The New Zealand Dental Services

PART I NEW ZEALAND

CHAPTER 1 The Origin and Development of the New Zealand Dental Corps in the Great War, 1914–18

BEFORE the Great War of 1914–18, the connection between dental health and fighting efficiency was but faintly recognised. There was a grudging acknowledgment that a toothless recruit might cause embarrassment when confronted with standard rations and thus be a military misfit, but little thought had been given to adjusting his disabilities to the military machine. In most cases he was rejected with the lame, the halt and the blind. Even the layman could see the injustice and futility of this policy, as instanced by the indignant reply of the Scottish recruit in Punch when told that his lack of teeth disqualified him from army service, ‘Mon, I'm no wanting to bite the Germans.’

Napoleon emphasised the importance of good food to the soldier, Florence Nightingale showed the advantages of sound nursing, the triumph of Sir Ronald Ross over the mosquitoes of Panama demonstrated to the world in dramatic fashion one vital part that medicine could play in any campaign. Anything approaching an organised army dental service, however, was as yet unknown in military history. It is not surprising, therefore, to find that at the outbreak of war in August 1914 no organisation existed in New Zealand to provide dental service for the military forces. It is encouraging that there were men with sufficient vision to see the necessity for such a service and the courage to provide one. Ten days after the declaration of war, a force left New Zealand for Samoa. It included, as members of the New Zealand Medical Corps, two dental officers attached to the field ambulance. Two and a half months later, when the Main Body of the Expeditionary Force sailed for Egypt, it included ten dental officers, still members of the NZMC.

These arrangements were thought to be unnecessarily lavish at the time but were fully justified by the work of these officers in Egypt, Gallipoli and France. A brief account of their activities as they affected the formation of the NZDC will be given later, but in the meantime important developments were taking place in New Zealand.

During the first nine months of the war, civilian dental practitioners were treating recruits both prior to mobilisation and after they had entered camp, either free of cost or at reduced fees borne by the recruit himself. In spite of this a large number of otherwise fit men were being rejected because of gross dental defects, and amongst those accepted there was still much treatment needed. Recognising this as a waste of manpower and seeing the difficulties in providing treatment for the Expeditionary Force, the New Zealand Dental Association in June 1915 put proposals to the Government for the formation of a co-ordinated dental service by civilian practitioners. It offered on behalf of its members to treat all enlisting men who would otherwise be rejected solely on account of dental defects. The fees for this work were to be at ordinary hospital rates, i.e., sufficient only to defray the cost of materials. It proposed that two of its members be appointed supervising officers to act as consultants and advisers to the Director of Medical Services in all matters connected with the dental treatment of recruits and troops. It also proposed that the treatment in camps by the few dental officers attached to the NZMC be reorganised, and it offered £100 towards the provision of better facilities for this.

The Association was taking a realistic view of a situation which demanded urgent action. Instead of pressing for the formation of an army dental service which would take time to organise and develop, it immediately made available a practical service from civilian practitioners. The scheme had the added value of getting the treatment done before the recruit entered camp, thus saving interruption of training. This was an important consideration in view of the announcement by the Minister of Defence that the period of training was to be reduced at the request of the Imperial authorities. It was gladly accepted by the Government and for over two years assisted in making most of the men for the reinforcements dentally fit. Mr T. A. Hunter,

Col Sir Thomas Hunter, KBE; born Dunedin, 10 Feb 1863; dental surgeon; Director of Dental Services, NZ Dental Corps, 1916–30; died Heretaunga, 29 Dec 1958.

chairman of the Executive Council of the Association, and Dr H. P. Pickerill,

Lt-Col H. P. Pickerill, CBE; born Hereford, England, 1879; plastic surgeon; Major, NZMC, 1916–20; died Silverstream, Aug 1956.

Dean of the faculty of dentistry of the University of Otago, were appointed as supervising officers.

The scheme, however, was put forward as an emergency measure only, intended to supply the need until an army dental service was formed. About this time, Surgeon-General R. S. F. Henderson, RAMC, arrived in New Zealand to advise on the reorganisation of the medical services to the NZEF. He was so impressed by the need for an efficient army dental service as advocated by the New Zealand Dental Association that, within two months of the Government's acceptance of the civilian practitioners' scheme, the formation of the New Zealand Dental Corps was authorised.

In November 1915 the New Zealand Dental Corps came into being. It was to be a separate organisation from the New Zealand Medical Corps, controlled by a Director of Dental Services in the rank of lieutenant-colonel, with two Assistant Directors in the rank of major. Mr Hunter became the first DDS and Dr Pickerill and Mr J. N. Rishworth

Col J. N. Rishworth, MBE; born Blenheim, 1876; dental surgeon; DDDS, 1 NZEF 1917–19; DDS, NZDC, 1930–34; died Auckland, Feb 1946.

were appointed as ADDSs. Principal Dental Officers were appointed to the main mobilisation camps, those dental officers attached to the NZMC were transferred to the new Corps and additional officers were appointed. The Gazette notice of the formation of the New Zealand Dental Corps appeared on 24 February 1916. (See Appendix I.)

At this time the 9th and 10th Reinforcements were in camp. The Principal Dental Officers at Featherston and Trentham soon found that the amount of work was enormous and asked for help. The Corps grew rapidly. More officers were appointed, buildings were erected, equipment found, mechanics and orderlies provided and a general organisation evolved. However, it was not until the 17th Reinforcements were in camp that the NZDC and the civilian practitioner scheme were completely coping with the work. This reinforcement numbered 1998 men, and the treatment given to them by the Corps and the civilians amounted to 6335 fillings, 5237 extractions and 854 dentures, leaving 371 fillings, 48 extractions and 32 dentures still to be done.

The Army's policy was to send away each month a reinforcement numbering approximately two thousand. During 1917 most of the treatment, and during 1918 practically all the treatment, was done before embarkation.

Overseas, the autonomy of control of the Dental Corps was not so quickly achieved as in New Zealand, but this is readily understandable in view of the obstacles to be overcome in fitting a new service into an established organisation such as a fighting division. During the voyage of the Main Body of the Expeditionary Force from New Zealand to Egypt, the dental officers began, under the poorest conditions, the task of examining every soldier and carrying out as much urgent treatment as possible. Their examinations revealed a serious condition, fully justifying the foresight of the authorities in providing dental officers for the Expeditionary Force. What had appeared to the critics to be an unnecessary luxury was soon to be applauded as an important contribution to the mainten- ancemaintenance of fighting strength.

‘An army today is a self-contained community; it contains everything its members need for war, from bullets to blood banks. I will always remember Churchill's anger when he heard of several dentist's chairs being landed over the beaches in Normandy! But we have learnt since the 1914–18 war that by caring for a man's teeth, we keep him in the battle.’— The Memoirs of Field-Marshal Montgomery, p. 348.

It was expected that the Main Body would very soon be in action after only a short period of training. The ADMS

Assistant Director of Medical Services.

therefore instructed the dental officers to concentrate on making every soldier, as far as possible, free from pain or disability in the near future. On arrival in Egypt they were distributed among the various regiments and units, where they extracted septic roots and badly decayed teeth, placed temporary fillings in large cavities, removed salivary calculus and made the mouths as healthy as possible. To attempt the achievement of complete dental fitness was quite impossible. As it was, the working conditions were far from ideal. Soldiers requiring treatment were undergoing a course of intensive training and could not be readily spared for dental parades. Fortunately, commanding officers were quick to realise the importance of the work and did much to assist. This appreciation of the value of the dental service was increased when it was learned that the Australian forces had arrived in Egypt without dental officers and had asked for assistance from those of the NZEF. Four New Zealand officers were temporarily transferred for duty with the Australians in spite of their inability to cope with all the urgent work amongst their own troops. Soon also, many patients from the British forces came seeking treatment.

When the Anzac forces went to Gallipoli, four New Zealand dental officers went with them, two with the New Zealanders and two with the Australians. The equipment for each officer was greatly curtailed, provision being made only for emergency operations for the relief of pain. During this campaign the troops lived mostly on bully beef and hard biscuits which played havoc with teeth, both natural and artificial, with the result that it was not long before there were urgent requests for more equipment.

After some months, five more dental officers were sent to Gallipoli from Egypt and a Field Dental Clinic was established at No. 2 Outpost, Anzac. The area was continually under fire and, owing to the scarcity of fresh water, constant visits had to be made to the beach for sea water to use in the vulcanisers. This clinic was the wonder and admiration of the British and Australian forces. It is interesting to quote from the official history of the New Zealand Medical Services, 1914–18, by Lieutenant-Colonel A. D. Carbery, CBE, NZMC:

New Zealand had certainly led the way in the provision of an adequate dental service for an Expeditionary Force and a dental hospital capable of carrying out any form of repair or mechanical work and the making of dentures, and provided with cylinders of nitrous oxide gas and dental engines, perched on a trenched hillside, cheek by jowl with a very noisy mountain battery, surely reaches the ‘limit’ in front line dentistry.

Following the evacuation from Gallipoli in December, there was a period of rest for the NZEF in Egypt. This was followed by a programme of training and a reorganisation to form a New Zealand Division. At this stage one of the original dental officers, Captain B. S. Finn, DSO, NZMC,

Col B. S. Finn, CBE, DSO, ED, m.i.d.; born Invercargill, 17 Oct 1880; dental surgeon; trooper, South African War, 1900–02; NZ Dental Corps, 1914–18 (Major, ADDS); DDS (Navy, Army and Air), 1934–49; died 23 Aug 1952.

was appointed Administrative Dental Officer to supervise and co-ordinate the work of the Dental Services. These were, however, still part and parcel of the medical services under the control of the ADMS. The autonomy of control achieved in New Zealand did not apply to the dental services overseas. That was to come later. The rap on the door requesting admission was insistent enough to demand attention. As Carbery states when discussing the reorganisation of the medical services for the Division at this stage:

One other administrative matter we must consider. The New Zealand Dental Service was now to be reorganised. Captain Finn, DSO, NZMC, the dental officer whom we have seen evacuating wounded from the No. 3 Pier at Chailak Dere, for which good work he had a DSO, was now appointed as acting administrative dental officer, attached to NZEF Headquarters. The ideal of a compact dental service attached to a Division was not as yet fully attained. The opinion of the GOC, NZEF at this time was that the OC of a medical unit to which a dental section was attached should be able to undertake the administration of the section so that a separate Dental Corps Headquarters was unnecessary.

Dental sections were formed comprising one dental officer, two mechanics and one orderly. Two were attached to each of the three field ambulances, with nine panniers of equipment weighing 7½ cwt. Later this was reduced as it was considered to be too much for the ambulance transport. In all, eleven sections were allotted to various units, including two to the New Zealand Infantry Base Depot which was to accompany the Division and one to the New Zealand Stationary Hospital. The Dental Stores Depot, with reserve stocks, was mobile and had a staff of one quartermaster-sergeant and a packer under the administrative dental officer.

In April 1916, when the Division took up its position in the Armentières sector in France, the dental services worked to this plan but in August of that year, when the Division moved preparatory to the Battle of the Somme, the dental sections were ordered to the Base as it was found impossible to carry their equipment. The service had, however, attracted attention because of its novelty and efficiency. Inquiries came from the DMS

Director of Medical Services.

of the Fourth Army, to which the ADMS of the New Zealand Division replied that he considered the sections unsatisfactory as field units because of the weight of their equipment, and that he preferred the old arrangement of having a dental officer with light equipment, weighing only 80 lb, attached to each field ambulance. In the meantime the sections concentrated on the treatment of reinforcements at the infantry base at Etaples.

They were soon missed in the field, and late in October 1916, at the request of the ADMS, three sections were returned to the Division. So much work had accumulated that they were quite unable to cope with it and the ADMS, in consultation with the GOC, decided to transfer several dental surgeons and mechanics, who were serving in a combatant capacity, to the Corps, and in November a dental hospital was established in a small communal school with a few huts attached. For the first time overseas the NZDC worked apart from medical units. As Carbery writes of this dental hospital:

Days of attendance were allotted to brigades and other formations. Sundays were also work days and were devoted to officers. The NZDC worked hard and well; in their first two months they treated 1702 cases and owing to the close proximity of the trenches—the front line was only 3¾ miles away—of a fully equipped dental establishment capable of executing any type of work required, a soldier could come down from the most advanced positions and have efficient treatment without being more than a few hours absent from his duties in the line.

A very important work performed by the dental officers this winter was the prophylaxis and treatment of ‘Trench Mouth’ or ulcero-membranous gingivitis caused by Vincent's organisms, now very prevalent amongst the men and, in the opinion of some observers, the cause of secondary lung complications of a severe type.

Another quotation from the same source refers to the period of rest and reorganisation of the New Zealand Division in July 1917 following the battle of Messines, and indicates a further stage in the evolution of the New Zealand dental services in the field:

The New Zealand dental sections had been remodelled and had now reached their perfected organisation. The dental section which had been formed in the United Kingdom to accompany the Fourth Field Ambulance was a very mobile unit; all cumbersome equipment had been eliminated, with the result that two small panniers (one pack mule load) now contained sufficient instruments and material for all operations, surgical and prosthetic, and the actual space taken up in transport only half of a half limbered G.S. cart.

General Service cart.

The dental hospital had also been made mobile by allotting one threeton lorry to the purpose of its transport as required.

There was no difficulty in maintaining a constant supply of expendable material as, in accordance with a contract made between the New Zealand Government and the War Office, all necessary dental equipment could be obtained from Advanced Supply Depots of Medical Stores. In this way all difficulties had been overcome by experience in the field and the New Zealand Dental Corps may justly claim to be the pioneers of a movement which resulted in an efficient and practical dental service for the front line troops.

Not only was dentistry establishing itself as a service to the troops; it was identifying itself as an essential component of the fighting machine, selling its wares with the utmost confidence to a cautious but rapidly appreciative market. These first steps in mobility are interesting as a prototype of the mobile dental unit in the next war, when the whole character of the war made fluidity of movement a primary essence for every unit in a military force.

From the beginning of 1917 onwards the NZDC established many sections in England for the treatment of New Zealand troops, as well as continuing its service in France. There was a depot on Salisbury Plain to train reinforcements as they arrived from New Zealand, two General Hospitals, a Convalescent Depot and, later, separate training depots for machine-gunners, engineers and artillery. To provide adequate dental service for these scattered portions of the New Zealand Forces the establishment of the NZDC was greatly increased. The DDS, Lieutenant-Colonel Hunter (later Sir Thomas Hunter) visited England to advise and report. Major Finn was appointed Deputy Director of Dental Services to the New Zealand Forces overseas, until he was recalled to New Zealand under the exchange system then in force, when Major Rishworth replaced him.

In December 1916 Major Pickerill, one of the two original Assistant Directors of Dental Services, arrived in England. The holder of medical as well as dental qualifications, he was soon seconded to the NZMC and established a plastic surgery and jaw injuries hospital. He devoted his efforts to the surgical aspect of the work, being assisted by a special section of the NZDC. His outstanding work further enhanced the prestige of the young Dental Corps, as well as that of the Corps to which he was seconded.

When the war ended in November 1918 the strength of the NZDC overseas was 42 officers and 70 other ranks.

This necessarily brief outline of the origin and development of the NZDC emphasises in particular the development of the Corps from a minor star in the medical firmament to a constellation of its own. Many authoritative references lead to the conclusion that New Zealand was well to the fore in providing dental services for its army, and particularly in establishing a Dental Corps as a separate entity from the Medical Corps. At this stage it is of little value to retrace the steps by which this independence was won. The important fact is that at the end of the Great War the New Zealand Dental Corps was independent of the Medical Corps as far as administration of its affairs was concerned. This cannot be too strongly stressed in view of the determined efforts made in the Second World War to take away this independence and merge the Dental Corps once more with the Medical Corps. The arguments used to justify the control of the Dental Corps by the Director-General of Medical Services were based chiefly on an examination of the conditions existing in other countries such as England and Australia. It is right, therefore, to emphasise in this chapter the claim that the New Zealand Dental Corps was the pioneer in providing dental service to the armed forces, that the service was a success and that it was independent in the control of its affairs. If these facts are borne in mind the depth of feeling exhibited in the controversy will be better understood.

CHAPTER 2 Between the Two Wars, 1919–39

IN December 1919 general demobilisation of the New Zealand Military Forces was nearly complete and the need for a large Dental Corps had passed. Lieutenant-Colonel Hunter was demobilised but was retained as Director of Dental Services for the Military Forces on a peacetime basis. He remained responsible for all policy matters which were referred to him by Major C. G. Gray,

Maj C. G. Gray; born 1880; dental surgeon; died 15 Aug 1941.

late Assistant Director of Dental Services, who remained on the active list and became Administrative Officer for the DDS. This was purely a temporary appointment to tide over the short remaining period of transition from war to peace.

The only treatment left for the Corps was that of patients at the military hospital at Trentham, the convalescent hospitals at Hanmer and Rotorua and the sanatoria at Cashmere and Pukeora. For this, one officer, Major R. D. Elliott,

Maj R. D. Elliott; Eastbourne; born Northern Ireland, 5 Feb 1879; dental surgeon.

and one mechanic were considered sufficient. There was also a section still attached to the jaw hospital in Dunedin where Lieutenant-Colonel Pickerill was completing the treatment of the long-term cases of jaw and facial injuries. One dental officer, Captain W. S. Seed,

Capt W. S. Seed; Christchurch; born Christchurch, 1887; dental surgeon.

and one mechanic comprised this section. With these exceptions, the NZDC was demobilised and its officers posted to the reserve. Within two years none was left on the active list.

In exile, 1922–33

After the war, a Territorial Force was maintained in New Zealand on a compulsory basis, the training consisting of regular parades and annual camps. In the annual report for 1920, the General Officer Commanding the New Zealand Military Forces made the following reference to the NZDC:

It is not proposed to retain a permanent establishment of the Dental Corps, but experience has shown the need for an Army to be dentally fit and the great influence sound teeth in a soldier have in reducing the rates of sickness and invaliding. It is proposed to maintain the Dental Corps as part of the New Zealand Territorial Force, utilising it in all future camps of training that force. A definite establishment will be laid down which will provide for peace requirements and for the expansion of the Corps for war purposes if necessary.

For the next decade, however, in spite of this statement of policy, the NZDC was not maintained as part of the Territorial Force, although there was retained a Director of Dental Services and a Reserve of Officers.

In 1930 Lieutenant-Colonel Hunter was posted to the retired list in the rank of colonel and was replaced as DDS by Lieutenant-Colonel J. N. Rishworth, MBE. Then, in 1931, the Territorial Force was placed on a voluntary basis, with considerable reduction in size. Strange to say, this general reduction was soon followed by a revival of the NZDC, but before describing this it is necessary to go back a year or so.

In 1928 a Territorial unit known as the Otago University Medical Company had been formed. It consisted of medical and dental students who were liable for compulsory military training and it aimed at combining this training with specialised work to qualify them as medical or dental officers in a future war. Commanded by Lieutenant-Colonel C. E. Hercus, DSO, OBE, NZMC,

Lt-Col Sir Charles Hercus, DSO, OBE, m.i.d.; Dunedin; born Dunedin, 1888; Professor of Bacteriology and Preventive Medicine, University of Otago; DADMS, A and NZ Mtd Div, 1916–19; Dean of Otago University Medical School, 1937–58.

it attended annual camps of fourteen days, the training consisting in instruction and exercises in stretcher drill, first aid in the field, military hygiene and the organisation of medical services in the field. This was in addition to instruction in general military subjects such as close-order drill, map reading and army organisation. The abolition of compulsory training produced a unit keen enough to flourish on a voluntary basis. From 1932 onwards, dental as well as medical instructors were included and the dental students were trained in the work and problems of a field dental officer in wartime. On the completion of their second and third annual camps, examinations, both practical and written, were held for the students. As a result of these examinations the dental students received an ‘A’ certificate after the second camp and a ‘B’ certificate after the third. A unit founded as a legitimate escape from the boredom and impracticability of the compulsory training scheme, which was lethargically administered and supinely accepted, fanned the spark of enthusiasm which had characterised the NZDC in the 1914–18 War. There would never be another war of course, the Great War had been a war to end wars, but the subject was extremely interesting and, who could tell, there were still armies and, where there were armies there was a need for a Dental Corps. The Otago University Medical Company thought so and so did the DDS.

In September 1931, Lieutenant-Colonel Rishworth submitted a memorandum to the GOC recommending that the Dental Corps be re-established as an active part of the Territorial Force. He sub- mittedsubmitted establishments for that Force and also for an Expeditionary Force in the event of mobilisation. Dental students who had completed their training in the Otago University Medical Company and had gained their two certificates would, on graduation, be eligible for commissions in the NZDC. They would be placed on the active list as soon as vacancies occurred in the establishment.

This was not wholly acceptable, and the matter was temporarily held in abeyance. Something, however, was done. Captains H. E. Suckling

Lt-Col H. E. Suckling, ED; Blenheim; born Christchurch, 1890; dental surgeon; Capt, NZDC, 1917–19; ADDS, Army HQ, 1940–45.

and R. B. Dodds

Lt-Col R. B. Dodds, ED; Dunedin; born Ashburton, 1894; Dean of Dental Faculty, University of Otago; CO 15 Fd Amb.

were transferred from the reserve to the active list, the former as dental officer to the 3rd Territorial Field Ambulance and the latter as instructional officer to the Otago University Medical Company. In addition, Mr O. E. L. Rout

Lt-Col O. E. L. Rout, ED; Wellington; born Invercargill, 15 Jan 1904; dental surgeon; ADDS (Army, Navy and Air) 1941–42, Mar 1946–Feb 1947; ADDS 2 NZEF(IP) 1942–44; ADDS 2 NZEF (UK) 1944–46.

was given a commission in the NZDC as a lieutenant in the Otago University Medical Company. Then, in January 1934, Lieutenant-Colonel Rishworth relinquished his appointment in favour of Lieutenant-Colonel Finn.

Revival, 1934–39

Due to Lieutenant-Colonel Finn's strong recommendation to the GOC, the NZDC was re-established in the Territorial Force in 1934. He submitted that this was the only method of ensuring an efficient dental service to be put into the field in the event of general mobilisation, in contrast to the position in 1914. A peacetime establishment was authorised:

(1)

Six dental sections, each consisting of one officer and two clerk orderlies. Two of these were to be attached to each of the three Territorial field ambulances.

(2)

The Dental Section of the Otago University Medical Company, which was recruited from dental students and officered by two NZDC officers.

With the appointment of officers already mentioned, this left a vacancy for five more officers for the sections attached to the field ambulances. These were filled by commissioning recent graduates from the Dental School instead of using reserve officers who had served in the last war. To complete the establishment, dental clerk orderlies were recruited, chiefly from the staffs of the dental trading companies. There were fourteen days of annual training, made up of weekend or whole-day parades and an annual camp of six days.

Although, on the establishment of the Territorial Force, each dental section was attached to a field ambulance, it went into camp attached to some other unit. In this way as many Territorial units as possible were provided with an emergency dental service and each dental officer gained experience in setting up a field dental section and fitting it and himself into the general military organisation. The emergency treatment for so short a time was not enough to interfere with general training but was greatly appreciated by the Force. In the first years the dental officers themselves provided all the equipment, but later, seven outfits of standard equipment were provided by the Army, each contained in two panniers and one chair case.

Very soon two significant facts were noticed. Firstly, there were more applications for commissions in the NZDC than there were vacancies, and secondly, there were more requests from commanding officers of Territorial units for dental sections than there were sections available. The enthusiasm of the profession, and of the Territorial units, did not result in an increase in establishment. New Zealand, in common with other members of the British Commonwealth, had not as yet provided the funds for other than a peacetime army. This, however, did not deter the DDS from planning for war, and Lieutenant-Colonel Finn gave freely of his own time in preparing a basis of organisation and administration which would serve the NZDC in time of peace, and provide for its rapid expansion in time of war. His persistence was rewarded by the authorisation of various regulations from time to time dealing with:

(1)

The dental standard required and the procedure for the dental examination and charting of recruits:

(a)

For the Permanent Force.

(b)

For the Territorial Force.

(c)

For general mobilisation.

(2)

The standard of dental treatment for peace and war.

(3)

Equipment tables.

(4)

Accounting for stores.

(5)

Mobilisation regulations.

(6)

War establishments.

(7)

Dress regulations.

(8)

NZDC regulations and standing orders.

(9)

General and field notes for the examination of officers.

(10)

Prescriptions for examination for Certificates ‘A’ and ‘B’ (Dental) and for the promotion of officers, NZDC.

(11)

Instructions to dental officers, Territorial Force.

(12)

Syllabus for courses of instruction for officers, NZDC.

A course of instruction at the Army School, Trentham, of one week's duration was held for officers of the NZDC in October 1938 and another in June 1939. Here they were instructed in general military subjects by the Chief Instructor at the school and in the organisation and work of an army dental service in war by the DDS himself.

In April 1939 three Assistant Directors of Dental Services were appointed, with the rank of major, one to the staff of each Military District headquarters.

As a result of Lieutenant-Colonel Finn's initiative and perseverance and the ready response of members of the profession, the skeleton of an army dental service was built up prior to the outbreak of war in September 1939. It was a new skeleton, for the old one had been buried after the last war, but it was ready to be clothed with the traditions of the past, so carefully preserved by the small band of enthusiasts to whom the NZDC owes a lasting debt of gratitude.

CHAPTER 3 Transition from Peace to War, 1939

THE outbreak of war in September 1939 found the New Zealand Dental Corps poor in strength but rich in theory. A peacetime establishment had been recognised, and although a full wartime establishment was not generally welcomed, there was at least an admission that without dentistry the health service to the armed forces was incomplete. The admission had advanced little beyond the conception of a cadre staff of trained organisers and an unspecified number of civilian executives. How far this conception fell short of the actual requirements and the story of the fight for recognition will be told later. In the meantime, the suggested plan for the examination and treatment of troops in the event of mobilisation had to be carried into effect with the dental forces available at the time. The position was definitely better than that existing at the beginning of the first war.

It has already been mentioned in the previous chapter that Lieutenant-Colonel Finn had submitted certain proposals to Headquarters for action in the case of general mobilisation. This transition period is concerned chiefly with two aspects of these proposals:

The standard of dental fitness expected of the troops.

The methods by which dental fitness was established.

1. Dental Standards

Certain standards were laid down for medical and dental fitness in Appendix XXIV of Army Standing Orders for Mobilisation, 1939, the dental ones being the result of submissions from Lieutenant-Colonel Finn.

The standards are given in detail in Appendix II, omitting the medical ones which are not relevant to this history. They were grouped under four headings:

Armed Forces for Home Defence.

Large Expeditionary Force.

Small Expeditionary Force for Garrison Duty Abroad.

Temporary Employment in New Zealand.

On examination the men were classified as:

‘F’ or dentally fit or capable of being made so in three working hours.

‘T’ or requiring treatment longer than three hours to be made fit.

‘U’ or dentally unfit, such as those requiring multiple extractions or suffering from a contagious oral disease.

For home defence nobody in categories ‘F’ or ‘T’ who was willing to receive treatment was to be rejected, but for small or large expeditionary forces only category ‘F’ men were to be accepted to begin with.

Standing Orders also gave instructions to dental examiners as a guide to assessment of standard, as well as defining their authority to make decisions and receive payment for their services. It is unnecessary to quote these details in full, but one curious anomaly is mentioned as an example of how confusion can be caused when regulations have to be built piecemeal to meet unknown contingencies. When these regulations were framed, the DDS did not know whether the dental treatment for the armed forces would be by civilians or a Dental Corps, and they reflect the uncertainty of the time, being built as a patchwork according to fluctuating circumstances. The anomaly concerned the standard expected of an artificial denture and probably arose from an attempt to ease the severity of the dental standards because of the urgent need for manpower, but the new patch was put in without taking out the old one. The two paragraphs, separated from their context, are:

Definition of a well fitting denture

A denture will not be considered as ‘well fitting’ unless six months have elapsed

Author's italics.

from the completion of the extraction of the replaced teeth; no further extractions must be required which will affect the stability of the denture or necessitate alterations. The denture must fit firmly, be without movement on mastication and complete all spaces where natural teeth are missing. The artificial teeth must correctly meet the corresponding teeth in the opposite jaw and afford a good masticating surface. The denture must be free from cracks and breaks.

[The dental examiner is wholly responsible for] … assessing approximately the time that may be involved in the treatment decided upon, taking into consideration from the information that will be made available to him whether arrangements have been made for a camp system of dental attention or by individual practitioners and, also, that where extensive extractions and the provision of artificial dentures is indicated, only the extractions should be completed and the provision of dentures deferred pending absorption.

Impressions for dentures, especially full dentures, will not be taken within a period of four months from the date of the completed extractions and, in no case, will they be taken, even though four months may have elapsed, until the dental examiner is satisfied that absorption is sufficiently completed for permanent dentures to be inserted.

In regulations framed on the basis of a known policy such a discrepancy would be unlikely to occur. As it was, it did not inspire confidence in the efficiency of the Army Dental Service in the eyes of civilian dentists.

2. The Methods by which Dental Fitness was Established

During the pre-war months of 1939, when general mobilisation was expected, the DDS made detailed arrangements for dental examination and charting of recruits. This was to be done by civilian dentists appointed as members of medical examining boards in the various districts. Careful consideration was given to the method of charting to be used and a Form NZ 360 (Record of Dental Examination), together with instructions to examining dentists, was prepared. The Assistant Directors of Dental Services, who had been appointed to the three Military Districts, prepared lists of dentists to serve on these boards and tested the organisation by the examination of recruits to fill the increased establishment of the Territorial Force. The result was that at the outbreak of war, many dentists were familiar with the routine and the scheme was ready for immediate adoption. As will be seen later, there were imperfections in the scheme but it was a good start and, in the absence of other than a skeleton Territorial Dental Corps, the only practical solution.

A plan had also been prepared and authorised whereby civilian dentists would do the limited amount of treatment at a stated scale of fees.

On 6 September 1939, three days after the declaration of war, Cabinet authorised the mobilisation of a Special Force of 6600 men to serve within or beyond New Zealand. Volunteers for this force, ultimately to become the First Echelon of the 2nd New Zealand Expeditionary Force (2 NZEF), were immediately dentally examined according to plan. Within two weeks, the results showed that the number falling into dental category ‘F’ was so low that too many otherwise medically fit men were being rejected for dental reasons. The standard for acceptance was then lowered by including in category ‘F’ those whose treatment to make them dentally fit would take six instead of three hours. Even then, many men who were medically fit were rejected because of dental defects. The added burden thrown on the shoulders of the civilian dentists by this change of standard and the rejection of valuable manpower gave impetus to the Army's programme for the construction of dental hospitals in the mobilisation camps and the formation of a Corps capable of undertaking full treatment of all troops.

