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Military Dental Services in New South Wales

The following is from an unpublished manuscript written by Colonel J. W. Skinner, ED, MDS, FACDS, entitled "The Military Dental Services in New South Wales," written in the 1950s. It deals with the history of the dental services of New South Wales during the 1914-1918 war.

Before Colonel Skinner's death, the original paper was given to Dr S. Levine, a senior endodontist, and this extract is published with Dr Levine's permission.

Dental services in the Australian Army at the outbreak of war were non-existent and this paper describes how attempts were made to remedy this appalling situation. Even though the Dental Corps had been formed and dentists were to be commissioned, the dental services at Gallipoli still remained the part time responsibility of those dentists who were serving as privates or non-commissioned officers and dental treatment could only be carried out after their military duties were finished for the day!

Dr M. Geoffrey Miller

Dentistry In NSW at the start of the Twentieth Century was still in a very backward state, no qualification or registration of practitioners being required until the passing of the Dental Act in 1900. Military dentistry was limited to the extraction of teeth by medical officers or by other soldiers sufficiently confident in their ability.

This earlier disregard for the comfort and health of the soldier in relation to his mouth and teeth might seem preposterous in a community that had access to civilian dentists of reasonable skill since the Eighteenth Century, but it should be remembered that prior to the First World War the private soldier was not such a valuable and expensive adjunct to the nation as he has recently become. The soldier of this century must be highly skilled in all the complexities of modern warfare. His training costs much time and money and with the scarcity of manpower he is not easily replaceable. Consequently in proportion to his value so much the better is he tended and the growth of the dental services in the army has resulted from the appreciation by the General Staff of their function in keeping the troops healthy.

The awakening of the Army commanders to the necessity for a dental service was not spontaneous but was provoked by the earnest and forceful petitions of members of the dental profession who saw the necessity of establishing efficient service of adequate professional status.

General Williams recommended the inclusion of a dental service within the AAMC but the military authorities did not approve the suggestions. At the outbreak of the 1914-18 War there was no dental service in the Australian Military Forces but a standard of dental fitness was required for enlistment in the AIF. Facilities were made available by civilian dentists in a honorary capacity to provide urgent treatment at centres in capital cities.

At the outbreak of 1914-18 War there was no place in the establishments of field ambulances and hospitals of the Australian Army Medical Corps for dentists. Regimental medical officers were provided on army scale of issue, with a leather pouch of extracting forceps and this was the only practical preparation made by the Medical Corps to provide for the dental necessities of the AIF, although a reasonable standard of dental fitness was required on enlistment of the recruits

The first official step in the formation of the Dental Services of AMF was taken on 6th January 1915 when an AAMC Reserve (Dental) was authorised to be established with 6 captains and 50 lieutenants with honorary ranks for the Commonwealth Forces. This reserve was not used until late in 1915.

The Commonwealth Dental Review 1914 (p. 490) reported that at the Odontological Society of NSW on 17th. August 1914:-

"A letter was read from the Military Superintendent asking for dentists to volunteer their services for attention to the mouths of the troops going forward for active service."

After considerable discussion it appeared that the military authorities would not allow volunteers to leave showgrounds to attend for treatment at dental hospitals as it would take too long marching them to and fro, the President stated.

It was resolved to the inform the Army that they would offer as many chairs and dentists as available until further notice and to approach other bodies, Sydney University Graduates, Association and Dental Graduates of NSW to cooperate.

An additional article of Commonwealth Dental Services by Percy A Ash on 16th. September 1914 (p. 501) headed "Dentistry for the Soldiers" reported that dentists had offered to treat 20,000 men who would be sent from Australian.

"At the Agricultural Grounds an operating room has been fitted up and a staff of generous practitioners is constantly in attendance; at the United Dental Hospital an adequate number of willing workers have been kept occupied day after day".

"The dentists and they alone, fully realise the value of good teeth to the soldier. The Boer War taught a lesson in that direction which will not readily be forgotten.

The records showed conclusively that a large percentage of the men were rendered unfit for service in consequence of dental troubles. In the face of this information it is very remarkable that those in control have not yet arrived at the conclusion that a properly equipped Dental Corps should accompany every army. Great efforts have been made to impress this matter on the Governments but nothing of value has no far been done. The standard reply seems to be that the Army Medical Corps is sufficient for the purpose. The best that a medical practitioner can do as rule, is to extract a tooth; he has not been trained to do more".

By 21 September it was reported that 72 dentists had offered their services for dental treatment of volunteers and that should the authorities not agree to the suggestion to send a dentist with each ship, the authorities had agreed to send dental materials in hope that one of the volunteers would be a dentist. At the Dental Association of NSW meeting on 3rd. September 1914 the President, Dr Maxwell Allan received Capt. Chard, 4th. Battalion 1st. Brigade who thanked members for their Voluntary efforts on the troops stating he had put 1,200 men up for treatment. Captain Chard presented an illuminated address to the association from the officers and staff of the 4th Battalion and mentioned that consideration had been given by the Colonel to one or two applications for commissions by dentists.

