whom 47 have completed their training, and will be transferred to clinics in the field within the near future.

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