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The New Zealand Dental Services

CHAPTER 14 — Repair and Reorganisation

page 195

Repair and Reorganisation

Treatment of the Division After Greece and Crete

ON returning to Egypt the Division moved into the Helwan-Garawi area and the indications were that it would remain there during June and July before being sent again to the field. This was a short period in which to establish complete dental fitness even if the Dental Corps had been at full strength, but 36 per cent of the dental officers had been lost in Greece and Crete. The extent and type of treatment had to be limited to meet the situation. A reasonable standard of dental fitness for the whole Division was preferable to complete dental fitness for some and no treatment for others.

As there was now no Mobile Dental Section to do this work, No. 2 Camp Dental Hospital under the command of Captain B. Dallas1 moved to Helwan Camp. Its first task was to make a general survey with the object of finding out what work was urgent and what could safely be left for a time. The men were charted and graded T1, T2 or T3 according to the degree of urgency of the work to be done. The T1 patients were called up first and the important work was completed. They could then be regraded T2 or T3 and dismissed until those classes were being called for treatment. T2 or T3 patients could be regarded as reasonably fit and unlikely to be serious dental casualties should the Division move suddenly to the field. This system worked very well and by the end of July all urgent treatment had been completed and the Camp Dental Hospital was busy treating T2 and T3 cases, this time aiming at complete dental fitness.

Meanwhile, in Maadi Camp, No. 1 Camp Dental Hospital under Captain H. C. Colson2 was examining and treating the reinforcements as fast as possible so as to establish a high degree of dental fitness before they were sent to join the Division. All this meant very long hours for the depleted Dental Corps.

Apart from these two concentrations of troops, 6 Infantry Brigade was stationed in the Canal area, Brigade Headquarters and one battalion were at Ismailia, one battalion was at Kantara and the third page 196 at Suez. The Convalescent Depot was near Ismailia and the dental officer reported that patients coming in from the brigade were interfering with his regular work. In consequence a dental section was sent to work at the Convalescent Depot on the brigade patients and another one to Suez. Their work was completed by 16 August and they returned to Maadi Camp.

As was to be expected after the Greece and Crete campaigns, artificial dentures caused the most concern. The ADDS's report of 1 August 1941 is interesting as, being founded on information gleaned at the time, his deductions on the causes of this loss of dentures are probably as close to the facts as any deductions could be.

The number of artificial dentures lost or broken during the operations in Greece and Crete was considerable and when the troops returned to Egypt the position was alarming. A relatively large percentage of men returned to this country without their dentures and in each instance it was stated that they were lost either during operations on land or during one of the two evacuations.

The loss of dentures can be attributed to many causes some of which are unavoidable, others indicate either negligence or wilful intent to lose them, but whatever the reason may be, the fact remains that the loss of dentures under active conditions does occur to an abnormal extent and no doubt will occur in future campaigns.

It was found that the hard biscuits which form a large portion of the rations played havoc with artificial dentures and from all units breakages were reported in large numbers. Many of these broken dentures either had to be, or were, removed and placed in kit bags, haversacks or pockets and thus were lost or left behind at the evacuation.

It is of interest to compare the returns for denture work during the period February, March and April with the corresponding figures for May, June and July. The first period covers the interval before the Division moved to Greece and the second the period when those evacuated from Greece and Crete were being treated.

1st Period 2nd Period
Number of new full upper or lower dentures 271 663
Number of new partial upper or lower dentures 151 292
Number of dentures remodelled 452 582
Number of dentures repaired 532 1546

The issue of new full dentures and repairs to broken dentures are nearly trebled in the second period.

