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Chapter IV, Personnel and Training

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

COMPOSITION OF THE DENTAL CORPS

Important items in a discussion of officers of the wartime Dental Corps are background, age, and previous military preparation. Information is not available concerning all of the 18,000 dental officers who served in the Army between 1 October 1940 and 31 December 1945,1 but a cross-sectional view of the 15,302 officers who were either on duty 31 May 1945 or had been released shortly before that date2 reveals the following:3

Distribution by Age

 Age

 Number

 Percent

Approximate years of practice before entering the Army*

Under 30

3,902

25.5

0-2

30-34

4,086

26.7

3-7

35-39

4,958

32.4

8-12

40-44

1,423

9.3

13-17

45-49

581

3.8

18-22

50-over

352

2.3

23-over

*Years of practice based on average age at graduation of 25-264 and assumption that men on duty in 1945 averaged 2 years of military service.

Distribution by Race

Race

Number

Percent

White

15,131

98.89

Negro

132

0.86

Chinese

25

0.16

Japanese

8

0.05

Others

6

0.04

Distribution by Component

Component

Number

Percent

Regular Army

266

1.7

National Guard

117

0.8

Organized Reserve Corp.

3,106

20.3

AUS (obtained through ASTP)

1,802

11.8

AUS (obtained from civilian life)

10,011

65.4

    1Memo, Mr. Isaac Cogan for Dir, Dent Cons Div, SGO, 29 Aug 46, sub: Dental Corps officers--historical data. SG: 322.053-1.
    2The number of dental officers actually on duty on V-E Day was about 14,700. When the data given here were calculated in June 1945 reports of separations during the preceding month were incomplete.
    3See footnote 1 above.
    4Strusser, H.: Dental problems in postwar planning. J. Am. Dent. A. 32:991-1003, 1 Aug 45.


106

Distribution by Specialty

Specialty

Number

Percent

Oral Surgeon (MOS 3171)

65

0.4

Exodontist (MOS 3172)

325

2.1

Periodontist (MOS 3174)

20

0.1

Prosthodontist (MOS 3175)

255

1.7

Staff Dentist (MOS 3178)

170

1.1

No specialty (MOS 3170)

14,467

94.6


The "average" dentist was about 33 when he entered the Army (assuming 2 years of service in 1945) and had been in private practice nearly 8 years. Though well-qualified as an operative dentist, he was not likely to have had extensive training as a specialist. Only 4 per 1,000 were oral surgeons and only 1 per 1,000 was a periodontist. Nearly two-thirds had entered the Army with no previous experience in the Armed Forces, and though professionally competent, almost all of this group needed more or less additional military training before they were fitted to fill responsible positions. This was the "raw material" from which the Army Dental Service was assembled.

ASSIGNMENT OF DENTAL OFFICERS

The proportion of dentists in service command installations in the United States, in the Air Forces, and in tactical organizations in the United States and overseas fluctuated with the progress of mobilization and with changes in the course of the war. The greatest number of dentists on duty at any time was 15,292 in November 1944.5 Subsequent strength reductions were not significant until after V-E Day. The maximum figure in the United States was reached a year earlier, in November 1943, with a total of 11,544 men (Air Forces, service commands, and tactical units).6 The largest number on duty with the Air Forces (United States and overseas) was about 3,739 in May 1945. The number of Army dentists overseas increased from about 1,000 (10 percent) in December 1942 to 3,221 (22.5 percent) in December 1943 and 6,017 (39.8 percent) in December 1944. The maximum number abroad was reached in March 1945 when 7,111 dental officers, or 48.1 percent of all Army dentists, were on foreign service, but the highest ratio was not reached until May 1945 when the 7,103 dentists overseas were 48.3 percent of the total on duty. At the end of 1915 only 2,886 (30.0 percent) of all dentists were overseas. The maximum number of Air Forces dentists overseas was 1,103 (29.5 percent) in May 1945.7

    5Memo, Mr. Isaac Cogan for Chief, Dent Cons Div, SGO, 8 Oct 46, sub: Basic data for Dental Corps. SG: 322.0531.
    6Unpublished data from the Resources Analysis Division, SGO, given to author in Oct 1946.
    7Unpublished data from the Personnel Division, Office of the Air Surgeon, given to author on 1 Oct 46.


107

The approximate authorized percentages of dentists in different types of assignments on 31 March 1944 were as follows:8

 

Percent

Tables of organization units (U.S. and overseas)

36.9

Army Service Forces, U.S. (Exclusive of T/O Units)

32.3

Army Air Forces, U.S. (Exclusive of T/O Units)

21.1

Theater overhead (Exclusive of T/O Units)

.7

Replacement pools

6.8

Other

2.2

This ratio was of course subject to constant change as emphasis was transferred from training activities in the United States to combat operations overseas. During the early part of the war a majority of dentists were required for work on new men in Army Service Forces and Air Forces installations in the United States. Later they were needed in the units actually engaged in operations (T/O units overseas and in the United States).

PROFESSIONAL CLASSIFICATION OF DENTAL OFFICERS

At the start of mobilization there was no effective plan for the classification of dental officers according to special qualifications. Some attempt was made locally to assign dentists to appropriate work but these efforts were hampered by the absence of any standardized system by which the specialized abilities of an officer could be determined at a glance. Too much reliance had to be placed on the dentist's own estimate of his qualifications, so that men with not much more than a desire to do a certain type of work were designated as specialists, while other trained officers were placed in routine jobs.9

On 21 October 1943 The Adjutant General directed that dental officers would be evaluated in respect to professional qualifications on the basis of questionnaires to be sent to The Surgeon General.10 At about the same time a War Department Technical Manual (TM 12-406) described six classifications for dentists, as follows:11

MOS 3170

(Dental officer) general practitioner.

MOS 3171

(Oral surgeon, dental) fully qualified oral surgeon. Should have extensive experience in oral surgery and have been a member of a hospital staff. Internship, residency, or fellowship desirable.

MOS 3172

(Exodontist) qualified as extraction specialist. Extensive training in exodontia, and internship or residency desirable.

MOS 3174

(Periodontist) qualified to treat investing tissues of teeth. Extensive training or experience very desirable.

    8Memo, Chief, Oprs Br, SGO, for CG, ASF, 5 Jun 44, sub: Requirements for Dental Corps officers. SG: 322.0531-1.
    9Final Rpt for ASF, Logistics in World War II. HD: 319.1-2 (Dental Division).
    10Ltr SPX 220.01 (6 Oct 1943) OC-E-SPGAP-MB-A, 21 Oct 43, sub: Correct classification and assignment of Army Service Forces officers and enlisted men. AG: 220.01 (19 Sep 43) (1).
    11TM 12-406, Officer classification, commissioned and warrant, 30 Oct 43.


108

MOS 3175

(Prosthodontist) qualified to construct bridges and dentures. Extensive training or experience essential.

MOS 3178

(Dental officer, staff) qualified to advise surgeons of major units on the operation of the dental service. Must have previous military experience.

(All dentists were required to be graduates of accepted schools, licensed to practice dentistry, and actually engaged in ethical practice at the time of entry into the Army.)

Early in 1944, TM 12-406 was amended to authorize the use of modifying letter symbols in connection with the MOS numbers, of medical officers only, to indicate relative ability within a specific field. Thus a surgeon of moderate skill might be designed "MOS D 3150," while a surgeon with outstanding back ground and experience would be listed as "MOS A 3150."12 This refinement, however, was not applied to other Medical Department officers, possibly because there were then in existence no recognized civilian standards for dental and veterinary specialists.

Original classifications of medical, dental, and veterinary officers were made from information contained in the "Classification Questionnaire of Med ical Department Officers."13 Later adjustments in classification were made from reports of "Reevaluation Data for Medical Department Officers."14 In the case of dental officers, the assignment of an MOS number was carried out in the Dental Division, SGO.

The Director of the Dental Division, SGO, found that these measures aided in the appropriate assignment of dentists, but that they were not a complete solution of the problem. He Stated after the war that:15

    . . . the system is very weak because there is no "measuring rod" and no "official" check or follow-up to determine an officer's true classification . . . There are too many officers classified as oral surgeons and as prosthodontists who in reality have had no formal training in those specialties and whose experience in these fields has been very limited. . . . The fact that a man's MOS states that he is an oral surgeon does not really mean that he is a qualified oral surgeon. . . . Although the present mechanics set up for the classification of dental officers is a definite advancement over that used at the beginning of the war, it definitely is not an effective instrument in the assignment and utilization of manpower.

The solution recommended was a "clearer definition of the meaning and intent of the several classifications as well as the setting up of additional criteria for selection; a dental classification section in Personnel Service, SGO, with sufficient personnel, which can currently follow up on all changes of classification, and which can check effectively on qualifications as well as on assignments of Dental Corps personnel."16

    12TM 12-406, C 1, 10 May 44.
    13WD AGO Form 178-2, 1 Jan 45.
    14WD AGO Form 178-3, 1 Aug 45.
    15See footnote 9, p. 107.
    16Ibid.


109

PROMOTION

In time of peace, promotion in the Dental Corps of the Regular Army was based on the same regulations which governed promotion in the Medical Corps, providing for original appointment in the grade of first lieutenant, with periodic advancement thereafter on the basis of total service.17 Total service required for promotion to the various grades above that of lieutenant was as follows:

Captain

3 years

Major

12 years

Lieutenant colonel

20 years

Colonel

26 years

For reasons which are not clear, Reserve officers could be promoted even more rapidly, after the following periods of total service:18

Captain

4 years

Major

9 years

Lieutenant colonel

15 years

Colonel

22 years

Regular Army dental officers were required to pass examinations on both professional and military subjects, except that candidates for advancement to the two highest grades were examined only on military problems.19 Reserve officers had to pass examinations in military subjects or complete specified correspondence courses appropriate to the higher grade.20 In addition, they had to attend at least one summer camp of 2 weeks duration prior to each promotion.

Original commissions in the grade of first lieutenant helped to equalize the status of the professional officer, who generally entered the service at an older age, with that of the line officer who started his career several years earlier and who generally obtained his education at Government expense. Promotion solely on the basis of time-in-grade was criticized because it did not reward the outstanding officer nor provide an incentive to special efforts. It did, however, eliminate political influence as a factor in advancement and left the officer more opportunity to exercise his own judgment without fear of reprisal as long as his performance and behavior met accepted standards.

With mobilization, key positions in a rapidly expanding Army had to be filled quickly by procedures which could be applied to Regular, Reserve, and temporary officers. On 1 January 1942 most of the peacetime promotion regulations were suspended, and advancement was thereafter based on the following factors:21

    17AR 605-50, 30 Jul 36.
    18AR 140-5, 16 Jun 36.
    19AR 605-55, 11 Oct 35.
    20See footnote 18, above.
    21WD Cir 1, 1 Jan 42.


110

1. Completion of a minimum specified time-in-grade.

2. Recommendations from superiors, attesting to the officers' qualifications.

3. Existence of a vacancy in the desired grade. Under these provisions dental officers enjoyed the same promotion status as members of other branches, at least in theory. In practice, unfortunately, stagnation of promotion in the Dental Corps soon became so serious that it was the cause for frequent criticism during the latter part of the war.22

A minor reason for the lack of opportunity for advancement in the Dental Service was of course the relatively low rate of attrition among dental officers.23

Another factor was the difficulty encountered, under emergency conditions, in determining which officers were best qualified for promotion. Little effort was made to transfer eligible officers from posts where no vacancies existed to installations where opportunities were better. At the worst, an officer's efficiency might actually reduce his chances for advancement since he was more likely to be held at the old, established installation, while the less desirable officer might be transferred to a new facility where more vacancies could be expected. A considerable element of chance was thus introduced into the promotion program, and men who were lucky enough to be in the right place at the right time advanced rapidly while equally competent men held the same grade for the duration of the war.

By far the most important reason for slow promotion in the Dental Corps, however, was the lack of positions in the Dental Service calling for grades above that of captain.

In the Zone of Interior, where the size and mission of installations varied widely, local commanders were given considerable freedom to determine what grades would be allotted to individual activities, as long as prescribed totals were not exceeded. The commanding general of a service command, for instance, received a total authorization of grades for his entire area, and he could distribute them among the respective corps pretty much as he pleased, according to their relative strength, his own estimate of responsibilities involved, or any other factors which seemed important. Similarly, the commander of a post or hospital might or might not allocate to the Dental Service enough of the field grades at his disposal to make reasonable promotion possible. Only in the case of very gross and obvious discrimination was the local commander likely to be called upon to justify his actions in this respect. The advantage of this policy was that promotion was placed in the hands of officials who were familiar with duties and responsibilities in the installation concerned; the disadvantage was that personal factors might play a considerable part in determining who should be advanced. Also, under regulations then in effect the dental officer could not personally support his recommendations concerning the grades needed by his activity, and he had to rely on the good will and aggressiveness of the surgeon, who alone served on the commander's staff.

    22See chapter I.
    23See chapter III, p. 56.


111

Under such circumstances it was perhaps inevitable that opportunities for promotion in the Dental Service varied greatly in different commands and installations in the Zone of Interior, and that serious inequities were possible. The normal allotment of dentists for a 25-chair clinic, for example, was considered to be 1 lieutenant colonel, 5 majors, and 19 captains or lieutenants,24 but this ratio was seldom attained. One general hospital was reported to have no dental officer in field grade in spite of the fact that it had 15 majors in other branches.25 Since the senior dentist was always a subordinate of the senior medical officer the former's grade tended to be set below that of the surgeon, and this lower grade of the dental surgeon was in turn reflected in lower grades for his subordinates throughout the Dental Service. At the end of 1943 only 1.6 percent of all service command dentists were colonels, 3.3 percent were lieutenant colonels, and 11.6 percent were majors; the proportion of medical officers in these top grades was approximately twice as great.26

The composition of tactical commands was not left to the discretion of commanders, but was prescribed by rigid "tables of organization." An infantry regiment could have two dentists in the grade of captain or lieutenant, and no deviation in number or grade was permitted. A captain in such a regiment could be promoted only if he could be transferred to another organization where a vacancy existed. Some limitation on promotion was obviously required to prevent a top-heavy accumulation of officers in grades not justified by their duties and responsibilities. As constituted during World War II, however, tables of organization provided few field grade vacancies in tactical commands.

In an infantry division, only 1 of the 12 dental officers was a major. Even a field army, with from 300 to more than 600 dentists, provided relatively few positions for field grade officers. In a "type" army of three corps and supporting troops, there were only 9 majors and 1 full colonel (the army dental surgeon) among about 244 dental officers in troop units. Among the 70 dentists with army hospitals the situation was better since this group included 16 majors and 3 lieutenant colonels, but of the total of about 314 dentists in this "type" army only 1 (0.3 percent) was a colonel, 3 (1.0 percent) were lieutenant colonels, and 25 (8.0 percent) were majors.

Hospitals in the overseas areas generally fared better than combat com-mands. Field hospitals, evacuation hospitals, and the smaller station hospitals (under 250 beds) provided no field grades for dentists in the first part of the war, but a 250-bed station hospital had a major, and all station hospitals with over 500 beds included both a lieutenant colonel and a major among their 4 or 5 dental officers.27 A 1,000-bed general hospital had a lieutenant colonel, and a 1,500-bed or 2,000-bed general hospital had a full colonel, a lieutenant colonel,

    24ASF Cir 389, 16 Oct 45.
    25The Surgeon General's Conference with Service Command Surgeons, 10 December 1943. HD: 337.
    26Info from Strength Accounting Br, AGO, given to author on 6 May 46.
    27Data extracted from the T/O's for combat and medical units.


112

and a major on its staff of dentists. The larger number of these medical installations in the communications zone raised the proportion of field grade dental officers in that area, but not to a sufficient degree to assure reasonable promotion in overseas areas as a whole.

Because the Air Force had very few hospitals the limitations imposed by tables of organization worked an especial hardship on its overseas dental personnel, and the ratio of Air Force dentists in the two top field grades (United States and overseas, combined) was only about half the meager ratio allotted to the Dental Service as a whole.28

The f act that dental officers had less opportunity to reach the grades above that of captain is shown in the following tabulation which lists the percentage of all officers of the Dental Corps, Medical Corps, and total Army in each grade as of 30 April 1945:29

Grade

Dental Corps

Medical Corps

Total Army*

General

-------

-------

0.18

(-------)

Colonel

0.83

2.35

1.24

(1.69)

Lieutenant colonel

2.71

7.34

3.36

(4.56)

Major

10.38

21.61

8.24

(11.20)

Captain

67.25

56.50

23.33

(31.70)

First lieutenant

18.83

12.20

37.42

(50.85)

Second lieutenant

-------

-------

26.23

(-------)

*Figures in parentheses provide a distribution of the total Army officers excluding generals and second lieutenants. The percentages for the total Army (not in parentheses) are based on total commissioned officers including generals as well as second lieutenants.

In August 1945 the Medical Corps had 9 major generals and 46 brigadier generals, while the Dental Corps had 1 major general and 1 brigadier general.

Comparisons between the proportions of medical and dental officers in the grades of lieutenant and captain slightly favor the latter, but cannot be considered significant since any lieutenant could be promoted captain as soon as he had spent the required time in grade. It is more difficult to explain the wide discrepancy in the general grades, but this situation probably had little effect on morale as very few dentists could hope to become general officers under any circumstances. It is in the range of the field grades that the dental officer was at the greatest disadvantage, and inability to reach those, grades was the greatest cause for dissatisfaction with promotion policies. The ratio of colonels and lieutenant colonels in the Dental Service was about one-third that in the Medical Corps, and about one-half that in the Army as a whole if generals and second lieutenants are not considered. The ratio of majors in the Dental Corps was about half that in the Medical Corps, and less than the ratio for the Army as a whole if generals and second lieutenants are not considered, in spite of the fact that most dental officers started one grade higher than most officers of branches outside the Medical Department.

