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Chapter III, The Procurement of Dental Officers

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

PROCUREMENT IN WORLD WAR I

At the time of the armistice, World War I, the strength of the Dental Corps totaled 6,284 officers. Not all of these had been called to active duty however, and the maximum number actually functioning with the Corps at any one time was 4,620.1 As nearly as can be determined, a little over 1,500 additional dentists who did not serve in their professional capacity were in the land forces as enlisted men.2 The Navy Dental Corps expanded from a total of 30 dental officers at the outbreak of hostilities to over 500 by the end of 1917,3 but the number of dentists serving as enlisted men in that organization is not known.

The Army, alone, enlisted or inducted 1,789 dental students, and the schools were so depleted that only 906 dentists graduated in 1920 as compared with 3,587 the year before.4

At the start of World War I, dentists were provided in an overall ratio of 1 officer for each 1,000 troops, but this figure proved so inadequate that on 30 September 1918 an increase to 2 dentists for each 1,000 men in the continental United States was authorized, and the allowance for hospitals was fixed at 3 officers for each 1,000 beds.5 The war ended, however, before these ratios could be placed in effect. In 1919 the War Department supported a bill to provide 1 dentist for each 500 men in the peacetime establishment, but in spite of the backing of The Surgeon General and the Secretary of War this legislation failed to pass.6

The grades held by Army dentists at the end of the war were as follows:7

Colonel

9 (0.2 percent)

Lieutenant colonel

17 (0.4 percent)

Major

91 (2.0 percent)

Captain

292 (6.5 percent)

Lieutenant

4,101 (90.9 percent)

    1Annual Report . . . Surgeon General, 1919. Washington, Government Printing Office, 1919, vol. II.
    2Ibid.
    3Annual Report of The Surgeon General, U. S. Navy, 1918. Washington, Government Printing Office, 1918.
    4Horner, Harlan H.: Dental education and dental personnel. J. Am. Dent. A. 33: 872, Jul 1946.
    5See footnote 2, above.
    6Colonel Logan's Farewell Letter to the Dental Corps. J. A. Mil. Dent. Surg. U. S. 3: 78-80, Apr. 1919.
    7See footnote 1, above.


36

THE DETERMINATION OF REQUIREMENTS FOR
DENTAL OFFICERS, WORLD WAR II

Experience Prior to World War II

In the decade preceding the Second World War, the average civilian dentist was responsible for about 1,800 persons, including infants and the aged who required little or no attention, though the ratio varied from approximately 1:500 in certain urban centers to less than 1:5,000 in some rural districts.8 9 Dental care for the civilian population was notoriously deficient. It was freely admitted that not over 25 percent of the public received the care needed to preserve dental health,10 11 and representatives of the dental profession estimated that it would require 1 dentist for each 524 persons just to provide annual maintenance treatment, with no attempt to correct old, accumulated defects. It was further estimated that the fantastic figure of 1 dentist for each 295 persons would be needed to rehabilitate the entire population in one year. These figures had little significance in determining dental officer requirements for a military population for the following reasons:

1. While the average civilian dentist actually saw only about 400 patients a year, many of them received nothing but emergency treatment.12 13 However, all of the military dentist's patients, regardless of the number, were in the age group needing constant and extensive care.

2. The stresses of military life required that the soldier have a higher level of dental health than his civilian contemporary.

3. The military dentist inevitably lost more time from professional duties than the civilian dentist: he had to devote more time to training for purely military functions, and his work was interrupted by maneuvers and tactical exercises.

Prewar military experience failed equally to provide an answer to the requirement problem. In the years between 1920 and 1939 the inadequate 1:1,000 ratio of World War I was liberalized somewhat, but it never exceeded 1.44 per 1,000 troops, as indicated in the following tabulation:14

    8See footnote 4, p. 35.
    9Bagdonas, Joseph E.: Economic considerations in reestablishing a dental practice. J. Am. Dent. A. 33: 4-20, Jan 1946.
    10Morey, Lon W.: Dental personnel. J. Am. Dent., A. 32: 131-144, Feb 1945.
    11Dollar, Melvin L.: Dental needs and the costs of dental care in the United States. Ill. Dent. J. 14: 185-199, May 1945.
    12See footnote 4, p. 35.
    13See footnote 9, above.
    14Memo, Col Albert G. Love for SG, 2 Oct 39, sub: Allowance of medical and dental officers. [D]


37

 Date

Number of officers authorized

Authorized ratio per 1,000

4 June 1920

298

1.00

30 June 1922

158

1.08

15 May 1936

183

1.26

29 January 1938

258

1.44

3 April 1939

*316

1.39

*This authorized strength was not reached prior to the war, and there were only about 269 dentists in the Regular Army Dental Corps in April 1942.

Based on the estimation that a proportion of 1 dentist for each 524 persons would be required just to provide maintenance care, it is not surprising that the cited peacetime authorizations proved inadequate. In 1928, when the ratio was approximately 1 dentist per 1,000 personnel, the Director of the Dental Division, SGO, reported that:15

    . . . a one to 1,000 proportion of dental officers to total strength is quite insufficient. Dental diseases in our Army have been, and . . . are today out of control. There is a limit beyond which it is impossible to go without more personnel. We are today approaching that limit, and about 50 percent remain who are continually in need of dental service.

In 1941, at a hearing before the Committee on Military Affairs, Brig. Gen. Leigh C. Fairbank16 testified that even under peacetime physical standards a 1:750 ratio had also fallen short of minimum needs.

By the start of the Second World War, therefore, experience had shown that any ratio of less than 1 dental officer for 750 men would be grossly inadequate, but since more liberal ratios had not been tried in practice experience was of little value in predicting the need for dental officers for the defense forces.

Estimates Based on Actual Requirements
for Dental Treatment

Had it been known exactly how much work the average wartime inductee would require it would have been possible to calculate the number of dental officers needed at any stage of mobilization. Were it known, for instance, that each new man would require 7.2 hours of treatment for the correction of old, accumulated defects, and 1.8 hours of treatment each year thereafter for regular maintenance care, the needs of a static force of 1,500,000 men, with a yearly turnover of 25 percent, could have been determined as follows:

 

Hours

1.8 hours of care for 1,500,000 men (annual maintenance)

2,700,000

7.2 hours of care for 375,000 recruits (rehabilitation)

2,700,000

    TOTAL

5,400,000

Number of dentists needed

3,000 (1 per 500 men)

    15Rhoades, R. H.: The Dental Service of the Army of the United States. J. Am. Dent. A. 15: 257-264, Feb 1928.
    16Testimony, General Fairbank, 18-20 Mar 41, in U. S. Senate Hearings before Committee on Mil Affairs, S. 783, p. 161.


38

In this case, which might approximate actual conditions in a peacetime force if dependents received no care, a ratio of 1 dentist for each 500 men would prove adequate.

However, if this hypothetical force were to be increased by nearly 4,000,000 men in one year as occurred in the United States Army in 1942, the situation would be far different. Total needs would then be as follows: Hours 1.8 hours of care for

 

Hours

1.8 hours of care for 3,500,000 men (average strength during year)

6,300,000

7.2 hours of care for 4,000,000 men (recruits)

28,800,000

    TOTAL

35,100,000

Number of dentists needed

19,500 (1 per 180 men)

In this situation, which also might approximate actual conditions during mobilization, the ratio which was adequate for the static force would provide only about 36 percent of the dentists needed by the expanding Army. Later, however, after this augmented force reached stability, the need for dentists would again be met by the 1:500 proportion, or by an even lower ratio.

Unfortunately, reliable information on which to base actual calculations of requirements for dental personnel was entirely lacking at the start of World War II. The figures used in the preceding illustration are only convenient approximations, useful for the development of a general principle. In chapter VI it is shown that almost no data on the dental condition of males of military age were available when plans for the mobilization of the emergency dental service were being laid.

Even if dental needs were known with considerable accuracy, it would generally be impossible to procure and equip dental officers in strict accordance with calculated needs. In Chart 1 the actual number of dentists on duty each month of World War II is compared with the theoretical requirement for the same period, based on the hypothetical figures used (1.8 hours for maintenance care, 7.2 hours for rehabilitation). The curve on this chart which shows theoretical needs is of course riot quantitatively accurate, but the wide fluctuations which are its conspicuous feature would be found on any similar chart, regardless of the exact figures used, as long as the time required for rehabilitation of new men greatly exceeds that required for annual maintenance. By comparison the slowly rising curve of dental personnel on duty reflects a number of delaying factors which are likely to be operative in any emergency. The two years from 1940 through 1941 represented a training period in which the immediate mobilization of a large force was not anticipated. With the start of actual hostilities considerable time was required to commission the necessary dentists, and through 1942 it was impossible even to equip fully all the dentists actually in uniform.


39

CHART 1. COMPARISON OF THEORETICAL MONTHLY REQUIREMENTS FOR DENTAL OFFICERS DURING WORLD WAR II WITH THE NUMBER ACTUALLY ON ACTIVE DUTY.

In contrast with the gradually rising curve of dental personnel on duty, the curve of theoretical requirements fluctuates rapidly and within wide limits. Nearly 30,000 dentists would have been needed late in 1942, when half a million men were inducted in 1 month, while only 10,000 would have been needed less than a year later, after the tempo of mobilization had slowed. To have procured, trained, and equipped 30,000 dentists in 1942, for only a few months work, would have resulted in a gross waste of manpower and industrial capacity. In most cases it will probably be found impractical or impossible to call to duty, to meet peak requirements, a number of dental officers greatly exceeding the number which will be needed when relative stability has been reached, regardless of calculated needs for short periods.

Nevertheless, reference to calculated requirements, even when based on very incomplete information, may point out possible improvements in the mobilization program. In particular, it will generally emphasize the desirability of building up the Dental Service as rapidly as possible after plans for the augmentation of the Armed Forces are announced, regardless of fixed ratios of dentists to total strength. In many respects the position of the Dental Service is comparable to that of a training activity. If several hundred thousand men are to be "processed" each month the necessary training centers


40

must be established in advance of the influx, not built up gradually on the basis of some fixed ratio of training personnel to the number of troops already in uniform. Similarly, the Dental Service should be in maximum practical operation at the start of a period of expansion, ready to care, for inductees as they pass through the training camps; if, however, the rate of mobilization of dental facilities is gauged to maintain some fixed ratio of dental officers to total Army strength, the necessary men and equipment will be available only at the end of the influx, after most inductees have already completed their training and have been assigned to tactical units. This situation will occur regardless of how liberal the accepted ratio may be.

It has already been pointed out that it will generally be impracticable to mobilize the full facilities needed to meet temporary peak demands; it is also possible that personnel and supply difficulties will hinder or prevent the early establishment of dental clinics in the future as they have in the past. These facts should not obscure the validity of the general principle that, when a major augmentation of the Armed Forces is imminent, the Dental Service should be built up to the total strength which will ultimately be required, as rapidly as may be possible under the circumstances existing at the time. At the start of World War II, for instance, it was patently impossible and undesirable to provide the 30,000 dental officers who might have been used in 1942. Further, it would have been impossible to equip such a number of dentists even if they could have been obtained. But 15,000 dentists were ultimately mobilized, and 10,000 were on duty by the end of 1942, while the average strength of the Dental Corps for that year of expansion was only about 6,000 officers, and only about 3,000 were available at the start of the year. It must be admitted that no improvement in the rate of mobilization of dentists was possible under conditions existing in 1942, but it is equally true that the 1:500 ratio of dentists to total strength, which was maintained fairly well, fell far short of meeting dental demands during that year. Further, if it had been possible to place on duty in May or June of 1942 the 10,000 dental officers who were working in Army clinics in December, the problems of the Dental Service would have been reduced materially.

Reference to calculated requirements for dental treatment will also reveal not only that the application of a fixed ratio of dentists to total strength tends to delay the mobilization of dental facilities, but that it fails to consider the primary factor in determining how many dentists will be required-the rate of flow of inductees. This weakness is of course based on the fact that treatment for old, accumulated dental defects has been, and may be expected to be, greatly in excess of requirements for yearly maintenance care. If only maintenance treatment were needed by inductees the amount of that treatment would be directly proportional to the number of men in the service, and a fixed ratio


41

of dentists to total strength, based on past experience, would be satisfactory. But when several times as many hours are necessary for the dental rehabilitation of an inductee as will be required for annual maintenance each year thereafter, the first consideration is not likely to be "how many troops are in the Army?" but "how many new men will be inducted during the year?" Thus, in the discussed hypothetical illustration, the ratio of dentists which met all needs of a static force broke down completely when applied to an expanding organization. These weaknesses of the method of fixing dental personnel on the basis of an established ratio in a time of emergency do not mean that such a ratio may not represent the maximum number of dentists that may be available, or that it may not be valuable as an indication of how many dentists will be required after stability has been reached. They do indicate, however, the need for a critical evaluation of any proposed ratio in the light of the actual probable demand for treatment whenever a major mobilization is planned.

It is possible, of course, that future developments in methods of waging war may alter the mission and function of the medical services even to the point of placing first emphasis on the care of the civilian population.

Limitations on the Number of Dentists
Available From Civilian Practice

During World War I only about 6,700 dentists were taken from private practice and the effect on civilian dental care was scarcely noticed. Prior to World War II very little thought had been given to the possibility that the number of dentists who could be obtained for the Armed Form was, in fact, strictly limited. Nor did it seem probable that there might not be a sufficient number of personnel left to care for the minimum needs of the civil population.

The first attempt to determine how many dentists could be spared for the Armed Forces was made in April 1941, when the American Dental Association (ADA) estimated that 21,000 dentists would fall within the draft age and that only 6,700 of these would be eligible for induction.17 However, this figure was based on induction criteria rather than on any survey of civilian needs, and it was therefore subject to change as draft regulations were altered.

In June 1942, local complaints of shortages of dental personnel impelled the Procurement and Assignment Service for Physicians, Dentists, and Veterinarians (PAS), of the War Manpower Commission (WMC), to sponsor a general survey of dental manpower.18 This survey, which was carried out with the assistance of the U. S. Public Health Service (USPHS), was completed in

    17Report of the Chicago meeting of the Committee on Dental Preparedness. J. Am. Dent. A. 28: 635, Apr 1941.
    18Minutes of the Directing Board, PAS, 22 Jun 42. On file Natl Archives, PAS, WMC.


42

February 1943 and revealed the following situation (projected to the end of 1943):19

Dentists listed in the 1940 census

70,417

Graduates, 1940-1943

8,928

    TOTAL

79,345

Losses of death and retirement, 1940-1942

3,830

Dentists estimated to be in nonprofessional work with various essential agencies

1,021

Anticipated losses, 1943

1,624

    TOTAL

6,475

    Remaining effectives, end of 1934

72,870

PAS decided that a minimum of 1 dentist for each 2,500 persons should be reserved for civilian care, or a total of 50,250 dentists for a civil population of 125,625,000. This left 22,620 dentists who could be utilized by the Armed Forces, 11,617 of whom were already on active duty in the Army, Navy, and Public Health Service.

The findings of PAS, that 1 dentist was required for each 2,500 civilians and that 22,620 dentists could be made available to the military, were of course open to question on theoretical grounds. In the absence of specific information on the dental condition of the American public any such estimates were necessarily arbitrary and based on opinion rather than upon factual knowledge. It could be pointed out, for instance, that even in peacetime many communities had never had more than 1 dentist for each 5,000 persons. Further, it was obvious that PAS' ratio could not be applied uniformly since those regions which had never approached the 1:2,500 ratio before the war could hardly expect to receive additional dental personnel in a time of national emergency, to bring them up to the authorized proportion. If these areas merely retained their prewar ratios, and if all other districts were reduced to the recommended quota, considerably more dentists would have been released for military service.

It was more difficult to criticize PAS findings from the practical point of view. No one could claim that a ratio of 1 dentist for 5,000 persons, or an average per capita expenditure for dentistry of 9 cents a year, was adequate for the maintenance of dental health; the fact that such conditions existed in some unfortunate regions did not justify their extension to the entire nation. And while neither PAS nor any other agency could state with certainty that a given ratio of dentists was actually required for civilians, the Armed Forces would have had equal difficulty in justifying any demand for an increased allotment since the figure set by PAS gave them nearly one-third of the nations' dentists for 12 million men, while only two-thirds were reserved for the remaining 125 million civilians.

    19Minutes of Committee on Dentistry, PAS, 20 Feb 43. On file Nail Archives, PAS, WMC.


43

Also, while many areas which had had less than 1 dentist for each 2,500 persons prior to the war would certainly have to continue with less than the PAS "minimum" ratio, the number of additional dentists made available to the military by this circumstance was very small due to peculiarities of distribution. Dentists who were "excess" by the PAS definition were concentrated mainly in the larger urban centers, and it was not feasible to take from 50 to 80 percent of the men in practice in such cities as New York or Los Angeles to bring those districts down to the recommended quota. A city of one million persons, for instance, with a ratio of 1 dentist for each 1,000 individuals would have 1,000 dentists; of these, 600 would have to be taken into the Armed Forces to reduce the proportion to 1 dentist for each 2,500 persons. But many of the dentists in such a city would be too old for active duty, or physically disqualified for military life; others would be in essential occupations. The number which would be accepted by the Armed Forces would in most cases be far below the 600 which would theoretically be declared available. The only way in which the remainder could be utilized would be to relocate them in less favored districts to release younger men who would in turn be taken by the Army or Navy. The alternative would be to leave a higher proportion of dentists in centers which had normally enjoyed a high ratio in peacetime, offsetting those regions which could not attain the 1: 2,500 ratio.

In view of these considerations, the findings and broad recommendations of PAS in respect to minimum requirements for civilian dental care must be considered reasonable and justifiable, at least until such time as more definite information is available concerning dental needs. When it is noted that the Army and Navy, together, mobilized about 22,318 dental officers in the war it is apparent that they were close to the bottom of the manpower barrel, and that no significant increase in the overall ratio of dental officers to total strength was possible. Any future mobilization plan must certainly recognize that the essential, minimum needs of the civilian population must be met, and that the supply of dental personnel is far from inexhaustible.

ACTUAL BASIS FOR DETERMINING DENTAL MANPOWER
REQUIREMENTS, WORLD WAR II

While formal requests for procurement objectives were generally brief, with no discussion of the method of calculation, the ultimate goal of the Chief of the Dental Division, SGO, and The Surgeon General was an overall ratio of 1 dentist for each 500 men. Since information on the dental condition of inductees was too meager to permit an accurate determination of the, number of dental officers needed to provide a calculated amount of treatment, it seems probable that the 1:500 ratio was based on one or more of the following considerations:

1. When the 1: 4000 ratio proved grossly inadequate in World War I, the 1:500 proportion was authorized in Zone of Interior installations (except


44

hospitals). Though this number of dental officers was not obtained before the end of hostilities, the ratio had been approved by the Secretary of War and the Chief of Staff, and it was probably given serious consideration by the officers responsible for organizing the Dental Service in World War II.

2. Ratios of from 1:1,000 to 1:700 had proved inadequate in peacetime and a further increase to 1:500 may have seemed to be the next logical step, especially when dental standards for induction were being drastically lowered.

3. It is possible that a ratio of 1:500 was considered the maximum which would be approved by the General Staff, regardless of demonstrable needs.

While the ratio of 1 dental officer for each 500 troops would ultimately have led to the mobilization of only a little more than the total number of dentists which PAS had decided could be spared for the Armed Forces, there is no evidence that this factor was originally considered in arriving at the figure for the Army Dental Corps. The 1:500 ratio appears to have been generally accepted during the early stages of the expansion of the defense forces, when it was not expected that the Army would reach a strength where its requirements for dentists would seriously threaten civilian practice. Virtual agreement between PAS and the Armed Forces in this case was apparently a happy coincidence.

Col. Robert C. Craven, who was responsible for personnel matters in the Dental Division, SGO, during the early part of the war, stated that the 1:500 ratio was first agreed upon informally between Brig. Gen. Leigh C. Fairbank, Director of the Dental Division, SGO, and Brig. Gen. George F. Lull, Chief of Personnel Services, SGO. When Brig. Gen. Robert H. Mills became Director of the Dental Division, SGO, in March 1942 he attempted to have that ratio officially recognized, but The Surgeon General felt that no definite action should be taken until requirements were more clearly established.20 General Mills was assured, however, that he could procure all the dentists he might need for corps area service commands, regardless of any fixed ratio, and relying on that promise he relaxed his efforts to obtain formal approval of the desired proportion.21 No further effort was made to have the 1:500 ratio recognized until near the end of hostilities, when postwar policies were being considered. During the early part of the war, procurement objectives seem to have been determined by informal agreement between the principal personnel officers concerned, with the proportion of 1 officer for each 500 men serving as a convenient, though unofficial, yardstick.22

In practice the 1:500 ratio was attained only for very short intervals during the war, and the average ratio over this period was 1 officer for 557

    20Memo, Brig Gen R. H. Mills for SG, 8 Apr 42, no sub. SG: 703.-1.
    21Proceedings of The Surgeon General's Conference with Corps Area and Army Dental Surgeons, 8-9 July 42. HD: 337.
    22The highly informal manner in which dental procurement objectives were established during the war has been confirmed in personal correspondence and conversations between the author and Col Robert C. Craven, Dental Div, SGO, and Maj Ernest J. Fedor, dental liaison officer with the Personnel Service during much of the war.


