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The Dental Corps

AMEDD Corps History > U.S. Army Dental Corps > Walter D. Vail and the History of the U.S. Army Dental Corps

DENTAL BULLETIN SUPPLEMENT TO THE ARMY MEDICAL BULLETIN

VOLUME 5, NO. 3 (July 1934)

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THE DENTAL CORPS

(Continued from page 98, April issue)

RECOMMENDATIONS

* The following recommendations are offered:

That the item “table, mess, folding,”' be added to the dental supply table, and one of these articles be issued to each dental surgeon at the itinerary stations. They are admirably adapted to the use of dental surgeons by being placed at the right side of the chair, having dental instrument chest No. 1 placed at one end facing inward, in lieu of a cabinet. This brings the trays of each chest within reach and permits of the space of table between chests being used for placing instruments and appliances within reach. They occupy a small space when folded and will make a valuable addition to the portable or field outfit.

That the dental outfits prescribed under paragraphs 339, 345, M.M.D.[Manual of the Medical Department], be amended to read as follows:

1st. All articles itemized under paragraphs 840, 341, 342, 343, and 344 be designated “Field Dental Outfit.”

2nd. All articles itemized under “a and b” paragraphs 345 with 341 and 343 be designated “Post Dental Outfit.”

3rd. All articles itemized under “c and d” paragraph 345 be designated “Dental Laboratory Outfit.”

That provision be made in the near future to reorganize the Dental Corps, U.S.A., giving it an official status in the permanent establishment.

Such reorganization can be effected without increasing the present expense of the Corps, which at the last appropriation

*(A continuation of Dr. Robt. T. Oliver’s report of activities of the Dental Corps, Philippine Islands, April 1901 to June 30, 1904).


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figured at $56,160, the new organization to contemplate the establishment of four grades (one file only for the highest) with the rank, privileges, emoluments, etc., equal to that of corresponding grades of the Medical Department.

* * *

That two Hospital Corps men instead of one (Par. 1581 A. R.) be assigned to dental surgeons as assistants. This will greatly increase the professional efficiency of the Dental Surgeons by relieving them of the less important duties. One Corps man who shows an aptness for same can be used as an operating assistant at the chair, caring for all instruments, their sterilization, preservation, etc., the other assistant can be taught the preparation of the dental surgeon’s records and paper work, including requisitions, records of operations, and the various reports, returns, etc. * * *

TRANSPORTATION

The transportation of dental surgeons with their assistants and equipment has been an important factor for consideration in this Division as it has been frequently necessary to insure safety from the molestation of marauding bands of natives. In the early days it was not uncommon for the dental surgeon and his outfit to travel among the various stations of his itinerary in the mountain districts, per pack train with an escort of armed men for protection ; and on many occasions it has been necessary for them to travel from one station to another aboard sailing praos with large bamboo outriggers. Recently, though, land transportation from one station to another has been effected by escort or light wagon, or by railroad (Manila and Dagupan) when practicable; and water transportation has usually been made aboard chartered inter island transports.

Transportation of dental surgeons by either the Army or Chartered Transports has very little to recommend it, except the final and ultimate destination. These vessels are assigned to certain routes and are only supposed to have two sailings per month. Owing to many exigencies of the service they have frequently been unable to make more than one sailing per month, which has resulted in unavoidable delays of dental surgeons at


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certain stations of their itineraries. Great care has been exercised in prescribing the routes, periods of time and departures from the itinerary stations, to make same correspond as nearly as possible with the sailing dates of transports to and from stations. This method has, in a way, modified the periods of time for which dental 'surgeons have heretofore been kept awaiting transportation; but owing to the uncertainty of transport sailings and indirect routes, a loss of three to twelve days has frequently occurred. On several occasions it has been deemed advisable to wire instructions to dental surgeons to accept passage on commercial interisland liners. These cases have been exceptions, however, and only when there seemed urgent need for the dental surgeon to make quick transportation to the next station.

CHARACTER OF SERVICE

The general efficiency of the Corps Service has been highly satisfactory to all concerned. The value of their services in relieving acute suffering for the thousands of men treated, the preservation of the vast number of teeth, the restoration of mouths to a healthy condition, and the consequent return of patients to a fit condition for martial duties, is a great factor that should not be overlooked .when considering the matter of a permanent and adequate organization of the Corps on a commissioned basis.