Another difficulty which faced the Corps immediately after the Greece and Crete campaigns was the shortage of equipment. The dental outfits sent to Greece with both the Mobile Dental Section and the field medical units were lost. The surgical and mechanical outfits ordered from the United Kingdom in 1940 had, according to a War Office cable, been despatched on 22 February 1941 but page 197 no trace of them could be found. Fortunately, the DDS in Wellington offered to replace the bulk of the lost equipment, an offer which was speedily accepted, but this could not arrive until the 6th Reinforcements came to Egypt somewhere about the end of July. The Middle East Dental Headquarters agreed to share its equipment with the NZDC, but at that time could not even re-equip the medical units. By careful stocktaking in every unit and a pooling of resources, with judicious borrowing and local buying, the gap was bridged and the work went on.

1 Maj B. Dallas, m.i.d.; Gisborne; born NZ 23 Jul 1900; dental surgeon.

2 Maj H. C. Colson, m.i.d.; Auckland; born NZ 11 Aug 1901; dental surgeon.

Rebuilding the New Zealand Dental Corps in the Middle East

The first step in the re-formation of the Corps was to replace the lost personnel and equipment; the second was to turn to profit the lessons learned. There was no reason to doubt the correctness of the policy already laid down, but there was a need to ensure that all components of the organisation should be so constituted as to guarantee its successful fulfilment. The opportunity had arisen through misfortune to design the tools for the work rather than adapt the work to the tools available.

Eight dental officers, eight mechanics and four clerk orderlies arrived with the 6th Reinforcements at the end of July 1941 and it was arranged that ten suitable other ranks should be transferred to the NZDC from the training battalions. The general framework of the organisation was as before: two Camp Dental Hospitals, a Base Depot Dental Hospital, a Mobile Dental Section and dental sections attached to each of the three field ambulances, each of the three general hospitals, and to the Convalescent Depot and a Mobile Casualty Clearing Station. All of these were staffed and directed in the first place by the ADDS at Headquarters 2 NZEF. Changes were made in the establishments of existing units and the Mobile Dental Section was completely re-formed. There was no rigidity of attachment to any of these units and the ADDS reserved the right to interchange staff at will.

Certain anomalies regarding rank in the Dental Corps needed adjustment before new establishments were finalised. The three dental hospitals, i.e., the two Camp Dental Hospitals and the Base Depot Dental Hospital, were very important units in the service. Together with the Mobile Dental Section, they were commanded by the ablest and highest qualified dental officers overseas. They were the training ground for dental officers, mostly of the rank of captain, and yet there was no provision for their commanding officers to hold field rank. The war establishment for field ambulances, general hospitals and the Convalescent Depot allowed the dental officer to hold the rank of major, and the duties and page 198 responsibilities could not be compared with those of the commanding officers of the dental hospitals. The senior dental officers would be wasted in these units, as the hospitals, both from the technical and professional points of view, were more responsible commands. The ADDS's request for field rank for their commanding officers was not granted as such but he was given authority to recommend a specific number of officers for field rank on a Corps basis, which left him free to place them where he wished. This was a distinct advance on the old system of rigid appointment according to units. The memorandum from the Military Secretary to Headquarters 2 NZEF on the subject read:

… in my view the ranks of members of the Dental Corps should be settled on a Corps basis. At the present time the establishments for General Hospitals provide for the dental officers attached being Majors or under whereas in point of practice the appointment will normally be filled by a captain (except for one existing specialist appointment—and possibly an additional one to be made on arrival of an officer from England).

The appointments of Majors to Dental Hospitals is probably sound: but liberty of action for the Dental Corps might well be preserved here so long as the total Corps Establishment is not exceeded.

Suggested establishment therefore is:

Lt-Cols. 1
Majors 5 (if the specialist from England proves to be sufficiently highly qualified, one more Major then wanted, to make 6).

The Officer in Charge of Administration, with whom the ADDS was chiefly concerned, considered this a reasonable allocation on the grounds that it should be a balance between the number in a battalion and the percentage in the Medical Corps, i.e., about one-sixth the total number of dental officers. He sanctioned it as such and agreed to reopen the subject should the establishment of the Corps be increased in the future. The ADDS was promoted to the rank of lieutenant-colonel on 26 July 1941.

