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Chapter II, Administration of the Dental Service

AMEDD Corps History > U.S. Army Dental Corps > United States Army Dental Service in World War II

Administration of the Dental Service

WORLD WAR I

Until World War I, no representative of the Dental Corps had been assigned for duty in The Surgeon General's Office (SGO). The affairs of the Dental Corps prior to this time had been administered as part of the routine work of the Personnel Division, SGO. However, on 9 August 1917 the Dental Section of the Personnel Division was organized, and Major William H. G. Logan, MC, was appointed as its first chief. Major Logan, who later became colonel, had both the D.D.S. and M.D. degrees. The Dental Section became the Dental Division on 24 November 1919.1 2

The following dental officers have served as Chief of the Dental Section or Director of the Dental Division, SGO, from 1917 to 1942:

Colonel W. H. G. Logan

1917-1919

Lieutenant Colonel F. L. K. Laflamme

1919

Colonel Robert T. Oliver

1919-1924

Colonel R. H. Rhoades

1924-1928

Colonel J. R. Bernheim

1928-1932

Colonel R. H. Rhoades

1932-1934

Colonel Frank P. Stone

1934-1938

Brigadier General Leigh C. Fairbank3

1938-1942

WORLD WAR II

Dental Division, SGO

During World War II, Army regulations prescribed that "matters relating to the dental service as a whole are administered by The Surgeon General with the advice and assistance of the Dental Corps assistant to The Surgeon General." In 1939 the duties of the Director of the Dental Division were described as follows: 4

    The Dental Corps assistant to The Surgeon General will serve as the Chief of the Dental Division of The Surgeon General's Office and will be responsible to that officer

    1Lynch, C., et al.: The Medical Department of the U. S. Army in the World War. Washington, Government Printing Office, 1923, vol I, p. 191.
    2Logan, W. H. G. : The development of the dental service of the United States Army in this country from 8 Apr 17 to 12 Feb 19. J. Am. Dent. A. 20: 1951-1959, Nov 1933.
    3The rank of brigadier general in the Dental Corps was authorized by Public Act 423, 75th Congress, 29 Jun 38.
    4AR 40-15, 20 Apr 39.


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    for the recommendation of plans and policies for the progressive development of the dental service, with special reference to measures for the preservation of the general health of the Army by the prevention and control of dento-oral diseases and deficiencies among persons subject to military control; for advising measures to place approved plans and policies into effect; and for giving technical advice to The Surgeon General on all matters pertaining to the dental service.

The Director of the Dental Division,5 as an adviser to The Surgeon General, thus had no formal authority in his own right. His recommendations were subject to The Surgeon General's approval and he could not present his views directly to higher officers. But while the Director of the Dental Division exercised very little legal authority over the operation of the Dental Service, his advice on purely dental-questions was accepted so routinely that from a practical point of view he enjoyed a substantial measure of actual control over the Dental Corps and its activities (figs. 1, 2, and 3).

The decision of the Director of the Dental Division was therefore generally accepted on the following matters which were, of little concern to other agencies:6

    1. The assignment of individual dental personnel to subordinate major commands. [He could not, however, control the assignment of dentists to specific posts or duties within those commands except in the few installations directly under the control of The Surgeon General.]
    2. The selection of items of dental supply for listing in the medical supply catalog.
    3. The development of courses of training for dental personnel, within time limits prescribed by higher authority.
    4. The establishment of professional standards of dental treatment.
    5. Professional requirements for commission in the Dental Corps.
    6. Types of treatment to be authorized.

However, as a subordinate of The Surgeon General the Director of the Dental Division could exercise no powers not enjoyed by The Surgeon General himself, and the latter's authority was by no means unlimited. The Surgeon General exerted great influence in those matters which concerned the Medical Department, but he had to defend his proposals against opposition from other interested officials, and the right of final decision remained with the executive branch in the person of the Commanding General, Army Service Forces; the Chief of Staff or the Secretary of War. Thus when The Surgeon General

    5The Director of the Dental Division at the start of the war and during the early mobilization period was Brig Gen. Leigh C. Fairbank. At the end of his tour of duty on 17 Mar 42, General Fairbank was succeeded by Brig Gen. Robert H. Mills. The latter was promoted major general on 7 Oct 43, becoming the first dental officer to hold that rank. When General Mills retired on 17 Mar 46 his responsibilities for postwar policies and development were assumed by Brig Gen. Thomas L. Smith (later Maj Gen.) who had been dental surgeon of the European theater during the combat period.
    6The practical authority of the Director of the Dental Division was based on custom rather than upon statute, and its extent is therefore a matter of opinion, not subject to documentation. The statements made here are based on personal conferences with Major General Mills and with most of the other senior dental officers who served in the Dental Division during the war.