45

men.23 Efforts to maintain the 1:500 ratio were finally abandoned in September 1943, when ASF placed a ceiling of 15,200 officers on the Dental Corps.24

As the war progressed an effort was made to refine estimated requirements for dental officers on a more definite basis than an overall ratio. In a memorandum from the SGO to ASF, dated 5 June 1944, analyzing the dental personnel situation, it was noted that anticipated needs had been calculated as follows:25

1. For tactical units in the Zone of Interior and overseas, according to authorized tables of organization.

2. For other Zone of Interior installations, on the basis of 1 dentist for each 500 troops, except for replacement training centers and separation centers, which were authorized 1 dentist for each 300 troops.

3. For general hospitals, according to tables published in War Department Circular No. 209, 26 May 1944.

4. Attrition was estimated at 50 officers monthly.

Tables of organization for tactical units mentioned in item 1 of the cited memorandum were planned to provide an average of 1 dentist for each 1,200 men. Many adjustments were necessary before this general principle could be applied to a host of smaller commands, and the results were sometimes unsatisfactory (see discussion in chapter VIII), but at least these tables of organization provided a means for calculating requirements for projected combat forces on an exact, if arbitrary, basis.

The determination of requirements for dental officers in Zone of Interior installations was more difficult. The following were some of the more important problems involved:

1. While procurement was based on the general ratios outlined in item 2 of the cited memorandum, the number of dentists actually requisitioned by any installations was established by the corps area commander, with the advice of his staff and local officials. As a result, dentist-troop ratios might vary widely, even in commands of the same general type. As early as December 1940, The Surgeon General asked that mandatory tables of organization be set up for the dental services of Zone of Interior camps and stations,26 but this request was disapproved by The Adjutant General as being contrary to the policy of

    23Calculated by the author from data in the files of the Dental Div, SGO.
    24The manner in which the ceiling for the Dental Corps was established, and the exact date, is not entirely clear. In a memorandum to the Deputy Surgeon General, of 7 Sep 43, Lt Col D. G. Hall of the Personnel Service, SGO, stated that his office had "that day" been notified of a revised requirement based on changed plans in ASF. (Memo, Lt Col. Durward G. Hall to Dep, SG, sub: Revised requirements for dental officers in the Army. SG : 322.0531.) Other incidental references indicate that representatives of the Dental Division, the Military Personnel Division, SGO, and of G-1 attended conferences on the matter before a decision was reached. It is also probable that PAS had a hand in the matter, but the extent to which its influence affected ASF is not known.
    25Memo, Brig Gen R. W. Bliss for CG, ASF, 5 Jun 44, sub: Requirements for Dental Corps officers. SG: 322.053-1.
    26Ltr, Col Larry B. McAfee to TAG, 10 Dec 40, sub: Personnel table, camp dental clinics. SG: 320.2-1.


46

decentralizing all possible authority to subordinate facilities.27 Recommended tables of organization for Zone of Interior installations were published from time to time, but they were merely "suggestions" which could be ignored by subordinate commands. In October 1943, the Director of the Dental Division, SGO, noted that few service commands had requisitioned what was considered an adequate number of dentists, and one service command had only 73 percent of the recommended total 1.28

The first "recommended" allotment of dental officers to Zone of Interior installations, published in December 1940, provided for IS officers and 26 enlisted men in each DC-1, and 11 officers and 17 enlisted men for each DC-2. These clinics had 25 and 15 chairs, respectively, but it was anticipated that they would be partially manned by tactical units in the Zone of Interior.29 In May 1944, War Department Circular No. 209 recommended the following manning levels:30

DC-1

25 officers

42 enlisted men

DC-2

15 officers

25 enlisted men

DC-3

8 officers

13 enlisted men

DC-4

3 officers

3 enlisted men

DC-5

1 officers

1 enlisted men

This directive also recommended that dental officers be assigned to general hospitals as follows:

1,000 beds

7 officers

1,500 beds

8 officers

1,750 beds

9 officers

2,000 beds

12 officers

2,500 beds

14 officers

3,000 beds

16 officers

3,500 beds

19 officers

4,000 beds

21 officers

However, this publication failed to answer many questions, since it based its recommendations on clinic types rather than on the number of troops served. Thus a DC-1 might be found in a camp with 7,000 men or in a camp with 12,000; obviously the dental needs of the two installations would not be identical.

An ASF circular of 16 October 1945 recommended that dentists be provided Zone of Interior camps on the basis of 2 officers and 3 enlisted men for each 1,000 troops served, plus 1 officer and 1 1/2 enlisted men for each 200 beds in the station hospital.31 It further suggested specific grades and classifications for both officers and enlisted men, as shown in Tables 1 and 2. The influence of these recommendations on the determination of Zone of Interior dental allotments cannot be determined.

    27(1) 1st Ind, TAG, to footnote 26,30 Dee 40. (2) See footnote 21, p. 44.
    28Memo, Dir, Dent Div for Chief, Prof Serv, SGO, 1 Oct 43, no sub. SG: 703-1.
    29See footnote 27, above.
    30WD Cir 209, 26 May 44.
    31ASP Cir 389,16 Oct 45.


47

2. It was difficult to predict the extent to which the dentists of tactical units in training in the Zone of Interior could be utilized in camp clinics. For a discussion of this problem see chapter VII.

3. The rate of attrition in the Dental Corps was not constant and it could not be predicted with accuracy. During the early part of the war it was less than had been expected, while later it was necessary to accelerate normal attrition to permit the replacement of older men with ASTP graduates.

TABLE 1. DENTAL OFFICERS RECOMMENDED FOR ZONE OF INTERIOR DENTAL CLINICS BY
ASF CIRCULAR No. 389, 16 OCTOBER 1945

Grade

Qualifications

DC-1

DC-2

DC-3

DC-4

DC-5

Lieutenant colonel

Dental staff officer

1

-----

-----

-----

-----

Lieutenant colonel

General

-----

1

-----

-----

-----

Major

General

-----

1

1

1

-----

Major

Oral Surgeon

1

-----

-----

-----

-----

Major

Exodontist

1

1

-----

-----

-----

Major

Prosthodontist

2

1

-----

-----

-----

Major

Periodontist

1

-----

-----

-----

-----

Captain or lieutenant

General

19

11

5

2

1

Captain or lieutenant

Exodontist

-----

-----

1

-----

-----

Captain or lieutenant

Prosthodontist

-----

-----

1

-----

-----

    Total officers

25

15

8

3

1

TABLE 2. ENLISTED ASSISTANTS RECOMMENDED FOR ZONE OF INTERIOR DENTAL CLINICS
BY ASF CIRCULAR No. 389, 16 OCTOBER 1945

Grade

Qualifications

DC-1

DC-2

DC-3

DC-4

DC-5

Technical sergeant

Administrative

1

-----

-----

-----

-----

Staff sergeant

Administrative

-----

1

-----

-----

-----

Sergeant

Administrative

-----

-----

1

-----

-----

Corporal

Clerk

1

1

-----

-----

-----

Technician, 3d gr

Laboratory technician

2

1

1

-----

-----

Technician, 4th gr

Laboratory technician

3

2

1

-----

-----

Technician, 4th gr

X-ray technician

1

-----

-----

-----

-----

Technician, 4th gr

Chair assistant

9

5

3

1

-----

Technician, 5th gr

Laboratory technician

5

3

1

-----

-----

Technician, 5th gr

X-ray technician

-----

1

1

-----

-----

Technician, 5th gr

Chair assistant

17

9

5

2

1

Private, first class

Supply clerk

1

1

-----

-----

-----

Private, first class

Basic

1

-----

-----

-----

-----

Private

Basic

1

1

-----

-----

-----

    Total enlisted men

42

25

13

3

1


48

CHRONOLOGICAL PROGRESS OF THE MOBILIZATION
OF DENTAL OFFICERS

Table 3 shows the monthly procurement of dental officers for the period 1 January 1939 to 28 February 1946.32

Though tension in Europe mounted during the late 1930's, staff officers responsible for the Army Dental Service showed little concern over dental personnel problems. It was expected that the fully mobilized ground and air forces would number only about 4,000,000 troops and that a ratio of 1.4 dentists for each 1,000 total strength would be sufficient. This would provide for a Dental Corps of 5,600 men.33 No difficulty had been experienced in obtaining almost this number of dentists during World War I, even without the benefit of a strong Organized Reserve. Also, in spite of the termination of the dental ROTC in 1932 (see chapter IV), 258 Regular Army dentists, 250 National Guard officers, and 5,197 Reserve officers were enrolled in the Dental Corps in September 1938; thus it appeared that if war came very few additional dentists would be required. It was also the opinion of The Surgeon General that dental officers could be procured rapidly and put on active duty with very little training, and it was frankly stated that no uneasiness need be felt even if the Dental Reserve fell to 50 percent of its authorized strength.34 At this time it was certainly not foreseen that the Army would reach a strength of over 8 million men, that a drastic lowering of physical standards would be necessary, and that the 1.4 ratio, which had failed to measure up to the lesser needs during and following World War I, would be completely inadequate for this expanded force.

TABLE 3. OFFICERS CALLED TO ACTIVE DUTY IN THE DENTAL CORPS, BY COMPONENT,
JANUARY 1939 THROUGH FEBRUARY 1946

Date

Component

Total

Regular Army

Reserve

National Guard

Army of the United States

1939

Total

19

25

----------

----------

44

January

----------

----------

----------

----------

----------

February

----------

1

----------

----------

1

March

----------

----------

----------

----------

----------

April

----------

----------

----------

----------

----------

May

----------

----------

----------

----------

----------

June

----------

----------

----------

----------

----------

July

13

2

----------

----------

15

August

----------

2

----------

----------

2

    32Monthly procurement of dental officers, 1 Jan 39 through Feb 46. Info furnished by Strength Acctg Br, AGO, 3 Jul 46.
    33Memo, Col James E. Baylis, Tng Div, SGO, for SG, 6 Sep 38. [D]
    34Ibid.


49

TABLE 3. OFFICERS CALLED TO ACTIVE DUTY IN THE DENTAL CORPS, BY COMPONENT,
JANUARY 1939 THROUGH FEBRUARY 1946--Continued

Date

Component

Total

Regular Army

Reserve

National Guard

Army of the United States

1939

September

----------

3

----------

----------

3

October

----------

1

----------

----------

1

November

6

9

----------

----------

15

December

----------

7

----------

----------

7

1940

Total

29

408

145

----------

582

January

----------

----------

1

----------

1

February

----------

3

1

----------

4

March

----------

30

----------

----------

30

April

----------

13

1

----------

14

May

----------

2

----------

----------

2

June

17

6

----------

----------

23

July

7

17

----------

----------

24

August

----------

21

----------

----------

21

September

----------

42

62

----------

104

October

----------

100

36

----------

136

November

----------

103

31

----------

134

December

5

71

13

----------

89

1941

Total

6

1,938

165

48

2,157

January

----------

125

57

----------

182

February

----------

159

71

----------

230

March

----------

202

31

----------

233

April

1

340

3

1

345

May

----------

218

1

----------

219

June

----------

140

1

----------

141

July

4

250

1

1

256

August

----------

150

----------

----------

150

September

----------

120

----------

1

121

October

----------

119

----------

12

131

November

----------

62

----------

23

85

December

1

53

----------

10

64


50

TABLE 3. OFFICERS CALLED TO ACTIVE DUTY IN THE DENTAL CORPS, BY COMPONENT,
JANUARY 1939 THROUGH FEBRUARY 1946--Continued

Date

Component

Total

Regular Army

Reserve

National Guard

Army of the United States

1942

Total

21

1,134

1

5,670

6,826

January

1

126

----------

179

306

February

2

77

----------

97

176

March

----------

85

----------

34

119

April

4

157

----------

149

310

May

1

149

----------

292

442

June

5

95

----------

457

557

July

4

259

----------

966

1,229

August

----------

100

1

1,038

1,139

September

3

56

----------

1,171

1,230

October

----------

13

----------

561

574

November

----------

15

----------

356

371

December

1

2

----------

370

373

1943

Total

----------

59

----------

4,941

5,000

January

----------

5

----------

162

167

February

----------

9

----------

192

201

March

----------

4

----------

277

281

April

----------

5

----------

374

379

May

----------

4

----------

910

914

June

----------

10

----------

556

566

July

----------

11

----------

679

690

August

----------

4

----------

540

544

September

----------

2

----------

347

349

October

----------

3

----------

266

269

November

----------

----------

----------

364

364

December

----------

2

----------

274

276

1944

Total

----------

40

----------

1,889

1,929

January

----------

4

----------

346

350

February

----------

14

----------

536

550

March

----------

5

----------

108

113

April

----------

8

----------

129

137

May

----------

1

----------

58

59

June

----------

----------

----------

19

19

July

----------

----------

----------

104

104

August

----------

----------

----------

5

5

September

----------

----------

----------

117

117


51

TABLE 3. OFFICERS CALLED TO ACTIVE DUTY IN THE DENTAL CORPS, BY COMPONENT,
JANUARY 1939 THROUGH FEBRUARY 1946--Continued

Date

Component

Total

Regular Army

Reserve

National Guard

Army of the United States

1944

October

----------

 2

----------

233

235

November

----------

6

----------

186

192

December

----------

----------

----------

48

48

1945

Total

----------

2

----------

233

235

January

----------

1

----------

49

50

February

----------

----------

----------

45

45

March

----------

1

----------

47

48

April

----------

----------

----------

85

85

May

----------

----------

----------

1

1

June

----------

----------

----------

4

4

July

----------

----------

----------

----------

----------

August

----------

----------

----------

1

1

September

----------

----------

----------

----------

----------

October

----------

----------

----------

----------

----------

November

----------

----------

----------

----------

----------

December

----------

----------

----------

1

1

1946

Total

----------

----------

----------

2

2

January

----------

----------

----------

1

1

February

----------

----------

----------

1

1

1939-1946

Aggregate

75

3,606

311

12,783

16,775

In September 1938, when the Dental Reserve had reached a level slightly over its authorized strength35, The Surgeon General recommended that all further procurement for that organization be suspended. This recommendation, which reflected the then optimistic attitude of The Surgeon General, was approved by the General Staff and, with a few exceptions (successful candidates for the Regular Army, recent graduates desiring immediate active duty) no new commissions were offered until October 1940.36 Between 30 June 1938 and 30 June 1941 the Dental Corps Reserve suffered a net loss of 771 officers, in spite of the fact that 722 commissions were given young dentists during fiscal

    35See footnote 33, p. 48.
    36Ltr, ACofS, G-1 to TAG, 29 Sep 38, sub: Suspension of appointments in the Dental Reserve Corps. [D]


52

year 1941.37 On the latter date the Dental Reserve numbered 4,428 officers.

Increases in the number of dentists on active duty were small prior to the inauguration of Selective Service in September 1940. The authorized strength of the Regular Army Dental Corps was raised to 316 officers in April 193938, and about 50 Reserve officers were called to voluntary duty in April and September 1939.39 On 30 June 1940, 354 dentists, including 101 Reserve officers, were on duty.40

By the end of July 1940,150 Reserve dentists had accepted voluntary active service, but this number was 391 less than the total then required, and it was anticipated that 1,259 dentists would be needed when expansion under the Selective Service Act was started in October.41 On 27 August 1940 the President was empowered to call to active duty, with or without consent, any member of the Reserve or National Guard.42 Any officer below the grade of captain, with dependents, could resign, however, and a considerable number of Medical Department officers made use of this privilege.43 By 26 October 1940 The Surgeon General foresaw an early exhaustion of the Dental Reserve and he recommended that the suspension on new commissions, which had been in effect since September 1938, be lifted without delay.44 Three days later the ban was lifted to the extent of permitting the corps area commanders to fill existing vacancies.45 Under current procurement objectives, however, there were very few dental vacancies at this time, and it was found impossible in some cases even to offer commissions to those few dentists who had been inducted as enlisted men.46

By 30 April 1941, 35.5 percent of all Dental Reserve officers were on active duty, though the proportion varied from 20 percent to 59 percent in different corps areas.47

On 5 May 1941 previous restrictions against new commissions in the Dental Reserve were further modified to permit the acceptance of any qualified dentists who had been inducted as enlisted men, and the corps areas were instructed to

    37Annual Reports . . . Surgeon General, 1938-41. Washington, Government Printing Office, 1938-41.
    38Sec 8, 53 Stat 558.
    39See footnote 14, p. 36.
    40Annual Report . . . Surgeon General, 1940. Washington, Government Printing Office, 1940.
    41Ltr, SG to TAG, 6 Aug 40, sub: Shortage of Medical Department personnel. SG: 320.2-1.
    42Annual Report . . . Surgeon General, 1941. Washington, Government Printing Office, 1941.
    43Ltr, TAG to all CA or Dept Comdrs, 1 Sep 40, sub: Resignation of officers of the Officers' Reserve Corps. SG: 210.83-ORC.
    44Ltr, Col Larry B. McAfee, to TAG, 26 Oct 40, sub: Appointment in the Medical, Dental, and Veterinary Reserve Corps. AG: 210.1.
    45Ltr, Col Larry B. McAfee to all CA surgs, 29 Oct 40, sub: Extended active duty vacancy required for approval of applicant for commission. [D]
    46See footnote 16, p. 37.
    47Ltr, TAG to all CGs, CofS, GHQ, Chiefs of all Arms and Services, 2 Jun 41, sub: Information as to the percentage of eligible reserve officers who are on extended duty as of April 30, 1941. AG: 210.31-ORC.


53

encourage applications from persons in this category.48 By 30 June 1941, 2,111 dental officers, predominantly Reserve, were on active duty.49

In October 1941 The Surgeon General reported some concern over the number of resignations and physical disqualifications in the Dental Reserve, and requested authority to reopen procurement in that branch. However, he still recommended against any great increase in the Reserve, since to grant commissions to men who could not be used by the Army would amount to. conferring exemption from military service, which was properly the prerogative of the Selective Service System.50 Apparently it was still believed that the Reserve, augmented with a few inductees and recent graduates, would be sufficient to meet anticipated needs. This optimism was not shared by the Federal Security Administrator, Paul V. McNutt. On 30 October 1941, in his recommendation to the President for the establishment of a Procurement and Assignment Service to insure the most economical use of limited medical personnel, Mr. McNutt also included a tentative plan for a draft of civilian professional men, should such action prove necessary.51 The attitude of The Surgeon General at this time is probably explained by the fact that 2,905 dental officers were on duty, or only 6 less than the authorized procurement objective, and Pearl Harbor was still in the future.52

Three days after entrance of the United States into the war all releases from active duty, except for physical disability or incompetence, were suspended.53 On 19 December the Medical Department was instructed to establish pools of medical personnel from which replacements could be made without delay. No specific level was prescribed for the Dental Corps, but 1,500 officers were to be maintained in such pools by the Medical Department as a whole.54

With the entry of the United States into actual hostilities the need for a rapid expansion of the Medical Department was clear. On 1 January 1942 The Surgeon General requested authority to call to duty 1,350 additional dentists,55 but The Adjutant General approved an increase of 500 only.56

In the latter part of January 1942, it was directed that only a limited num-

    48Rad, TAG to CGs all CAs, 5 May 41. AG: 210.1-ORC.
    49Officers appointed in the Dental Corps from 1 January 1939 through February 1946. Info furnished by Strength Accounting Branch, AGO, 3 Jul 46. RD: 320.2.
    50Memo, Lt Col R. C. Craven for TAG, 8 Oct 41. AG : 080 (ADA).
    51Ltr, Paul V. McNutt, Federal Security Administrator, to the President, 30 Oct 41.[D]
    52Lt Col Alfred Mordecai : A history of the Procurement and Assignment Service for physicians, dentists, veterinarians, sanitary engineers, and nurses, War Manpower Commission. HD: 314.7-2.
    53Ltr, TAG to Chief of the Army Air Forces; Commanding General, Air Force Combat Command; Chief of Staff, GHQ; and the Chiefs of all Arms and Services, 10 Dec 41, sub: Suspension of releases from active service. SG: 320.2-1.
    54Ltr, TAG to Chief of each arm or service, 19 Dec 41, sub: Officer filler and loss replacements for ground arms and services. SG: 320.2-1.
    55Ltr, SG to TAG, 1 Jan 42, sub: Procurement objective, Medical Department officers, Army of the United States. AG: 210.1.
    561st ind, TAG to SG, 24 Jan 42, to ltr cited in footnote 55.