NEW ZEALAND colour image

The aim of the New Zealand Dental Corps was to send every overseas contingent away from New Zealand as nearly dentally fit as possible. This was stated in the 1914–18 War but was achieved only in the later stages of that war. In this war the plan of dental selection of recruits and their immediate treatment made it effective from the beginning. It was never more than a makeshift plan calculated to implement the NZDC policy and give the necessary breathing space for the mobilisation of the NZDC on a war basis. It was, however, a distinct advance on the position existing in 1914.

CHAPTER 4 Mobilisation

CIVILIAN dentists were examining and treating the volunteers for the First Echelon of 2 NZEF before their entry into the mobilisation camps. As far as it went it was an excellent scheme, but none knew better than the DDS that it could not survive the deluge of work soon to be expected. For this reason, he regarded it as only a stepping stone to the ideal of a fully staffed and equipped Army Dental Service. For this reason, also, he had spent hours of the time that could so easily have been devoted to his private practice in Auckland, in transforming his dream into a practical plan to be adopted in the event of war. Strings of official memoranda and explanatory personal letters adorn the files of the Territorial Dental Corps as a testimony to his enthusiasm and persistence. His plans duly arrived at Army Headquarters, but not for adoption as will be seen later.

On 17 September 1939 he arrived in Wellington to take up his appointment as Director of Dental Services on a full-time basis. His first efforts were directed to staffing the new Corps and providing stock and equipment for it. He was quickly to realise the gulf between the ideal and reality. There was a lethargy at Army Headquarters, if not an actual antagonism, towards establishing an adequate Army Dental Service. Working from a small box of an office, without a clerk or a typist, he began the fight again. Once more he had to explain the need for an Army Dental Service, to justify the provision of staff and equipment, to haggle over expenditure that the lessons of the last war demanded if the mistakes were not to be repeated in this. Knowing full well that his policy was correct and that eventually circumstances would force its recognition, he went ahead with his plans largely on his own initiative, accepting the kicks as an earnest of the halfpence to come.

The attitude of Army Headquarters is explained in the following memorandum to the Minister of Defence on the subject of dental examinations and treatment. Dated 8 September 1939, it was signed by the Adjutant-General and the Director of the Division of Dental Hygiene. It stated inter alia:

It is recommended that a reasonable amount of dental treatment should be provided in order to make the men fully fit. If this recommendation is approved, consideration should be given to the two methods by which such treatment may be carried out.

(a)

Dental treatment after enlistment and concentration at mobilization camps.

(b)

Dental treatment after enlistment but prior to concentration at mobilization camps.

With regard to (a), this will entail the provision of:

An extensive dental hospital at each of the four mobilization camps. This would involve heavy expenditure in buildings and after the initial pressure of work had been overcome, would be much greater than the normal requirement of the camp.

Equipment for such hospitals. A large quantity of equipment would be necessary at the outset and in this case also the amount would be far beyond normal requirements. In addition, the equipment required could only be obtained from dental supply houses and it is known that sufficient stocks are not held by these. Importation of equipment or commandeering from civil dentists is the only alternative if equipment is to be provided at mobilization camps.

Staffs of dentists, dental mechanics and orderlies for each hospital. These would have to be brought into camp on a temporary basis and naturally will involve heavy expenditure.

With reference to (b), this course has none of the disadvantages outlined above. The treatment would be spread over the dental practitioners of the Dominion, thus making full use of existing facilities. The work could be carried out expeditiously and prior to the men going onto the Army pay roll. The men would arrive in camp medically and dentally fit and therefore able to proceed with their training without interruption.

It is therefore recommended that method (b) should be adopted.

The memorandum then outlined the procedure to be adopted under paragraph (b) and was approved by the Minister of Finance on 9 September. This is a remarkable document and deserves the closest scrutiny, for it is difficult to imagine a more fertile field in which to examine the political and military thought of the time.

The Director of Dental Services was, by his appointment, adviser to the Army on all matters connected with the dental treatment of the troops and had already submitted war establishments for the NZDC, plans for treatment and specifications for buildings. The memorandum was drawn up without consulting him. Advice was sought from the Director of the Division of Dental Hygiene, the head of a Government department dealing chiefly with the dental treatment of primary school children. It is reasonable, therefore, to assume that the plans of the Director of Dental Services were incompatible with the views of the army authorities and that they sought other advice. Acceptance of the suggestions in the memorandum without a struggle would have reduced the authority of the Director of Dental Services to that of a rubber stamp. Had they not collapsed under the weight of their own inaccuracies, Lieutenant-Colonel B. S. Finn would probably have slipped from the pages of this history.

The 1914–18 War had shown the large volume of dental work that could be expected among the troops and the tremendous struggle the New Zealand Dental Corps had to cope with it all. This was surely enough evidence to discourage any civilian scheme for dental treatment. Dentists were working hard and could not be expected to give priority to army patients, and it would have been impossible to force them to do so. Also, some of them would have to be brought into the Army to train as dental officers for the forces overseas. Staffs of dentists, mechanics and orderlies would therefore still be needed. If the work was to be carried out ‘prior to the men going onto the Army pay roll’, the time for this to be done must be much longer than if the men were all congregated in camp. The mobilisation of the Division and its reinforcements must therefore be delayed to that extent.

Expense was stressed in the memorandum on two occasions in connection with buildings and equipment, but no comparison was made with the expense of operating the civilian scheme nor was a premium put on the greater efficiency of an Army Dental Corps, as proved beyond doubt in the 1914–18 War.

The statement that equipment was not available from the supply houses was not correct as the Director of Dental Services had submitted lists of equipment and stocks (together with prices) which were held ready for the purpose. The Assistant Directors in the three Districts had made full inquiries as to suitable non-expendable equipment for purchase, hire or gift in addition to that held by the supply houses. There were also seven field surgical panniers equipped to mobilisation standard. Some equipment was therefore available to start the Corps, although the machinery for obtaining further supplies was not perhaps as facile as it might have been. It must also be remembered that under the civilian scheme additional stock would be needed under less economic conditions.

The assertion that large dental hospitals would be beyond the needs of the camps after the initial pressure of work had been overcome was a guess wide of the mark. It showed a disregard of experience and was directly opposed to the considered opinion of the Director of Dental Services. A bad guess can be forgiven on the score of ignorance, but there was no such excuse in this case as there was ample evidence on which to form an opinion without recourse to guessing. It is therefore difficult to understand how an appreciation of the position so unrelated to the actual situation could have been given.

The result of this uncooperative attitude was that there was a serious check to the formation of the Corps on a war basis. In spite of it, however, the DDS went ahead with his plans, but every request had to be fought for and many ventures had to be launched on his own initiative without the blessing of official authority. It is quite certain that, if he had not been so sure of the rectitude of his cause as to be prepared to act first and argue afterwards, the New Zealand Dental Corps would not have amounted to much.

Such was the position in September 1939, with the DDS seeing clearly the large amount of work pending and, even more clearly, the difficulty in getting staff, equipment and buildings. It was known that a force of approximately 16,000 men was to be mobilised and sent overseas in three echelons, to be followed by regular reinforcement drafts. Men would also be needed for staffing the camps and for coastal defence and anti-aircraft batteries. The following notes were compiled at the time by the DDS to illustrate how the staffing position was approached. The ratio of dental officers to men was varied later, but the main principles give a much more realistic view of the whole situation than that of the memorandum quoted above:

New Zealand Dental Corps. War Establishment Notes (a)

Establishment of dental officers to accompany New Zealand Special Force overseas.

When troops first leave New Zealand they will be dentally fit and the establishment of dental officers at this stage will be based on a requirement for maintenance purposes of one dental officer for 2,000 men.

When troops have been absent from New Zealand for six months it is estimated that their dental requirements will show a marked increase and the Dental Corps will require to be reinforced to the extent of providing one dental officer for 1,000 men.

When troops have been absent from New Zealand for a further six months, i.e., a total of twelve months, there will be a further increase in their dental requirements and it is considered that the ultimate strength of the Dental Corps should be based on a requirement of one dental officer per 500 men.

The Dental Corps overseas was to be gradually reinforced by sending dental officers at regular intervals to bring the strength up to 32, or one officer to 500 men in a force of 16,000. This gave an opportunity for dentists to be brought in from civilian life in time to be trained as dental officers before being sent overseas. To continue with the notes of the DDS:

(b)

Establishment of Dental Officers in mobilization camps in New Zealand. The following factors must be taken into account in deciding upon the number of dental officers required in the mobilization camps:

The completion of initial dental treatment for recruits.

The maintenance of dental fitness for troops in training.

The training of dental officers for the supply of reinforcements to the NZDC overseas.

The completion of initial dental treatment for recruits.

(a)

First Echelon. The majority of the recruits will be dentally fit on entry into camp but there will be a fair proportion who require denture work to complete the restoration of their occlusion in accordance with the accepted standard of dental fitness.

(b)

Second and Third Echelons and Reinforcement Drafts. A large number of these men, say 80%, will require some form of dental treatment before being passed as dentally fit. If the present system is continued and all surgical work (fillings and extractions) and repairs to dentures, up to a maximum of six hours' work, is undertaken by private practitioners, there will still remain an increasingly high proportion, say 40%, who will require denture work.

The maintenance of dental fitness for troops in training. This should be comparatively light for several months after the initial treatment is completed. Each man however will be examined on entry into camp. This is essential. It is also highly desirable that each man should be re-examined as far as possible at six monthly intervals.

The training of dental officers for the supply of reinforcements to the NZDC overseas. It is essential that dental officers going overseas should have at least three months' preliminary experience in New Zealand Dental Corps methods and organisation in a mobilization camp. During this period also it would be possible to gauge each officer's suitability for the work.

As already shown …, there will be a progressive increase in the number of dental officers required overseas and it is therefore necessary that the amount of initial treatment performed for recruits in camp should be considered in the light of the necessity for drafting dental officers into mobilization camps and providing them with an adequate amount of work.

It thus becomes obvious that an increasing amount of initial dental treatment will require to be performed in camp and a correspondingly decreasing proportion carried out by private practitioners before recruits enter camp.

Meanwhile, the civilian practitioner scheme as applied to the examination and treatment of the men of the First Echelon was in full swing. Despite its value as the temporary expedient for which it was designed, it soon became obvious that it had many imperfections. Some of these were noted in a memorandum to the DDS from Major R. B. Dodds, NZDC, Dean of the faculty of dentistry of the Otago University in Dunedin:

The medical boarding of the first draft from this area is practically completed now. I have attended every board as an assistant in the organisation under Dr Fergus. The boards, as you know, have been held in the dental school and I have had an excellent opportunity of discussing with all dental supervisors matters relating to the dental examinations. Further, some of the ‘F’ and ‘T’ men have been treated at the dental school, the latter at half hospital fees.

I feel now that the position calls for certain comments with regard to the system as it is operating at present. All these points are derived from first hand knowledge. I have concluded:

That the system of examination with mirror and probe cannot be accurate enough to ensure that, even if Form 362 is completed, the soldier would proceed to camp dentally fit on NZDC standards.

That a number of ‘F’ class men, either through lack of opportunity or other reasons, have failed to attend their dentist to have the treatment in Form 362 completed and thus have gone to camp with a large number of fillings and other work outstanding.

That the whole system offers far too great a variation in the standards of examination, classification and treatment, i.e., there is no common standard in these things that would be acceptable, for instance, to a Principal Dental Officer of a mobilization camp.

That the present system is not sound economically. Organised and disciplined treatment by Dental Corps personnel must inevitably serve the troops on the most economical basis possible.

It follows from these conclusions that, if a force is to proceed overseas using a dental standard accepted by the Dental Corps during the last war, the system must inevitably be that developed during that war from 1917 onwards. Ample evidence that history is repeating itself with regard to this matter may be obtained from a study of old files of the New Zealand Dental Journal—evidence moreover which can be corroborated by NZDC officers who had experience of mobilization camps of the last war.

(signed) R. B. Dodds, Major NZDC 11 October 1939

Major Dodds was merely emphasising imperfections of the scheme which had been anticipated by the DDS and of which he had warned Headquarters with such little effect. There was, however, another factor which carried considerable weight. The public purse was being affected. A draft memorandum by the Adjutant-General, undated but probably written in November, sums up the position with suitable emphasis:

It was anticipated that when recruiting for the special force commenced, the response would be of such an extent that it would provide wide scope in the process of selection and, in consequence, the cost of dental treatment would be kept at a moderate level by selecting from those offering their services only those who were of the required dental standard or those who, by the repair of minor dental defects, involving not more than three hours' dental treatment, could be raised to the dental standard specified.

In view of the above, it was decided that the dental treatment then anticipated as requisite should be carried out by civilian dental practitioners prior to the men being concentrated at mobilization camps.

Actually, the number offering their services was not so great as anticipated and it also became evident that the general dental condition of the men offering their services was much below the standard expected. So much so that it was found necessary to increase the period of dental treatment required to six hours. Even with this added facility considerable difficulty was experienced by Districts in filling their quotas of men who were dentally as well as medically fit. Consequently the initial estimate of costs of requisite dental treatment has been exceeded, and it is therefore considered desirable that the situation in regard to dental treatment should be reviewed with the object of ascertaining if a more economical method could be instituted.

As far as can be gathered at the moment, of the number who have offered their services and have been accepted in the first echelon, not less than 85% have required dental treatment and, from the information at present available, it is estimated that the average cost per man of such initial treatment will be approximately £2 2s. 0d. The estimated cost for the first echelon is £11,780.

Other factors are, that of recruits entering mobilization camps whose dental treatment was carried out by civilian dentists, it has been found that 15% require further treatment. This is due to an inevitable amount of dental defects being missed by the dental member of the medical board and the ever-recurring denture remakes and repairs which are to be expected when approximately 25% are wearing some form of artificial denture. There will also be a percentage of those accepted for the special force who may have to be provided with partial dentures to remedy deficiencies that are considered detrimental to their general health.

It is anticipated that the general dental condition of the men enlisted in the second and third echelons of the special force will be lower than the standard of those enlisted with the first echelon. If the dental treatment of these two echelons is carried out in the same manner as that for the first echelon, it is estimated that the cost of such treatment will amount to approximately £17,417, giving for the three echelons a total estimated cost of £29,197.

It is estimated that the cost of the alternative method of rendering the special force dentally fit by carrying out all dental treatment in mobilization camps after the troops are concentrated will be £17,135.

In addition to this, trouble was arising out of the claims from the civilian dentists for payment for their services. There were cases when the work was not done satisfactorily, and even claims for work that had not been done. Men were being treated who did not appear in camp for one reason or another. Enlistments were sometimes cancelled after treatment had been completed; specialist fees were being claimed, and so on. The whole position became so confused that finally, on 19 December 1939, the DDS suggested to the Adjutant-General that all claims be certified and passed for payment as the cost of checking them would amount to more than could be saved by adjusting the discrepancies.

The scheme collapsed under its own weight and on 15 December authority was given for all dental treatment, with the exception of extractions which would bring the recruit temporarily below a minimum standard of masticatory efficiency, to be carried out in camp by the NZDC. Even this exception was removed on 9 January 1940, leaving the NZDC with full responsibility for all treatment. In March the dental member of the medical board was dispensed with and all examinations were carried out in camp by the NZDC, the only exception being those suffering from infective oral condi- tionsconditions such as ulcero-membranous stomatitis, which could be recognised by the medical member of the board and deferred until the condition had been treated.

It must not be thought that while this fight for recognition was going on there was nothing happening in the Dental Corps outside Headquarters. Most of the recruits for the First Echelon entered mobilisation camps at Ngaruawahia, Trentham and Burnham at the beginning of October. Fourth Field Ambulance went to Burnham and to it was attached Lieutenant W. McD. Ford.

Lt-Col W. McD. Ford, ED; Wellington; born Christchurch, 1910; dental surgeon; dental officer, 2 NZEF, 1939–41; served in NZ, 1942–44; PW Repatriation Gp (UK) 1944–45; ADDS, Army HQ, 1949–.

At the same time three other officers were mobilised and posted to the camps: Lieutenant J. A. S. Mackenzie

Maj J. A. S. Mackenzie, m.i.d.; Waikohowai, Huntly; born Levin, 26 Jun 1908; dental surgeon; OC NZ Mobile Dental Sec Jun 1940–Apr 1941; p.w. 25 Apr 1941.

to Ngaruawahia, Lieutenant J. F. Fuller

Col J. F. Fuller, OBE, ED, m.i.d.; Wellington; born Westport, 1913; dental surgeon; ADDS 2 NZEF, Jan 1940–Oct 1944; DDS (Navy, Army and Air) 1949–.

to Trentham and Captain E. B. Reilly

Maj E. B. Reilly, ED; Christchurch; born 1905; dental surgeon.

to Burnham. These four officers had all served in the Territorial Force. Dental sections were set up in the camps for the treatment of casualties, mostly denture repairs. Accommodation was limited to tents except in Trentham, where a building was taken over. Very little work was done at this stage as there was only the Territorial equipment available and this did not include prosthetic equipment. The denture repairs were done with the use of equipment borrowed from private practitioners.

Towards the end of October six more officers were mobilised and posted to the camps: Lieutenants J. G. W. Crawford

Maj J. G. W. Crawford, MBE, ED; Auckland; born Gisborne, 2 Jul 1909; dental surgeon; p.w. 25 Apr 1941.

and C. K. Horne

Capt C. K. Horne; Auckland; born NZ 8 Oct 1913; dental surgeon.

to Ngaruawahia, Lieutenants H. A'C. G. Fitzgerald,

Maj H. A'C. G. Fitzgerald; Hastings; born 1908; dental surgeon.

G. McCallum

Maj G. McCallum, MBE, ED, m.i.d.; Wellington; born Milton, 1905; dental surgeon; PDO Trentham and Burnham Camps 1939–41; OC 1 Mobile Dental Unit Aug 1943–Nov 1944.

and T. V. Anson

Maj T. V. Anson; Wellington; born Wellington, 1902; dental surgeon; PDO, Northern Military District, 1940–41; Brigade Dental Officer, 8 Bde, Fiji, Jul 1941–Jan 1942; Dental Officer, No. 2 (GR) Sqn, Nelson, Feb–Oct 1942.

to Trentham, and Lieutenant J. R. H. Hefford

Capt J. R. H. Hefford; Christchurch; born England, 1917; dental surgeon.

to Burnham. Two of these, McCallum and Hefford, had served in the Territorial Force. A little extra equipment had been obtained but practically all the instruments and much of the stock was provided by the officers themselves. Accommodation at Ngaruawahia and Burnham had been improved by the provision of marquees. Living accommodation, especially at Trentham, was exceedingly primitive, consisting for the dental officers of the bare minimum of four walls, a roof and a bed.

Dental examination of all troops in the three camps was then undertaken. This, with completing treatment not finished by the civilian dentists, emergency work for the camp staff and maintenance for the 6600 men of the First Echelon, kept the dental officers fully occupied, working as they were under field conditions.

Towards the end of November a new stage was reached. The dental services expanded and, from an administrative point of view, became consolidated to form camp dental hospital groups rather than multiple field dental sections. Papakura Mobilisation Camp, which was to replace Ngaruawahia as the main camp in the Northern Military District, was opened and Lieutenant Mackenzie was transferred there to take charge. Lieutenant Fuller was placed in charge of Trentham and Captain O. E. L. Rout was mobilised and posted to Burnham. These three officers held the appointments of Principal Dental Officer in accordance with the NZDC war establishments drawn up in pre-war years and now approved. (See Chapter 5, Organisation.)

By the end of December the mobilised strength of the NZDC was 22 officers and about 50 other ranks. Buildings for dental hospitals at Papakura and Burnham were completed and occupied in December, although still far from complete with many internal fittings. Thus in the three main mobilisation camps accommodation was available, for at Trentham a building had been available as a temporary hospital from the start. At Ngaruawahia, however, tents were still in use.

When the troops of the First Echelon were ready to embark on 5 January 1940, they had all received a final check of their dental condition and some 6500 men left New Zealand completely dentally fit. Part of the credit for this must be given to the civilian dentists but the Dental Corps can claim its share. The approximate figures for the treatment carried out for the First Echelon while in camp, i.e., by the NZDC, are: 3000 fillings, 750 extractions, 250 dentures (full, partial and remodelled) and 200 repairs to dentures. The work was done in the face of many handicaps. Temporary accommodation had to be set up and equipment found before anything other than emergency treatment was possible. It took time to make satisfactory arrangements with the camp authorities and officers commanding units to provide a flow of patients, for at this time the general camp organisation itself was only in the developmental stage and the training programmes were subject to sudden changes. Final leave of fourteen days further interrupted the work just at a time when it had started to run more smoothly. Still, by dint of hard work and long hours, the result was achieved and the subsequent history of the dental services with 2 NZEF overseas indicates that this effort and the treatment by the NZDC of the succeeding echelons and reinforcements was the foundation of the excellent dental health record enjoyed by New Zealand troops throughout the war.

There were other troops in New Zealand than the echelons of 2 NZEF and they provided a problem of their own. Within a week of the declaration of war a force was mobilised to man the coastal batteries and subsidiary defence stations. These men were not selected according to any standard of dental fitness, nor were they included in the civilian practitioner scheme for dental treatment. The only provision made for them was that when a man reported with toothache, the medical officer authorised the necessary treatment from a civilian dentist. This was only for the relief of pain and did not include other work to make him dentally fit.

In December Government approval was given for dental examination and treatment of these troops to be undertaken by the NZDC. The policy was that the NZDC would be temporarily detached from the mobilisation camps whenever intervals in the treatment of overseas drafts made this possible. They were to operate as mobile field dental sections, taking fully equipped outfits from the mobilisation camps. The first of these intervals occurred when the First Echelon went on final leave, and between 21 December 1939 and 11 January 1940 field dental sections operated at Narrow Neck and North Head in the Northern Military District, Fort Dorset in the Central and Battery Point and Godley Head in the Southern Districts. The result was that at least all urgent work was completed for the fortress troops at these establishments.

Staffing the New Zealand Dental Corps

In staffing the Corps there were two important questions to answer:

How much treatment was needed to make the troops dentally fit and maintain them so?

How many dentists, mechanics and orderlies were required to do this?

The first question could not be answered with complete accuracy but the amount of treatment could be roughly assessed by analysing the results of the examination of the men who volunteered for the First Echelon and the results of examination and treatment in the 1914–18 War. From these figures it was possible to arrive at a fair average for a given number of men.

The answer to the second question then appeared to be one of mathematics, provided the source of supply did not dry up. It was known approximately how much work a dental officer could do in a given period, how many mechanics and orderlies he needed to assist him and how much equipment he would need. On paper the problem was simple; in practice not so simple. In the first few months of the war the DDS used the rules of mathematics to justify his requests for staff but, when it was decided that the Corps was to be built up in proportion to the armed forces, other factors had to be considered. There were different factors affecting dentists, mechanics and orderlies, so the three will be considered separately.

Dental Officers

There was no difficulty at the beginning of the war in finding enough dentists to volunteer for service in the Corps; in fact, more applied than could be immediately accepted. But, even in these early times, the action of volunteering did not mean acceptance, as the DDS demanded a high standard for the Corps, quite apart from medical fitness to stand up to the work. The dentist had to have high professional ability and be of good ethical standing, fit to receive the King's Commission. The Dental Corps was not going to be a dumping ground for profession failures or playboys. The needs of the civilian population also had to be considered and dentists could not be drawn into the Army from areas poorly provided with dental services.

The maintenance of a balance between civilian and military requirements was recognised as important by the Government, and in December 1939 the Minister of Health approved the setting up of a sub-committee of the Medical Committee of the Organisation for National Security to advise on this and other dental matters of national concern. Consisting of Mr J. L1. Saunders,

Col J. L1. Saunders, CBE, DSO, m.i.d.; Lower Hutt; born Dunedin, 1891, dental surgeon; Otago Regt 1914–18 (Lt-Col); twice wounded; comb 2 Inf Bde (Territorial Force) 1939–42.

Director of the Division of Dental Hygiene in the Department of Health, Lieutenant-Colonel Finn, and Mr O. M. Paulin

Capt O. M. Paulin; born Dunedin, 14 Jul 1895; dental surgeon; NZDC 1918 and 1942–45; died Richmond, 14 May 1959.

representing the New Zealand Dental Association, the dental sub-committee held its inaugural meeting on 29 January 1940 in Wellington. By this time thirty-one dentists had received, or were about to receive, their commissions in the NZDC, so the first action was to ratify these appointments. This they did with the exception of Captain O. E. L. Rout who, they considered, would be better employed in his capacity as a lecturer at the Otago University Dental School.

At the beginning of the war there were 697 dentists on the New Zealand register. Twenty-five of these were in Government employment, at the dental school or in the island dependencies, so in the meantime were not to be considered. This left 672, of whom many, through age or ill health, were unable to serve with the military forces, but who might release younger and fitter men for service.

At this time all manpower for the fighting forces came from volunteers so the authority of the Organisation for National Security and its committees was limited. In the case of dentists the committee's main function was to see that the needs of the civilian population were not adversely affected by too many enlistments from the same quarter. To help it in deciding this, it asked the New Zealand Dental Association to appoint dentists in the various districts throughout the Dominion from whom recommendations could be obtained. Subject to this proviso, the selection of applicants was made by the DDS after careful inquiry into their suitability and the committee abided by his recommendations.

On 18 June 1940, however, the National Service Regulations were gazetted by Order in Council. By these regulations 22 July 1940 was made the closing date for voluntary enlistment, and thereafter men were called up by ballot both for overseas and Territorial service with the armed forces. Dentists were therefore liable to be called up as combatants either for overseas service or Territorial training, and the delicate balance between military and civilian dental requirements was in jeopardy. Exemption from combatant service could not be granted by the committee, but the National Service Department recognised the need for some degree of conservation of dental manpower. The department had what was known as a ‘Schedule of Important Occupations’, which was in the process of revision when this question was being considered. The Director, Mr J. S. Hunter, wrote to the Medical Committee on 2 September 1940 to the effect that while the postponement or reservation of a person drawn in a ballot was a matter entirely for the decision of a tribunal that was to be set up, certain recommendations for dentists and dental mechanics were suggested for inclusion in the revised schedule. No dentist would be released for Territorial training and if he was called up in a ballot for overseas service his case would be referred to the National Medical Committee, which included the dental subcommittee, whose opinion would be transmitted to the Appeal Board for consideration. The result was eminently satisfactory as the Appeal Board invariably acted on the recommendations of the committee.

The committee also recommended that those dental students who had completed one full year of professional study, i.e., who had completed the second year of their dental course, should not be withdrawn for military service but would be required to continue their professional studies.

The result of this was that the DDS was able to select those dentists he needed for the Corps with a reasonable chance of getting them, and still had a free hand in rejecting unsuitable applicants, with a knowledge that they would not be withdrawn from the general dental pool. That the DDS was careful in his choice is shown by the very small number who turned out to be misfits. That his standard was high can be seen by the instructions given on many occasions to officers leaving to take up a command overseas:

You will remember that your first duty is to look after the men you command, then to equip yourself with the necessary military and specialist knowledge to make your branch of the service the most efficient section of the military organisation. Everything has been done to give you rank and status in the Force and it rests with you to build up from this with your own initiative and personal application a branch of the service that will function under all conditions presenting. It is up to you to live up to the ideals of your profession apart from inculcating into the minds of other branches of the force, by practical demonstration and propaganda amongst all Units, the importance of our specialist service and the essential part that dental health contributes to the mental and bodily health of the soldier.

With the strictest observance of Service Regulations and Procedure and the continuance of the loyalty and co-operation you have shown, so will the ‘Esprit de Corps’ be built up and the traditions of the New Zealand Dental Corps and your profession be upheld. Nevertheless do not forget that commissioned rank in the professional services is easily gained and the soldier who presents to you for treatment, of whatever rank, is deserving of all the consideration that you, as a professional man, can offer him, and he will get it and with good measure from the New Zealand Dental Corps.

The Corps owes a debt of gratitude to Colonel Finn for selecting his officers with such care and for constantly refreshing them with his own idealism. At one time in the war he was so desperate for dental officers that he was prepared to take them direct from graduation and train them at the camp dental hospitals. This was against his principles, and later when the supply improved he insisted that new graduates must have at least six, or preferably twelve, months' practical experience in the dental department of a public hospital. The wisdom of this is seen when troops are scattered over the country and dental officers have to work alone, supported only by their own initiative and professional experience.

Civilian requirements were assessed as one dentist to 2200, but in 1942, when general mobilisation had taken place and large numbers of dental officers were needed, the profession was asked to work at a ratio of one to 3300. It is interesting to compare the civilian figures with those of the 1914–18 War as computed by the National Efficiency Board. The ratio of dentists to population in 1914 was one to 2196, and in 1917 one to 2922. The difference in the ratio at the peak periods of the two wars can be attributed to the fact that in 1942 New Zealand was threatened with invasion and a large number of men were mobilised to protect the homeland, needing more dental officers in the armed forces and leaving fewer for civilian requirements. So serious was the position in 1942 that the dental sub-committee circularised the dentists advising them of the position and asking that they co-operate by modifying their plans for treatment, simplifying as far as possible all operative and prosthetic work while the emergency lasted. The general reaction to this circular was favourable as it was realised that some action was necessary if the interests of the civil and military population were to be safeguarded. There was some criticism, especially from a company providing certain services to the profession, on the grounds that their interests were being vitally affected, but the position was too serious for much notice to be taken of it.

The Germans apparently had the same difficulty in providing an adequate dental service for the civilian population. In May 1942 the following paragraph appeared in the dental magazine Oral Hygiene:

Nazis Lack Dentists

With many of the country's dentists in military service, toothaches are becoming widespread in Germany. The Koelnische Zeitung of Cologne reported ‘There simply are not enough dentists.’ The paper urges the people to be patient, to consult a dentist only when absolutely necessary, ‘as for example when the pain becomes too great or chewing is impaired seriously’.