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BG Leigh C. FairbankFigure 1.  Brig. Gen. Leigh C. Fairbank, Director, Dental Division, 17 March 1938-16 March 1942

 

 

 

 

 


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MG Robert H. MillsFigure 2.  Maj. Gen. Robert H. Mills, Director, Dental Division, 17 March 1942-16 March 1946

 

 

 

 

 


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BG Thomas L. SmithFigure 3.  Brig. Gen. Thomas L. Smith, Director, Dental Division, 17 March 1946-20 April 1950

 

 

 

 

 


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recommended, on the advice of the Director of the Dental Division, that dental officers be furnished tactical units in a ratio of 1 officer for each 1,000 men, he was overruled when tactical officers convinced the Chief of Staff that such action would add too much to the noncombat overhead of the fighting commands. Similarly, the recommendations of the Director of the Dental Division were given serious consideration, though not always accepted, on the following matters which affected the Dental Service:

    1. Dental standards for military service.
    2. Personnel requirements for the Dental Service.
    3. Tables of organization and equipment for dental installations.
    4. Dental reports and records.
    5. Plans for dental installations.
    6. Personnel authorized to receive dental care.

When the United States entered the war, the Director of the Dental Division, then a brigadier general was responsible directly to The Surgeon General. He was assisted by a. staff of 5 officers and 8 civilian employees. The Dental Division was divided into sections for Finance and Supply, Military Personnel, Plans and Training, and Statistics, with the following assigned responsibilities:7

    Executive Officer:

      a. Supervision of mail and records.
      b. Review and recommendations of action on inspection reports.
      c. Selection and assignment of dental interns.
      d. Coordination of subdivisions of the Dental Division.

    Finance and Supply:

      a. Recommendations on selection and distribution of dental equipment and supplies.
      b. Recommendations on matters pertaining to construction and alteration of dental installations.
      c. Recommendations on claims for dental attendance.

    Military Personnel:

      a. Initiation of recommendations to the Personnel Division, SGO, for assignment and transfer of dental personnel.
      b. Transcription and review of efficiency reports.
      c. Classification of personnel. d. Review of applications for commission in the Dental Reserve Corps.
      e. Examination of models of teeth and decisions as to dental qualifications.

    70rganization of the Dental Division during the war was very informal and subject to change on short notice in accordance with the number and experience of the assigned personnel. Three days after this organization was outlined Brig Gen. Leigh C. Fairbank described five sections in the Dental Division: (1) Personnel, (2) Professional Service, (3) Plans and Training, (4) Statistical, (5) Miscellaneous.


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    Plans and Training:

      a. Preparation of manuals and films for training dental service personnel.
      b. Preparation of administrative regulations pertaining to the Dental Service.

    Statistics:

      a. Collection of historical data on organization and functioning of the Dental Service.
      b. Review of articles for publication and editing of Army Dental Bulletin.
      c. Review of professional reports.
      d. Tabulation of statistical data.

By 30 June 1942 the staff of the Dental Division had reached its maximum strength of 7 officers (including the Director) and 13 civilian employees. The internal organization of the Division underwent. several changes during the war, but they were of a minor nature.8

With the reorganization of the Army in March 19429 all service and supply branches were placed under a newly formed "Services of Supply" (SOS), later called "Army Service Forces; (ASF). Under this plan The Surgeon General was made responsible to the Commanding General, SOS, rather than to the Chief of Staff, and medical affairs had to be cleared through ASF headquarters. Major dental policies therefore had to be passed upon by (1) The Surgeon General, (2) the Commanding General, ASF, and (3) the General Staff, before they could be made effective. The formation of ASF also proved to be the first step in a general decentralization of authority to the corps areas (later the service commands), a policy which ultimately affected the operation of the Dental Division to a marked degree. Previously, The Surgeon General had had considerable control over the field performance of medical activities, including the immediate supervision of general hospitals and the privilege of assigning personnel to specific installations. In the Annual Report of Army Service Forces for 1943 it was stated that "With the creation of the Service Commands in July 1942, the Administrative Services, for the most part, ceased to have direct control over the field performance of their particular activity. Instead, responsibility ... was invested in the hands of Service Commanders."10 The Surgeon General was thus limited to prescribing general policies for the Medical Department, the application of which became the responsibility of service commanders. The control of general hospitals was delegated to the service commands in August 1942.11