54

ber of Regular Army dental officers, varying from 2 in the Fifth Corps Area to 13 in the Fourth, would be allotted to corps area activities.57

On 12 April 1949, The Surgeon General was instructed by Services of Supply (SOS) to establish Medical Officer Recruiting Boards to commission officers in the field. This action was intended mainly to speed the lagging procurement of medical rather than dental officers, for dentists were not to be accepted unless they were under 37 years of age or had been classified I-A by their draft boards. By May 1942 it was evident that the Army would reach a strength much greater than had been anticipated in prewar plans. In that month the Military Personnel Division, SOS, estimated that 7,110 dentists would be needed by 1 January 1943, as follows:58

Services of Supply

2,699

Operations of AGF

2,472

Army Air Force

1,755

Pools

184

As of 31 March 1942 there were 3,373 dental officers on duty and it was estimated that only 587 more could be obtained from the Reserve; it would therefore be necessary to make 3,150 new appointments in the Army of the United States (AUS) during the remainder of 1942.59 On 3 July 1942 The Surgeon General reported that the procurement objective of 500 officers, authorized on 24 January, had been filled and he requested an additional objective of 4,000 dentists.60 This time his request was approved in full within a few days.61

Some difficulty was expected in obtaining 4,000 more dentists for on 9 July 1942 The Adjutant General directed the corps areas to add dental officers to all Medical Officer Recruiting Boards and. granted authority, for the first time, to consider applications for original appointments from the following:62

    1. Dentists between the ages of 37 and 45.
    2. Dentists qualified only for limited service.
    3. Dentists whose training and experience justified an original appointment above the grade of lieutenant.

Though dentists in these categories were to be accepted only by authority of The Surgeon General, they had not previously been placed on active duty under any circumstances. At about the same time the, Dental Division, SGO, was directed to call to active service all physically qualified lieutenant colonels and colonels of the Reserve, a step which had been postponed as long as possible

    57Ltr, TAG to all CA comdrs, 27 Jan 42, sub: Allotment of Regular Army officers for duty with the Corps Area Service Commands. AG: 320.2.
    58Memo, Brig Gen James E. Wharton for Pers Off, SGO, 11 May 42. SG:320.2-1.
    59Ibid.
    60Ltr, Lt Col Francis M. Fitts to CG, SOS, 3 Jul 42, sub: Procurement objective, Dental Corps, Army of the United States. SG: 320.2-1.
    61Ltr, TAG to SG, 8 Jul 42, sub: Procurement objective, Army of the United States, for duty with Dental Corps (Surgeon General). SG 320.2-1.
    62Ltr, TAG to CGs all CAs, 9 Jul 42, sub: Dental Corps members for certain Medical Department recruiting boards. AG: SPX 210.31.


55

due to the difficulty of assigning men in the higher grades to appropriate positions.63 Misgivings concerning dental procurement proved unfounded at this time. On 1 September 1942 dental representatives were removed from the Medical Officer Recruiting Boards and the latter were instructed not to accept any new dental applications.64 A few days later the Dental Division, SGO, notified its liaison officer with the ADA that the objective of 4,000 officers authorized in July 1942, had nearly been filled and that commissions would thereafter be given only to men who had been declared Class I-A by their draft boards.65 From September through November 1942 further procurement of dental officers was actually discouraged.

On 16 November 1942 The Surgeon General reported that there were 9,706 dental officers on duty, a number slightly in excess of current requirements. However, with mobilization plans providing for many more men than had been considered necessary at the beginning of the year, it was estimated that 17,248 dentists would be needed by the end of 1943. The Surgeon General therefore asked for a new procurement objective of 7,200 dental officers in addition to the 300 officers of the unexpended portion of the old objective.66 This request was approved on 27 November.67 On 15 January 1943 PAS, WMC, agreed to declare 400 civilian dentists available each month through the year, for a total of 4,800 dentists; the remaining 2,700 dental officers were to be obtained from the newly established Army Specialized Training Program (ASTP) (see chapter IV), from dentists inducted as enlisted men by Selective Service, and from students holding inactive Medical Administrative Corps Reserve commissions.68

During the first months of 1943, the program to meet the procurement objective of 7,500 dental officers lagged somewhat, though difficulties of dental procurement were overshadowed by the much more acute shortage of medical officers. In February the Dental Division asked that PAS speed its activities as only 269 dentists had been declared available since 1 January. In April, the Medical Department was still short 1,042 dentists and 6,677 physicians, but by May, when the situation in respect to medical officers was grave, some improvement was noted in the procurement of dental officers.69 Though Selective Service placed dentists in the "scarce" category at about this time,70 this action was intended only to prevent the waste of dental manpower in non-professional activities, and on 22 May representatives of the War Department

    63See footnote 21, p. 44.
    64Rad, TAG to CG, 1st SvC, 1 Sep 42. SG: 210.31-1.
    65Ltr, Col Robert C. Craven to Maj Kenneth R. Cofield, 4 Sep 42. [D]
    66Ltr, SG to CG, SOS, 16 Nov 42, sub: 1943 procurement objective, Dental Corps, Army of the United States. SG: 320.2-1.
    67Ltr, TAG to SG, 27 Nov 42, sub: Increase in procurement objective, Army of the United States, for The Surgeon General (Dental Corps). SG: 320.2-1.
    68See footnote 52, p. 53.
    69Ltr, SG to ACofS, G-1, 13 May 43, sub: Procurement of physicians and dentists. AG: 210.1.
    70WD Memo W605-23-43, 15 May 43, sub: Scarce categories of specialized skills. AG: 210.1.


56

and PAS found that "the dental picture was not alarming."71 By the end of June 1943, 12,046 dental officers were on duty, and half of the year's objective had been obtained.72

On 7 September 1943, when about 13,500 dentists were in the service, ASF placed an arbitrary ceiling of 15,200 officers on the Dental Corps. It was then estimated that in addition to graduates of the ASTP and students holding Reserve Medical Administrative Corps commissions only 1,124 more dentists would be needed from civil life. Both PAS and the Officer Procurement Service (OPS) of the ASF were notified not to accept additional applications from dentists who were over 38 years of age or who were not physically fit for unlimited military service. This action is especially significant when it is noted that at this same time The Surgeon General was seriously considering a draft of 12,000 physicians.73 By 9 December 1943, over 14,200 dental officers were in the military service and further procurement from civilian sources, other than from students in the ASTP or the Medical Administrative Corps Reserve, was stopped.74

On 16, December 1943, The Surgeon General agreed, at the request of the Veterans Administration, to commission all dentists of that agency who were under 63 years of age, and about 170 dental officers in this category were ultimately accepted. These men remained in their normal duties with the Veterans Administration.75

Peculiarly, serious difficulties in dental procurement did not arise until the Dental Service approached its maximum strength in the spring of 1944, and then the principal problem was not to obtain replacements, but to find vacancies for graduates of the ASTP and for such dentists as might be inducted by Selective Service. At that time the Dental Corps numbered nearly 15,000 officers, many of whom had already been on active duty for 2 to 3 years. Very few of these men could be returned to civilian life under existing directives, and natural attrition had proved to be much less than expected. On the other hand, the ASTP had been established early in 1943 to provide about 825 dental officers every 9 months, and unless vacancies could be found for them they would have to be released to private practice after the Government had given them draft exemption and paid for a considerable part of their professional training.

The Dental Division and the War Department did not agree on the best solution for this problem. The Dental Division was influenced mainly by the fessional training.

    71Minutes of Conf between the Directing Board, PAS, and representatives of the WD, 22 May 43. On file Natl Archives, PAS files, WMC.
    72Annual Report ... Surgeon General for CG, ASF, (1943). HD: 319.1-2.
    73Draft of proposed call on Selective Service for the conscription of 12,000 physicians, submitted toThe Surgeon General on 9 Oct 43 by Lt Col Durward G. Hall. [D]
    74Ltr, Col Durward G. Hall to Exec Off, PAS, 10 Dec 43, sub: Cancellation of further procurement of dentists. [D]
    75Annual Rpt, Procmt Br, Mil Pers Div SGO, 1943. HD: 319.1-2.


57

1. During the early stages of mobilization some men had been commissioned who were physically or mentally incapable of performing their duties efficiently. Their presence decreased the effectiveness of the entire Dental Service.

2. Long before the start of actual hostilities many Reserve officers had volunteered for active duty in the emergency. After 3 years of service, during which their colleagues at home had enjoyed exceptionally high incomes, these officers were anxious to return to their offices as soon as they could be spared. It was believed that if ASTP graduates were released while the older men were held in the Army the resulting drop in morale would be catastrophic.

The Dental Division therefore wished to replace older men with recent graduates who had no family ties and who might be expected to be available during the demobilization period.

The War Department, on the other hand, apparently attached more importance to the following considerations:

1. Any great turnover in dental personnel would mean wasted effort in training replacements.

2. Officers with several years of service were considered the most valuable to the Army, and it was doubted if recent graduates of the curtailed dental course would be equal in ability to men with 5 to 20 years of practical experience.

3. Line officers and enlisted men who had proved themselves in combat could be replaced only at the cost of American lives; they had to be, retained until the last battle was won. To release dental officers, who generally lived a less dangerous and rigorous life, while combat personnel had to remain in the fighting, might seriously impair the morale of the latter.

For these reasons the War Department at first preferred to keep the older officers in service, even at the expense of discharging recent graduates under the Army training program. It later changed its attitude to conform more nearly to that of the Dental Division, but this did not occur until the graduating class of June 1944 had been lost and the dental ASTP had been terminated.76

On 11 March 1944 The Surgeon General, at the request of the Dental Division, advised the Military Personnel Division, ASF, that the authorized ceiling for dental officers had been reached; in addition, that approximately 1,294 ASTP students would graduate during the remainder of the year. At the same time he noted that many dental officers were in a "limited service" status and he recommended that the following be relieved from active duty in numbers sufficient to make room for the younger men:77

    76Data on reasons for War Department opposition to the discharge of older dental officers in early 1944 have been difficult to obtain, and reliance has had to be placed on information given by officers on duty in the War Department at the time. Considerable material has been obtained from Maj Ernest J. Fedor, who was dental liaison officer with the Military Personnel Division, SGO, during much of the war. There is some reason to believe that the War Department saw the advantages of replacing the older officers, but that it wished to avoid a categorical statement of policy which would receive wide publicity and which might lead to criticism by line personnel who could not be included.
    77Memo, Col Robert J. Carpenter, Exec Off SGO, for Dir Mil Pers Div, ASF, 11 Mar 44. SG: 322 . 0531.


58

    1. Any dentist over 45 years of age who was classified "limited service."
    2. Dentists over 38 years of age who were recommended for release by corps area commanders. This provision was expected to authorize the discharge of men who were not sufficiently incompetent to be released under existing criteria, but who were of doubtful value to the dental service.

This request was disapproved on the grounds that existing directives were adequate to assure the discharge of inefficient officers. The primary purpose of this proposal, to create vacancies, was apparently given little consideration.78 On 1 April 1944, however, Lt. Col. Durward G. Hall, of the Military Personnel Division, SGO, reported to The Surgeon General that he had received, informal, verbal authority to exceed the official ceiling for short periods of time to permit the commissioning of some, ASTP graduates, and that he had also been instructed to release enough dentists over 40 years of age to maintain the required level. G-1 and ASF refused to confirm these agreements in writing, however, and Colonel Hall was doubtful concerning the advisability of putting them in effect.79

On 16 May 1944 the Director of the Dental Division was informed by the Military Personnel Division, SGO, that due to a lack of vacancies no graduates of the class of June 1944 would be commissioned in the Army, though some names would be referred to the Veterans Administration and the Navy.80 About 225 dental ASTP graduates were actually commissioned at this time by the Navy.81 Shortly thereafter the dental ASTP was terminated, except for senior students who would finish their courses by 1945.82 While The Surgeon General advised against this step, even he apparently underestimated the, difficulties which would be encountered in maintaining a Dental Service for a million or more men in the postwar period, after wartime officers had been dis-charged and Selective Service had been terminated. On 5 June 1944 he stated that while it "might be desirable from some points of view to grant at least some appointments to ASTP graduates," such action was "not justified in view of the present strength of the corps."83

A partial change of attitude on the part of the War Department General Staff was registered in July 1944 when the Commanding General, ASF, was directed to commission qualified ASTP students graduating after June 1944 if they were not desired by the Navy.84 Necessary vacancies were to be created

    78Memo, Brig Gen R. B. Reynolds, Mil Pers Div, ASF, for SG, 25 Mar 44, sub: Relief from active duty of temporary officers of Dental Corps over 40 years of age on permanent limited duty status. HD: 314.
    79Memo, Lt Col Durward G. Hall for Dep SG, 1 Apr 44. [D]
    80Memo, Maj Ernest J. Fedor for Maj Gen R. H. Mills, 16 May 44, sub: Disposition of dental ASTP graduates who will complete their course in dentistry during the month of June 1944. [D]
    81Ltr, Capt W. F. Peterson to SG, 10 Oct 44, sub: ASTP dental students commissioned in the U. S. Naval Reserve. [D]
    82See discussion of the Dental ASTP in chapter IV.
    83Memo, Brig Gen R. W. Bliss for CG, ASF, 5 Jun 44, sub: Requirements for Dental Corps officers. SG: 322.053-1.
    84Memo, Maj Gen M. G. White for CG, ASF, 18 Jul 44, sub: ASTP dental program. Quoted in semiannual report, Pers Serv, SGO, 1 Jul-31 Dec 44. HD: 319.1-2.


59

through the discharge of surplus, overage officers or by the reclassification of the inefficient. The effectiveness of this step was largely nullified, however, by the fact that the dental ASTP would graduate its last student in April 1945, in contrast to the medical ASTP which would continue to provide replacements until January 1948. No authority was given at this time to commission graduates holding Medical Administrative Corps Reserve commissions or dentists who might be inducted, though the latter could be discharged under existing regulations.85 On 28 August 1944 The Surgeon General was further advised that some 300 senior students holding Medical Administrative Corps Reserve commissions could be placed on active duty on graduation.86

Peak strength of the Dental Corps was reached in November 1944, when 15,292 officers were on duty.87 At the end of 1944 there were 15,110 dental officers in the service.88 Only 1,418 dentists had been commissioned during the year, as follows:89

Graduates of the dental ASTP

997

Graduates with Reserve MAC commissions

94

Civilians (other than inductees)

324

Dentists inducted as enlisted men

3

From 1 August through 31 December, 503 officers had been discharged, mainly to create vacancies for younger men, and at the end of the year 212 still awaited separation under previous commitments.90

By 1945 the dental procurement picture was beginning to change. The Dental Corps remained at just a little under. authorized maximum strength, but the only prospective replacements were the 218 senior ASTP students who were to graduate in April and 180 students holding Reserve Medical Administrative Corps commissions, many of whom might be rejected for physical defects. Nine hundred former ASTP students would graduate after April, but they had been unconditionally released by the Army in June 1944 and the Military Personnel Division of the SGO was very doubtful if G-1 could be "sold" on any new procurement program from civilian life.91

Early in February 1945 a, dental officer with the Military Personnel Division, SGO, noted the possibility of a later shortage of dentists, and that office warned the Director of the Dental Division that future procurement was pre-

    85AR 615-360, 25 May 44.
    86Ltr, Maj F. E. Golembieski to SG, 28 Aug 44, sub: Appointment of inactive Medical Administrative Corps dental graduates. Quoted in semiannual report, Pers Serv, SGO, 1 Jul-31 Dec 44, Incl 10. HD: 319.1-2.
    87Memo, Mr. Isaac Cogan for Chief, Dental Cons Div, SGO, 8 Oct 46, sub: Basic data for Dental Corps. SG: 322.0531. The figure given includes officers with the Veterans Administration, traveling, or sick. It does not include officers on terminal leave, officers enroute home for discharge, or officers sick in hospital, not expected to return to duty.
    88Data from Resources Anal Div, SGO. [D]
    89Annual Report, Pers Oprs Br, Pers Serv SGO, 1944. HD:319.1-2.
    90Memo, Maj Ernest J. Fedor for Chief, Procmt Br, Pers Serv SGO, 17 Jan 45, sub: Dental Corps active duty strength. HD: 314.
    91Ibid.


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carious and that conservation of dental officers would be necessary.92 More revealing was a note attached to this correspondence, in which the Director of the Military Personnel Division recommended to his own personnel that "we slow down on the Release and Separation Board in the Military Personnel Division; take no more (dentists) in nor request any new procurement objective; let attrition go below the ceiling and gamble on redeployment and partial demobilization overtaking us." Apparently it was believed at this time that most procurement troubles would be over with the expected end of hostilities, and if dental officers were required for the postwar period they could be obtained through Selective Service. The possibility that demobilization might actually result in a temporary increase in the demand for dental treatment had been mentioned as early as June 1944, but it seems not to have been considered too seriously.93

When the war ended in Europe the Dental Corps numbered 14,700 officers, providing an overall ratio of 1.8 dentists for each 1,000 troops, or 2.6 per 1,000 in the United States and 1.3 per 1,000 overseas.94

Soon after V-E Day The Adjutant General suggested a review of the procurement objectives for dental officers to determine if they might not be reduced in view of changed conditions. In reply The Surgeon General noted that previous sources of replacements were rapidly drying up and he asked that:95

    1. Present authority to commission Medical Administrative Reserve Corps graduates, applying only to those who had been enrolled in the senior class as of 1 July 1944, be extended throughout 1945.
    2. Authority be granted to commission any dentist inducted as an enlisted man, rather than discharge him under current instructions.

It was not expected that these measures would suffice to maintain the existing strength of the Dental Corps, but it was believed that they would enable the Dental Service to meet the lessened demand for treatment which might accompany a decrease in the total strength of the Army. No action was taken on this request. By July 1945 The Surgeon General anticipated a shortage of 475 dental officers by the end of the year, and he recommended that the Dental Corps be maintained at 15,000 officers (exclusive of those with the Veterans Administration) until March 1946. He further advised that 805 new dental officers be obtained, as follows:96

Students holding MAC commissions

70

Inducted dentists

35

Former ASTP students

700

    92Memo, Lt Col Durward G. Hall for Maj Gen R. H. Mills, 8 Feb 45, sub: Dental Corps officers. SG: 322.0531.
    93See footnote 83, p. 58.
    94See footnote 87, p. 59.
    95Memo, SG for AG, Appointment and Induction Br, Appointment Sec, 4 Jun 45, sub: Procurement objective for appointment in the Army of the United States. AG: 210.1 (G-1).
    96Memo, Brig Gen R. W. Bliss for ACofS, G-1, 6 Jul 45, sub: Ceiling and procurement objective for Dental Corps officers. HD: 314.


61

On 18 July the General Staff approved these recommendations.97 It must, be noted, however, that the Army had no hold on former ASTP students who did not choose to volunteer, and instructions to the service commands actually specified that no persuasion would be used in recruiting from that category. Nor were applications from civilian dentists, other than former ASTP students, to be accepted.98 This limited, largely voluntary program produced very little result.

Soon after the collapse of Japan all procurement of officers was stopped by a blanket order issued by The Adjutant General.99 By this time the Dental Corps was down to 13,600 men, and on 20 September the Deputy Surgeon General requested that the commissioning of MAC students be resumed to permit the earlier discharge of older dentists. This time no mention was made of procuring former ASTP students then in civilian status.100 This request of the Deputy Surgeon General was approved about a month later, but it could have little effect in any event since there were only 173 MAC students remaining in the schools, and rejections for physical disability were high because a large proportion of the physically fit had given up their Reserve status to enter the ASTP.101 By the end of the year the strength of the Dental Corps was down to 9,600 men.102 Serious personnel difficulties were still not anticipated in this period as evidenced by General Mills' statement in October that, even though dentists were being discharged in connection with the reduction of the Army, no major procurement program was being considered.103

With the sudden end of the war, pressure for the release of veteran Medical Department officers mounted rapidly, to a point where a congressional investigation was threatened. In particular, the Office of The Surgeon General was flooded with letters protesting the fact that men with several years of service were being held in the Army while students who had been given deferment and whose education had been partially paid for by the Government were being released to private practice.104 Nevertheless, it was found necessary to maintain considerable forces to meet unexpected postwar responsibilities.