    28See footnote 7, p. 106.
    29Strength of the Army, 1 May 45.


113

The unfortunate results of slow promotion in the Dental Corps were described as follows by the dental surgeon of the Middle East theater:30

    A condition which had a very adverse effect on the morale of dental officers ... was relative discrimination in the grades to which dentists could hope to attain. This is a familiar complaint, but it was well founded. When twenty-five percent of medical officers were in field grade, for instance, only seven and one-half percent of dental officers could reach field grade. The inevitable result . . . was that dental officers found themselves passed at regular intervals by men of other branches with less experience and ability. I do not wish to imply that the discrimination existed only between the Medical and Dental Corps, nor can the blame be placed on medical officers commanding in this theater. . . . I merely draw attention to the condition as it undoubtedly existed. Dental officers, like the rest of the Army, recognized that in time of national emergency individuals must be prepared to sacrifice their own personal welfare for the successful prosecution of the war. They had given up their practices and their homes because they felt they could make an important contribution toward winning that war, and as long as they had this conviction they were glad to give their best efforts, with or without promotion. But when a dental officer was passed again and again by men of other branches who were less experienced, no more intelligent, and certainly no harder working, he inevitably arrived at the conclusion that his own work was not considered important. I need not elaborate on the danger of such an attitude.

The Director of the Dental Division, SGO, stated in 1945 that:31

    There is no doubt that proportionately there are more position vacancies for briga-dier generals, colonels, and lieutenant colonels in the Medical Corps by virtue of the fact that the medical officer commands the hospitals. . . (but) it is believed generally in the Dental Corps that the ratio of Medical Corps officers to Dental Corps officers, in accordance with strength figures, is not equitable. It was extremely difficult for officers of the Dental Corps to understand such a vast difference in all field grades, and there was only one general result-lowered morale.

During the war a number of efforts were made to improve the status of dental officers in respect to promotion. In 1943 the American Dental Association claimed that failure to insure equal promotion for dentists violated the act of 6 October 1917 (40 Stat. 397) which provided that officers of the Dental Corps would have the same grades, proportionately distributed, as officers of the Medical Corps.32 These charges were based on the contention that Section 10 of the National Defense Act, as amended by Section 10, act of 4 June 1920 (41 Stat. 766), which prescribed promotion by length of service, had merely amplified the principle established in the act of 1917, but The Judge Advocate. General ruled that the law providing for promotion by length of service had rescinded the earlier legislation, and that there was no legal requirement that

    30Address by Col George F. Jeffcott before the Association of Military Surgeons in New York on 2 Nov 44. This paragraph was omitted from the version of that talk which was published in The Military Surgeon, Jan 1945.
    31See footnote 9, p. 107.
    32Ltr, Dr. J. Ben Robinson, Pres ADA, to Maj Gen James C. Magee, 5 Feb 43, no sub. SG: 080 (American Dental Association).


114

the Medical and Dental Corps should have the same proportion of officers in each grade.33

In January 1943 the Director of the Dental Division, SGO, initiated important steps to speed the promotion of lieutenants. Prior to this time tables of organization or tables of allotment had prescribed specific numbers of lieutenants for the Dental Service of units or installations, and in many cases the result was complete stagnation of promotion, regardless of length of service. The situation was particularly serious in the smaller tactical commands, where the lieutenant of an infantry regiment was practically "frozen" in grade since changes in personnel were infrequent after the unit was once organized. The Director of the Dental Division requested that tables of organization which included dental lieutenants be amended to read "lieutenants or captains," thus making it possible to advance dentists out of the lowest grade when they met other requirements for promotion, regardless of the existence of a position vacancy. This recommendation was adopted for both medical and dental officers of table-of-organization units in May 1943.34 It was extended to include Zone of Interior installations in July of the same year.35 The effect in tactical units was immediate, but some difficulty was encountered in Zone of Interior installations since service commands were operating under maximum ceilings in each grade, and they hesitated to advance Medical Department officers when such action would use up position vacancies previously earmarked for other activities.36 By January 1944, however, the proportion of captains in the Dental Corps had risen from about 25 percent to over 48 percent, and by V-E Day 68 percent of all dental officers were captains and only 19 percent were lieutenants.37

Partially successful efforts were also made to increase the grades held by dentists in hospitals, which provided almost the only opportunity for promotion to field grade. In 1942, for instance, a 300-bed station hospital was authorized only a captain and a lieutenant, but by 1944 the allotment was a major and a captain. Similarly, the major, captain, and lieutenant of a 750-bed evacuation hospital were each authorized the next higher grade. A major was added to the tables of organization of the 1,000-bed general hospital. In general, an effort was made to have the senior dental officer of any hospital given the same grade held by the chiefs of the medical or surgical services.38

The Deputy Surgeon General39 stated in October 1943 that brigadier generals would be appointed in the Dental Corps to act as dental surgeons of the three principal theaters, but no such action was taken until February 1945,

    331st ind, Chief Mil Affairs Div, JAGD, 2 Nov 43, on ltr, Chief of Legal Div, SGO, to JAG, 28 Oct 43, sub: Rank of dental officers. SG: 322.0531-1.
    34WD Cir 122, 18 May 43.
    35WD Cir 169, 24 Jul 43.
    36See footnote 25, p. 111.
    37See footnote 29, p. 112.
    38See footnote 9, p. 107.
    39Memo, Brig Gen George F. Lull, for Pers Div, G-1, 26 Oct 43. SG:322.053-1.


115

when Col. Rex McDowell, of the Dental Division, SGO, was promoted. In 1945 the Director of the Dental Division, SGO, asked for legislation to authorize 1 major general and 4 brigadier generals for the Dental Service, with 1 each of the latter to be assigned to the Air Forces, the Ground Forces, and the Service Forces, but no action was taken on this request.40

Efforts to increase the authorization of field grades for dentists in tactical commands, outside of hospitals, were generally unsuccessful. A single dental officer in a battalion was unlikely to be granted a grade higher than that held by a company commander who was responsible for over 200 men. It is probable that some improvement would have been possible, if the Dental Service of the larger elements, such as the division, could have been organized into larger detachments, in which higher grades for those officers having increased professional or administrative responsibility would have been justified. Such an organization had more important advantages than the possibility of increasing the allotment of field grades (see chapter VIII), but it was attempted only on an experimental basis during World War II.

In general, the opportunities for promotion in the Dental Corps were increased during the war, especially in respect to the company grades, but the Director of the Dental Division, SGO, stated at the end of hostilities that the measures taken had not been adequate, and that "there was no real solution reached with reference to field grades."41

MORALE

Official wartime reports seldom mentioned morale problems among dental officers, suggesting that deficiencies were not considered serious. From the practical point of view, dentists certainly rendered loyal and effective, service during the period of hostilities. Unfortunately, here is good evidence that many dental officers left the Armed Forces, including the Army, with the feeling that they had not received fair treatment, and relations between the Dental Corps and the civilian profession left much to be desired as the Medical Department faced the postwar era.42 The ADA, in particular, was called upon to defend itself from the bitter criticisms of members who felt that their interests had not been adequately guarded,43 and these criticisms were passed on to the Dental Services of the Armed Forces with interest.

Many complaints could of course be ascribed to the age-old military privilege of "griping." Also, it would be too much to expect that wartime

    40Memo, Maj Gen R. H. Mills for Col B. C. T. Fenton, 21 Sep 45. This memorandum has been seen by the writer, but it was not placed in permanent files of SGO.
    41See footnote 9, p. 107.
    42Series of editorials in Oral Hygiene from July to October 1943. See also (1) The Army Dental Corps. J. Am. Dent. A. 32: 487-488, 1 Apr 45. (2) Sauce for the goose. J. Am. Dent. A. 32 : 888-889, 1 Jul 45. (3) New regulations for the Army Dental Corps. J. Am. Dent. A. 32: 1290, 1 Oct 45. (4) Theory and fact in dental legislation. J. Am. Dent. A. 32: 1301-1308, 1 Oct 45. (5) The right to gripe: The fifth freedom. J. Am. Dent. A. 33:118, 1 Jan 45.
    43Ibid. (4).


116

service should be pleasant and in the haste of mobilizing the nation's defense resources it was probably inevitable that some men should get more favorable assignments than others, that promotion should not always be equitable, and that misassignments should be made. Such injustices will probably continue to exist under emergency conditions in spite of all efforts to end them. On the other hand, some criticisms were undoubtedly justified, and even those which appear to have been exaggerated deserve consideration since imagined deficiencies were often as detrimental to morale as those which were, real.

Among the more important causes of dissatisfaction were the following:

1. Unfavorable promotion status. (See discussion, this chapter.)

2. A fairly widespread opinion that the Dental Service was unnecessarily dominated by medical officers. (See discussion under "Medicodental Relations" in chapter I, pp. 7-15.)

3. Unfavorable assignments and lack of opportunity for promotion for members of the Reserve called to active duty early in the war. Reserve officers were among the first to be brought into the service, before other dentists were, being taken from civilian life in large numbers. Because they had had some military training they were often placed in tactical units where dental practice was limited to routine, minor operations, and where promotion was notoriously slow. The inexperienced man, on the other hand, was more likely to be placed under supervision in a large clinic or hospital where military knowledge was less important. Here his opportunities for improving his professional skill were better, probability of advancement was increased, and the chance of being shipped overseas to a combat theater reduced. The Reserve officer tended to feel that he had been "sold down the river" because he had taken sufficient interest to prepare himself for military service before war broke out. This matter is discussed in greater detail in chapter III.

4. The establishment, especially during the early part of the war, of "amalgam mills" where long hours were spent at the chair doing routine operative work which offered little stimulation to professional interest. The situation was sometimes complicated further by the prescription of daily "quotas" which each officer had to meet. Insofar as "production line" procedures contributed to efficiency and assured that the best qualified men would render specialized treatment, they were probably unavoidable. At best, approximately 90 percent of all dental care required by recruits consisted of routine restorative work, and the understandable desire of dentists to widen the scope of their experience could be gratified only to a limited extent in wartime. (See the discussion of quota dentistry in chapter VI, pp. 223-225.)

5. The handling of the dental ASTP, and related demobilization policies. First protests in this field came in June 1944 when ASTP graduates who had received part of their training at Government expense were discharged to enter private practice. (See discussions in chapters 111, pp. 56-59 and IX, pp. 340-342.)


117

The serious drop in the morale of dental officers during the war, as expressed in postwar personnel difficulties and criticism in the professional press, was of course regrettable. At the same time it served a constructive purpose in that it emphasized defects which urgently needed attention.44

COMBAT ACTIVITIES, AWARDS

Dental officers shared the risks and hardships of the units to which they were assigned. They participated in Pacific landings, in assaults on Europe's fortified lines, and in airborne attacks in the Mediterranean. One dentist served as commanding officer of an infantry regiment,45 and another was dropped by parachute into Greece late in 1943, aiding the Greek guerillas and organizing a medical service for them until that country was liberated in 1945. After liberation of Greece this officer was instrumental in obtaining the release of British officers held as hostages by leftist Greek forces. For his efforts he received the Order of the British Empire as well as Greek and American awards.46 Recognized and unrecognized instances of heroism and exceptional devotion to duty were too numerous to be discussed in detail. In addition to those receiving the Purple Heart for wounds received in action, 384 dental officers received other awards as follows: Legion of Merit, 24; Silver Star for gallantry in action, 10; Soldier's Medal, 2; Bronze Star, 347.47 In October 1945 Maj. Gen. Robert H. Mills, who had been Director of the Dental Division, SGO, during more than 3 years of war, was awarded the Distinguished Service Medal, the highest award for outstanding administrative duties.

From 7 December 1941 through 31 December 1946,48 116 dental officers died from all causes. In this period, 20 dental officers were killed in action; 60 dentists were wounded, 5 of whom died; 38 were made prisoners of war, of which number 12 died (including 2 shown among the 20 killed in action), and 1 reported missing in action who subsequently returned to duty. (There were a total of 91 nonbattle deaths, 10 of which occurred while in a prisoner of war status.) Capt. Howard A. McCurdy, Dental Reserve, who lost his life in

    44By the end of 1948 the Dental Corps had been given new administrative status, temporary promotion policies were being revised, and the military were showing an increased willingness to take the representatives of the civilian professions into their confidence when problems concerning members of those professions were encountered. "Quota" dentistry was dead, probably for good, and the more knotty question of giving individual dentists greater freedom in military practice without reducing efficiency was being considered. These changes would probably not eliminate all complaints in any future mobilization, but they promised much for long-term improvement in the efficiency and morale of the Dental Service.-Ed.
    45Colonel Roy A. Green to return to private practice. J. Am. Dent. A. 33: 379, 1 Mar 46.
    46Iowa dental officer receives honor from Britain. J. Am. Dent. A. 32: 1350, 15 Nov 45.
    47HTM-14, 1 Aug 46, Decorations and awards awarded by the War Department and overseas theater commanders, for period 7 December 1941 thru 31 May 1946. In Decorations and Awards Br, AGO.
    48Army Battle Casualties and Nonbattle Deaths in World War II, Final Report, 7 Dec 41-31 Dec 46. Strength and Acctg Br, AGO.


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the Philippines in January 1942, was the first dental officer killed by enemy action in World War II.49

TRAINING OF DENTAL OFFICERS

World War I

During the First World War, over 4,000 inexperienced dental officers were called to duty in a relatively short period of time. Initially, no provision had been made for training these men, but fortunately, many had been members of the Preparedness League of American Dentists and had received some instruction in both military dentistry and military administration. The Preparedness League was formed in March 1916 to provide free dental service for men wishing to enlist in the Army and, later, to prepare potential draftees to meet induction requirements.50 51 It had also extended its activities to sponsor study clubs for dentists who expected to enter the Reserve, a program which was started even before the United States entered the war. A standard course of study was drawn up by the League and approved by The Surgeon General. This included instruction in anatomy, dental and oral surgery, pathology, X-ray, fractures, anesthesia, prosthetic restoration, bone grafting, first aid, military law, and military administration.52 The Association of Deans of Dental Schools approved the plan and after June 1917 most schools made their facilities available without cost to the Government or individuals. Colonel Logan, head of the Dental Service, stated that the majority of schools cooperated in the program and that from 4,000 to 5,000 dentists completed the training.53

The first effort by the Army to train dentists came with the establishment of the section on Surgery of the Head in the SGO. This office sponsored classes in maxillofacial surgery for selected officers at Washington University, St. Louis; Northwestern University, Chicago; and the University of Pennsylvania, Philadelphia, (Thomas W. Evan Institute). From October 1917 to March 1918 these courses provided instruction along the same lines as that given in the Preparedness League program.54

In March 1918 a field service school was established at Camp Greenleaf, Fort Oglethorpe, Georgia, for the instruction of dental officers and their enlisted assistants.55 The course at Camp Greenleaf included a month of in-

    49Dental officer killed in action. Army Dent. Bull. 13:149, Apr 1942.
    50Beach, J. W.: Preparedness League of American Dentists. J. Nat. Dent. A. 4: 176, Feb 1917.
    51Beach, J. W.: Preparedness League of American Dentists-Our first birthday. J. Nat. Dent. A. 4: 363-370, Apr 1917.
    52Synopsis of study club course in war dental surgery for the sectional units of the Preparedness League of American Dentists. J. Nat. Dent. A. 4: 795-797, Jul 1917.
    53Logan, W. H. G. : Development of the dental service during the present war. J. Nat. Dent. A. 5: 993-1004, Oct 1918.
    54Ibid.
    55Ibid.


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struction in basic military subjects, followed by a month of study in anatomy, oral surgery, the effects of focal infection, and the fixation of fractures. Every effort was made to have new officers sent to this school, and 1,200 had been enrolled when the war ended in November 1918.

Training for Regular Army Dental Corps
Officers Prior to World War II

Candidates for the Regular Army Dental Corps in the period between World Wars I and II were required to be graduates of accepted civilian dental schools and to have at least 2 years of experience in the practice of dentistry. Many were without previous military experience, however, and required both basic military training and additional professional instructions before they were qualified to assume complete responsibility for the Dental Service of a camp or post. As they reached the higher grades, dental officers also required additional training to fit them for positions of greater responsibility. The Army was therefore called upon to provide graduate instruction of all types from the most elementary to the most advanced, both military and professional.

Basic Graduate Course, Army Dental School. The first step in the preparation of a new dental officer was to supplement his, previous education in oral surgery, operative dentistry, and prosthetics; subjects in which he would need to be especially proficient if called upon to take over the operation of the Dental Service at an isolated post. In a 4-month basic course at the Army Dental School in Washington (postgraduate only) the new officer received training in these specialties as well as refresher instruction in those subjects which he might have forgotten since graduation from dental school. Unfortunately, a chronic shortage of officers made it impossible to schedule these courses regularly and the last class was given in 1935. An average of seven officers took this course annually between 1930 and 1935.56

Officers' Basic Course, Medical Field Service School. After the professional education of the new dental officer had been brought up to date at the Army Dental School, he was sent to the Medical Field Service School (MFSS) at Carlisle Barracks for an additional 5 months of basic military instruction. With other officers of the Medical, Veterinary, and Medical Administrative Corps he studied the organization of military units, the organization and function of medical field units, preventive medicine, first aid, the evacuation of wounded, records and returns, supply procedures, and military law. He learned about Army regulations and customs of the service and he practiced close-order drill in the ranks. During 2 weeks of field maneuvers he put into practice the fundamentals he had studied in the classroom and served as part of the staff of a battalion aid station, a collecting station, and a medical regi-

    56Annual Reports of Technical Activities, Army Medical Center, for the years 1930-35. HD: 319.1-2.


