The New Zealand Dental Services
CHAPTER 4 — Mobilisation
CIVILIAN dentists were examining and treating the volunteers for the First Echelon of 2 NZEF before their entry into the mobilisation camps. As far as it went it was an excellent scheme, but none knew better than the DDS that it could not survive the deluge of work soon to be expected. For this reason, he regarded it as only a stepping stone to the ideal of a fully staffed and equipped Army Dental Service. For this reason, also, he had spent hours of the time that could so easily have been devoted to his private practice in Auckland, in transforming his dream into a practical plan to be adopted in the event of war. Strings of official memoranda and explanatory personal letters adorn the files of the Territorial Dental Corps as a testimony to his enthusiasm and persistence. His plans duly arrived at Army Headquarters, but not for adoption as will be seen later.
On 17 September 1939 he arrived in Wellington to take up his appointment as Director of Dental Services on a full-time basis. His first efforts were directed to staffing the new Corps and providing stock and equipment for it. He was quickly to realise the gulf between the ideal and reality. There was a lethargy at Army Headquarters, if not an actual antagonism, towards establishing an adequate Army Dental Service. Working from a small box of an office, without a clerk or a typist, he began the fight again. Once more he had to explain the need for an Army Dental Service, to justify the provision of staff and equipment, to haggle over expenditure that the lessons of the last war demanded if the mistakes were not to be repeated in this. Knowing full well that his policy was correct and that eventually circumstances would force its recognition, he went ahead with his plans largely on his own initiative, accepting the kicks as an earnest of the halfpence to come.
The attitude of Army Headquarters is explained in the following memorandum to the Minister of Defence on the subject of dental examinations and treatment. Dated 8 September 1939, it was signed by the Adjutant-General and the Director of the Division of Dental Hygiene. It stated inter alia:
It is recommended that a reasonable amount of dental treatment should be provided in order to make the men fully fit. If this recommendation is approved, consideration should be given to the two methods by which such treatment may be carried out.page 21
Dental treatment after enlistment and concentration at mobilization camps.
Dental treatment after enlistment but prior to concentration at mobilization camps.
With regard to (a), this will entail the provision of:
An extensive dental hospital at each of the four mobilization camps. This would involve heavy expenditure in buildings and after the initial pressure of work had been overcome, would be much greater than the normal requirement of the camp.
Equipment for such hospitals. A large quantity of equipment would be necessary at the outset and in this case also the amount would be far beyond normal requirements. In addition, the equipment required could only be obtained from dental supply houses and it is known that sufficient stocks are not held by these. Importation of equipment or commandeering from civil dentists is the only alternative if equipment is to be provided at mobilization camps.
Staffs of dentists, dental mechanics and orderlies for each hospital. These would have to be brought into camp on a temporary basis and naturally will involve heavy expenditure.
With reference to (b), this course has none of the disadvantages outlined above. The treatment would be spread over the dental practitioners of the Dominion, thus making full use of existing facilities. The work could be carried out expeditiously and prior to the men going onto the Army pay roll. The men would arrive in camp medically and dentally fit and therefore able to proceed with their training without interruption.
It is therefore recommended that method (b) should be adopted.
The memorandum then outlined the procedure to be adopted under paragraph (b) and was approved by the Minister of Finance on 9 September. This is a remarkable document and deserves the closest scrutiny, for it is difficult to imagine a more fertile field in which to examine the political and military thought of the time.
The Director of Dental Services was, by his appointment, adviser to the Army on all matters connected with the dental treatment of the troops and had already submitted war establishments for the NZDC, plans for treatment and specifications for buildings. The memorandum was drawn up without consulting him. Advice was sought from the Director of the Division of Dental Hygiene, the head of a Government department dealing chiefly with the dental treatment of primary school children. It is reasonable, therefore, to assume that the plans of the Director of Dental Services were incompatible with the views of the army authorities and that they sought other advice. Acceptance of the suggestions in the memorandum without a struggle would have reduced the authority of the Director of Dental Services to that of a rubber stamp. Had they not collapsed under the weight of their own inaccuracies, Lieutenant-Colonel B. S. Finn would probably have slipped from the pages of this history.page 22
The 1914–18 War had shown the large volume of dental work that could be expected among the troops and the tremendous struggle the New Zealand Dental Corps had to cope with it all. This was surely enough evidence to discourage any civilian scheme for dental treatment. Dentists were working hard and could not be expected to give priority to army patients, and it would have been impossible to force them to do so. Also, some of them would have to be brought into the Army to train as dental officers for the forces overseas. Staffs of dentists, mechanics and orderlies would therefore still be needed. If the work was to be carried out ‘prior to the men going onto the Army pay roll’, the time for this to be done must be much longer than if the men were all congregated in camp. The mobilisation of the Division and its reinforcements must therefore be delayed to that extent.