Information on the total number of dentists to serve with the Army Dental Corps during the war is not completely reliable. The Strength Account-

    97Ltr, TAG to SG, 18 Jul 45, sub: Ceiling and procurement objective for Dental Corps officers. AG: 210.1 (G-1).
    98Ltr, CG, ASF, to CG, 1st SvC, 25 Jul 45, sub: Procurement of dental officers. AG : 210.1.
    99Ltr, TAG to all agencies having procurement objectives, 2 Sep 45, sub: Cancellation of procurement objectives. AG: 210.1.
    100Ltr, Maj Gen Geo. F. Lull to ACofS, G-1, 20 Sep 45, sub: Waiver of procurement objectives for appointment as second lieutenants MAC-AUS (students, interns) as first lieutenants, Medical and Dental Corps, AUS. AG: 210.1.
    101Ltr, TAG to SG, 13 Oct 45, sub: Appointments of second lieutenants, MAC-AUS, as first lieutenants, Medical and/or Dental Corps, AUS. AG: 210.1.
    102See footnote 88, p. 59.
    103Ltr, Maj Gen R. H. Mills to Capt D. E. Cooper, 26 Oct 45, no sub. SG:210.8.
    104Nearly the whole of SGO file 322.0531 for the year 1946 is taken up with complaints against the release of former Dental ASTP students.


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ing Branch, AGO, reported that 16,775 dentists were called to active duty from 1 January 1939 through 28 February 1946.105 for a total of about 17,100 men, including Regular Army and Reserve personnel already serving at the start of the war. The Resources Analysis Division, SGO, however, estimated that about 18,000 dentists were on duty between October 1940 and the end of 1945.106

SOURCES AND METHODS OF PROCUREMENT FOR DENTAL OFFICERS,
WORLD WAR II

General Considerations

On V-E Day the Army Dental Corps was made up of the following categories:107 108

Component

Number of Officers

Percentage of total strength

Regular Army

266

1.7

National Guard

117

0.8

Organized Reserve

3,106

20.3

AUS (ASTP Graduates)

1,802

11.8

AUS (from civil life)

10,011

65.4

Regular Army

Since Regular Army dental officers were chosen in highly competitive examinations and received thorough training they were generally well qualified in the broad aspects of their profession. A few of the 250 Regular Army dental officers were unfitted for higher administrative duties by temperamental or other defects, but the majority were well trained in that field (see chapter IV) and they filled key positions with credit to themselves and the service. Prewar clinical training, however, had not encouraged the development of skilled specialists. In an era when a high proportion of posts was small, the average Army dentist had to be able to handle a case of periodontoclasia, treat a fractured mandible, construct a denture, or supervise a station laboratory, and emphasis was placed on all-round ability rather than on qualification in a single narrow field. Few dental officers had been able to limit their practices to one branch of dentistry. With the exception of certain outstanding individuals, therefore, the Dental Service had to rely heavily on Reserve officers or former civilians to provide the more complicated types of treatment.

The Regular Army Dental Corps was also unbalanced in respect to age and experience. Of the 269 officers on duty in April 1942, nearly 100 had been

    105See footnote 32, p. 48.
    106Memo, Mr. Isaac Cogan for Dir, Dental Div, 29 Aug 46, sub: Dental Corps officers, historical data. SG: 322.053-1.
    107Ibid.
    108The total given here, 15,302, is slightly higher than the number actually on duty on V-E Day as it includes a few officers who had been released but whose discharge had not yet been reported. For other data on race, age, and clinical qualifications see chapter IV.


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in the service for 24 years or longer; another 100 had approximately 5 years or less of active duty, leaving only about 70 men with from 6 to 23 years of service. One hundred and two dental officers were in the grades of colonel or lieutenant colonel, 146 were in grades of captain or lieutenant, and only 21 officers were in the grade of major, where maximum physical vigor was combined with at least 12 years of experience.109 This situation was unavoidable since it bad originated in the rapid expansion of the Dental Service during and immediately following the First World War, and it would be corrected by natural attrition over a period of years.

At best, the Regular Army Dental Corps provided only about 11/2 percent of the 17,000 to 18,000 dentists who were on duty with the land forces at some time during the war.

National Guard

The 250 dental officers in the National Guard at the start of the war provided a nucleus of personnel who had had some service with their units in the field and who were available on very short notice. New commissions in the National Guard brought the total taken on active duty from that source to 311 officers,110 but like the Regular Army, the Guard was too small to provide a significant part of the total treatment required in a major mobilization. In general, the training and efficiency of National Guard dentists was comparable to that of Reserve officers, with the difference that they had generally had the benefit of slightly more practical experience.

The Organized Reserves

On 6 September 1938, 5,197 officers were enrolled in the Dental Reserve, a figure exceeding the authorized total by 97 officers. At that time it was expected that 5,100 Reserve dentists, plus about 500 Regular Army and National Guard officers, would be sufficient for the force of about 4 million men which might be mobilized in an emergency. So little concern was felt over dental procurement that the granting of new Reserve commissions was immediately stopped,111 and it was not resumed for more than two years.112 During this period the Dental Reserve lost 771 officers, and 30 June 1941 it was down to a strength of 4,428 men, distributed in the following grades:113

Colonel

7

Lieutenant colonel

96

Major

354

Captain

909

Lieutenant

3,062

    109Army Directory for 20 April 1942.
    110See footnote 49, p. 53.
    111See footnote 36, p. 51.
    112See footnote 45, p. 52.
    113See footnote 42, p. 52.


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Prior to the start of hostilities in Europe a negligible number of Dental Reserve officers had been on active duty with the Civilian Conservation Corps. A few more had been taken on duty in connection with increases in the Air Force and for reinforcement of the defenses of Panama. Thus, on 30 June 1940, 101 Reserve dentists were on voluntary active service.114

On 18 November 1940, maximum age limits for initial active duty with the Reserve were established as follows:115

1. For troop duty, not more than five years above maximum prescribed for initial appointment in the grade held.

2. For duty other than with troops:

Colonel

60 years

Lieutenant colonel

58 years

Major

54 years

Captain

50 years

Lieutenant

47 years

On 19 February 1941 it was directed that Reserve officers would be assigned on the same basis as Regular Army officers, with no restrictions on the positions they might fill.116

At the end of June 1941, there were 2,090 Reserve and National Guard dental officers on active duty.117 By the end of the year the number had reached about 2,900.118 On 7 November 1941 it was directed that, with a few exceptions, dentists taken on active duty directly from civilian life would thereafter be commissioned in the Army of the United States, which was the temporary emergency force, rather than in the permanent Reserve.119 On 15 April 1942, when about 3,220 Reserve and National Guard dental officers had been called,120 The Surgeon General reported that the Medical Department Reserve was nearly exhausted, so far as physically fit officers in usable grades were concerned, and that emphasis would thereafter have to be directed toward the procurement of civilians with no previous military training.

From 1 January 1939 through February 1946 a total of 3,606 Dental Reserve officers were called to active duty.121 However, it cannot be stated what proportion of the 4,428 dental reservists listed on 30 Julie 1941 saw active

    114Ibid.
    115Ltr, TAG to CGs Hawaiian, Panama Canal, Philippine, and Puerto Rican Depts; each Chief of Arm and Service; and each CA Comdr, 18 Nov 40, sub: Reserve officers, resident in overseas departments, for extended active duty under Public Resolution 96, 76th Congress. AG: 210.31-1.
    116Ltr, TAG to all Comdrs of CAs and Depts, each Chief of Arm and Service, and CGs 1st, 2d, 3d, and 4th armies, 19 Feb 41, sub : Administrative status of Reserve officers on extended active duty. AG: 210.31 ORC.
    117See footnote 42, p. 52.
    118See footnote 55, p. 53.
    119Ltr, TAG to CGs of all armies, CAs, and Depts, Chiefs of Arms and Services, and chiefs of other sections of the WD Overhead, 7 Nov 41, sub: Policies relating to appointments in the Army of the United States under the provisions of PL 252, 77th Congress. AG:210.1.
    120Ltr, Lt Col John A. Rogers, SGO (no addressee indicated), 23 Apr 42, sub: Appointment in the Army of the United States (Medical Department). SG: 320.2-1.
    121See footnote 49, p. 53.


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duty, because additional commissions were granted between that date and 7 November 1941 when new commissions in the Reserve were discontinued. It seems probable that the figure was close to 75 percent.

Before Selective Service and PAS could be established the Reserve supplied trained dental officers when they were immediately needed. In general, these officers performed their duties creditably. Their training had not always been sufficient, however, to enable them to fill the more critical positions, and the classification of Reserve officers had not been accurate enough to permit assignment of specially qualified individuals to appropriate functions. Above all, the wartime experiences of many Reserve officers led them to doubt the advantages of belonging to that organization. Prior to the war the principal inducements for entering the Reserve, besides patriotism, had been (1) assurance that the dentist would serve in the field for which he was trained, and (2) the prospect that in time of emergency the superior training of the Reserve officer would put him in a favorable position for promotion and assignment. Events showed that there was little danger that any dentist would have to serve in enlisted status, and the Reserve dentist in the grade of captain or lieutenant seemed to have little more chance for promotion than the dentist called directly from civil life. As previous incentives for accepting Reserve commissions diminished in importance it seemed probable that postwar procurement for that organization would have to be stimulated by financial remuneration in the form of pay for the time expended or as retirement privileges.

Interviews with senior dental officers have brought out the following comments concerning the effectiveness of the Dental Reserve Corps:122 123

1. The patriotism, zeal, and professional qualifications of the average Reserve dentist were above criticism.

2. The Dental Reserve supplied essential officers during the most critical period of the mobilization for war, before the Selective Service System was in effective operation. Officers were obtained in a more orderly way through the Reserve than would have been possible through Selective Service, at least until the establishment of the PAS.

3. Reserve officers in the lower grades were able to assume their military duties immediately, with little or no additional training. Some, though not all, of the senior officers successfully filled key positions when the Dental Service was filled out with former civilians with no previous experience.

4. Some senior officers of the Reserve were found to lack the experience and training required in important positions, and since routine chair work was not appropriate for their high grades their proper assignment was extremely difficult. This was not necessarily the fault of the officer himself since he had usually fulfilled the requirements for promotion to the field grades, but sporadic

    122Final Report of The Surgeon General, Medical Department Personnel, included in ASF report on Logistics in World War II, 1945. HD 319.1-2.
    123See footnote 21, p. 44.


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correspondence courses and occasional 2-week periods of active duty were simply not sufficient preparation for major administrative duties which bore little resemblance to the officer's peacetime activities. In some aggravated cases senior officers of the Reserve had actually given up the practice of their profession years before and were engaged in other occupations. When such men were called upon to instruct juniors or to operate larger installations, the Dental Service inevitably suffered.

5. Prior to the war, classification of Reserve officers was defective and little accurate information was available concerning their true qualifications. As a result, most Reserve dentists were immediately assigned to tactical commands where it was believed they could be most useful, and many clinical experts were lost to professional centers where they were badly needed. The men themselves were discouraged when their special skills were not employed.

6. In the year of the "phony" war, before Pearl Harbor had emphasized the national danger, Reserve officers were called from their homes and practices to staff the clinics of an Army assembled primarily for training purposes. Meanwhile, their competitors enjoyed the "boom." Under these conditions some Reserve officers felt that they had been called upon to make uncalled-for sacrifices for their patriotism. If they had been encouraged by the thought that they would get quicker promotion in the coming expansion, their disappointment was even more acute, when some of these same competitors demanded, and received, higher grades as the price of volunteering for active duty, while the Reserve officer remained assigned to a tactical unit where promotion was stagnated. (This complaint was more frequent in the Medical Corps than in the Dental Corps, where few initial appointments were given above the grade of captain.) Also, the very fact that a Reserve officer had some training in military matters often led to his assignment to a tactical organization, where opportunities for the practice of his profession were poorest, while the man without military experience was sent to a hospital where he maintained or improved his skill and where he lived under much m ore pleasant conditions. Finally, when it was announced in 1944 that ASTP graduates would be released to private practice, while Reserve officers with 3 years or more of service would be kept in the Army, criticism from Dental Reserve officers reached a new peak, though the Office of The Surgeon General was in no way responsible for that decision. The experiences of some of these officers led them to advise young graduates to stay out of the Reserve and take their chances on induction 9 especially since there was little probability that they would have to serve as enlisted men in any event.124

World War II experience also indicated the need for more comprehensive training and more practical experience for Dental Reserve officers in the higher grades.

    124Personal Ltr, Dr. Charles W. Freeman, Dean, Northwestern University Dental School, to Maj Maurice E. Washburn, 21 May 46. SG: 322.0531.


67

ASTP, Medical Administrative Corps Reserve,
Enlisted Reserve

The procurement of some 1,900 dental officers through the ASTP, and of approximately 1,200 through the MAC and Enlisted Reserves, is discussed in Chapter IV. These men were generally recent graduates who entered the service in the lowest grade, directly from school. They were already obligated to render military service, and had not been engaged in essential civilian practice, so their procurement offered no special problems.

Selective Service and Dental Procurement

It has been pointed out that until the spring of 1942 the, Dental Service was expanded mainly with officers from the Reserve and National Guard. The Surgeon General was able to pass on every application for these branches, to insure compliance with professional, moral, and ethical standards, and the number taken from civil practice did not constitute a serious threat to civilian dental care. As these sources approached exhaustion, however, and as prospective requirements loomed larger, emphasis was switched to the procurement of dentists engaged in private practice who lacked previous connection with the Armed Forces. By V-E Day nearly two-thirds of the Dental Corps consisted of men taken directly from Civil life.125 As it became necessary to dip deeper into the reservoir of civilian practitioners The Surgeon General had to rely on other agencies to assist in locating eligible men, determining if they could be spared from their communities, and inducing them to accept active duty.

The first official, nonmilitary agency to enter the dental procurement field was the Selective Service System. As the only authority which could order an individual into the Armed Forces, this organization had great potential importance for the Dental Service, but for some time after it was established late in 1940 its activities proved more embarrassing than helpful, for the following reasons:

1. The Selective Service law provided for the deferment of persons essential to the national health or welfare, but blanket deferment on an occupational basis was specifically prohibited. the responsibility for determining which individuals were actually indispensable rested mainly on the local draft boards. Neither the heads of the Selective Service System nor the members of local boards were at first seriously concerned over the possibility that a shortage of dental personnel might develop, and the latter did not hesitate to induct dentists who were not at the moment urgently essential in their communities. On the other hand, the ADA and The Surgeon General believed that the dental personnel situation was cause for alarm, and that serious difficulties could be avoided only if every dentist were employed according to his skills.126

    125See footnote 106, p. 62.
    126Memo, Brig Gen Albert G. Love for ACofS, G-1, 25 Mar 41. HD:314.


68

Since there were very few vacancies in the Dental Reserve, it appeared that dentists inducted into the Army would have to serve as enlisted men in duties which could be performed equally well by less highly trained personnel. The Surgeon General warned the War Department that it would be the, target of widespread criticism from the profession and from civilian communities if the services of badly needed dentists were wasted in relatively minor activities.

2. Selective Service boards were not technically qualified to pass on questions of professional qualifications or ethics, nor were they greatly concerned with such matters. They therefore tended to induct dentists who could not have been commissioned by the Army, even if vacancies had existed. In some instances, in fact, the boards apparently selected for induction those dentists who were considered least valuable to the, community, and such men were likely to be of doubtful value to the services as well.127

The Surgeon General was powerless to prevent the induction of dentists by Selective Service, but he attempted, unsuccessfully at first, to provide for the commissioning of qualified inductees in the Dental Corps. On the same day that the Selective Service System was established The Surgeon General reminded The Adjutant General that commissions in the Medical Department Reserve had been suspended since December 1939128 and that professional personnel who would later be in short supply would probably be inducted as enlisted men. He recommended that commissions be offered any inducted physi-cian, dentist, or veterinarian, and those who faced imminent induction.129 A notation on this letter states that it was "returned informally," apparently without action. Substantially the same request was repeated on 26 October 1940,130 and on 29 October the corps areas were authorized to resume commissioning Medical Department personnel to fill actual vacancies.131 Dental vacancies were practically nonexistent at this time, however, so this directive had little effect so far as the Dental Corps was concerned. In November 1940 The Surgeon General asked the corps areas to save the few available dental vacancies for men who might be inducted,132 but even this slight gain was short-lived since the granting of new commissions was again suspended on 8 December 1940.133 Procurement to fill vacancies in the Medical Department was again resumed on 19 December134 but The Surgeon General again reported that there

    127Interv by the author with Maj Gen R. H. Mills (6 Oct 47) and Maj Ernest J. Fedor (24 Nov 47).
    128Commissions in the Dental Reserve had actually been suspended since September 1938.
    129Ltr, Col Larry B. McAfee to TAG, 16 Sep 40, sub: Appointment in the Medical, Dental, and Veterinary Corps Reserve. [D]
    130See footnote 44, p. 52.
    131See footnote 45, p. 52.
    132The original radiogram from The Surgeon General has not been found. It is mentioned in "Preparedness and War Activities of the American Dental Association: A resume" J. Am. Dent. A. 33: 80, 1 Jan 46.
    133Ltr, TAG to CA and Dept Comdrs, 8 Dec 40, sub: Suspension of Appointments in the Officers' Reserve Corps. [D]
    134Ltr, TAG to each CA and Dept Comdr, and SG, 19 Dec 40, sub: Appointments in the Medical Department Reserve. [D]


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were almost no vacancies in the Dental Corps.135 A notice in the Journal of the American Dental Association for December 1940, that any inducted dentist could apply for a commission, proved premature.136 On 22 January 1941 the Chief of the Dental Division again recommended that physicians, dentists, and veterinarians who received low call numbers, or who were inducted, should be offered commissions137 but no action was taken at this time.

Meanwhile, other interests had become involved in the matter. Two days after Selective Service was inaugurated Senator James E. Murray introduced a bill providing that any licensed physician or dentist who met established mental and physical standards should be commissioned in lieu of induction.138 This measure also provided for the deferment of medical and dental students, interns, and residents. At first it was reported that the Army was not opposed to this bill,139 but on 16 December 1940, the War Department formally registered its disapproval, based on the following considerations:

1. It was felt that rigid regulations favorable to any one branch were not justified. If all Medical Department personnel were given commissions on induction, engineers, lawyers, and other groups would feel entitled to the same treatment.

2. It was believed that deferment of persons actually essential to the preservation of the nation's health could be accomplished without legislation and that mandatory legislation would handicap the administration of Selective Service.140 No final action was taken on this measure before the end of the congressional session, and substantially the same bill was reintroduced on 6 January 1941.141 Before hearings could be held, however, an amended version was introduced which provided not only for the commissioning of inducted dentists and the deferment of students, but for the deferment of teachers in medical and dental schools.142 Hearings were held on this bill from 18 to 20 March 1941143 and the Army again opposed passage, adding as another reason the fact that it did not wish to be placed in the position of having to commission any physician or dentist who might be inducted, regardless of his professional, ethical, or

    1351st ind, SG, 20 Jan 41, to ltr from Lt Col T. W. Wren to CG, 8th CA, sub: Application for appointment in the Dental Corps Reserve. [D]
    136Fairbank, L. C. : Dentistry in mobilization. J. Am. Dent. A. 27: 1972, Dec 1940.
    137Memo, Brig Gen Leigh C. Fairbank for Brig Gen William E. Shedd, 22 Jan 41, sub: Reserve commissions for physicians, dentists, and veterinarians subject to induction Into the military service. HD: 314.
    138S. 4396, 76th Cong., introduced 18 Sep 40.
    139Committee on Legislation. J. Am. Dent. A. 28: 989-990, Jun 1941.
    140Ltr, SecWar (Henry L. Stimson) to Hon Morris Sheppard, Chairman, Sen Committee on Mil Affairs, 16 Dec 40. Quoted in "Report of Hearings Before the Committee on Military Affairs, United States Senate, 77th Congress, on S. 783, 18-20 Mar 41." Washington, Government Printing Office, 1941, p. 144.
    141197, 77th Cong., introduced 6 Jan 41.
    142S. 783, 77th Cong., introduced 6 Feb 41.
    143Report of Hearings before the Committee on Military Affairs, United States Senate, 77th Congress,on S.783,18-20 Mar 4l. Washington, Government Printing Office, 1941.