Further steps were taken in 1943 to stabilise the dental service to civilians. A Dentists' Employment Order, 1943, was written into the Industrial Manpower Emergency Regulations, 1942. Briefly, this order, operating from 9 September, prevented any registered dentist from ceasing practice, changing his type of practice or setting up practice at any other place or places without prior consent in writing of a District Manpower Officer. This order served two useful purposes. It helped the work of the dental sub-committee by simplifying the organisation of dental manpower and it protected those dentists already serving with the NZDC from unscrupulous opportunists who might seek to filch their practices from them in their absence.

Dental Mechanics

The National Service Department did not recognise dental mechanics as belonging to the ‘Schedule of Important Occupations’ but it did concede that they should be subject to some direction. All those drawn in the ballots for overseas service were referred to the National Medical Committee as in the case of dentists. For those drawn in the ballots for Territorial training, postponement of calling up was dealt with by the Appeal Board on the individual merits of the case. A letter from the DDS to the Director of Mobilisation on 1 May 1941 ran:

The New Zealand Dental Corps can absorb all dental mechanics or dental technicians available through Expeditionary Force ballots and the Director of National Service has notified Appeal Boards accordingly, also suggesting that, where these ballotees are released for military service it should be conditional upon service in their technical capacity and additionally that the appeals of grade II and III mechanics should be adjourned until their medical board papers have been perused at Army Headquarters with a view to their being utilised in home service duties thereby releasing grade I mechanics for overseas.

It should be explained that the classifications ‘Dental Mechanic’ and ‘Dental Technician’ are synonymous and appear indiscriminately in memoranda quoted in the text.

There was, however, a definite need to preserve the balance between military and civilian requirements, although perhaps not to such an extent as with dentists. It was therefore decided that if the dental sub-committee was satisfied that a mechanic was a competent tradesman and essential to civil requirements, an appeal from military service would be lodged on his behalf on the grounds of public interest. This was not entirely satisfactory as it entailed much unnecessary correspondence and delay. Also, in many cases, no sooner were appeals lodged and dealt with than the DDS would require the men urgently and could not get them until the appeals had been withdrawn. A simpler scheme was therefore evolved. After the issue of the Gazette the sub-committee made inquiries into the bona fides of each mechanic drawn in the ballot. This was a necessary precaution as in a number of cases boys who could barely lay claim to the proficiency of a ‘plaster boy’ had styled themselves dental mechanics. These were useless to the NZDC and to the civilian population except as trainees. After their bona fides had been established, the mechanics continued in their civil occupation until their services were asked for by the DDS. In other words, every dental mechanic was kept in his trade either in civilian or military practice. This exemption applied also to the National Military Reserve and the Home Guard, except of course in the event of full mobilisation of the latter in the defence of New Zealand's very existence, when dentists, mechanics, Toms, Dicks and Harrys would all be in it together.

In February 1943 Mr G. Clark of the dental mechanics' union was appointed by the Minister of Health to the dental sub-committee. He attended only those meetings at which the release of dental mechanics was being discussed.

These arrangements did not fully satisfy the demands of the NZDC for trained mechanics and already attempts had been made to train its own in the mobilisation camps. As will be seen in the chapter on this subject, this was not completely successful at first, but it led to the formation of training schools under capable teachers in March 1943. The demand for mechanics from civilian life therefore decreased and actually none were brought into either the Army or the Air Force after October 1942. Eventually, on 16 February 1944 the following resolution was passed by the National Medical Committee on the advice of the DDS:

That with the dental mechanics who are gradually being released to civilian occupation from the Armed Forces, together with those already serving as apprentices and employed as journeymen mechanics, or in business on their own account, the dental profession is reasonably served by dental mechanics under present conditions.

That in view of the increasing number of dental mechanics being released from the Armed Forces, the necessity no longer exists for dental mechanics who are, or have been, called in ballots to be retained in their civilian occupations or for their work to be regarded as a protected industry.

The removal of dental mechanics from an essential industry classification restored the balance which had been disturbed by the release of mechanics from the armed forces. Those who had been drawn in ballots were then called up either for general military service or for other essential industries in equal numbers to those released from time to time by the armed forces.

Dental Orderlies

In selecting non-technical staff for the Corps, the policy was to look for keen men of a reasonable standard of education and personal cleanliness, fit to work in a hospital team. The choice was limited by the needs of the combatant units, for whereas dentists and mechanics naturally gravitated towards the Dental Corps whatever their medical grading, untrained men who were medically Grade I could not often be spared for a non-combatant unit such as the NZDC. There were, however, many men graded II for slight abnormalities sufficient to disqualify them for service in a combatant unit who were of a sufficient standard of physical fitness to make them valuable members of the NZDC. It was perhaps not fully appreciated at first to what extent the NZDC would be employed and the high standard of fitness required of those serving in a field ambulance or a mobile dental unit, but it was realised that there must be Grade I men to accompany the NZDC overseas. The result during the first ten months of the war, when all the men were voluntary enlistments, was that Grade II men welcomed the opportunity to serve with the NZDC but Grade I men were difficult to get, as the choice of orderlies for service overseas was limited by the large amount of work the NZDC had to do in New Zealand.

There were certain key men who should not be called nontechnical. Men with a knowledge of dental stock, such as employees of supply houses, were the natural choice for NCOs in charge of stores, but these were hard to get as they could ill be spared from their civilian occupations. Most of the stores NCOs were trained in the Corps after serving as dental orderlies. Men with the capacity for leadership were needed as administrative NCOs. Again, these mostly proved their worth as dental orderlies and rose in rank and authority according to merit, as there were very few men who had had experience in the Territorial Dental Corps from whom to chose.

The general selection of orderlies in the early part of the war was excellent and to those who served in New Zealand and overseas in the NZDC can be attributed much of the success of the Corps in the war. There were difficulties at a later date when the Dental Corps, in common with other non-combatant units, had to absorb its share of pacifists and objectors, but the constitution of the Corps was then sufficiently strong to do this without serious indigestion.

The obvious course of employing women in the camp dental hospitals to release men for service overseas and in the mobile units in the field was delayed by prejudice from the more conservative of the military authorities, and it was nearly eighteen months after the declaration of war before serious consideration was given to this prolific source. Before this no facilities existed for women in camp except for nursing sisters, and even the welcome invasions by concert parties arrived under strong duennal escort. Appropriately it was the youngest service which made the first move to use women as dental orderlies, as selection of suitable girls to join the Women's Auxiliary Air Force began in July 1941. The type sought was those who were ‘bright and quick in the uptake but not necessarily with previous dental experience’. Added incentive was given by arranging classes of instruction by dental officers to qualify them to sit for trade tests which gave extra status and, of course, extra pay. Later the Navy and the Army used girls of the Women's Royal New Zealand Naval Service and the Women's Army Auxiliary Corps. There is no doubt about the success of the women as dental orderlies, and some were even trained as dental mechanics in the NZDC training schools. Some adjustment of existing establishments was necessary as it was not considered right to ask for the same amount of work from the women as was expected from the men. The proportion was fixed at three women to replace two men.

Summary

The number of dentists, mechanics and orderlies serving in the NZDC in the war varied considerably at different times, but the following figures are interesting. Taking 697 as the number of dentists on the register at the beginning of the war, and remembering that many of these, through age, health or location were debarred from service, the creditable number of 215 were mobilised in the NZDC for varying periods. Practically every experienced dental mechanic in the Dominion who was fit for service was also mobilised at some time or other. The number of men and women who served as orderlies is difficult to assess but the strength of the NZDC for the three services at 31 March 1945 was:

Officers NCOs and Males Other Ranks Females Total 137

This includes three non-professional officers.

341 95 573

On the whole the staffing system worked satisfactorily and the balance between military and civilian requirements was well maintained.

CHAPTER 5 Organisation in New Zealand—Army

THERE are two main points to be considered in the organisation of any unit in the armed forces:

The relationship of the unit to the general organisation.

The internal organisation of the unit itself.

The relationship of the New Zealand Dental Corps to the general organisation of the Army centres round the head of the Corps, the Director of Dental Services. It is therefore essential that his position be clearly understood.

The Director of Dental Services

The General Officer Commanding a force is responsible for everything pertaining to that force, including the dental health of his troops, but being a layman, he appoints a dental expert to organise and carry out the necessary work on his behalf. The Director of Dental Services is therefore an administrative officer with dental qualifications. The terms of his appointment read that he is responsible to the Adjutant-General for the organisation, maintenance and efficient working of the New Zealand Dental Corps and to the Quartermaster-General for the provision and inspection of dental equipment and stores.

In addition to these administrative and supply duties he has another role, viz., operational. He has to deploy his units in accordance with the commander's plan and must issue his orders in exactly the same manner as does any other commanding officer, such as the Commander of the Royal Artillery or the Director-General of Medical Services. He must therefore have close liaison with the operational staff. The shorter the channels of communication between him and the heads of the other departments, the more expeditiously can his organisation function. Similarly, any interference with these channels of communication must affect the efficiency of his organisation. In the case of the Director of the New Zealand Dental Corps, there was interference with the channels of communication by the claim of the Director-General of Medical Services that the dental services were part of the medical and, as such, should be subject to his direction. The terms of the Director of Dental Services' appointment in this war were clear and precise so it would appear that the claim should have been dismissed, but unfortunately it was allowed to persist and became a source of annoyance and confusion. The main argument in favour of medical supervision was that the general health of the troops was the responsibility of the Director-General of Medical Services and that dental health was included in this category. This was correct up to a point, and the Director of Dental Services was always ready to agree that he had a responsibility to ensure that the dental health of the troops conformed to the general standards of health laid down by the medical services. To this extent he recognised a responsibility to the Director-General of Medical Services. A conference was held early in 1939, of which the closest search has revealed only pencilled minutes, in which it is claimed that the DDS agreed that the NZDC should revert to control by the DGMS. As no alteration in the terms of the appointment of the DDS was made officially by the Adjutant-General, it can only be assumed that this referred to the question of general policy affecting the health of the troops and not to matters of internal organisation. What the DDS did not agree to, and what the terms of his appointment contradicted, was the right of the Director-General of Medical Services to have any say in the method by which the standard of dental health was maintained. The controversy was bitter and undoubtedly affected the harmonious relationship which should have existed between the two Corps, and most certainly made the task of organisation more difficult for the DDS. Strong action by the Adjutant-General in support of his written instructions would have ended the controversy, but such action was not forthcoming, and what there was was tempered by expediency, allowing the sore to fester and erupt again.

Apart from his army appointment, the DDS was made responsible to the Naval Board through the Naval Secretary, and the Air Board through the Air Member for Personnel, for the dental health of the men in their services. His official title was therefore Director of Dental Services, Navy, Army and Air, but he carried army rank only.

The DDS was given the task of rendering all the armed forces dentally fit and maintaining them so. The responsibility was his and his alone. He had direct access to the heads of the services for his requirements, his immediate superior officer being the Adjutant-General or his counterparts in the Navy and the Air Force. He was expected to co-operate freely with the heads of other departments but was subordinate to none. All appointments to the NZDC were made by Army Headquarters on his recommendation. He was responsible for the training and distribution of officers and other ranks of the Corps and their calling up for service in New Zealand or overseas. His advice was available on professional questions, dental statistics and reports. In co-operation with other branches of the staff, he was responsible for the provision of accommodation in military districts, camps, depots, hospitals, transports and hospital ships for the successful dental treatment of the troops. He was expected to inspect the dental services in military camps and formations at bases and in the field. Also he was expected to co-operate with the dental council and the representatives of the dental profession in the conservation of the needs of the civilian population.

During the whole of the war the DDS was Colonel B. S. Finn, who received his army command in 1934, his naval command in April 1939 and his Air Force command on 17 September 1939.

Internal Organisation

In a previous chapter it has been stated that the Director of Dental Services had given considerable thought before the war to the organisation of the NZDC for war purposes and had made certain recommendations to Headquarters. It is now convenient to examine his recommendations regarding organisation in more detail and to see what notice was taken of them. The analysis will show how difficult it was to carry out his obligations in the face of the uncooperative attitude of the authorities. His recommendations were:

Some administrative staff at headquarters.

A quartermaster for Dental Services to negotiate and advise in the purchase of equipment and stores, to be responsible for the issue and maintenance of the same and the establishment of an Army Dental Store in conjunction with the Ordnance Department.

Three Assistant Directors of Dental Services to rank as Lieutenant-Colonels and act as staff officers for dental services attached to each military command headquarters. Their duties would be to co-ordinate between their respective command headquarters, the Principal Dental Officers of military districts and standing camps and the Director of Dental Services and to act for the latter in their districts. The Central Military District ADDS was in addition to assist the DDS at Headquarters.

Three district Principal Dental Officers whose duties were to be:

(a)

To assist the command ADDS.

(b)

Be dental officer in charge of any dental centre situated in command headquarters area and carry out the dental duties required for the personnel of the troops in that area including the dental examination of recruits, invalid soldiers and members of the Forces as might be required by the Commandant.

(c)

Give regular oral hygiene lectures to troops and hold classes of instruction for non-commissioned officers and other ranks of the NZDC in connection with their specialist duties.

Considerable correspondence passed between the Director of Dental Services and the Director-General of Medical Services, on the one hand, and the Adjutant-General on the other, with the following result:

Administrative Staff at Headquarters

No appointments were made, not even a typist.

Quartermaster

No appointment was made, with the result that all the stores organisation and administration, which was highly technical and could not be handled by the Ordnance Department without advice, fell on the already overburdened shoulders of the DDS himself. It was not until the war had been in progress for seven months that Major H. E. Suckling relinquished his appointment as ADDS of the Southern Military District and was appointed ADDS, Army and Air, at Army Headquarters, where he gradually took over all the stores administration. This appointment he held until 31 January 1945.

Three Assistant Directors of Dental Services

Three part-time majors only were appointed, one each to the Northern, Central and Southern districts. Each of these officers was responsible to the DDS for the dental fitness of all mobilised military personnel in his district. They supervised and controlled on behalf of the DDS all dental services required for the Army and were responsible for the checking of the dental accounts rendered by the civilian dentists treating troops.

This part-time service was to be not less than two and a half hours daily and the remuneration was £150 per annum. The duties took up much longer than two and a half hours a day, but even if this were not the case, each officer had to work at least fifteen hours a week at four shillings an hour. They were all running busy dental practices in which overhead expenses went on while they were on army duty, so that actually they were paying for the privilege of serving in the Army.

It is hardly surprising that this part of the organisation did not last and that, in the middle of 1940, the Principal Dental Officers of the three main mobilisation camps took over these duties as well as their own.

Three District Principal Dental Officers

It was found that the district mobilisation camps were close enough to their district headquarters to dispense with these appointments and allow the Principal Dental Officers of the camps to act in the dual capacity.

As soon as the mobilisation camps were ready a Principal Dental Officer was appointed to each, i.e., Papakura, Trentham and Burnham in the Northern, Central and Southern Military Districts respectively. The Principal Dental Officer was responsible through the Camp Commandant, and the District ADDS, to the DDS for:

(a)

Dental examination and condition of the troops, the class of operations performed and for all professional matters connected with his Corps.

(b)

The control of the dental centre and staff, being responsible to the Camp Commandant for the discipline of his unit.

(c)

Dental equipment and stores issued to him and the submission of requisitions for approval for all dental stores required by the unit.

(d)

Arranging regular lectures to all troops in the camp on oral hygiene, classes of instruction in specialist duties for non-commissioned officers and other ranks of the NZDC, and for grading mechanics.

(e)

Arranging special classes of instruction for dental officers in military routine and procedures.

(f)

General co-operation with the training staff in completing the dental treatment of the troops so as to interfere as little as possible with their training.

(g)

Furnishing all reports through Camp Headquarters on the dental treatment and any returns that might be required by the DDS.

Although the Principal Dental Officers were appointed as executive officers, it can be seen that their administrative duties were considerable, especially when they took over the additional duties of ADDS of the district. They therefore had little time available for the actual practice of dentistry. Nevertheless they were appointed for their professional knowledge as well as for their administrative ability and were nominally responsible for the standard of work of the dental officers and mechanics under their command.

This was the framework on which the future organisation was built:

diagram of military hierarchy

The Director-General of Medical Services has been included in this diagram to show that he, like the Director of Dental Services, was responsible to the Adjutant-General and was in no way included in the dental organisation.

Organisation below the level of the Principal Dental Officers was dependent on general army policy so it is as well to outline briefly once again what that policy was. A special force of approximately 16,000 men was to be mobilised, initially trained and sent overseas in three echelons, to be followed by various reinforcement drafts. In addition, other troops were mobilised to man the coastal defence and anti-aircraft batteries, to act as camp and headquarters staff, guards of vital points such as hydro-electric stations and reservoirs, and later for a field force.

Three main mobilisation camps had been built, one at Papakura, 18 miles south of Auckland, one at Trentham, the same distance north of Wellington, and one at Burnham in the South Island, about 16 miles south of Christchurch. In addition to this there was a canvas camp at Ngaruawahia, on the Waikato River near Hamilton, and in early 1940 the Show Grounds at Palmerston North were taken over for the training of the Maori Battalion.

Dental treatment for these different groups of troops had to be arranged according to the time available. The intention of the Corps to send every soldier overseas dentally fit meant that first priority must be given to the echelons and reinforcements. The first concentration of dental personnel must therefore be in the mobilisation camps and the size of the establishments was calculated by the DDS and submitted to Army Headquarters. The amount of work could be assessed reasonably accurately, the time available was known within predictable limits and the rate of work of the average dental officer had already been noted from previous experience. To cope with the simultaneous dental treatment of the other mobilised troops bigger establishments would be needed, but the DDS only asked for enough to carry out the urgent task of sending the overseas troops away dentally fit, relying on the intervals between the echelons to catch up with arrears in the other work until the Corps organisation could be built up to cover everything. The problem was complicated and there was a reluctance to provide what, with some justification, appeared to be a sledgehammer to kill a gnat. There was no precedent in any country where a concentrated effort to promote complete dental fitness had been attempted except in the New Zealand Forces in the latter stages of the 1914–18 War, and it appeared that the lessons of that war had been imperfectly digested. The result was that every establishment submitted was sifted through the finest financial grille and the early dental staff had to work phenomenal hours to achieve their objective.

As an example of this, establishments to begin with were cut down to nearly two-thirds of those recommended by the DDS; they were accompanied by a grudging admission of their inadequacy, as shown by the following extract from a memorandum from the Adjutant-General dated 5 March 1940:

The DDS still retains the authority to move personnel to overtake necessary work, even to the limit of adding surplus to the Camp Hospital, but at all times drawing from another authorised establishment.

This was robbing Peter to pay Paul and took no notice of the fact that more or less equal work was needed in each centre at the same time. The privilege was therefore of little use. That the memorandum was accompanied by an enclosure of outdated establishments when new ones had been authorised on 23 February was but another indication of the confusion existing at the time.

Out of the confusion, however, came reasonable establishments to cope with the echelons and reinforcements, though little relief for the DDS from his administrative problems at headquarters and an inadequacy for the amount of work throughout the country.

Dental treatment for the mobilised troops in the coastal batteries, etc., was provided in Wellington and Christchurch by the respective mobilisation camps, but in Auckland there was a special dental hospital for this purpose. At a delightful camp at Narrow Neck on the north shore of the Waitemata harbour, a building, originally used as a dental hospital in the 1914–18 War, was reconditioned and again brought into service for one dental officer, orderly and mechanic. In Dunedin, and elsewhere in the south, use had to be made of the civilian dentists.

Later, when troops became dispersed and when more dental personnel became available, the organisation expanded accordingly. Other large hospitals were built, such as that at Waiouru near the centre of the North Island. Group hospitals were established such as that at Linton, near Palmerston North, and, most important of all, mobile sections and caravans were used. By this time the importance of dental health was fully recognised and no difficulty was experienced in building up a large and efficient organisation. A study of the following diagram will explain the organisation as it existed when more troops were mobilised in New Zealand than ever before in her history.

See p. 46.

This organisation, although authorised, was never fully used as it was found to be impossible to staff it at a time when every man and woman was needed to defend the country against the threat of Japanese invasion. Some appointments had to be abandoned and some had to be filled by those doing other duties. For example, the depot was staffed by mobilisation camp personnel and did not function as a separate entity, although it has since become the nucleus of the suggested peacetime organisation of the Corps and is an integral part of the framework on which the Corps can be built for a future war.

Certain sections and groups of the organisation were under the direct control of the DDS and the others were divided among the three military districts. These were under the command nominally of the Officer Commanding the District Depot, but actually of the Principal Dental Officer of the mobilisation camp, who combined these two appointments.

As in the study of biology we find the most complex structures can all be reduced to a cellular fundament, so can the operative organisation of the NZDC be considered in terms of its smallest unit, the dental section. The dental section is a self-contained unit capable of carrying out all classes of dental treatment other than specialties. It was designed to operate in areas, training depots, forts and camps, other than mobilisation camps, and consisted of one officer, one or two orderlies and one mechanic. From this minimum can be built all the other organisations required, but below this the unit cannot function.

It is now possible to analyse the full organisation of the NZDC in New Zealand. Before doing this it is interesting to note that history up to a point was repeated. Although the dental treatment in this war was begun in earnest much sooner than in the 1914–18 War, it was again three years before the organisation was at its peak. In the Great War it was 1917 before the Dental Corps arrived at the stage of sending all troops overseas dentally fit, and in the Second World War it was 16 October 1942 before the full organisation was authorised. It must surely be admitted that the task is easier of accomplishment with efficient organisation, and it is hoped that the record of the work of the Corps in the two wars will bear testimony to its worth, and that the organisation in another war will be there at the beginning.

diagram of military hiearchy

Headquarters Dental Services

On 16 October 1942 the Adjutant-General authorised an establishment for this headquarters to administer the NZDC for the Navy, Army and Air Force. It comprised:

Director of Dental Services in the rank of colonel.

Assistant Director of Dental Services, stores and equipment, in the rank of lieutenant-colonel.

Assistant Director of Dental Services, administration, in the rank of major.

Staff Officer in the rank of captain (or subaltern). This officer was not a dentist and it is interesting to note that this appointment, together with that of the officer in charge of the dental store, was the first authorisation for commissioned rank in the NZDC for a non-professional. Although authorised in October 1942, it was not until 15 December 1943 that F. D. Sheppard

Lt F. D. Sheppard, MBE; Christchurch; born Dover, Kent, 23 May 1907; manufacturing chemist's representative.

and G. A. Hay

Lt G. A. Hay; Christchurch; born Christchurch, 1916; accountant.

were gazetted as second-lieutenants in the appointments of Staff Officer and Quartermaster respectively. They were promoted to lieutenants on 15 December 1944, the highest rank to be achieved by a layman in the NZDC in the war.

Administrative Warrant Officer. There was authority for the rank of first class, but only second class was granted.

Four clerks for general duties. One of these was a staff-sergeant and the other three were WAACs, one of whom was a corporal.

One WAAC orderly.

Two civilian typists.

For transport a five-seater car was allotted.

The organisation had grown to such an extent that even this seemingly generous allocation was not enough and should be regarded as the minimum rather than a satisfactory precedent to follow. Asked to comment on it at the time, the DDS wrote in characteristic fashion:

Officers—No argument. Four is the irreducible minimum. Even this involves them in long and arduous hours to the point of real risk to health. Staff Officer dental services has recently been graded three and this is undoubtedly due to pressure of responsibilities and hours aggravating a physical disability of long standing origin.

His detailed comments in the same report on the duties of noncommissioned officers and other ranks show that there were no drones in the headquarters hive.

Reference to the diagram will show that the following were under the direct command of this headquarters:

Base Dental Store

No. 2 NZDC Depot

Mobile Dental Caravan Group

Army Headquarters Dental Section

Trentham Camp Dental Hospital

Waiouru Camp Dental Hospital

Northern, Central and Southern Military Districts

Base Dental Store

This store was administered by the ADDS and had, up to 1942, been working under the handicap of very inadequate staff. The new establishment was as follows:

Quartermaster in the rank of captain (or subaltern). As mentioned above, this officer was not a dentist and thus did not receive the professional pay allowance granted to dental officers in New Zealand and overseas.

Accountant in the rank of Warrant Officer first class.

Head storeman in the rank of Warrant Officer second class.

Three ledger clerks who were WAACs, one being a sergeant, one a corporal and one a private.

Four storeman-packers (male). One was a sergeant and one a corporal.

One civilian typist.

This gave the store a staff of eleven, an increase of five on the previous figure.

The Depot

This was a decentralisation of command on lines similar to the original appointment of an Assistant Director of Dental Services in each Military District headquarters. The Assistant Directors' positions could still be filled if required, but it was not intended to do this except on direct instructions from Army Headquarters, so the officers commanding the three depots really acted in those capacities. No. 1 Depot was in the Northern District, No. 2 in the Central and No. 3 in the Southern. As has been already pointed out, the depot was a phantom organisation staffed by mobilisation camp personnel. In other words, the Principal Dental Officer of the district was officer commanding the depot, principal dental officer of the mobilisation camp and Assistant Director of Dental Services at district headquarters combined in one person. It was a strange position, reminiscent of Pooh Bah in The Mikado, for by a strict observance of the correct channels of communication there were occasions when he carried on a correspondence with himself.

Each depot was responsible for the staffing and maintenance of camp dental hospitals, maxillo-facial injury sections, static and mobile sections, and for the dental health of the army troops, divisional troops, area troops and fortress troops in the district. The establishment was eight:

Officer Commanding in the rank of major.

Adjutant, a captain or subaltern, who was not a dental officer.

Regimental Sergeant-Major in the rank of Warrant Officer first class. His duties were to take charge of general military training for the Corps.

Staff-sergeant in charge of the district store.

Three clerks. One a sergeant and one a corporal.

An orderly, general duties, who would act also as a batman.

A five-seater car was allotted to the depot, with the exception of Depot No. 2 which shared that provided for Dental Headquarters and had none of its own.

The Adjutant and the Regimental Sergeant-Major were not appointed owing to the difficulty in procuring suitable men at a time when this type of officer could not be spared from duty with combatant units.

Mobile Dental Caravan Group

This group must not be confused with the mobile dental sections operating in the three districts. It was a group of twelve caravan trailer sections under the direct control of the DDS. Each section consisted of four, a dental officer in the rank of captain, a sergeant mechanic, and a sergeant and private clerk orderly. The trailer was fully equipped and was drawn by a 2-ton truck fitted with a special draw bar. One of the orderlies was the driver and was in charge of the vehicles.

This group enabled the DDS to send dental reinforcements quickly to any district. The section would then come under the temporary command of the Officer Commanding the Depot. There was an allocation of these sections to each depot but this was not used in the form of rigid attachment, the former method being found more satisfactory under the fluid conditions of troop deployment existing at the time. The origin of these trailer caravans is interesting. As the troops were scattered all over the country they could not attend the established dental hospitals, nor was it possible, or politic, to establish new hospitals for them. The NZDC had to work on them where they were. Sometimes huts could be found to work in but often enough only a tent was available. With the approach of winter this was not a cheerful prospect, and the Auckland Branch of the New Zealand Dental Association, realising this, made a fine patriotic gesture. It subscribed to the building of a caravan trailer to be equipped as a dental surgery and prosthetic laboratory. After consultation with the DDS as to the design, one was built and duly presented to the New Zealand Government for the use of the NZDC. The cost, complete with all fittings such as instrument drawers, sterilising unit, sink and water supply, electric light, benches, cupboards and cabinet work, but exclusive of tyres, was £430. This price included £55 sales tax, which it was thought might have been forgone by the Government under the circumstances, but all efforts to have this done were fruitless. The movable equipment was supplied by the DDS from the Army Dental Store and the tyres were procured from army stock.

This gesture by the Auckland dentists provided the example for the provision of a number of these vehicles. The Wellington Branch of the New Zealand Dental Association followed suit, and then on 16 July 1942 authority was given by the War Cabinet for the expenditure of £4300 for ten more. Actually it was a saving of expense as the Government had already approved the provision of standard dental huts in certain camps with an establishment of 800 to 1000 men, at a cost of £450 each. Besides being cheaper in initial cost, the caravans could serve more troops.

The provision of these caravan trailers did not do away with the necessity of providing some huts but it did allow scattered units of the Army and Air Force to be treated in comparative comfort in places where it was uneconomical to erect huts. There were some limitations in the use of caravans. They could not negotiate some of the narrower bridges which still existed in parts of New Zealand, e.g., on the road round Lake Taupo. A clearance of 9 ft was necessary and every driver carried a 9 ft rope in the cab of the truck with which to take measurements. Also, after experience with the first gift trailer, it was found that the tempered masonite used in its construction was not strong enough to withstand the hard knocks sustained in travelling, e.g., in passing through frequent mobs of driven stock. The newer trailers were therefore made of 20-gauge steel for the lower half of the body, with masonite above.

That they were a success is undoubted. To quote one report from Lieutenant P. B. Sutcliffe, NZDC,

Capt P. B. Sutcliffe; Auckland; born USA, 15 Mar 1900; dental surgeon.

to the DDS:

Dental caravans are absolutely necessary. There is no comparison between working in a tent and working in a caravan. In the north, where there is a lot of rain, a caravan makes it possible to carry on with good work in all weather and at all hours. The hygienic appearance of the caravan creates a good impression on officers and men alike. The whole outfit has the appearance of good dentistry, not a makeshift.

Wellington Dental Section

This part of the organisation is only mentioned because it was responsible for the dental treatment of Navy, Army and Air Force personnel at headquarters in Wellington. Although living in Wellington with its civilian dental facilities, these men and women were as much a responsibility of the NZDC as the troops in camp or in the field. The section was no different from any other dental section and was situated in a glassed-in annex of Government Buildings, familiarly known as ‘The Tomato House’. It was under the direct control, indeed almost under the actual view, of the DDS himself.

Trentham and Waiouru Camps

These were army camps as distinct from district camps. That is to say, they were controlled by the DDS from Army Headquarters and did not come under Central Military District command.

Northern, Central and Southern Military Districts

Most of the district organisation is easily understood by examining the diagram on page 46. The areas mentioned are geographical military divisions, and it will be noticed that all areas did not have a dental section attached to them. In such cases an area was serviced by a conveniently situated Air Force dental section, a mobile section, or possibly a caravan trailer section. Possibly it might already have a section there under a different name, as was the case with Area 4, in which Ngaruawahia Camp was located. There are one or two other organisations that need some explanation, such as the Camp Dental Group at Linton, the maxillo-facial injuries section at Burwood and the mobile dental sections. Before giving details of these it is necessary to include a description of the Territorial Force which, by the time these establishments were authorised, had played a part in moulding NZDC policy.