Expense was stressed in the memorandum on two occasions in connection with buildings and equipment, but no comparison was made with the expense of operating the civilian scheme nor was a premium put on the greater efficiency of an Army Dental Corps, as proved beyond doubt in the 1914–18 War.
The statement that equipment was not available from the supply houses was not correct as the Director of Dental Services had submitted lists of equipment and stocks (together with prices) which were held ready for the purpose. The Assistant Directors in the three Districts had made full inquiries as to suitable non-expendable equipment for purchase, hire or gift in addition to that held by the supply houses. There were also seven field surgical panniers equipped to mobilisation standard. Some equipment was therefore available to start the Corps, although the machinery for obtaining further supplies was not perhaps as facile as it might have been. It must also be remembered that under the civilian scheme additional stock would be needed under less economic conditions.
The assertion that large dental hospitals would be beyond the needs of the camps after the initial pressure of work had been overcome was a guess wide of the mark. It showed a disregard of experience and was directly opposed to the considered opinion of the Director of Dental Services. A bad guess can be forgiven on the score of ignorance, but there was no such excuse in this case as there was ample evidence on which to form an opinion without recourse to guessing. It is therefore difficult to understand how an appreciation of the position so unrelated to the actual situation could have been given.
The result of this uncooperative attitude was that there was a serious check to the formation of the Corps on a war basis. In spite of it, however, the DDS went ahead with his plans, but every request had to be fought for and many ventures had to be launched on his page 23 own initiative without the blessing of official authority. It is quite certain that, if he had not been so sure of the rectitude of his cause as to be prepared to act first and argue afterwards, the New Zealand Dental Corps would not have amounted to much.
Such was the position in September 1939, with the DDS seeing clearly the large amount of work pending and, even more clearly, the difficulty in getting staff, equipment and buildings. It was known that a force of approximately 16,000 men was to be mobilised and sent overseas in three echelons, to be followed by regular reinforcement drafts. Men would also be needed for staffing the camps and for coastal defence and anti-aircraft batteries. The following notes were compiled at the time by the DDS to illustrate how the staffing position was approached. The ratio of dental officers to men was varied later, but the main principles give a much more realistic view of the whole situation than that of the memorandum quoted above:
New Zealand Dental Corps. War Establishment Notes
Establishment of dental officers to accompany New Zealand Special Force overseas.
When troops first leave New Zealand they will be dentally fit and the establishment of dental officers at this stage will be based on a requirement for maintenance purposes of one dental officer for 2,000 men.
When troops have been absent from New Zealand for six months it is estimated that their dental requirements will show a marked increase and the Dental Corps will require to be reinforced to the extent of providing one dental officer for 1,000 men.
When troops have been absent from New Zealand for a further six months, i.e., a total of twelve months, there will be a further increase in their dental requirements and it is considered that the ultimate strength of the Dental Corps should be based on a requirement of one dental officer per 500 men.
The Dental Corps overseas was to be gradually reinforced by sending dental officers at regular intervals to bring the strength up to 32, or one officer to 500 men in a force of 16,000. This gave an opportunity for dentists to be brought in from civilian life in time to be trained as dental officers before being sent overseas. To continue with the notes of the DDS:
Establishment of Dental Officers in mobilization camps in New Zealand. The following factors must be taken into account in deciding upon the number of dental officers required in the mobilization camps:
The completion of initial dental treatment for recruits.
The maintenance of dental fitness for troops in training.
The training of dental officers for the supply of reinforcements to the NZDC overseas.
The completion of initial dental treatment for recruits.
First Echelon. The majority of the recruits will be dentally fit on entry into camp but there will be a fair proportion who require denture work to complete the restoration of their occlusion in accordance with the accepted standard of dental fitness.
Second and Third Echelons and Reinforcement Drafts. A large number of these men, say 80%, will require some form of dental treatment before being passed as dentally fit. If the present system is continued and all surgical work (fillings and extractions) and repairs to dentures, up to a maximum of six hours' work, is undertaken by private practitioners, there will still remain an increasingly high proportion, say 40%, who will require denture work.
The maintenance of dental fitness for troops in training. This should be comparatively light for several months after the initial treatment is completed. Each man however will be examined on entry into camp. This is essential. It is also highly desirable that each man should be re-examined as far as possible at six monthly intervals.