70

moral status.144 Since both medical and dental officers testified against the measure it must be assumed that in spite of his repeated attempts to get authority to commission inducted dentists The Surgeon General was also opposed to the Murray bill, probably because it left him Do chance to reject the few men who were undesirable because they had graduated from substandard schools or because they had engaged in unethical practice. The combined opposition of the War Department and of Selective Service blocked the passage of this legislation.

Meanwhile, as The Surgeon General had foreseen, the War Department was flooded with protests from congressmen, civilian communities, and the profession, at the wasteful use of physicians and dentists as enlisted soldiers. Since The Surgeon General was in agreement with these complaints, and had been prevented from taking corrective action by higher authority, he washed his hands of the whole matter and referred all protests to The Adjutant General as "pertaining to your office." In January 1941 the Chairman of the Military Preparedness Committee of the ADA discussed this question with Senator Claude Pepper, and the latter directed a letter of inquiry to the Secretary of War. When this communication was referred to The Surgeon General, he submitted an analysis of probable needs showing that the Reserve would be depleted by June 1942, and again proposed that procurement for the Dental Reserve be resumed.145 However, when the ADA in February 1941, recommended an increase in the Dental Reserve Corps from 5,100 officers to 8,000 officers, The Surgeon General opposed such action. It was stated later that he felt that this number of men could not be used, and to enroll officers in the Reserve, beyond the number which would be called to active duty, was equivalent to granting occupational deferment, which was a prerogative of Selective Service.146 147 It must be kept in mind that at this time the country was still nearly a year away from active participation in the war.

As a result of the recommendations of The Surgeon General, the numerous protests received, and the threat of legislative action if existing policies were not changed, the War Department finally, on 5 May 1941, authorized the granting of a commission to any inducted dentist who was found to be qualified148 Senator Murray stated that his bill had forced consideration of the problem, and this was implied, if not admitted, in General Fairbank's state-ment that the action of 5 May had "followed participation of Army representatives in hearings on the Murray bill."149

      144Ibid.
      1452d ind, SG to TAG, 18 Feb 41, on ltr, SecWar to TAG, 27 Jan 41. SG: 080 (ADA).
      146See footnote 50, p. 53.
      147Camalier, C. W. : Preparedness and war activities of the American Dental Association : A resume. J. Am. Dent. A. 33:80, 1 Jan 46.
      148See footnote 48, p. 53.
      149Memo, Brig Gen Leigh C. Fairbank for SG, 25 Feb 42, sub: Procurement of dentists for military service. HD: 314.


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The action of the Army in making it possible to offer commissions to inducted dentists solved only half of the problem, however. It still did not prevent the more or less indiscriminate conscription of men who were not immediately needed or wanted by the Armed Forces or who were in essential civilian positions. By the spring of 1941 Selective Service itself was beginning to show some alarm over the professional personnel situation, and on 22 April it cautioned the local boards that a shortage of dentists might impend.150 This tentative warning was confirmed on 30 April.151 Local boards were then reminded that (1) they still had full responsibility for determining if a dentist was indispensable in his own community, (2) the Army did not need dentists for the time being, and (3) if a board felt that a dentist should be inducted anyway he should be notified that he might apply for a commission as soon as he entered active duty. This directive had the effect of discouraging the draft of dentists, though it did not categorically prohibit such action.

In January 1942 Selective Service advised its boards that it was essential that all dentists be used where their services would do the most good, and it directed that the recently formed PAS, WMC, be consulted in determining essentiality.152 This regulation was obviously not intended to confer blanket exemption on dentists, however, since the boards were notified at the same time that when dependency was the only cause for deferment it should be kept in mind that the salary of a commissioned officer was normally sufficient for the support of a family. In February 1942 the Director of the Dental Division reported that dentists were still being inducted, and he recommended that Selective Service modify its regulations to prevent the conscription of Medical Department personnel except with the advice and consent of the PAS.153 No formal action was taken on this request, but within 2 months the ADA reported that Selective Service boards were generally deferring dentists, at least until the PAS could be placed in full operation.154 In December 1942 Selective Service again advised the local boards to give careful consideration to the occupational deferment of dentists,155 and the conscription of professional personnel was thereafter a very minor problem, though it did not cease entirely.

    150Memo, Dir, Selective Service System, for all State Directors, No. I-62, 22 Apr 41, sub: Occupational deferment of students and other necessary men in certain specialized professional fields (III). On file Natl Hq Selective Service System.
    151Telegram, Dir, Selective Service System, to all State Directors, 30 Apr 41. On file Natl Hq Selective Service System.
    152Memo, Dir, Selective Service, for all State Directors (I-363), 28 Jan 42, sub: Occupational deferments of medical doctors, dentists, and doctors of veterinary medicine. In Memoranda to all State Directors 1940-43. Washington, Government Printing Office, 1945.
    153 See footnote 149, p. 70.
    154The procurement and assignment service for physicians, dentists, and veterinarians. J. Am. Dent. A. 29: 653, Apr 1942.
    155Selective Service Occupational Bulletin No. 41, 14 Dec 42, sub: Doctors, dentists, veterinarians, and osteopaths. In Occupational Bulletins 1-44, and Activity and Occupation Bulletin 1-35. Washington, Government Printing Office, 1944.


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As noted above, during the first years of the war Selective Service was most often blamed for inducting professional personnel who were not wanted by the Armed Forces. During this period the War Department, WMC, and the professions tended to deprecate the activities of Selective Service in mobilizing physicians, dentists, and veterinarians as an indiscriminate threat to essential civilian medical care and to the economic use of scarce personnel, and late in 1941 all of these agencies approved the formation of PAS, WMC (to be discussed later in this chapter), as an organization which was expected to supplant Selective Service in this field. Though liaison between PAS and Selective Service was imperfect at first, the system was functioning by the end of 1942, at least to the extent that Selective Service boards were inducting very few physicians or dentists who had not been cleared by PAS.

Unfortunately, a serious weakness was revealed in this program early in 1943 when voluntary procurement for the Medical Department began to lag. Fifty percent of all physicians and 17 percent of all dentists declared "available" by PAS refused to accept commissions, and the Medical Corps, in particular, faced a critical and mounting shortage of personnel.156 157 But when the War Department and PAS decided that the time had come for Selective Service to exercise its powers,158 those powers were found to be inadequate, at least under existing policies. Among the reasons for, this situation, the following were most important:

1. While Selective Service had been criticized for inducting professional personnel, it had done so only under the same policies that applied to any other category, according to a priority based mainly on age, physical condition, and absence of family responsibilities. It was a fundamental principle of Selective Service that every man should be considered for military service on the basis of such impersonal factors, and boards were now as reluctant to induct an individual merely because he happened to be a physician or dentist as they had been to exempt him for the same reason earlier in the war. But the supply of young professional men with few dependents was small. Because of the long period of training required, medical personnel tended to be older than their contemporaries in industry; because they enjoyed a good income and constituted a stable element in the community they tended to acquire families soon after entering practice. It was now found that in spite of earlier complaints the majority of physicians, dentists, and veterinarians were immune to induction under current criteria.

PAS protested that from 70 to 80 percent of all recalcitrants were not subject to induction because of age or dependency.159 One state director reported

    156See footnote 52, p. 53.
    157Another author has declared that 26 percent of 7,259 dentists declared available by PAS refused to accept commissions. See State Officers' Conference. J. Am. Dent. A. 31: 1574-1576, 15 Nov 44.
    158Rpt of Conference between Col Harley L. Swift, Off Dir Mil Pers, ASF, and representatives of PAS, 20 Mar 43. Off file Mil Pers Div, SGO, PAS file.
    159Minutes of Meeting, Directing Board, PAS, 31 Jul 43. Off file Mil Pers Div, SGO, PAS file.


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that out of 130 physicians declared eligible, only a handful had been induced to apply for commissions, and he complained that the remainder were not at all impressed with the possibility that they might be inducted as enlisted men.160 Even if he were drafted, the professional man had little to fear since he would in all probability be offered a commission without delay, and he often preferred to take the slight risk involved when he refused to comply with PAS recommendations. When it was suggested that Selective Service take over PAS' functions even The Surgeon General was doubtful that the situation would be improved by such action as long as such a large proportion of professional men were deferable for age or dependency.161

2. Selective Service regulations were generally drawn up on the assumption that an inductee would serve as an enlisted man, with an enlisted man's pay and allowances. In determining eligibility for induction these regulations did not recognize that the professional man would immediately be commissioned. and enjoy an income adequate to support a family in moderate circumstances.

3. During the first part of the war the Armed Forces, the WMC, and public officials had repeatedly warned the Selective Service System that it was taking professional personnel from communities where they would later be needed urgently, and that such personnel should not be inducted without strong reason. Now it was becoming clear even to laymen that these, warnings had been well founded, and the growing shortage of physicians and dentists in his own area made the member of a Selective Service Board extremely reluctant to approve the induction of additional men in these categories, even at the request of PAS.162

The only solution to this problem was for Selective Service to place a call on its local boards for the required number of physicians and dentists on an occupational basis. As noted above, however, this action would have been a radical departure from established policies, and as such it was extremely distasteful to the Selective Service System. Prior to this time no man had been inducted merely because he happened to be a cook or truck driver who was critically needed by the Armed Forces, and any modification of this principle was regarded with apprehension by that agency. But the situation in respect to professional personnel was not entirely comparable to that of cooks and truck drivers; unlike the latter, physicians and dentists could not be trained in a few weeks or months in an emergency, and they could be obtained in large numbers only from civilian life. If the normal operation of Selective Service failed to produce the number required, more drastic steps were necessary. In October 1943 the War Department reluctantly made a formal call on Selective Service for the conscription of 12,000 physicians.

    160Ltr, Dr. Creighton Barker to Lt Col Durward G. Hall, 27 Dec 43. [D]
    161See footnote 69, p. 55.
    162Interv between the author and Maj Ernest J. Fedor, Dental Liaison Off, Mil Pers Div, SGO, 25 Nov 47.


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The dental personnel situation, which had always been less critical than the medical, was much improved by the summer of 1943, and dentists were not included in the proposed draft of physicians. In fact, other developments eventually prevented even the proposed induction of physicians, but not until an important precedent had been established; it was finally recognized by the Armed Forces, PAS, and Selective Service that the latter might have to undertake the priority induction of specific groups whose special skills were essential to the national defense if sufficient personnel could not be procured voluntarily.163

From the end of 1942 until May 1946 Selective Service played a small part in the procurement of dental officers and very few dentists were inducted as enlisted men. Sixty-one applications for commissions were received from conscripted dentists during 1943, of whom 46 were accepted.164 Only seven officers were commissioned from the ranks from 1 January 1944 through August 1945. Thirty-five applications were rejected in the same period but this figure means little because men who were refused commissions could, and did, make new applications at frequent intervals; it is probable that most of the applications received in 1944 and 1945 came from men who had been rejected for good reasons a year or more before.165

With the end of hostilities the dental personnel picture began to deteriorate and Selective Service again became a factor in procurement. ASTP had graduated its last dental student in the spring of 1945. The shortage of civilian dentists was acute, and even recent graduates could count on incomes of as much as $10,000 yearly in private practice. Above all, effective pressure to volunteer for military service for patriotic reasons was almost eliminated. Yet the Army still had several million men scattered all over the world who had to be furnished dental care. Under these circumstances the military had no alternative but to ask for a draft of dentists.166 This draft shattered all precedents for it was the first and only time during and immediately following the war that Selective Service asked its boards to induct men from a specific occupational group.167 (Very few dentists were actually drafted in 1946 since the Army took every precaution to insure that men threatened with induction would be offered commissions with the least possible delay.)168

Information on the number of dentists who actually served any considerable time as enlisted men during the war is indefinite. Selective Service re-

    163This principle was later made the basis for the draft of dentists in 1946.
    164History of the Army Dental Corps, Personnel, 1940-43, p. 41. HD:314.7-2 (Dental).
    165Info compiled by the author from annual procurement summaries received from the Mil Pers Div, SGO.
    166Memo, Maj Gen Norman T. Kirk for ACofS, G-1, 17 May 46, sub: Procurement objective for Dental Corps officers. SG: 322.0531.
    167Info given the author by Dr. Matheus Smith, Natl Hq, Selective Service System, 24 Nov 47.
    168Col (later Brig Gen) James M. Epperly, Dental Div, SGO, estimated that only about 4 dentists were inducted by their boards before they could be granted commissions. Personal interv with author, 10 Nov 47.


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ports that 558 dentists were inducted and that 49 enlisted during the life of that agency.169 Army records, on the other hand, indicate that only 263 inducted dentists and 14 who enlisted voluntarily were commissioned between 1 January 1941 and 30 June 1945.170 A few additional were commissioned after 30 June 1945, but the total number of enlisted dentists commissioned by the Army probably did not exceed 300 officers. Since, the Navy did not accept any inducted dentists171 these figures, if correct, would indicate that some 300 dental graduates actually continued to serve in enlisted status.

This conclusion is open to question, however, on the following grounds:

1. A few dentists who were inducted against the advice of the Army after the middle of 1944 were immediately discharged. In AGO records these men would be shown to have been discharged as enlisted men, though their period of service, was extremely short.

2. It is probable that a certain number of laboratory technicians, dental assistants, or even dental students, were mistakenly listed as "dentists" in Selective Service forms. These men would of course not be eligible for commissions in the Army.

Col. Louis H. Renfrow, of the Selective Service System, has said that "all but a very few" of the inducted dentists were commissioned.172 Similarly, Maj. Gen. Robert H. Mills stated that only a handful of inducted dentists were not commissioned.173 On the other hand, Maj. Ernest Fedor, formerly of the Military Personnel Division, SGO, reported that that office received some 100 to 125 applications for commissions which were rejected for various reasons, including the following:

1. A few unfortunates were unable to convince a board of line officers that they possessed the superior intelligence, or met the generally higher standards, demanded of an officer.

2. Some applicants were refugee dentists of doubtful background and ability who had volunteered for military service as an aid to establishing citizenship.

3. Some dentists held no state licenses, or had not practiced since graduation from dental college. Others had abandoned the practice of their profession for many years. The Army refused to commission such personnel.

4. Some dentists had been engaged in grossly unethical practice or had been convicted of felonies.

5. A few dentists actually refused commissions because they were in locations near home which they feared to lose, because they preferred their current

    169Personal ltr, Col Louis H. Renfrow, Selective Service Natl Hq, to the author, 10 Sep 47. HD: 31.4.
    170Info given the author by Mr. Kirkman J. Rhodes, Strength Accounting Br, AGO, 8 Sep 47.
    171Info given the author by Comdr J. V. Westerman, Bu Med and Surg, USN, 25 Nov 47.
    172Renfrow, L. H. : Dentistry in the Selective Service System. The Mil. Surgeon 101: 423, Nov 1947.
    173See footnote 127, p. 68.


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duties, or because they felt their opportunities for an early discharge were better as enlisted men than as officers. The Army could not use the above categories in its clinics, and it is doubtful if any useful purpose would have been served by releasing most of them to return to civilian life.

It seems probable that a little over 100 men technically classified as dentists served as enlisted men in the Army during the war. On the other hand, there is every indication that most dentists whose qualifications were not open to serious question were either offered commissions or discharged. This opinion has been confirmed by the Selective Service System,174 the Dental Division,175 and organized dentistry.176

The Procurement and Assignment Service,
War Manpower Commission

The background and activities of the Procurement and Assignment Service are covered in detail in Lt. Col. Alfred Mordecai's "History of the Procurement and Assignment Service for Physicians, Dentists, Veterinarians, Sanitary Engineers, and Nurses, War Manpower Commission."177

Briefly, PAS was formed in October 1941 as a Division of the Office of Defense Health and Welfare Services. Its mission was to insure that scarce medical personnel would be used to the best advantage of all concerned, so that the needs of the Armed Forces and of critical defense areas could be met with minimum hardship for the civilian population. In April 1942 PAS was transferred to the War Manpower Commission and functioned under that bureau for the remainder of the war. From the beginning, PAS was operated in close cooperation with the Armed Forces, USPITS, the civilian professions, and the Selective Service System. At the time of its organization PAS consisted of the following:

1. A central policy board of 5 members (later increased to 8), including Dr. C. Willard Camalier as a representative of the dental profession.

2. Nine advisory subcommittees (later increased to 15) which were concerned with the various medical branches. At first a single committee on dentistry was included, but later a separate committee on dental education was added.

3. Nine corps area subcommittees, each consisting of 2 physicians, 1 dentist, 1 medical educator, 1 dental educator, 1 veterinarian, and 1 hospital representative. These corps area, subcommittees were at first expected to be the principal operating units, but they proved unwieldly and the state subcommittees eventually assumed most administrative functions.

    174See footnote 172, p. 75.
    175See footnote 127, p. 68.
    176See footnote 147, p. 70.
    177See footnote 52, p. 53.


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4. Thirty-nine state subcommittees (some covered more than one state; one state had two committees) consisting of a chairman and subordinate committees on medicine, dentistry, veterinary medicine, and, eventually, sanitary engineering and nursing. The chairman of the state dental committee was nominated by the state dental society and he, in turn, nominated the members of his committee.

5. County or district subcommittees for each profession, as required. Chairman of these committees were nominated by the district or county dental societies, and in turn they nominated their own assistants. These committees were advisory only, and no one but the state chairman could declare a dentist available, but as a matter of custom the recommendations of the local chairmen were accepted in the absence of compelling reasons to the contrary.

6. The Professional and Technical Employment and Training Division of the War Manpower Commission. Though a separate agency, this unit assisted PAS by maintaining rosters of medical personnel, with data on special qualifications, if any.

When PAS began to function, early in 1942, it met a definite need in the procurement picture. As long as most physicians and dentists were obtained from the Reserve, with very few commissions granted to men with no military experience or training, The Surgeon General was able to contact prospective officers, pass on their professional qualifications, and place them on active duty. Even when larger numbers of dentists had to be procured he was able to decentralize this function to corps area Medical Officer Recruiting Boards with fair success. But when it became necessary for the Army and Navy to take nearly 30 percent of all the dentists in the United States it was essential to insure not only that the Armed Forces got the officers they required, but that the reasonable needs of the civilian population, especially in critical defense areas, were considered. Selective Service was familiar with local conditions but it lacked the technical information for such a project, and its efforts to procure medical personnel before the inauguration of PAS generally resulted only in increased confusion. Very early in the war the professional societies had attempted to list all professional personnel and record essential data on specialties, and at first they made some effort to induce younger men to volunteer for military service, but many dentists failed to return questionnaires,178 and the men who were "selected" for Army duty by their colleagues were resentful and inclined to question the justice of the method followed. No matter how impersonal the proceedings, when a society tried to decide which of its own members were most eligible, the resulting protests and charges of favoritism generally made it glad to turn the whole problem over to an impartial, semiofficial agency with no axe to grind.

The PAS agreed to produce the required officers for the Army, advise Selective Service concerning the availability of medical personnel, and assure

    178Committee on Dental Preparedness, Resume of activities. J. Am. Dent. A. 27:1970, Dec 1940.


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the dental profession and the nation that dental manpower would not be wasted and that the needs of local communities would be considered. To carry out these aims it inaugurated two projects: (1) It made a strong effort to list every dentist in the country with supplementary data on special abilities, educational background, age, dependents, et cetera. (2) It set up the mechanism for determining how many men could be spared from any given area, selecting those who were most eligible and declaring them available to the military.

The ADA had originally sent out a questionnaire to all dentists for whom it could obtain addresses in October 1940179 but lists were incomplete and the response was not too good; over a year later only 75 percent of the questionnaires had been returned, and in some states only about half of the dentists replied.180 The questionnaires received by the ADA were eventually turned over to PAS and they provided useful information in the first stages of that agency's operations, but PAS found it necessary to cooperate with the National Roster of Scientific and Specialized Personnel in sending out new questionnaires in February 1942.181 Data so obtained were available to the Central Board, State Chairmen, or the military.

The question of the availability of dentists for military duty involved several factors, including the following:

1. How many dentists were in practice in the United States?

2. How many dentists would be required to meet the minimum needs of the civilian population?

3. Which areas could best spare the dentists needed by the Armed Forces? An overall survey of medical personnel had been made very early in the operation of PAS, but at first local chairmen were relied upon to determine the availability of dentists.182 This policy did not prove satisfactory, however, for the following reasons:

1. Dental manpower was distributed very unevenly over the nation. Some cities had more than one dentist for every 1,000 persons, while some rural areas had less than one dentist for 5,000 individuals. PAS representatives in the latter districts felt called upon to deliver at least a few dentists, though they could not, in fact, be spared. The representative in a big city might declare, a large number of men available and still obtain only a small proportion of the dentists which could have been taken without endangering civilian practice.

