The New Zealand Dental Services
The intention was to examine and make dentally fit every man in the force once every six months, but with wide dispersal of troops, scarcity of transport and no margin for sickness or accident, this was not feasible. The ADDS reported on 31 May 1943:
It has been considered that an average figure for maintenance conservative treatment after six months is 50 fillings for 100 men, taking into consideration that 50% to 60% wear either partial, single or complete dentures. It was found however that examination of a cross section of 75 men of 30 Battalion, which was rendered dentally fit in February 43, disclosed 54 fillings for the 75. It appears therefore, subject to confirmation when general examination of all units is carried out after the six-monthly period, that the maintenance figures may be somewhat higher. This may be attributed to (a) Diet, (b) Conditions affecting general resistance, (c) Acclimatisation period. Steps are being taken to advise all personnel in oral hygiene and page 319 special care of the teeth and oral tissues but it is anticipated that the treatment required to maintain the Force will necessitate strict periodical survey of all units. It is expected that, even with the assistance of dental units arriving from New Zealand, it may not be possible to begin re-examination and treatment strictly within the six-monthly period in the first instance, the amount of casualty work also being a factor.
Dental officers had been working at the ratio of one to 1500 men instead of one to 1000 as originally intended. Everyone agreed that more staff was needed but there was little unanimity when it came to deciding the form it should take and how it should be apportioned. The DDS and the ADDS based their calculations on the amount of work to be done and a wide experience of the number of officers and men needed to carry it out. The new establishments they submitted for approval were practical but immediately became a bone of contention. The Medical Corps wanted dental sections attached to the Casualty Clearing Station and the Convalescent Depot, regardless of the fact that this had already been promised by the ADDS should the need arise. Its ideas were unacceptable to both ADDS and DDS as conflicting with the flexibility of the existing organisation. The Adjutant-General also took exception to some of the establishments and suggested various combinations and eliminations, presumably on the grounds of economy.
In the face of this opposition, what should have been a simple addition, designed specifically to meet a known situation, became an exercise in the art of sophistry and intrigue. The DDS, sure of the accuracy of his appreciation, submitted the establishments in a different form to achieve the same result. The issue became confused in a maze of correspondence out of which the DDS arose triumphant, having seized on a mistake to get his men overseas before it was discovered. As will be seen later, the end fully justified the means. Anything less than the establishment provided or a rigid attachment of personnel to medical units would have made the task impossible.
In addition to the reinforcements from New Zealand, the dental section which had been working on Norfolk Island was sent to New Caledonia. The new establishment totalled 21 officers and 86 other ranks. This was based on a ratio of one dental officer to 900 troops, which in view of the fact that the force would soon be widely dispersed, was none too many. The ADDS could provide treatment under operational or static conditions and could attach sections to medical units without losing the services of those sections when attachment became unnecessary. Generous provision was made for transport but, although approved, this was not allotted for reasons set out by the GOC to Army Headquarters on 12 April 1943:page 320
At the moment I do not think any transport, or at any rate anything more than a limited amount of transport, is required for the Dental Services with this Force. For operations such as those which may be ahead of us, the transport is more likely to be boats than trucks. I suggest however that the establishments as drafted, be approved, but that in the meantime no effort be made to fill the transport requirements. It is more important that such vehicles as we can get from New Zealand should be allotted to units which have to undertake cross-country tasks.
This was eminently reasonable and apparently the Dental Corps could draw transport from the general pool when moves were necessary. Unsuccessful efforts were made to have the Quartermaster in charge of the Store commissioned as a subaltern, as was the case in the Base Dental Store in Wellington.
About July 1943 it became apparent that the Division was to move further forward although the Base was to remain in New Caledonia. Hopes of completing the strength of 15 Brigade could not be fulfilled and it was disbanded, leaving the Division on a two-brigade basis, consisting at this time of approximately 17,000 men, expected shortly to rise to 19,000.
The first task of the Dental Corps was to concentrate in the two brigade areas, Taom Valley and Bouloupari, so that all divisional troops would be dentally fit before embarkation to the forward areas. After a long discussion with the GOC, the ADDS decided that the Mobile Dental Section and 2 Maxillo-Facial Injuries Section would go forward with the Division, the latter being attached to the Casualty Clearing Station. The Officer Commanding the Mobile Dental Section would be the Senior Dental Officer with the Division and, as such, responsible for the dental health of the troops in the forward areas. The Maxillo-Facial Injuries Section would be conveniently situated to maintain the chain of treatment. In view of the medical policy of quick evacuation, cases would soon be back at the General Hospital in New Caledonia, to which the senior maxillo-facial officer was attached. Under this arrangement there would be ten dental officers at the Base, excluding the ADDS, and nine in the forward area. Just before embarkation the officer in charge of 2 Maxillo-Facial Injuries Section was graded as unfit for tropical service and returned to New Zealand. The need for an immediate appointment of a substitute emphasises the importance of training all dental officers in the principles of maxillo-facial work. The intricate and often lengthy treatment of these cases can well be left to higher trained specialists, but the importance of the preliminary treatment cannot be too strongly stressed.
The ratio of dental officers to men again became one to 1000, which later proved to be none too many. In the climate they were to work in sickness could be expected to take its toll. Already in page 321 New Caledonia there had been cases of dengue fever, including the ADDS himself, and so many ailments, especially among the mechanics, that the ADDS went so far as to recommend a 10 per cent surplus of key personnel. Confidential reports from American sources painted a gloomy picture of casualties from malaria. They spoke of a 20 per cent average and as much as 70 per cent for some units. Though the New Zealanders hoped to reduce these figures to 10 per cent by enforcing strict anti-malaria precautions, the Dental Corps could not afford even this amount of wastage. Only men who were medically Grade I were allowed farther forward than New Caledonia, which meant that any change of grading would send them back to Base.
The Division was virtually dentally fit on embarkation, the condition of the base units was described as satisfactory and the curtain was ready to rise for the second act.