The training of dental officers for the supply of reinforcements to the NZDC overseas. It is essential that dental officers going overseas should have at least three months' preliminary experience in New Zealand Dental Corps methods and organisation in a mobilization camp. During this period also it would be possible to gauge each officer's suitability for the work.
As already shown …, there will be a progressive increase in the number of dental officers required overseas and it is therefore necessary that the amount of initial treatment performed for recruits in camp should be considered in the light of the necessity for drafting dental officers into mobilization camps and providing them with an adequate amount of work.
It thus becomes obvious that an increasing amount of initial dental treatment will require to be performed in camp and a correspondingly decreasing proportion carried out by private practitioners before recruits enter camp.
Meanwhile, the civilian practitioner scheme as applied to the examination and treatment of the men of the First Echelon was in full swing. Despite its value as the temporary expedient for which it was designed, it soon became obvious that it had many imperfections. Some of these were noted in a memorandum to the DDS from Major R. B. Dodds, NZDC, Dean of the faculty of dentistry of the Otago University in Dunedin:
The medical boarding of the first draft from this area is practically completed now. I have attended every board as an assistant in the organisation under Dr Fergus. The boards, as you know, have been held in the dental school and I have had an excellent opportunity of discussing with all dental supervisors matters relating to the dental examinations. Further, some of the ‘F’ and ‘T’ men have been treated at the dental school, the latter at half hospital fees.page 25
I feel now that the position calls for certain comments with regard to the system as it is operating at present. All these points are derived from first hand knowledge. I have concluded:
That the system of examination with mirror and probe cannot be accurate enough to ensure that, even if Form 362 is completed, the soldier would proceed to camp dentally fit on NZDC standards.
That a number of ‘F’ class men, either through lack of opportunity or other reasons, have failed to attend their dentist to have the treatment in Form 362 completed and thus have gone to camp with a large number of fillings and other work outstanding.
That the whole system offers far too great a variation in the standards of examination, classification and treatment, i.e., there is no common standard in these things that would be acceptable, for instance, to a Principal Dental Officer of a mobilization camp.
That the present system is not sound economically. Organised and disciplined treatment by Dental Corps personnel must inevitably serve the troops on the most economical basis possible.
It follows from these conclusions that, if a force is to proceed overseas using a dental standard accepted by the Dental Corps during the last war, the system must inevitably be that developed during that war from 1917 onwards. Ample evidence that history is repeating itself with regard to this matter may be obtained from a study of old files of the New Zealand Dental Journal—evidence moreover which can be corroborated by NZDC officers who had experience of mobilization camps of the last war.
(signed) R. B. Dodds,
11 October 1939
Major Dodds was merely emphasising imperfections of the scheme which had been anticipated by the DDS and of which he had warned Headquarters with such little effect. There was, however, another factor which carried considerable weight. The public purse was being affected. A draft memorandum by the Adjutant-General, undated but probably written in November, sums up the position with suitable emphasis:
It was anticipated that when recruiting for the special force commenced, the response would be of such an extent that it would provide wide scope in the process of selection and, in consequence, the cost of dental treatment would be kept at a moderate level by selecting from those offering their services only those who were of the required dental standard or those who, by the repair of minor dental defects, involving not more than three hours' dental treatment, could be raised to the dental standard specified.
In view of the above, it was decided that the dental treatment then anticipated as requisite should be carried out by civilian dental practitioners prior to the men being concentrated at mobilization camps.
Actually, the number offering their services was not so great as anticipated and it also became evident that the general dental condition of the men offering their services was much below the standard expected. So much so that it was found necessary to increase the period of dental treatment required to six hours. Even with this added facility considerable difficulty was experienced by Districts in filling their quotas of men who were dentally page 26 as well as medically fit. Consequently the initial estimate of costs of requisite dental treatment has been exceeded, and it is therefore considered desirable that the situation in regard to dental treatment should be reviewed with the object of ascertaining if a more economical method could be instituted.
As far as can be gathered at the moment, of the number who have offered their services and have been accepted in the first echelon, not less than 85% have required dental treatment and, from the information at present available, it is estimated that the average cost per man of such initial treatment will be approximately £2 2s. 0d. The estimated cost for the first echelon is £11,780.
Other factors are, that of recruits entering mobilization camps whose dental treatment was carried out by civilian dentists, it has been found that 15% require further treatment. This is due to an inevitable amount of dental defects being missed by the dental member of the medical board and the ever-recurring denture remakes and repairs which are to be expected when approximately 25% are wearing some form of artificial denture. There will also be a percentage of those accepted for the special force who may have to be provided with partial dentures to remedy deficiencies that are considered detrimental to their general health.