Dental Services for the Territorial Force

In May 1940 a programme of intensive training for the Territorial Force was begun. Territorial units went into camp at various times and in various places throughout the country. Racecourses and show-grounds were usually used, but there was also the permanent camp at Waiouru which catered especially at this time for Territorial training. The men underwent a course of three months' continuous training in camp and in the field and by May 1941 over 30,000 had been trained under this scheme. The scheme was quite independent of the training of troops for overseas service which was going on at the same time in the mobilisation camps, and the 30,000 mentioned above was additional to the 23,483 trained and despatched to the New Zealand Expeditionary Force during the same period.

From what has been said of the dental condition of the recruits for the Expeditionary Force, it can be understood that at least an emergency dental service had to be provided for the Territorial troops if they were to be under continuous training for three months. The treatment was limited to the relief of pain and to other dental operations which would retain the soldier on duty and enable him to carry on during his period of training. It included the extraction of teeth for the relief of pain or a septic condition, the insertion of dressings to relieve pain when extraction was unnecessary, the repair of broken artificial dentures and the treatment of diseases or neglected conditions of the gums by the removal of accumulated calculus and by other prophylactic measures. In addition to this treatment, a further duty of the dental officers was to educate all ranks in the importance of oral hygiene and care of the teeth by individual instruction where necessary, by short lectures on the subject, and by arranging with commanding officers to draw attention to the matter in standing and routine orders. A complete dental examination of all troops in camp was to be carried out and this was to be recorded on the usual dental history chart, NZ361, which was then to be attached to the personal file of the soldier concerned. The object of the examination and charting was to find out the amount of treatment required should the soldier be called for general service requiring dental fitness.

The method of providing this limited service was by field dental sections at the various camps and a permanent dental section at Waiouru Camp. The field sections comprised one officer and one or more other ranks, with equipment limited to a field surgical pannier and field dental chair. On arrival they established themselves in any available accommodation, tented or otherwise. The limited service authorised and the limited personnel and equipment to carry it out did not warrant the permanent attachment of a section to all the numerous camps in the country with the exception of Waiouru. It was usual to attach a section long enough to carry out the examinations and any necessary urgent treatment, then withdraw it and reattach it about a month later. The personnel and equipment were provided by the camp dental hospitals, which in this respect assumed the role of NZDC depots. The Principal Dental Officer of the mobilisation camp, acting in the capacity of Principal Dental Officer of the district with the authority of an Assistant Director of Dental Services, made all the detailed arrangements for the Territorial camps to be treated other than the decision when and where the dental section should be attached, which was made by the DDS. As the ADDS was in the terms of his appointment responsible to the DDS for the dental fitness of all mobilised personnel in his district, it is suggested that the decision as to when and where a section should be attached would have been better made by him than by the DDS, whose knowledge of local conditions was second-hand. The reluctance of the DDS to decentralise command appears as a weakness in an otherwise excellent organisation.

Up to the end of 1941 these field dental sections had operated in Territorial camps in Whangarei, Avondale, Ellerslie, Alexander Park, Cambridge, Te Aroha, Rotorua, Wanganui, Waverley, Foxton, Palmerston North, Napier, Dannevirke, Tauherenikau, Addington and Forbury Park. In some cases where the camps were near a mobilisation camp or Air Force station, the troops could be sent there for treatment.

In spite of these arrangements it was soon apparent that members of the Territorial Force were being sent to private practitioners in nearby towns for treatment. This was no doubt due to the fact that sections were not permanently attached and, owing to the limited scope of treatment, emergencies were bound to occur in their absence. It was the obvious course to take when the NZDC had not the staff to cope fully with the situation, but this was not the view taken by the authorities. In January 1941 a circular memorandum was sent to all dental practitioners informing them that the NZDC was attempting to provide all necessary urgent treatment for Territorial troops while in camp, and pointing out that any of these men seeking treatment were responsible for all fees incurred and that these could not be claimed from the State. The NZDC did its best to give extra service—for instance, one section moved for several months on a circuit covering camps at Palmerston North, Dannevirke, Wanganui and Foxton, visiting each twice weekly—but this was a severe strain on its resources and was still inadequate. The position was most unsatisfactory. There was very little urgent work coming within the scope of the NZDC, and what there was could not be timed to coincide with the visits of the sections. To use sections capable of a big output of work to deal with occasional emergencies was uneconomic.

In July 1941 there was a complete reversal of policy and it was decided that, apart from Waiouru and camps close to permanent dental sections of the Army or Air Force, all necessary urgent treatment for Territorial troops would be carried out by private practitioners in the nearest town. The DDS nominated the practitioners to whom the soldiers would be referred by the camp medical officer. The soldier himself paid the fee but received a refund from the Army by handing the receipt to the adjutant of the camp. These instructions and the maximum fees recoverable by the soldier for various types of treatment were incorporated in a circular memorandum sent out from the Adjutant-General to all camps and dental practitioners concerned.

Under the original plan it had been intended to examine and chart all Territorial troops under training, retaining the forms for future reference. In January 1941 this was discontinued as it was considered that sufficient data had been acquired, and that to continue the procedure was a waste of time for the NZDC and an interference with training programmes. The annual report on the dental services for the year ending 31 May 1941 shows that the number examined during that year was 11,215 and that the dental condition was similar to that of recruits for the 2 NZEF, except that to make them dentally fit more fillings but fewer dentures would be needed.

Further information about the dental condition of the young men of New Zealand was obtained in August 1941 when the 18-year-old reservists were being called up in the Territorial ballot for training. The Director-General of Health asked for a survey of the dental condition of these men in the 18–19 age group. He said that particular attention was being paid to their medical condition to find out the number fit for service and the reasons for rejecting those not fit. In conjunction with this he wanted to find out the relative dental fitness of the group and, in particular, the number wearing artificial dentures. The examinations were carried out in September and the results were staggering: 2020 were examined, and for every 100 of these, 540 fillings, 103 extractions and 10·2 dentures were required. Of every 100 men examined, 7·1 were wearing full upper and lower dentures, 13·2 were wearing full upper or lower dentures and 4·3 were wearing partial dentures. Thus 24·6 per cent of these men at 18 to 19 years of age were wearing an artificial denture of some kind.

During the last three months of 1941, owing to the threatening position in the Pacific, large numbers of Territorial troops were fully mobilised, becoming known as embodied cadres of the Territorial Force. Being fully mobilised they were to receive full treatment from the NZDC. They went into camps at Whangarei, Avondale, Rotorua, Palmerston North, Forbury Park and Wingatui. Dental sections had to be permanently attached to these camps, with full equipment and facilities for carrying out all surgical and prosthetic treatment. At all these camps, with the exception of Palmerston North, the sections consisted of one officer and one or two other ranks, and accommodation was sought in some existing hut or building where running water and good light were available. At Palmerston North, where the camp was in the Show Grounds, a temporary dental hospital was established in an existing building to provide accommodation for 6 officers and 11 other ranks. The majority of the embodied cadres at this camp were to be dispersed to other camps and a concentrated effort was made to make them dentally fit before this happened.

Another group was also mobilised at the end of 1941, the National Military Reserve. This meant that the NZDC in early 1942 became responsible for the dental health of a large portion of the male population of New Zealand. With the best will in the world, the achievement of complete dental fitness for all these men was impossible with the staff available. There had to be some rationing of work and the standard of treatment for the Territorials and the National Military Reserve had to be reviewed. The two groups presented different problems: the former had a dental condition similar to that of the men called for overseas service and the latter, being drawn from a much older age group, consisted in the main of denture wearers.

The first undertaking was to remedy septic conditions by the removal of roots or irreparable teeth and to treat any oral lesion so as to place the oral cavity in a reasonably healthy condition, being careful not to reduce the masticatory efficiency below a workable minimum. No organised attempt, however, was to be made to achieve complete dental fitness. Prosthetic work was limited to the repair of existing dentures. To quote the DDS in a memorandum to PDOs and OsC dental sections dated 13 January 1942:

It is to be remembered by all concerned that, if a man who has been mobilized from civil life and is thus otherwise medically fit, presents with a hopeless carious condition of teeth or is fully or even partially edentulous, and claims that he does not possess artificial dentures or is wearing dentures and requests remodelling, he will have to carry on as he did before mobilization. He obviously managed to assimilate three meals a day, maintained his working efficiency in that state and was physically fit, so he can continue to carry out his military duties until the situation is stabilized, especially when one considers that the daily rations are similar, if not in some cases better, than those to which he is accustomed.

On 21 February 1942 instructions were given to chart the dental condition of all ranks and to proceed with any necessary treatment, giving priority to the 18–25 year-old Territorial group. The others, including the National Military Reserve, were eventually to be provided for. In the meantime their urgent requirements were to be met by the NZDC, with the assistance of the selected private practitioners in the scheme inaugurated in December 1941.

As the troops were even more scattered over the country than in 1941, it was even more important that the NZDC should devise a method of treating them wherever they were so as to interfere as little as possible with the general defence scheme. This led to the formation of Mobile Field Dental Sections, and these will now be described in detail as part of the district organisation.

Mobile Dental Sections in New Zealand

The original method of carrying out dental treatment for the Territorial Force in New Zealand was by attaching a dental section to each field ambulance. With the troops scattered all over the country and with the amount of work to be done, this was impracticable and some method had to be devised to provide a more extensive and elastic organisation. It was quite impossible for the troops to attend the existing dental hospitals and equally impossible to provide enough new hospitals to cover the vast area over which they were spread. The answer was obvious. If the troops could not come to the NZDC, the NZDC must go to the troops and, like the snail, take its house with it. The Mobile Field Dental Section therefore became an important part of the NZDC organisation. At the same time, the necessity for attaching a dental section to the field ambulance disappeared under the conditions existing in New Zealand in early 1942, although, as will be seen in later chapters, this method of attachment had other uses.

On 8 January 1942 authority was given to form nine Mobile Field Dental Sections, three to be attached to each military district. They were to be fully equipped and given two months' supplies and were to be staffed from the three mobilisation camp dental hospitals. Then, on 26 March, a further war establishment enlarged on this and provided for six sub-sections to be attached to each section. The sections were numbered from 1 to 9 and the sub-sections from 1 to 6. There were three in each military district. In referring to any sub-section, the number of the parent section was shown first, followed by the number of the sub-section, e.g., 5/6 was the sixth sub-section of No. 5 Mobile Field Dental Section operating in the Central District command. The normal attachment of a mobile section was to a brigade group or Area and sub-sections were detached for duty with the units comprising the group or area.

The sub-section became attached to a unit and was rationed, quartered and paid by that unit. The sub-sections were fully equipped and capable of carrying out all classes of treatment.

The general organisation of the section was elastic enough to allow the officer in charge wide scope for variation in the employment of his men. For instance, by omitting the prosthetic pannier and substituting an orderly for the mechanic, a sub-section could be sent out as a surgical unit and the prosthetic cases could be sent by motor-cycle transport to the Field Prosthetic Laboratory for pro- cessingprocessing. During hostilities a sub-section could be attached to a medical unit if required, or all the sub-sections could be withdrawn to Lines of Communication or the Base and reattached when conditions were more suitable for dental work. The basis of allocation in the Territorial Force was one dental officer to 800 men. This took into consideration that the existing dental hospitals were able to do some of the work when suitably situated.

With the attachment of the mobile dental section to a brigade group or Area, the officer commanding the section became responsible to the DDS for the dental health of the troops and acted as adviser to the Brigade or Area Commander on dental matters. All movements or arrangements for treatment were made through the headquarters of the formation to which he was attached, but he could communicate direct with the DDS on technical subjects. He was expected to co-operate closely with the Senior Medical Officer in matters affecting the general health of the troops. In other words, he was to the officer commanding the formation what the DDS was to the GOC.

The personnel of a mobile dental section numbered 43. There were 8 officers, 1 warrant officer, 2 staff-sergeants, 6 sergeants, and 13 rank and file of the NZDC, and 1 sergeant and 12 rank and file of the Army Service Corps attached to drive and service the vehicles. These were divided into a headquarters section and six sub-sections.

Headquarters Section consisted of:

Officer Commanding Major Dental Officer Captain or Subaltern Staff Quartermaster-Sergeant Warrant Officer Second Class Three orderlies Staff-Sergeant, Corporal and Private Two mechanics Staff-Sergeant and Corporal Two clerks Corporal and Private Two motor-cycle orderlies Privates Army Service Corps (7) Sergeant, Corporal and five Privates.

Each of the six sub-sections consisted of:

Dental Officer Captain or Subaltern Orderly Sergeant Mechanic Sergeant, Corporal or Lance-Corporal Army Service Corps (1) Private.

There were thirteen motor vehicles allotted to each section. Each sub-section had a 30-cwt truck to carry personnel and equipment.

At headquarters there were:

One covered 3-ton truck fitted as a prosthetic laboratory. One covered 3-ton truck for ordnance equipment and stores. One 15-cwt truck as a water tank. One 30-cwt truck. One heavy motor car. Two motor-cycles.

The prosthetic laboratory on the 3-ton truck was fitted with benches so fixed that they could be easily removed and re-erected in a hut, building or tent. Water was in an 8-gallon tank. Lighting was by two six-volt batteries with two in reserve. There were windows for natural lighting. The canopy of the truck was raised to give a minimum clearance of 5 ft 9 in. Access was from the back by steps and the whole truck could be locked up when not in use. Bottled gas

A natural rock gas from California, bottled in cylinders.

was used for the Bunsen burners and vulcanisers, and foot-treadle lathes and foot engines were used in the absence of electric power.

The equipment for the section was carried in panniers. Each subsection had a surgical, prosthetic and stores pannier, an emergency haversack, canvas chair case and two Indian pattern tents, one for operating and one for prosthetics. A tarpaulin 18 feet by 12 feet was also included. Sub-sections did not carry bottled gas but worked with primuses. The headquarters section, however, had a pannier for bottled gas and two each of the surgical, prosthetic and stores panniers, two haversacks, three tents and two tarpaulins. With this equipment the section and sub-sections could work under all conditions and were independent of building accommodation, although huts or houses were always used if available in preference to tents. The tent is difficult to camouflage and is easily visible from the air so was an unwelcome addition to a fighting unit. At one time it was thought that a ‘Hubbard hut’, named after the designer, would solve the problem but they proved to be unsatisfactory, being too low in the stud, unable to be kept open in wet weather and too difficult to keep clean in fine weather. Their only use was as sleeping accommodation.

Ten pistols, £455 or £38 inch, with 180 rounds and thirteen £303 rifles with 1300 rounds were issued to each section. The dental officers carried pistols, but the rifles were issued to the Army Service Corps drivers as the Dental Corps was non-combatant and carried the same certificates of identity required by the Geneva Convention as did the Medical Corps, nursing service and chaplains. On the other hand it did not use the Red Cross on its vehicles, buildings, panniers, etc., except when working with a medical unit. In this respect the following correspondence is interesting:

Dental Officer, Lauthala Bay Station, Fiji, to DDS, 10 December 1942:

Some confusion seems to exist as to our position in relation to the British Red Cross. Some orderlies have Form NZ 630 (Certificate of Identity) as well as rifles. Four of us have not been issued with the above forms. This causes us no particular concern but we feel that there should be some uniformity in this matter one way or the other. We understand that both American and Australian Dental Corps travel under the Red Cross.

DDS to Dental Officer, Lauthala Bay Station, Fiji:

It is to be noted that NZDC personnel are not permitted to carry rifles. Please take steps immediately to withdraw any rifles that have already been issued. With reference to the Red Cross, this emblem is not used by the NZDC on any vehicles, buildings, panniers etc.

This was in line with a decision already given in 1940 by the British Army in Egypt in answer to an inquiry from the New Zealand Mobile Dental Section. (See pp. 166–7.)

The Mobile Dental Section proved its worth in the Army and, in a country like New Zealand with its scattered farming community, the lesson might be remembered and the same or a similar organisation adopted in a civilian dental service.

The Maxillo-Facial Injuries Section

This was at Burwood, near Christchurch, where the Army built accommodation in conjunction with a branch of the Christ-church Public Hospital. The hospital itself was a civilian organisation but the army part was in charge of a New Zealand Medical Corps plastic surgeon, who had with him a dental officer and mechanic who had received specialist training in maxillo-facial work in England. The section consisted of the officer and mechanic mentioned and an orderly, either NZDC or WAAC. A more detailed description of this specialist section is given in the chapter devoted to maxillo-facial work.

The Camp Dental Group

At Linton, near Palmerston North, a dispersal camp was built for troops retained for the defence of New Zealand, the design differing from that of the mobilisation camps. The men were quartered in blocks spread over about fifteen acres. Each block was therefore almost a camp in itself, being self-supporting and fully equipped, though controlled from one headquarters.

If one dental hospital had been built as in a mobilisation camp, the men would have had to travel some distance for their treatment, with the loss of valuable time. It was therefore decided to build a small dental hospital for two chairs in each block and control them from a headquarters in much the same way as was done in the Mobile Dental Section. Indeed, until these small hospitals were built, No. 5 Mobile Dental Section was located at Linton and undertook all treatment for the camp. In October 1943 the mobile dental section was disbanded and was immediately re-formed as the Camp Dental Group. The organisation was really a mobile dental section shorn of most of its transport.

It consisted of a headquarters and six sections, but as each hospital was designed for two officers, the usual proviso regarding temporary increase in personnel applied to cover excessive demands on their services. The establishment was as follows:

Group Dental Officer in the rank of major.

Seven dental officers, captains or subalterns.

Administrative Warrant Officer second class.

Staff-sergeant as storeman.

Fifteen clerk orderlies, seven of them corporals.

Seven mechanics. A staff-sergeant at Headquarters and six sergeants.

An orderly as driver in charge of a 15-cwt truck.

Other than the truck, transport consisted of one bicycle.

This group did not actually function as by the time the dental hospitals were completed, the camp was not needed. It appears, however, that it was the correct organisation for the purpose. The Mobile Dental Section with all its transport and elaborate establishment was unnecessarily lavish, and the centrally situated hospital was uneconomical in time and personnel. Again it is emphasised that to keep a force dentally fit, the Dental Corps must take the initiative by providing facilities that are accessible and interfere as little as possible with the first duty of a soldier, which is to fight.

This was the basic organisation of the NZDC in New Zealand. The bare bones that had rattled in the pre-war Territorial camps were unrecognisable in the vital body that sought the troops wherever they might be. It was a Corps organisation, able to concentrate its forces quickly where the need was greatest. For example, the main mobilisation camps needed one officer and one orderly for every 200 men of 2 NZEF and one mechanic for every 400, but in Waiouru Camp, where there were men other than 2 NZEF, an officer and orderly for 500 and a mechanic for 600 was enough as there was more time available for treatment. Waiouru, however, was equipped with a dental hospital similar to those at the other camps and, should the classification of the troops in the camp change, dental reinforcements could be sent immediately. Even if this was not the case, the mobile dental sections, or the caravan group, could be used. No man in the New Zealand Forces could be long out of touch with the NZDC.

As a contrast to the ease with which emergencies were met under the completed organisation, two examples of what happened in the early days of the war are given.

On 10 January 1940 the DDS was notified by the Director of Mobilisation that the Maori Battalion would go into camp at the Show Grounds, Palmerston North, on 26 January. There were no mobile sections or caravan groups in those days, only a handful of NZDC officers and men straining hard to cope with the work of the mobilisation camps. Nevertheless, a tented camp dental hospital was set up and two officers, one mechanic and two orderlies arrived on transfer from Trentham with field dental outfits containing surgical and prosthetic equipment. By 31 January the Senior Dental Officer, Captain H. A'C. G. Fitzgerald, reported that most of the troops had been examined. Only five weeks were available to do the necessary treatment according to the information received, and a request was made for extra staff to the extent of two officers, one mechanic, two orderlies and one clerk. This could not be provided at once but gradually came to hand. By dint of very hard work and long hours, the battalion was made dentally fit by 13 March. This was a remarkable effort, reflecting the greatest credit on all concerned. The Quartermaster-General's branch and the Public Works Department provided a large marquee with duckboard flooring, rise and fall electric lights, power points, running water and drainage at very short notice. The DDS was the driving force, determined to implement his policy of sending every draft overseas dentally fit, and the officers and men of the Corps responded readily to every call made on them. The task was not made easier by the fact that many of the Maoris came from remote districts, some of them having never had any dental treatment before. In the battalion of 691 men, 2029 fillings, 1232 extractions, 416 major scalings and 160 dentures were done. The scalings alone took a long time as this type of work is always to be found among the Maoris, and is much more extensive than among the white population.

The second example occurred while the treatment of the Third Echelon troops was in progress. A group of Railway Survey, Construction and Operating companies was hurriedly mobilised and went into camp at Ngaruawahia on 24 June 1940. Although they eventually embarked with the Third Echelon, it was expected at the time that they would go at shorter notice. On 26 June the information was sent by telephone from the DDS to Headquarters, Northern Military District, and this was followed by a memorandum from the Adjutant-General:

Confirming the telephone message of the Director of Dental Services of even date would you please arrange that instructions are issued to the Principal Dental Officer, Papakura, to establish a Dental Hospital at Ngaruawahia immediately with himself in charge, leaving a skeleton staff only at Papakura to attend to any urgent dental treatment presenting.

All work on the 3rd Echelon at Papakura and Fortress Troops at Narrow Neck is to be suspended for this period and all equipment and stores necessary transferred.

Whilst the Dental Hospital is being installed the Dental Officers should be given every facility to have the respective units examined and charted on form NZ 361.

Would you also issue instructions that full co-operation is to be given by Unit Commanders to enable the Dental staff to render as many men dentally fit as possible prior to embarkation.

Following the telephone message, the movement and the preparations for a temporary hospital at Ngaruawahia were immediately ordered by Northern Military District headquarters through the camp commandants at Papakura and Ngaruawahia. At 10 a.m. that day the PDO at Papakura, Major T. V. Anson, received the first intimation of the move. Work on the Third Echelon was immediately stopped, equipment and stores were packed and 11 officers and 23 other ranks left Papakura at 1 p.m., arriving at Ngaruawahia, a distance of 55 miles, late in the afternoon. At half past eight the following morning they were at work examining the men in chairs out in the open air while the brilliant sunshine dispelled a heavy frost. An ordnance shed was cleared of old vehicles and rapidly prepared as a dental hospital with electric light for the operators. It was bitterly cold and operators and patients were extremely uncomfortable, but after tins full of red-hot coke had been placed between the chairs work went on apace. The condition of the mouths was not as bad as that of the Maori Battalion, but there was a desperate urgency to complete the work because of the uncertainty about the time available.

Eight hundred and seventy-eight were examined, of whom 557 required treatment. One thousand four hundred and forty-four fillings, 552 extractions and 101 dentures were done and, apart from one or two cases, the work was completed by 9 July. One officer and two other ranks were left to mop up and deal with emergencies and the rest returned to Papakura on 10 July to continue with the work on the Third Echelon.

These two examples show that even when the Corps was far from adequately staffed, the organisation was developing along the right lines, forecasting the mobility of the future and refusing to be defeated by the shibboleths of the past. The fight for recognition was over; the NZDC was accepted as essential to the army organisation. The organisation attracted interest in Australia and the New Zealand Liaison Officer was asked by the Australian Senior Dental Officer to secure full particulars and details. As a result Colonel Finn went to Australia in March 1942 for general discussions on dental problems affecting the two forces.

CHAPTER 6 Organisation in New Zealand—Air Force

BEFORE 1937 there was no organisation for dental service to the Royal New Zealand Air Force, but in April of that year the Director of Dental Services awakened the interest of certain senior Air Force officers by personal interviews and private correspondence. As a result he was asked to forward an account to them of the organisation and regulations governing the dental services to the New Zealand Division of the Royal Navy as a pattern for study. This started the ball rolling, but there was a temporary check because of the opinion expressed by the Principal Medical Officer that the dental services should be organised as part of the medical service under his command. He asked that the Air Board support him in this and postpone any action until his return from Australia some months later.

At this time there were two Air Force stations in the North Island, Hobsonville and Ohakea, and one in the South Island, Wigram. All personnel were permanent members of the Air Force and were not likely to exceed three hundred at each station except for short intervals. The men were inclined to attend the cheapest dentists for their treatment, often with unsatisfactory results. The DDS suggested that part-time dental officers be appointed, one to each station, to work at specified fees. Apart from allocating space for dental surgeries in the plans of the sick quarters to be built on the stations, nothing was done until after war was declared. Then the call for recruits forced the issue, and on 17 September 1939 the DDS of the Army, Lieutenant-Colonel Finn, was gazetted as Director of Dental Services to the Air Force and was faced with the task of building a dental service from nothing.

In October he arranged for all airmen then serving, approximately 1400 of them, to be examined by civilian dentists in the same way as the men for the First Echelon had been examined. The purpose of this was purely to provide some data on which to assess the requirements of an Air Force dental service. No decision was made regarding treatment until 18 December 1939, when the Air Member for Personnel, the Assistant Air Secretary, the Adjutant-General, the DDS, the Director-General of Medical Services and the Army Secretary met for that purpose.

By this time the strength of the Air Force was approximately 3000, with a monthly entry of about 300, and naturally officers commanding stations were frequently inquiring from Air Headquarters what facilities were available to provide their men with urgent dental treatment. Until some finality could be reached arrangements had to be made to send the men to private practitioners on the authority of the station medical officer and refund to them the cost from the Air Department.

The result of the meeting was that a scheme was approved by Cabinet on 15 January 1940. Dental sections were to be established at the larger Air Force units and travelling dental sections were to deal with the smaller stations. A provisional establishment, based on an estimated ultimate strength of 7000, was authorised as one Assistant Director of Dental Services, twelve dental officers, nineteen orderlies and nine mechanics, a total of forty-one. The cost of the scheme was estimated not to exceed £16,000 per annum and was to be an extension of the Army Dental Service, administered by the DDS, staffed by NZDC personnel at army rates of pay but attached to the Air Force for duty. The £16,000 meant about £2 5s. 8d. per head, which was about half the estimated cost of having the work done by civilian dentists.

Almost immediately it was realised that the scheme was based on a miscalculation of the rate of growth of the Air Force. The British War Cabinet inaugurated an Empire Air Training Scheme to train no fewer than 20,000 pilots and 30,000 other aircrew per annum for the Royal Air Force. An advanced training ground was established in Canada and elementary schools were set up in each Dominion according to its capacity. Under this scheme New Zealand agreed to train 1400 pilots annually. Of these, 520 were to be trained to elementary standard to proceed to Canada for advanced training, and the other 880 were to be fully trained to go direct to the RAF, with the exception of a few to be retained for duty in New Zealand. In addition, initial ground training was to be given to 546 observers and 936 wireless operators and air gunners who would receive their main training in Canada. This was a heavy commitment and led to considerable expansion of the organisation and a complete change of policy. The NZDC was affected by the change and the original organisation became obsolete before it had even been established. It was therefore decided in April 1940 that every air station should have a permanent dental section and that the original proposal of servicing the smaller stations by travelling sections should be abandoned.

To appreciate the NZDC problem it is necessary to know something of how the RNZAF provided the men for the Empire Training Scheme. On entering the service a recruit was first sent to a Ground Training School to receive initial training in subjects he would meet later in his career and to be introduced to service conditions. There were two of these schools, one at Levin,

Later transferred to Rotorua.

where the RNZAF had taken over the Government training farm at Weraroa, and the other at Harewood, in the South Island. Air gunners, observers and airmen pilots went to Levin, while flight riggers, flight mechanics, radio mechanics, wireless operators, fitter armourers, armourers and instrument repairers went to Harewood.

From Levin the air gunners and observers, after a course of from four to eight weeks, left for Canada for further training. The airmen pilots, as yet untrained in flying, had a general course of six weeks and then went to one of the four Elementary Flying Training Schools at Harewood, Taieri, Whenuapai or New Plymouth. Here they learned to fly in light aircraft and were either sent to Canada or to one of the Service Flying Training Schools at Wigram, Blenheim or Ohakea to complete their training in more advanced types of aircraft. From the Service Flying Training Schools most of them went to the United Kingdom, a few being kept for operational or instructional duties in New Zealand.

Similarly, those who went to Harewood Ground Training School received courses of various lengths and then went to such stations as Rongotai, Hobsonville or Wigram according to their classifications. After further instruction they either went overseas or to a New Zealand station for duty.

Hobsonville, Ohakea, Woodbourne and Wigram were operating at the outbreak of war and Levin was established within a month. During 1940, Whenuapai, New Plymouth, Harewood, Taieri and Rongotai were established, and before the end of the year dental sections were operating on all ten stations. They were staffed by officers and other ranks of the NZDC who had received several months' experience of military and Dental Corps routine in army camp dental hospital groups. They remained in army uniform, being merely seconded to the Air Force. This arrangement persisted throughout the war and by it the DDS was able at any time to transfer personnel between the Army and the Air Force.

When considering the ultimate goal of dental fitness for the Air Force, little distinction could be made between classifications as to the quantity of work to be expected. The time available for treatment became the factor to influence the dental organisation. Obviously, air gunners and observers who were undergoing a course of from four to eight weeks before leaving for Canada had to receive priority over men whose training in New Zealand would last several months. Where time was limited more dental personnel had to be concentrated. Also, when the training staff were trying to instil into laymen in a few weeks a mass of technical knowledge and skill that in peacetime would have taken as many months, they were liable to begrudge the time spent at dental parades. The policy therefore was to do as much treatment as possible at the recruit training schools, with a priority always for those leaving for overseas. At the Elementary Flying Training Schools priority was again given to those who would do their advanced training in Canada, leaving the work for the rest to be done at the Service Flying Training Schools. When the men arrived at the Flying Instruction School or the General Reconnaissance Station, the dental officer's duty was that of maintenance only, except for the station staff and WAAFs.

It can be seen that each station had its own problems, but the general dental organisation was co-ordinated so that at some stage of his career every man was rendered dentally fit. Owing to the delay in authorising a service for the Air Force and in supplying suitable accommodation, even of a temporary nature, it was some time before this object was achieved. It was April 1940 before the first three dental sections were established at Levin, Ohakea and Woodbourne, and the rest of that year was concerned chiefly with establishing further sections and attacking the leeway of work. It was not until 1941 that there was a true correlation of the work of all sections and a culmination of the policy of rendering all recruits dentally fit soon after entry and maintaining them so at all times. From then on the Air Force received a comprehensive service covering recruits, staff at headquarters and on all stations.

