Army dentistry in the past 100 years

When WW1 was declared in August 1914 and the Australian government decided to send troops to Europe, some dentists volunteered, but the defence forces did not see the need for a dental corps. The first record of
an enlisted dentist in the Army was Private John Keith Henderson. He was in his final student years at Sydney University, and took his own instruments with him to help his fellow soldiers. Between August and
December 1914, he performed over 1900 extractions, 160 fillings, and 50 pain relief dressings. He was later killed in France.

The shocking losses of the Gallipoli campaign began in April 1915. It led to 26,111 casualties and 8, 141 deaths. It also played a role in the development of dentistry within the armed forces. Of all the military personnel removed from the warzone, over 600 were directly connected with dental problems.
“Trenchmouth” disease was a common gum disease associated with poor nutrition and poor conditions in the trenches. For those afflicted by trenchmouth, they not only had pain, but were also unable to eat the
hard army biscuits.

By April 1916, the Australian commanders recognised this growing problem and developed 36 fully equipped dental units. By February 1917, dental officers were given the authority to parade men for compulsory inspection and treatment. This was an approach sometimes called, “If you can’t bite, you can’t fight.” Eventually, there were 118 dental units at a ratio of 1 dental officer per 4,200 men. Unfortunately, the British attitude at the time seems to be that the life of the foot soldier was probably short, so why waste resources on his dental needs? However, when General Haig developed an acute abscess, the only dentist available to treat him in France was an Australian.

When WWII broke out, the Army changed the ratio to 1 dentist per 1,000 troops. However, even this was found to be an underestimation of the needs, e.g. one single division (~15,000 troops) was found to require about 50,000 fillings, 40,000 extractions, and 10,000 dentures. One of the major needs were the maintenance of dentures – many enlisted men already had dentures, but the clenching of their teeth during shelling made them clench their teeth, often causing the dentures to break.

In April 1943, the Australian Army Dental Corp was granted separate status form the Medical Corps, and later renamed the Royal Australian Army Dental Corps (RAADC). In total, about 550 Australian dentists served during WWII, along with 1,500 technicians and nurses.

Australian dental units provided support in the Occupation Force sent to Japan. More units were sent to Korea in July 1952 and July 1953. In October 1955, another unit was sent during the Malaya Emergency. The first Australian dental unit arrived in Vietnam in June 1965. There was a major change as the dentists now operated on the frontline as opposed to earlier wars where they operated out of base hospitals. They
were also often charged with treating locals for dental emergencies.

Australian dentists have been sent to the Gulf War in 1991; Somalia and Rwanda in 1993; Bougainville in 1997; and east Timor in 1999. In more recent conflicts in Afghanistan and Iraq, Australian armed forces have increasingly relied upon allied healthcare services for their needs, in a much more streamlined approach. There was roughly 1 dental team
(dentist, technician, hygienist, and nurses) per 1,000 troops. The other significant difference is that nowadays the troops are all made dentally fit before they are sent, so the dental team are mainly there for emergencies and maintenance.

Soldiers of the modern era have far less cavities and gum problems of a century ago. However, they are often fairly young and susceptible to wisdom teeth problems. In the first Gulf War, impacted wisdom teeth
and other dental issues were the cause of the second highest casualty rate and for people being pulled out of frontline service.

Adapted from: “Fang Farriers: A History of the Royal Australian Dental Corps”, by Dr Sven Kuusk and excerpts printed in the ADA News Bulletin (April 2018).