It is anticipated that the general dental condition of the men enlisted in the second and third echelons of the special force will be lower than the standard of those enlisted with the first echelon. If the dental treatment of these two echelons is carried out in the same manner as that for the first echelon, it is estimated that the cost of such treatment will amount to approximately £17,417, giving for the three echelons a total estimated cost of £29,197.
It is estimated that the cost of the alternative method of rendering the special force dentally fit by carrying out all dental treatment in mobilization camps after the troops are concentrated will be £17,135.
In addition to this, trouble was arising out of the claims from the civilian dentists for payment for their services. There were cases when the work was not done satisfactorily, and even claims for work that had not been done. Men were being treated who did not appear in camp for one reason or another. Enlistments were sometimes cancelled after treatment had been completed; specialist fees were being claimed, and so on. The whole position became so confused that finally, on 19 December 1939, the DDS suggested to the Adjutant-General that all claims be certified and passed for payment as the cost of checking them would amount to more than could be saved by adjusting the discrepancies.
The scheme collapsed under its own weight and on 15 December authority was given for all dental treatment, with the exception of extractions which would bring the recruit temporarily below a minimum standard of masticatory efficiency, to be carried out in camp by the NZDC. Even this exception was removed on 9 January 1940, leaving the NZDC with full responsibility for all treatment. In March the dental member of the medical board was dispensed with and all examinations were carried out in camp by the NZDC, the only exception being those suffering from infective oral condi- page 27 tions such as ulcero-membranous stomatitis, which could be recognised by the medical member of the board and deferred until the condition had been treated.
It must not be thought that while this fight for recognition was going on there was nothing happening in the Dental Corps outside Headquarters. Most of the recruits for the First Echelon entered mobilisation camps at Ngaruawahia, Trentham and Burnham at the beginning of October. Fourth Field Ambulance went to Burnham and to it was attached Lieutenant W. McD. Ford.1 At the same time three other officers were mobilised and posted to the camps: Lieutenant J. A. S. Mackenzie2 to Ngaruawahia, Lieutenant J. F. Fuller3 to Trentham and Captain E. B. Reilly4 to Burnham. These four officers had all served in the Territorial Force. Dental sections were set up in the camps for the treatment of casualties, mostly denture repairs. Accommodation was limited to tents except in Trentham, where a building was taken over. Very little work was done at this stage as there was only the Territorial equipment available and this did not include prosthetic equipment. The denture repairs were done with the use of equipment borrowed from private practitioners.
Towards the end of October six more officers were mobilised and posted to the camps: Lieutenants J. G. W. Crawford5 and C. K. Horne6 to Ngaruawahia, Lieutenants H. A'C. G. Fitzgerald,7 G. McCallum8 and T. V. Anson9 to Trentham, and Lieutenant J. R. H. Hefford10 to Burnham. Two of these, McCallum and Hefford, had served in the Territorial Force. A little extra equipment had been obtained but practically all the instruments and much of the stock was provided by the officers themselves. Accommodation at Ngaruawahia and Burnham had been improved by the provision of marquees. Living accommodation, especially at Trentham, was page 28 exceedingly primitive, consisting for the dental officers of the bare minimum of four walls, a roof and a bed.
Dental examination of all troops in the three camps was then undertaken. This, with completing treatment not finished by the civilian dentists, emergency work for the camp staff and maintenance for the 6600 men of the First Echelon, kept the dental officers fully occupied, working as they were under field conditions.
Towards the end of November a new stage was reached. The dental services expanded and, from an administrative point of view, became consolidated to form camp dental hospital groups rather than multiple field dental sections. Papakura Mobilisation Camp, which was to replace Ngaruawahia as the main camp in the Northern Military District, was opened and Lieutenant Mackenzie was transferred there to take charge. Lieutenant Fuller was placed in charge of Trentham and Captain O. E. L. Rout was mobilised and posted to Burnham. These three officers held the appointments of Principal Dental Officer in accordance with the NZDC war establishments drawn up in pre-war years and now approved. (See Chapter 5, Organisation.)
By the end of December the mobilised strength of the NZDC was 22 officers and about 50 other ranks. Buildings for dental hospitals at Papakura and Burnham were completed and occupied in December, although still far from complete with many internal fittings. Thus in the three main mobilisation camps accommodation was available, for at Trentham a building had been available as a temporary hospital from the start. At Ngaruawahia, however, tents were still in use.