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ment. In separate classes for dentists the new officer became familiar with dental field equipment and the administration of a dental clinic. One hundred and forty-one dental officers graduated from this course from the founding of the school in 1921 through 1939.57

Advanced Graduate Course, Army Dental School. As the Army dental officer approached field grade he might be sent to the advanced graduate course of the Army Dental School where he received 4 months of instruction in oral surgery, x-ray technique, prosthetics, operative dentistry, preventive, dentistry, and periodontal diseases. This course was not expected to qualify the dentist as a specialist but it gave him the general background he needed to act as chief of the Dental Service at a larger post or hospital. Outstanding civilians were brought in to lecture oil special subjects and all the facilities of the Army Medical School, Walter Reed General Hospital, the Dental Research Laboratory, the Army Institute of Pathology, and the Central Dental Laboratory were utilized to make this training the most effective possible. The potential value of the course was limited, however, by the small number of officers able to attend, and only 27 men graduated in the 11 years from 1930 through 1940.58

In 1936 the Army Dental School provided a course for professional specialists which was attended by four officers,59 but with this single exception it did not attempt to furnish extensive instruction leading to qualification in a dental specialty.

Advanced Officers' Course, Medical Field Service School. After attaining field grade, usually before examination for promotion to lieutenant colonel, dental officers might be sent to the 3-month advanced course of the MFSS. This course was designed to fit the officer for staff duties and the administration of the Dental Services of large units. A relatively small proportion of eligible officers were able to take the course, however, and from 1923 to 1939 there were but 21 graduates.60 A larger proportion of senior officers took the special extension course of the MFSS which covered essentially the same material and exempted the candidate from solution of a field problem in his examination for promotion to the grade of lieutenant colonel.

Instruction in Civilian Institutions. A limited number of dental officers were authorized to receive instruction in civilian institutions for periods of from a few weeks to a year. In the 11 years from 1930 to 1940 (inclusive) 32 received such training, though from 1937 to 1940 only 3 courses were authorized.61

Nonmedical Service Schools. Dental officers were theoretically eligible for courses of instruction at such advanced Army schools as the Command and

    57Special Rpt, undated, from Col Neal Harper, DC, received in 1945. HD: 314.1-2.
    58Annual Reports of Technical Activities, Army Medical Center, for the years 1930-40. HD: 319.1-2.
    59Annual Reports of Technical Activities, Army Medical Center, for the year 1936. HD: 319.1-2.
    60Annual Reports, Medical Field Service School, 1923-39. HD: 319.1-2.
    61Annual Reports of The Surgeon General, U. S. Army, 1930-1940, Washington, Government Printing Office, 1930-1940 (cited hereafter as Annual Report . . . Surgeon General).


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General Staff School and the War College. In practice they were not ordered to these schools until after the start of hostilities in World War II, and then in almost negligible numbers.

Extension Courses.At any time in his career the dental officer was eligible to take correspondence courses published by the MFSS. These were primarily designed for Reserve officers, however, and the number of regulars enrolled was small. Command and General Staff extension courses were also open to dental officers with appropriate background, but enrollment was limited and few dentists in the peacetime establishment were able to get advanced training in general staff procedures.

Dental Internships. Dental internships were first authorized in February 1939.62 Eight graduates of the class of June 1939 were selected and trained for 1 year in 1 of 6 major hospitals. (Walter Reed General Hospital, Letterman General Hospital, Fitzsimons General Hospital, Army-Navy General Hospital, William Beaumont General Hospital, and the Station Hospital, Fort Sam Houston.) Interns were regarded as potential, candidates for the Regular Army Dental Corps and were selected on the basis of scholarship, physical fitness, and adaptability for military service. They were eligible for appointment in the Dental Corps without the 2 years of private practice required of other applicants and without competitive professional examination.63 They received $60 monthly plus quarters and subsistence. Only about one-fifth of all applicants were accepted and the qualifications of successful candidates were high. A total of 27 interns were taken into the Dental Corps out of 28 receiving this training between 1940 and 1942. The last class of nine interns graduated in June 1943, but none of this group were taken into the permanent establishment due to the suspension of all Regular Army procurement during the war. An earnest effort was made by the Dental Division, SGO, to have these men commissioned at the end of hostilities, but the request was rejected by higher authority. Tentative plans for resumption of the dental intern program after the war called for the granting of reserve commissions to accepted candidates, who would then be called to active duty for the required period of training, with the pay and allowances of their grade.

Summary. The prewar training of the Regular Army dental officer was generally effective, but the fact that the permanent Dental Corps numbered only about 260 officers at the start of World War II meant that this source could supply only key personnel, a negligible proportion of the 15,000 officers needed to staff the Dental Service.

Training for Reserve Officers Prior to World War II

On 30 June 1941 the Dental Reserve Corps numbered 4,428 officers in the following grades: 7 colonels, 96 lieutenant colonels, 354 majors, 909 captains,

    62SG Ltr 6, 14 Feb 39.
    63AR 605-20, 19 Aug 42.


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and 3,062 lieutenants.64 From 1 January 1939 through 28 February 1946,3,606 Reserve dentists were called to active duty,65 including a few who were given commissions after 30 June and before 7 November 1941, when procurement for the Reserve was terminated.

Immediately following World War I the Reserve was made up largely of officers who had had some active military experience. In the period between the two World Wars, however, the Dental Reserve was maintained and augmented with men who either had had no military training whatever, or who had received limited training in connection with their professional education. These new officers required additional instruction and practical experience to fit them for the duties they would perform on mobilization.

Reserve Officers' Training Corps. For 10 years, until 1932, eight dental schools cooperated with the Army to offer courses which would qualify students for commissions in the Dental Reserve on graduation. Regular Army personnel were loaned as instructors, and students attended 30 hours of class yearly. (Credit, for 60 additional hours was given for courses such as maxillofacial surgery, taken by the undergraduate as part of his regular professional training.) The course was divided into basic and advanced sections of 2 years each. Enrollment in the basic class was usually obligatory and entitled the student to no pay. A smaller number of selected students took the senior course on a voluntary basis and received a "ration allowance" of about $9 a month. Advanced students were required to attend one 6-week summer camp during which they received the pay of an enlisted man of the lowest grade ($21 monthly). Instruction was given on the organization of the Army and the Medical Department, dental reports and records, the care of maxillofacial injuries, and the operation of dental field facilities. In the summer camp the candidate drilled, set up field installations, and observed military organizations in actual operation. Of 6,854 officers commissioned in the Dental Reserve from 1922 to 1935, 2,274 or 33.2 percent were graduates of the ROTC senior course.66 Unfortunately, the dental ROTC program was drastically curtailed as an economy measure in 1932 and the last class graduated in 1935.

Extension Courses for Reserve Officers. Before the war, the, Army sponsored a series of graduated correspondence courses designed to meet the needs of Reserve officers of all degrees of experience and in all grades. Extension courses began with such basic military subjects as map reading, military law, customs of the service, and organization of the Army. They advanced to specialized instruction in sanitation, evacuation of wounded, medical reports, and the tactics of medical organizations in the field. Completion of the appropriate courses was practically a prerequisite for promotion, and the Reserve officer

    64Annual Report ... Surgeon General, 1941 (1941) p. 143-147.
    65Officers appointed in the Dental Corps from 1 January 1939 through February 1946. Strength Acctg Br, AGO, 8 Jul 46. HD: 320.2.
    66Annual Reports of the Secretary of War, 1922-1940, Washington, Government Printing Office, 1922-1940 (cited hereafter as Annual Report . . . Secretary of War).


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was able to develop his knowledge as his responsibilities increased with each higher grade. From 1935 to 1938 all average of 8,000 Medical Department Reserve officers, or a little over one-third of the total strength, were continually enrolled in extension courses.

Summer Camps for Reserve Officers. The Medical Field Service School routinely devoted the summer period to training programs for Reserve officers. A 2-week camp was scheduled for the instruction of junior Reserve officers, another was held for those assigned to units. A 6-week camp, designed to train key personnel for larger medical units, was held for senior captains and field grade officers. Reserve dentists all over the United States were also given occasional 2-week tours of active duty at nearby posts where they received "on-the-job" training. In the 12 years before 30 June 1940, 6,034 dental officers received some type of summer camp training, though there is considerable duplication in this figure since it includes those who attended more than one camp during the period.67 In addition, between 200 and 300 National Guard Dental officers annually attended camps conducted by that component.

Following the war, senior dental officers stated that, in general, prewar Reserve training bad been adequate for the company grades, but that it had not always been extensive enough to prepare men in the higher grades to hold key positions in the Dental Service. In particular, Reserve training was found to have placed greater stress on didactic instruction rather than on practical experience. The completion of correspondence courses, plus 2 weeks of active duty every few years, was often insufficient preparation for a former small town dentist who might be called upon to operate a camp dental service for 25,000 men. These comments on the deficiencies of prewar Reserve training should not be construed as blanket criticism of the Reserve program; thousands of dentists were able to step into routine military duties without delay because they had received some preliminary training as civilians, and some Reserve officers administered major dental services with distinction. But the utilization of field grade dentists who, through no fault of their own, were inadequately trained for the duties appropriate to their grades, was a problem for the Dental Service and for the officers concerned.68

Training for Dental Officers During World War II

At the start of World War II the Regular Army Dental Corps and auxiliary components could together provide less than one-third of the 15,000 dental officers needed for the expanding military establishment. The remainder had to be obtained directly from civil life. Most of these new officers needed intensive professional and administrative training before they were qualified to assume unfamiliar duties in a military organization. This necessi-

    67See footnote 66, p. 122.
    68Pers interv by the author with Maj Gen Robert H. Mills, 6 Oct 47. Also pers ltr to the author from Brig Gen Leigh C. Fairbank, 9 Oct 47.


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tated a large-scale expansion of all prewar programs and the initiation of extensive new facilities.

Basic Training, Medical Field Service School. The Medical Field Service School at Carlisle, Pa., assumed an important role in the training of dental officers mobilized for the emergency. Though the courses varied somewhat to meet changing conditions, the school continued throughout the war to instruct new officers in military organization and administration, the functions of field units, and the operation of the Dental Service. Before 1942 special dental lectures had been given as an incidental duty by the senior officer of the post, but in June of that year the dental representative received full faculty status.69 At the height of the training program in 1944 the dental representative had five assistants. In the 6-week course which was in effect during most of the wax, dental officers received 22 hours of special dental instruction in addition to 250 hours on general military subjects with officers of the Medical, Veterinary, and Medical Administrative Corps. The dental course covered the organization, functions, and administration of the Dental Corps, the duties of dental officers in fixed and mobile installations, dental property, the training of assistants, dental surveys, first aid to and evacuation of jaw casualties, approved splinting methods, and the relations of dental officers to other arms and services.70

The first change to a wartime schedule at the MFSS came late in 1939 when the normal 5-month basic course was reduced to 3 months so that an extra class could be started in the spring of 1940. In December 1940 the course was cut to 4 weeks and called the "Refresher Course." Up to this time the basic course had been intended for new Regular Army officers, but by the end of 1940 Reserve officers with some military experience were being called to active duty and it was felt that 1 month of training would be sufficient to supplement their previous preparation. Summer classes for Reserve and National Guard officers were dropped in 1940 since all officers were then being prepared for extended active duty. Extension courses were carried on until the summer of 1941. By September 1941 the pool of Reserve officers was becoming exhausted and dentists without any previous training we're being called to active duty, leading to the decision to lengthen the course to 8 weeks. A critical shortage of officers in July 1942 caused the basic course to be temporarily reduced to 4 weeks but as soon as possible (December 1942) it was restored to 6 weeks and remained at that figure for most of the remainder of the war. In February 1945 the course was further extended to 8 weeks.71 In February 1946 activities of the MFSS were transferred to Brooke Army Medical Center, Fort Sam Houston, Texas.

    69History of the Army Dental Corps, 1941-43, p. 82 of Personnel Section. HD: 314.7-2 (Dental).
    70The training of dental officers. Bulletin of the U. S. Army Medical Department, 80: 14, Sep 1944 (cited hereafter as Army Medical Bulletin).
    71History of training, World War II, vol X, Chart 3. HD:314.7-2.


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From 1 January 1941 to 30 June 1945, 4,473 dental officers completed the basic training courses at the Medical Field Service School, as follows:72 73

1941

421

1942

440

1943

1,508

1944

1,574

1945 (January to June, incl.)

530

A little over 25 percent of all dental officers on duty during the war received Medical Field Service School training.74 It was not until May 1945 that the War Department was able to direct that all dental officers would thereafter complete field training before being assigned to a Unit.75

Basic Training, Medical Department Replacement Pools. About the middle of 1942, training programs were instituted for officers in replacement pools at the MFSS, 4 officer replacement centers, 14 named general hospitals, several medical supply depots, and at the Gulf Coast Air Corps Training Center.76 These pools had an authorized capacity of 200 dental officers. While officers were available for varying lengths of time, the courses were planned on a 1-month basis and were mainly "on-the-job" training in medical facilities of the installation. Since these courses were informal in nature, and since the flow of officers through the pool determined the instruction each man received, it is impossible to state how many dental officers completed this training.

Professional Training, Army Dental School. In the year ending 30 June 1940 the Army Dental School gave no professional courses for officers. In the year ending 30 June 1941 the basic graduate class, which until 1935 had been given as a 4-month course, was revived as a 3-month "Special Graduate Course" and given to two classes totaling 40 Regular Army officers. In addition, refresher courses of from 1 to 4 weeks were commenced in February 1941.77 These were designed to train dentists in oral surgery, prosthetics, or operative dentistry in preparation for assignment as chiefs of such services in dental clinics. Refresher courses were continued until June 1942, when they were dropped after a total of 166 officers had completed the training. Four other general hospitals and the station hospital, Fort Sam Houston, also gave refresher courses during this period but the total number of officers attending these classes cannot be determined.

After 31 August 1941 the Army Dental School cooperated with the Army Medical School and Walter Reed General Hospital in giving maxillofacial

    72Summary of Dental Corps officers graduated from the MFSS, 9 September 1940 to 3 August 1946. HD: 353 (1946).
    73In addition to the figures given here, a few dental officers may have graduated in a special class of 802 Medical Department officers which passed through Camp Barkley in 1944. Reports do not break down the composition of this class by corps, but since it was scheduled to meet the needs of a large number of medical interns it is probable that few dentists were included.
    74See footnote 9, p. 107.
    75WD Cir 144,16 May 45.
    76SG Ltr 48, 23 May 42.
    77SG Ltr 32, 5 Apr 41.


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plastic courses to train teams qualified to care for these difficult injuries. Until the end of 1942 these courses were of 4 weeks' duration. They were then lengthened to 6 weeks. The last course ended in September 194378 after a total of 139 dental officers had been qualified.

After 1943 no courses for officers were given at the Army Dental School.

Maxillofacial and Plastic Training, Civilian Institutions. In September 1942 maxillofacial training at the Army Medical Center was supplemented by courses given at selected civilian schools. Twelve-week courses were given at Columbia University and 6-week courses at Harvard, University of Pennsylvania, Washington University (St. Louis), Mayo Foundation (Minn.), and Tulane University (New Orleans). The last class ended in August 1944, after 287 officers had been trained, including about 148 dental officers. The number of classes given at each school varied from two to seven. During the war a total of 287 dental officers received maxillofacial training at military and civilian installations.79

Maxillofacial Training in, Hospitals. In February 1942 it was directed that all general hospitals except Darnall General Hospital would institute training programs for maxillofacial plastic teams.80 It was expected that these would mainly provide experience in teamwork for previously qualified individuals, but if trained personnel were not already available, authority for instruction in civilian institutions was granted.

Refresher Courses, Army Hospitals. In May 1945 refresher courses in Army general hospitals were authorized for a limited number of dental officers who had been on extended administrative duty during the war.81 Instruction was to be for a period of 12 weeks in the clinics of the selected hospitals under the guidance of permanently assigned personnel. Since the program was still under way at the end of the war it is not known how many dental officers may have benefited from this training, but the initial response was not so large as was expected since most dentists preferred to return to their practices without delay.

Unit Training. Dental officers assigned to tactical units took part in the training programs of their organizations, learning by actual field operations the duties which they would be called upon to perform in combat. In order to provide the time for this unit training the bulk of the dental work for tactical organizations in the United States was performed by station dental clinics operating under the service commands. However, unit dentists were also assigned to these permanent station clinics for part-time duty, both to help with the rehabilitation of their personnel and for professional training. In January 1941 it was directed that: (1) unit dental officers would receive train-

    78Annual Reports of Technical Activities, Army Medical Center, for the years 1942-44. HD 319.1-2.
    79Unpublished data obtained from the files of the Training Division, SGO, by the author.
    80AGO ltr, 27 Feb 42, sub: Training in auxiliary surgical groups. AG: 353 Med (2-19-42).
    81AGO ltr, 1 May 45, sub: Refresher professional training for Dental Corps officers. SG: 353.


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ing in medical tactics as auxiliary medical officers and in emergency treatment of jaw casualties within their respective organizations, and (2) they would receive professional training in camp or hospital dental clinics under direction of the camp or station surgeon.82 After frequent disputes over how much time should be spent in each type of activity it was finally directed that about half of the unit dentists' time would be devoted to field training and the remainder to clinic training and duty.83 Clinic dentists also took part in local training schedules which provided instruction in military courtesy and customs, conduct of the clinic, property, and reports and returns.84

Dental Consultants. In September 1944 the Dental Division was author ized to contract for the services of qualified civilian consultants to assist in training and to advise less experienced men in oral surgery and prosthetics. Fourteen dentists were made available at various times, including 10 prostho dontists and 4 oral surgeons. These men visited dental installations, advised local dental officers on procedures and the treatment of cases, and made recommendations to the Dental Division, SGO, concerning general conditions noted. Dental consultants were required to demonstrate the utmost common sense and tact, in addition to high professional qualifications, in the performance of their duties. Until they convinced local dental officers of their sincere desire to be of assistance, the latter tended to regard the consultants as "snoopers" or inspectors, rather than as educators. A few consultants also tended to recommend lengthy procedures which were admittedly superior to accepted practices, but which were not consistent with the necessary policy of "the greatest good for the greatest number." In spite of these difficulties the dental consultants showed an understanding of the problems of the Army and of the local dental officers, and their constructive advice helped materially to raise the standards of the Army Dental Service.