The Commonwealth Dental Review October 1914 quotes an article from the Melbourne Newspaper "Argus", related to the formation of an Army Dental Corps:

"The Secretary of the Australian College of Dentistry (Mr E. Joske) has forwarded a further urgent memorandum to Colonel Fetherston, the Director General of the Army Medical Corps, with respect to the teeth of the Expeditionary Forces, as the council of the college thought it ought be of assistance at this urgent juncture of affairs if their proposals were placed before him in concrete form for submission to the Minister for Defence.

(1) With respect to the dental treatment of troops leaving by ship; The appointment of a dentist (to be a commissioned officer) and of a dental mechanic to be a noncommissioned officer) to accompany the troops on board each ships The dentist could attend to about 20 patients a day and this dental treatment would enable the troops to arrive at their destination with their teeth in a sound condition.

The approximate cost as regards operative treatment would be, for each ship:-

Portable chair bracket and spittoon .. .. .. 20 pounds

Instruments .. .. .. .. .. .. .. .. .. .. 25 pounds

Drugs and material .. .. .. .. .. .. .. 30 pounds

Minor expenses .. .. .. .. .. .. .. .. .. 5 pounds

Total cost .. .. .. 80 pounds

The material would be sufficient to treat about 700 men surgically. As regards mechanical treatment, the council estimate a complete kit of instruments and tools and materials sufficient to supply approximately 250 sets of artificial teeth would be 70 pounds. Then there would be the remuneration of the dentist and the mechanic on each ship to be provided for.

(2) As regards the formation of a dental corps:- One dentist and one dental mechanic to each battalion of infantry, one dentist and one dental mechanic to each battery of artillery; one dentist and one dental mechanic to each thousand men of the Light Horse.

In each case the dentist to be a commissioned officer; the dental mechanic to be a non-commissioned officer. Over and above these there should be a captain attached to the staff of the brigadier general, who should attend to the officers teeth, be in charge of the whole dental corpse and receive instructions direct from the brigadier-general.

As regards the Australian Navy, there should be at least one dentist and one dental mechanic attached to each thousand men. The dentist to be a commissioned officer, the dental mechanic to be a non-commissioned officer.

(3) As regards the treatment of the teeth of the Second Expeditionary Force, the council of the college will be glad to make immediate arrangements for their treatments provided the Government bear the expense.

The expense of treating the teeth of the First Expeditionary Force was borne by the college authorities. With the assistance of the willing services of private dentists and of the dental students of the college, also aided by the gifts of teeth from the various dental depots.

The President of the Dental. Board (Mr Donald Smith of NSW) on the authority of the Chief Secretary chaired meetings of all the dental societies to discuss dental treatment of the troops and at the meeting of 12th October 1914, the following communication from the secretary of Defence to Dr Philpots from Secretary of the National Dental Association Melbourne dated 16th September was read:-

"I am directed to acknowledge the receipt of your letter of 13 inst, and in reply, to inform you that although it has been decided to form a dental corps for services in Australia no particulars are yet available. These, however will as soon as possible be published in the press.

"The Minister has decided that no dentist shall accompany the expeditionary forces. The Corps to be created will be attached to citizen forces in Australia."

In May 1915 the DGS agreed that; dentists might be appointed for service in Australia and Egypt with the rank of Lieutenant.

In June 1915 the dental standard of enlistment. for AIF was lowered to admit recruits dentally unfit but capable of being made fit for the army. On 6th July 1915, following advice from the War Office arising from reports of senior medical officers from Anzac and Egypt, 14 dental officers (honorary Lieutenants) 12 mechanics and 13 privates were appointed for service with the AIF overseas to be attached to general hospitals. They sailed in July 1915 with equipment not. limited to scale of issue.

Representations were made to the DGMS by these officers and ten more officers were appointed; they arrived in Egypt with a QM of Dental Services in December 1915. The QM was empowered to purchase and issue dental stores and supplies. This appointment marked the first step in the proper organisation of Dental Services.

The Dental Services continued to be administered by a medical officers although at this stage the establishment of a Dental. Corps was advocated by dental officers, but coldly received at the War Office.

All the dental supplies available in Egypt were bought up and the approved scales of dental stores supplied from England and Australia did not arrive until 1916, after most of the troops had departed. In February 1916, dental officers were given their first authority to call up soldiers for dental examination and treatment. Previously this was a prerogative of medical officers.

There was a total of 39 dental officers and one QM, plus other ranks in Egypt in March 1916. They were fully equipped to a standard scale and the dental sections were allotted to medical units from field ambulances to general hospitals. There was a depot of medical and dental Stores as well.

The DGMS, Major General Howes ensured that dental sections embarked with field ambulances so these were the first dental sections of the British Army to be allowed to enter France as part of the recognised establishment of a field ambulance. It was not until 13th December 1916 that the DMS appointed Captain Marshall (as major) to act as dental adviser on his staff. Major Marshall took up duties at AIF Administrative HQ London. His duties included supervision of the dental services in FRANCE .

By November 1917 the administrative establishment of the Army Dental. Services had been built up to one lieutenant-colonel Staff Officer (Dental Services) at AIF Administrative HQ, 3 Major Staff Officers (DS) in France with AIF, supply Depots in UK and Egypt.

There were six majors serving as senior dental officers in Convalescent depots and Base Training Depots. The total number of dental units overseas in England, France and Egypt was 118. In 1918 there were 130 officers serving overseas with the AIF.

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