When the troops of the First Echelon were ready to embark on 5 January 1940, they had all received a final check of their dental condition and some 6500 men left New Zealand completely dentally fit. Part of the credit for this must be given to the civilian dentists but the Dental Corps can claim its share. The approximate figures for the treatment carried out for the First Echelon while in camp, i.e., by the NZDC, are: 3000 fillings, 750 extractions, 250 dentures (full, partial and remodelled) and 200 repairs to dentures. The work was done in the face of many handicaps. Temporary accommodation had to be set up and equipment found before anything other than emergency treatment was possible. It took time to make satisfactory arrangements with the camp authorities and officers commanding units to provide a flow of patients, for at this time the general camp organisation itself was only in the developmental stage and the training programmes were subject to sudden changes. Final leave of fourteen days further interrupted the work just at a time when it had started to run more smoothly. Still, by dint of hard work and long hours, the result was achieved and the subsequent page 29 history of the dental services with 2 NZEF overseas indicates that this effort and the treatment by the NZDC of the succeeding echelons and reinforcements was the foundation of the excellent dental health record enjoyed by New Zealand troops throughout the war.
There were other troops in New Zealand than the echelons of 2 NZEF and they provided a problem of their own. Within a week of the declaration of war a force was mobilised to man the coastal batteries and subsidiary defence stations. These men were not selected according to any standard of dental fitness, nor were they included in the civilian practitioner scheme for dental treatment. The only provision made for them was that when a man reported with toothache, the medical officer authorised the necessary treatment from a civilian dentist. This was only for the relief of pain and did not include other work to make him dentally fit.
In December Government approval was given for dental examination and treatment of these troops to be undertaken by the NZDC. The policy was that the NZDC would be temporarily detached from the mobilisation camps whenever intervals in the treatment of overseas drafts made this possible. They were to operate as mobile field dental sections, taking fully equipped outfits from the mobilisation camps. The first of these intervals occurred when the First Echelon went on final leave, and between 21 December 1939 and 11 January 1940 field dental sections operated at Narrow Neck and North Head in the Northern Military District, Fort Dorset in the Central and Battery Point and Godley Head in the Southern Districts. The result was that at least all urgent work was completed for the fortress troops at these establishments.
7 Maj H. A'C. G. Fitzgerald; Hastings; born 1908; dental surgeon.
9 Maj T. V. Anson; Wellington; born Wellington, 1902; dental surgeon; PDO, Northern Military District, 1940–41; Brigade Dental Officer, 8 Bde, Fiji, Jul 1941–Jan 1942; Dental Officer, No. 2 (GR) Sqn, Nelson, Feb–Oct 1942.
Staffing the New Zealand Dental Corps
In staffing the Corps there were two important questions to answer:
How much treatment was needed to make the troops dentally fit and maintain them so?
How many dentists, mechanics and orderlies were required to do this?
The first question could not be answered with complete accuracy but the amount of treatment could be roughly assessed by analysing the results of the examination of the men who volunteered for the First Echelon and the results of examination and treatment in the 1914–18 War. From these figures it was possible to arrive at a fair average for a given number of men.
The answer to the second question then appeared to be one of mathematics, provided the source of supply did not dry up. It was known approximately how much work a dental officer could do in page 30 a given period, how many mechanics and orderlies he needed to assist him and how much equipment he would need. On paper the problem was simple; in practice not so simple. In the first few months of the war the DDS used the rules of mathematics to justify his requests for staff but, when it was decided that the Corps was to be built up in proportion to the armed forces, other factors had to be considered. There were different factors affecting dentists, mechanics and orderlies, so the three will be considered separately.
There was no difficulty at the beginning of the war in finding enough dentists to volunteer for service in the Corps; in fact, more applied than could be immediately accepted. But, even in these early times, the action of volunteering did not mean acceptance, as the DDS demanded a high standard for the Corps, quite apart from medical fitness to stand up to the work. The dentist had to have high professional ability and be of good ethical standing, fit to receive the King's Commission. The Dental Corps was not going to be a dumping ground for profession failures or playboys. The needs of the civilian population also had to be considered and dentists could not be drawn into the Army from areas poorly provided with dental services.
The maintenance of a balance between civilian and military requirements was recognised as important by the Government, and in December 1939 the Minister of Health approved the setting up of a sub-committee of the Medical Committee of the Organisation for National Security to advise on this and other dental matters of national concern. Consisting of Mr J. L1. Saunders,1 Director of the Division of Dental Hygiene in the Department of Health, Lieutenant-Colonel Finn, and Mr O. M. Paulin2 representing the New Zealand Dental Association, the dental sub-committee held its inaugural meeting on 29 January 1940 in Wellington. By this time thirty-one dentists had received, or were about to receive, their commissions in the NZDC, so the first action was to ratify these appointments. This they did with the exception of Captain O. E. L. Rout who, they considered, would be better employed in his capacity as a lecturer at the Otago University Dental School.