Film Strips and Moving Pictures. Libraries of film strips and moving pictures were maintained at each service command headquarters, in some sub-libraries at large posts, and in theater headquarters. These training aids were available on call from any installation. Moving pictures of importance to dentists were "Endotracheal Anesthesia for Dental Operations," "Harelip and Cleft Palates" (three films), "Ankylosis of the Mandible" (arthroplasty), "Retruded Chin" (cartilage graft), and "Dental Extraction under Pentothal-sodium ."85 A film on "Dental Health, for the general. instruction of military personnel, was completed early in 1945. The basic outline for the film was developed by the Dental Division in cooperation with the Bureau of Public Relations of the ADA. The scenario was written by Signal Corps specialists,

    82AGO ltr, 14 Jan 41, sub: Organization, training, and administration of medical units. AG: 320.2.
    83AGO ltr, 31 Jul 42, sub: Utilization of dental officers for professional duties. AG : 210.312 (Dental Corps) (7-12-42) QD-A-PSM.
    84Training. Dental Bulletin, supp. to Army Medical Bulletin 11 : 175-177, Oct 1940.
    85TB MED 4, 14 Jan 44.


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and filming was completed in Hollywood under Signal Corps supervision. In 25 minutes the film described, in nontechnical language, the need for oral hygiene, the proper care of the teeth and gums, provention of caries, and the use and care of dentures.86 Film strips were supplied on first aid for wounds of the face and jaws, bandaging, control of hemorrhage, traction appliances, clearing of the airway, and the construction of splints.87 88 At the end of the war a new series of film strips was being prepared covering diseases of the mouth, dental anomalies, dental caries, periodontal diseases, cysts, and tumors. These strips were to be accompanied by descriptive booklets elaborating on the conditions depicted.89

Publication. Three technical manuals pertaining to the Dental Service were published during the, war. A handbook for dental assistants and techni-cians was printed in 194190 and revised in 1942.91 This manual contained chapters on the anatomy of the teeth and mouth, prosthetic procedures, dental x-ray technique, oral hygiene, duties of the dental assistant, and the keeping of dental records. Another publication on the repair and maintenance, of hand-pieces was issued in September 1944.92 A third manual on the dental x-ray machine was printed in January 1945.93

A symposium on the treatment of maxillofacial wounds was prepared by the Army Dental School in 1941, and published under the auspices of the Preparedness Committee of the American Dental Association.94 This booklet, entitled "Lectures in Military Dentistry," was purchased by the Surgeon General's Office for general distribution among dental officers, and it was also made available to interested civilian dentists through the ADA.

Until July 1943 the Dental Corps sponsored publication of the quarterly "Dental Bulletin, Supplement to the Medical Bulletin," containing instructions and information on matters of interest to the Dental Service. After October 1943 such material was carried in the monthly Medical Bulletin and publication of the separate Dental Bulletin was discontinued. The Army took an active part in publication of the "Atlas of Dental and Oral Pathology," a volume containing descriptions of all of the more important dental lesions, with micro-photographs and case histories. It had originally been prepared at the Army Institute of Pathology and published under auspices of the ADA before the war. A revised edition was published in 1942.95

    86New training films and film bulletin available. Army Medical Bulletin 88: 44, May 1945.
    87Film strips approved for release. Army Dent. Bull. 13: 57, Jan 1942.
    88Training aids. Army Dent. Bull. 13: 138, Apr. 1942.
    89Dental film strips. Army Medical Bulletin 88: 56, May 1945.
    90Handbook for the dental assistant and mechanic. Washington, The Surgeon General, 1941.
    91TM 8-225, Dental Technicians. Washington, Government Printing Office, 1942.
    92TM 8-638, Engine, Handpiece, Straight; Engine, Handpiece , Angle. Washington, Government Printing Office, 1944.
    93TM 8-634, Dental X-ray Machine. Washington, Government Printing Office, 1945.
    94Lectures on military dentistry. Chicago, Preparedness Committee of the American Dental Association, 1942.
    95Committee on dental museum. J. Am. Dent. A. 29: 2260, Dec 1942.


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THE WAR AND UNDERGRADUATE DENTAL EDUCATION

In time of peace the Army has customarily relied upon established civilian institutions for the undergraduate education of professional officers for the Medical Department. In both World Wars, however, the Army and Navy have felt it necessary to initiate special programs to insure the continued operation of the professional schools and to provide readily available replacements of officer personnel.

In World War II the Army and the Navy became deeply involved in the field of professional training, and for a period of approximately 1 year the majority of the nation's dental students were in military status, studying under military contracts with the dental schools. Conflicting needs of the Armed Forces for young manpower on one hand, and for a steady supply of professional replacements on the other, indicate that the Army, Navy, and Air Force must be prepared at least to advise on the deferment of students in the health sciences in any future emergency, whether or not they plan to take a more direct part in medical education.

Selective Service and Dental Education

In drawing up legislation for compulsory military service Congress consistently refused to provide for blanket exemption of any group on the basis of occupation. During discussions preceding passage of the Selective Service Act of World War II strong pleas for the deferment of professional students were made by representatives of schools and professions, but the only concession made was to permit all university students to complete the current academic year, with no general deferment authorized beyond 1 July 1941.96 (ROTC students were permitted to finish the last 2 years of their courses.) Within 2 days after the Selective Service Act became law, Senator James E. Murray introduced a bill specifically deferring medical and dental students,97 but it f ailed to receive favorable attention. The Army itself opposed the measure because it was considered contrary to the spirit of the Selective Service Act, which contemplated deferment only on the basis of individual essentiality to the war effort.98 Between January and May 1941, similar student deferment legisla-tion was introduced 99 100 101 102 but all such bills were defeated.103 The unfavorable response to these measures indicated that failure to grant blanket deferment to professional students was not an oversight, and that the Selective Service Act

    96Selective Service in Wartime. Washington, Government Printing Office, 1943, p. 232.
    97S. 4396, 76th Cong., introduced 18 Sep 40.
    98Ltr, SecWar (Henry L. Stimson) to Hon Morris Sheppard, Chm Senate Committee on Mil Affairs, 16 Dec 40. Quoted in Reports of Hearings before the Committee on Military Affairs, U. S. Senate, 77th Congress, on S. 783, 18-20 March 1941. Washington, Government Printing Office, 1941.
    99S. 197, 77th Cong., introduced 6 Jan 41.
    100S. 783, 77th Cong., introduced 6 Feb 41.
    101H. R. 4184, 77th Cong., introduced 26 Mar 41.
    102S. 1504, 77th Cong., introduced 13 May 41.
    103Selective Service in Peacetime.Washington, Government Printing Office, 1942, p. 172.


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correctly interpreted Congress' determination to avoid legislation which could be construed as favorable to any special group.

On the other hand, educational facilities for the vital health professions had long been barely adequate to meet minimum needs in normal times, and it appeared that the long-range interests of the nation required the maintenance of the medical, dental, and veterinary schools, not only to meet the expanded immediate needs of the Armed Forces, but to insure adequate health care of the civilian population following the end of hostilities. Also, the schools of arts and sciences could keep in operation with student bodies made up largely of women and physically rejected men, while professional schools with their predominantly male student bodies faced probable closure if all men eligible for military service were removed. Once these complex organizations were broken up their reconstitution would be a difficult and time-consuming task. Efforts to comply with the letter of the Selective Service law and at the same time to safeguard essential professional training led to some confusion and uncertainty during the early stages of mobilization.

Early Selective Service directives concerning deferment for essentiality did not specifically mention professional students, and determination of their eligibility was left to the discretion of local boards. In February 1941, however, those boards were reminded that automatic deferment for university students would end in July, and they were directed to consider the cases of men in training for critical occupations before that time.104 On, March 1941 boards were again reminded that certain students were eligible for deferment under existing regulations, and were directed to consider each applicant on the basis of the importance of the occupation, the length of time already spent in training, and the probability that the student would actually engage in the activity after his education had been completed.105 The ADA promptly advised the deans of all dental schools to seek delay in the induction of dental students on the basis of these instructions.106 So far as dental students were concerned, however, the effectiveness of both of these early directives was lessened by the fact that dentistry had not been declared a critical occupation. On 22 April 1941 Selective Service notified its local boards that the Office of Production Management (OPM) had warned that a shortage of dentists might be imminent,107 and the position of dental students was materially improved when this tentative information was confirmed a week later.108 On 1 May 1941 the official Selective Service news magazine emphasized in very

    104Unnumbered memorandum for State Directors of Selective Service, 13 Feb 41, sub: Classification of students. In Memoranda to All State Directors 1940-43. Washington, Government printing Office, 1945.
    105See footnote 96, p. 129.
    106Ltr, C. Willard Camalier to deans of all dental schools, 26 Apr 41. SG: 327.22-1.
    107Memo, Dir Selective Service, for all State Directors (I-62), 22 Apr 41, sub: Occupational deferment of students and other necessary men in certain specialized professional fields (III). Washington, Government Printing Office, 1945.
    108Telegram, Dir, Selective Service System, to all State Directors, 30 Apr 41. On file Natl Hq, Selective Service System.


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strong terms the need for deferring dental students,109 and a directive of 12 May 1941 stated: "It is of paramount importance that the supply [of dentists] be not only maintained but encouraged to grow, and that no student who gives reasonable promise of becoming a qualified dentist be called to military service before attaining that status."110

Under these policies a considerable number of medical, dental, engineering, and physical science students were deferred from military duty after the end of automatic deferment in July 1941. A survey made late in 1941 showed that 81 percent of all dental students 21 years of age or over were continuing their education under occupational deferment, a higher proportion than in any other group.111 Deferment for other students ranged from 80 percent in the medical schools to 46 percent in courses in biology. In February 194:2 the ADA reported that an affidavit of the dean of a dental school that an individual was a bonafide student was generally being accepted by local boards as sufficient reason for delaying induction.112

In March 1942 Selective Service outlined requirements for the deferment of persons in training as follows:113

    The applicant for deferment must be in training for a critical occupation essential to the war effort.

    A shortage of persons engaged in that occupation must exist.

    There must Dot be sufficient persons already engaged in training for the occupation to meet future requirements.

    The trainee must have advanced sufficiently in his course to give promise of successful completion.

Since it was ruled that no student could be held to "give promise of successful completion" of a university course with less than 2 years of previous instruction, deferment for professional students was automatically limited to those who had completed preprofessional training. In December 1942 Selective Service again emphasized the need for allowing dental students to continue their education, and authorized deferment after completion of the first preprofessional year.114 On advice of the War Manpower Commission, Selective Service provisions covering the deferment of preprofessional students were further liberalized on 1 March 1943 to permit delaying the induction of any individual who would be qualified to enter a professional school by 1 July 1945 and who held a firm acceptance for admission to such school.115

    109Deferment of students in specialized fields sanctioned to meet national defense needs. Selective Service, vol I, No. 5, 1 May 1941.
    110Memo, Dir Selective Service, for all State Directors (I-99), 12 May 41.
    111See footnote 103, p. 129.
    112Dental students and instructors. J. Am. Dent. A. 29: 291, Feb 1942.
    113Memo, Dir, Selective Service System, for all State Directors, No. I-405, 16 Mar 42, sub: Occupational classification. On file Natl Hq, Selective Service System.
    114Selective Service Occupational Bulletin No. 41, 14 Dec 42, sub : Doctors, dentists, veterinarians, and osteopaths. In Occupational Bulletins 1-44, and Activity and Occupation Bulletins 1-35. Washington, Government Printing Office, 1944.
    115Selective Service Occupational Bulletin No. 11, as amended 1 March 1943, sub: Student deferment. In Occupational Bulletins 1 to 44 and Activity and Occupation Bulletins 1 to 35. Washington, Government Printing Office, 1944.


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The deferment of actual dental students remained fairly certain during the remainder of the war, and it will be noted later that total enrollment in dental schools materially exceeded peacetime registration. In April 1944, however, deferment of predental students was restricted to those who would be able to enter a, dental school by 1 July 1944.116 The ADA vigorously protested this action,117 and the Director, WMC, asked the Director, Selective Service, to reconsider the order, but the request was refused. The Director, WMC, then asked the Armed Forces to give military status to enough preprofessional students to assure continued full operation of the, schools, but the latter replied that the immediate need for manpower should not yield to the possible use of such students as doctors in 1949 or later, and they stated further that the current Selective Service policy had the full approval of the Army and Navy. Attempts of PAS, WMC, to have the Director of War Mobilization intervene in the matter brought the reply that the problem was clearly the responsibility of Selective Service. The PAS estimated at this time that there would be 1,446 civilian vacancies in the dental classes starting in 1945 (the Armed Forces. programs, discussed later in this chapter, were expected to fill 38 percent of the available openings), and stated that if predental education were confined to veterans, women, and physically disqualified males only a small proportion of those vacancies would be filled.118 On 23 June 1944 Representative Louis E. Miller of Missouri introduced a bill to commission 6,000 medical and premedical students, and 4,000 dental and predental students, but this legislation failed to pass.119

The fears of PAS were later proved to be well founded, and as a result of the discontinuance of predental education only 1,197 freshmen were enrolled in dental schools in October 1945, compared with 2,496 a year earlier.120 It is clear that if the war had continued indefinitely very few students would have been left in the dental schools under deferment policies in effect in 1944 and 1945.

Deferment of Dental Students Through
the Granting of Reserve Commissions

While Selective Service policies actually permitted a large proportion of all dental students to remain in school, the Office of Defense Health and Welfare Services, PAS, ADA, and to some extent the Armed Forces, appear not to have been satisfied that deferment was sufficiently certain under Selective Service regulations. As late as April 1942 the ADA reported continuing difficulty in insuring student deferment.121 Also, during much of this period

    116Selective Service as the Tide of War Turns. Washington, Government Printing Office, 1945, pp. 79-80.
    117Selective Service restricts deferment of predental students. J. Am. Dent. A. 31 : 735, May 15,1944.
    118Procurement Service issues statement on dental students. J. Am. Dent. A. 31: 878-880, June 15, 1944.
    119H. R. 5128, 78th Cong., introduced 23 Jun 44.
    120The supply of dental students. J. Am. Dent. A. 32:1454-1455, Nov-Dee 1945.
    121President's Page. J. Am. Dent. A. 29: 653, Apr 1942.


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predental. students had uncertain protection, and unless a steady flow of replacements into the entering classes could be maintained, a deferment for actual 7 dental students would eventually become meaningless. These considerations, and a desire to insure the availability of young dentists on graduation, ultimately led to involvement of the Armed Forces in the field of dental education.

Even before passage of the Selective Service Act in August 1940, The Surgeon General was given authority to transfer to the Medical Administrative Corps (MAC) Reserve any medical, dental, or veterinary student who held a Reserve commission in another branch and who would therefore be subject to call to active duty.122 These MAC Reserve officers were retained in inactive status until their professional education was completed, when they were called on active duty in the appropriate corps of the Medical Department. The number of such students was of course small, and it seems probable that this action was taken mainly to provide later replacements in scarce categories rather than because the Army then felt any responsibility for the continuation of medical education to meet postwar civilian needs. In Feburary 1941 The Surgeon General requested additional authority to grant MAC commissions to any junior or senior students in the medical, dental, or veterinary schools, basing his plea on probable future needs for the Army.123 He pointed out that the Navy had already authorized the commissioning of medical students and that the Army would soon find itself at a disadvantage in procuring replacements unless it acted promptly. The Adjutant General disapproved this request, stating that exemption from the draft could be justified only when it was clear that students would be required in key positions in industries essential to national defense.124

In April 1941 pressure for military action to insure the deferment of professional students came from a new source outside the Armed Forces, and this time the need for safeguarding medical education for long-term civilian needs, as well as for the more immediate needs of the Army and Navy, was plainly advanced as an important consideration. On the advice of the Health and Medical Committee of the Office of Defense Health and Welfare Services the Administrator of the Federal Security Agency reported to the Secretary of War that he felt increasing concern over the problem of "how to insure for our military and civilian needs the requisite number of doctors and dentists, both now and in the future."125 He noted that the Navy was granting Reserve commissions to junior and senior students, but he stated that it was also necessary to safeguard the two lower classes, and he endorsed a resolution of the Health and Medical Committee calling for first and second year students to be given the status of "cadets" and for third and fourth year students to

    122See footnote 64, p. 122.
    123Ltr, Maj Gen James C. Magee to TAG, 18 Feb 41, sub: Commissioning of junior and senior students in the Medical Department Reserve Corps. AG: 210.1.
    1241st ind, by TAG, 18 Mar 41, to ltr cited in footnote 123.
    125Ltr, Paul V. McNutt to SecWar, 28 Apr 41. AG: 210.1 Med-Res (4-28-41).


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be commissioned in the MAC Reserve. He stated further that even if deferment could be arranged through Selective Service a continuing supply of medical personnel should not depend upon the understanding of 6,000 local boards, thus giving a clue to the rather surprising decision to approach the problem through the military rather than through Selective Service.

The Federal Security Administrator's letter influenced the, Under Secretary of War to send a memorandum to General Marshall stating that he was keenly interested in the problems of the "supply of physicians for the Medical Reserve" and that he hoped the program suggested by the Health and Medical Committee could be put in action.126 It will be noted that through oversight or intent the reference to dentists, which had been included in the original recommendations of the Health and Medical Committee and in the Federal Security Administrator's communication, was omitted from the letter of the Under Secretary of War. The question of whether or not the Armed Forces should properly assume any responsibility for medical education to meet purely civilian needs was also avoided. The Surgeon General added his recommendation for the granting of commissions to all medical students, but he failed to mention dental students in spite of the fact that he had requested the same privilege for them less than 2 months before. Since The Surgeon General had been a member of the Health and Medical Committee which had drafted the original petition he was certainly familiar with the situation, and, presumably, favorably inclined toward including dental students in the program, and their omission may have been unintentional, in the thought that "medical students" would include dental and veterinary students as well.127 The problem of preprofessional students was not considered at this time.