The establishments of the Camp Dental Hospitals were then altered to permit the commanding officers to be either major or captain, the senior dental clerk orderly was given the rank of WO II, and the number of orderlies was increased by two. The same status was given the commanding officer of the Base Dental Hospital and the establishment was increased by one officer, three orderlies and three mechanics.

In the field ambulances the important change was that a dental mechanic was included in the establishment. This was a natural corollary to the experiences of the Division in Greece and Crete, where the majority of the casualties concerned artificial dentures.

page 199

The new Mobile Dental Section was formed in Egypt to the formula of the ADDS. The only assistance asked from the DDS was the provision of equipment and enough men from whom to choose the staff. Captain W. G. Middlemass1 was selected as the commanding officer and promoted to the rank of major. The nucleus of the section was re-formed and preparations were made to receive reinforcements, which being effected, the section moved to Maadi Camp, entering the School of Instruction for a special course on 7 August 1941. The purpose of this course was not so much to learn extraneous subjects which could be of little use in the field, but to mould it into a unit. The new establishment differed in minor details only from the establishment of the section lost in Greece and, as at this stage the alterations could only be based on theory after a limited and unsuccessful experience in the field, it is of little value to examine it in any detail. There were, however, some radical alterations in the method of equipping the section, based on the experiences of the section which worked in the Western Desert in 1940, and also some changes in administration.

The equipment began to arrive from New Zealand in early August on a generous scale and of a type and quality leaving little to be desired. There were, however, certain items not suitable for use in the field and some deficiencies which experience had shown should be included. Consequently, it was decided to receive it into the dental store, not as complete outfits but as individual items, and to build up entirely new field outfits. The deficiencies were to be made up either from Medical Stores or by buying from local supply houses.

For example, the equipment for a complete Field Dental Section had hitherto consisted of chair case, prosthetic pannier, surgical pannier and store pannier. The foot engine had been carried in a compartment in the surgical pannier and items which could not be packed in the surgical or prosthetic panniers had been carried in the store pannier. The first change was to remove the foot engine from the surgical pannier and place it in a specially constructed case, which could either be carried independently or in the chair case. All the surgical equipment could now be carried in the surgical pannier and the prosthetic in the prosthetic pannier, allowing the store pannier to be dispensed with. Each section was provided with a portable mechanic's bench, complete with trestles and with screw holes and bolts in the correct positions for assembly. The fitted mobile dental laboratory, so prominent a feature of the previous section, became a Field Dental Laboratory, consisting of page 200 a 4-ton lorry of standard design carrying equipment in panniers and two portable laboratory benches specially fitted and designed on which the equipment could be assembled. The trend was towards standardisation and simplification, leaving out all luxury equipment or specialised apparatus difficult to replace. The section could operate either as a complete unit similar to a camp dental hospital or it could break up into sub-sections. Some of these sub-sections were both surgical and prosthetic and some only surgical. All ambiguity in respect of command was removed. As far as personnel and policy matters were concerned, the ADDS was to be in full control and, except when the section was actually attached to the Division, he would control the movements and even the distribution of dental officers among units. When the section came under divisional control its commanding officer would be responsible to the ADMS of the Division for location, duties and discipline and would make his movements and attachments in consultation with that officer. At all times the ADDS was to receive returns of work and reports of the location of each unit, even when the attachment was to the Division, but in addition to and not to the exclusion of the ADMS.

The Mobile Dental Section thus became an integral part of the Dental Corps in the Middle East, a non-divisional unit to be used anywhere within the 2 NZEF but primarily to maintain the dental fitness of all units in the field. As the Division was then in the field undergoing training at Baggush, the section moved from Maadi on 30 September 1941 and immediately began systematic examination and treatment.

1 Lt-Col W. G. Middlemass, MBE, ED, m.i.d.; Dunedin; born Kaitangata, 5 Sep 1905; dental surgeon; OC 1 Mobile Dental Unit Jun 1941–May 1943; ADDS Jun 1943–Feb 1944; Colonel Commandant, RNZDC, 1958.