2. The southern states, which generally had the lowest proportion of dentists to total population, had already supplied the most dentists on a volun-teer basis during 1940 and 1941.

3. No uniform yardstick had been established by which local chairmen

      179Committee on Dental Preparedness. J. Am. Dent. A. 27: 1658, Oct 1940.
      180Procurement and assignment agency for professional personnel in the Army. J. Am. Dent. A. 28: 2026-2030, Dec 1941.
      181See footnote 52, p. 53.
      182See footnote 19, p. 42.


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could determine how many dentists should be retained to meet the reasonable needs of the civilian population.

In June 1942 the directing board of PAS decided to undertake a nationwide survey of dental resources as a basis for establishing state allocations.183 The Committee on Dentistry carried out this survey with the assistance of USPHS and the results were, reported on 20 February 1943.184 The findings of this committee have already been discussed in this chapter under "Limitations on the Number of Dentists Available from Civilian Practice."

When it had been determined how many dentists were in practice in any area, and how many were required for civilian care, state chairmen were assigned quotas based on current military needs. When procurement reached its fastest tempo in the first months of 1943 PAS was obligated to declare 400 dentists available each month.185

The first procedure adopted by PAS and The Surgeon General for the procurement of medical personnel involved the following steps:186

1. The Surgeon General notified the central office, PAS, of his requirements for officers.

2. The central office, PAS, made up lists of names, from its files and forwarded them to the SGO liaison officer with the appropriate professional organization for ethical and educational clearance.

3. The SGO liaison officer sent the lists to the state PAS chairmen concerned. The latter eliminated all men considered essential and returned the lists to the central office, PAS.

4. The central office, PAS, mailed individual application forms and authorizations for a physical examination at an Army installation.

5. Physical examination reports were mailed, by the surgeons completing them, directly to The Surgeon General. Completed applications were returned by the individual to the central office, PAS, where they were checked for accuracy by an SGO liaison officer, and if correct they were sent to The Surgeon General.

6. If the applicant was acceptable to The Surgeon General all papers in the case were forwarded to The Adjutant General, who offered the man a commission. The Surgeon General notified any applicant whose request for a commission was rejected.

This system proved to be very cumbersome in operation and it was simplified considerably in the spring of 1942 when the Medical Officer Recruiting Boards were established by The Surgeon General. These boards were organized in each state, with authority to contact prospects, pass on their professional qualifications and ethical standing, and offer commissions in the grades of

    183See footnote 18, p. 41.
    184See footnote 19, p. 42.
    185See footnote 52, p. 53.
    186Ibid.


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lieutenant or captain on the spot. The boards often set up their offices in the same quarters occupied by the state PAS, and cooperation was close and informal. PAS retained the sole right to declare any man available, however, and the boards were instructed to process no physician or dentist who was not cleared by the state PAS chairman.187 188 189

When the functions of the Medical Officer Recruiting Boards were taken over by OPS, ASF, at the end of 1942, The Surgeon General again had to pass on the acceptability of applicants and the procurement process again became more complicated. The field offices of OPS then contacted prospects in cooperation with local PAS representatives, completed applications, and forwarded them to The Surgeon General. If the prospective officer appeared to be acceptable his application was sent to the central office, PAS, which forwarded it to the state chairman for clearance as to availability. The latter sent the application to the SGO liaison officer with the appropriate professional society for ethical and professional clearance, and it was then returned to The Surgeon General for final action. The clearance of the state PAS chairman was an essential part of the application.

When professional personnel who had been declared available by PAS refused to apply for commissions the case was turned over to Selective Service for appropriate action.

Opinions concerning the effectiveness of PAS, in respect to the procurement of dentists, varied. Certainly some agency was needed to determine availability and advise Selective Service and The Surgeon General on matters affecting medical manpower. This function PAS seems to have performed with reasonable satisfaction. But its name suggested that PAS was expected to go further and actually present to the Armed Forces the names of qualified men who would accept commissions if they were physically fit, and in this activity it was less successful. Half of the physicians declared available, and a smaller proportion of the dentists, refused to volunteer for military service. In the critical days of early 1943 both the Army and Navy expressed considerable dissatisfaction concerning PAS' inability to provide replacements. The agency was accused of "pussyfooting" and it was stated that PAS chairmen should "get tough," that younger men were needed as state chairmen, or even that Selective Service should take over PAS functions. The shortage of dental officers was less acute than that of medical personnel, but a representative of the Dental Division also expressed some concern over the lagging procurement of dentists during the first 2 months of 1943. Much of this criticism seems to have stemmed from a misunderstanding of the limited powers of PAS and of its proper function. If the PAS had had effective backing from Selective Service any man declared available would have hurried to apply for a com-

    187Ltr, TAG to CG, 1st CA, 28 Apr 42, sub: Medical Officer Recruiting Boards. AG: 210.31.
    188Memo, SG for Medical Officer Recruiting Boards, 27 May 42, sub: Memorandum to Medical Officer Recruiting Boards. Natl Archives, PAS files, WMC.
    189Ltr, SG to Medical Officer Recruiting Boards, 20 Jun 42: Instructions. [D]


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mission to prevent his induction as an enlisted man, but it was apparent from the start that professional personnel were not much worried over the possibility of being drafted.190 The Assistant Executive Officer of Selective Service himself admitted that his organization had had great difficulty in supporting the OPS in its efforts to obtain medical officers and that local boards often refused to take the advice of PAS.191 PAS was an advisory body only; it had no authority to apply official pressure to recalcitrants. It could supply technical knowledge which Selective Service did not possess, but Selective Service had to exercise any compulsion required. It would therefore appear that the first consideration, if an agency similar to PAS is to be established in the future, should be a definite arrangement for effective cooperation between that body and Selective Service.192

PAS was also criticized by a representative of the Dental Division for f ailing to pass on the ethical qualifications of dentists. It was stated that local PAS personnel were afraid to commit themselves in doubtful cases, merely declaring the man available and leaving it up to The Surgeon General to refuse or accept him.193 This, again, would appear to have been the proper function of The Surgeon General's liaison officers with the professional societies, rather than of PAS.

It was also inevitable with so much at stake, that personalities and professional jealousy should sometimes enter the picture. PAS necessarily had to give the directors of schools and hospitals a certain amount of freedom to determine which members of the staff were essential and which could be spared. One hospital director was categorically accused of using his influence in this respect to force younger physicians to play his political games under threat of induction into the Army.194 It was also felt that methods used by local personnel were not always wisely chosen. It was reported, for instance, that in some large cities, where individuals could not be known personally, the local chairmen contacted the supply houses to see who ran up the largest bills, and declared these men essential on the grounds that they were obviously doing the most work!195 Such abuses were apparently infrequent, however, and there seems to be no reason to believe that PAS was not as impersonal in its actions as any human agency could be. Certainly PAS personnel gave unselfishly of their time and energy in a thankless job.

    190See footnote 1601, p. 73.
    191Ltr, Richard H. Eanes, Asst Exec Off, Selective Service System, to Maj Gen Geo F. Lull, 21 Mar 44, sub: State Director advice No 206. [D].
    192It must be admitted, however, that local PAS representatives were sometimes suspected of declaring medical personnel available under pressure from higher authority, and then informing Selective Service Board members that they did not actually believe these individuals could be spared. Information from Maj Ernest Fedor, given the author 25 Nov 47.
    193See footnote 21, p. 44.
    194The confidential letter carrying this accusation has been seen by the author, but no useful pur-pose would be served by divulging the names of individuals and institutions concerned.
    195See footnote 162, p. 73.


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At the end of the war the Director of the Dental Division stated that PAS bad proved "workable."196

After giving PAS credit for preventing the induction of dentists as enlisted men, to which it was not entitled, the American Dental Association noted that:197

    The Procurement and Assignment Service, through its State and local committees, brought the selection of dentists for service down to a level where local factors could play an important part. Admittedly, it did not work perfectly, and inequalities can be found without too much research. But the fact remains that the Procurement and Assignment Service did a better job than any previous similar agency. Dentists should see to it that, in any future crisis, it is given sufficient authority to make its program more effective.

PAS took a very minor part in dental procurement for the Army after 9 December 1943.

Medical Officer Recruiting Boards

As it became necessary to procure large numbers of medical personnel directly from civil life in 1942 The Surgeon General was authorized to establish decentralized boards which could locate prospective officers, pass on their professional and ethical standing, and offer them immediate commissions in one of the two lower grades without reference to the SGO. The corps areas were instructed to form these boards in April 1942198 but they were of minor importance to dental procurement for several months since there were very few vacancies in the Dental Corps at that time. When The Surgeon General was authorized a new procurement objective of 4,000 dentists in July 1942, it was directed that a dental officer would be added to each of the 30 boards which were then operating in 25 States.199 The Surgeon General's objective was reached very rapidly, and dentists were removed from the remaining boards on 1 September 1942.200 At the same time the boards were instructed to process no more dental applications except for men classified I-A by Selective Service. Initial quotas for physicians were also being met, and the first board had already been closed for this reason on 26 June 1942. By 21 October 1942 most boards had suspended operations because there was no longer a need for their services. The OPS, ASF, came into operation in November 1942, and the Medical Officer Recruiting Boards did not have an opportunity to demonstrate their effectiveness in the personnel crisis of 1943.

The Medical Officer Recruiting Boards were more important to the Medical Corps than to the Dental Service and they are discussed at length in other sections of the Medical History. In general, Medical Department officers,

    196See footnote 122, p. 65.
    197The right to gripe: The fifth freedom. J. Am. Dent. A. 33: 118-122, 1 Jan 46.
    198Ltr, TAG to CG, 1st CA, 28 Apr 42, sub Medical officer recruiting boards. AG: 210.31.
    199See footnote 62, p. 54.
    200See footnote 64, p. 55.


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working closely with PAS, were able to approach individuals and professional societies more effectively than laymen, and the activities of the, Medical Officer Recruiting Boards were compared favorably with those of the nonprofessional Officer Procurement Service Boards which succeeded them. The fact that nearly 4,000 dentists were commissioned in less than 2 months showed that boards operating under The Surgeon General could play an important part in dental procurement if the need arose and they had the opportunity.

Officer Procurement Service, ASF

On 7 November 1942 the War Department directed that all direct com missions from civil life would thenceforth be handled through an Officer Procurement Service operating under ASF.201 For most branches of the Army, officer replacements were being obtained largely from officer candidate schools at the end of 1942, and very few men without previous military experience were being considered. Instructions given OPS indicate that no small part of its mission was to keep a tight rein on direct commissions from civil life, to keep them to a minimum, and this negative attitude seems to have colored its early operations. But the Medical Department was faced with a different problem; it needed officers and it needed them in a hurry, and they could be obtained only from civil practice. The Surgeon General made no secret of the fact that in his opinion OPS hindered rather than helped procurement, and that it was a poor substitute for his own Medical Officer Recruiting Boards.

Soon after OPS started to function in February 1943, The Surgeon General expressed great dissatisfaction with the results attained and recommended that if no improvement were noted by the end of March, the Medical Officer Recruiting Boards be reestablished. On the same day the Dental Division complained of the slow procurement of dental officers since the first of the year, and the delay was blamed on OPS since PAS reported that the needed dentists were available. By May 1943 the dental personnel situation was less disturbing, but the shortage of medical officers remained so acute that the SGO began to consider a special conscription by Selective Service.202 The procurement, of medical officers continued to lag until ASTP graduates became available, but whether the difficulties encountered were due to deficiencies of OPS, or to the f act that civilian medical resources were approaching exhaustion, a matter of opinion. Since the procurement of dental officers under OPS offered no problems not common to all Medical Department procurement, detailed discussion of that agency will be left for the general medical administrative history.

American Dental Association

The American Dental Association was of course deeply interested in the procurement of dental officers. Soon after the start of hostilities in Europe

    201WD Cir 367, 7 Nov 42.
    202See footnote 69, p. 55.


84

in the fall of 1939, the Director of the Dental Division asked the ADA to establish a committee to consult and cooperate with the military.203 At the time no action was taken, but when the request was repeated in December a "Committee on National Defense" (later called the "Committee on National Preparedness") was appointed without further delay.204 Corresponding committees were formed in each state. It appears that The Surgeon General initially expected the ADA to play a major role, in the procurement of dental officers, and in July 1940, he specifically requested the Association to undertake the following program: 205

1. The Association to conduct a survey of the dental profession through its state and local societies.

2. The local societies to canvass their members to determine which of these would be willing to serve, which could be spared for military service, and which should remain at home because of age, physical disability, or essentiality in civilian capacity.

3. The local societies to list those who were selected for possible military duty according to their professional qualifications, listing as oral surgeons, prosthetists, etc., only those of outstanding ability. Also, to select qualified men to serve on examination boards.

4. The state societies to maintain a roster of all available members.

5. The American Dental Association to maintain a numerical roster of available men, by states.

6. The Medical Department of the Army to have one or more selected officers on duty with the American Dental Association when and if necessary.

7. The War Department, corps areas, or regional officers to call upon the American Dental Association for dentists by Specialties, as and when required.

8. The American Dental Association to call upon the states according to their quotas for the dentists required; the states, in turn, to call upon the local societies for their quotas.

The plan discussed above would have placed almost the entire burden of procurement on the ADA; the Army was merely to request a certain number of dentists with the desired qualifications and the ADA was to deliver them. The Association would have assumed the duties liter assigned to PAS in that it would have had to determine local needs, specify the dentists which could be spared, and maintain a roster according to individual qualifications. In addition it would have accepted much of the responsibility of Selective Service in determining individual eligibility for military duty and, presumably, in exerting the pressure necessary to induce dentists to accept commissions in the Army.

The ADA was apparently favorably inclined toward the plan because it would give some assurance that dentists would not be taken indiscriminately,

    203President's Page. J. Am. Dent. A. 28: 982, Jun 1941.
    204See footnote 154, p. 71.
    205Ltr, Maj Gen James C. Magee to Dr. Arthur H. Merritt, Pres ADA, 6 Jul 40. SG: 080 (ADA) T.


85

without regard to the needs of their communities, and because it would give the organization an opportunity to perform a valuable service.

A program for an immediate survey and classification of all civilian dental personnel was submitted to the Board of Trustees of the ADA in September206 1940. It was approved without delay and $20,000 appropriated for the purpose, in addition to $5,000 for expenses of the Preparedness Committee. Questionnaires were mailed in October of the same year.

Unfortunately, serious defects soon developed in the scheme to use the ADA as the principal dental procurement agency. The Association lacked official status, and about 25 percent of the questionnaires sent to individual dentists were ignored. Also, the local ADA officers were too close to their membership to have the objective attitude and impersonal status required of any official who is to determine which men will be taken from the community for military service. There is no evidence that the endeavors of the ADA in this respect were anything but disinterested, but some dentists objected strongly to being picked for the Armed Forces by their competitors, and charges that political influence was being exerted were inevitable under the circumstances. Antagonism resulted among local members, and the whole task soon proved very distasteful to those who had to carry it out. Further, when a dentist refused to accept a commission after being recommended by the ADA the latter had no authority to enforce its decision.

The ADA was happy to relinquish its thankless task to PAS in 1942. It played an important part in the inauguration of that organization, and it maintained close liaison with it throughout the war.207 It turned over to PAS the data. it had obtained through its survey of civilian dentists, providing that body with much valuable information on which to proceed while plans were being made for PAS' own survey of June 1942. The ADA also cooperated closely with the Dental Advisory Committee of the Selective Service System.208

The ADA rendered an important service to The Surgeon General by assuming responsibility for determining the professional and ethical status of prospective dental officers. In May 1942209a representative of the SGO was placed on duty with the national headquarters of the ADA and the Association furnished him the information on which to decide whether or not a man's standing in the profession made him acceptable for the Army Dental Corps. Membership in the ADA was not required, but dentists who did not meet recognized ethical standards, who were graduates of substandard schools (mainly foreign), who did not possess valid licenses to practice, or who had been convicted of serious offenses, were rejected for military service in the Dental Corps.

    206See footnote 203, p. 84.
    207Committee on Dental Preparedness: A procurement and assignment agency. J. Am. Dent. A. 28:2057-2060, Dec 1941.
    208See footnote 147, p. 70.
    209WD SO 131, 19 May 42.


86

The part played by the ADA in the rehabilitation programs for Selective Service registrants is discussed in chapter VI.

The ADA consistently objected to the induction of dentists and dental students as enlisted men. It backed the Murray bills to commission inducted dentists and defer dental students and instructors, and it made vigorous efforts to have the Dental Reserve increased in 1940 and 1941 to permit the commissioning of inducted dentists.210 It also sponsored a plan to provide care for the patients of dentists in the Armed Forces and to keep the latters' practices intact until their return.211

ATTRITION IN THE ARMY DENTAL CORPS

In the period from 7 December 1941 through 31 December 1946, 2,107 dental officers were lost to the Army, as follows: 212 213

Cause

Total

Cause

Total

Killed in action

20

Over 38, no suitable assignment

448

Died of wounds

5

Key man in industry or Government

3

Declared dead

0

Hardship

8

Missing in action (subsequently returned to duty)

1

Honorable discharge

4

Captured

38

Resignation

64

Deaths from accident, aircraft

8

Reclassification, honorable and other than honorable

28

Deaths from accident, not aircraft

15

Dishonorable discharge

6

Died of disease

56

Conditions other than honorable

29

Suicide

2

Other

12

Other nonbattle deaths

10

Unsatisfactory service

2

Retirement

15

Necessary to national health

1

Physically disqualified

1,328

 

-----

 -----

Overage

4

 

-----

 -----

(See chapter IX for losses due to demobilization.)

From 7 December 1941 to 30 June 1945, an average of about 50 dental officers were lost each month, for all causes. This was a rate of about 5.2 percent a year of the average of 11,400 dental officers on duty during this period. This rate was far from uniform, however, and was artificially stimulated in 1944 to permit replacement of some veterans by younger ASTP graduates.

In general, combat losses, or discharges for disabilities resulting from wounds, were almost negligible so far as the overall manpower problem was concerned. Only 20 dentists were returned to the Zone of Interior for serious injuries during the period 7 December 1941 through 31 December 1946, and not all of these officers were lost to the Service. Thus, losses from battle action

    210See footnote 147, p. 70.
    211Ibid.
    212Casualty data are for the period 7 December 1941 through 31 December 1946. Army Battle Casualties and Nonbattle Deaths in World War II, Final Report, 7 Dec 41-31 Dec 46. Strength and Acctg Br, AGO.
    213Statistics for the remaining causes are for the period 7 December 1941 through 30 June 1945. Compiled from data on file in the Personnel Stat Unit, Administrative Services Div, AGO.


87

(killed, died of wounds, captured, or missing) amounted to 1.5 percent of the mean, Dental Corps strength overseas during the 4 war years, or about 0.38 percent per year. (See also chapter IV, p. 117, for casualty data, 7 Dec 41-31 Dec 46.)

Administrative discharges accounted for 624 separations, or 30 percent of the total. Of these, 448 were men over 38 years of age who were released to create vacancies for younger ASTP graduates, and to the extent that these separations were optional they need not be considered in the personnel problem.

By far the largest proportion of all losses, 63 percent, were due to physical disqualification. The 1,328 dentists discharged for this reason in the period reported amounted to 12 percent of the average of 11,400 officers on duty, or about 3.5 percent each year. It has already been pointed out that few physical discharges resulted from battle injuries; most represented normal attrition under the stresses of wartime conditions. These losses were understandably higher than in peacetime when retirements for physical disability had amounted to about one-half of 1 percent a year.

About 45 dentists, or 0.4 percent of the average strength for the period, were released under conditions "other than honorable." This was only 0.25 percent of about 18,000 dentists on duty at some time during the emergency.

During the first 2 years of the war the Dental Corps was primarily concerned with obtaining enough officers to staff its expanding installations and some dentists were accepted who, for physical or other reasons, had a less than average work capacity. By 1943, however, the Army was approaching relative stability and it was possible to place greater emphasis on physical fitness and efficiency. Also, the ASTP was expected to supply a large number of graduates who had been given deferment from military service and had received at least a part of their training at Government expense. It was highly desirable that these men be taken into the Dental Corps rather than released to return to civilian practice. Finally, a certain amount of "turnover" in the Dental Service was, necessary to provide a balanced force from the standpoint of age and total service. Efforts to improve the efficiency of the Dental Corps and to create vacancies for young replacements took two main directions: (1) to relieve from active duty those officers whose physical condition limited their assignment or prevented them from working normal hours, and (2) to eliminate those few officers whose efficiency was below accepted standards.

