The New Zealand Dental Services
Dental Care of Isolated Groups
Dental Care of Isolated Groups
It is interesting to analyse the problems arising when troops are employed for any length of time where dental treatment is not available. This occurred with certain New Zealand troops during the page 118 war and as it led to the issue of specific instructions which not only met the situation with ingenuity but removed anomalies affecting the policy as a whole, the story will be told in full.
New Zealand entered into an obligation before the war that, in the event of hostilities, she would be responsible for guarding the cable station on Fanning Island. It was therefore decided to send a platoon from the New Zealand Regular Force to the island. In peacetime the Regular Forces did not receive free dental treatment so no arrangements had been made to treat these men, known as ‘A’ Company. There was no dentist at Fanning Island and, as the first party was to leave New Zealand in August 1939 before war was declared, there were no dental officers enlisted in the NZDC. The possibility of dental casualties was recognised, as can be seen from the memorandum from the Army Secretary to the Secretary of the Treasury of 22 August 1939:
Re Fanning Island Platoon—Dental Treatment
In peace the regular military forces do not receive free dental treatment although this is granted to the Navy and the Air Force.1 In the NZEF all ranks were provided with free dental treatment and no distinction was made regarding the small percentage of regular soldiers serving with the NZEF. There is a resident medical officer at Fanning Island but no dental officer and without considerable expense it would be difficult to make any provision for dental treatment for the platoon. The men will be on the island for at least six months and it is desirable that there should be no trouble from the dental side while they are there.
The only, but not entirely satisfactory, solution is to ensure that every man is made dentally sound before he leaves New Zealand and where possible the work to be carried out for a period of six months ahead. As the soldier cannot be compelled to have this treatment carried out at his own expense, it is recommended that the platoon should be treated on the same basis as a force for overseas service and dental treatment provided by the Government. Until the teeth of the men have been examined it is not possible to give an estimate of the cost, but as these men were required to reach a certain dental standard before they were accepted for the Regular Force, it is not anticipated a large amount will be involved.
As the platoon will be sailing at an early date it will take some time to arrange treatment at the most economical rates and it would be helpful if you could treat this as an urgent matter.
This was recommended by Treasury and approved by the Minister. Twenty-six men were treated at a total cost of £95. This concession led to the removal of the anomaly whereby different classifications of fully mobilised troops received different dental privileges. On 6 March 1940 free dental treatment was authorised for recruits to the New Zealand Regular Force.
The platoon left for Fanning Island dentally fit. No dental officer went with it, but the first relief was accompanied by a medical officer, Captain M. Kronfeld, NZMC,1 who was provided with a dental syringe, needles, local anaesthetic and extracting forceps, as well as facilities for inserting palliative dressings for the relief of pain. He was on the island from February to October 1940 and reported that there were no cases of either toothache or denture trouble during this period, for which he gave credit to the thoroughness of the treatment in New Zealand before embarkation. It cannot be denied, however, that there was an element of luck in this and the situation was not entirely satisfactory. The chief worry was over those wearing artificial dentures. Of thirty-eight men, ten were wearing full upper and lower dentures, three were wearing full upper or lower dentures and two had partial dentures. That is, approximately 40 per cent were denture wearers.
In April 1941 an attempt was made to give the medical officer some method of doing more for the dental casualty. The DDS wrote to him as follows:
Herewith dental equipment and materials contained in a Dental Emergency Haversack … for your use and to supplement the dental syringe, needles, local anaesthetic and extracting forceps previously supplied.
The bradawl and floss silk are for the purpose of temporarily repairing broken artificial dentures, the method being to drill holes with the bradawl close to the line of fracture and lace the parts together with the floss silk….
This was only an emergency measure and the DDS was not happy about accepting responsibility for the force without further reducing the prospect of dental accidents. He wrote to the Adjutant-General on 23 April 1941:
Re ‘A’ Company—Dental Standard and Treatment for
With reference to the above force and the existing methods of selection for and despatch of reliefs, it is submitted that where it affects the dental condition of these soldiers, the position is unsatisfactory and resulting in 50% of this force being made up of men who are wearing artificial dentures. They were rendered dentally fit before embarkation on standard 2NZEF lines and an emergency surgical dental haversack with full technical instructions was issued with the first relief for the use of the medical officer and was replenished whenever it was discovered a relief was embarking, but no provision has or can be made for renewal or repair of artificial dentures without the provision of a full dental section NZDC.page 120
1 Lt-Col M. Kronfeld; Wellington; born Auckland, 25 Jan 1899; medical practitioner; MO Fanning Island, 1940; RMO 28 (Maori) Bn Jun 1941–Jan 1942; Senior Medical Administrative Officer, 2 NZEF, Oct 1943–Aug 1944; Port Health Officer, Wellington.
The following is submitted for your consideration and approval please:
That as the Director of Dental Services is responsible for the dental treatment and maintenance of the dental health of the armed forces, it is requested that he be placed on the circulation list by General Staff when reliefs for ‘A’ Company and other special forces are being organised, in order that the question of their dental requirements may be met and arrangements made, where possible, for their dental maintenance.
That in the instance of ‘A’ Company the following dental standard of fitness be laid down.
‘A’ Company Dental Standard of Fitness
The dental classification will be:
Dentally fit means: No man who is otherwise medically fit will be rejected for dental reasons who has
Normal dental occlusion which may include soundly restored teeth or teeth capable of being rendered sound.
A masticatory efficiency of not less than nine points,1 the distribution of the points being left to the judgement of the Principal Dental Officer who will take into consideration the physical condition of the soldier and the length of time the loss of masticatory efficiency has been existent. If a soldier has been able to stand up to the training in a mobilization camp or a heavy regiment of the NZ Artillery, eat three meals a day and be physically fit with only six incisors, a molar on one side and a premolar on the other side, all occluding, he can continue to carry out the duties involved with this force.
Dentally unfit means: Those wearing or requiring the supply of artificial dentures to remedy a deficiency of masticatory efficiency, taking an absolute minimum of nine points efficiency, or presenting with an oral condition that is considered detrimental to his general health and a menace to his fellow soldiers.
This memorandum had two important results. Firstly, the DDS received the vital information to which he was justly entitled, and secondly, wearers of artificial dentures were debarred from service in places where full dental treatment was not available.
There were men in isolated places other than Fanning Island affected by this new standard of dental fitness, notably the Chatham Islands and the Kermadecs. Both these stations had coastwatchers but, as they were reasonably close to New Zealand (the Kermadecs could be reached in one and a half days by ship), the position was somewhat easier. Therefore, at the request of the Director of Mobilisation, who was having difficulty in getting suitable volunteers who conformed to this rigid standard, the DDS agreed to allow denture wearers to be accepted, provided that new dentures were made for them and the old ones kept as spares in case of loss or breakage.