The Assistant Chief of Staff G-1 concurred to the extent of approving the commissioning of third and fourth year medical students, as prospective officers, but he recommended strongly against going further to include freshmen and sophomores. He stated that since the Selective Service Act expired in 1945 no student should be accepted by the military who would not graduate by 1943, to allow for 1 year in internship and 1 year of service before the end of the draft. He added that in his opinion the question of the total production of doctors was a national one, not coming within the province of the, War Department, and that if the Selective Service Act endangered medical education it should be revised, rather than resort to the subterfuge of insuring deferment by means of granting semimilitary status.128 The commissioning of junior and senior medical students only was authorized on 26 May 1941.129

    126Memo, Robert P. Patterson, UnderSecWar, for Gen George C. Marshall, 1 May 41. AG: 210.1 Med-Res (5-1-41).
    127Memo, Maj Gen James C. Magee, for ACofS G-1, 10 May 41. AG: 210.1 Med-Res.
    128Memo, ACofS G-1 for CofS, 14 May 41, sub: Deferment of medical students. AG: 210.1 Med-Res (5-1-41).
    129Ltr, TAG to all CA and Dept Comdrs, 26 May 41, sub: Deferment of medical students. AG: 210.1 Med-Res (5-1-41).


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In January 1942 the Federal Security Administrator asked the War Department to reconsider its decision against commissioning first and second year medical students, though no additional reasons were given.130 Again The Surgeon General supported the request, and this time dental and veterinary students were specifically included in his recommendations.131 The Adjutant General again disapproved such action, stating that it would grant certain students deferment for as long as 5 years,132 but his advice was rejected, and on 11 February 1942 the War Department announced that any accepted male matriculant in a medical school could be given an inactive commission.133 Reference to dental students and preprofessional students was again omitted, though the provision for enrolling any "accepted matriculant" might have covered premedical students under certain conditions.

Dentistry had been declared a critical occupancy nearly a year before134 and in April 1942 the Federal Security Administrator (acting as the Director of the Office of Defense Health and Welfare Services) again recommended that the privilege of accepting inactive MAC commissions be extended to dental and veterinary students.135 He stated that the seriousness of the situation had been called to his attention by the Health and Medical Committee of the Office of Defense Health and Welfare Services, the Procurement and Assignment Service, and officials of the professional organizations. He noted that Selective Service boards were still refusing to defer professional students in some instances, and emphasized the need to delay the induction not only of actual enrollees in medical, dental, and veterinary schools, but of men preparing for those schools as well. The requests of The Surgeon General and of other bodies responsible for assuring a steady supply of replacements in the health services apparently had some influence on the War Department, and the Assistant Chief of Staff G-1 recommended to the Chief of Staff that the Army authorize the commissioning in the Reserve of dental and veterinary students and of students holding acceptances for dental or veterinary schools.136 Approval of the Secretary of War was obtained on 14 April and the necessary orders were issued on 17 April 1942.137 The interpretation of "students holding acceptances for dental or veterinary schools" was not specific, and it has been claimed that, in some cases at least, deans "accepted" enough high school gradu-

    130Ltr, Paul V. McNutt to SecWar, 6 Jan 42. AG: 210.1 Med-Res (1-6-42).
    131Ltr, Maj Gen James C. Magee to TAG, 15 Jan 42, sub: Granting commissions to medical students in the Medical Administrative Corps. SG: 210.1-1.
    1321st ind, 28 Jan 42, SG:210.1-1. TAG to ltr cited in footnote 131.
    133Ltr, TAG to all CA and Dept Comdrs (except the Philippine Dept), 11 Feb 42, sub: Commissions for medical students. On file AG central files as Tab A to ltr, Brig Gen J. H. Hilldring, G-1 to CofS, 6 Apr 42, G-1/16455-25, sub: Commission of medical and dental students. AG:210.1.
    134See footnote 108.
    135Ltr, Paul V. McNutt to SecWar, 2 Apr 42. AG:210.1,
    136Ltr, Brig Gen J. H. Hilldring to CofS, 6 Apr 42, sub: Commission of dental and veterinary students. AG: 210.1 (4-6-42).
    137Ltr, TAG to all CAs and Dept Comdrs (except the Philippine Department), 17 Apr 42, sub: Commissions for dental and veterinary students. AG: 210.1 (4-6-42).


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ates just starting predental training to assure adequate entering classes 2 years later.138 It has already been noted that Selective Service did not grant deferment to predental students until December 1942, and then only to men who had completed the first year of training.

In anticipation of the inauguration of the Army Specialized Training Program, the granting of new MAC commissions was discontinued in February 1943.139 A majority of the 5,383 students already holding Reserve commissions later resigned them to accept active duty in the Enlisted Reserve under ASTP, but a few retained their commissions until graduation. Best information now available indicates that approximately 1,059 MAC graduates were taken on active duty in 1943, 111 in 1944, and 16 in 1945, for a total of 1,186 officers.140

The Army Specialized Training Program
for Dental Undergraduates

(The Army Specialized Training Program, in its general aspects, has been discussed at length in a report by Col. Francis M. Fitts, M. C.141 The present discussion will therefore be limited mainly to those phases of the program having special significance for dental education. Much of the material used is from Colonel Fitts' work; his documentation is not repeated.)

In December 1942 the Armed Forces announced a plan to give military status to students in training for certain essential occupations and to continue their education at Government expense.142 The reasons which impelled the Army and Navy to take a direct part in medical education are not clearly documented, but the following were probably most pertinent:

1. It has already been noted that agencies responsible for the health care of the nation during the emergency were not assured that Selective Service could be relied upon to permit continuous education in the health services during the war. In spite of Selective Service advice to the local boards the latter sometimes hesitated to consider deferment for students when they were compelled to send other young men to combat. It was also felt that Selective Service policies were subject to revision on short notice and that they could not be depended upon in establishing long-term commitments.143

2. The Armed Forces wanted to have sufficient prospective professional

    138Info given to author by Maj Ernest Fedor, who was in the Mil Pers Div, SGO, during a large part of the war.
    139WD Memo W150-3-43, 8 Feb 43, sub: Discontinuance of appointments in the Medical Administrative Corps of accepted matriculants in medical, dental, and veterinary schools and the disposition of those officers previously appointed as such. SG : 210.1-1.
    140Data computed by Lt Col John Brauer, DC, from statistics furnished by the Procurement Branch, SGO; the Appointment and Induction Branch, AGO; the Classification and Assignment Branch, AGO; and the Resources Analysis Division, SGO.
    141Fitts, F. M.: Training in medicine, dentistry, and veterinary medicine, and in preparation therefor, under the Army Specialized Training Program, 1 May 43 to 31 Dec 45. HD: 353 ASTP.
    142SOS Cir 95, 18 Dec 42, sub: Establishment of the Army Specialized Training Program.
    143See footnote 125, p. 133.


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replacements actually under military control to assure the use of these with certainty and without delay as soon as their training was completed.

3. It was feared that students themselves would not he content to remain in school as civilians, even if deferment were assured. Nearly 2,000 former dental students served with the AEF, alone, in World War I, so depleting the schools that only 906 men graduated in 1920, compared with 3,587 in 1919.144

4. It was probably felt that if professional students were to be relieved from the obligation to serve in hazardous assignments, the opportunity to attain student's status should not depend upon individual ability to pay the rather heavy costs of university training. Under ASTP the son of a laborer, or a soldier already inducted, would in theory have the same opportunity to get a dental education as the son of a wealthy family.

Details of the new program were released in April 1943 as follows:

1. Professional students already enrolled in the Enlisted Reserve were to be called to active duty under ASTP. Students who held Reserve MAC commissions could resign them and be placed in the Enlisted Reserve for subsequent call to active duty, though they were not obligated to do so.

2. Acceptable dental students not in the Reserve (MAC or enlisted) could volunteer for induction and transfer to the Enlisted Reserve under ASTP.

3. Predental students would be selected from men already enrolled in predental classes who volunteered for induction in the Enlisted Reserve, or from qualified individuals already in the Army who requested transfer to ASTP. Students not already in predental training would be accepted only if they (a) had an Army General Classification Test score of 115 or better, (b) passed an aptitude test for the medical professions, and (c) were approved by an interviewing board representing both the Army and the dental schools. Another board had to approve advancement from predental. training to a dental school. Since the ASTP was necessarily started with men already enrolled in the schools, and since the dental phase was largely terminated after 1 year, very few new students were actually selected under the above provisions.

4. Preprofessional training for all the medical sciences was to be given in a common course of five terms of 12 weeks each. The first two terms were devoted to a general course prescribed for all ASTP beginners, medical and nonmedical. The remaining three were consumed in a special preprofessional course drawn up by ASF with the assistance of representatives of the medical, dental, and veterinary schools. The entire 60 weeks of preprofessional training included the following required subjects:

English

8 semester hours

Physics

8 semester hours

Organic chemistry

8 semester hours

Biology

8 semester hours

    144Dentistry as a professional career. Chicago, American Dental Association, 1946, p. 11.


138

5. Dental schools were to continue to give their regular wartime undergraduate courses, which had been shortened in January 1942.145 Individual schools were to determine their own criteria for passing grades, examinations, and the general maintenance of professional standards.

6. On graduation, students were to be commissioned in the Army Dental Corps and called to active duty.

It was planned to utilize 35 percent of the capacity of the dental schools for the Army, starting about 970 new students every 9 months. With an estimated 15 percent attrition, this would provide about 825 potential dental officers every 9 months. Maximum enrollment was reached in March 1944 when 6,143 students in dental schools were enrolled in ASTP. The Navy was expected to take an additional 20 percent of total capacity, to provide 475 dental officers every 9 months, so that the Armed Forces, together, were to account for 55 percent of the capacity of the dental schools. In October 1943, however, the 7,775 students enrolled by the Army and Navy amounted to nearly 90 percent of the total of 8,888 students in the dental schools.146 Since 5,883 dental students had held Reserve commissions in February 1943, and since only 6,143 were enrolled in ASTP at its maximum, it is clear that the majority of the dental ASTP enrollees were men who had already been deferred as members of the MAC Reserve.

It was also planned to start an average of 130 preprofessional students, earmarked for the dental ASTP, each month. It was expected that this number would provide 110 new students monthly for the dental schools.

The dental ASTP was activated in the period from May through July 1943. All dental schools in the United States, totalling 39, participated, including Meharry and Howard Universities for Negro students.

By 1944 the need for additional young manpower to push the war to a successful, early conclusion became critical and the Army began to consider a reduction in long-term training programs. In March 1944 it was announced that the entire ASTP would be cut back from 145,000 men to 35,000, though no reduction in the medical or dental programs was anticipated at that time. A few days later, however, the director of the Military Personnel Division advised The Surgeon General that it seemed doubtful that men then in preprofessional training would ever be used by the Army in view of changes in the general war situation.147 He reflected only current confusion on the propriety of the Armed Forces concerning themselves with medical education for civilian needs when he noted that the Army should not be placed in the position of agreeing to an interruption of medical education, even when gradu-

    145In January 1942 the Council on Dental Education, ADA, had recommended that the dental course during the war be continuous (no summer vacation) and that it be cut to three years instead of four. This recommendation was accepted by all schools. See Acceleration of the dental school program. J. Am. Dent. A. 29 : 287-288, Feb. 1942.
    1467,775 out of 8,888 in dental schools are in armed services. J. Am. Dent. A. 31 : 164, 15 Jan 44.
    147Memo, Lt Col Durward G. Hall for SG, 28 Mar 44, sub: Medical section, Army Specialized Training Program. SG: 353.9-1.


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ates would not be available until after the emergency, but that the responsibility properly lay with Selective Service, and that in his opinion the latter would not act as long as the military were in the field. He recommended that further procurement for entering classes be terminated. There is no indication that this advice had any direct influence on the subsequent curtailment of the dental ASTP, but it is of interest as revealing the trend of thought among officers charged with personnel responsibilities in the Office of The Surgeon General.

On 18 April 1944 ASF announced that the Army's share of the classes entering dental schools after 1 January 1945 would be 18 percent instead of 35 percent, and that no commitments would be made covering classes to, start in 1946.148 At this time the Dental Corps was approaching its maximum authorized strength (see chapters III and IX), and efforts of The Surgeon General to have a significant number of older dental officers replaced with younger men were meeting with little success; as a result it was impossible to commission the ASTP graduates of June and early July 1944, and they had to be unconditionally released by the Army,149 causing much adverse com ment from dental officers and civilians. On 2 June 1944 the director of the Strategic and Logistic Planning Unit advised The Surgeon General that a demand for continuation of the dental ASTP could no longer be supported on the basis of military requirements,150 and in drawing up recommendations for future ASTP training in the medical sciences The Surgeon General recommended, on 9 June 1944, that the dental and veterinary programs be dropped. On the protest of the Director of the Dental Division, however, this request was withdrawn on 27 June and resubmitted to provide for a continuation of dental training. In reply, The Surgeon General was advised on 1 August 1944 that the War Department General Staff had definitely decided to drop the dental ASTP.151 This statement came as an anticlimax, however, since the termination of the dental ASTP had already been announced by the War De partment on 18 July 1944.152 Under the terms of this latter directive all senior students, numbering about 1,175 men, were to be allowed to complete their courses, when they would be commissioned in the Dental Corps. Dental students not in their final year (about 4,810 men), and predental students who would complete their preliminary training at the end of the current term and who held acceptances for dental courses beginning prior to 31 December 1944,

    148Memo, Brig Gen W. L. Weible for SG, 18 Apr 44, sub: War Department policy governing training in medicine and dentistry under ASTP. SG: 353.9-1.
    149Ltr, Col J. R. Hudnall to Comdt, 3930 Service Unit, ASTU, University of Southern California, Los Angeles, Calif., 1 Jul 44, sub: Disposition of senior dental ASTP trainees on date of graduation. SG: 000.8 (University of S. Calif.) W.
    150Memo, Lt Col Durward G. Hall for Deputy SG, 2 Jun 44, sub: Demand schedule for ASTP graduates. SG: 353.9-1.
    1513d Ind, Brig Gen Russel B. Reynolds, 1 Aug 44, on Ltr, Col J. R. Hudnall to CG ASF, 9 Jun 44, sub: Requirements for ASTP graduates for last nine months of 1944 and the year 1945. SG: 353.9-1.
    152Ltr, Maj Gen M. G. White, ACofS G-1, to CG, ASF, 18 Jul 44, sub: ASTP dental program. SG: 353.9 (Med).


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were to be discharged from the Army at the end of the term, to continue their education at their own expense. Students who could not meet these requirements (about 722 men), or who could not pay for their own schooling, were to be transferred to the Medical Department as enlisted men. The dental ASTP was thus limited to senior students in July 1944 and it came to an end with the classes graduating in April 1945.

Cost of the Dental ASTP. It is difficult even to estimate the cost of the dental ASTP since such unknown factors as the expense of providing medical care for trainees and the potential cost of veterans' benefits following the war were involved. Some of the more important items, calculated to 12 October 1945, have been reported as follows:153

Academic cost per student per month (tuition, books, instruments)

$64.90

Housing (at institutions)

9.04

Housing (on commutation)

37.50

Food (at institutions)

31.50

Food (on commutation)

54.00

The monthly cost for academic expenses, food, and housing thus varied from $105.44 for students housed and fed under contract, to $156.40 for students granted commutation for housing and food obtained on their own responsibility. To this amount must be added at least $50 per month for salary, plus an unknown amount for overhead, including the salaries of military administrators, hospitalization, travel, et cetera. Money received from the resale of books and equipment after the termination of the program reduced the above cost for academic expenses by about $8.00 per month.

Results of the Dental ASTP. The following tabulation summarizes the results of the Dental ASTP:

Number of dental schools participating

39

Number of months in operation

26

Total dental students enrolled

7,734

Disposition of 7,734 enrollees:

Graduated

2,458

Discharged to continue at own expense at end of program

4,651

Failed

472

Dropped for other reasons

101

Transferred to Medical Department as enlisted men

52

Disposition of 2,458 graduates:

Commissioned in the Dental Corps

1,914

Discharged for lack of vacancies, June and July 1944

113

Commissioned by Veterans Administration, mainly in June and July 1944

36

Commissioned by Navy, same period

269

Disqualified for physical or other reasons

126

Predental students enrolled

1,407

Completed predental training

499

 153Statistics relating to the dental ASTP program. Published by the Training Contracts Section, Production and Purchases Div, ASF, undated. HD: 314.


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Discussion, Dental ASTP. The Dental ASTP was bitterly criticized almost from its inception until long after it had gone out of existence, indicating the need for a, careful evaluation of the objectives and policies involved in order to avoid similar difficulties in any future emergency.

Probably the most fundamental criticism was based on claims that there was actually no need for the military to venture into the unfamiliar field of undergraduate professional education. The profession, the schools, and the public were of course interested in maintaining an adequate flow of dental graduates and in keeping the dental schools operating in a healthy condition. It has already been pointed out that various professional and governmental agencies, which apparently did not have full confidence in Selective Service's intentions, had repeatedly requested the Armed Forces to give students inactive military status to insure their deferment. But the professional agencies, at least, vigorously opposed the more detailed involvement of the Army and Navy in the administration of dental education, even though the actual instruction was left to the established schools. As early as May 1943 the position of the ADA was stated as follows:154

... recalling vividly the awkward blunder of the administration of the Student's Army Training Corps in World War I, which, but for the providential Armistice in November 1918, would probably have led to the collapse of higher and professional education, we have hoped profoundly that dental education might be spared military regimentation during this war. With every wish to see competent dentists provided promptly and unhesitatingly for the Army and the Navy, as they happily have been, and, we believe, will continue to be, we are concerned about the working out of a system of dental education "by contract" with, the Army and Navy. We gravely question whether the common end to be gained, about which there is no debate, may not be accomplished more economically, more expeditiously, with sounder educational procedure, with greater assurance of a steady supply of new entrants to dental practice to meet civilians as well as war service needs with greater safety for the future of the profession, by the conduct of the dental schools free from the inevitable effects of Army and Navy regimentation. . . .