Establishments varied on the different stations according to their size and function from time to time. Dental sections or multiples of these were therefore moved from station to station according to the needs of the moment. All control was from the DDS at Headquarters through the RNZAF organisation, which was similar to that of the Army with a Northern, Central and Southern group. The very rapid growth of the Air Force was met by adding more and more dental sections until the dental service became comparable in size to that of the Army in New Zealand. The report of the Chief of the Air Staff for the year ending March 1942 shows that, during that period, 5591 embarked for overseas and at the end of it the total strength in New Zealand was 11,867; and this was before the large-scale reorganisation which took place to meet the Japanese threat had had full time to take effect.

With this reorganisation in 1942 the RNZAF became an operational rather than just a training service. Mostly in the North Island, many new stations were built to accommodate operational squadrons and operational training units and to cater for the American squadrons which were expected in New Zealand. Training was concentrated in the South Island, particularly at a large group station called the Delta. This station was run in much the same way as the group army camp at Linton, and the dental organisation was much on the same lines. It was bigger than anything previously attached to any Air Force station in New Zealand. Peak expansion of the Air Force in New Zealand was reached in 1943–44, by which time the danger to New Zealand had receded, and from then on there was a gradual closing down of stations.

The service to the Air Force emphasises the advantage of Corps administration. Isolated units of the Navy, Army or Air Force were seldom far from either a static or a mobile dental section. Central control, fully cognisant of concentrations and movements of troops of all services, could deploy with a fluidity unhampered by administrative difficulties. As stated by the DDS in his fifth annual report for the period 1 April 1944 to 31 March 1945:

It will be appreciated that certain RNZAF Units rely on Army dental sections for their dental treatment as being the most economical method, due either to their location or small establishment. Likewise there are instances where army and navy personnel are reliant upon the RNZAF dental services.

To summarise:

Because of its division into groups or stations, the RNZAF was best serviced by the attachment of dental sections or their multiples. The only exception to this was the organisation at the Delta which resembled the organisation of a mobile dental section.

The staffing of the Air Force dental sections by NZDC personnel from the army dental service gave a fluidity of movement to the whole Corps, which was of advantage to the three services and made it possible to cope with the rapid changes in Air Force organisation.

The dental problems of the three services were identical and could only be controlled by one DDS, unhampered by service jealousies, and using his dental forces with the one aim of establishing and maintaining dental fitness in all the armed forces all the time.

All overseas personnel were made dentally fit before embarkation, and the happy relationship between the Air Force and the Dental Corps which exists today is sufficient tribute to the efficiency of the organisation and the tactful administration of its staff.

CHAPTER 7 Organisation and Treatment of the Royal New Zealand Navy

THE dental service for the Royal New Zealand Navy provides a sharp contrast to that for the Army and the Air Force. It is hoped to show that the fault did not lie with the New Zealand Dental Corps, whose every effort was to give the same service to all branches of the armed forces. The fact remains that the Navy was not prepared to accept that service except under conditions of its own making, and the result fell short of the ideal. There was already a dental service in the Royal Navy before the war but, if this was considered sufficient by the Admiralty, it was but a cipher to the needs of the New Zealand Division of that service. The dental needs of that force were identical with those of the other two services, and the spasmodic attention of a handful of dental officers attached to ships or shore stations merely scratched the surface of the problem. The New Zealand Division was suckled on the traditions of the Royal Navy, whose dental service had been in existence since 1915. In support of these statements it is therefore fair and reasonable to examine the position as it existed in New Zealand in 1933.

The only dental examination of candidates for entry into the New Zealand Division of the Royal Navy was carried out by a medical officer. Physical and medical standards were laid down by the Naval Board in July of that year in a pamphlet entitled ‘Instructions for Surgeons and Agents’. There was only one reference in that pamphlet to dental matters:

Candidates under the age of seventeen should have twenty one teeth present either sound or capable of efficient repair, and those over seventeen should have twenty two. They should have some molars and incisors in good and efficient occlusion on both sides of the mouth. Where teeth are only capable of efficient repair and the candidate does not intend to have the defects made good prior to final examination, acceptance for entry will be subject to his undertaking to have the necessary treatment effected at his own expense.

This was meaningless and it is difficult to understand on what grounds the arbitrary assessment of the number of teeth was based. After the age of twelve the full complement of teeth is twenty-eight, and after the eruption of the third molars or wisdom teeth, not normally present at the age of seventeen, the full number would be thirty-two. Granted that a boy of sixteen should have at least twenty-one of his twenty-eight teeth present in good occlusion to qualify, why, when one year older, should he have twenty-two? It must also be remembered that the decision was not made by a dental officer. It was neither fair to the medical officer, nor the candidate, to expect a decision on such false premises.

In 1934 it was recognised that all was not well and the Naval Secretary wrote to the Commodore commanding the New Zealand Station:

I am directed to request that the standard of dental fitness required of candidates for entry in the New Zealand Division of the Royal Navy and the routine for the examination of candidates may be reviewed, and a report furnished as to the suitability or otherwise of the present arrangements.

It is desired to maintain as high a standard as practicable and consideration of requirements in ‘Instructions for Surgeons and Agents’ section 11 paragraph 12 (c) should be directed towards determining whether they are fair and reasonable from the point of view of the general standard of dental fitness in New Zealand.

The opinion of the Director of Dental Services, Lieutenant-Colonel B. S. Finn, DSO, should prove of value.

Apart from the excellent suggestion that expert advice be sought from the DDS, there was also a suggestion that the regulations be brought more in line with those dealing with entry into the Royal Navy and the Royal Marines, where no candidate could be rejected for dental reasons without prior examination by a dental officer.

The New Zealand Division consisted of ships on loan to the Government from the Royal Navy, manned partly by the Royal Navy and partly by New Zealanders. Conservative dental treatment was provided at the public expense to all naval and Royal Marine personnel and to officers and men of the Naval Reserve Forces while training in His Majesty's ships and shore establishments of the New Zealand Division. This was carried out by civilian dentists, who were appointed as Naval Dental Surgeons and Agents. In the various out-ports these agents worked at a standard scale of fees and in Auckland, the Naval Base, they were paid at a flat rate per annum. The system, which incidentally had been in force in England before 1915, was unsatisfactory, so, in 1935, the Naval Board asked the New Zealand Government to co-operate with the Admiralty in maintaining a dental officer with the New Zealand Division. A satisfactory graduate was to be selected and sent to England for commission as Surgeon-Lieutenant (D) in the Royal Navy, with the understanding that he would return for service with the New Zealand Division and come under the direction of the DDS.

This was an important decision. It recognised the need of the New Zealand Division for a dental service but bowed in conciliation to the traditional organisation of the Royal Naval Dental Service, which was hopelessly inadequate to cope with New Zealand conditions. As Surgeon-Lieutenant (D) the officer came under the control of the Royal Naval Medical Service, but while serving with the New Zealand Division he was subject to direction from the Director of Dental Services of the New Zealand Forces. Lieutenant-Colonel Finn was not fully appointed as DDS until 1939 but acted as DDS at the time of the dental officer's appointment. He was an army officer receiving a very small honorarium from the Navy and had little official authority, and what little there was needed the utmost tact to administer in His Majesty's ships. Somewhat naturally, the commanding officer of a ship did not welcome interference with his direction of his dental officer per medium of his medical officer, as was the custom in the Navy. With equal justification, the DDS, having regard for his responsibility to the Naval Board, felt that he should have some say in the management of the dental service to the Navy. Mutual tolerance and understanding were essential. They were not conspicuous. In justice to the DDS, he had no intention to usurp the powers of the commanding officers and was entirely distinterested in the internal economy of the ship to which his dental officer was attached. ‘His control was limited to technical matters. He was, however, vitally interested in the dental health of the ship's company, for which he had a responsibility to the Naval Board. He had to equip the dental officer to establish and maintain dental health, and had a right to expect co-operation from the commanding officer to that end. He made it perfectly clear that for discipline the dental officer was under the sole direction of the commanding officer, but that the DDS expected full reports of the dental health of the ship's company direct through the commanding officer, and not per medium of the medical officer. If this had been borne in mind by all concerned the service would have been happier and more efficient.

To return to the decision to commission a New Zealand graduate in the Royal Navy, there was some delay in finalising the arrangements and in the meantime a New Zealander, Mr A. C. Horne,

Surg Cdr (D) A. C. Horne, RN (retd); Auckland; born Bluff, 1909; dental surgeon; served in HMS Achilles and Leander, 1936–40; reverted to RN 1940–49; Senior Naval Dental Surgeon, Devonport.

who had gone to England on his own account, joined the Navy as a Surgeon-Lieutenant (D). It was decided to use this officer, and he came to New Zealand in HMS Achilles as Squadron Dental Officer. He was borne in the flagship and was responsible to the DDS for the dental health of the two cruisers, naval base and training depot of approximately 1300 men. At this time there were two naval sloops on the station, but as they were not part of the New Zealand Division, they made their own arrangements for dental treatment.

This was a decided improvement on past arrangements and worked reasonably well under peace conditions, when the movements of the flagship could be foretold with some accuracy, but there were drawbacks. A dental officer permanently attached to a cruiser was restricted in his activities with other ships or shore establishments. This was recognised by the DDS, as can be seen by his letter to the Royal New Zealand Air Force when a dental service for that force was being considered:

Personally I do not favour the establishment of the dental officer on a cruiser permanently for obvious reasons, but circumstances prohibited the installation of a shore dental clinic at the base where the dental officer would normally be stationed, transferring periodically to either of the cruisers for duty. Provision is made in the plans of the new base sick quarters for a modern dental clinic to cope with all classes of dental work and, when erected, it is hoped that perhaps an increase of staff on the station may be effected which will allow all naval personnel to be catered for, having their own prosthetic laboratory and dental mechanic, X-ray plant and facilities for major surgical operations etc. Treatment at the public expense by civilian dental surgeons will be confined to an occasional extraction or repair.

The naval base was situated at Devonport, Auckland, in the name of HMS Philomel, an obsolete vessel moored there for use as accommodation and training. The dental clinic in the sick quarters did not materialise but, some time later, a dental department was established in the entrance hall of the squash courts. The Squadron Dental Officer came ashore in August 1939 into these poorly designed and inadequately lighted quarters to work to the best of his ability. There was no prosthetic laboratory and all dentures had to be processed by the Naval Dental Surgeon Agent in Auckland. This was the only service dental treatment, as in ports other than Auckland civilian dentists were used.

This was the position at the outbreak of war. It was in conformity with the policy of the Royal Navy, where dental officers were carried afloat only in capital ships, aircraft carriers and in one ship in each cruiser squadron. With a high dental standard on enlistment, such a service could only expect to drift with the tide, but with the standard in New Zealand, it was submerged in a torrent. With war came a rapid expansion of the Navy from the only source available, New Zealand citizens, and enough has already been said about them to realise that most of them were dental cripples. The Royal Australian Navy, faced with similar conditions, had already increased its service to one dental officer to each cruiser, but New Zealand continued to drift, with the exception of providing a dental section from the Army for the training station, HMS Tamaki, on Motuihi Island in the Auckland harbour.

A serious problem then arose in the two cruisers employed on detached duty far from their base. They were dependent on casual dental attention in such ports as they might visit for fuel. Such visits were of short duration and only the more urgent cases could be treated, with a complete lack of continuity of treatment. A report from HMNZS Leander in February 1941, after ten months’ detached service, showed that although 336 cases had been attended to in this manner, the work was piling up and routine examinations were out of the question. The commanding officer wrote to the Naval Secretary as follows:

The routine under which the cruiser in New Zealand waters now operates is not known but presumably facilities for dental treatment ashore are less frequent than in peace time. Even when lying in a naval base, the presence on board of a dental officer would result in an appreciable reduction in the time lost from training and important ship work. The possibility of the ship being ordered abroad at short notice is a further factor in favour of the proposal, while a dental officer possesses qualifications which would be of real value in action. The necessary accommodation can be made available provided that the ship is not carrying a flag.

In other words, the Admiral's sea cabin could be used.

The general dissatisfaction was crystallised into action by the emphasis of this report, and on 17 March 1941 the DDS wrote to the Naval Secretary:

With reference to the dental condition of the sea-going personnel I have to report that present arrangements are not efficient nor are they economical.

HMS ‘Achilles’ and HMS ‘Monowai’

There is virtually no provision for the dental treatment of the ships' companies of either of the above excepting that which may be provided during their brief visits to the naval base and ports other than Auckland, with the result that the dental condition of the personnel—of HMS ‘Achilles’ especially—is deteriorating.

Port and Shore Establishments

A considerable amount of money is being paid to Naval Dental Surgeon Agents for dental treatment of ratings from minesweepers, trawlers and shore establishments at Wellington, Christchurch and Dunedin and for denture work carried out by the agent at Auckland.

The result was a complete reorganisation aimed at bringing the service into line with those operating for the Army and the Air Force. The services of the Naval Dental Surgeon Agents were dispensed with except for urgent relief of pain at Lyttelton or Dunedin, on occasions when a ship's movements did not allow time for treatment at Army or Air Force stations. Examinations for ‘continuous service’ engagements were still done by them and their sterling service was recognised by an official letter of thanks from the DDS on behalf of the Naval Board.

At HMS Philomel new quarters were designed and authorised, and a dental section was seconded from the Army for duty. A full service including prosthetics was then available for Auckland from either the Philomel or Tamaki. The oral surgery specialist stationed at Papakura was at their service and, in ports other than Auckland, any ship not carrying a dental officer sent its men to the nearest Army or Air Force dental section. The Monowai, an armed merchant cruiser, was to have a dental section when she was ready to go to sea at the end of 1941. At long last the Navy was being offered a dental service comparable with that in the other services, but it was not prepared to accept it entirely in that form. The traditions of the Royal Naval Dental Service had to be upheld and a new Corps, however efficient in operation, could not be easily assimilated.

The result was a compromise. HMNZS Achilles took the Squadron Dental Officer, Surgeon-Lieutenant (D) D. M. Page, RN,

Surg Lt-Cdr (D) D. M. Page, RN; Hong Kong; born NZ 1914; dental surgeon.

from the Philomel, nominally responsible to the DDS in New Zealand but actually reverting to the system in vogue in the Royal Navy. HMNZS Leander, at that time away from New Zealand waters, instead of being provided with a dental section under the co-ordinated scheme for the three services, had to have special arrangements made for her. Lieutenant J. C. W. Davies, NZDC,

Surg Lt (D) J. C. W. Davies; Hamilton; born Hawera, 12 Dec 1916; dental surgeon.

had to resign his commission and be recommissioned as a temporary Surgeon-Lieutenant (D), RNZNVR. He had to be antedated three years in seniority to offset a disparity between naval and army rates of pay, and similarly, Sergeant F. E. Aldridge, NZDC,

Sick Berth Petty Officer F. E. Aldridge; Hastings; born 21 Nov 1917; dental mechanic.

had to receive the rank of Sick Berth Petty Officer before he could join the ship. To all intents and purposes they became separated from the NZDC organisation and could be used nowhere but in the Navy.

Even this compromise was not effected without considerable opposition from Navy Headquarters. From the comments on the files it is doubtful if the serious dental condition of the Navy in late 1941 would have led to the reorganisation if the attraction of reduced costs had not been thrown into the balance. The estimates are interesting, though only a fraction of what they would be today. Ignoring the pay of the Squadron Dental Officer and his staff, which was common to whatever scheme was adopted, the cost of treatment by civilian dentists for the year ending 31 March 1941 was:

£ Auckland 443 Wellington 475 Christchurch 161 Dunedin 203 Total £1282

The Director of Dental Services' estimate was as follows:

Annual Capital £ £ 1. To provide dental officers for cruisers on New Zealand Station Nil Nil Transfer of Surgeon-Lieutenant (D) with (a) Sick Berth rating Nil Nil (b) Equipment provided by DDS 60 500 2. To provide dental officer for cruiser operating on detached service Transfer of: (a) Lieutenant NZDC 528 Nil (b) Sergeant NZDC as SBPO 277 Nil (c) Equipment ex Philomel Nil Nil 3. To provide a complete NZDC section for Auckland and to undertake prosthetic work (a) Personnel 1218 Nil (b) Equipment 96 550 2179 1050 4. To provide dental service at ports other than Auckland Discontinue Agents and prosthetic service at Auckland and make use of existing NZDC sections Saving of 1285 £894 £1050

At £1000 capital outlay and £900 per year, the New Zealand Navy was offered a dental service afloat and ashore, more than it had had before. The Navy was by far the smallest of the three services in New Zealand and its dental problem in comparison was negligible under the general Corps organisation. With the obstacles it placed in the way, it created a problem impossible of solution. Admittedly there were some difficulties of accommodation afloat, but the urgency of the dental problem itself, combined with the insistent demands of the medical and dental authorities, forced acknowledgment of the essential nature of the service. In this connection, Surgeon-Commander H. K. Corkill, RNZNR,

Surg Capt H. K. Corkill, OBE, VRD; born Wellington, 21 Nov 1897; surgeon; BEF, France (wounded Apr 1918); Director, Naval Medical Services, RNZN, Jun 1941–Feb 1946; died 8 Aug 1954.

Director of Naval Medical Services, wrote:

All opposition quickly faded when the great value of the service became apparent. The service provided by the Army Dental Department proved thoroughly successful throughout the remainder of the war. Not only did it provide for the needs of the New Zealand personnel but it rendered extensive service to ships of the British Pacific Fleet. One feature in particular which excited the envy and admiration of the Royal Navy was the provision afloat of competent technicians and equipment for prosthetic work.

The provision of prosthetic facilities was a sine qua non in the NZDC wherever it operated, at the base or in the field, so without detracting from the sincerity of the tribute from the Director of Naval Medical Services, it cannot be regarded as anything remarkable. It can only be regarded as a further reason why the NZDC organisation for the three services was so much more efficient than that existing in the Royal Navy. Without the naval compromise it would have been more efficient.

From the end of 1941 to late 1943, only one surgeon-lieutenant (D) was appointed with the exception of the Squadron Dental Officer, who already held a commission in the Royal Navy. All other work was in the hands of dental officers with army rank. This was not acceptable to the Navy, who insisted that all officers in His Majesty's ships should have naval rank. This was against the principles of the NZDC, who worked as Corps troops, but it was felt that it was better to accede to the request rather than cause disharmony. An added argument in favour of the change was the attitude of the dental officers themselves. From conversation with some of them it appears that allegiance to an army command, even of a technical nature only, was not appreciated by commanding officers of the Navy, and ‘Toothy’, as he was familiarly called, ‘Trod a very narrow and sometimes difficult path between the Navy and the Army.’ ‘Toothy’ may have been supersensitive, but there is no doubt that he sometimes was made to feel that as an army officer he was not quite in the picture. His attitude was therefore probably the line of least resistance. The result was that all dental officers seconded to naval units were commissioned as surgeon-lieutenants (D), RNZNVR.

Apart from the disadvantages already mentioned, there were individual disadvantages. The rate of promotion in the Navy was slower than in the Army. There was an irritating disparity between the pay of a medical and a dental officer, which was inconsistent with the comparative volume of work. The naval medical officer received three shillings more per day and two shillings more deferred pay, a total of five shillings. There was also a reluctance to give suitable recognition to the special qualifications of the dental mechanic. The rank LSBA (D) was not given in the New Zealand Navy until May 1942, although the Royal Australian Navy made use of it. A first-grade dental mechanic was indistinguishable from a dental orderly or a medical orderly with no special qualifications. The Naval Board on 18 July 1942 wrote as follows:

As ratings serving in cruisers are only called upon to act in the capacity of dental mechanics on occasions, the institution of the rating DM is not justified, notwithstanding the fact that the ratings borne for dental duties may be qualified for higher duty. It is not in accordance with the Naval Board's policy to allow in complements ratings of a higher grade than those necessitated by Service requirements.

The reasoning was unsound. The ratings had to be fully qualified even to act as mechanics on occasions. The Navy had not trained them but had received them fully trained as first-grade mechanics, key personnel who could ill be spared from useful work with the other services. The last sentence is the crux of the matter: ‘It is not in accordance with the Naval Board's policy to allow in complements ratings of a higher grade than those necessitated by Service requirements.’ The assessment of service requirements was entirely that of the Naval Board, and the greatest mistake of the NZDC was that it did not accept this at its face value and provide a service commensurate with the lower standard acceptable by the Board. The other services would not then have been deprived of the excellent mechanics who were not fully appreciated by the Navy. It is hoped that the disadvantages for officers and ratings serving in the Navy were outweighed by the compensation of more harmonious conditions. Whatever their plumage, however, they still were responsible to the DDS for the dental health of the ship or station to which they were attached.

Despite these difficulties, the dental health of the Navy improved after the NZDC came in in 1941. The description of its somewhat precarious attachment can be conveniently divided into four:

New Zealand.

The Pacific.

The cruisers.

Demobilisation.

1. New Zealand

Just as there were three military districts in New Zealand, there were three naval ones, although the boundaries were not the same. The dividing lines ran east and west, one at Gisborne and one at Westport. The central district therefore included the lower part of the North Island and the upper part of the South Island. Each district received the name of a ship, the Northern being HMNZS Philomel, the Central HMNZS Cook, and the Southern HMNZS Tasman.

Philomel was situated at the naval base in Auckland and was responsible for the treatment of all naval personnel in the Auckland area, with the exception of those under training at HMNZS Tamaki on Motuihi Island, where there was a separate dental section. Cook was at Shelly Bay, on the shores of the Wellington harbour, and had a similar responsibility in the central district to that of Philomel. In addition, the Wellington Dental Section provided treatment for those at Navy Headquarters. Tasman was at Lyttelton. There were not enough in this district to support a dental section, so treatment was carried out by either Army or Air Force dental sections or by borrowing from them for a time. Several attempts were made to have a dental section permanently attached to Tasman on the grounds that too much time was wasted in travelling to and from the Army and Air Force sections, but the numbers were too small to warrant it.

This was the nearest that the Navy came to being serviced by a comprehensive Corps dental service. Men at the Base, from minesweepers and motor launches, and at times from visiting units of the British Pacific Fleet, were accepted at any dental section, Navy, Army or Air Force. Ships in any port, as well as scattered radar posts, were always within reasonable distance of dental attention.

2. In the Pacific

The Corps system of treatment was adopted in the Pacific but not without a struggle. There was no difficulty in Fiji, where the naval force was small, consisting of 23 officers and 132 ratings. Some were New Zealanders and others belonged to the Fiji Naval Volunteer Force, of whom 206 were natives. HMS Viti was the seagoing ship and the shore personnel belonged to HMS Venture. Full treatment for the Europeans and partial treatment for the natives was easily given by existing Army and Air Force dental sections. Details are given in the chapter on Fiji.

In the Solomons, however, there was a flotilla consisting of five ships, the Arabis, Arbutus, Matai, Tui and Kiwi. The base was situated in the Russell Islands under the name of HMNZS Kabu. Operating in the area was the No. 1 Mobile Dental Section of the RNZAF and the DDS intended to use this to treat HMNZS Kabu. Again the Navy failed to appreciate that there was a comprehensive dental service for all the New Zealand Armed Forces and attempted to make its own arrangements. What is more, it proposed an archaic and totally inadequate dental service which could not be justified except under conditions of the utmost urgency, and which constituted a definite menace to the health of the men. It was suggested by a surgeon-lieutenant (D) that the Sick Berth Attendants carried in the ships should be given lectures and practical instruction in the relief of dental pain, a supply of instruments and some written instructions. The Director of Naval Medical Services agreed and recorded his approval of the use of the Sick Berth Attendants as dental operators. Fortunately for the men of the Navy, the decision rested with the Director of Dental Services.

The surgeon-lieutenant is entitled to his views as to the capabilities of Sick Berth Attendants to carry out dental work but showed surprising disregard for service procedures. He submitted his scheme to the DDS through the Director of Naval Medical Services, implying that the latter had a right to be an intermediary in such correspondence, whereas his only right was in permitting his Sick Berth Attendants to be used in any other capacity than that in which they were trained. It was not his province to arrange for dental treatment of the flotilla without consultation with the DDS, and the surgeonlieutenant should have known that what he was suggesting was a danger to the men of the ships. Colonel Finn's reply was emphatic and unequivocal:

I have to inform you that the well-intentioned and prepared instructions and charts for the purpose of enabling Sick Berth Attendants to render urgent dental treatment to RNZN personnel cannot be approved.

It is pointed out to you that such procedure on the part of the rating would render him liable to prosecution for committing a breach of the ‘Dental Act’ 1937 which prohibits, as do service regulations, anyone other than a registered dental practitioner (or medical practitioner where the services of a dental practitioner are not available) from performing any dental operations in the oral cavity.

All Naval Officers in charge and Ships' Commanding Officers concerned are being notified that Number 1 RNZAF Mobile Dental Section NZDC is responsible for the dental treatment of RNZN personnel in the South West Pacific area, and that dental sub-sections are located throughout the New Hebrides, Solomons and Admiralty Islands, and have instructions to give every facility for dental treatment to RNZN personnel.

You are to take immediate steps to withdraw the instructions, dental instruments and authority for Sick Berth Attendants to undertake urgent dental treatment.

3. The Cruisers

HMNZS Achilles: Before August 1939 this cruiser carried the Squadron Dental Officer, who was a surgeon-lieutenant (D), RN, but at the outbreak of war and during her glorious action with the Graf Spee he was at the Naval Base and the cruiser was without a dental officer. As a result, the dental health of her complement seriously deteriorated. It was not until June 1941 that Surgeon-Lieutenant (D) D. M. Page, RN, returned on board. The Admiral's sea cabin once again became a dental surgery, but not for long. It was more often needed either for a Flag Officer or for sleeping accommodation for other officers near their action stations. The dental surgery was therefore transferred to the gunroom pantry, where the light and ventilation were poor and the outer port propeller throbbed incessantly. Even in harbour the accommodation ladder obscured the scuttle and it was difficult to work in comfort.

Dentistry in a cruiser was often interrupted. Heavy calibre shoots meant that all breakable equipment had to be dismantled, while rough weather and high speed made operation impossible. In action the dental officer had to work with the medical officer in the care of wounded and, in any case, all his equipment was dismantled, as instance the report from the dental officer in January 1943:

January 5 (A.M.), the ship was hit by a bomb resulting in casualties. January 5 to 9 inclusive no dentistry was attempted. Sterilizer badly damaged and engine foot-control soaked in water and repaired by ship's staff.

The Achilles went to England in early 1943 for a refit and on 12 April her dental officer left her for a course in the treatment of jaw injuries at East Grimstead, Sussex, being discharged on leave at the end of the course. She was recommissioned in May 1944 and joined by Surgeon-Lieutenant (D) A. De Berry, RNZNVR,

Surg Lt (D) A. De Berry; Auckland; born Hokitika, 25 Feb 1914; dental surgeon.

who had come to England in HMNZS Leander, arriving on 26 January. From 8 February to 13 May this officer also attended at. East Grimstead and from 15 to 19 May had a course in ‘damage control’ in London.

There is no doubt that at sea there was only a possibility of maintaining dental comfort and the standard of dental fitness had to deteriorate, but there were other factors which influenced the position and accentuated the difference between the naval dental service and that of the other services. The question is, whether as much was done under this system as would have been done under the organisation already proving so successful in other theatres of war.

In the Achilles from 1 July 1944 to 28 February 1945, 1160 fillings were found on examination to be required but only 702 were done. Likewise, 539 men needed treatment but only 272 were made dentally fit. The ship's complement was 850, which with one dental officer ashore would be well within his capabilities. Taking fillings as a reasonable basis for comparison of the rate of work afloat and ashore, it was 22 a week as against 63 for a similar period. Having due regard for the handicaps of bad weather and gunnery, the discrepancy was too much. The reason was that the naval assessment of the value of dental fitness was below that of the New Zealand Dental Corps. The dental officer was too often used for duties outside his profession. One dental officer in the Achilles reported that he could not avoid being called on for cipher duties, which took up as much as a whole forenoon, until he took the bull by the horns and refused to do any more. In the meantime, while decay was eating into the mouths of the ship's company, the dental officer was frittering away his time as a supernumerary clerk.

HMNZS Leander: As already described, the report from the commanding officer about the unsatisfactory dental service precipitated the reorganisation of the service to the Navy in 1941. Apart from this, there is little difference in the dental organisation from that in her sister ship Achilles. When she was damaged in action in 1943, her dental staff went ashore but rejoined her when she sailed for England on 25 November 1943. They returned to New Zealand in the Achilles when the Leander ceased to be attached to the New Zealand station, being replaced by HMS Gambia.

HMNZS Gambia: On 27 September 1943, the DDS received the following communication from the Naval Secretary:

I have to inform you that telegraphic advice has been received from the High Commissioner for New Zealand that a Surgeon-Lieutenant (D) RN has been appointed to HMS ‘Gambia’, on loan to the Royal New Zealand Navy.

The Naval Board concur in a proposal that a New Zealand Dental Officer be sent to join HMS ‘Gambia’ in order to relieve the Royal Naval Dental Officer, and I have to ask you to nominate an officer for this appointment from the dental officers at present seconded to the Royal New Zealand Navy. The officer selected will be required to take passage approximately mid-October next.

Captain H. C. B. Wycherley, NZDC,

Surg Lt (D) H. C. B. Wycherley; Palmerston North; born 1910; dental surgeon.

was selected. He had been seconded to the Navy since June 1941 but resigned his commission and was recommissioned as Surgeon-Lieutenant (D), RNZNVR, joining the cruiser in England in January 1944. At the same time LSBA (D) J. E. Batten,

Ldg Sick Berth Attendant J. E. Batten; Auckland; born Wellington, 1903.

who had been serving in the Achilles, transferred to the Gambia. When the cruiser returned to New Zealand in November 1944, Surgeon-Lieutenant (D) E. H. Stephenson

Surg Lt (D) E. H. Stephenson; Christchurch; born Gisborne, 1916; dental surgeon.

took Wycherley's appointment and LSBA (D) T. E. Gill

Ldg Sick Berth Attendant T. E. Gill; Auckland; born 1924.

that of Batten.

During Stephenson's appointment certain interesting changes in the equipment and design of the surgery took place. The first concerned lighting. During a 6-inch-gun shoot the lamps vibrated more than was considered safe and were suspended from the bulkhead in a manner that made it difficult to remove them quickly. After removing the inner lining, two iron staples were welded to the deckhead itself, a piece of five-ply wood was fastened to the staples by rubber shock-absorbers and to this were attached the three ‘Controlens’ panel lamps, each having two shock-absorbers. The bulbs could then be removed when there was a shoot and damage to the rest of the system was unlikely. The second concerned the water supply to the unit. The cruiser was expected to spend long periods at sea and fresh water was therefore strictly rationed.

