In 1913, Dr Norman K. Cox, the President of the New Zealand Dental Association, proposed a system of school clinics operated by the state and staffed by 'oral hygienists' to address the dental needs of children between the ages of 6 and 14 years. At the time, the idea was considered to be unorthodox, but in 1920, at a special meeting of the New Zealand Dental Association, 16 members voted for the adoption of school dental nurses with 7 opposed to the proposal. Such a drastic change in the voting could be accredited to the refusal of New Zealand troops during the first world war. The recruits were rejected due to rampant and uncontrolled dental diseases.