After all this military machine does its work, it will transpire, we predict, that there was really no occasion or necessity for doing anything. What more do the Army and Navy want than a steady flow of well-trained dentists to meet their replacement needs? The dental schools could have gone on and would have gone on cheerfully without any overlordship or regimentation, and, indeed, without any financial aid. . . . All the Government needed to do was to establish a sensible working scheme for the deferment of enough bona fide high school and liberal arts college students to sustain the present enrollment in dental schools...

In justification of the Armed Forces' decision to place dental students on active duty, it should be noted that the opinion that professional trainees would be content to remain in school if they were assured of deferment was not universally accepted. Even the Secretary-Treasurer of the American Association of Dental Schools reported that "the average student of the desirable type took a rather dim view of deferment while other young men of his age were in

    154Dental education in wartime. J. Am. Dent. A. 30: 741-749, 1 May 43.


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uniform, " and he stated that "assignment [to the Armed Forces], as a principle, appeared to be the most desirable, although uneconomic procedure."155 The feeling that if young men were to be given deferment from dangerous duty to remain in school the Armed Forces should select those to be given that oppose tunity, and that those selected should be paid so that such preferred treatment would not be based on economic status, has already been mentioned. By the time the dental ASTP was inaugurated, however, it was already reasonably clear that no general voluntary exodus from the professional schools need be anticipated in World War II, and that deferment would in itself be sufficient stimulus to keep a sufficient number of dental students in training. Enrollment in the dental schools had, in fact, actually increased from 7,184 in 1937 to 9,014 in 1943, when it was higher than at any time since 1928.156 The contension that any qualified individual should have equal opportunity to obtain deferment for professional education, regardless of ability to pay, was a plausible theory, but in practice the ASTP had to be set up with students who had, for the most part, already been pursuing their courses for from 1 to 5 years, and who were presumably already assured that they would be able to pay the necessary costs. Thus it was found, when the dental ASTP was Terminted in 1944 and students were forced to continue at their own expense, that only a little over 1 percent had to drop out. Whether the professional student was entitled not only to deferment in time of war, but to the salve to his feelings which was provided by the fact that he was placed in uniform, is at least open to question.

The belief that the personnel needs of the Dental Services of the Armed Forces could not be met unless dental students were placed under military control has also been challenged. When ASTP was first being considered, in the fall of 1942, the Army Dental Corps was faced with a procurement objective of over 7,000 officers for 1943, and there is every indication that some difficulty in getting this number of dentists was anticipated. (See chapter III) Selective Service had shown its inability to draft dentists in significant numbers, and it was apparently felt that dental students should be required to make themselves available for immediate military service on graduation in return for the privilege of deferment. The Director of the Dental Division stated in August 1944 that:

The Dental Corps at one time had an anticipated procurement objective of at least 25% more than the maximum level reached...

It has been stated that the Army could have attained all the dental officers desired without the ASTP, and that the dental schools could have produced just as many officers for the Army. This statement in all probability is true, but the fact is that the procurement objective for dentists was never reached in many of the states. There was no mechanism whereby dentists could be drafted except through the normal channels of Selective Service. That many dentists refused commissions in

    155Personal Ltr, Dr. John E. Bulher to Col William Wilson, 11 May 48.
    156Horner, H. H.: Dental education and dental personnel. J. Am. Dent. A. 33: 872-888, 1 Jul 46.


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the Army is a fact that nearly every State Dental Procurement and Assignment chairman can testify. Many dentists . . . preferred to have the other fellow go. These facts, and those associated with the potential military needs, caused the War Department to include dentistry in the ASTP.

After the war the Director of the Dental Division noted that:

. . . when the ASTP was initiated said program was justified for the reason that it was impossible to predict the length of the war and available dentists in civilian life were limited. It is believed, however, that the Army Dental Corps needs could have been satisfied without the AST Program.157

The ASTP predental training was criticized by dental educators who felt that the five-term course was inadequate. At the invitation of The Surgeon General representatives of the professional schools met in January 1943 to advise on the premedical, predental, and preveterinary courses. This committee, which included three dental educators, recommended a common program for all branches of medical science and they advised that six semesters of 12 weeks each be allowed for preprofessional schooling. It recommended further that the course include the following minimum requirements:158

English

6 semester hours

Physics

6 semester hours

Biology

6 semester hours

General chemistry

8 semester hours

Organic chemistry

4 semester hours

An additional 30 hours were to be selected from optional technical subjects, depending upon the facilities of the school and the desires of the student. The curriculum finally approved by ASF has been described in paragraph 4, page 137.

The charge that dental educators had not been consulted is certainly open to question, though one dental representative on the committee stated later that they had accepted the final plan in an effort to make the best of a program which they had personally thought ill-advised, but which had been definitely decided upon by the War Department.159

The effect of the ASTP on the morale of other military personnel was unfavorable, but difficult to evaluate in respect to degree. The young men who had been taken from a school of business administration and sent to New Guinea could not always understand why the able-bodied boy next door was continuing his dental education as before, except that now the Government took care of his expenses and paid him a salary. The paratrooper's pride in his skill as a fighting man was apt to be dampened when he heard that college students at home were wearing uniforms which the general public could not distinguish from the one he was currently wearing in a foxhole on the wrong side of the Rhine. This type of "discrimination" was regrettable but unavoid-

    157See footnote 9, p. 107.
    158Ltr, SG to Dir ASTP, 2 Jan 43, sub: Premedical and medical education. SG: 353.9-1.
    159Army specialized training program. J. Am. Dent. A. 31:1149-1154,15 Aug 45.


144

able if there was to be no break in the training of replacements for vital occupations, but the opinion was widely held and expressed that the Army had done enough when it guaranteed deferment for professional students, without subsidizing them and giving them the status of soldiers.

Probably the most bitter criticism of ASTP came from dental officers of the Armed Forces, especially when it was announced in 1944 that recent graduates would be released to civil life. Dental officers on military duty were not always in full possession of all the facts concerning the ASTP, and the fairly common belief that dental students had been educated at Government expense and then released to enjoy the lucrative practice at home is understandable, if not entirely justified. Actually, no dental student received all, or even a major part, of his schooling under ASTP. Juniors entering the program in 1943 received up to 2 years of education at Government expense; others received a maximum of about 1 year since only seniors were continued in the course after July 1944. Also, in spite of the Army decision to release graduates in June and July 1944 only a small proportion entered civil practice. The lack of vacancies at that time was temporary, and all qualified men graduating from July 1944 until ASTP ended in April 1945 were given commissions in the Army Dental Corps. All but 113 of the physically qualified graduates of the dental ASTP eventually entered the Army, Navy, Veterans Administration, or the Public Health Service.160 (For a discussion of the reasons why ASTP graduates were not commissioned in the summer of 1944 see chapter III.)

Even a considerable number of the critics of ASTP held that once it had been established it should have been kept in operation until the end of the war, both to assure continued replacements for civilian practice and to provide dental officers when it became necessary to demobilize veteran dentists after the end of hostilities. Colonel Fitts states in his report that:

It is extremely interesting to note that the curtailment and termination of both the dental and veterinary training programs have proved to have been premature and ill-advised. The lack of replacements for dental officers has required the retention of dentists in the active military service for periods in excess of those required for emergency medical officers, with resulting criticism and dissatisfaction. The dental ASTP trainees who were discharged in order to continue their studies as civilians have upon graduation been under no obligation or compulsion to enter the military service either as enlisted men or officers. Efforts at the recruitment of volunteers as replacements among this group have proved completely futile and on 24 May 1946 the War Department placed a special call on Selective Service for the draft of dentists.

Though the Director of the Dental Division and The Surgeon General had advised against the termination of the dental ASTP, the War Department appeared to feel that it could not justify the program when the Dental Service was refusing to accept graduates for lack of vacancies. At the time the dental ASTP was terminated the demand for combat troops was so critical that

    160Memo, Brig Gen J. J. O'Hare, Chief, Manpower Control Group, to Gen Willard S. Paul, ACof S G-1, 8 May 46, sub: Dental ASTP program. SG: 353 (Student training).


145

partially trained pilots were being transferred to the infantry, and medical units overseas were being stripped of able-bodied enlisted men, who were replaced with untrained, limited-service personnel. It may or may not be held that the action taken was unjustified, but it cannot be argued that the reasons which motivated the War Department were trivial. (See also the discussions of this problem in chapters III and IX.)

The Deferment of Instructors in Dental Schools

The question of maintaining the faculties of the dental schools during the war did not at first receive the attention given the maintenance of their student bodies. Some increase in the load carried by individual instructors was possible, and as a group the teachers were less likely to be subject to induction under Selective Service because of age. The problem eventually assumed important proportions, however, and its solution involved the Armed Forces, Selective Service, PAS, and various other organizations and agencies.

Instructors were not mentioned in the first bills introduced in Congress to provide for the deferment of dental students. A modification of the earlier Murray bills, introduced in the Senate in February 1941, directed the exemption of professional instructors, but this legislation, and later similar acts, met the same fate as the various bills to defer students.161 Selective Service also omitted consideration of instructors in its early directives concerning occupational deferment, but on 20 June 1941 all State Directors were advised that serious consideration should be given to the exemption of individuals found necessary for the instruction of students in critical occupations.162

Early in 1943, PAS became interested in this problem and conducted a survey to determine the actual situation.163 Thirty-eight dental schools were found to have 2,000 instructors, of whom 1,200 were declared to be essential by the schools themselves. Fifty percent of the instructors were under 45 years of age, and 40 percent were under 40 years of age, but no attempt was made to obtain more detailed information on eligibility for induction under Selective Service. The medical schools were found to vary greatly in the proportion of instructors declared essential, from a minimum of 10 percent to a maximum of 98 percent; similar figures were not given for the dental schools, but comparable variation was reported to exist. PAS recommended that 12 instructors be allowed for the first 100 students in professional schools, and that 9 instructors be authorized for each additional 100 students, but it was found that few schools approached the calculated ideal. Individual institutions varied from a minimum of only 40 percent of the recommended total of instructors to a maximum of 206 percent. PAS appealed to the schools to adhere to the proposed ratio, but the results of this effort, if any, are unknown.

    161See footnote 100, p. 129.
    162See footnote 107, p. 130.
    163Minutes of committee on Dentistry, PAS, 13 Feb 43. Natl Archives, PAS files.


146

The professional press carried numerous discussions of the shortage of dental instructors, but factual data on this subject, beyond that reported by PAS, have not been revealed. After the war the Secretary-Treasurer of the American Association of Dental Schools advised that in any future emergency it was essential that professional schools be assured an adequate complement of trained teacher personnel, either by deferment or by assignment from the military forces after being taken on active duty.164

Summary, Dental Undergraduate Education, World War II

In spite of outspoken criticism of many aspects of the handling of professional students during World War II it is clear that the primary objective, to maintain the dental schools and to provide a continuing flow of graduates, was attained. Shortly after automatic deferment was ended in July 1941, over 80 percent of all dental enrollees were already being deferred by their local boards on an occupational basis. More vigorous action by Selective Service in late 1941 and in 1942, and the granting of inactive military status by the Armed Forces, not only maintained enrollment, but increased it by 1943 to the largest figure since 1928. Average registration in the dental schools in the 5 war years, from 1941 through 1945, was 8,416 students, compared with an average of only 7,354 students in the 9 years from 1932 through 1940.165

It would seem that World War II policies in respect to the deferment of professional students cannot be criticized for impeding dental education; it is not equally certain that they should not be criticized for actually increasing the number of students registered in professional schools in wartime. The need for a long-term augmentation of training in the medical sciences cannot be denied, but the propriety of a major increase in enrollment in dental schools in a time of national emergency, when the desire for deferment from dangerous military service was presumably a strong motive for seeking a professional education, is at least open to question. Students who were already enrolled in the dental schools, or who had begun their general university preparation with the specific purpose of entering dental training, were of course above suspicion in this respect, but since average enrollment during the war exceeded the prewar average by more than a thousand men it is difficult to escape the conclusion that a considerable number of men of military age took up the study of dentistry for reasons directly or indirectly connected with the war. To the extent that these men were motivated by a desire to escape military duty, rather than by a strong desire to enter the profession of dentistry, their deferment could hardly be a cause for satisfaction, either to the profession or to the public. It would seem that agencies responsible for the exemption of professional students should, by voluntary agreement if possible, limit such exemption to a number consistent with average normal enrollment.

    164See footnote 155, p. 142.
    165Enrollment data from 1932 through 1945 obtained by author from the Washington office of the ADA, 26 May 48.


147

It is true that the end of ASTP in 1944, and the simultaneous termination of Selective Service deferment for predental students, would have resulted in a serious situation if the war had not come to a close in a short time. In October 1945 only 1,197 freshmen dental students were enrolled, compared with 2,496 the year before,166 and it was estimated that as a result there would be only about 1,000 graduates in 1948.167 It is highly probable that both the actions which led to this situation were based on a reasonable belief that hostilities would not be prolonged after 1944, but the ensuing rapid reduction in freshmen enrollment emphasized the need for assuring continuous predental education if the dental schools are to continue their operations.

The ideal mechanism for providing deferment for students in essential occupations was not found during World War II. Attempts to attain that end through legislation failed because they conflicted with the basic concept, accepted by Congress, that no group should be granted blanket preferred consideration under the Selective Service law. Any exception to that policy would probably result in strong political pressure to have the privilege extended to an ever-widening population. Even if blanket deferment of dental students were authorized, the administration of such a policy would entail serious difficulties; if no restrictions were prescribed the schools would soon be flooded with applicants who were interested mainly in exemption from military duty, and if the number to be deferred were limited, the question of determining which men should be accepted would involve knotty political and administrative problems.

The Selective Service System was of course charged with formal responsibility for determining which individuals should be inducted and which should be allowed to continue in training for essential occupations, and it actually authorized most deferments of dental students until the Armed Forces started granting inactive Reserve commissions in late 1941 and early 1942. Selective Service was again left to carry almost the entire burden of exempting dental students after the Armed Forces abandoned their dental undergraduate programs in 1944, and during all this period a considerable number of professional students who were not eligible for, or who did not desire, military status continued their education under Selective Service policies. It has been pointed out, however, that in spite of this record many dental educators, members of the profession, and even governmental agencies responsible for national health, had serious misgivings concerning Selective Service's willingness and ability to follow a consistent course which would insure the regular operation of the schools. Selective Service was committed to a policy of placing heavy responsibility on the local boards, on the theory that they were most familiar with circumstances which affected individual priority for induction, and critics appear to have felt that the local boards lacked the technical background for

    166See footnote 120, p. 132.
    167See footnote 156, p, 142.


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selecting dental students and that they could not be relied upon to follow the general policies recommended by national agencies which were familiar with larger aspects of the problem of continuing training in the health services. This fear does not seem to have been supported by the facts since enrollment in the dental schools increased steadily from 1940 through 1943, though it was reported that individual boards refused to defer professional students.

The suitability of Selective Service as the agency to defer professional students may be questioned on more fundamental grounds. The entry of the military into the educational field minimized Selective Service's problem by the time it became necessary to choose large numbers of new students, and it will be seen later that Selective Service actually delegated much of its nominal authority to the dental schools. If it had retained full responsibility in this matter during the entire war it would ultimately have been faced with the necessity for finding acceptable answers to such problems as the following:

1. How many students should be granted deferment each year to take up the study of dentistry?

2. How should students be allocated geographically and according to schools? Should state quotas be determined? Rural and urban? Racial? Should wartime quotas attempt to correct longstanding peacetime imbalances in the distribution of dentists? How assure that state universities would accept a reasonable proportion of students from adjoining states having no dental schools?

3. How coordinate the actions of local boards which had no way of comparing the qualifications of their applicants with those appearing before other boards?

4. How select approximately 2,000 students each year from some 10,000 applicants so as to insure deferment for those who were most likely to succeed in school and in the practice of the profession? Could this selection be left to the schools without risking charges of favoritism? Should Selective Service set up agencies for investigating scholastic records, giving aptitude tests, and otherwise determining the relative eligibility of thousands of would-be dental students?

5. Should ability to pay for a dental education be a deciding factor in the selection of students for deferment in time of war?

6. How eliminate applicants who were interested in deferment rather than in the practice of dentistry? A similar situation arose very early in the war when it became apparent that Selective Service alone could not handle the problem of procuring physicians, dentists, and veterinarians, on the basis of individual liability for military service, without endangering the health services of the nation. In this instance the Procurement and Assignment Service of the War Manpower Commission was established to render expert advice, though coopera-


149

tion between the two agencies sometimes left much to be desired. It is possible that with the assistance of some such body of professional experts, either in or out of its own organization, Selective Service could have handled the question of deferring students with reasonable satisfaction, but it seems probable that a purely lay body would have been on unfamiliar ground had it attempted to administer such a highly technical matter unaided.

It is noted above that during the period when it was nominally responsible for the deferment of dental students Selective Service actually delegated most of its responsibility to the schools. Students already enrolled were generally continued in their studies without question by the Selective Service boards, and the deferment of new applicants was normally based on acceptance for admission to a dental school. For all practical purposes, therefore, the deans of the professional schools had the final decision in determining which applicants would be accepted to continue their education and which would be rejected and inducted into the Armed Forces. It is clear, from published criticisms of the Army and Navy programs, that the dental schools preferred to select their own students, and that they wanted nothing from any governmental agency but deferment of the men chosen.168 The Armed Forces entered the situation before the results of this policy could be fully determined in World War II and there is no evidence that the deans of the dental schools did not choose applicants as impartially as possible, on the basis of their desirability for the profession as interpreted by the deans themselves. It is possible, however, that with the best intentions in the world both the schools and Selective Service would ultimately have come in for serious criticism if the matter had not been largely taken from their hands by the inauguration of the Army ASTP and the Navy V-12 programs.