    8Final Rpt for ASF, Logistics in World War II. HD: 319.1-2 (Dental Div).
    9WD Cir 59, 2 Mar 42.
    10Annual Report of the Army Service Forces for the fiscal year 1943 (cited hereafter as Annual Report . . . Army Service Forces).
    11AR 170-10, par 6, 10 Aug 42.


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The service commands were also given increasing authority over personnel. The system of "bulk allotment," in particular, practically ended any control The Surgeon General or the Dental Division might have exercised over the assignment or promotion of dental officers within the service commands. This system has been described as follows:12

    Under the system a . . . Service Commander is allotted a total number of officers, nurses, warrant officers, WAAC officers, enrolled women, and enlisted men, restricted only as to percentage in grade, or in small installations, numbers in grade.... It removes restrictions upon the distribution of grades among the personnel of the several arms or services, while preserving the limitations upon the distribution of grades within the total organization.

This policy of decentralizing the control of personnel to the service commands relieved the Dental Division of much routine detail which could be handled more efficiently locally, but it also made the correction of inequities more difficult when these were found to exist.

On 26 March 1942, the Dental Division was redesignated the "Dental Service."13 This change was mainly a "paper transaction" and had no appreciable effect on the operations of the Dental Corps. On 1 September 1942, however, a modification was announced which had more far-reaching results. Up to this time the Dental Division had been an independent branch of the Office of The Surgeon General, and its director had had direct access to that official. Now the Dental Service was placed, with a number of other medical specialties, under a newly organized Professional Services group. The Director of the Dental Division no longer had direct access to The Surgeon General, and all the many decisions affecting some 15,000 officers had to be passed on by at least three higher officers, and usually four, before they could be put into effect.14 This was not an altogether new experiment since the Dental Division had been placed under Professional Services in 1931,15 but it had been found advisable to restore its independent status in 1935.16 The Director of the Dental Division stated that during the war "The Dental Corps experienced greater administrative difficulties while under Professional Service, since all recommendations and activities had to be cleared through that Service to The Surgeon General. Such clearance through Professional Service required too much time when time was at a premium."17 The Dental Division was restored to its independent status on 25 August 1944.18

The Director of the Dental Division claimed repeatedly that there was great need for representation by dental officers in other divisions of the SGO dealing with matters affecting the Dental Service. He stated that "The

    12ASF Cir 39, 11 Jun 43.
    13Annual Report . . . Surgeon General, 1942. Washington, Government Printing Office, 1942.
    14SG OO 340, 1 Sep 42.
    15Annual Report . . . Surgeon General, 1932. Washington, Government Printing Office, 1932.
    16Annual Report . . . Surgeon General, 1936. Washington, Government Printing Office, 1936.
    17See footnote 8, p. 28.
    18SG OO 175, 25 Aug 44.


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Dental Corps ... is vitally interested in all personnel problems, all supply problems, all operations and planning, as well as all training problems," and he recommended that dental. officers be placed in the divisions occupied with these activities.19 Under the stress and confusion of wartime it was very difficult to keep informed of impending actions or changes of policy unless close liaison were maintained. A dental officer was actually assigned to the Supply Division from November 1942 to March 1943.20 Later, in May 1943, representation was established in the Military Personnel Division and continued for the duration of the war.

DENTAL ADMINISTRATION IN CORPS AREAS
(SERVICE COMMANDS)

The administrative status of the senior dental officer in a corps area (service command after 22 July 1942) was analogous to that of the Director of the Dental Division in the War Department. The corps area commander had full executive authority, while the surgeon was his adviser on matters concerning the Medical Department. The dental surgeon was, in turn, charged with furnishing "advisory and administrative assistance to the corps area surgeon on matters pertaining to the dental service in the corps area ."21 Specifically, he made recommendations concerning allotments and assignment of enlisted men and officers, the proper issue and use of dental supplies, the adequacy of contemplated construction of dental facilities, the training program for dental officers and enlisted personnel, and the publication of orders concerning the Dental Service. The corps area dental surgeon could not issue orders in his own name, but submitted his problems to the corps area commander through the surgeon.

