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The New Zealand Dental Services

Dental Condition of the Force

Dental Condition of the Force

It is convenient at this stage, after the withdrawal of the Division from the Libyan campaign and before following it farther, to take stock of the results of the work of the Corps. In his report of 1 February 1942 the ADDS states:

With the exception of 5 Brigade Group, which is at present under treatment, the entire Force is virtually dentally fit.

A most striking feature is the almost complete absence of Acute Ulcerative Gingivitis and Stomatitis (Trench Mouth) a condition which is prevalent in all Forces in the Middle East other than the 2 NZEF.

The 2 NZEF is probably in better condition dentally than other Forces in the Middle East and, in general, all men with carious teeth have had them filled. Furthermore, mouths are inspected regularly and maintained in healthy condition. Since all Forces in the Middle East are living under similar conditions it would seem as if the predisposing cause of the disease is mainly the presence of either salivary calculus or carious teeth which, by lowering the resistance of the gum tissue locally, provides a home for the pathogenic organisms to flourish and multiply.

Regarding trench mouth, it is interesting to note the precautions, other than those mentioned in the above report, taken by the NZDC to prevent an outbreak and to compare them with those taken by the Army Dental Corps attached to the Royal Air Force.

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In the NZDC every case was treated by the Dental Officer but was also reported to the Medical Officer, with a recommendation that it be strictly isolated. In addition to this it was recorded on a dental history sheet which was sent to Headquarters for attachment to the soldier's personal file. Any suspected outbreak was reported immediately to the ADDS, with reasons for the suspicion and details of the steps being taken to prevent further spread of infection.

The Dental History of the Royal Air Force published by the Air Ministry in September 1947 states:

The importance of being prepared for outbreaks of this disease when personnel were living under war time conditions was realised. The difficulty of deciding what constituted an outbreak was overcome by making all dental officers report if seven or more persons in any one week developed the disease. Vigorous measures were planned to control outbreaks and a special team consisting of a dental officer experienced in the treatment of diseases of the gums and two dental hygienists was formed to be sent to any station on which an outbreak had been reported. Extra dental hygienists were available if required. However, as this team was only formed in 1943, treatment before this date was undertaken by unit dental officers with such extra assistance as could be provided. Fortunately outbreaks were so seldom encountered that only on four occasions was the team required.

Constant vigilance was common to both Corps and the elimination of salivary calculus was recognised as one fundamental in the prevention of the disease. The British service recognised this by the employment of dental hygienists and the NZDC by repeated emphasis in instructions to dental officers. Seven cases in one week in one unit would have created a state of extreme urgency in the NZDC. Apart from this, the elimination of caries was a large contributing factor in the prevention of the disease. The NZDC had to work at high pressure to achieve this result and it was working on the ratio of one dental officer to 1000 men, while the ADC with the RAF was working in June 1940 at 1 to 1250 and from January 1943 onwards at 1 to 1375. On some stations, of course, where there were possibly only 1000 men, the ratio would be exceeded by the ADC, but over-all, and taking into consideration the larger proportion of natural dentitions in the RAF compared with the New Zealand Forces, it would appear that there could not be such a complete elimination of caries.

The work done by the NZDC to achieve this happy result during the twelve months 1 February 1941 to 31 January 1942 is as follows, the corresponding figures for the previous twelve months being given in parentheses:

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Number of men examined 66,739 (14,347)
Number requiring treatment 36,083 (10,170)
Number rendered dentally fit 28,785
Number of fillings 33,468 (6,657)
Number of extractions 5,401 (Not available)
Number of dentures, new or remodelled 5,694 (1,297)
Number of denture repairs 5,222 (1,308)
Total denture cases 10,916 (2,605)
Maxillo-facial cases: Number treated and discharged 36 (12)

In view of the fact that 67,000 men were examined during the year it can be assumed that most men in the force were examined at least twice.