In the first place, it is doubtful if dental educators, as individuals, were any better fitted than Selective Service to answer such questions as the following:

1. How many students should be admitted? During the war the capacity of the school was apparently the deciding factor in most cases, and it appears that the schools and the profession escaped criticism for the resulting great increase in enrollment only by sheer good luck.

2. Should students be selected purely on the basis of individual qualifications, or should some effort be made to apportion vacancies on a geographical basis? If the latter, how?

3. How could a dental school supported by state funds resist strong political pressure to limit deferment to citizens of that state, so as to provide for students who normally came from adjoining states with no dental schools of their own? if vacancies were to be reserved for out-of-state students, how should they be apportioned among the many schools which might be called upon to accept such students? Who would enforce such apportionment?


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4. If questions of the fair allotment of vacancies could be solved by voluntary cooperation between schools, how could accepted policies be implemented through Selective Service, which alone could grant actual deferment?

5. How select a few thousand new students from the many thousands of applicants each year? Educators were presumably best fitted to determine the scholastic qualifications of applicants, but even the opinions of experts in this field are notoriously fallible. During World War II the problem was further complicated by the fact that in order to insure his deferment until he could complete predental requirements, a dean often had to "accept" a dental student soon after graduation from high school, long before his capacity to absorb highly technical university training had been established. The increasing reliability of aptitude tests also suggests that in the near future trained personnel administrators may be able to select prospective dental students with greater accuracy than educators relying upon their own impressions and upon scholastic records, but neither personal impressions nor aptitude tests will eliminate the opportunist who is interested in draft deferment rather than in the practice of dentistry.

Such problems can be solved only by an agency which has full information on national as well as local needs, which has close liaison with the Armed Forces, with Selective Service, with other interested governmental activities, and with the professional organizations; and which has sufficient official authority to insure adequate consideration for its recommendations.

Potentially at least, the greatest objection to leaving the deferment of students to dental educators is probably the degree of personal responsibility involved. It has already been pointed out that wartime enrollment in the dental schools exceeded normal peacetime registration by more than a thousand men, and that Selective Service boards openly charged that the universities were "havens for slackers."169 So far as is known the corollary charge, that the schools were using the national emergency to swell their own income, was never made, but the possibility that it would be was constantly present. it seems highly probable that most deans were influenced only by a sincere desire to provide needed personnel for the profession, but the administration of any policy having to do with exempting individuals from dangerous duties in war-time inevitably and properly receives close scrutiny from Congress, the public, and the press, and the opportunity for misunderstanding is enormous. The objections to allowing any private individual or organization to select men to receive such a fundamental privilege as exemption from military service are obvious. It is probable that if the deans had carried this heavy responsibility during the entire war they would ultimately have become targets for such vigorous criticism, and such political and personal pressure, that they would have welcomed the intervention of some official or semiofficial agency roughly similar to the Procurement and Assignment Service.

    169See footnote 96, p. 126.


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The military were probably least qualified of all agencies to select new professional students, and it is difficult to find theoretical or practical justification. for the Army and Navy becoming involved in such extraneous matters in a national emergency. The Armed Forces initiated their World War II training programs with men already enrolled in dental schools or in pre-dental preparation, and had the assistance of dental educators in selecting new applicants during the short time they were directly concerned with dental undergraduate instruction, but this field was so remote from military activities that it would seem more appropriate to leave it to other agencies. Much can also be said for the early contention of the War Department that the military should not involve itself with any phase of professional education beyond the minimum steps necessary to insure sufficient trained replacements, and that questions of deferment of professional students to meet the needs of the civilian population should properly be the responsibility of Congress, Selective Service, the Federal Security Agency, the War Manpower Commission, and other nonmilitary organizations. The fact that at least some of these agencies considered it necessary to request the Armed Forces to assume such an unfamiliar role in World War II emphasizes the need for a clear and enforceable policy on student deferment at the start of mobilization.

The statement of the Director of the Dental Division after the war, that Army requirements for dental officers could have been met without recourse to the ASTP, seems well substantiated.

AUXILIARY DENTAL PERSONNEL

Period Before World War II

Soon after contract dentists were first authorized it was provided that each would have an enlisted assistant detailed from members of the Hospital Corps and that these assistants would be under full control of dentists during duty hours.170 As early as 1904, Dr. Marshall reported to The Surgeon General that it was difficult to obtain enlisted assistants, and that competent men became dissatisfied with the long hours, confining work, and lack of opportunity for advancement incident to assignment to the Dental Service.171

In World War I, about 5,000 enlisted assistants were on duty with 4,620 dental officers. These men were detailed from Medical Department enlisted personnel and were largely trained by the officers with whom they worked.

In the period between World Wars I and II, dental auxiliary personnel continued to be obtained from the Medical Department though provision was made in Army regulations for special detail of enlisted men to the Dental Service.172 Men so detailed, on the authority of The Surgeon General, were

    170Manual for the Medical Department, 1906. Washington, Government Printing Office, 1906, p. 40.
    171Ltr, Dr. John S. Marshall to SG, 16 Feb. 04. Natl Archives: 70760-27.
    172AR 40-15, 28 Dec 42.


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to be more directly under the control of dental officers for training and duty than would those merely assigned, and it was believed that this provision would ensure a more stable source of auxiliary dental personnel. In practice few men were ever so assigned and the merits of the plan were never determined. It was abandoned completely in May 1943.173

Before World War II, it was generally believed by enlisted men of the Medical Department that duty with the Dental Service meant long hours and loss of opportunity for promotion. Dental officers spent months training laboratory technicians and chair assistants, knowing all the while that the best grade they could offer in their relatively small clinics would be that of private first class or corporal, and that as soon as these men had sufficient service to be considered for promotion they would have to transfer to the surgical service or medical supply. The alternative was to accept those misfits who had no ambition or hope for advancement. Seldom could the Dental Service offer grades comparable to those available in other, larger departments. Further, when the enlisted man of the Dental Service was examined for promotion he was questioned on general medical subjects in which men assigned in other services had the obvious advantage. As a result, service in the dental clinic came to be regarded as a dead end on the road to promotion. There was very little change in this situation until the start of World War II.

Auxiliary Personnel, World War II

Mobilization for World War II brought considerable improvement in the adequacy and status of auxiliary personnel provided the Dental Service. In June 1941, only 1,488 enlisted men and a limited number of civilians were on duty with dental installations.174 In September 1943, 13,851 enlisted men and 2,441 civilians were so engaged,175 and by January 1944 the number had in creased to 15,585 enlisted men and 2,410 civilians.176 The percentages of men in the various grades and a comparison with grades held by enlisted men of the Medical Department as a whole were as follows:

Grade* 

Dental Service (Total Army)

Dental Service (Continental US)

Medical Dept. (Continental US)

Percent

Percent

Percent

Master sergeant

0.06

0.09

0.50

Technical Sergeant

0.48

0.61

1.50

Staff sergeant and technician 3/c

4.36

3.84

5.00

Sergeant and technician 4/c

13.60

12.72

11.70

Corporal and technician 5/c

44.01

39.19

17.80

Private first class

20.35

23.56

23.10

Private

17.11

19.96

40.90

*308 Wacs in unknown grades are not included in above percentages for the Dental Service.

    173AR 40-15, C 1, 10 May 43.
    174History of the Army Dental Corps, Personnel, 1940-43. HD: 314.7-2.
    175Ibid.
    176Annual Rpt, Dental Div SGO, 1945. HD.


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It is apparent that the enlisted man of the Dental Service had a poor chance of reaching the, top three grades, but he had a better chance than the enlisted man of the Medical Service to reach the grades of sergeant and corporal.

By June 1944, enlisted personnel were being replaced somewhat by civilians and the number of enlisted men on duty had dropped to 14,859 while that of civilians had increased to 3,446. These figures remained substantially unchanged until the start of demobilization.177

When initially assigned to the Dental Service all enlisted assistants had completed from 8 to 17 weeks of basic military training; many had no other experience in the duties they would have to perform.

Dental Laboratory Technicians. One of the first problems to be solved by the Dental Service in World War II was a severe shortage of dental laboratory technicians. When the dental requirements for induction were considerably relaxed in October 1942, the disqualification rate for dental reasons sharply decreased and by the end of 1942 it reached the level of 0.1 percent. It remained at about that level for the remainder of World War II.178 To meet the needs of the hundreds of thousands of men who would previously have been considered unfit for military duty, the Army was eventually to construct over two and a half million dentures, requiring a mobilization of laboratory facilities on a scale not foreseen in early planning.

To meet this need for increased laboratory facilities, the Army could count on inducting only a fraction of the required personnel. A survey by the Dental Laboratory Institute of America and the American Dental Association showed that in 1942 there were only a. little over 12,000 trained dental technicians in the entire United States.179 Many of these were ineligible for induction because of age or dependency, and when it is noted that about one-third of all men actually called by Selective Service during World War II were rejected for physical and mental reasons, it is apparent that but a few laboratory men could be taken from the civilian reservoir. It should be noted that civilian demand for dental prosthetic appliances also increased greatly during the war because of the rapid rise in general income levels. A sample group of laboratories questioned early in 1942 reported that they had lost about 18 percent of their technicians.180 If this proportion held throughout the country the Armed Forces inducted about 2,200 laboratory workers from this source.

To make the situation worse, many of the dental technicians taken into the Armed Forces during the first part of the war were lost to the Dental Service.181 The test group of laboratories previously mentioned reported that only 44

    177Unpublished data from the files of the Dental Division. Abstracted by Lt Col John C. Brauer, DC, Dent Div SGO.
    178Unpublished data from the Medical Statistics Div, SGO.
    179Complete survey of dental laboratory technicians to be undertaken by committee. J. Am. Dent. A. 29: 2060, 1 Nov 42.
    180Ibid.
    181Proceedings of The Surgeon General's Conference with Corps Area and Army Dental Surgeons, 8-9 Jul 42, p. 11. HD: 337.


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percent of their inducted laboratory men were sent to duty with the Dental Corps. Some were assigned from the reception centers to nonmedical units, probably on the basis of mechanical ability; others were assigned as chair assistants because Army classification procedure at first failed to distinguish clearly between laboratory and assistant functions.182 The latter mistake was readily correctable, except when technicians taken from Zone of Interior laboratories were assigned as chair assistants to units going overseas, in which case they were often irrevocably lost to the prosthetic service.

On 23 November 1942, on the advice of the Director of the Dental Division, the chief of the Personnel Service, SGO, asked Army Service Forces to take steps to insure that dental laboratory technicians would be assigned to the Medical Department, and requested further that the forces in the United States be combed for technicians who had already been assigned to other branches.183 At about the same time the ADA and the Dental Laboratory Institute of America cooperated to make the survey of laboratory manpower which has already been mentioned and to furnish the Dental Division, SGO, with the names of inducted technicians so that a check could be made of their current assignments. In January 1943 the Dental Division also requested that the practice of assigning laboratory men to chair assistants' duties be stopped.184

In February 1943 it was reported that The Adjutant General was taking the following steps:185

1. Directing an Army-wide report on dental technicians performing other duties.
2. Requesting from the Surgeon General's Office a, list of vacancies for dental technicians.
3. Notifying reception centers to send all inductees with laboratory experience to the nearest Medical Department replacement training center for assignment.

While few dental technicians were assigned outside the Medical Department after the spring of 1943, another critical situation soon arose when ASF directed that personnel fitted for general overseas assignment would not be retained in service commands in the United States. Some laboratory men were of course required overseas, but in April 1943 the Director of the Dental Division complained that Zone of Interior installations were being stripped of dental mechanics who were subsequently being assigned to tactical units as dental chair assistants.186 He strongly recommended to ASF that dental laboratory men be assigned only to those organizations having prosthetic facilities. Two

    182AR 615-26,15 Sep 42.
    183Ltr, Chief, Pers Serv, SGO, to Dir, Mil Pers, ASF, 23 Nov 42, sub: Dental technicians. SG: 221 (Technologists).
    184Memo, Dental Div. SGO for Pers Serv, SGO, 28 Jan 43. SG : 221 (Technologists).
    185Memo, Dir Tng Div, SGO, for Pers Serv, SGO, 26 Feb 43, sub: Dental laboratory technicians (067). SG: 221 (Technologists).
    186Ltr, Chief, Pers Serv, SGO, to Dir, Mil Pers, ASF, 7 Apr 43, sub: Dental laboratory technicians (Dental Mechanics). SG: 221 (Technologists).


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days later The Adjutant General, authorized The Surgeon General to make his own arrangements to that end with the individual service commands concerned. On 14 April 1943 The Adjutant General notified The Surgeon General that a, separate personnel category (SSN 067) had been reserved for dental technicians, to distinguish them from dental chair assistants (SSN 855), paving the way for a clear definition of the two types of duty in drawing up tables of organization.187 The new classifications were published in a memorandum from The Adjutant General's Office (AGO), dated 13 May 1943.188

These measures did much to prevent the waste of laboratory men in routine jobs. In January 1944, however, the whole matter was again thrown into confusion when ASF placed laboratory men in the "scarce" category and directed that they would not be assigned to any overseas organization.189 190 This action was apparently designed to prevent the misuse of such personnel, but it overlooked the fact that a limited number of technicians were needed in theaters of operations, and the Director of the Dental Division immediately recommended modification of the order. A letter was subsequently prepared for the Commanding General, ASF, listing the specific units in which the assignment of laboratory men was essential,191 and the misunderstanding was corrected in a War Department circular of 4 April 1944.192 A supplementary order of 29 May 1944 directed that dental technicians would be used only in the duties for which they had been trained.193

Steps to improve the utilization of laboratory personnel proved generally effective, but they did not prevent a minor loss of technicians to other duties. Hospitals sometimes reclassified dental technicians as chair assistants to avoid an excess of this category over the numbers permitted by tables of organization, but in such cases the individual usually continued to perform his old duties as long as he remained with the unit. If he were transferred, however, he was likely to be assigned on the basis of his specification serial number. In other cases the authorization for laboratory technicians was revoked for certain units, and the men holding laboratory ratings were sometimes reclassified under such circumstances to prevent their loss to the organization. Keeping dental technicians assigned to their proper duties was a continuing problem for the Dental Service throughout the war.194

A defect of the broad classification of "dental technicians" was that it failed to specify individual special skills or degrees of experience. Both Army and civilian laboratories normally function on a "production line" basis, with

    187Memo, TAG for SG, 14 Apr 43, sub: Dental laboratory technicians. SG: 221 (Technologists).
    188AGO Memo W 615-45-43, 13 May 43, sub: Revision of specification serial numbers--AR 615-26. SG: 221 (Technologists).
    189ASF Cir 26, 24 Jan 44.
    190ASF Cir 50, 16 Feb 44.
    191Ltr, Chief, Oprs Serv, SGO, to CG, ASF, 3 Mar 44, sub: Dental laboratory technicians (067). SG: 300.5-5.
    192WD Cir 130, 4 Apr 44.
    193WD Memo W 615-44, 29 May 44, sub: Critically needed specialists.
    194History of the Army Dental Corps, 1 Apr 44-1 May 1944. HD: 024.10-3.


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each man carrying out a limited operation. The technician who is qualified to perform all duties in a laboratory with equal competence is therefore rare. Under the Army classification a hospital which needed a man to set up teeth was likely to receive a replacement whose specialty was polishing dentures.

Even in peacetime the, number of trained technicians entering the Army from civilian life had been negligible, and the Medical Department had conducted training for this category of personnel since the founding of the Army Dental School in 1922. An average of 18 men had graduated from the 4-month course each year in the period 1935-1938.195 The training emphasized laboratory work, but it also included some instruction in administration, x-ray technique, and chair assisting. The course was expected to be increased to a full year beginning with the class of September 1939, but the outbreak of war caused this class to be graduated in July 1940, and thereafter the period of instruction was reduced to 3 months.

The wartime 3-month course for laboratory technicians was really a combined course for laboratory men and chair assistants, though most time was spent on laboratory procedures. It included instruction in dental anatomy and tooth carving, dental materials and metallurgy, dental records, dental roentgenology, dental hygiene, inlays and crowns, chair assisting, impressions, clasps, full and partial dentures, and actual work in the laboratory. It also included instruction in the care and maintenance of equipment.196 Applicants were required to have the equivalent of a high school education and must have completed basic military training. The course given at Fitzsimons General Hospital in 1942 was as follows:

Organization

2 hours

Basic dental instruction

40 hours

Dental assisting

47 hours

Chair assisting

9 hours

Army dental records

6 hours

X-ray

25 hours

Fractures

5 hours

Mailing dental materials

2 hours

Prosthetics:

Upper partial dentures

42 hours

Lower partial dentures

78 hours

Full dentures

128 hours

Acrylic splints

35 hours

Total

283 hours

Crown, bridge, and inlay:

Metallurgy

12 hours

Posterior bridge

92 hours

Anterior bridge

28 hours

Total

132 hours

    195Annual Reports ... Surgeon General, 1935-38.
    196ASP Manual M3, 25 Apr 44. HD.


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The first month was devoted to didactic instruction and the last 2 months to actual work in a laboratory under supervision. It was recognized that competent dental technicians could not be trained in 3 months and the course was expected to establish a basis for the individual's further progress at his home station. The rating of SSN 067 was conferred at the schools only on the best qualified graduates (40 percent at Fitzsimons General Hospital, 1943). More often it was given later, on recommendation of the unit dental surgeon after the student had improved his knowledge by "on-the-job" training. Those who showed little aptitude for laboratory work remained SSN 855's (chair assistants).