At the beginning of the war there were 697 dentists on the New Zealand register. Twenty-five of these were in Government employment, at the dental school or in the island dependencies, so in the page 31 meantime were not to be considered. This left 672, of whom many, through age or ill health, were unable to serve with the military forces, but who might release younger and fitter men for service.
At this time all manpower for the fighting forces came from volunteers so the authority of the Organisation for National Security and its committees was limited. In the case of dentists the committee's main function was to see that the needs of the civilian population were not adversely affected by too many enlistments from the same quarter. To help it in deciding this, it asked the New Zealand Dental Association to appoint dentists in the various districts throughout the Dominion from whom recommendations could be obtained. Subject to this proviso, the selection of applicants was made by the DDS after careful inquiry into their suitability and the committee abided by his recommendations.
On 18 June 1940, however, the National Service Regulations were gazetted by Order in Council. By these regulations 22 July 1940 was made the closing date for voluntary enlistment, and thereafter men were called up by ballot both for overseas and Territorial service with the armed forces. Dentists were therefore liable to be called up as combatants either for overseas service or Territorial training, and the delicate balance between military and civilian dental requirements was in jeopardy. Exemption from combatant service could not be granted by the committee, but the National Service Department recognised the need for some degree of conservation of dental manpower. The department had what was known as a ‘Schedule of Important Occupations’, which was in the process of revision when this question was being considered. The Director, Mr J. S. Hunter, wrote to the Medical Committee on 2 September 1940 to the effect that while the postponement or reservation of a person drawn in a ballot was a matter entirely for the decision of a tribunal that was to be set up, certain recommendations for dentists and dental mechanics were suggested for inclusion in the revised schedule. No dentist would be released for Territorial training and if he was called up in a ballot for overseas service his case would be referred to the National Medical Committee, which included the dental subcommittee, whose opinion would be transmitted to the Appeal Board for consideration. The result was eminently satisfactory as the Appeal Board invariably acted on the recommendations of the committee.
The committee also recommended that those dental students who had completed one full year of professional study, i.e., who had completed the second year of their dental course, should not be withdrawn for military service but would be required to continue their professional studies.page 32
The result of this was that the DDS was able to select those dentists he needed for the Corps with a reasonable chance of getting them, and still had a free hand in rejecting unsuitable applicants, with a knowledge that they would not be withdrawn from the general dental pool. That the DDS was careful in his choice is shown by the very small number who turned out to be misfits. That his standard was high can be seen by the instructions given on many occasions to officers leaving to take up a command overseas:
You will remember that your first duty is to look after the men you command, then to equip yourself with the necessary military and specialist knowledge to make your branch of the service the most efficient section of the military organisation. Everything has been done to give you rank and status in the Force and it rests with you to build up from this with your own initiative and personal application a branch of the service that will function under all conditions presenting. It is up to you to live up to the ideals of your profession apart from inculcating into the minds of other branches of the force, by practical demonstration and propaganda amongst all Units, the importance of our specialist service and the essential part that dental health contributes to the mental and bodily health of the soldier.
With the strictest observance of Service Regulations and Procedure and the continuance of the loyalty and co-operation you have shown, so will the ‘Esprit de Corps’ be built up and the traditions of the New Zealand Dental Corps and your profession be upheld. Nevertheless do not forget that commissioned rank in the professional services is easily gained and the soldier who presents to you for treatment, of whatever rank, is deserving of all the consideration that you, as a professional man, can offer him, and he will get it and with good measure from the New Zealand Dental Corps.
The Corps owes a debt of gratitude to Colonel Finn for selecting his officers with such care and for constantly refreshing them with his own idealism. At one time in the war he was so desperate for dental officers that he was prepared to take them direct from graduation and train them at the camp dental hospitals. This was against his principles, and later when the supply improved he insisted that new graduates must have at least six, or preferably twelve, months' practical experience in the dental department of a public hospital. The wisdom of this is seen when troops are scattered over the country and dental officers have to work alone, supported only by their own initiative and professional experience.