The numbers of men whose efficiency as soldiers has been materially 'benefitted by prophylactic treatment and the maintenance of a hygenic condition of the oral cavity (and incidently improving the entire digestive tract) has been worth the total expense of the Corps. Many cases of gastro-intestinal diseases, which for greater or less periods of time have been augmented by the ingestion of pyogenic bacteria, have been benefitted by the elimination of diseased oral conditions. Many oral surgical cases, such as fractured jaws, necrosis of bone, caries of bone, impacted third molars, empyema of the maxillary sinus, ranula, exsection of nerve trunk, exsection of jaw, etc., have been treated in the Division.

These operations coming within the jurisdiction of specialists in oral surgery, have been greatly appreciated by the Medi-


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cal Officers to whom they have come under observation. Of all oral surgical operations performed at Dental Base No. 1, there has been 100% of cures resulting.

* * *

ITINERARY SERVICE

This class of service has been continuous throughout the Division for the same reason for which it was inaugurated in the fall of 1901, to wit: “That the greatest benefit to the greatest number could be accomplished by sending dental surgeons to stations throughout the departments, instead of sending dental patients to dental surgeons at only the one centrally located station of their territory.” This plan was, however, been modified to a certain extent by Division Orders issued the first of the year 1903, which permit the dental surgeon to visit only a certain number of large stations throughout the territory assigned him, creating substations of the smaller stations, and requiring dental patients to be sent to the dental surgeon at his nearest regular station, in charge of a non-commissioned officer, reporting at such dates as may be previously arranged for between the dental surgeon and the commanding officer. This plan has resulted in very material benefit and has given greater time for the dental surgeon to practice a more conservative treatment. It has worked very satisfactorily in regard to dental patients at substations and has eliminated the loss of time necessary to the packing, repacking, and unpacking the outfits, awaiting transportation and during transportation as shown by previous year's records when all stations were visited.

All dental surgeons excepting those on duty at dental base stations have been visiting itineraries of stations throughout their respective departments.

DENTAL BASE STATIONS

Realizing early that it would be impracticable for any dental surgeon on duty at department stations to attempt other than operative dental treatment for the troops in his district, on account of unportable character of laboratory equipment, supplies, etc., and yet recognizing the importance of prosthetic treatment


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for those men who had lost a sufficient number of teeth to materially modify their masticatory functions; it was deemed expedient to establish a prosthetic dental laboratory in connection with the dental office at the headquarters of each department, to be designated as Dental Base Stations, where, it was contemplated, all prosthetic cases occurring throughout the respective departments should be transferred by proper authority for the required treatment.

In addition to the above, oral surgical cases coming within the jurisdiction of the department dental surgeons, were to receive the necessary operation or treatment, and the dental surgeon in charge was to render operative dental treatment to all officers and enlisted on duty at the department headquarters or post where his base station was located. A majority of all oral surgical cases, however, have been transferred to Dental Base Station No. 1, Manila, for operation.

Two Dental Base Stations were equipped and established in the early part of 1902,—at department headquarters, Manila, P. I., and at Cebu, Cebu, P. I., where they remained until the reorganization of the Division about October 1902, incident to G.O. No. 191, Headquarters Division of the Philippines, series 1902, when the one at Cebu, Cebu, was transferred to Iloilo, Panay, headquarters of the Department of the Visayas, and another Dental Base Station was equipped and established at the headquarters of the newly created Department of Mindanao,—at Zamboanga, Mindanao. These stations are numbered respectively, Dental Base Stations No. 1, No. 2, and No. 3; according to the sequence of their establishment. They have been the most important dental stations of their departments, have rendered valuable service along their prescribed line, and have been in charge of competent dental surgeons who have been selected by demonstrated merit in the specialty of Military Dental Surgery and all that is embraced within that term. The appointment to these important stations has been considered in the light of promotion.


