The New Zealand Dental Services
1. Dental Standards
1. Dental Standards
Certain standards were laid down for medical and dental fitness in Appendix XXIV of Army Standing Orders for Mobilisation, 1939, the dental ones being the result of submissions from Lieutenant-Colonel Finn.
The standards are given in detail in Appendix II, omitting the medical ones which are not relevant to this history. They were grouped under four headings:
Armed Forces for Home Defence.
Large Expeditionary Force.
Small Expeditionary Force for Garrison Duty Abroad.
Temporary Employment in New Zealand.
On examination the men were classified as:
‘F’ or dentally fit or capable of being made so in three working hours.
‘T’ or requiring treatment longer than three hours to be made fit.
‘U’ or dentally unfit, such as those requiring multiple extractions or suffering from a contagious oral disease.
For home defence nobody in categories ‘F’ or ‘T’ who was willing to receive treatment was to be rejected, but for small or large expeditionary forces only category ‘F’ men were to be accepted to begin with.
Standing Orders also gave instructions to dental examiners as a guide to assessment of standard, as well as defining their authority to make decisions and receive payment for their services. It is unnecessary to quote these details in full, but one curious anomaly is mentioned as an example of how confusion can be caused when regulations have to be built piecemeal to meet unknown contingencies. When these regulations were framed, the DDS did not know whether the dental treatment for the armed forces would be by civilians or a Dental Corps, and they reflect the uncertainty of the time, being built as a patchwork according to fluctuating circumstances. The anomaly concerned the standard expected of an artificial denture and probably arose from an attempt to ease the severity of the dental standards because of the urgent need for manpower, but the new patch was put in without taking out the old one. The two paragraphs, separated from their context, are:
Definition of a well fitting denture
A denture will not be considered as ‘well fitting’ unless six months have elapsed1 from the completion of the extraction of the replaced teeth; no further extractions must be required which will affect the stability of the denture or necessitate alterations. The denture must fit firmly, be without movement on mastication and complete all spaces where natural teeth are missing. The artificial teeth must correctly meet the corresponding teeth in the opposite jaw and afford a good masticating surface. The denture must be free from cracks and breaks.
[The dental examiner is wholly responsible for] … assessing approximately the time that may be involved in the treatment decided upon, taking into consideration from the information that will be made available to him whether arrangements have been made for a camp system of dental attention or by individual practitioners and, also, that where extensive extractions and the provision of artificial dentures is indicated, only the extractions should be completed and the provision of dentures deferred pending absorption.page 18
Impressions for dentures, especially full dentures, will not be taken within a period of four months from the date of the completed extractions and, in no case, will they be taken, even though four months may have elapsed, until the dental examiner is satisfied that absorption is sufficiently completed for permanent dentures to be inserted.
In regulations framed on the basis of a known policy such a discrepancy would be unlikely to occur. As it was, it did not inspire confidence in the efficiency of the Army Dental Service in the eyes of civilian dentists.