Civilian requirements were assessed as one dentist to 2200, but in 1942, when general mobilisation had taken place and large numbers of dental officers were needed, the profession was asked to work at a ratio of one to 3300. It is interesting to compare the civilian figures with those of the 1914–18 War as computed by the National Efficiency Board. The ratio of dentists to population in 1914 was one to 2196, and in 1917 one to 2922. The difference in the ratio at the peak periods of the two wars can be attributed to the fact that in 1942 New Zealand was threatened with invasion and a large number of men were mobilised to protect the homeland, page 33 needing more dental officers in the armed forces and leaving fewer for civilian requirements. So serious was the position in 1942 that the dental sub-committee circularised the dentists advising them of the position and asking that they co-operate by modifying their plans for treatment, simplifying as far as possible all operative and prosthetic work while the emergency lasted. The general reaction to this circular was favourable as it was realised that some action was necessary if the interests of the civil and military population were to be safeguarded. There was some criticism, especially from a company providing certain services to the profession, on the grounds that their interests were being vitally affected, but the position was too serious for much notice to be taken of it.
The Germans apparently had the same difficulty in providing an adequate dental service for the civilian population. In May 1942 the following paragraph appeared in the dental magazine Oral Hygiene:
Nazis Lack Dentists
With many of the country's dentists in military service, toothaches are becoming widespread in Germany. The Koelnische Zeitung of Cologne reported ‘There simply are not enough dentists.’ The paper urges the people to be patient, to consult a dentist only when absolutely necessary, ‘as for example when the pain becomes too great or chewing is impaired seriously’.
Further steps were taken in 1943 to stabilise the dental service to civilians. A Dentists' Employment Order, 1943, was written into the Industrial Manpower Emergency Regulations, 1942. Briefly, this order, operating from 9 September, prevented any registered dentist from ceasing practice, changing his type of practice or setting up practice at any other place or places without prior consent in writing of a District Manpower Officer. This order served two useful purposes. It helped the work of the dental sub-committee by simplifying the organisation of dental manpower and it protected those dentists already serving with the NZDC from unscrupulous opportunists who might seek to filch their practices from them in their absence.
The National Service Department did not recognise dental mechanics as belonging to the ‘Schedule of Important Occupations’ but it did concede that they should be subject to some direction. All those drawn in the ballots for overseas service were referred to the National Medical Committee as in the case of dentists. For those drawn in the ballots for Territorial training, postponement of calling up was dealt with by the Appeal Board on the individual merits of the case. A letter from the DDS to the Director of Mobilisation on 1 May 1941 ran:page 34
The New Zealand Dental Corps can absorb all dental mechanics or dental technicians available through Expeditionary Force ballots and the Director of National Service has notified Appeal Boards accordingly, also suggesting that, where these ballotees are released for military service it should be conditional upon service in their technical capacity and additionally that the appeals of grade II and III mechanics should be adjourned until their medical board papers have been perused at Army Headquarters with a view to their being utilised in home service duties thereby releasing grade I mechanics for overseas.
It should be explained that the classifications ‘Dental Mechanic’ and ‘Dental Technician’ are synonymous and appear indiscriminately in memoranda quoted in the text.
There was, however, a definite need to preserve the balance between military and civilian requirements, although perhaps not to such an extent as with dentists. It was therefore decided that if the dental sub-committee was satisfied that a mechanic was a competent tradesman and essential to civil requirements, an appeal from military service would be lodged on his behalf on the grounds of public interest. This was not entirely satisfactory as it entailed much unnecessary correspondence and delay. Also, in many cases, no sooner were appeals lodged and dealt with than the DDS would require the men urgently and could not get them until the appeals had been withdrawn. A simpler scheme was therefore evolved. After the issue of the Gazette the sub-committee made inquiries into the bona fides of each mechanic drawn in the ballot. This was a necessary precaution as in a number of cases boys who could barely lay claim to the proficiency of a ‘plaster boy’ had styled themselves dental mechanics. These were useless to the NZDC and to the civilian population except as trainees. After their bona fides had been established, the mechanics continued in their civil occupation until their services were asked for by the DDS. In other words, every dental mechanic was kept in his trade either in civilian or military practice. This exemption applied also to the National Military Reserve and the Home Guard, except of course in the event of full mobilisation of the latter in the defence of New Zealand's very existence, when dentists, mechanics, Toms, Dicks and Harrys would all be in it together.
In February 1943 Mr G. Clark of the dental mechanics' union was appointed by the Minister of Health to the dental sub-committee. He attended only those meetings at which the release of dental mechanics was being discussed.