Release of Limited Service Officers. As early as July 1943 the War Department had directed that line. officers qualified only for limited service might be released, but physicians, dentists, and chaplains had been specifically excepted.214 A similar order of 1 November 1943 applied to dentists,215 but

    214Radiogram, Maj Gen M. G. White, ACofS G-1, 10 Jul 43, quoted verbatim in History of the Army Dental Corps, 21 Feb-1 Apr 44, Bi-weekly Dental Service Reports. HD: 024.
    215Ltr, TAG to CGs AAF, AGF, ASF, 1 Nov 43, sub: Instructions relative to retention of officers on active duty for limited service. AG 210.85.


88

was again modified in January 1944 to exclude physicians, dentists, and chaplains.216 In February 1944 the Director of the Dental Division recommended that dental officers once more be included in the category which could be separated when found eligible only for limited service, but at the time no action was taken. In March 1944, with the urgent need for creating vacancies for prospective ASTP graduates (see discussion this chapter, pp. 56-59), this recommendation was resubmitted, and on 18 April 1944 The Adjutant General published a directive providing that, dental officers were to be released if: (1) they had been commissioned for general service and were later found to be qualified only for limited service, or (2) if they had originally been accepted for limited service but had suffered deterioration of their physical condition while in military service.

Some difficulty was encountered in persuading all concerned to give effective support to the policy of April 1944. In August 1944 ASF complained that even retiring boards were returning limited service dentists to active duty with the recommendation that they be used in administrative functions when they could not work at the chair.217 ASF pointed out the lack of administrative positions in the Dental Service and advised that since plenty of physically qualified young dentists were available from ASTP the retention of limited service officers was not desired. About 2 months later, however, the policy of ASF was modified by the War Department to permit major commands to retain limited service dental officers if it could be certified that their services were required and could be used efficiently.218

Except for a few senior students the dental ASTP had been terminated by the end of 1944 and replacements were more difficult to find. The Surgeon General therefore abandoned the attempt to have all limited service dentists released219 and on 23 December 1944220 the ASF directive which made the separation of such officers mandatory was rescinded. It cannot be determined how many dental officers were released under this program since they were included in the larger category separated for physical disabilities. Also, many officers classified for limited service only were separated under other provisions, especially those pertaining to the discharge of personnel for whom no suitable assignment could be found. At any rate the number of limited service dental officers released as such was unimportant in the overall personnel picture.

Release of Officers for Whom no Suitable Assignment Existed. The first general attempt to separate the less efficient officers, other than those in the limited service category, was made in December 1943 when The Adjutant

    216Ltr, TAG to CGs, AAF, AGF, ASF, 13 Jan 44, sub: Instructions relative to retention of officers on active duty for limited service. AG: 210.85.
    217ASF Cir 272, 24 Aug 44; ASF Cir 274, 25 Aug 44.
    218WD Cir 403, 14 Oct 44.
    219Memo, Maj Ernest J. Fedor for Dir Mil Pers Div, 28 Nov 44, sub: Relief from active duty of Dental Corps officers. HD: 314.
    220ASF Cir 420, 23 Dec 44.


89

General authorized major commands to release officers over 45 years of age "for whom no suitable assignment could be found."221 In January 1944 the age limit for such separations was reduced to 38 years.222 It was pointed out that a number of officers in all branches had rendered valuable service during mobilization, but that due to physical defects or other circumstances over which they had no control they could not be placed in appropriate positions now that the Army was entering a new phase of the war. Such of these men as were surplus in their commands, who did not come under other regulations permitting their discharge, and whose service had justified separation under honorable conditions, were to be released without prejudice.

The separation of dental officers under this directive proceeded very slowly and eventually more specific action was initiated. In May 1944 the War Department noted that recommendations for the release of dentists had been based primarily on personal desires rather than the good of the service, and ordered a general survey of all dental officers with a view toward selecting for discharge those who were least effective.223 The Surgeon General ordered replacement pools, where dental officers awaited assignment, to refer to a general hospital for disposition any dentist unable to do a full day's work. Other officers in these pools, who were over 38 years of age and could not be assigned to appropriate positions, were to be interviewed to determine if they would accept voluntary separation. By the end of 1944, 121 dentists were released on the basis of such individual recommendations, but that number was fax short of the figure required to permit the commissioning of available ASTP graduates.224

In order to reduce the dental replacement pools which then numbered 811 officers, and to permit the commissioning of an anticipated 900 ASTP graduates, ASF directed The Surgeon General, on 10 August 1944, to recommend specific quotas to be separated by the various major commands.225 Order of priority for discharge, without regard to age, was to be:

1. Officers who were not physically capable of doing a full day's duty operating at a dental chair.
2. Officers marked "limited service" who required special consideration as to climate, diet, type of work, or who were qualified for assignment within the United States only.
3. Officers in the lower efficiency rating brackets.
4. Officers in a limited service status, other than those in "2" above.
5. Officers in other categories whose relief from active duty could be accomplished under current War Department directives.

    221Ltr, TAG to Divs of WDGS, 8 Dec 43, sub: Relief from active duty of officers for whom no suitable assignment exists. SG: 210.8.
    222Ltr, TAG to Divs of WDGS, 12 Jan 44, sub: Relief from active duty of officers for whom no suitable assignment exists. SG : 210.8.
    223WD Memo W605-44, 25 May 44.
    224Semiannual Rpt Procmt Br Mil Pers Div SGO, 1 Jul to 31 Dec 44, pars. 1 o, p. q. HD.
    225Memo, Brig Gen Russel B. Reynolds, Dir Mil Pers Div ASF, for SG, 10 Aug 44, sub: Relief from active duty of Dental Corps officers. Filed as incl 11 to rpt cited in footnote 224.


90

The authority to release officers in the categories listed, regardless of age, was an exception to War Department policy and at the time, was applied only to the Dental Corps.

In order to protect officers eligible for separation under this policy but who had rendered faithful and valuable service, the aforementioned directive was, at the suggestion of the Assistant Chief of Staff G-1, later modified to eliminate any reference to inefficiency. As finally published it provided for the release of:226

1. Officers who were not physically capable of doing a full day's duty operating at a dental chair.
2. Officers marked "Limited Service" who required special consideration as to climate, diet, type of work, or who were qualified for assignment within the United States only.
3. Officers whose relief from active duty could be accomplished under current War Department policies.
4. Officers selected by The Surgeon General who could be released with least detriment to the service. This category was to be used after exhausting categories "1" through "3" above...

In compliance with the 29 August 1944 directive, The Surgeon General recommended on 2 September 1944 that 1,209 dental officers be separated in the United States as follows:227

Service Commands (10 to 15 percent in each area)

516

Surgeon General (to be released from pools)

376

Army Air Forces

200

Army Ground Forces

75

Office, Chief of Transportation

35

Military District of Washington

7

A second list covering officers overseas was submitted on 28 September.228 it recommended the release of 5 percent of the dentists in each theater, for a total of 2l2 officers. The Adjutant General approved in toto the overseas request but in the United States a preliminary quota of only 250 dentists was authorized for separation.229 This was subsequently increased to 290230 and it was expected that new allotments would be announced between January and May 1945. By the end of 1944, 239 dental officers had been released under this program in the Zone of Interior231 and the overseas quota of 212 officers was being processed,

    226Memo, Brig Gen Russel B. Reynolds for SG, 29 Aug 44, sub: Relief from active duty of Dental Corps officers. Filed as incl 11 to rpt cited in footnote 224.
    227Memo, Col J. R. Hudnall for CG ASF, 2 Sep 44, sub: Relief from active duty of Dental Corps officers. Filed as incl 11 to rpt cited in footnote 224.
    228Incl 12 to footnote 224, Memo, Maj Gen R. H. Mills for CG ASF, 28 Sep 44, sub: Relief from active duty of Dental Corps officers. HD.
    229See footnote 224, p. 89.
    2301st ind, TAG to CofT, 4 Nov 44, on Ltr, Lt Col A. Kojassar, OCT, to TAG, 12 Oct 44, sub: Relief from active duty of Dental Corps officers. SG 210.8.
    231See footnote 224, p. 89.


91

but by that time the personnel situation had changed considerably and no further "mass" quotas were announced. On 29 December 1944 a new War Department circular summarized and liberalized earlier provisions for the relief of officers for whom no assignment could be found, who were essential to national health and interest in a civilian capacity, or who suffered unusual hardships because of their military service, and future releases for causes other than physical disability were generally carried out under that circular.232 No further pressure was applied to speed the separation of older or less efficient men. (See pp. 87-88).

Release of Dentists Needed in their Local Communities. For some time before the end of 1944 the Procurement and Assignment Service had tried to have released from active duty Army physicians who were urgently needed in their communities. Results bad been insignificant, however, both because The Surgeon General could spare very few officers and because PAS at first showed little critical judgment in drawing up its recommendations.233 As a result of a conference early in January 1945, PAS notified its state chairmen for physicians that the Army would consider separating a few medical officers though no men would be released who were under 39 years of age, who were qualified for general service, or who were practicing a specialty in the Medical Department. Great care was recommended in selecting only the most worthy cases.234 Dental officers were not mentioned in the instructions to PAS state chairmen, but before the end of demobilization some 18 officers were actually separated as essential to national health or interest.235

Release of Dental Officers for Hardship. Release of dental officers for hardship, also authorized by War Department Circular 485, 29 December 1944, took place slowly prior to the end of the war. By the end of June 1945 only eight dentists had been separated for this cause. In August 1945, however, the War Department directed that increased consideration be given this f actor as a cause for release from active duty before eligibility was established under normal separation criteria.236

Slowed "Turnover" Immediately Prior to V-E Day. At the end of 1944, the dental ASTP was approaching its termination and it appeared that in the future very few replacements would be available from this source. On 17 January 1945, a representative of the Military Personnel Division, SGO, warned that unless conservation of dental officers was practiced the procurement of dentists from civil life would have to be resumed by the end of June.237 Alerted

    232WD Cir 485, 29 Dec 44.
    233A note accompanying a report of a conference between Army and PAS representatives in January 1945 states that "They (PAS) threw everything at us before; lists were meaningless." On file with Ltr, PAS to state chairmen for physicians, 27 Jan 45, sub: Release of physicians from the Army Medical Corps to return to practice . SG: 210.8.
    234Basic communication referred to in footnote 233.
    235Data given to the author by the Strength Accounting Br AGO, 13 Feb 48.
    236By the end of August 1947 a total of 45 dental officers had been discharged for hardships. See also footnote 235, above.
    237See footnote 90, p. 59.


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by this warning, it was announced on 8 February 1945 that dental officer personnel then on duty would be considered as being within a critical and scarce category.238 Further, that separations for causes other than those authorized by the provisions of War Department Circular 485 (see p. 91) would be limited insofar as practicable.239 While the application of this rigid conservation policy enabled the Dental Corps to maintain its strength at the level required, it also slowed down the "turnover" of its officer personnel. This created a personnel situation which was far from favorable, and which at the end of the war (see chapter IX, Demobilization), was subject to a great deal of criticism.

STANDARDS FOR COMMISSION IN THE ARMY DENTAL CORPS

Physical Standards

With minor exceptions (e. g., dental standards for Medical Department officers and chaplains early in the war) physical standards for commissioning in the Dental Corps were the same as for all other branches.240 Approximately one-third of all applicants were rejected for physical defects.241

The Dental Division was very reluctant to commission dentists who could not work a full day, who could not serve in unfavorable climates, or who were otherwise unavailable for general assignment. The first deviation from this policy came in July 1942 when Medical Officer Recruiting Boards were directed to accept dentists in the limited service category, apparently anticipating that sufficient officers could not otherwise be obtained.242 By September 1942, procurement objectives were being filled without difficulty and The Surgeon General directed that only men threatened by induction would be commissioned, automatically eliminating limited service applicants.243 With the granting of a new procurement objective for 7,200 dental officers in November 1942, restrictions on the commissioning of dentists were temporarily lifted and those in limited service categories again accepted, though The Surgeon General passed on all applications and it is probable that the number approved was kept as, low as possible. On 8 September 1943 the PAS was asked not to declare available any dentists who were classified for "limited service" only. No additional dentists were accepted in that category during the remainder of the war, and with the first of 1944, efforts were concentrated on eliminating such officers already in the Dental Corps (see discussion this chapter, pp. 87-88).

    238See footnote 92, p. 60.
    239Ibid.
    240See AR 40-105 for physical standards for military service at different periods of the war. Also, MR 1-9, 31 Aug 40. HD.
    241Ltr, Col Robert C. Craven to Dr. John W. Leggett, 1 Sep 42. [D]
    242See footnote 62, p. 54.
    243See footnote 65, p. 55.


93

Age restrictions for dental officers varied considerably from time to time. In November 1940 it was directed that Reserve dentists would be called to active duty only when they were under the following maximum ages:244

First lieutenant

47 years

Captain

50 years

Major

54 years

Lieutenant colonel

58 years

Colonel

60 years

In August 1941 these. provisions were modified to require that dentists on duty with troops be not over 56 year old, or 58 years if they were on Army staffs. Age-in-grade requirements were simultaneously removed.245

But while trained Reserve officers were generally accepted for active duty as long as they were not over the prescribed maximum age, the principal need was for young, vigorous men who could be assigned to combat units or to over-seas areas with unfavorable climates. Most of this group were taken directly from civil life, without previous experience, and commissioned in the lowest grade. For these reasons the Dental Division desired to limit, as far as possible, procurement outside the reserve to men under 37 years of age who were eligible for general military duty and for whom the grade of lieutenant or captain would be appropriate. But the Dental Corps also wanted to be able to offer a commission to any dentist who might be threatened with early induction, so the maximum age limit went to 39 years during the periods when the Selective Service age limit was set at that figure. For brief periods when procurement threatened to lag, the upper age limit was raised to 44 or even 45 years.

When The Surgeon General established his Medical Officer Recruiting Boards in April 1942 he was instructed to accept older physicians to the extent necessary to permit him to obtain men with the necessary professional qualifications, but applicants for the Dental Corps were still to be accepted only if they were under 37 years of age.246 The following month this directive was modified to allow the commissioning of dentists over 37 who were classified I-A by their Selective Service Boards247 and in June 1942 The Surgeon General informed The Adjutant General that a few men between the ages of 37 and 50 would be commissioned, but only with the express approval of The Surgeon General in each case.248 It was implied that such exceptions to general policy would be made only to permit the commissioning of outstanding individuals, and the records support that inference. As a matter of fact, routine instruct-

    244See footnote 116, p. 64.
    245Ltr, TAG to CGs of all Armies, Army Corps, Divs, CAs, Depts, Def and Base Comds, COs of Exempted Stas, Chiefs of Arms and Servs, Chief of Armored Force, Chief AAF, CG, AF Combat Comd, and Chief of Staff, GHQ, 23 Aug 41, sub : Extension of tours of active duty, reserve officers. SG 210.31-1.
    246See footnote 198, p. 82.
    247Ltr, Lt Col J. R. Hudnall to Lt Col A. R. Nichols, 16 May 42, sub: Medical officer recruiting board, letters of appointment and related forms. [D]
    248Ltr, Lt Col Francis M. Fitts to Off Procmt Div, AGO, 24 Jun 42, sub: Officer procurement for the Army of the United States. SG:320.2-1.


94

tions to the Medical Officer Recruiting Boards a week later again directed that dental officers were to be appointed only if they were under 37 years of age.249 With the authorization of a new procurement objective of 4,000 dentists on 8 July 1942, the boards were temporarily instructed to accept applications from dentists up to 45 years of age, though applications from men over 37 still had to be approved by The Surgeon General.250

In January 1943 The Surgeon General directed that only dentists under 38 years of age would be considered, but on 19 May the Secretary of War was notified that dentists would be accepted up to age 42, or age 44 if classified I-A. In June 1943 the service commands were authorized to accept dentists between the ages of 38 and 44 if they had been declared available by the PAS, had refused commissions, and had been recommended for induction by Selective Service, but it is believed that this procedure was followed in very few cases.251 In September 1943 the PAS was requested not to declare available any dentists who had reached the age of 38. By the end of 1943 The Adjutant General had authorized the release of dentists over 45 years of age for whom no suitable assignment could be found252 and this age limit was subsequently lowered to 38.253 In March 1944 the Dental Division recommended that all dentists over 40 years of age be released, but this request was denied by ASF.254 255

On V-E Day the age distribution of the Dental Corps was as follows:

Age

Number of officers

Percentage of all officers

Under 30

3,902

25.5

30-34

4,086

26.7

35-39

4,958

32.4

40-44

1,423

9.3

45-49

581

3.8

50 or over

352

2.3

Professional and Ethical Standards

Educational requirements for dental officers were relatively simple; the. applicant had to be a graduate of a standard school acceptable to The Surgeon General. All American schools were approved, including those limited to Negro students. The question of foreign schools was troublesome to the Medical

    249Telegram, TAG to Medical Officers' Recruiting Board, 9th CA, 2 Jul 42. AG: 210.31.
    250See footnote 62, p. 54.
    251Ltr, TAG to CG, 5th SvC, 8 Jun 43, sub: Induction of physicians and dentists 38 years of age and over. SG: PAS files, Mil Pers Div.
    252Ltr, TAG to Divs of WD Gen Staff, CGs AGF, AAF, ASF, Def Comds, Overseas Theaters and Depts, 8 Dec 43, sub: Relief from active duty of officers for whom no suitable assignment exists. SG: 210.8.
    253Ltr, TAG to Divs of WD Gen Staff, CGs AGF, AAF, ASF, Def Comds, Overseas Theaters and Depts, 12 Jan 44, sub: Relief from active duty of officers for whom no suitable assignment exists. AG: 210.85.
    254Memo, Exec Off, SGO, to Dir Mil Pers Div, ASF, 11 Mar 44. HD: 314.
    255The original of the communication rejecting The Surgeon General's request of 11 March 1944 has not been found. This letter, dated 25 March 1944, is quoted verbatim, however, in a report of the Dental Division for the period 21 Feb-1 Apr 44, on file in Bi-weekly Reports file. HD: 024.
    256See footnote 106, p. 62.


95

Corps, but the number of graduates of foreign schools applying for dental commissions was negligible.

During the first year of the war an applicant for the Dental Corps was required to have a valid license to practice in a state or territory, but in January 1943 this requisite was dropped, as far as recent graduates were concerned, to make it possible to accept the latter immediately, without waiting for them to take a board.

The enforcement of ethical standards involved some knotty problems. It was of course directed that only dentists in good standing in the profession would be commissioned, but the definition of ethical practice, and its application in specific cases, was not always easy. In the absence, of evidence to the contrary, membership in the ADA was a prima, facie indication of acceptability, but approximately one-third of the dentists in the United States were not members of the ADA and these men had to be considered on their own merits. In some cases it was charged that actual membership had been required locally. In New York City, for instance, the Allied Dental Council complained that its members had been asked if they belonged to the 2d District Dental Society (ADA) when they applied for commissions at the city recruiting board257 It was not specifically stated that they would otherwise be rejected, but rightly or wrongly that inference was drawn. The Surgeon General immediately replied that membership in any society was not a requisite for a commission in the Army.258 But the ADA was allowed to set the ethical standard for acceptance, by the Dental Corps, and to pass on the standing of individuals through the SGO liaison office at ADA national headquarters, resulting in occasional protests from groups having less rigid requirements. In May 1943, for instance, a number of members of a New York society met with representatives of the Dental Division to protest refusal of the 2d District Dental Society to certify them to the Army, mainly on the grounds that they were "advertisers." They were informed that "dentists in New York City . . . must conform to the code of ethics laid down by the 2d District Dental Society."259 A few days later the protesting dentists were called to a joint meeting with representatives of the 2d District Society and they were informed that if they met the requirements of that organization (i. e., removed the offending signs) they would be certified. Many dentists followed this advice and were accepted.