Experience in the Hospital Ship Maunganui showed that the unit could function with salt water with only some tarnishing of the bowl, which meant periodical replacement at small cost. The saliva ejector could operate at a pressure of 30 pounds but the circulating system could only provide a pressure of 25 pounds. The answer was to instal a small booster pump, bringing the water to the unit by means of a half-inch pipe. The pump was actually made, but there was trouble in getting a suitable 230-volt DC motor to work it and before the ship went in to refit, hostilities had ceased and the necessity had gone.

Towards the end of the war the NZDC in the New Zealand cruisers had to bow further to the system operating in the Royal Navy. In April 1945 a Fleet Dental Surgeon, Surgeon-Commander (D) S. R. Wallis, RN, was appointed to the British Pacific Fleet. He was on the staff of the Commander-in-Chief and was accommodated in the flagship for fleet administrative and ship's duties. All correspondence relative to dental matters and personnel of the fleet, demands for stores and returns of treatment had to be passed to him. The New Zealand cruiser was part of this fleet, so the dental officer was in the anomalous position of being subject to direction on policy matters from two sources. There was no friction as it was recognised that the organisation was customary in fleets of that size in the Royal Navy, but it is submitted that the system was less efficient than the Corps system used by the New Zealand Dental Corps for the three services. Regular examination and treatment are necessary if a force is to be maintained in a state of dental health, and this can be done only if dental reinforcements can be readily mustered and as easily transferred. By insisting on the dental service being part of the Navy system the fluidity of movement was lost. The dental service became confined in watertight compartments, not only in the ships it served but in relation to the rest of the Corps. The details of organisation of a service in seagoing ships away from their bases for a long time are, admittedly, more difficult to arrange than in the other services, and the appointment of a Fleet Dental Surgeon was one method of co-ordinating the dental work of the Fleet. If the Navy consisted of ships perpetually at sea, fighting the war as lone rangers, it would be the only system, and the lowering of the dental standard of the officers and ratings would have to be accepted as a service exigency. Such, however, was not the case, and under a Corps organisation embracing the three services dental reinforcements could have been quickly made available to catch up with arrears of work whenever opportunity offered. The main point is that reinforcements must be available immediately, and this is only possible if the dental services are under one command. The insistence that the dental service to the Royal New Zealand Navy be even partly segregated from the main organisation made this impossible. The dental forces at the service of the Fleet Dental Surgeon were puny compared with those that the Director of Dental Services could offer.

HMNZS Monowai: In this ship, an armed merchant cruiser, was a modern dental surgery in addition to all facilities for prosthetic work. Much of her work was done at the base, Philomel, when she was in Auckland, but at sea she carried a dental section in charge of an officer of the NZDC. She was not at sea for such long periods as the cruisers, so a comparison of the dental health of her complement with that of the cruisers is inconclusive, the conditions of work being entirely different.

4. Demobilisation

When the time came for men to be discharged from the Navy, the same obligation was undertaken by the Government as with the other two services. The dental condition was to be no worse than it was on entry into the service. The instructions were as follows:

Members of the Royal New Zealand Navy will be made ‘dentally fit’ before release but where a member, on being discharged, has been certified dentally fit within a maximum of six months prior to discharge, this certificate will be accepted for the purpose of dental clearance. No extractions necessitating the provision of artificial dentures will be performed for any member due or liable for discharge at short notice unless the member signs a witnessed declaration that he or she requests extractions and agrees to the insertion of immediate dentures and that the cost of any remake will not be sought from public funds.

Where it is possible to anticipate discharge, endeavours will be made to render the officer or rating dentally fit at an early date in order that ultimate discharge will not be unnecessarily delayed.

As far as the Navy was concerned this was lip service, as the dental service as constituted could not keep abreast of the work already presenting, let alone organise a drive for complete dental fitness before discharge. The watertight compartments into which the Navy confined its dental units were a sufficient barrier to the natural flow of dental reinforcements to cope with such an emergency. Before actual discharge everybody was examined and the necessary treatment was authorised by the Dental Division of the Department of Health to be carried out by civilian dentists, as was the case with the other services. The Government's obligation was fulfilled, but the Navy dental organisation was unable to play the same part in this as did the NZDC for the other two services.

CHAPTER 8 Organisation of Stores and Equipment

AT the end of the 1914–18 War all dental stores and equipment were disposed of by tender, with the result that for several years the Defence Department held no stocks at all. This was the position when the Dental Corps was reorganised in 1934, when the Territorial camps were asking for treatment and the Corps was keen to undergo training. An approach to the Department for supplies produced a reply that made it abundantly clear that, unless the Corps could supply its own, it might as well fold up its tents and creep silently away. The Quartermaster-General was emphatic on the subject in a minute to the Under-Secretary of Defence on 17 October 1934:

The Department has no dental equipment or stores and Dental Officers will bring their own equipment to the camps they attend. The cost of any expendable stores (Drugs, filling materials and so forth) expended in the camp will be met by the Department. … As soon as the Department is in a position to do so, dental equipment will be provided as part of the war equipment necessary on mobilization. The equipment necessary for work in peacetime camps will then be provided. In view however of the extensive deficiencies that have to be made good in the war equipment of combatant units, the provision of dental equipment must be relegated to a low priority and will not be possible in the ordinary course of events for some time.

In the face of this rebuff, the DDS decided to approach the Director of the Division of Dental Hygiene of the Department of Health, who controlled the Government dental clinics for the treatment of school children by dental nurses. The Department's store only carried stocks applicable to this limited scope of treatment but had exceptional purchasing facilities in which the Corps hoped to share. The result was that enough materials were obtained to enable six dental sections to carry out urgent treatment at the Territorial camps and six metal panniers in which to pack them. The dental officers continued to provide their own instruments, but chairs were lent by private practitioners, dental trading houses and the Otago University Dental School.

In April 1935, through further efforts by the DDS, Cabinet approval was obtained for the expenditure of £140 to provide:

Seven travelling dental engines.

Seven dental students' cabinets.

Seven folding wooden chairs.

Seven spirit sterilisers with stands.

With the exception of the chairs, which were made to order by the Public Works Department, this was all got from the Health Department.

Approval was then obtained to manufacture seven field dental surgical panniers and seven field dental prosthetic panniers. These were made at the Ordnance Workshops at Trentham to the design of the DDS, who had used the same type in the 1914–18 War with marked success. They were ready by December 1935 and were distributed early in 1936.

The pannier is a container for equipment and stock. To facilitate transport, it is of a standard size, standard weight both full and empty and has distinctive markings. The Government Dental Department used metal panniers and these were quite satisfactory where civilian transport was used and weight was a secondary consideration. In the field, however, ease of movement and identification were important so the new ones were made of 3-ply (later 5-ply) wood, covered with canvas for protection and were suitably painted and branded. The prosthetic pannier was a plain box, but the surgical one was ingeniously partitioned to hold a portable dental engine, student's cabinet, and other stores and equipment of specified quantity and weight.

The chair was carried in a canvas case along with miscellaneous articles such as a folding table, hurricane lamp, canvas basin and blankets.

Until September 1936, the necessary field equipment was gathered from many sources. Dental instruments, however, still had to be supplied by the officers themselves.

Early in 1938 the DDS drew up a Peace Equipment Table which gave full details of the contents of a surgical pannier and chair case. As yet the prosthetic pannier was not to be equipped. Dental sections were then authorised to indent to bring their outfits up to full content. This was accomplished by December.

And so, after four years of great effort, the nucleus of a dental store was built up. But this was for peace requirements and the dove of peace was rapidly moulting. Munich came and went, with none but the most ingenuous believing in its bona fides. The next step was to prepare a list of stores that would be required in the event of mobilisation for war. This was submitted to Army Headquarters by the DDS in August 1939 and became the basis of the War Equipment Table. It was too late, however, for in the meantime the Government had severely restricted imports and the supply houses, while holding reasonable stocks for everyday needs, could not place unlimited orders at will, or even any orders except under an import licence. The Assistant Directors of Dental Services each had a schedule of what was required and found out what was avail- ableavailable from the supply houses and from private practitioners by gift, loan or purchase, but this was a precarious source of supply as well as being only temporary. It was a wise move, however, as when buying began, the state of the market was thoroughly known.

Mobilisation and the First Year of War

At the outbreak of war the only stores held by the Corps were the seven peacetime outfits described above, and this was the case for over two months. Until stores came to hand, the early volunteers brought their own instruments into camp, and even supplied most of the stock from their own practices. Later this stock was refunded from army supplies.

The first big requisition, for electric units, chairs and sterilisers to the value of £2409, was placed on 7 October 1939. From the end of November 1939 supplies came to hand in growing quantities, being received at the Main Ordnance Depot at Trentham, where part of the existing medical store was set apart to accommodate them. They were distributed as follows. The dental sections at Papakura, Ngaruawahia, Palmerston North, Trentham and Burnham forwarded monthly indents through their respective camp quartermasters to the DDS. If he approved, he sent the indent to the Chief Ordnance Officer (COO) for action and despatch. The items were then vouchered from the COO to the camp quartermaster concerned. It will be seen that the DDS at that time took no part in the actual accounting and merely controlled the issue in an advisory capacity.

In February 1940 approval was given to purchase the entire stocks of a dental trading firm in Auckland. These stores, valued at about £822, formed the nucleus of a dental store for the Royal New Zealand Air Force established at Rongotai air station in April 1940. The Air Force had a different accounting system from the Army. It used the ‘Powers’ system in which each item had a reference number. This meant that a new vocabulary of dental stores had to be drawn up, divided into sections such as drugs, dressings, surgical instruments, prosthetic materials, etc. Each section was numbered and each item in the section had a serial number. Indents had to be on a special Air Force form. The channel of communication was from dental section to station equipment officer to DDS for approval, to Rongotai store for action, and back to the station equipment officer and the dental section. The accounting was done by the RNZAF central accounting section in Wellington. The actual receiving, packing and despatch was in the hands of a Dental Corps corporal.

One store for the Army and another for the Air Force, with different accounting officers and different systems, was an unwieldy organisation. The first steps towards simplification were taken in May 1940, when the DDS suggested to the Quartermaster-General that the two stores should amalgamate into one Army Base Dental Store to cater for both services. His main reasons were:

To obviate raising separate purchase requisitions and consequent competition on an already diminishing market.

To provide more favourable buying.

To promote a more equitable and convenient distribution of stores.

To enable the DDS to exercise complete control over their custody, proper use and accounting.

It is unfortunate that he did not mention the disadvantages of having different accounting systems in the two services at that time, as the anomaly might have been removed instead of existing for another three years. The Quartermaster-General and the Air Secretary agreed to the amalgamation. Premises were found in Lambton Quay, Wellington, and became the Army Base Dental Store. There was one large room and two smaller ones with a total area of 1400 square feet. The necessary shelves and other fittings were built in and everything was ready by the first week in July.

By this time Major H. E. Suckling was Assistant Director of Dental Services at headquarters, in charge of stores and equipment. He personally supervised the transfer of the stores held at Trentham to the new premises. Thus the Army Base Dental Store became an accounting unit and the DDS assumed the responsibilities of accounting officer. He also became purchasing officer and supervisor of all payments by the Treasury for dental stores.

In August the RNZAF stores at Rongotai, valued at £3777, were also transferred to the Lambton Quay premises and vouchered from the Air Department to the DDS. All stores for use of the dental sections attached to RNZAF stations were now supplied from the Army Base Dental Store and charged to the Air Force—a little trouble but worth it.

The original staff of the store consisted of a Warrant Officer second class as accountant and two storemen packers.

The Dental Corps was expanding quickly and by the end of August 1940 it was becoming increasingly difficult to get enough supplies from New Zealand sources, so indents, to the value of £4125, were placed with the New Zealand Supply Liaison Officer in Melbourne. These supplies came to hand promptly and in full, giving the new store enough to satisfy demands until the end of the financial year on 31 March 1941.

The camp dental hospitals at Papakura, Trentham and Burnham had each been provided with rock-gas installations, X-ray machines, compressed air units and nitrous oxide and oxygen anaesthetic machines, as well as dental units, chairs and cabinets, and good instruments and stocks. Unfortunately the electric motors for the dental engines to be attached to the units were unprocurable in New Zealand and those that arrived from Canada in early 1941 were unsatisfactory. Fifty motors had then to be ordered from the United Kingdom, but it was February 1942 before they arrived. In the meantime every secondhand electric engine which could be bought or borrowed was welcomed into the Corps and coaxed into service, often by prodigies of mechanical wizardry. The foot engine, scorned by the modern graduate as an emblem of obsolescence, recaptured some of its former glory and spelt the difference between failure and success.

The first year of the war was a race against time to get enough stores and equipment to make every man dentally fit before embarkation for overseas. The race was won, the task completed, and much of the credit must go to those who overcame a very real problem in producing supplies continuously in the face of a host of difficulties.

In January 1941 a dental section was attached to HMNZS Tamaki, the naval training station on Motuihi Island, Auckland, and the Navy began its association with the Army Base Dental Store.

The Second Year, 1 April 1941 to 31 March 1942

During this year the three services grew to such an extent that the problem of supply assumed great importance. Prior to 1941 the only dental stores and equipment used by the Royal New Zealand Navy were supplied by the Admiralty, but in June of that year the DDS took these over. New dental sections for the Navy were established at the Naval Base, HMNZS Philomel, in the two cruisers Achilles and Leander and in the auxiliary cruiser Monowai. These now drew supplies from the Army Base Dental Store. At the same time the first changes in unit accounting began as the ship's dental officers were made accounting officers working under the army system.

For some time the army camp quartermasters had been having difficulty in accounting for dental stores because of unfamiliarity with technical nomenclature and usage. They had been asked to take the responsibility for a large amount of expensive stock and equipment which they could not check without expert advice. They had no knowledge of what constituted a reasonable rate at which expendable material should be consumed and, without some idea of the nature of the stock, no method of judging with any certainty whether it was expendable or non-expendable. Who but a dentist for instance would know that, while the handle of a mouth mirror is obviously non-expendable stock, the mirror which screws into it is just as obviously expendable because of the ease with which it is made unserviceable by scratching? Technical stores are better and more easily handled by those who understand their uses. The main mobilisation camps and the Air Force made no change as yet, but in the case of all other dental sections the stores were vouchered direct to the dental officer, who became the accounting officer.

During this year nine mobile dental sections were established. As these consisted of a headquarters section and six sub-sections, each commanded by a dental officer, the senior dental officer became the accounting officer and distributed the stores to his sub-sections.

With the mobile sections, static sections, mobilisation camps, naval and Air Force sections to supply, it is small wonder that the resources of the store were taxed to the limit. Such equipment as dental engines, chairs, vulcanisers and sterilisers were in very short supply and the arrival of stocks from overseas was uncertain. In March 1942 an urgent appeal was made to the dentists of the country for any equipment they could spare. Out of 245 who were circularised, 150 replied offering equipment of all sorts for sale, loan or gift.

As a comparison with the previous year, 22 dental establishments besides the mobile sections were supplied, 1055 issues were made and stores to the value of £17,280 were received. Requisitions were placed overseas amounting to £19,000, made up of £18,740 from the United States of America and £250 from Australia.

The Third Year, 1 April 1942 to 31 March 1943

During this year there was continued expansion of the armed forces with more and more dental sections to supply. For instance, the twelve caravan trailers had to be equipped and stocked both surgically and prosthetically. Further Air Force stations were opened and troops were scattered over the length and breadth of the islands.

The increasing danger of enemy action made it inadvisable to have all the stores concentrated in the same building. Bulk stores were therefore established in Rutland Street, Auckland, and at Burnham Mobilisation Camp. It was not proposed to use these stores except in the case of emergency, so everything remained on charge to the DDS at Wellington. It is indicative of the healthy state of the supply position at that time that, in the busiest year experienced by the store, it was possible to hold stocks in reserve without interfering with normal distribution.

During 1942, overseas requisitions were placed to the value of £40,924, made up of £17,628 in the United Kingdom, £22,500 in Australia and £796 in India, or what was known as the Eastern Group. Stores bought in New Zealand reached the record figure of £44,783 and 1504 issues were made. The staff under the control of Lieutenant-Colonel H. E. Suckling numbered eleven.

The Fourth Year, 1 April 1943 to 31 March 1944

This year saw the beginning of retrenchment of the armed forces as the threat of enemy action diminished. Consequently, many of the dental sections were disbanded. The effect of this on the store was an embarras de richesses. The equipment and stock held by the disbanded sections were returned to the store. At the same time the influx of stores already ordered from overseas gathered momentum and seriously taxed the accommodation available. As a last straw, stores began to arrive from the United States of America against an indent placed by the Rt. Hon. J. G. Coates when on a mission to that country in 1941. This equipment from lend-lease sources was unexpected. An attempt was made to cancel the order, but the New Zealand Joint Staff Mission replied that, as the items had already either been shipped or assigned to New Zealand, delivery must be accepted. Stores to the value of £17,440 duly arrived. To cope with this flood it was necessary to find bigger premises and a building was provided by the Government Accommodation Board in Molesworth Street, Wellington. It was conveniently situated, and was 3000 square feet as against the 1400 feet of the old store. The new store began operations on 18 September 1943.

Two important changes in the administration and distribution of the dental stores for the RNZAF took place at this time. Firstly, the station equipment officers handed over their accounting responsibilities to the dental officers, and secondly, the army system of accounting was adopted in place of the ‘Powers system’. This simplified the work of the store as well as making the interchange of officers between the Army and the Air Force easier.

In January 1944 the last accounting anomaly was removed and the Principal Dental Officers of the mobilisation camps relieved their respective quartermasters of all responsibility for dental stores and equipment. The quartermasters welcomed this move. This assumption of responsibility by the officers of the Corps made it incumbent on the stores staff to see that they were fully instructed in accounting procedure. Everything was laid down in ‘Instructions to Officers NZDC’, a copy of which was in every officer's possession, but, in addition, regular visits were made to each accounting unit by an expert from the store. There is no doubt that this was the right policy for from then on the efficiency and simplicity with which the system worked were remarkable. Stores were being handled by people familiar with their uses. Clerical duties were standardised, were quickly and easily mastered and were by no means onerous. The change did not, however, reduce the debt of gratitude the Corps owes to the quartermasters and station equipment officers who administered the supplies for so long, who bore with infinite patience the puzzled and sometimes indignant inquiries of the fledgling resenting the inflexibility of service procedure, extricated the over-confident from costly mistakes, taught those willing to learn and, having taught, retired with grace and, it is suspected, with some measure of relief.

In December 1943 the accountant of the store, WO II G. Hay, was commissioned and given the appointment of Quartermaster of the Dental Services. This was a big advance for, apart from the individual merits of the officer himself, it was a recognition of the level to which the Corps had advanced from the days so short a time ago when it was the Cinderella of the services.

In May 1943 a curious suggestion was made by the New Zealand Medical Corps that the Army Optical Service should incorporate its supplies with those of the Dental Corps, and should be administered by the dental quartermaster. The reason for the suggestion is somewhat obscure, for the dental staff knew no more about optical equipment than the general QM branch or the Medical Corps knew about the dental. The DDS wisely refused.

The organisation continued in this form until the end of the war and for two years afterwards, when the store moved to Trentham in charge of a Warrant Officer first class, with the Ordnance Department once more as accounting official. It was well stocked, in fact overstocked, from the Molesworth Street store. Some of the more perishable stock was sold through the War Assets organisation and some, such as rubber for vulcanisation, and the vulcanisers themselves, is obsolete. The nucleus though is still there and, unless the apathy of 1918 to 1939 is repeated, the NZDC of the future should not be embarrassed by short supplies.

CHAPTER 9 The Training of Staff

THERE were two types of training required in the Dental Corps, technical and general. The officers and mechanics already had the technical training but, apart from the few who had served in the Territorial Dental Corps before the war, none of them knew anything about military matters, nor was it possible, because of the amount of dental treatment demanding attention, to give them all an immediate and comprehensive course of general training. In the very early days of the war, therefore, much had to be learned by individual observation and inquiry. This was inevitable in a young Corps with its meagre administrative facilities, but it was not intended to allow this haphazard method to continue and definite steps were taken to standardise the work and make every officer and man familiar with his technical and general duties.

Training of Dental Officers

When the men of the Second Echelon went on final leave, a course of instruction was held at the Army School, Trentham, for as many dental officers as could be spared from treating the fortress troops and mobilisation camps' staff. The course was held from 4 to 19 April 1940 and was attended by thirty-two officers, including the seven who were to go overseas with the echelon. It was similar to the courses held in 1938 and 1939 for Territorial officers. The general training included army organisation and administration, military law, squad drill, map-reading, anti-gas training and weapon training. The technical part included lectures and discussions on the care of equipment, procedure for supplies, training of orderlies, the policy of dental treatment in the armed forces and aspects of dentistry particularly applicable to war, such as the treatment of Vincent's stomatitis and injuries to the jaws and face. The DDS and other senior dental officers gave these lectures; one of the lecturers was Lieutenant-Colonel H. P. Pickerill, CBE, NZMC (retired), whose work on maxillo-facial injuries in the 1914–18 War has already been mentioned.

As soon as time permitted the DDS issued a book of ‘Instructions to Officers NZDC’, a copy of which was given to every officer in the Corps in New Zealand. This contained all the information an officer should require in the administration and organisation of his unit, as well as certain standardisation of dental technique peculiarly applicable to the conditions of work in the armed forces. There was no attempt to influence unduly the individual officer's dental technique, but some standardisation was necessary in the matter of providing stock and equipment sufficient for all purposes everywhere in the Corps. Every officer was expected to be thoroughly conversant with the contents of the book, to keep it up-to-date with any amendments, to produce it on the demand of an inspecting officer and to keep it with him always as his ‘Standing Orders’. The first copies were distributed in 1941 but became so full of amendments that a revised edition was published in 1943 after the Corps organisation had become more stable.

It is extremely difficult in wartime to find time to train dental officers without interfering with their primary function, which is treatment of the troops. This is an added argument in favour of having a trained nucleus in peacetime ready to occupy key appointments on mobilisation for war. For example, it would be useless and dangerous to detach a sub-section from a mobile dental section in charge of a dental officer with no knowledge of map-reading, in a part of the country where all road signs had been removed. Serious attempts were made by the DDS to give each officer as much general training as possible by arranging with the staff officers at the mobilisation camps to give them drill and instruction whenever they could be spared from their dental duties, but these occasions were infrequent.

In 1941 an opportunity occurred to give the Corps some practical experience in the field. During April, May and June, field force exercises were held in each of the three military districts. According to the General Staff memorandum of 24 February, the objects of these exercises were:

(a)

To exercise commanders, staffs and leaders in functions of command and duties in the field.

(b)

To practise all ranks in field exercises in co-operation with other units, arms and services.

The NZDC took part in these exercises with both these objects as well as a third, which was to provide urgent treatment to the troops in the field. The exercises occupied fourteen days and, in each district, the number of troops involved was in the vicinity of 6000, nearly all belonging to the Territorial Force and therefore not dentally fit.

The Principal Dental Officer of each camp dental hospital group was appointed ADDS for the respective field force. Although NZDC war establishments were taken as a basis, he had to make his own appreciation after conferring with the General Staff of the field force, taking into consideration the composition of the force, the operations planned and the details of the terrain. He had to make all arrangements to provide dental service to the ‘Enemy’ and the ‘Home’ forces, and on the completion of the exercise forward a report to the DDS with recommendations and lessons learned. The exercise to be of any value to the dental officers had to be organised on a skeletal divisional scale, which made the object of providing treatment easy of achievement, but the deployment of dental forces had, to a certain extent, to rely on a conception of larger manoeuvres than actually took place. If this had not been the case there would have been little reason to move the sections or sub-sections, and the value of the exercise would have been lost. For this reason also, there was a certain amount of criticism of dental forces being farther forward than was considered wise, and this was undoubtedly true, but the front was so shallow that in actual warfare the base would have been as far forward as the dental sections would have gone and there would have been no exercise for the NZDC. As it was, by the use of imagination, the organisation had a practice run and the officers had an opportunity to learn something about movement in the field and co-operation with other units.

Training of Dental Mechanics

While recognising the excellent reputation of most of the mechanics employed in the Corps, it cannot be denied that there were some disappointments. There was no qualifying examination in civilian life to guarantee a standard of efficiency and nothing to prevent the half-trained man from claiming the status of expert. As an example, the large advertising dental firms made so many artificial dentures that some of them adopted the chain system in their laboratories, i.e., a man would be trained in one process of the work and might be retained in only that process for some time. This man could claim in all good faith that he had had years of experience in a dental laboratory, whereas in fact he was not capable of constructing an artificial denture in all its phases. Without further training he was useless to the NZDC.

A large number of mechanics were required in the Corps, not only for the large amount of work to be done in New Zealand but to accompany the troops overseas. First-class mechanics were difficult to get and, before the National Service Department took action to prevent it, several were lost to the Corps by having volunteered for service in combatant units. The result was that the Corps in the early part of the war was always short of mechanics. It therefore decided to augment the supply by training some of its own. A few men who were mechanically minded and keen to be trained were selected and classified as dental mechanic's orderlies to work in the prosthetic laboratories of the mobilisation camp dental hospitals.

PDO Papakura Mobilisation Camp to DDS, 9 September 1940:

A course of lectures and demonstrations has been arranged starting tomorrow, 10 September, for mechanic's orderlies. The four at Papakura are showing considerable aptitude for the work and I feel confident that with extra tuition it will not be long before at least two of them will be in a position to be used as junior mechanics.

In six months two of them were so appointed. They were not by any manner of means dental mechanics, but they had a working knowledge of all branches of denture construction as carried out in the army prosthetic laboratories and the opportunity to learn more. Of those trained in this way some fell by the wayside, but others served as dental mechanics in New Zealand and overseas.

This method of training was somewhat haphazard as it was not always possible to get dental officers and senior mechanics willing, or even competent, to act as satisfactory teachers. In 1943, therefore, schools were started for the specific purpose of training mechanics and dental officers appointed to devote their whole time to it. On 1 March 1943, Captains P. B. Sutcliffe and C. H. M. Brander

Capt C. H. M. Brander; Christchurch; born Inverness, Scotland, 1912; dental surgeon.

and Lieutenant K. P. Tompkins

Capt K. P. Tompkins; New Plymouth; born Takapuna, 1905; dental surgeon.

became prosthetic officers and instructors at the mobilisation camps at Papakura, Trentham and Burnham respectively. Similar action was taken in the RNZAF when Captain O. M. Paulin was appointed on 18 March to Whenuapai Air Station.

Men and women were given a course of approximately twelve months and then sat an examination. An exception was made for trainees with previous experience who were allowed, on the recommendation of the officer commanding the school, to sit the trade test without completing the syllabus.

The candidate had to get 70 per cent marks in the technical syllabus and produce a certificate from the officer commanding the school as to his readiness for examination before being allowed to sit the test. Those not recommended were either deferred for six months or transferred to other duties as unsuitable and unlikely to qualify. There were two examiners, one being the PDO of the camp dental hospital to which the school was attached and the other was appointed by the DDS.

On passing, the successful candidates were given provisional standing as ‘B’ grade dental mechanics, NZDC, and were sent to other camp dental hospitals for a further three to six months' training. At the end of this probationary period they were given the full status of ‘B’ grade dental mechanics, NZDC, without further examination, providing the report of the officer commanding the prosthetic school was satisfactory.

There was one danger in the scheme of which the DDS was fully aware. After the 1914–18 War, dental mechanics who had served with His Majesty's Forces were given the opportunity by the Government, in the face of expert advice to the contrary, to qualify and register as dentists by a shorter and less arduous route than that of the customary dental degree or certificate. This precedent was used as a lever to persuade the Government to take similar action in this war. Certain mechanics in the NZDC in New Zealand and the Middle East were misguided enough to avoid the usual channels of communication and write direct to two Cabinet ministers on the subject. Their unorthodox approach was unfortunate for their cause, as it invited disciplinary reprisals, alienated any sympathy their officers might have had for them and sharpened the inevitable refusal. The Corps, while urgently needing mechanics and willing to train them as such, did not intend to allow them to make similar mistakes through lack of a proper understanding of the limitation of their qualifications.

A statement to the press from the annual conference of the New Zealand Dental Association held in Dunedin in September 1946, although made for the purpose of informing the public of the dangers contained in a petition to Parliament from dental mechanics seeking the right to practise prosthetic dentistry without proper training, so aptly sums up the situation that it is quoted here:

The construction of dentures for the replacement of the natural teeth demands an intricate knowledge of many basic medical and dental subjects other than technical procedures and we wish to correct any public misunderstanding which may exist regarding the capability of anyone other than a fully-qualified dental surgeon to undertake the work.

The scheme of training appeared to be satisfactory, but unfortunately it was started so late in the war that by the time the first trainees gained their full status as ‘B’ grade mechanics, there were signs of a general retrenchment and the fledglings were never tested in full flight. Judging by the comprehensive nature of the course and the interest shown in it, the scheme was of sufficient value to recommend its adoption early in a future war. Even with the advances made and being made in preventive dentistry, it is difficult to visualise a force of New Zealand troops with less than half wearing artificial dentures of some kind.

Training of Dental Orderlies

The men and women engaged as dental orderlies were selected more for their intelligence and general suitability than for their previous knowledge of dental work. Their training as dental assistants was primarily in the hands of the officers of the Corps, who varied in their capabilities as teachers and, in the very early part of the war, were in military knowledge little more than a page ahead of their pupils. With the advent of the officer's vade-mecum in 1941 there was a standardisation of training, but before that each officer taught his orderly the fundamentals of chairside assistance, care and sterilisation of instruments, mixing of amalgam and cements and recording of examinations and treatment according to his own ideas on the subjects. Training in military matters was in the hands of the Principal Dental Officers or officers commanding sections, as also was the training in specialist branches such as administration, clerical or stores NCOs. It was not the best type of training but it was all that could be done at the time, and many excellent orderlies were produced by these methods.

It was not until 1942 that a scheme was submitted whereby WAAFs were trained and examined for trade testing to classify them as Group ‘D’ (dental). A syllabus was prepared and lectures and practical tuition were given by the officers commanding the dental sections at the various Air Force stations. By this time the officers were better equipped to teach and knew much more of service procedure and Corps organisation. Trade testing was held twice a year or at the discretion of the DDS, the first taking place three months after the inauguration of the scheme. There were two main subjects:

Surgical duties.