The dental technician training program soon outgrew the Army Dental School and courses were given in six general hospitals in 1940. Nine schools were in operation during fiscal 1943 and over 5,000 students were enrolled during that year. Maximum authorized capacity was 600 men a month. Many of the schools operated double shifts during 1943 to accommodate the augmented classes without additional equipment. The program fell off sharply in the latter part of 1944 and only a handful of students remained after March 1945.

Results of the training program for dental technicians are listed in the following tabulation:197

Fiscal Year

Enlisted men enrolled

Wacs enrolled*

Elinsted men graduated

Wacs graduated*

1940

13

0

13

0

1941

295

0

121

0

1942

1,012

0

843

0

1943

5,438

0

3,691

0

1944

3,361

103

3,791

69

1945

1,007

396

1,550

346

Totals

11,126

499

10,009

415

    *In the entire program, from July 1939 through January 1946, 511 Wacs enrolled in the dental technicians schools of whom 473 graduated.

The percentage of failures from July 1939 through January 1946 were as follows:198

Type

Enlisted men

Wacs

All students

Percent

Percent

Percent

Scholastic

4.7

2.2

4.6

Other

4.8

5.3

4.8

Totals

9.5

7.5

9.4

    197See footnote 79, p. 126.
    198The percentages of failures quoted here were calculated from figures of the Training Division, SGO, which show 541 scholastic failures and 573 other failures out of a total enrollment of 11,847. Of the entire enrollment, 10,713 men were graduated through April 1946 (men enrolled in January did not graduate until April). Since 20 enrollees of the total number are not accounted for in the numbers reported for failures and graduates, it may be that these students did not complete the course during the February-April 1946 period. However, if these 20 were to be considered as failures, the total percent would only be changed from 9.4 to 9.6.


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Since graduates of the technicians' schools were seldom given specialist's ratings until they had served for some time at their own stations it is not known exactly how many became laboratory workers and how many remained chair assistants. In July 1945, 2,494 men, or 17.6 percent of the 14,191 enlisted men with the Dental Service, were rated SSN 067.199

The Director of the Dental Division stated in 1945 that the 3-month course had been too short for dental laboratory workers, though he felt that it was adequate for chair assistants. He recommended a minimum course of 6 months for technicians, to be extended to one year if possible.200

Use was made of civilian laboratory technicians to replace enlisted men where possible but civilians were never employed in this work to the extent, that they were as assistants and hygienists, probably due to difficulties of procurement. By August 1943, 144 civilian laboratory men were on duty with the Army, but this number declined through 1944.

Prosthetic Supply Clerks. Beginning on 20 March 1944, six enlisted men of the Dental Service were given 4 weeks of training at Binghamton Medical Depot to prepare them for duty as prosthetic supply clerks. The scarcity of personnel capable of handling the many sizes, shapes, and shades of porcelain teeth stocked in laboratories and depots made this small but important course necessary.201

Dental Assistants. With mobilization it became necessary to staff large numbers of clinics with assistants in a very short time and more emphasis was placed on training for this category. In the paragraph on dental technicians it is explained that the dental technicians' course was a combined project, including instruction in both laboratory procedures and the duties of a chair assistant. Those men who did not show mechanical aptitude for laboratory work eventually went to duty as chair assistants (SSN 855). It is not known exactly how many graduates of Army schools became dental assistants because the final rating as technician or assistant was often made at the home station. In July 1945, 11,697 men, or 82.4 percent of a total of 14,191, were rated as SSN 855.202 Since only 11,625 enlisted personnel attended the Army schools through fiscal 1945, and since the enlisted auxiliary personnel of the Dental Service numbered over 15,000 men at its maximum, we can assume that not more than two-thirds of the chair assistants had formal school training. The equivalent of a high school education and completion of basic military training were prerequisites for training as a dental assistant.

In January 1943, the Director of the Dental Division recommended approval of a request from Camp Pickett for 100 WAC personnel for duty as

    199Information from the Strength Accounting Branch, AGO, given the author on 11 Dec 46.
    200See footnote 9, p. 107.
    201A report of the schooling of enlisted personnel, Medical Department, 1 Jul 39 to 30 Jun 44. In the history of training in the Army Service Forces for the period 1 Jul 39-30 Jun 44, vol IV, p. 109. HD: 314.7-2.
    202See footnote 199, p. 158.


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dental assistants, and at the same time recommended that women be used to replace male assistants in all large Clinics.203 The Surgeon General approved this request and forwarded it to the Director of the Women's Army Corps for action. In June 1943, The Surgeon General estimated, on information from the Dental Division, that 1,519 Wacs could he used in Army dental installations.204 Training courses for Wac dental technicians were established at Army-Navy, Brooke, Fitzsimons, Wakeman, and William Beaumont General Hospitals and at Fort Huachuca, and a total of 473 female dental technicians, including 9 Negro Wacs, were trained from September 1943 to January 1946, most of these (335) at Wakeman General Hospital.205 Three hundred and eight Wac assistants were on duty in January 1944. By June the number had increased to 462.206 It is not known how many ultimately went to duty with the Dental Service but the figure was certainly far short of the 1,519 which it had been estimated could be used.207

The fact that wider utilization was not made of Wac dental assistants was due mainly to inability to obtain them. There were, however, certain disadvantages in using women for such work. Requirements for quarters were more difficult to meet, their sickness rate was higher, and they could not be assigned to some types of tactical units. Another objection to Wac assistants was that male clinic personnel had to assume additional work in connection with heavy clinic maintenance. In many places the Wacs scrubbed floors and worked on an almost equal basis with the men, but there was a feeling among the males that they were given additional work when a considerable number of women assistants were assigned to a clinic. On the other hand, the Wac assistants were not subject to the strict limitations on hours and type of work which applied to salaried civilian women assistants.

For some years civilian dental assistants had been used in a few large clinics. As enlisted assistants became harder to replace an effort was made to obtain a substantial number of civilians for this duty in fixed installations in the United States. In July 1942 The Surgeon General specified conditions under which female civilian assistants could be hired.208 Civilian dental assistants were to be given the Civil Service grade of SP-3, paying $1,440 yearly. They were required to have a minimum of 6 years grade school education and at least 1 year of experience as a dental assistant. They provided their own uniforms. Civilian dental assistants were to conform to the rules of conduct prescribed for Army nurses. In January 1943 the additional grade of "Junior Dental

    203Memo, Dir Dental Div, SGO, for General McAfee, 5 Jan 43, no sub. SG : 322.5 (Camp Pickett).
    204Ltr, SG to CG, ASF, 2 Jun 43, sub: Technical training of WAAC personnel. SG: 322.5-1.
    205See footnote 79, p. 126.
    206Ltr, Capt Emily Gorman to Mr. Frank Rand, 11 Oct 44, no sub. SG: 221 (Technicians).
    207It is extremely difficult to get information on the personnel on duty with the Dental Service during the war since all enlisted men and women were assigned only to the Medical Department; they were placed on specific duties by local surgeons and might be shifted on short notice. Strength returns from installations did not specify the services to which personnel were assigned.
    208SG Ltr 75, 27 Jul 42.


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Assistant," SP-2, paying $1,320 yearly, was established.209 The position of Assistant, Junior Dental Assistant was to be filled by persons with limited experience and was considered temporary until additional training had been completed in the dental clinic. By June 1944, 2,909 civilian dental assistants were oil duty in the United States and 15 had been hired overseas. (None were sent overseas from the United States during the actual combat period.) Later figures are not available, but it is probable that the strength given for June 1944 represents about the maximum number on duty during the war as the percentage of the Army on duty overseas increased rapidly after this time and civilian assistants were not sent abroad.

The use of civilian assistants released a large number of men for other duties. In general, they were superior to enlisted men in the handling of patients and in the care of instruments and small equipment. On the other hand, they worked limited hours and were not available for emergencies. They could not be called upon to clean floors and do major maintenance work in the clinic and the rate of absence was generally thought to be higher than for enlisted men, though there are no statistical data bearing on this matter. The use of both enlisted and civilian personnel in the same clinic sometimes resulted in friction as the women received twice as much pay for shorter hours. Also, unless janitor service was provided, the enlisted man was required, after the close of the day's operations, to clean not only his own operating room but also that of the civilian assistant. In general, the service rendered by civilian assistants justified their use, but best results were obtained when civilian and enlisted personnel in clinics were mixed as little as possible.

Dental Hygienists. Before the war civilian dental hygienists were on duty in only a few of the larger clinics. Training in this work was given enlisted men in the Army Dental School course and oral prophylactic treatments were generally given by enlisted men or by dental officers. With mobilization it was decided to make wider use of civilian hygienists and the condi-tions of employment were prescribed in July 1942.210 The position of dental hygienist was rated as SP-4, and paid $1,620 yearly. The applicant was required to (1) be a graduate of a course of at least 2 years at a recognized school of oral hygiene, (2) have a license from a state or territory, and (3) have practiced 2 years in a clinic or office of a private dentist. In July 1943 this last requirement was waived.211 The position of senior dental hygienist, SP-5, was authorized in clinics where five or more hygienists were on duty, or under certain other circumstances involving increased responsibility. The pay of a senior hygienist was $1,800 yearly. In January 1944, over 500 hygienists were on duty, a figure which was approximately the maximum during the war.212 Soon after the declaration of war four civilian dental hygienists were

    209SG Ltr 1, 1 Jan 43.
    210See footnote 206, p. 159.
    211SG Ltr 117, 1 Jul 43.
    212See footnote 177, p. 153.


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sent overseas with their organizations and they were allowed to remain until returned to the United States under routine, established policies. No additional female hygienists were permitted to leave the Zone of Interior, however, and their places were taken by enlisted men prior to embarkation. The status of dental hygienists during the war was the cause of considerable dissatisfaction on the part of hygienists' organizations. Difficulty was first encountered when dental assistants were occasionally promoted to the grade of hygienist, SP-4. Such promotion was never authorized, but occurred with sufficient frequency to make necessary a specific prohibition against the practice in July 1943.213 The Dental Division agreed with hygienists' organizations that, except for military personnel trained by the Army itself, the scaling and polishing of teeth should be limited to persons who had completed the prescribed course of instruction in authorized schools. With the inauguration of the Women's Army Corps, requests were made for the incorporation of dental hygienists as officers in that organization. This request was opposed by both the Medical Department and the Dental Division because of rigid regulations, affecting the utilization of WAC personnel. These regulations provided that Wacs could not replace civilian employees and would replace male officers in the ratio of one Wac for one male officer. It was therefore feared that commissioning of hygienists in the WAC would entail the loss of an equal number of dental officers.214

Late in 1942 the Medical Department sponsored a bill (H. R. 3790, S. 839) to provide commissions for female dietitians and physiotherapists. This step was made necessary by difficulties encountered when organizations employing these essential civilians were shipped overseas. The Dental Division called attention to the fact that hygienists would probably remain a permanent part of the Army Dental Service and recommended that they also be included in the pending bill, but this recommendation was returned with the pencilled notation "not now, " signed by the executive officer of the Surgeon General's Office. Organizations representing the hygienists made a vigorous presentation of their cause in congressional committee hearings, however, and finally succeeded in having a clause incorporated authorizing the President to provide commissions for other "technical and professional female personnel in categories required for service outside the continental United States."215 But since the bill did not specifically mention hygienists the Medical Department later held that their services were not required outside the United States and that it was not necessary to invoke the provisions of the bill in their interest.216

In July 1944, the Director of the Dental Division called attention to difficulties in obtaining dental hygienists and assistants and noted that the Army

    213See footnote 211, p. 160.
    214Ltr, Maj Gen Norman T. Kirk to Hon Harve Tibbott, 2 Sep 43. SG: 231 (Dental Hygienists).
    21556 Stat 1072.
    216Ind, Brig Gen Larry B. McAfee to IAS to SG from TAG, 6 Apr 43, sub: Dental hygienists not included in Public Law 828, 77th Congress. SG: 231 (Dental Hygienists).


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had no installations with five hygienists where the grade of SP-5 could be authorized.217 He recommended creation of the position of "Senior Dental Assistant," SP-4, and a corresponding increase of rating for hygienists to SP-5 and SP-6, the latter to pay $2,000 yearly. At the end of the war no action had been taken on this recommendation. In September 1944 the Director of the Dental Division again recommended the establishment of a Hygienist's Corps, on the basis of 0.3 officers per 1,000 strength of the Army. He recommended that hygienists be limited to the grade of captain, unless dietitians and physiotherapists were to be granted higher grades, in which case it was recommended that hygienists be placed on an equal status. In 1945 he again recommended the commissioning of hygienists, but advised that only graduates holding a bachelor of science degree in oral hygiene be accepted.218 No action had been taken in this direction at the end of the war. (In 1943 the Navy offered commissions in the WAVES to hygienists who were graduates of courses of at least 2 years. Hygienists with less than this minimum training were accepted as pharmacist's mates.)219

Informal Training, Auxiliary Personnel. One of the most important aspects of the training of auxiliary personnel was the daily informal instruction which such personnel received while performing their duties in dental installations. New men were placed on duty in operating clinics, learned their work under the supervision of dental officers, and in turn helped teach other men or were incorporated into cadres to form the nucleus of new organizations. This training was continuous during the war and accounted for the only instruction (other than basic training) that at least one-third of all dental enlisted men received.

Course on Care of Equipment. Early in 1942, a course of instruction in the care and minor repair of dental equipment was initiated by a large dental manufacturer. The course lasted 2 weeks and representatives of other manufacturers were invited to lecture on their particular products so that a wide coverage of the field was obtained. Approximately 180 enlisted assistants received this training.220

Summary, Auxiliary Personnel

Over 18,000 auxiliary personnel were used in the operation of the Dental Service by 15,000 dental officers. In wartime, dental officers should not waste their efforts in work which can be done by less specialized personnel, and considerably more than the above number of auxiliary assistants could have been used efficiently if they had been available. It has been estimated that the

    217Memo, Maj Gen R. H. Mills. for Pers Serv, SGO, 24 Jul 44. SG: 231 (Dental Hygienists). (This communication accompanies a memo to Col George Kennebeck from Brig Gen Rex McDowell (no subject), 16 Mar 45, same file.)
    218See footnote 9, p. 107.
    219Capt Robert S. Davis discusses problems of Navy Dental Corps. J. Am. Dent. A, 31: 587-589, 15 Apr 44.
    220Report of the Dental Division, SGO, for fiscal 1942. HD: 319.1-2.


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services of a full-time dental assistant will increase the output of a dentist from 30 percent (U. S. Public Health Service) to 63 percent (U. S. Navy), but the wartime ratio of 1.2 auxiliary personnel per dental officer did not permit assignment of a full-time dental assistant to each officer after provision had been made for hygienists, x-ray technicians, clerical workers, and laboratory technicians.221

Shortage of manpower in time of war makes necessary the wide use of female auxiliary personnel, including civilians.

In a mobilization, competent laboratory technicians will not be available in sufficient numbers from among inducted men, and a program for their training must be anticipated. Every precaution must be taken to insure that inducted laboratory technicians are assigned to appropriate duties in the Army. A course of 3-months duration is not adequate for the training of laboratory technicians, but will provide a sufficient basis for further "on-the-job" training in a dental laboratory.

It is evident that there was considerable waste effort involved in giving laboratory training to nearly 10,000 enlisted personnel when over 80 percent ultimately served as chair assistants. The whole period of training was not entirely wasted for this group, however, since the course included some work important to dental assistants as well as to the laboratory technician. There is also some need, especially in time of peace, for assistants who can "double in brass" to carry out minor laboratory procedures at smaller stations having no assigned technicians. But in the opinion of senior dental officers the training for chair assistants in a time of emergency could profitably be cut to 1 or 2 months and separated from that given prosthetic workers. During World War II it was necessary to send a large number of men to the technician's schools to obtain the few who could acquire the needed special skills, but aptitude tests developed during the latter part of that war should make it possible in the future to select candidates for laboratory training with a much higher degree of accuracy. When it can be predicted with fair certainty that students chosen for technician training will be able to complete the course successfully it will probably be more economical of time and effort to shorten the period of training for assistants and to eliminate from the already overcrowded laboratory course all instruction intended for them.

It was the general opinion of dental officers that the Dental Service exercised inadequate control of its enlisted auxiliary personnel. The most serious difficulties were:

1. Clinic personnel were under the direct command of the medical detachment commander, acting for the surgeon. They could be, and were, taken from their duties in the clinic for training or other nondental work. When such withdrawals were moderate in number and made on adequate notice, they were annoying but unavoidable. When they were made in large numbers on short

    221Army-Navy Register, 21 Sep 46, p. 11.


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notice they were disastrous in a service which had to schedule its work weeks ahead.

2. The fact that auxiliary personnel were not permanently assigned to the Dental Service was directly responsible for some inefficiency in operation. Months of training were required to qualify a competent dental assistant, and when a skilled man was transferred to other duties because he felt that life was easier in the surgery, or to increase his chance for promotion, both the Dental Service and the Army suffered.222

3. The f act that promotion of enlisted assistants was in the hands of medical officers was widely believed to have resulted to the disadvantage of dental auxiliary personnel. This belief is not wholly confirmed by comparison of the grades held by dental and medical enlisted men in the United States. Medical officers did have the authority to promote or demote dental personnel without consultation with the dental officers in charge of clinics, however, and though this action was rarely taken, the results, when it did happen, were inevitably detrimental to efficiency and morale.

The following changes were among those most commonly recommended by dental officers:

1. Permanent assignment of enlisted personnel to the Dental Service, with transfer only for significant reasons which would normally justify transfer between other corps of the Army.

2. Adequate provision for promotion of outstanding enlisted men within the Dental Service so that competent men could plan a career in that service without jeopardizing their chances of arriving at the higher grades.

3. Correction of the system whereby dental personnel were examined for promotion in purely medical subjects, in competition with men who had been engaged in medical activities in their daily work.223

    222See footnote 9, p. 107.
    223Ibid.