Like the Director of the Dental Division in the SGO, the corps area dental surgeon exercised considerable influence over the actual operation of the Dental Service in spite of formal limitations on his authority. His recommendations were normally accepted without question in respect to:22

    1. The assignment of officers to subordinate installations, within the authorized total strengths.
    2. The authorization of equipment and supplies for dental installations.
    3. The operation of central dental laboratories and the dental services of general hospitals.
    4. The construction of dental facilities.

    19See footnote 8, p. 28.
    20WD SO 300, par 10, 4 Nov 42.
    21See footnote 4, p. 22.
    22Statements concerning the powers of corps area dental surgeons are of course not applicable to all service commands at all times. Some dental surgeons enjoyed greater authority, some less. The summary given here represents only the combined opinions of many senior dental officers interviewed during the war.


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    5. Directives concerning clinical treatment.

His advice concerning the following was considered seriously, but not necessarily accepted if opposed by other staff divisions:

    1. Total requirements for enlisted and commissioned personnel.
    2. Allotments of personnel for training.
    3. The promotion of dental officers.

At the start of the war general hospitals were operated directly under The Surgeon General, but after August 1942 they became the responsibility of the service command surgeon, and the service command dental surgeon exercised more or less direct control over their dental services.23 Central dental laboratories were operated under corps area and later, service command, supervision during the entire war.

Prior to October 1940 the duties of corps area dental surgeons were performed, in addition to their normal functions, by senior dental officers assigned in the vicinity of corps area headquarters,24 though it was provided that full time officers would be assigned in time of war. Dental surgeons were specifically assigned to the corps areas beginning in October 1940, and a revision of Army regulations in December 1942 provided for routine peacetime assignment of service command dental surgeons.25

The Director of the Dental Division believed that service command dental surgeons were somewhat hampered by their lack of direct contact with other staff divisions. They could present their views only through the surgeon, and they received only the information relayed to them by that officer. The Director of the Dental Division reported that service command dental surgeons were limited in their authority and that they had insufficient assistance to enable them to perform their office duties and at the same time maintain the necessary supervision in the field.26

DENTAL SECTION OF THE AIR SURGEON'S OFFICE,
ARMY AIR FORCES
27

Prior to 28 January 1942, dental affairs in the Office of the Air Surgeon had been administered by the particular division most concerned, i. e., personnel affairs by the Personnel Division, etcetera. On that date a Dental Section was established and Lieutenant Colonel George R. Kennebeck was assigned as Deputy for Dental Service.28 The need for dental representation in the Office of the Air Surgeon had been pointed out by the Dental Division in Sep-

    23See footnote 11, p. 28.
    24See footnote 4, p. 22.
    25AR 40-15, 28 Dec 42.
    26See footnote 8, p. 28.
    27Kennebeck, George R.: Dental service of the U.S. Air Forces. Mil. Surgeon 101: 385-392. Nov 1947. (A more complete history of the Air Force Dental Service was (Jan 48) being written by Lt Col Walter J. Reuter.)
    28WD SO 2, par 16, 2 Jan 42.


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tember 194129 but action was delayed by the opposition of the Air Surgeon himself.30 The new Dental Section assumed staff functions for that part of the dental service assigned to the Air Forces not in theaters of operations. The Dental Division, SGO, continued to prescribe general policies and procedures applicable to the Army Dental Service as a whole, but it no longer acted on those problems peculiar to the Air Force. The functions of the new division were specifically outlined as follows:

    1. Review reports of dental activities with the Army Air Forces.
    2. Review articles submitted by dental officers with the Army Air Forces prior to publication in professional journals.
    3. Initiate timely recommendations for changes in types and allowances of dental supplies and equipment.
    4. Make recommendations to the Officers' Section, Personnel Division, regarding assignment, reassignment, and promotion of dental officers with the Army Air Forces.
    5. Exercise professional supervision over dental personnel with the Army Air Forces.

