Can Impacted Teeth Cause Moral Delinquency?
- Author:
Arthur Holmes, Ph.D.
University of Pennsylvania, Philadelphia.
A teacher in a crowded school room was fretted beyond endurance by one boy in particular. It was not because of his lessons; he stood well in his class, in fact at the head. There was plenty of evidence that he did not come from a poor home. His clothing was good, his hands were clean, he wore a necktie and collar; there was a general air of good breeding about him. It was neither dulness nor home training that made Harry the most troublesome boy to handle in that school. He could never sit still; he was always turning around, moving about and talking to the other scholars, until finally he so wore upon the nerves of his teacher that she was compelled to send him home with a note of suspension. Then the father took him in hand, but parental authority, discipline, and persuasion all failed. Conduct at home and school grew steadily worse and along with elements of mischievousness came actual criminal tendencies. Truth telling became a lost art; be lied continually and without apparent reason; things about the house disappeared; his father’s watch was purloined and sold for five cents; small articles at school were not safe if left within his reach. The climax was attained when this acquisitive faculty took the form of financial appropriation, which ended in his stealing sums of money from the neighbors, amounting at one time to five dollars.
Having got completely beyond the control of both school and family discipline, the boy was handed over to the Juvenile Court and put on probation. This treatment, however, did not bring the desired results. Frequent incarcerations at the House of Detention for the purpose of frightening Harry failed to affect him in the least. Next, a special school was tried, but that had no permanent effect. Finally, in October of 1909, as a last resort, he was brought to the Psychological Clinic for examination. Nothing abnormal was found in his physical condition. There were no special stigmata of degeneration nor any hint of mental or moral imbecility. At the Nose and Throat Clinic a small adenoid growth was found and an operation advised. His parents were informed of this fact and arrangements for an operation were promised. For a couple of months Harry disappeared from the view of the Psychological Clinic and it was thought that he had returned to the well trodden paths of school and home proprieties.
However, about the first of December, he turned up again in the company of his father and a probation officer. His conduct instead of improving had been growing steadily worse; his nervousness at school had reached a point where he not only wouldn’t sit still, he even climbed upon his desk, wished to answer all questions, was noisy and troublesome, utterly fearless and careless of consequences. At home his disobedience, irritability and stubbornness were frequent causes of domestic turmoil. When permitted to go out on the street at night, only upon his promise to return by a specified hour, he seemed utterly to forget supper, bedtime, or parental discipline and returned at his own pleasure or was found and brought home by his father. His other bad habits had also increased rather than decreased.
Outwardly there was no apparent change in his condition, but a careful examination of his mouth revealed the chief factor in his trouble. A number of his first teeth had not yet been shed and the second teeth were slowly forcing their way out alongside of the old ones. His gums, now very much swollen and red, were the source of constant and almost unbearable irritation. He was immediately taken to the Dental Clinic where Dr Edward C. Kirk was struck with the interesting condition of the boy and suggested that the whole difficulty might primarily be due to impacted dentition. In his report he says:? “On the lower right side, the space between the first permanent molar and first premolar has been partially closed by the pushing forward of the first permanent molar. This condition has led to a partial impaction of the second premolar which is, as yet, unerupted and which may be a source of peripheral irritation. On the whole, the case is, from my point of view, a typical one of what I called dentitional stress; that is to say, of nervous irritation leading to a choreic tendency resulting from the general nervous irritation which frequently arises during the period of exchange of the permanent for the deciduous set of teeth. “I am of the opinion that as soon as the secondary dentition is fully in place his nervous phenomena will disappear. I should consider it the part of wisdom to relieve the young boy of all other sources of nervous stress until that stage of dentition already referred to has been reached. It is a case for fresh air, out-of-door employments and general improvement of hygienic conditions rather than for medical treatment.”
In spite of Harry’s rebellion and loudly expressed fear, he was immediately relieved of one outgrown canine tooth. The effect was almost instantaneous. His whole nervous system seemed to express itself in one sigh of relief. On the way back from the Dental Clinic, he began an animated conversation with the social worker, unburdened his mind 011 many points and initiated confidences which have grown ever since. From that time his improvement has been marked and continuous. His teeth were removed gradually as it was found expedient. Closely associated with this dental condition, and possibly aggravated by it, was an eye weakness discovered at the Eye Clinic. In order to insure proper treatment, Harry was placed in charge of the social worker of the Psychological Clinic who saw that the drops were regularly put in his eyes, accompanied him to the eye specialist, and not only secured glasses for him but accomplished the hitherto impossible feat of making him wear them.
On account of the dental work and the refraction of his eyes, he was not sent back to public school. Through the Psychological Clinic a private school was found where the boy could receive the intelligent and sympathetic training he needed. His whole demeanor under the private instruction has been that of a normal boj. He has been put upon his honor and trusted in numberless ways and in every ca’se he has justified the expectations of his teacher. He is now a healthy boy, with a boy’s natural curiosity, with good manners, good temper, with no more than the average nervousness, and with every prospect of taking his proper place in society and developing into an efficient and moral citizen. The case described is typical of the work done in the Psychological Clinic. The home, public school, special school, and Juvenile Court with its system of probation, each working independently, had failed. The Psychological Clinic, performing the function of clearing house in relation to its allied agencies, was able to ameliorate the condition. In this case the Clinic came in contact with the home through a skilled social worker, who gave advice to the parents and information concerning various kinds of schools. It touched the public schools and special schools through the teacher and principal who first had trouble with this boy and were compelled at times to suspend him. To them it furnished information concerning the cause of the boy’s bad conduct which may prove helpful in future cases. The Juvenile Court, through its probation officer, turned to the Clinic for information concerning the mental condition of this boy with special reference to his moral responsibility, for in such a case of delinquency the first question of importance is whether the child is a moral imbecile and should be placed in some institution for life, or whether he is merely bad and in need of certain disciplinary and reformatory measures. The various medical departments through their clinics, and the Dental Department gave their contributions toward the solution of the problem; but, without some one to see that the boy visited these clinics, their effects would not have reached him. Finally, when the physical defects had been removed, the Psychological Clinic was brought in direct communication with a number of private schools and institutions.
Cases of this kind illustrate the peculiar function of the Psychological Clinic and demonstrate the necessity for its existence. No other institution for the welfare of children can take so comprehensive and intelligent an interest in each individual boy or girl and at the same time bring so many agencies to bear upon the case. Sociologically considered, its chief function is in correlating these various agencies for ameliorating the condition of children.
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