These arrangements did not fully satisfy the demands of the NZDC for trained mechanics and already attempts had been made to train its own in the mobilisation camps. As will be seen in the chapter on this subject, this was not completely successful at first, but it led to the formation of training schools under capable teachers page 35 in March 1943. The demand for mechanics from civilian life therefore decreased and actually none were brought into either the Army or the Air Force after October 1942. Eventually, on 16 February 1944 the following resolution was passed by the National Medical Committee on the advice of the DDS:
That with the dental mechanics who are gradually being released to civilian occupation from the Armed Forces, together with those already serving as apprentices and employed as journeymen mechanics, or in business on their own account, the dental profession is reasonably served by dental mechanics under present conditions.
That in view of the increasing number of dental mechanics being released from the Armed Forces, the necessity no longer exists for dental mechanics who are, or have been, called in ballots to be retained in their civilian occupations or for their work to be regarded as a protected industry.
The removal of dental mechanics from an essential industry classification restored the balance which had been disturbed by the release of mechanics from the armed forces. Those who had been drawn in ballots were then called up either for general military service or for other essential industries in equal numbers to those released from time to time by the armed forces.
In selecting non-technical staff for the Corps, the policy was to look for keen men of a reasonable standard of education and personal cleanliness, fit to work in a hospital team. The choice was limited by the needs of the combatant units, for whereas dentists and mechanics naturally gravitated towards the Dental Corps whatever their medical grading, untrained men who were medically Grade I could not often be spared for a non-combatant unit such as the NZDC. There were, however, many men graded II for slight abnormalities sufficient to disqualify them for service in a combatant unit who were of a sufficient standard of physical fitness to make them valuable members of the NZDC. It was perhaps not fully appreciated at first to what extent the NZDC would be employed and the high standard of fitness required of those serving in a field ambulance or a mobile dental unit, but it was realised that there must be Grade I men to accompany the NZDC overseas. The result during the first ten months of the war, when all the men were voluntary enlistments, was that Grade II men welcomed the opportunity to serve with the NZDC but Grade I men were difficult to get, as the choice of orderlies for service overseas was limited by the large amount of work the NZDC had to do in New Zealand.
There were certain key men who should not be called nontechnical. Men with a knowledge of dental stock, such as employees of supply houses, were the natural choice for NCOs in charge of stores, but these were hard to get as they could ill be spared from page 36 their civilian occupations. Most of the stores NCOs were trained in the Corps after serving as dental orderlies. Men with the capacity for leadership were needed as administrative NCOs. Again, these mostly proved their worth as dental orderlies and rose in rank and authority according to merit, as there were very few men who had had experience in the Territorial Dental Corps from whom to chose.
The general selection of orderlies in the early part of the war was excellent and to those who served in New Zealand and overseas in the NZDC can be attributed much of the success of the Corps in the war. There were difficulties at a later date when the Dental Corps, in common with other non-combatant units, had to absorb its share of pacifists and objectors, but the constitution of the Corps was then sufficiently strong to do this without serious indigestion.
The obvious course of employing women in the camp dental hospitals to release men for service overseas and in the mobile units in the field was delayed by prejudice from the more conservative of the military authorities, and it was nearly eighteen months after the declaration of war before serious consideration was given to this prolific source. Before this no facilities existed for women in camp except for nursing sisters, and even the welcome invasions by concert parties arrived under strong duennal escort. Appropriately it was the youngest service which made the first move to use women as dental orderlies, as selection of suitable girls to join the Women's Auxiliary Air Force began in July 1941. The type sought was those who were ‘bright and quick in the uptake but not necessarily with previous dental experience’. Added incentive was given by arranging classes of instruction by dental officers to qualify them to sit for trade tests which gave extra status and, of course, extra pay. Later the Navy and the Army used girls of the Women's Royal New Zealand Naval Service and the Women's Army Auxiliary Corps. There is no doubt about the success of the women as dental orderlies, and some were even trained as dental mechanics in the NZDC training schools. Some adjustment of existing establishments was necessary as it was not considered right to ask for the same amount of work from the women as was expected from the men. The proportion was fixed at three women to replace two men.
The number of dentists, mechanics and orderlies serving in the NZDC in the war varied considerably at different times, but the following figures are interesting. Taking 697 as the number of dentists on the register at the beginning of the war, and remembering that many of these, through age, health or location were debarred from service, the creditable number of 215 were mobilised in the NZDC for varying periods. Practically every experienced dental page 37 mechanic in the Dominion who was fit for service was also mobilised at some time or other. The number of men and women who served as orderlies is difficult to assess but the strength of the NZDC for the three services at 31 March 1945 was:
|Officers||NCOs and Males||Other Ranks Females||Total|
On the whole the staffing system worked satisfactorily and the balance between military and civilian requirements was well maintained.
* This includes three non-professional officers.