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OFFICE ACCOMMODATIONS

As a rule, Dental Surgeons have been given the best room available for their operations at the various stations of their itineraries; usually a part of the hospital has been assigned for the purpose, although it has not been uncommon that rooms have been assigned in the houses of Quartermasters, or even of Commanding Officers, where a better operating light has been obtainable. Generally speaking, Dental Surgeons have received very courteous treatment from officers at their stations, in regard to their accommodations and personal welfare. This has been due largely to an appreciation of the invaluable services performed by these specialists in maintaining the health and physical fitness of the commands. At home, or proper stations, it has frequently been the rule to assign a house to the dental surgeon, large enough to be used for an office and for living quarters. This plan has proven very satisfactory to all concerned. At Camp McGrath, near Batangas, Batangas province, where two Squadrons of the 112th [sic, 12th] Cavalry are stationed, the commanding officer had a building specially constructed for a dental office, from the plans submitted by the Dental Surgeon then on duty there. This exemplary action of the Regimental Commander has been greatly appreciated by the Dental Corps, and it is hoped it may establish a precedent that will result in similar actions being taken at other important large stations in the Division. It was recommended from this office about a year and a half ago, “that, adequate provisions be made for the construction of suitable offices and operating rooms for the use of dental surgeons at each army post now building or under contemplated construction in the Division. Early advantage to thus be taken to secure ample space; a north (operating) light, high and wide windows, good ventilation, convenient lavatory, supply lockers, etc.” Three letters of similar character have been forwarded to the Adjutant General, Philippines Division, in regard to provisions to be made in the plans for a hospital at Fort William McKinley, Rizal province, now building, for the construction of a suitable office and operating room (as above described). Two of said letters were filed in the Chief Surgeon’s Office, Philippine Division, and the third, dated October


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1, 1904, was forwarded approved, but has not had time yet to be heard from; it is hoped it may be approved, as Fort McKinley will be a Brigade Post and the most important station in this Division, with a sufficiently large number of troops to warrant the permanent assignment of a Dental Surgeon, who should have every convenience at hand to assist in the performance of his arduous duties, doubtly [sic, doubly] fatiguing in this tropical climate.

In the early part of the Dental Corps service in this Division, it became necessary on several occasions for a dental surgeon to visit Camps when troops were in the field on campaign; at Such Camps they were compelled to operate under canvas, and while much good was derived by the commands from the emergency treatment rendered, it was clearly demonstrated that a tent was a very poor and unsatisfactory place for dental operations, on account of the difficulty in securing proper light, which was either a too direct sunlight and consequently very hot, or else diffused through the top canvas which cast false shadows in the oral cavity; and it was found impossible to keep the delicate instruments of the outfit from rusting, on account of the moisture arising from the ground and that which beat through the roof.

SERVICE IN PEKING, CHINA.

Pursuant to instructions contained in par. 9, S.O. No. 32, Headquarters Philippines Division, dated Feb. 18, 1904, the Examining and Supervising Dental Surgeon on duty in this Division, left Manila, P.I., April 2, 1904, enroute to Peking, China, for temporary duty with the U. S. Legation Guard. Upon arrival April 21, he was informed that all the officers and men of the command, (“B” Co., 9th Infantry), required dental treatmerit, as the services of a Dental Surgeon had never been obtainable, and the character and professional ability of the two civilian dentists available (one Chinese and one Japanese), were such that few of the men would call upon them even in the most urgent cases. Subsequent examination of the Company showed that over 96% of the 142 men comprising the command were in immediate need of dental treatment and that several men had been temporarily relieved from duty at different times and placed on sick report on account of dental and oral lesions that


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could not be successfully treated at the hospital. In the services rendered this command it was the endeavor to place the mouths and teeth of all these men in as good condition as possible, saving all teeth that skilled treatment would permit, and in many cases, anticipating the inroads of decay by cutting suspicious spots out of teeth and permanently filling them, it being the intention to get the men’s teeth of that Company in a fit condition to last at least a year and a half, i.e., providing the same individuals of the company remained there for that period of time. In this connection it is deemed advisable, and therefore recommended, that all recruits hereafter transferred to the U.S. Legation Guard at Peking, China, be thoroughly examined by a dental surgeon, and their teeth put in condition for at least one and a half years’ service so that it will not be necessary to send a dental surgeon for temporary duty at that station oftener than that period ; and then it can be reasonably certain that under ordinary conditions there will be only a minimum amount of suffering in the command from dental lesions.

Following is a summary of cases presented and operations performed at Peking, China, for “B” Co. 9th Infantry, U.S. Legation Guard from May 1st to July 11, 1904:

* * *

CASUALTIES

One death has occurred in the Corps on duty in the Division. Contract Dental Surgeon C. A. Petrie, U.S.A., died on February 12, 1902, of pyorrprosis and intestinal obstruction. Dr. Petrie was a faithful and diligent officer whose efficiency at Appari, Cagayan, has met the unanimous commendation from officers at that station.

One Contract Dental Surgeon has been returned to the United States on account of sickness. Contract Dental Surgeon F. P. Stone, U.S.A., was transferred from sick in First Reserve Hospital, Manila, P.I., to the Army General Hospital, Presidio of San Francisco, California, on October 10, 1903, on account of a severe attack of amoebic dysenterry [sic, dysentery].


