Dental State of British Recruits

The following chapter on the dental health of British recruits is taken from pages 134-136 of Volume 1 of the History of the Great War, Medical Services, General History, Edited by Major-General MacPherson.

Dr Geoffrey Miller, Editor

Very many recruits appeared for voluntary enlistment at the beginning of the war who were being rejected on account of defective teeth, and who with suitable dental treatment would have been accepted for general service. At first there was a tendency to relax the dental standard, but instructions on this point had to be cancelled, owing to the bad state of teeth of men sent as drafts to units in the field. The British Dental Association, the Scottish Dentists' Association., dental surgeons and dental institutions throughout the country volunteered to treat gratuitously the men rejected on account of such dental defects as could be rectified in order to render them fit for service, and in this way materially assisted recruiting. Early in the war arrangements were made by the War Office with the British Dental Association by which a medical officer examining recruits was empowered to send men whom he considered could be made fit by dental treatment to dental surgeons and dental institutions in the neighbourhood of the recruiting office. In November, 1914, commands were also asked to prepare a list of dentists of high standing who would be willing to act as honorary consultants in dental surgery to the military hospitals. Instructions were issued in the same month to the effect that no man was to be discharged on account of decay or loss of many teeth if by dental treatment he could be rendered fit to remain in the service; full advantage being taken of the facilities placed at the disposal of commands for gratuitous treatment. Later on, in January, 1915, men with defective teeth might be attested if otherwise fit for general service and willing to undergo dental treatment; and in February of the same year a recruit might be passed as fit "subject to dental treatment," which was then to be carried out when he joined his depot.

The dental work which was thus introduced into the army led at a very early period of the war to the recognition of dentistry as a special branch of army medical organization and of special importance in connection with recruiting. There was at first a slow but steady increase in the number of dentists appointed to special commissions both for service at home and overseas. Twelve were sent to France in November, 1914, and the number was increased to twenty in December, but, at home, dental treatment remained in the hands of civil practitioners, until towards the end of January, 1915, when a few commissioned dentists were posted to home stations for the treatment of recruits and serving soldiers, but they were so few that practically the whole of the work was still carried out by civil dentists, many of whom were unqualified practitioners whose work there were no means of effectively controlling. The result of this was that many men had their teeth extracted unnecessarily and were held back from drafts until their mouths were ready for dentures. Other difficulties arose in connection with the refusal of men, who had been passed into the army, to undergo dental treatment, and the necessity of appointing inspecting dental officers was forced on the administrative medical services in August, 1915, with the result that in September of that year commands were authorized to select a suitable dental officer, from amongst those serving in the command, who should be on the staff of the D.D.M.S. and advise on all dental matters. The shortage of commissioned dental officers, however., impeded their work to a considerable extent ; and when the Military Service Acts of 1916 came into force a large increase in the number of military dental surgeons became necessary. The numbers gradually increased to 463 in December, 1916, and continued to increase year by year till it reached a maximum of 849 at the time of the Armistice in November, 1918. (In February 1915, the number was 36, in May, 1915, 57, in August, 1915, 150, and 300 in August, 1916.)

During 1916 and 1917, notwithstanding these efforts at establishing a high standard of dental treatment amongst recruits, administrative difficulties arose in many directions, and it was with a view to advising and co-ordinating the work throughout the United Kingdom that an inspecting dental officer was appointed to the staff of the Director-General of the Army Medical Service at the War Office in March, 1918. Lieut.-Colonel Helliwell, after taking up the appointment and inspecting the dental work in the commands, submitted a long report to the War Office in May of that year. He stated that the dental treatment at home was quite inadequate and that only a very small proportion of the men requiring dental treatment were being made dentally fit for service abroad. (70 per cent. of the recruits and men at home were estimated to be in need of dental treatment). He estimated that the number of men at home liable to service overseas who required dental treatment each month was 136,150, and that the number of dental surgeons required was 667, exclusive of 100 required for the Royal Air Force. The number of dentists in the home commands was at that time 282, and, in consequence of this report, the number was increased in October to 690. Lieut.-Colonel Helliwell's report contained many other details and suggestions for army dental organization and treatment. They were eventually embodied in an Army Council Instruction of October, 1918. The dental condition of the drafts for overseas steadily improved as a result of this evolution of the dental services, and, as already noted, dentistry has now become recognized as an integral part of the military medical organization.

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