The practice of allowing the ADA to pass on the ethical status of non-members may be questioned, but it is difficult to see how the problem could have been solved in any other way. The ordinary citizen is assumed to be honest if he is not convicted of a crime, and the merchant who gains an advantage in

    257Ltr, Dr. M. J. Futterman, Chairman, National Victory Committee, Allied Dental Council, New York, to SG, 24 Jun 42. [D]
    258Ltr, Maj Gen R. H. Mills to Dr. M. J. Futterman, 30 Jun 42. [D]
    259Statement, Col Robert C. Craven to Co-chairman of Mil Affairs Committee, 2d District Dental Society, 17 May 43. [D]


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a business deal is considered to be a smart operator, but the ethics of the commercial world are not applicable to dental practice; if the merchant delivers goods other than those specified the fact is readily apparent and redress can easily be made, but the quality of the dentist's work can be determined only after many years have elapsed, and after irreparable damage may have been done. The dentist is therefore in a unique position of trust in that he must consider not only his own interests but those of his patients as well. To protect its patients, and its own good name, the dental profession has found it necessary to set for itself standards which are materially higher than those prescribed by law, which are generally drawn up to meet commercial requirements. This has been accomplished through the only organization representing any large proportion of American dentists, the ADA.

Not all of the criteria established by the ADA have been accepted by nonmembers of that body. Advertising, for instance, tends to substitute the press agent's skill for a laboriously acquired professional reputation, but in itself it may not indicate gross moral deficiency. It was therefore held in some quarters that the fact that a dentist had advertised for patients was not an adequate reason for barring him from the Army Dental Corps. As a matter of past experience, however, advertising had so often been associated with other, more objectionable practices that it was certainly a danger signal to be given considerable weight in determining whether or not a dentist was of the type wanted for Army installations. In general the ADA standards had been found satisfactory in operation, and their acceptance by the Dental Corps would appear to have been justified. Moreover, The Surgeon General had neither the information nor the organization with which to undertake the evaluation of thousands of dentists, and the ADA was the only body which had both. It has been suggested that the PAS should have assumed respon-sibility for determining ethical and professional standing, but if it had been given that task it would almost certainly have had to go to the ADA for the information on which to act.

COMMISSIONS ABOVE THE GRADE OF FIRST LIEUTENANT

During the war the Dental Division generally disapproved of granting initial commissions above the lowest grade, and even when an allotment of higher grades was authorized it was seldom filled. This policy was voluntarily adopted without pressure from higher authority in either the SGO or the War Department. The first major procurement objective of the war, granted in January 1942, provided for the procurement of 5 majors, 20 captains, and 475 lieutenants, but it was filled almost entirely in the grade of lieutenant.260 When the Medical Officer Recruiting Boards were established in April 1942 The Surgeon General was permitted to offer sufficient commissions above the

    260See footnote 56, p. 53.


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lowest grade to attract qualified applicants, but a few weeks later the boards were specifically directed that dentists would be commissioned in the grade of first lieutenant only, except in special cases, and with the approval of The Surgeon General.261 In June 1942 The Surgeon General notified The Adjutant General that a few dentists above the age of 37 would be given commissions as captains or majors with the approval of the Chief of the Dental Division, but implied that such cases would be very rare.262 In September 1942 an officer of the Dental Division stated that captaincies would be given only to men over 40, with special qualifications. A few appointments above the lowest grade were made in 1943, but by 1 January 1944 only 2 dentists had been commissioned as majors and 163 as captains.263 At least one of the above majors was commissioned for the Veterans Administration, and most subsequent commissions above the grade of captain were for that organization.

The policy of the Dental Division in respect to granting higher original commissions was criticized by PAS, which felt that its task would have been easier if it could have offered captaincies or majorities to hesitant applicants. Some dental societies also felt that qualified specialists or older men with families should be given grades above that of first lieutenant. The position of the Dental Division was that for each dentist appointed as a captain or major some officer who had volunteered a year or more before would be deprived of promotion. It was felt that men already in the service generally had as much to offer as the dentists who were holding out for advanced grades, and there could be no question but that the former were better qualified from the military point of view. Only in exceptional cases did clinical proficiency justify giving a dentist without military background a commission in a higher grade than had been offered the man who volunteered immediately after Pearl Harbor. The situation was also complicated by the absence of definite standards for determining clinical qualifications; as long as there were no recognized boards to say whether or not a dentist should be classed as a specialist, claims to special ability were made very freely, and to have granted dentists advanced grades on the basis of their own statements would in many cases have resulted in an injustice to the Government and to the officers already commissioned. There can be no doubt, however, that qualified oral surgeons or prosthetic specialists were not attracted by the grades they were offered in the Dental Service, and this fact was noted in personnel summaries submitted at the end of the war.264 If the policy of assigning dental officers to units in the grade of either captain or lieutenant is followed in the future it will be possible, to offer captaincies to the more experienced dentists without jeopardizing the

    261Ltr, SG, no distribution indicated, but apparently directed to Medical Officer Recruiting Boards, 23 Apr 42, sub: Appointment in the Army of the United States (Medical Department). SG: 320.2-1.
    262See footnote 247, p. 93.
    263Brown, P. W. : Procurement of dental officers from civil life, p. 32. HD: 314.7-2 (Dentistry--Army Dental Corps).
    264See footnote 122, p. 65
    .


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rights of earlier volunteers. The establishment of recognized specialty boards will also make it possible to commission qualified dentists as captains or majors on an equitable basis, with a minimum of protest from nonboard members. But only a limited number of vacancies exist in the higher grades, and if they are used carelessly, to lure reluctant dentists when procurement becomes more difficult, the earlier volunteers will suffer, and morale may be expected to drop.

THE DEFERMENT OF INSTRUCTORS IN DENTAL SCHOOLS

(See Chapter on "Personnel and Training.")

THE NONPROFESSIONAL USE OF DENTAL OFFICERS

The number of dentists in the United States has never exceeded the bare minimum required to meet the most urgent requirements. When the Armed Forces took nearly a third of all civilian dentists the remainder were able to care for the nonmilitary population only with the greatest difficulty. No more men could be spared without endangering the health of war workers, school children, and the general public. It was therefore imperative that the available supply of dental officers be used with the utmost economy.

Under some circumstances a military dentist had to be prepared to assume nonprofessional duties. A dental officer with a small task force attacking a Pacific island, for instance, could not hope to accomplish much dental work during the assault phase, and he could generally render the most valuable service by acting as assistant to a medical officer. Also, during the first part of the war, medical organizations, and even tactical units, were sometimes so short of trained personnel that any officers with military experience had to fill key positions until replacements could be trained. In these situations dental officers were used as executives or even as detachment commanders. Regulations provided that dentists could not command any unit, but these directives were often ignored.265 When the Dental Division recommended in 1942 that an order be published prohibiting the use of dentists for other than their proper clinical or administrative duties, the Military Personnel Division of the SGO flatly refused approval on the grounds that dental officers were at that time indispensable in many auxiliary positions.266

There was less justification for the tendency to use dental officers in minor duties which could have been performed by administrative personnel with a few months of training. In the case of tactical commands this abuse often resulted from the circumstances surrounding the formation of new units in the Zone of Interior. As new organizations were assembled there was usually an interim period during which most dental care was furnished by the permanent station

    265See footnote 21, p. 44.
    266Ibid.


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dental clinic. At this time assigned dental officers often lacked their equipment, and the full complement of enlisted personnel had not yet arrived. A field hospital, for instance, had little clinical work to perform until it went overseas, yet it had a full quota of administrative positions to be filled by inexperienced officers. Under these conditions it was almost routine practice to assign the three dental officers to nonprofessional tasks since they had free time and the other officers were busy coping with unfamiliar jobs.

But when such a unit arrived overseas the situation changed completely. The dentists were immediately overwhelmed with demands for treatment, but the assignment to outside duties often continued. The dental surgeon of the Middle East theater found that two dentists in one hospital were together acting as mess officer, supply officer, transportation officer, finance officer, censor officer, and sanitary officer.267 The dental surgeon of the China-Burma-India theater reported that "We really have plenty of dental officers en route to and in the theater if they could be properly placed and put on their proper duty, but we still have plenty with supply units, messing with minor staff jobs, censoring mail, running messes, etc."268

The improper utilization of dental officers during the first years of World War II also derived in part from the prewar doctrine that the dentist's normal duty in combat was to assist the surgeon. This conception had in turn resulted from the admitted circumstance that under the World War I organization the Dental Service could not function too effectively in a forward area and some other duty had to be found for the dental officer of a unit in action. The period of actual combat in World War I was too short to reveal the danger of this policy, but as the Second World War progressed it was found that evacuations for dental emergencies soon reached important proportions when routine treatment was neglected over any considerable period of time; the dental officer could render the most important service to his command by giving all his time to his proper professional duties. The dental surgeon of the European theater reported that "the dental officers were used purely as auxiliary medical officers in most instances . . . until the medical officers realized that men were getting into the chain of evacuation for dental reasons only, showing that the best utilization of dental officers was not being made."269 A conference of senior dental surgeons, called by The Surgeon General in February 1945, recommended that:270

    The utilization of dental officers as auxiliary medical officers, as a routine procedure, is condemned.... the dental needs of a division require the full and most efficient utilization of its dental personnel in dental activities at all times.

    267Jeffcott, G. F.: Dental problems in the Middle East Theater of Operations. Mil. Surgeon 96: 54-58, Jan 1945.
    268Personal ltr, Col Dell S. Gray to Col Rex McK. McDowell, 1 Jul 44. [D]
    269Ltr, Col. Thomas L. Smith, Dental Surg, ETO, to SG, 6 Feb 45, sub: History of the Dental Division, Headquarters, ETOUSA, from 1 Sep through 31 Dec 44. HD: 730 (Dentistry) ETO.
    270Memo, Maj Gen R. H. Mills to Brig Gen F. A. Blesse, 8 Feb 45. [D]


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It was ultimately clear that if dental officers could not render regular dental care under the existing organization, that organization would have to be changed. (See discussion of the division Dental Service in chapter VIII.)

Until the middle of 1942, dental officers' services were also misused to some extent in permanent installations of the Zone of Interior. (See chapter I, page 14.) This practice was prohibited in the Zone of Interior by a War Department directive of 31 July 1942 which provided that in the future dentists would be used only in the operation or supervision of the Dental Service, and that dentists currently performing other functions would be replaced as soon as substitutes could be trained.271 The Air Force issued a similar directive on 7 September 1942.272

World War II experience supported the following conclusions in respect to the proper use of dental officers:

1. The number of dentists available in an emergency will normally be strictly limited. It will be sufficient only if they are used with the greatest economy.

2. If the dentists assigned to combat units are used for other than professional duties, except for very short periods of time, evacuations for dental emergencies may be expected to result in an excessive loss of manpower when it is most urgently needed.

3. It is essential that the Dental Service be organized to permit dental officers to function with a minimum of interruption due to tactical operations. If dental officers cannot treat the soldiers of their commands during combat they should be removed and used for the care of units in reserve.

4. Some line officers who do not appreciate the need for regular denial care in their commands will probably continue to use dentists in nonessential activities until prevented by a specific official directive or by a reorganization of dental facilities.

Early steps to prevent the misuse of dentists were reasonably effective in the Zone of Interior, but they had no direct application outside the United States. Changes in the organization of dental facilities in tactical units and the development of the mobile operating and prosthetic units improved the situation overseas to some extent, but the nonprofessional use of dentists was not altogether eliminated before the end of hostilities. Finally, in October 1945, the War Department directed all commands, Zone of Interior and overseas, that no medical, dental, or Army Nurse Corps officers would be used in positions which could be filled by officers of other corps of the Medical Department.273

    271Ltr, TAG to CGs all Svcs, 31 Jul 42, sub: Utilization of dental officers for professional duties. AG: 210.312 (Dental Corps).
    272AAF Reg 25-4, 7 Sep 42, sub: Utilization of dental officers with the AAF. On file in the Office of the Air Surgeon, USAF.
    273WD Cir 307, 6 Oct 45.


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THE RELOCATION OF CIVILIAN DENTISTS

The program to relocate civilian dentists who were excess to the needs of their communities, so that they could provide dental treatment in areas where they were more critically required, was of course not a responsibility of the Armed Forces. It did affect the overall utilization of dental manpower, however, and the Army was even more directly concerned when it had to furnish dental care at such locations as the Oak Ridge atomic bomb plant. Actually, the relocation program seems to have received very little attention during the war, either because it was considered unnecessary or because it was considered impractical by those who would have had to enforce it.

Early in 1944 Congress appropriated $200,000 to be used to encourage dentists and physicians to move to districts where health care was precarious. Volunteers were to be paid $250 a month for 3 months to enable them to get a start in the new location, and all moving expenses were to be paid. Local communities were to carry one-quarter of the total expense in each case.274 The small amount of money appropriated indicates that the effort was experimental, and practical results of the voluntary relocation program were actually negligible. Only 7 applications were received, and 3 dentists were moved; 1 other moved with Federal assistance but with no expenditure of funds. The project was abandoned in June 1944.275

In theory PAS could have brought about the relocation of dentists by declaring them nonessential in their own areas, making them subject to conscription if they did not move to critical districts. But such action depended upon effective support from Selective Service, and it has already been seen that such support was lacking. Moreover, PAS itself showed little interest in the matter. Dr. C. Willard Camalier, who was Chairman of the War Service Committee of the ADA, and also a, member of the Directing Board, PAS, had reported that:276

    ... while we have no figures on the matter, I am inclined to feel that very little, if any, of this (relocation) was done. As a-member of the Procurement and Assignment Directing Board, I was quite well aware of the fact that the Armed Services were taking so many dentists from civil practice that those left were kept so busy that it would not have been profitable for them to locate in other sections of the United States. They would have all they could possibly look after in their own areas. In several instances, such as Michigan, near the war plants, and a few points down South, officers of the U. S. Public Health Service were detailed to care for the needs of the population. Dentists under the auspices of the Army were utilized at Oak Ridge, Tennessee.

Whether or not the relocation program was necessary, or whether it would have produced more tangible results if a more sustained effort had been made

    274Congress provides fund for relocation of civilian dentists. J. Am. Dent. A. 31 : 166, Jan 1944.
    275Relocation program for dentists halted June 30. J. Am. Dent. A. 31 1021, Jul 1944.
    276Personal ltr, Dr. C. Willard Camalier to the author, 16 Oct 47. [D]


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by all concerned, is not a matter for consideration here. It seems clear, though, that dentists who are very busy in their home communities will not voluntarily move to other locations; if such redistribution becomes unavoidable in a future emergency some compulsion or extra remuneration must be provided.

UTILIZATION OF FEMALE DENTISTS

Three bills to authorize the commissioning of female dentists were introduced in Congress between June 1943 and March 1945.277 278 279 The Dental Division and the Army opposed enactment of all of these bills on the grounds that there was no shortage of male dentists in the Armed Forces and that to commission females would raise special problems of housing and assignment.280 After 1944 it was also noted that the Army was already being criticized because it could not accept all ASTP graduates. Another consideration, which was implied but not stated in these protests, was that the factor which limited the number of dentists available to the Armed Forces was not a numerical shortage of male dentists but the necessity for leaving sufficient personnel to meet the minimum needs of the civilian population. It would have served no useful purpose to commission women and then leave a corresponding number of able-bodied males to care for their patients. Probably as a result of Army disapproval, none of the bills to commission female dentists was passed by Congress.

POSTWAR PROCUREMENT FOR THE DENTAL CORPS

On 10 August 1945 the War Department announced that it was considering a plan for increasing the Regular Army Dental Corps by offering commissions to dental officers who had demonstrated their capabilities during the emergency period.281 The necessary legislation was passed by Congress on 28 December 1945,282 and the procedure to be followed was published by the War Department on the following day.283 The integration program was designed to bring the total number of officers in the Regular Army to 50,000, an increase of a little under 34,000 officers. The Dental Corps was authorized an additional 476 officers, to bring its total strength to 743 dentists.284

    277H. R. 2892, 78th Cong., introduced by Representative John J. Sparkman, on 7 Jun 43.
    278H. R. 1704, 79th Cong., introduced by Representative John J. Sparkman, on 23 Jan 45.
    279S. 731, 79th Cong., introduced by Senator Claude Pepper, on 13 Mar 45.
    280For criticism of the bills to commission female dentists see: (1) Ltr, SecWar to Hon Andrew J. May, 22 Jul 43. (2) Ltr, SecWar to Hon Elbert D. Thomas, 8 May 45. (3) Memo, Maj Gen R. H. Mills for Mil Pers Div SGO, 27 Mar 45. All in HD: 314.
    281WD Cir 243, 10 Aug 45.
    282Public Law 281, 79th Cong., 28 Dec 45.
    283WD Cir 392, 29 Dec 45.
    284Data given the author by Col James M. Epperly of the Dental Div SGO, on 15 Jan 48.


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SUMMARY, DENTAL OFFICER PROCUREMENT PROGRAM

The dental officer procurement program of World War II was successful in that more than 15,000 qualified dentists were obtained for the Army under very difficult conditions. The principal defects revealed were:285

1. During the early part of the war applicants were accepted without regard to their true availability, endangering civilian dental practice in some areas.

2. The policy of commissioning almost all applicants in the, lowest grade protected earlier volunteers but it lost the services of some expert clinicians, who might profitably have been accepted as captains or majors in spite of their lack of military experience. Deviation from World War II policy, in a limited number of selected cases, will probably prove advisable in any future mobilization.

3. The classification of officers according to special skills was not accurate enough, especially during the first years of the war, to permit the most efficient assignment and utilization of personnel. Clinical specialists were sometimes assigned to small tactical units rather than to hospitals or other large installations where their services could best be used.

4. Experience at the end of hostilities, when dental officers had to be held in the service after other officers were released, and when conscription was necessary to procure even a part of the replacements needed, clearly demonstrated the need for a slow but constant turnover of dental personnel during a long war. Older men with families and with established practices will be willing to serve in the Army during the early stages of an emergency, but they will bring strong and effective pressure to bear if, after they have served for 2 or 3 years, they see recent graduates of the dental schools returning to civilian life to take over their practices. The situation of a dental officer in this respect is different from that of a line officer. No able-bodied young man who is eligible for service in the infantry, for instance, will be allowed to evade military duty after he graduates from high school or college; he will be taken into the Army without delay, and his status will generally be inferior to that of the man who came on duty at an earlier date. But the shortage of dentists in the United States is such that recent dental graduates will not ordinarily be taken into the Armed Forces for nondental duty. If they cannot be used as dental officers because of a lack of vacancies they will be allowed to set up offices in civilian communities to provide badly needed dental care. It is easy to understand the older dentists' position that the younger men should be given their share of military service, releasing officers who have already had several years of active duty. When Dr. X, who had served 3 years in the Army, with 2 years overseas, received a letter from his wife saying that young Dr. Y, who had graduated the year before, had now taken over most of Dr. X's practice

    285See footnote 122, p. 65.


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his morale took a severe dip. When Dr. X was later held in the Army after other officers with similar service were being released, his general distaste for all things military was converted to an active resentment which would color his future actions as a member of the dental profession and as a citizen.

If the Army Dental Corps consists almost entirely of officers with several years of service when hostilities end, these men will have to be released without delay; at about the same time compulsory procurement may be terminated, resulting in a critical personnel crisis. By the very nature of their business, dentists cannot afford to give up the practices which they have taken years to build to accept temporary, voluntary, military service in the postwar period. If the older men are gradually replaced by recent graduates during the war a more balanced Dental Corps will result, demobilization at the end of hostilities will be more orderly, and personnel difficulties will be minimized during the difficult period of transition from war to peace.

5. The procurement program was characterized by frequent changes of policy which confused and irritated cooperating agencies and the dentists themselves. The ADA complained of this situation as follows: 286

    When war came, the Army opened and closed commissions in the Dental Corps with such eccentric rapidity that dentists and state Procurement and Assignment chairmen were in a perpetual quandary. On one day a large procurement objective would be set and on another the Dental Corps would be closed and dentists in the process of getting commissions, having closed their offices would be sent back to civilian life. The Army Specialized Training Program war, initiated with the proper flourish of military trumpets as the answer to the problem of providing the Army with a continuing supply of dental personnel. This program was barely in full motion when one entire class of dental graduates was sent into civilian life because "procurement objectives" allegedly had been reached. . . . Under this mistaken knowledge of its own needs the Army eventually shut down the entire dental ASTP and permitted many potential dental officers to return to civil life instead of completing their training as replacements for veteran officers. So certain was the Army that the matter of dental personnel was well in hand that, at about this time, the Dental Corps was again closed.

This criticism was of course extreme, and not fully justified. So far as is known, dentists in the process of being commissioned were always accepted for service if they met physical requirements. The frequent changes in policy complained of generally paralleled War Department changes in estimates of the forces needed to meet new developments, and the extent to which the flow of dentists into the Armed Forces could have been smoothed out is a matter of opinion. Procurement objectives were admittedly changed on short notice, however, and a more consistent program would certainly be desirable, to the extent it could be achieved under emergency conditions.

    286Dental officers pay again. J. Am. Dent. A. 33: 755-757, 1 Jun 46.