Dental Care in Germany during WW1

The following extract from the US Medical War Manual No.5; "Lessons from the Enemy" - How Germany Cares for her War Disabled", 1918, by John McDill, M.D. F.A.C.S., Major, Medical Reserve Corps, U.S. Army, describes German Dental Care.

Dr M. Geoffrey Miller

DENTAL PROTECTION.- According to Professor Dr. W. Dieck, of Berlin, dental diseases are alarmingly prevalent among the German people. Statistical investigation has proved that only 2 or 3 per cent. of school children have sound teeth. Investigations among soldiers have shown similar results. How can the dental care of an army of millions be successfully accomplished in a country where the profession of dentistry is so backward? Many army corps have in time of peace special dental stations where the soldier is given aid and treatment; and wherever such dental stations are lacking, private dentists are appointed to look after their welfare.

At the beginning of this war the dental care becarne more complicated. Every man had to be examined and either recommended for service or treatment. This added enormously to the responsibility and activity of the dentists appointed by the military medical board. Many cases required prolonged treatment, and although preservation of affected teeth should be the fundamental object, this must be restricted in time of war, and the preference must often be given to the extraction of diseased teeth. It is perfectly justifiable and advisable that before entering the army or navy all broken teeth or roots be removed from the gums, even if they cause no discomfort. Such roots and their surrounding bone substance are in the majority of cases not free from gernis and decay, and are the cause of abscesses, inflammation of the tissues and general infection elsewhere.

Frequently the gums and jaws are diseased and form regular breeding places of disease germs which may be in a quiescent state for years and some day break out upon the first irritation. A man suffering with inflammation of the jaw is not much better than a wounded soldier; and it should be remembered that with every injury to the jaw the germs present in the diseased part heighten the danger of infection, local and. general.

Dr. Dieck suggests that better preparation could be made for a war of the future in regard to dental care if the fiecessity of dental sanitation among German school children gradually penetrates through the people, and if communal as well as governmental authorities will give more efficient aid in this direction.

The importance of early or preventive treatment cannot be emphasized enough. A scheduled care of the teeth on the battlefield is seldom possible even to those who were accustomed to it. It can also be understood that soldiers in active service look at tooth sanitation as a matter of minor importance, unless they actually suffer with a toothache.

Besides the treatment for dental diseases and its consequences, the army dentist has other duties; the most important is that of treatment, in connection with a skilled surgeon, of injuries of the jaw.

With the fighting methods of today the number of such injuries is ever on the increase. The numerous cases of jaw injury and their treatment have proven that the trained assistance of the dentist is a necessity and it has been provided for. Even after the war of 1870-1871 the surgeon-general, Dr. von Langenbeck, made the statement: "I should not care to go through another campaign without having obtained competent technical assistance for those who have sustained injury of the face and fractured jaws."

In the case of jaw fracture the technical knowledge of today permits a speedy reunion and replacement of the fractured parts to their normal position, and makes the early resumption of mastication possible without disturbing or interfering with the healing process. If parts of the bone structure have been destroyed, plastic and dental surgery come to the rescue with transplants or artificial substitutes, not only to prevent disfigurement, but also to make mastication possible.

In a cosmetic respect much can be done, when as the result of scar shrinkage after serious injury to the soft parts, or after loss of supporting bone substance, deformities of the face have appeared. Gradual stretching of the scar tissue, artificial substitutes for the missing bone, and plastic skin operations frequently bring about surprising results. Dental technic and plastic surgery go hand in hand to relieve soldiers of war's injuries or at least to greatly diminish their disabilities.

Dental care for the war in Germany is at the present time provided for in the following manner:

1. Several army dentists with complete outfits are a part of the sanitary division of every army corps. According to the sanitary regulations they are intended for the field hospitals belonging to the line of communications, but when necessary can be called to the place of action and the emergency stations.

2. Dentists of the reserve hospitals in the homeland must in the first place treat soldiers who suffer with dental disorders, and secondly, such as are suffering from injury to the jaw. Some reserve hospitals are intended entirely for jaw injuries, as for instance those in Berlin, Duesseldorf, Strassburg and Heidelberg.

3. Civil dentists are, by contract or voluntarily, active in hospitals of the Red Cross, and emergency hospitals and trains, or in certain private localities.

As a result of this war the much-mooted question of introducing the military dentist will gain new interest in the future.

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