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SERVICES RENDERED.

Grand totals and aggregates of corrected summaries of Dental Cases Presented and Dental Operations Performed, from May 1, 1901 to September 30, 1904, are given below:

* * *

Grand total, Cases presented

78,587

Grand total, Operations performed

82,562

Grand total, Patients treated

30,262

 

 

PERSONAL SERVICE

The Examining and Supervising Dental Surgeon has been on duty since Oct. 21, 1901, in the Office of the Chief Surgeon of the Division, as executive officer of the Dental Corps; after the establishment of Dental Base Station No. 1, Manila, at the First Reserve Hospital, Manila, in March, 1902, he was directed to take command of same in addition to his other duties. With the exception of the tour of temporary duty at Peking, China, with the U.S. Legation Guard, from April 2nd to August 1st, 1904, his duties have remained the same during the entire three years of his service in this Division.

Very respectfully,

Robert T. Oliver,

Contract Examining and Supervising

Dental Surgeon, U.S. Army. (S.G.O. 89178 K-1).

__________

The foregoing report was forwarded October 25, 1904, to the Office of the Surgeon General by J. B. Girard, Assistant Surgeon General, U.S. Army, Chief Surgeon, Philippine Department. The following is extracted from his indorsement:

“Respectfully forwarded to the Surgeon General, U.S. Army, approved in a general way, and subject to the following remarks and strictures bearing on the writer’s recommendations.


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“Dr. Oliver recommends that the allowance of dental surgeons in the Philippine Islands be increased to 17, a number by no means excessive under present conditions. In this connection the undersigned respectfully invites attention to the fact that since the addition of dentists to the Medical Department of the Army, their services have been demanded by an enormous, ever growing proportion, reaching, perhaps, 90% of the rank and file. That is the case not only in the Philippines, where the climate is supposed, whether correctly or not, to induce dental caries, but in the home garrisons just as well. As the majority of the men is made up of young soldiers in their first enlistment, the conclusion is unavoidable that the diseased condition of their teeth can not, in most cases, be due to exposure or hardships connected with their service, but must have existed at the time of their enlistment. The calls for dentists from various Army posts, both in the United States and in the Philippines, are now so frequent and urgent, that, if it is contemplated to properly repair every recruits jaws and keep them thereafter in good working condition, the number of Army dentists must be greatly increased, more than doubled, certainly, for it is patently insufficient at present. But, if no increase is to be expected, the only practicable remedy to this faulty state of things must be the issue of strict injunctions to Recruiting Officers and Examining Surgeons; to carefully examine all applicants' jaws and to mercilessly reject all who do not possess absolutely sound teeth.

“With regard to the recommendation for the re-organization of the so-styled “Dental Corps, U.S. Army,” the undersigned desires to enter his emphatic disapproval of any such expression, and of all measures or efforts to give Army dentists a separate standing in the Army by the establishment of an independent hierarchy of grades, whether outside of the Medical Department, or within and connected with that Department itself, in the latter case, creating a sort of “imperium in imperio” subversive of military discipline by the division of authority and contrary .to the interests of the service. The care of soldiers' teeth, considered by itself, is undoubtedly a serious matter, and should be sedulously provided for, but, when looked at from the broad point of view of the Sanitary Service of the Army, it assumes much more modest proportions, and becomes simply an incident and a sub-


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ordinate subject among a multitude of other more important questions; * * * The Medical Department of the Army should be one and indivisible, constituting but one Corps under a single head and with but one line of grades, all, including dental and other assistants, subordinate to one and another according to rank and deriving their faculties from the same fountian [sic, fountain] head of authority.

“While expressing himself thus strongly on this special subject the undersigned is quite disposed to advocate the granting of military commissions to Dental Surgeons; he is of the opinion that the system of employing professional, men in the Army, on a quasi military footing as Contract Surgeons and Contract Dental Surgeons is radically wrong as long as these men are expected to associate on equal terms with military officers. Their present position is ambiguous, humiliating, and unsatisfactory in every way. Either let them be and remain civilians pure and simple, and stand on their own personal merit, or confer upon them military commissions which, by placing them on a level with their associates, will safe-guard their self-respect and secure for them the regard which they are legally entitled to from officers and enlisted men.”

(To be continued).

(NOTE:—This is the sixth installment of a series of articles pertaining to the organization of the Dental Corps and the development of the Army dental service. These installments area compilation of available records with such comment as is necessary to connect the record.—W.D.V.).