The Air Surgeon's Office did not directly control the dental services with Air Force units in theaters of operation; these were under the supervision of theater chief surgeons. However, Air Force commands in foreign theaters did have dental staff officers who were responsible for the dental service of air units, under the theater chief surgeons. Dental personnel for the Air Force were commissioned by the Army and requisitioned as needed from The Surgeon General.

ADMINISTRATION OF THE DENTAL SERVICE
IN CAMPS AND STATIONS

In subordinate installations in the Zone of Interior the senior medical officer retained his status as adviser to the commanding officer, but he usually became commander of the hospital or dispensary as well, thus exercising control not only over the making of policies, but over their direct application at the operational level. The dental surgeon, on the other hand, did not become commanding officer of the dental clinic, and legally he continued to enjoy only the right to make recommendations to the surgeon concerning the dental service. In practice he might be delegated almost complete authority by the latter, but such authority was a privilege, not a right, and it varied widely in different installations.

The dental surgeon of a camp or station generally had reasonably effective control over the following activities:

    29Memo, Brig Gen. Leigh C. Fairbank for SG, 25 Sep 41, sub: Dental Service for the Air Corps. SG: 703-1.
    30Memo, Col. David N. W. Grant for Exec Off SGO, 1 Oct 41, sub: Dental Service for the Air Corps. SG: 703-1.


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    1. The assignment of dental enlisted and commissioned personnel to duties within the dental clinic.
    2. The supervision of treatment given. Army regulations provided that "except as otherwise prescribed herein, the selection of professional procedures to be followed in each case, including the use of special dental materials, will be left to the judgment of the dental officer concerned."31
    3. Initiation of requisitions for supplies for the dental service.
    4. The conduct of dental surveys.
    5. The technical training of personnel assigned to the dental service.

His recommendations were customarily given serious consideration in respect to the following, but they were not always accepted, and under unfavorable circumstances they might practically be ignored:

    1. Requirements for dental personnel or facilities.
    2. Promotion of personnel assigned to the dental clinic.
    3. Leave or furlough privileges for personnel of the dental service.
    4. Efficiency reports on dental personnel.

The dental surgeon often had little to say about the following:

    1. The use of clinic personnel for duties outside the dental clinic.
    2. Training of dental personnel, outside of training rendered in the dental clinic.

ADMINISTRATION OF THE DENTAL SERVICE,
ARMY GROUND FORCES

When the Army Ground Forces (AGF) was established in 1942 as a separate command of the Army no provision was made for a complete medical staff. A small division for Hospitalization and Evacuation was included in Headquarters, AGF, but it was expected that most medical functions would be performed by The Surgeon General. No dental officer was assigned to AGF headquarters. Under The Surgeon General, the Dental Division had authority to prescribe policies for the entire Army, including AGF and Army Air Forces (AAF), but operation of the Dental Service for such a large part of the Armed Forces inevitably involved emergency situations requiring immediate action. Lack of liaison with AGF headquarters delayed solution of some of these problems and increased the difficulty of arriving at decisions based on full and accurate information. An attempt was made to have a dental officer assigned to AGF in the spring of 1945, but it met with no success. The Director of the Dental Division later claimed that lack of liaison with AGF had hampered the Dental Service significantly.32

    31AR 40-510, par 1, 19 Feb 40.
    32See footnote 8, p. 28.


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ADMINISTRATION OF THE DENTAL SERVICE
IN A THEATER OF OPERATIONS
33

A theater dental surgeon made recommendations to the theater chief surgeon concerning plans and policies for the dental service of the entire area, including the Air Forces. He advised in respect to requirements for supplies and personnel; he consolidated and forwarded dental reports for the theater; and he made the inspections required to assure a high standard of dental care in compliance with the directives of his own and higher headquarters. The theater dental surgeon was also, very often, the dental surgeon of the communications zone and in that capacity he supervised the operation of the hospital dental services in that communications zone, the dental treatment of service personnel, and the operation of central dental laboratories.

Theaters necessarily enjoyed considerable independence of action, and the theater dental surgeon, under the chief surgeon, had a great deal of freedom in planning for the dental service, as long as personnel allotments were not exceeded and major regulations and policies were not violated. As in other headquarters, however, he was subordinate to the theater chief surgeon and he could act only with the approval of that officer.

    33See chapter VIII.