Clerical duties and accounting for stores.

There was a written paper of one hour's duration and a quarter-hour oral examination in each subject. General capabilities were the subject of a report from the officer commanding the section to the DDS, and this was considered with the examination results. Examinations were conducted from Air Headquarters, Wellington, by arrangement with the DDS, who had control of all classification of WAAF dental personnel. The oral examinations were held on the RNZAF station. On completion of the examination the WAAFs were classified:

Group IV: WA2—Written and oral, 50 per cent in each subject.

Group IV: WA1—Written and oral, 60 per cent in each subject.

This reclassification carried an increase in pay as ‘Qualified Personnel’. This produced more highly trained assistants than the haphazard methods of the past had done.

The RNZAF was the only service to adopt this trade testing for dental orderlies, and judging by its success, it is reasonable to suggest its adoption by the other services. The tuition can be given without interfering with normal routine and should take little organisation to set it in motion. It entails extra hours of work, but the officer is repaid by more efficient orderlies and the orderly has the incentive of more pay and added interest in the subject. A sine qua non is a nucleus of officers capable of teaching and this, to begin with, would have to come from those holding commissions in the Regular Forces or the Territorial Force.

CHAPTER 10 The Building of Dental Hospitals

WHEN the New Zealand Dental Corps assumed the responsibility for treatment of the armed forces in the Dominion and overseas, one of the first considerations was the provision of suitable accommodation. The use of tents or converted huts was only excusable under field conditions or when time precluded the building of permanent hospitals. Costly, delicate and complicated equipment is used in the practice of dentistry, and this has to be suitably housed and readily available if treatment is to be of the high standard the forces have a right to expect. In addition to this, there is a considerable strain on an operator working long hours in an exacting profession which demands the best conditions to produce the best results. Suitable hospitals, however, cost money, and enough has been said of the official reluctance at the beginning of the war to recognise the value of the Dental Corps in the general scheme of things, to show that getting authority for the necessary expenditure was not easy. Eventually, good hospitals were built in every permanent camp or station.

An example of tented accommodation in the early part of the war was when the Maori Battalion was in the Manawatu Agricultural and Pastoral Association's showground at Palmerston North. Major L. P. Davies, OBE,

Maj L. P. Davies, OBE; born 1883; dental surgeon; NZDC 1916–19 (Capt); died Wellington, Nov 1950.

ADDS of the Central Military District, reported on 14 March 1940:

The dental staff comprised the Principal Dental Officer and four other dental officers, one administrative sergeant, four dental orderlies, three mechanics and one mechanic's orderly. I found the dental quarters to comprise one large marquee and one bell tent.

The marquee was approximately 15' × 30' and here the mechanical work, office work and surgical work were carried out…. There was a duck-board flooring in the mechanical portion but in the surgical part there was no flooring at all…. Conditions were not altogether favourable in wet and rough weather. There was an electric light above each chair and also in the mechanical room and the lighting conditions generally were as satisfactory as could be expected under the circumstances. Electric power was used for an electric vulcaniser and for electric engines. Primuses were used for other heating requirements.

On questioning the PDO I found that the dental plant, including the electric plant, stood up to the weather very well.

Drainage was … by means of a septic tank. Water was laid on and facilities for washing were provided by means of canvas basins. I might also state that space was provided in the marquee for sleeping one member of the staff to act as caretaker.

The bell tent accommodated one officer and one orderly. I found here a close wooden flooring with no provision for lighting or drainage. As this was only a make-shift tent it answered the purpose for which it was intended….

It must have been difficult to maintain reasonable asepsis under these conditions, and even more difficult to impress the patients that the standard of service received was not in some measure commensurate with the surroundings.

Dental hospitals, whether large as in a mobilisation camp where up to nineteen officers were operating, or small as for a single section, have certain essential requirements, and all are constructed on the same principles. A study of these essentials will give some idea of the general layout of all dental hospitals without the need for describing the details of the many different designs, although it must not be forgotten that the numerous designs were the result of much thought and effort by Dental Headquarters and the Public Works Department.

In general, the building had to be so situated as to be easily accessible to the patients. It had to be orientated to provide the best operating light, big enough to accommodate staff and patients, yet small enough to allow hospital cleanliness to be observed. It had to have water, electricity, sewerage, gas, compressed air and heating, as well as having specialised apparatus installed and suitable fittings designed and constructed. There had to be a surgery, office, workroom, waiting room and lavatory. In the case of the larger hospitals, a store, X-ray room, darkroom, and a room for extractions and oral surgery had to be provided.

The Surgery

The centrepiece of the surgery was the chair. While in some cases hydraulic pump chairs were provided, most of them were of the folding type made of wood with adjustable headpiece and back. They were reasonably adequate, though lacking in strength and range of movement in comparison with the pump chairs. On the left of the chair was a unit complete with spittoon, saliva ejector, bracket, electric engine and compressed air atomiser. They were made in New Zealand and proved to be very satisfactory. On the right of the chair was a cabinet for instruments and drugs, with its top designed for use as a writing desk.

The chair, unit and cabinet required a width of 7 ft 6 in. to 8 ft and at least 12 ft from the window to the back wall. When a series of chairs were placed alongside each other as in the larger hospitals, 8 ft from the centre of one chair to the centre of the next was allotted.

Makeshift workshop in old storehouse, Nagaruawahia black and white photograph of group of soldiers

Camp Dental Hospital surgery, Trentham, 1943 black and white photograph of military dental clinic

No. 2 Mobile Dental Section at Whangarei black and white photograph of military trucks and tents

At work in a carvan trailer, Trentham black and white photograph of army field dentist

New Zealand Dental Corps carvan trailer black and white photograph of mobile dental clinic

Srurgery at RNZAF Station, Delta black and white photograph of army dental clinic

Dental haversack and contents black and white photograph of dental instruments

Surgical pannier and contents black and white photograph of dental instruments

Prosthetic pannier and contents black and white photograph of dental instruments

1 New Zealand Camp Dental Hospita, Maadi. Patients clean their teeth at the Oral Hygiene Bench before entering the surgery black and white photograph of soldiers queue for dentist

A field dental section operating in a Base area black and white photograph of dental clinic in tent

Lieutenant-Colonel J. F. Fuller, OBE, ADDS 2 NZEF black and white photograph of army officer

2 New Zealand Camp Dental Hospital, Maadi, before its building was completed black and white photograph of field dental hospital

In the Western Desert, 1940. Patients wait outside the surgery of a field ambulance dental officer black and white photograph of soldiers awaiting treatment

Officers of a New Zealand mobile dental section have breakfast in the field black and white photograph of officers taking breakfast

There is an age-old controversy among dentists about the most suitable daylight for operating. In the southern hemisphere the majority, as revealed by a poll taken among the dental officers, favoured the southern light, some almost to the point of fanaticism, while the minority with equal vehemence swore by the northern. As there were some hospitals in long narrow army huts where the chairs were placed back to back, it is hoped that officers of appropriate schools of thought were employed. There was one point, however, of universal agreement, that direct sunlight must be avoided at all costs because of eye strain from glare. This made the eastern and western aspects unsuitable. Some form of artificial light was necessary for dull days and evening work, but this was discouraged whenever adequate daylight was available. All the hospitals were equipped with a rise and fall light fitted with a suitable reflector above each chair. In addition, a battery operated light which could be worn on the forehead was a standard issue to each section.

It is reasonable to presume that, with the development of the fluorescent tube, this will be the lighting of the future, but its first trial in Waiouru Camp was a failure owing to technical faults in the light itself. A better type was installed in HMNZS Cook in 1945 with more success.

Every surgery was provided with hot and cold water. It was found necessary to filter the cold water to prevent blocking the saliva ejector system, and for this purpose a strainer was fitted outside the hospital. Some hospitals had their own electric hot-water system, some were connected with the camp supply, some used the ‘Zip’ type heater and one, at least, had a coke boiler. A steriliser bench, a plaster bench covered with battleship linoleum and a wash-hand basin completed the furnishing of the surgery.

The walls, ceiling and joinery were painted and enamelled, usually in a light green colour which was very restful for the eyes. The floor was either covered with linoleum or left bare, in which case the wood was highly polished. In Papakura, Trentham and Burnham it was remarkable how well the floor kept its ballroom appearance in spite of the tramp of many pairs of hobnailed boots, and it reflects great credit on the orderlies who spent so much time and effort on its care.

Heating in winter was in most cases of the tubular electric type although some of the smaller hospitals had a coke heater standing on a concrete block. Adequate heat is essential in a dental hospital as without it the work must suffer. The occasion of the treatment of the Railway Construction companies in Ngaruawahia in 1940, already mentioned, is a case in point. Without drums of red-hot coke between the chairs, the operators' hands would have been too cold to work and the patients could not have sat out the appointments. The method of using braziers such as this is not recommended as a routine practice, however, and the writer who was in charge of the unit at that time must confess that he was haunted by the spectre of carbon monoxide poisoning, which happily did not arise.

Compressed air for the unit was provided by an electric motor and tank situated in the workroom with a pipe through to the surgery.

The hospitals in the mobilisation camps and the larger Air Force stations had, besides the main surgery, two rooms for extractions, oral surgery, general anaesthetics and X-rays, with a darkroom for processing films. The attempt to provide a private surgery for the use of the PDO of mobilisation camps, presumably to work on Very Important Personages, was not a success. In the first place, it was placed right opposite the main door, which was the draughtiest part of the building, and secondly the exalted patients usually expressed a wish to take their seats in the common row.

The Office

Only the bigger hospitals had a room set aside as an office. In the smaller ones all the clerical work was done in the surgery and, while admitting some convenience in this arrangement because of the smallness of the staff, it would appear that a separate office, not necessarily large but close to the waiting room, is more efficient and easier to run. Clerical duties such as calling up and interviewing patients, filing records, writing reports, telephoning and typewriting should not be allowed to interfere with the work of the dental officer in the surgery. Little emphasis was put on providing efficient office equipment, probably because in most cases not enough emphasis was placed on the business capability of those expected to carry out the work. Untrained people were expected to run the clerical side of the equipment of perhaps sixteen or seventeen dental practices working to full capacity. They had to see that every man in camp was called for treatment in time to be made dentally fit before leaving for overseas. They had to study the movements of men from unit to unit as laid down in routine orders. They had to keep a record of work to be done, work completed and stores needed and expended. They had to type reports and correspondence, see that the dental records for each patient were forwarded to the proper quarter at the correct time, as well as arranging all details for the unit such as pay, leave and clothing. When it is remembered that, except by a fortunate accident, none of them could use a typewriter, except later when girls were employed, and that in the early part of the war it was even difficult to get a typewriter, their work stands out as an example of willing service, often misdirected and needlessly prolonged. The result was that the Principal Dental Officer was continually submerged in a morass of clerical duties because there was no trained clerk to help him. There is a strong case not only for an office in every dental building but for trained clerical staff to run it.

The Mechanical Laboratory or Workroom

This was where the mechanical construction of artificial dentures was carried out. All work for the patient was carried out in the surgery by the dental officer but the actual construction was done in the workroom by the mechanic to his instructions.

Benches were built round the walls for plaster work, vulcanisation, boiling out wax, packing rubber, setting up teeth and the hundred and one procedures connected with the work. Water, light and electricity were needed and gas for Bunsen burners, vulcanisers and gas rings. It was not possible to rely on a supply of coal gas for every dental hospital and, as it was the policy of the Corps to standardise all equipment, bottled gas was used. This was a rock gas mined in California and stored in cylinders of 20 lb and 210 lb. A smaller jet was required than that used for coal gas so special burners and connections were necessary. It was very satisfactory and had the advantage over coal gas of being portable. Although classed as ‘Dangerous’, with a recommendation that it be stored in a magazine, no fires, with the exception of one due to carelessness in leaving a vulcaniser unattended, occurred during the whole war, and it was used in mobile laboratories as well as hospitals. There were some anxious moments about supplies at the time of Japan's entry into the war, when America placed an embargo on the export of steel cylinders, but these difficulties were overcome and no shortages were experienced.

The bench accommodation, including space for plaster work, polishing, packing, vulcanising, soldering, inlay casting and general work, together with the cupboards and drawers, was well designed on conventional lines and need not be described in detail.

In a small hospital the room was about 12 ft by 8 ft and in the big mobilisation camps was 40 ft by 13 ft 6 in., which was none too large for the volume of work that passed through it.

W aiting Room

In the bigger hospitals a room some 18 ft square with benches round the walls was provided, and in the smaller ones a tent was usually used. The first sight to greet a patient in any NZDC hospital was a notice reading:

All ranks must parade with their toothbrushes and clean their teeth thoroughly before dental examination or treatment.

In most cases a sink was supplied for this purpose, but when there was no sink or running water, a field oral hygiene outfit and soakage pit were used. This was a metal tank of about 2 ft cube, containing water and standing on a wooden platform 3 ft 6 in. high. A rubber tube fitted with a clip came from the tank and rested when not in use in a jar of antiseptic attached to the stand. Alongside the outfit a hole was dug in the ground and filled with stones to form a soakage pit. To use it one wet the toothbrush by removing the tube from the antiseptic and pressing the clip. The teeth were then cleaned over the soakage pit, the tube being replaced in the antiseptic.

This, while obviously not as satisfactory as a sink with running water and proper sewerage, was a distinct advance on what existed in the 1914–18 War, and which continued through the Territorial interlude and even made an appearance in this war. To quote a memorandum to all dental officers dated 22 December 1939:

Where sinks and other facilities are not provided, Principal Dental Officers will take steps to have two buckets branded ‘Clean Water’ and ‘Waste’ respectively, placed on a bench two feet high in a prominent position at the entrance to the clinic, preferably inside the building, with a mug and a receptacle for common salt.

This was known as an oral hygiene bench, a name which expresses the meritorious intention but not the complete failure of its activities. Far from promoting oral hygiene, it was a menace to health and an encouragement to the spread of infection. The buckets were unprotected from dust and flies. Patients were puzzled by the whole outfit and sometimes mistook the clean bucket for the waste, and even if they correctly carried out the instructions, the water and mug were contaminated by the first user. The outfit has long since been discarded and it is inconceivable that enlightened knowledge of health will tolerate its resurrection.

From this general description it should be possible to visualise the conditions under which the NZDC worked in the various camps in New Zealand. Good, well-equipped hospitals built of wood, painted in many cases with camouflage, the interior polished and shining, a setting to impress the patient that this was no temporary service, no rough and ready tooth carpentry, but dentistry equal to that he received from the dentist of his choice before he joined the forces.

CHAPTER 11 Treatment

THE general organisation of the Dental Corps, the provision and training of staff, the purchase and distribution of supplies and the standard of dental health to be achieved have been described. Consideration must now be given to the main function of the Corps, its raison d'être, treatment. Practically every man of military age in New Zealand either had some degree of dental disease or was a potential casualty as a wearer of artificial dentures. The perfect natural dentition was so rare as to be an object for demonstration to other dentists. It is safe to state that the number of men possessing their own teeth who did not require some treatment from the NZDC during their term of service was negligible, and very few of those wearing artificial dentures completed the course without trouble of some sort. As the DDS wrote in his ‘Instructions to Dental Officers’ regarding the duties of the Corps:

This is to promote the highest order of dental fitness attainable for the fighting forces and to ensure that they are maintained in such a state. The quality of the fighting soldier depends on the basic factor of his degree of physical fitness in which the state of his oral cavity plays no small part. Experience in the last war and in this has proved that after troops have been engaged in battle, quite a considerable amount of dental treatment is required, particularly in replacing lost and broken dentures. This constitutes a vital problem with New Zealand troops, 50% to 60% of whom are denture wearers.

The New Zealand Dental Corps was not so much concerned with patching up the battle casualties as with reducing the number of those casualties by ‘promoting the highest order of dental fitness’ and ‘maintaining such a state’. This could not be achieved haphazardly and demanded a definite plan of campaign. Every man had to be dentally examined as soon as possible after his entry into the forces, firstly to assess the amount of treatment required, and secondly to provide a permanent record of his dental condition at that time.

Examination

The first examinations were carried out by civilian dentists as members of medical boards using a special form (NZ War 360) on which to record the result. The dental condition was recorded on this form but the amount of treatment was more especially assessed as to whether the recruit could qualify, under the limited standard of dental health, for entry into the forces at all. When, however, the Dental Corps accepted full responsibility for the treatment of all mobilised forces, this form was abolished and Form NZ361 was used for the Army and the Navy. The Air Force, whose dental service was the last to start, first used the standard RAF Form 48, which was a combined medical and dental history sheet. There was, however, so much confusion and waste of time in the necessary exchange of these forms backwards and forwards between the medical and dental officers, that a separate dental history sheet, Form AF129, identical with Form 361, was adopted in September 1940.

It was important that there should be a standard method of recording the results of examinations in the three services so that they would be intelligible to every officer of the Corps, so not only were the same forms used but the same symbolism was used. There is room for criticism of the symbolism adopted in New Zealand, and this took active form in the adoption of a different system in the Middle East, but the New Zealand system had the merit of being identical with that in use by the majority of dentists in the country and, if not perfect for use in a field force, was easily understood and a convenient basic standard.

The instructions were that all ranks must be examined within forty-eight hours of entering camp. It was considered that one dental officer with an orderly, assisted by a clerk or the NCO in charge of the party, could examine on an average thirty men an hour. This may appear excessive and, without a full knowledge of the circumstances, the criticism that the examination must have been perfunctory is reasonable. It must be borne in mind that the figure is an average and that many of the men were wearing full artificial dentures and did not take long to examine. The cases that took the longest were those with good natural dentitions, when it was important that no lesion should be missed before accepting the responsibility of signing the patient as dentally fit. For those men who had some treatment to be done, it was more important to find out the approximate amount of work required to a reasonable degree of accuracy than to delay the beginning of treatment for the whole force by attempting to diagnose the more obscure cavities. When that man returned for treatment the occasional cavity that had been missed would be found. A completely accurate diagnosis in any case is impossible without the use of X-rays, and it would be difficult to use these at the time of examination of a large body of troops. In practice the examinations were extremely accurate.

If it could be certain that once a man was in camp he would stay there until his treatment was completed, the system outlined above would be reasonably satisfactory. Unfortunately this was not so and, although theoretically his Form 361 accompanied him on his personal file wherever he moved, in practice this was not the case. Forms had a habit of going astray for many reasons. Sometimes routine orders were inaccurate or late in publishing details of movements. Sometimes the dental clerical staff, who were more often than not trying to handle business details beyond their capacity, failed to take the necessary action. Often there appeared to be a lack of co-ordination between units and a failure to appreciate that movement of personnel affected a large number of organisations. In this respect the Dental Corps had to fight hard for a place on the distribution list of important memoranda which vitally affected it, and this added considerably to its difficulties. As the war progressed the position improved, but in the early stages it was not appreciated how many apparently remote instructions had an effect on the organisation of dental treatment.

Whatever the reasons, Form 361 was often late in accompanying the personal file, which usually meant that a diligent dental officer carried out his instructions and made out a new one, with the result that the records of examinations and treatments were spread over several forms. Even if this was not the case, the original record of examination was subjected to the risk of loss or damage by being continuously handled and transferred from place to place.

Appointments for Treatment

Appointments could not be made haphazardly and a number of factors that had not concerned the dental officer in private practice had to be considered. These were:

The training syllabus and camp routine orders had to be consulted. For example, it was inadvisable to make appointments for men whose companies were needed for rifle practice on the range or who were ‘Duty Company’.

The total time for treatment had to be estimated. Those needing multiple extractions had to receive priority so that as long as possible could be allowed for the mouth to heal before fitting artificial dentures.

It was necessary to estimate how long each course of treatment would take. Except in special circumstances, it was inadvisable to keep a man in the chair longer than an hour at a time. On the other hand, the greater number of times the man had to attend the more time he was away from his training, and the more time he wasted in going to and from the hospital and in waiting his turn for treatment. Also, time was wasted in the hospital in sterilisation of instruments. As much work as possible had to be done at each appointment consistent with a high standard of operative work and the patient's welfare.

Enough of different classes of work had to be called up to keep all departments of the hospital fully occupied.

Considerable tact was needed in convincing unit commanders that the time spent in the promotion of oral health in their men was not wasted in comparison with their general training. When it was seen that the Corps policy was to interfere as little as possible with training and duty, there was seldom any friction and most unit commanders became valuable allies.

In every body of men there was the ‘old soldier’ who welcomed the dental parade as an excuse to evade unpleasant duties. Appointments therefore were all made through the unit orderly room and an appointment and dismissal form, stating time of arrival and departure, was used.

Appointments were not made with individual dental officers except in such cases as ‘Trench mouth’, when continuity of treatment was desirable.

In the bigger hospitals it was customary to use one officer to do most of the extractions in the early stages and another to specialise in the prosthetic work so as to keep the mechanical staff fully occupied. The remaining officers would then concentrate on the filling work, which constituted the bulk of the work.

In the Air Force there were other factors to be considered. The officer in charge of each dental section had to evolve his own system to get a steady flow of patients without interfering with training or duties. This was not easy and called for careful arrangement of work by the dental officer and willing co-operation from officers commanding flights and sections on the station. In the mobilisation camps soldiers were made available in groups, but on air stations individual appointments had to be made. Fortunately all dental sections had telephones. Where extractions were necessary the weather had to be considered, so that an interval in the flying programme could be used to advantage. Unfortunately the medical officer was often working to the same plan and wanted the same period for his inoculations. On the other hand the extractions were few, most of them having been done during the period of preliminary training at Levin or Harewood. Another factor was that it was found that, while the average soldier tolerated dental treatment better than the average patient in civilian life, in the Air Force the reverse was the case. Men undergoing intensive courses of technical or flying training, or engaged for long hours on aircraft maintenance, did not tolerate dental treatment with the same equanimity. Filling operations took longer, local anaesthesia was more often necessary and appointments had to be shorter.

On the average the treatment required by the aircrew trainees involved about 400 fillings per hundred men, which was practically the same as in 2 NZEF, but the number of extractions and dentures was lower. Only young men of a comparatively high educational standard were accepted for aircrew and most of these had received continuous and complete dental treatment during adolescence. On the other hand, as has already been pointed out, the examination of these mouths demanded more care and the conservative treatment took longer. It was also more important to detect and eliminate root infection in men who were destined to fly at high altitudes, when those defects, dormant under normal conditions, were likely to show up. The men were also at the most susceptible age for caries and for complications from impaction or incomplete eruption of the third molars. It was extremely important that men who would shortly be engaged in operational flying in Europe should be free from all dental complications.

Before going into details as to how the treatment was carried out, it is well to state what was offered and how it was received. The DDS in his instructions to all dental officers stated:

The same care and attention to patients and the same high standard of dental treatment should be observed as would normally be expected in a high class dental practice.

This was the highest standard that could be set and in most cases it was fully appreciated, but there were some cases where it was looked on with suspicion. The cases were remarkably few but, as they constituted a problem which must inevitably occur, however high a standard is offered in the future, they must be considered.

Refusal of Treatment

In dealing with the large number of sailors, soldiers and airmen it is not surprising that there were some who, for various reasons, refused to submit themselves to the treatment prescribed. In many cases, by tactful handling, the dental officer managed to overcome these prejudices, especially where the cause was apprehension, but he could go no further than persuasion and, if the refusal was persisted in, had to refer the case to the man's commanding officer. To the commanding officer of the old school the answer appeared simple. An order was an order, and if it was disobeyed there were enough unpleasant penalties to see that it did not happen again. This view, however, was founded more on custom than on sound law, and the old soldier's philosophical observation that there was only one thing that could not happen to him in the Army was proved to be inaccurate. The history of the dispute is interesting.

In April 1940 the dental officers' instructions were:

Any soldier refusing treatment will sign a declaration to this effect on NZ War 361 (overseas 361A) dated and countersigned by the dental officer concerned. Refusal to undergo treatment will not be regarded as sufficient cause for discharge although as a result of such a refusal he may not be up to the required standard unless a Medical Board, which will include a dental officer, be of the opinion that without such treatment the soldier is, or may become, physically unfit to carry out his duties.

The Deputy Adjutant-General summed up the position at the time in commenting on a specific case on 8 March 1940:

There does not appear to be any disciplinary action which can be taken in this case as it does not appear to be an offence. In future, provision could be made to ask the recruit if he is willing to undergo treatment before accepting him. In this case the alternatives are to let him go overseas as he is (probably unfit) or have him declared unfit by a board and discharged.

This was most unsatisfactory as it was bad policy to send unfit men overseas, where they might become unfit for duty and have to be sent back to New Zealand, and the alternative of discharge by a medical board in New Zealand eased the path of the obstructionist and malingerer. An attempt was therefore made to increase the authority of commanding officers.

In 1941, Regulation 41 of the National Service Emergency Regulations 1940 was invoked. This made it an offence for a man to refuse to submit to treatment by a medical or dental practitioner on being required to do so by an officer having authority over him, if that treatment was deemed necessary for the purpose of rendering him fit for service. Before going into camp the offence was tried in the civil courts, and after entering camp, in military courts under Article 1417 of King's Regulations and Admiralty Instructions, Section 18 of the Army Act or Section 18 of the Air Force Act (Imperial). Everything then rested with the man's commanding officer, and the dental officer, apart from taking a signed and witnessed declaration and entering it in the paybook and on the dental history sheet, had no further worry about it, or so it seemed. In practice it was found that commanding officers were chary of using their powers under the Act, with the result that men who refused treatment in some cases apparently had their refusal backed by authority. This put the dental officer in an awkward position. To quote the DDS:

There is the straight out malingerer who definitely refuses treatment. He willingly signs a statement on his dental history sheet that he refuses necessary dental treatment and this fact is reported to his commanding officer. Nothing happens. Hours are wasted in many instances endeavouring to persuade these men, but they are conscripts and do not want to be made fit for service, though the dental officers persuade a few. This is a tragic waste of valuable time which is a big factor when so much dental treatment is required and I regret to say that territorial officers in a few cases have encouraged them. Prior to this period men were anxious to go overseas and knew that they had to be dentally fit, but this incentive is gone and evasion is increasing, which is causing grave concern.

Obviously something had to be done. To invoke a law without sanctions was to undermine discipline and invite ridicule. There was much legal argument which it is not proposed to analyse as it is outside the scope of this history, but the position may well be crystallised in the words of the Assistant Adjutant-General of the Southern Military District:

To allow the refusal to go unpunished would undoubtedly be prejudicial to discipline but so also would a trial by Court Martial if it failed to result in a conviction.

A strategic withdrawal from an untenable position was carried out and on 7 August 1942 the provisions of the National Service Emergency Regulations as affecting refusal to submit to treatment by a medical or dental practitioner, with the exception of the section dealing with vaccination and inoculation, were suspended. Nobody was to be prosecuted or charged and no proceedings or other steps were to be taken to require submission or to punish for not submitting. Any prosecutions already started in the civil courts were to be withdrawn, or if the magistrate refused permission for them to be withdrawn, no evidence was to be offered.

It speaks well for the tact of the dental officers and the good reputation of the NZDC as a whole that the number of men and women who persisted in their refusal to undergo treatment was very small. Those who did persist were no longer any concern of the Corps, except that certified copies of their signed refusals were kept at Headquarters to refute any claims they might make in the future to have dental work done for them at the public expense, and to exonerate the Corps from responsibility for their dental condition.

It is now proposed to discuss some aspects of dental treatment as they were affected by service conditions and requirements.

Extractions

Most of the extractions were carried out under local anaesthesia, except such cases as acute alveolar abscesses and similar conditions where this type of anaesthesia was contra-indicated. In cases of multiple extractions it was customary to admit the patient to the camp medical hospital for a day after operation for observation, nursing and special feeding. In other cases the co-operation of the Regimental Medical Officer and the unit quartermaster was sought to get special diet and easy duty. Occasionally the patient was either sent home on sick leave or to a field ambulance, military hospital or public hospital, but this only occurred if there were no facilities for hospitalisation in the camp. Where general anaesthesia was indicated, and this was limited to cases involving six or more teeth except in special circumstances, most of the main dental hospitals had machines for the administration of nitrous oxide and oxygen.

Where no machine was available the services of the medical officer were available to administer other anaesthetics. Intravenous evipan was a popular choice.

Although cases were admitted to the camp hospital, the dental officer continued to be responsible for them except for rations, discipline and nursing.

The services of dental officers with experience in oral surgery were available at the main mobilisation camps and to them could be referred cases of major oral surgery from sections where there were not the same facilities for diagnosis, hospitalisation and postoperative treatment. It must not be thought that they alone did all the oral surgery in their districts. The dividing line between the general practitioner and the specialist was no more clearly defined in the Army than it was in civilian life. The individual officer's judgment was the deciding factor as to whether the specialist was to be used or not. All dental officers were supplied with the necessary armamentarium for any class of lesion they might meet, but all of them did not have X-ray or hospital facilities, which were usually essential for successful oral surgery.

Fillings

The establishment of masticatory efficiency of long duration in the least time was the primary consideration in the choice of filling materials. Most were of silver amalgam with a protective lining of cement. Where aesthetic demands precluded the use of amalgam, as in the case of anterior teeth, synthetic porcelain was used. The malleted gold filling and the gold inlay had no place in army practice, but inlays of acolite and of a gold-coloured metal called ‘Allcast’ were used occasionally.

Pulp Treatments and Root Fillings

The ill favour with which the pulpless tooth is regarded by the dental profession is reflected in the very small amount of this work which was done by the NZDC. With full permission to do this type of work at their own discretion, the dental officers in New Zealand decided that only 14 in every 10,000 fillings should be root fillings.

Ulcero-membranous Stomatitis

This disease is also known as Vincent's Stomatitis or trench mouth, and, when it attacks the fauces, tonsils and pharynx, as Vincent's Angina. It is contagious and community life provides ideal conditions for it to become epidemic. A state of lowered vitality such as that following influenza, overwork, severe cold or lack of essential vitamins in the diet is a general predisposing cause, while a septic mouth, calculus, overhanging fillings, food traps or impacted teeth provide ideal local conditions.

The etiology being both general and local, combined with its epidemic possibilities, put the disease in the no-man's-land between medicine and dentistry. Its importance as a potential incapacitator of large bodies of troops demanded a clear decision as to whose responsibility it was to treat it and prevent it spreading. As the general health of the troops was the responsibility of the Medical Corps, some medical officers considered it was in their department. As the disease was an oral one, usually diagnosed by the dental officer, and as treatment was mostly local, the dental officers considered it was in theirs.

