Bertie Germ, the “murder house” and the ‘’buzzer’’ – all were part of Manawatū childhoods for most of the 20th century.
The School Dental Service was started 100 years ago, prompted by concern about children with mouthfuls of shockingly decayed and infected teeth. Children’s learning was impeded and their general health affected.
Writing in 1920 about ‘The Nation of Tomorrow’, the Manawatu Standard’s editor was among those urging free medical and dental care for children.
Nutrition in childhood determined whether ‘’the adult being emerges either vigorous and robust or weak and unfitted for the battle of life, and proper nutrition is impossible with defective molars”.
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School doctor Elizabeth Gunn was more direct about some of the children in schools she visited: “I do not wonder when I see the septic foetid mouths of these children that they are listless, inattentive and perverted.”
The mouth was the pathway to the body and conditions as varied as impetigo, ear problems, chronic dyspepsia, headaches and appendicitis were, rightly or wrongly, attributed to dental caries and oral sepsis.
The language might have been excessive, but more recent research has confirmed links between poor oral and physical health and even heart disease (though maybe not ‘’perversion’’).
In its first year school dentists and the newly-trained dental nurses performed 13,047 fillings and nearly 15,000 extractions of ‘’unsavable’’ teeth. The number doubled the following year, extractions still exceeding fillings.
The experience was not an edifying one for the nurses or the children.
Dunedin-based nurse May Falconer remembered doing 1700 extractions in a year: ‘’Sometimes the pus would run down over your finger. You’ve no idea what the mouths were like.”
If school dental clinics are now tainted by memories of fear and pain, we do well to also remember the suffering of many children in the absence of treatment – then and now.
Palmerston North parents proved keen for their children to obtain dental treatment.
In 1922 Central School – now Central Normal – offered a room for use as a dental clinic. The clinic opened in 1923 with two graduates from New Zealand’s first intake of dental nurse trainees.
Treatment wasn’t entirely free. The Health Department paid for clinic equipment and supplied the nurses’ salaries. Beyond that, a committee of volunteers was needed to furnish and maintain the clinic.
The committee was authorised to collect five shillings annually from parents for each child treated, ‘‘indigent’’ families to be exempt. By 1929 the clinic was handling 1450 appointments a month.
Other clinics followed: College Street in 1931 and a central dental clinic in King Street in 1933. By 1934 the clinics covered 27 schools and 1300 students, some from country districts.
By the 1950s dental clinics were standard in most Palmerston North schools, including the first in the North Island to be erected at a convent school (Pirie Street, 1944).
Nationally, the average age of the first dental nurse trainees was 28, relatively mature compared with general nurses.
There was a high turnover, many marrying and leaving the service. Some nurses stayed to become fixtures in the city: Nurse Lorraine (Rae) Wimsett came from a Palmerston North family and worked in various local clinics for more than 30 years.
School commemorative volumes invariably mention the dental clinic or ‘‘murder house’’. In West End the Best End, Val Mills viscerally relates her encounters with Nurse Oates and the local school dental clinic; white, sterile and terrifying.
Grasping the arms of the clinic’s wooden chair she could see the rows of little shining instruments, the rubber puffers, the white bowl with swirling water, and the drill, tucked safely away to the side at first.
After picking away at Val’s teeth with a hook shaped instrument, “Nurse Oates reached up her hand and the buzzer sailed into view. It hovered over me, like a long arm of torture, giving me plenty of time to anticipate the next painful step, while Nurse Oates ground away and prepared the filling”.
Such memories are typical. Having a filling done in a school dental clinic was a slow process. High speed drills were not introduced until the 1970s and local anaesthetics were used all too sparingly for procedures other than extractions.
By 1980 nearly all primary and intermediate school children in New Zealand came under the School Dental Service, along with 65 per cent of pre-schoolers. However, the centralised service did not survive the health reforms of the 1980s and 1990s, its management devolving to area health boards.
By this time the fluoridation of many local water supplies was starting to have a positive effect, as were new forms of treatment.
Our children are losing the battle against tooth decay.
A 1988 survey showed that half of all 12 and 13 year olds nationally were cavity-free or had only one tooth decayed or filled – a very different picture from even 20 years earlier.
But there was another side. There were very clear regional, socio-economic and ethnic differentials in oral health, differentials which appeared to grow over the next two decades.
Māori and Pasifika children, in particular, fell through the gaps of a reconfigured community dental health service.
Newspaper headlines in more recent years echo the horror stories of the 1920s, with regular references on Stuff to “dental clearances” – the removal of all teeth from a child’s mouth, at least now done under general anaesthetic.
‘Bertie Germ’, the personification of dental cavities in 20th century dental clinic posters, is as active as ever in the mouths of many children.
Margaret Tennant is a Manawatū historian and Professor Emeritus at Massey University.