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The New Zealand Dental Services

Oral Hygiene and Care of the Teeth

Oral Hygiene and Care of the Teeth

Among the instructions issued to dental officers was one relating to the arrangement of lectures to be given to the troops at regular intervals on oral hygiene and the care of the teeth. This most important subject was sadly neglected. The emphasis was on repair rather than prevention, for dental disease was firmly established, and popular opinion was that it was an inevitable companion of civilisation. The subject of preventive dentistry was therefore difficult to teach with any degree of interest. The enthusiast was regarded with polite tolerance of his idealism but with a firm conviction that his panacea would be irksome and probably of doubtful value.

page 116

That dental disease can be reduced by proper attention to diet and prophylaxis is beyond doubt. That a series of lectures on the subject can effect this reduction is no more likely in the Army than in civilian life. The man who can stand up in front of a crowd of his fellows, neutralise their apathy, interest them in a technical subject, win their co-operation and fire their enthusiasm must have an exceptional personality. The average dental officer regarded lecturing as a formidable ordeal and, however well versed in his subject, was seldom impressive. A sample lecturette was included in the appendix to ‘Instructions to Officers’ but could not be repeated too often and, even though it contained excellent material, needed a trained delivery to carry conviction.

Why not therefore appoint a dental officer with the technical qualifications and lecturing ability to carry out this important duty? Specialists were appointed as oral surgeons, others as teachers of prosthetics, but the most important subject was given an ancillary role. The dental officer was busy mopping up an ocean of dental caries. Dry land was a chimera, even then consisting in his fancy of quicksand. It is small wonder that he doubted his ability to stem this mighty tide with his puny strength and begrudged the time from his well-earned recreation for the necessary effort. The duty was not neglected and many lectures were given. The point is that it is very doubtful if they did any good.

A better approach to the subject might have been to have concentrated on insinuating the postulates of a correct diet into the army rations. Dental disease is a concomitance with improper feeding. Our diet is impoverished by over-refinement of sugars and starches and provides ideal conditions for the growth of mouth bacteria. The lack of detergent foods removes the safeguard of automatic cleaning with its attendant gum massage, as well as depriving us of adequate exercise of the jaws. These and other dietary matters seriously affect the maintenance of dental health and should be given proper emphasis in the policy of the Dental Corps.

Under service conditions diet can be controlled and, with a fighting force largely depending for its efficiency on physical fitness, it should be controlled. The incidence of dental disease could be greatly reduced by the co-operation of dentists, producers, manufacturers, retailers and consumers, but the gap between the first and the last is too great to be bridged by idealistic propaganda while the fleshpots beckon so temptingly. Control could go a long way towards bridging this gap and still provide a satisfying and sapid diet beneficial to dental health and acceptable to the men. The Dental Corps has a duty to assist in this control and might well achieve better results by devoting some of the energy previously page 117 spent on trying to reform the individual, to insisting on being represented at the conclaves of the commissariat. With improved diet and an organised campaign of education by competent lecturers, the Dental Corps could give inestimable service to the Army and indirectly to the nation. A word of explanation is necessary here lest it be thought that this is an attack on the army caterers. It is not suggested that the standard of catering in the Army lost any thing in comparison with that in civilian life. It was excellent, judged by that standard. What it is intended to convey is that the diet of our time is responsible for many of our dental troubles and that service conditions of community living offer a priceless opportunity for the correction of some of its faults.

What success would attend the Corps in this direction is problematical. A previous attempt by the DDS to encourage prophylaxis in the Army met with a rebuff from high authority and it was not nearly so controversial as the regulation of diet. In May 1941 the DDS recommended that every officer and other rank in 2 NZEF entering a district mobilisation camp should be issued with a free toothbrush or denture brush, and that replacements should be available at a cost well below that ruling at the time. The Navy had already been doing this with a brush made in New Zealand from first-grade pig bristles. The canteen boards were prepared to co-operate. The brushes were to be of standard design and quality and could have been sold for about seven pence a toothbrush and ten pence a denture brush as against the ruling price in mobilisation camps of 1s. 6d. for an inferior article. To provide these brushes free for two years to the 2 NZEF was estimated to cost £1141 9s. 9d. The DDS had made full inquiries from suitable firms and had their assurance that the brushes could be made at this cost and delivered to date. The necessary authority was refused but the adoption of standard NZDC tooth and denture brushes for purchase from the various canteens at a nominal cost was commended. The Canteen Board and the NAAFI sold them at a price below one shilling.

The concession was something achieved, but as nobody could compel the troops to buy, there were probably many who went without. Admittedly nobody could compel the troops to use a brush regularly, even if it was issued free, but it is still felt that the decision was an unfortunate one and that an opportunity to educate the troops in at least one method of improving their health was neglected.