The instructions from the DDS to his officers were quite clear. They were to treat all cases and were given implicit instructions how to do it. They were warned to be continually on their guard to prevent the spread of the disease. They had to notify the DDS by telegram of every case diagnosed, in addition to notifying the medical officer and unit commander. Apparently the instructions from the Director-General of Medical Services to his officers were not so specific and the medical officers were left to form their own opinions as to who should treat the disease. There was justification for both views but no justification for the lack of co-operation between the two Corps when it came to treatment.

Matters came to a head in 1941 when the Senior Medical Officer at Papakura Mobilisation Camp refused to admit cases sent to his camp hospital for isolation and evacuated them to the Auckland Public Hospital for treatment, thus taking them out of the control of the Principal Dental Officer of the camp. Under these circumstances the Principal Dental Officer had no option but to inform the DDS that he was unable to accept responsibility unless allowed to carry out the implicit instructions given to him on his appointment. He asked that a ruling be given to settle once and for all where the responsibility for treatment of the disease laid. As a result the Director-General of Medical Services gave the following instructions to the Assistant Director of Medical Services at Auckland:

During normal periods, namely when there is no epidemic or other unusual sickness rate in the mobilization camp, the Senior Medical Officer should retain all mild cases of disease whether contagious or otherwise, or accidents which can be effectively treated, in the camp hospital. This includes measles, mumps etc. As regards Trench Mouth in particular, there is no reason why this disability should not be retained in the camp hospital under the treatment of the Senior Dental Officer. The patient will of course be under the general control of the Senior Medical Officer for discipline etc. and the nursing personnel, but will carry out the treatment ordered by the Dental Officer. I may say in passing that the camp hospital at Papakura has a staff of three trained NZANS personnel with NZMC personnel, and the equipment, sterilisation etc., [which] is quite sufficient for dealing with all classes of minor disabilities including contagious diseases.

As you are aware the one great principle in the Army Medical Service is conservation of manpower and it should be the aim of the medical staff not to evacuate patients who can be equally well treated within the camp area. I do not in any way minimise the importance of Trench Mouth as a highly contagious disease, but at the same time I do feel that the camp hospital should be prepared to take cases of this nature under normal conditions. Will you please instruct the Senior Medical Officer accordingly.

Apart from treatment which was on standard lines, the most important consideration was to prevent the spread of the disease throughout the camp. The patient's eating and drinking utensils were kept away from the others and each patient received a printed card of instructions.

Most of the cases in New Zealand were of the mild sporadic type and nothing in the form of a serious epidemic occurred. In March 1944 there was a scare when an unusually large number of men, newly arrived from Middle East service, reported at Trentham Camp with the disease. Again in February 1945 there was a slight outbreak at Waiouru Camp. Neither of these was a serious epidemic, although without thorough precautions they might have become so. No case was considered cured until three negative bacteriological tests at weekly intervals had been obtained.

Artificial Dentures

It has already been pointed out that 50 to 60 per cent of New Zealand troops were wearers of artificial dentures of some kind. These were easily lost or broken and in some cases were a convenient excuse for malingering. With all these men potential casualties, it can be seen that the prosthetic department of the Dental Corps was highly important in the service organisation. Apart from dealing with the casualties when they occurred, the policy of the Corps was to keep the supply of artificial dentures to a minimum. This, of course, applied chiefly to partial dentures which, with certain exceptions, were only supplied where there was a definite masticatory insufficiency without them. Too many partial dentures were worn in the kitbag as it was, so unless the patient was cooperative or a dental cripple, it was a waste of time making them. A rule was therefore laid down which allowed wide discretionary powers but protected the dental officer from the odium engendered by his refusal to make luxury partial dentures. No denture of fewer than six teeth was to be made except on the express instruction of the Principal Dental Officer or officer commanding a dental section. While fully realising that the psychological aspect had to be con- sideredconsidered to keep a man healthy in mind as well as body, and that appearance played a big part in this, essential treatment could not be sacrificed on the altar of aesthetics. On the other hand, an officer or NCO would be in serious difficulty on the parade ground with even one of his front teeth missing. In practice, therefore, no man was left with unsightly gaps unless he was quite satisfied to remain that way or had been in that condition in civilian life and had not thought fit to provide himself with a partial denture. Also, so obvious a dental defect was a poor advertisement for the Corps, even if its correction did little to increase masticatory efficiency. The discretionary powers were therefore usually used, even if they elicited an audibly gruff but secretly sympathetic reprimand from the DDS.

Confirmed by personal conversation between the DDS and author, 5 January 1949.

All dentures were made for utility under hard conditions and the aesthetic considerations, while being far from neglected, had to be secondary to this. They were all made of vulcanite, although a certain amount of acrylic resin was available for repairs to dentures of other materials. To produce efficiency and conserve time, the workroom staff in the larger hospitals worked on the chain system. One or two prosthetic officers were appointed and the calling up of denture patients and organisation of the workroom were the result of consultation between them and the senior dental mechanic.

One of the greatest prosthetic difficulties was provided by those men who came into camp with septic mouths requiring extensive extractions. In the early stages of the war, when every man was urgently needed to build up the Division in the Middle East, the Dental Corps was instructed that no member of the forces who was otherwise medically fit was to be debarred from going overseas or withdrawn from a reinforcement because of a dental disability. The average time that an echelon or reinforcement would be in camp, i.e., from date of mobilisation to embarkation for overseas, was two months. It was quite impossible to extract all the teeth and expect the mouth to be healed sufficiently for the construction of dentures of any degree of permanence in so short a time. It was also undesirable that men should go overseas without any teeth or with their mouths in a septic condition. The instructions to dental members of medical boards examining recruits did not anticipate any but the dentally fit being allowed to leave the country and, even then, were sufficiently contradictory to be confusing. (See Chapter 3.)

The situation was met by a compromise. The teeth were extracted as soon as possible after arrival in camp, as long a time as possible being left for absorption to take place. Before embarkation dentures were made on the understanding that they would have to be remade overseas when further bone absorption had taken place. Many of these were made under extremely difficult circumstances on bulbous, irregular alveolar ridges, but some degree of masticatory efficiency was obtained. A list of all men in this category was sent with the draft so that they could be examined on arrival. Although a modification of this technique might have been more satisfactory, many excellent results were got by this method, and it is certain that even this temporary standard of dental fitness was preferable to the septic conditions on arrival in camp.

Taking everything into consideration, the results obtained in New Zealand for the men going overseas were very good and the highest standard of dental fitness was produced in the time available. There was, however, another problem connected with men who required multiple extractions. Some of them, after having had their extractions, were discharged from the forces instead of going overseas. The Army recognised a liability to provide these men with dentures. Sometimes it was not possible to do this before discharge; for example, the man might be transferred to a public hospital. In these cases the Officer in Charge of Sick and Wounded made the necessary arrangements for him to be treated when available. In most cases the work was done at a camp dental hospital, but occasionally a man had been sent home, perhaps to an isolated district, before the work could be done for him. To bring him to camp, feed and board him and return him home was a considerable expense, and it was recommended that in these cases the work should be done by a civilian dentist at the public expense. The suggested fees were lower than those agreed upon when civilian dentists were treating First Echelon troops. They were:

Full upper or lower denture, £5.

Partial (including first tooth), £1 10s.

Each additional tooth, 7s. 6d.

Unexpected opposition was encountered from the Ministers of Defence and Finance who considered the fees too high. The Minister of Defence suggested that the hospital boards might do the work more cheaply, but on consulting the Minister of Health was told that all the hospitals were too fully occupied with their own work. Apparently the fact that the man would have to be brought from his home to the hospital, fed, boarded and returned home was omitted from the calculation of the cost. Fortunately the argument, which lasted from March to December 1940, ended without the necessity for a decision, as every relevant case was meanwhile attended to in a camp dental hospital and great care was taken that no future case could possibly fall into that category. There is no evidence that the private practitioner was consulted as to whether his patriotism would have prompted him to undertake the work at a financial loss, or at least at a nominal fee.

With so many dentures made for the troops, precautions had to be taken to see that proper care was taken of them. The following was therefore put in camp and routine orders on frequent occasions:

All ranks are warned that they are liable to be charged with the cost of replacements of artificial dentures lost through neglect. Dentures must always be removed and put in a safe place before going swimming or when sickness from any cause is likely. Particular care must also be taken during respirator drill and night exercises. Failure to carry out the above is the direct responsibility of the soldier concerned.

Where the loss or irreparable breakage of a denture originally supplied to an officer, soldier, airman or rating, either at his own or at the public expense, could be shown to have been due to any culpable act or omission on his part, he was placed under deductions of pay for the cost of the new denture. Under service conditions these costs were assessed at:

Each full upper or lower denture, £2 10s.

Each partial upper or lower including first tooth, 10s.

Each additional tooth up to twelve teeth, 3s.

Each case was referred by the dental officer to the relevant commanding officer, together with all information for his decision regarding liability. There was always the right of trial by court martial. Deductions were entered in the paybook and published in orders.

From the amount of emphasis laid on the provision and maintenance of artificial dentures, it can be seen that New Zealand troops are to a large extent dependent on an adequate dental service. It is doubtful if before the war this fact was fully appreciated and it is hoped that the experience of the war will not allow it to be forgotten. There is much truth in the statement by Bernard Shaw towards the end of the last century: ‘When you have the toothache the one happiness you desire is not to have it. When it is gone you never dream of including its absence in your assets.’

Oral Hygiene and Care of the Teeth

Among the instructions issued to dental officers was one relating to the arrangement of lectures to be given to the troops at regular intervals on oral hygiene and the care of the teeth. This most important subject was sadly neglected. The emphasis was on repair rather than prevention, for dental disease was firmly established, and popular opinion was that it was an inevitable companion of civilisation. The subject of preventive dentistry was therefore difficult to teach with any degree of interest. The enthusiast was regarded with polite tolerance of his idealism but with a firm conviction that his panacea would be irksome and probably of doubtful value.

That dental disease can be reduced by proper attention to diet and prophylaxis is beyond doubt. That a series of lectures on the subject can effect this reduction is no more likely in the Army than in civilian life. The man who can stand up in front of a crowd of his fellows, neutralise their apathy, interest them in a technical subject, win their co-operation and fire their enthusiasm must have an exceptional personality. The average dental officer regarded lecturing as a formidable ordeal and, however well versed in his subject, was seldom impressive. A sample lecturette was included in the appendix to ‘Instructions to Officers’ but could not be repeated too often and, even though it contained excellent material, needed a trained delivery to carry conviction.

Why not therefore appoint a dental officer with the technical qualifications and lecturing ability to carry out this important duty? Specialists were appointed as oral surgeons, others as teachers of prosthetics, but the most important subject was given an ancillary role. The dental officer was busy mopping up an ocean of dental caries. Dry land was a chimera, even then consisting in his fancy of quicksand. It is small wonder that he doubted his ability to stem this mighty tide with his puny strength and begrudged the time from his well-earned recreation for the necessary effort. The duty was not neglected and many lectures were given. The point is that it is very doubtful if they did any good.

A better approach to the subject might have been to have concentrated on insinuating the postulates of a correct diet into the army rations. Dental disease is a concomitance with improper feeding. Our diet is impoverished by over-refinement of sugars and starches and provides ideal conditions for the growth of mouth bacteria. The lack of detergent foods removes the safeguard of automatic cleaning with its attendant gum massage, as well as depriving us of adequate exercise of the jaws. These and other dietary matters seriously affect the maintenance of dental health and should be given proper emphasis in the policy of the Dental Corps.

Under service conditions diet can be controlled and, with a fighting force largely depending for its efficiency on physical fitness, it should be controlled. The incidence of dental disease could be greatly reduced by the co-operation of dentists, producers, manufacturers, retailers and consumers, but the gap between the first and the last is too great to be bridged by idealistic propaganda while the fleshpots beckon so temptingly. Control could go a long way towards bridging this gap and still provide a satisfying and sapid diet beneficial to dental health and acceptable to the men. The Dental Corps has a duty to assist in this control and might well achieve better results by devoting some of the energy previously spent on trying to reform the individual, to insisting on being represented at the conclaves of the commissariat. With improved diet and an organised campaign of education by competent lecturers, the Dental Corps could give inestimable service to the Army and indirectly to the nation. A word of explanation is necessary here lest it be thought that this is an attack on the army caterers. It is not suggested that the standard of catering in the Army lost any thing in comparison with that in civilian life. It was excellent, judged by that standard. What it is intended to convey is that the diet of our time is responsible for many of our dental troubles and that service conditions of community living offer a priceless opportunity for the correction of some of its faults.

What success would attend the Corps in this direction is problematical. A previous attempt by the DDS to encourage prophylaxis in the Army met with a rebuff from high authority and it was not nearly so controversial as the regulation of diet. In May 1941 the DDS recommended that every officer and other rank in 2 NZEF entering a district mobilisation camp should be issued with a free toothbrush or denture brush, and that replacements should be available at a cost well below that ruling at the time. The Navy had already been doing this with a brush made in New Zealand from first-grade pig bristles. The canteen boards were prepared to co-operate. The brushes were to be of standard design and quality and could have been sold for about seven pence a toothbrush and ten pence a denture brush as against the ruling price in mobilisation camps of 1s. 6d. for an inferior article. To provide these brushes free for two years to the 2 NZEF was estimated to cost £1141 9s. 9d. The DDS had made full inquiries from suitable firms and had their assurance that the brushes could be made at this cost and delivered to date. The necessary authority was refused but the adoption of standard NZDC tooth and denture brushes for purchase from the various canteens at a nominal cost was commended. The Canteen Board and the NAAFI sold them at a price below one shilling.

The concession was something achieved, but as nobody could compel the troops to buy, there were probably many who went without. Admittedly nobody could compel the troops to use a brush regularly, even if it was issued free, but it is still felt that the decision was an unfortunate one and that an opportunity to educate the troops in at least one method of improving their health was neglected.

Dental Care of Isolated Groups

It is interesting to analyse the problems arising when troops are employed for any length of time where dental treatment is not available. This occurred with certain New Zealand troops during the war and as it led to the issue of specific instructions which not only met the situation with ingenuity but removed anomalies affecting the policy as a whole, the story will be told in full.

New Zealand entered into an obligation before the war that, in the event of hostilities, she would be responsible for guarding the cable station on Fanning Island. It was therefore decided to send a platoon from the New Zealand Regular Force to the island. In peacetime the Regular Forces did not receive free dental treatment so no arrangements had been made to treat these men, known as ‘A’ Company. There was no dentist at Fanning Island and, as the first party was to leave New Zealand in August 1939 before war was declared, there were no dental officers enlisted in the NZDC. The possibility of dental casualties was recognised, as can be seen from the memorandum from the Army Secretary to the Secretary of the Treasury of 22 August 1939:

Re Fanning Island Platoon—Dental Treatment

In peace the regular military forces do not receive free dental treatment although this is granted to the Navy and the Air Force.

The Army Secretary was not accurate in this statement as the Air Force did not receive free dental treatment until January 1940. (Author.)

In the NZEF all ranks were provided with free dental treatment and no distinction was made regarding the small percentage of regular soldiers serving with the NZEF. There is a resident medical officer at Fanning Island but no dental officer and without considerable expense it would be difficult to make any provision for dental treatment for the platoon. The men will be on the island for at least six months and it is desirable that there should be no trouble from the dental side while they are there.

The only, but not entirely satisfactory, solution is to ensure that every man is made dentally sound before he leaves New Zealand and where possible the work to be carried out for a period of six months ahead. As the soldier cannot be compelled to have this treatment carried out at his own expense, it is recommended that the platoon should be treated on the same basis as a force for overseas service and dental treatment provided by the Government. Until the teeth of the men have been examined it is not possible to give an estimate of the cost, but as these men were required to reach a certain dental standard before they were accepted for the Regular Force, it is not anticipated a large amount will be involved.

As the platoon will be sailing at an early date it will take some time to arrange treatment at the most economical rates and it would be helpful if you could treat this as an urgent matter.

This was recommended by Treasury and approved by the Minister. Twenty-six men were treated at a total cost of £95. This concession led to the removal of the anomaly whereby different classifications of fully mobilised troops received different dental privileges. On 6 March 1940 free dental treatment was authorised for recruits to the New Zealand Regular Force.

The platoon left for Fanning Island dentally fit. No dental officer went with it, but the first relief was accompanied by a medical officer, Captain M. Kronfeld, NZMC,

Lt-Col M. Kronfeld; Wellington; born Auckland, 25 Jan 1899; medical practitioner; MO Fanning Island, 1940; RMO 28 (Maori) Bn Jun 1941–Jan 1942; Senior Medical Administrative Officer, 2 NZEF, Oct 1943–Aug 1944; Port Health Officer, Wellington.

who was provided with a dental syringe, needles, local anaesthetic and extracting forceps, as well as facilities for inserting palliative dressings for the relief of pain. He was on the island from February to October 1940 and reported that there were no cases of either toothache or denture trouble during this period, for which he gave credit to the thoroughness of the treatment in New Zealand before embarkation. It cannot be denied, however, that there was an element of luck in this and the situation was not entirely satisfactory. The chief worry was over those wearing artificial dentures. Of thirty-eight men, ten were wearing full upper and lower dentures, three were wearing full upper or lower dentures and two had partial dentures. That is, approximately 40 per cent were denture wearers.

In April 1941 an attempt was made to give the medical officer some method of doing more for the dental casualty. The DDS wrote to him as follows:

Herewith dental equipment and materials contained in a Dental Emergency Haversack … for your use and to supplement the dental syringe, needles, local anaesthetic and extracting forceps previously supplied.

The bradawl and floss silk are for the purpose of temporarily repairing broken artificial dentures, the method being to drill holes with the bradawl close to the line of fracture and lace the parts together with the floss silk….

This was only an emergency measure and the DDS was not happy about accepting responsibility for the force without further reducing the prospect of dental accidents. He wrote to the Adjutant-General on 23 April 1941:

Re ‘A’ Company—Dental Standard and Treatment for 1.

With reference to the above force and the existing methods of selection for and despatch of reliefs, it is submitted that where it affects the dental condition of these soldiers, the position is unsatisfactory and resulting in 50% of this force being made up of men who are wearing artificial dentures. They were rendered dentally fit before embarkation on standard 2NZEF lines and an emergency surgical dental haversack with full technical instructions was issued with the first relief for the use of the medical officer and was replenished whenever it was discovered a relief was embarking, but no provision has or can be made for renewal or repair of artificial dentures without the provision of a full dental section NZDC.

The following is submitted for your consideration and approval please:

(1)

That as the Director of Dental Services is responsible for the dental treatment and maintenance of the dental health of the armed forces, it is requested that he be placed on the circulation list by General Staff when reliefs for ‘A’ Company and other special forces are being organised, in order that the question of their dental requirements may be met and arrangements made, where possible, for their dental maintenance.

(2)

That in the instance of ‘A’ Company the following dental standard of fitness be laid down.

‘A’ Company Dental Standard of Fitness

The dental classification will be:

Dentally fit.

Dentally unfit.

Dentally fit means: No man who is otherwise medically fit will be rejected for dental reasons who has

(a)

Normal dental occlusion which may include soundly restored teeth or teeth capable of being rendered sound.

(b)

A masticatory efficiency of not less than nine points,

See Appendix II.

the distribution of the points being left to the judgement of the Principal Dental Officer who will take into consideration the physical condition of the soldier and the length of time the loss of masticatory efficiency has been existent. If a soldier has been able to stand up to the training in a mobilization camp or a heavy regiment of the NZ Artillery, eat three meals a day and be physically fit with only six incisors, a molar on one side and a premolar on the other side, all occluding, he can continue to carry out the duties involved with this force.

Dentally unfit means: Those wearing or requiring the supply of artificial dentures to remedy a deficiency of masticatory efficiency, taking an absolute minimum of nine points efficiency, or presenting with an oral condition that is considered detrimental to his general health and a menace to his fellow soldiers.

This memorandum had two important results. Firstly, the DDS received the vital information to which he was justly entitled, and secondly, wearers of artificial dentures were debarred from service in places where full dental treatment was not available.

There were men in isolated places other than Fanning Island affected by this new standard of dental fitness, notably the Chatham Islands and the Kermadecs. Both these stations had coastwatchers but, as they were reasonably close to New Zealand (the Kermadecs could be reached in one and a half days by ship), the position was somewhat easier. Therefore, at the request of the Director of Mobilisation, who was having difficulty in getting suitable volunteers who conformed to this rigid standard, the DDS agreed to allow denture wearers to be accepted, provided that new dentures were made for them and the old ones kept as spares in case of loss or breakage.

Treatment of Enemy Aliens

On the outbreak of war enemy aliens were interned on Somes Island in the middle of Wellington harbour. The New Zealand Government immediately authorised free dental treatment for all internees, the work to be carried out by the NZDC. A dental officer visited the island at regular intervals doing fillings, extractions and prophylactic work, and sending the dentures to Trentham Mobilisation Camp for processing. The policy was to examine all internees every three months. It is interesting to note that reciprocity from the German Government for our nationals interned there was not given until September 1943. The following cable was received from the High Commissioner for New Zealand in London on 5 September 1943:

2067. German Government propose on reciprocal basis dental treatment for civilian internees be provided at the expense of the interning power same as for prisoners of war. United Kingdom Government agree on behalf of their own internees. Please advise whether you agree for New Zealand.

Jordan

The Minister of External Affairs replied on 7 September:

No. 616. Your telegram No. 2067. We are agreeable on basis of reciprocity to provide dental treatment for civilian internees of German nationality detained in New Zealand. Indeed we would point out that this free service has been given to German nationals during the whole period of their internment.

External

When it is realised that the New Zealand soldiers who were guarding the internees at the beginning of the war were members of the Regular Force, and as such ineligible for free dental treatment, the Government's interpretation of its obligation to enemy aliens was generous indeed. This gratuitous concession put the Government in a strong position when it came to dealing with all the petty complaints which they expected and received. Most of the internees accepted the benefits and appeared grateful, but some refused treatment from the dental officer, demanding attention from civilians, and others considered they were entitled to and demanded dental luxuries. As far as the Dental Corps was concerned, the standard of dental fitness and the treatment offered were identical with those for the mobilised New Zealand Forces.

Among the internees was a German who had been practising as a dentist in New Zealand before the war. He asked the Camp Commandant to allow him to have his dental engine with him so that he could work in the camp. At first sight this appeared reasonable and the Commandant granted it, providing no liability was incurred against the Army. It is unfortunate that the request was not more carefully examined as it led to arguments and incidents which might have been avoided. At the instigation of the DDS the permission was withdrawn for reasons given in the following memorandum from the Adjutant-General to the Minister of Defence:

The policy at present is for dental attention to be provided by the Army dental section to all internees who require it, on the same scale and up to the same standard as that given to personnel of the armed forces.

If permission were granted for the use of this dental engine, it would lead to requests for further equipment, instruments and stores which would involve the Government in an expense which is not justified. The amount of extra equipment which would be involved before an adequate service could be provided would be considerably more than the dental engine now asked for.

It is understood that there are other dentists on the island and there may conceivably be more in the future, all of whom would have equal claims to consideration, which, if not granted, would lead to a plea of favouritism.

Lastly, if the use of private equipment were allowed, a claim for deterioration on account of wear and tear would undoubtedly be made against the Government at a later date.

It is therefore recommended that the application be declined. The DGMS and the DDS are in agreement.

This was written in May 1941 but did not finish the matter as a further application was made in March 1942 through the consul for Switzerland, quoting an extract from Article 14 (Prisoners of War) of the Geneva Convention:

It shall be permissible for belligerents mutually to authorise each other, by means of special agreements, to retain in the camps doctors and medical orderlies for the purpose of caring for their prisoner compatriots.

Legal advice was sought on this point. The legal opinion was that, considering there was a very complete service provided by the NZDC, this Article did not create any duty to allow the applicant to treat German internees, who incidentally were only in a bare majority. Apart from the legal opinion, an incident had already occurred which showed the inadvisability of granting the application. Just before being deprived of his instruments, the German dentist had extracted all the upper teeth from an Italian internee who had complained of a vague pain in the incisor region. The dental officer had seen the Italian a month before and had signed him as dentally fit. Apart from being a breach of customary ethics, which mattered little under the circumstances, the dentist's action placed the Army under an obligation to provide a full upper denture where one should not have been needed. Permission was therefore again refused. A further offer of assistance from the same source in May 1943 was declined with thanks, the applicant being told that the NZDC was fully organised and adequate to carry out all necessary treatment.

In February 1943 the internees, about 180 in number, were moved to a camp on the Pahiatua Racecourse in the Wairarapa district because, with the possibility of enemy attack on New Zealand, Somes Island would probably come under fire. An NZDC section was deployed for their use. Occasional visits from this section should have been enough to satisfy any reasonable demands but the internees decided to be difficult. Representations were made by both the delegate of the International Red Cross and Dr Schmid, representative of the protecting power, that a local dentist should attend the camp to undertake special work, such as gold fillings, at the internees' expense. This class of work was not authorised for the New Zealand Forces, but in this case the request was granted on the understanding that the private practitioner should do only that work recommended by the officer commanding the dental section. The privilege was abused and unauthorised work was done.

It was therefore decided that the NZDC section should remain permanently in the camp and undertake all classes of work, which could be done with equal skill and much more expeditiously. The decision as to whether special work was necessary was left to the dental officer, with the right of appeal to the DDS.

This was a considerable concession and placed the internees on a better footing than our own men, who had to pay for special work, as it was considered impossible to implement the decision without providing all materials free. There were still some grumblers but, after explanation by the consul for Switzerland and the German camp leader, nothing further was heard of the matter.

In late 1944 the internees were returned to Somes Island as it was considered by the Chiefs of Staff that the danger of attack had sufficiently diminished. The responsibility for treatment then rested with the officer commanding the dental section at Fort Dorset who visited the island once a month.

In the various reports from the dental officers who examined and treated the internees are some interesting observations on dental conditions and peculiarities. They are insufficient to form scientific conclusions but are worthy of study.

14 February 1941: I personally carried out a dental examination of internees and in no instance was it considered that dental treatment was urgent. A number of chronic conditions was found, being, it is estimated of some years standing. The general cleanliness of the mouths was bad, the Italians on the whole worse than the Germans.

8 January 1942: The oral condition of the Japanese was very bad and apparently no attempt had ever been made at mouth hygiene. Practically everyone who did not require full extractions, required very extensive scaling and prophylactic treatment.

13 May 1942: The oral condition of the Japanese, while showing improvement, still leaves much to be desired.

30 August 1942: … the oral hygiene of the Italians is not as good as it should be. Nearly half the fillings were for the Germans of the older age group while the percentage of fillings required by the Japanese is small. The Italians without exception dislike dentures and every endeavour has been made to save teeth so that dentures can be avoided. Local anaesthesia is used extensively for conservative work.

Racial characteristics have to be taken into consideration when doing prosthetic work. In particular the best results have been obtained with Germans when the setting up is such that a sliding protrusive movement of the lower jaw is easily made. These internees appear to make that movement the test of comfort in a denture, even though better aesthetic, and just as good functional results, could be obtained with a slight overbite.

All the internees who have had dentures inserted express satisfaction with the results.

8 December 1942: It would appear that oral hygiene of German and Italian internees leaves much to be desired but that of the Japanese is quite good.

The improvement in the oral condition of the Japanese may have been due to the instructions given by the dental officer to their leader, who spoke fluent English. The philosopher might draw conclusions from these reports. The German with his practical outlook demanding mechanical efficiency even at the expense of aesthetic design. The mimicry of the Japanese in his ready adaptation to new conditions, exemplified by his effort to improve his oral hygiene. The laissez faire of the Latin, or should it be status quo?

When Japanese prisoners of war began to arrive in New Zealand they were given the same generous treatment. They were in camp at Featherson in the Wairarapa and were provided with an NZDC dental section as a matter of course, which is in marked contrast to the service received by our prisoners of war in Germany, Italy and Japan. (See Chapter 32.)

Treatment for our Allies

When the first troops arrived in New Zealand from the United States of America, they brought their own dental officers with them. The NZDC offered full co-operation, such as extending the facilities of its hospitals, lending equipment and replenishing stores or acting as locum tenens.

New Zealand, however, was not the front line for the American troops and most of them soon moved up into the Pacific, taking their dental organisation with them. Those who remained were not in sufficient numbers to warrant the provision of the United States Dental Corps to treat them.

The DDS arranged that those men attached to the United States Joint Purchasing Board should receive full dental treatment at the Wellington Dental Section by appointment through their own headquarters with the dental officer in charge.

In 1945 the DDS was asked by the United States Government representative in New Zealand to give dental treatment to the men of American ships calling at New Zealand ports. By this time the NZDC was not so widely distributed in New Zealand as previously so dentists in each port were nominated to carry out the work at the scale of fees then operating for the Government National Dental Service Scheme for adolescents. Between the NZDC and the civilian dentists a considerable amount of work was carried out for ships of the United States.

A ship that received regular attention from the NZDC was the No. 1 Netherlands Hospital Ship Oranje. She carried an NZDC section which, in addition to being responsible for the 2 NZEF men for whom it was primarily put on board, carried out the necessary treatment for the Australian, English, American and Canadian troops, and the ship's staff and German internees. On at least one occasion the Royal Netherlands Navy also received treatment from the NZDC.

Recording and Reporting

The life of the Corps depended to a large extent on accurate information being individually recorded and collectively analysed. Most of the recording was standardised by the use of printed forms. Reports were daily, weekly, monthly and sometimes annually, each with its definite destination through rigid channels of communication.

Anything not covered in this way was embodied in a written report by the dental officer commanding the section. This report was not compulsory and was often omitted. It may not have appeared, either to the dental officers or to the DDS, to have been of vital importance at the time, but the value to the historian cannot be too strongly stressed. It represented the thoughts and problems of the officers most intimately connected with the details of the NZDC organisation which can never be recaptured by studying impersonal official reports. In this respect the war diaries of commanding officers overseas varied from the bare record of daily routine duties to vital human documents providing richly coloured miniatures to enrich the finished canvas. It should be borne in mind that apparently unimportant details when connected together often produce an answer of the utmost importance. The progress of the Corps in the future might well depend on the faithful recording of every detail, however unimportant it might seem at the time.