Today, army dentistry is an integral part of military medicine with male and female dentists serving in front line positions. It has not always been like this. The poor state of oral and dental health of many army recruits in the Boer War reflected that of the poorer sections of society in Victorian times. Passing through the First and Second World War years the general and dental health of the troops slowly improved; and treatment by maxilla-facial surgeons of wounds to the face and jaws gradually evolved. This paper follows the far-reaching changes in the British army.
The Victorian Period and The Boer
War (1899 - 1902)
The roots of 20th century military dentistry are
associated with the Boer War, when the size of the British army grew to almost
200,000 men.1 Some 38% of potential recruits in 1898/9 were
rejected, many for poor health.2 This was not surprising bearing in
mind their social background: social deprivation, poor living conditions (many
came from squalid slums) and lack of food. Of 69,553 men inspected 4,400 were
not accepted due to “loss or decay of many teeth”.3 Poor dental
health was just one problem. The Army Medical Services were in their infancy
and dental treatment was almost non-existent.
Many recruits in the late 1890s were previously unemployed.
The army provided regular and more substantial meals than those eaten by manual
labourers in London.
This diet plus better sanitary conditions, discipline and regular exercise
helped to improve the health of soldiers but many suffered from diseases of the
mouth and teeth. The situation was considerably worsened by a diet of ox meat
or bully beef and hard biscuits, which many could not eat. Several thousand
soldiers were hospitalised due to dental problems and many had to be
discharged; a considerable loss to the fighting power of the British forces.
In 1900 Frederick Newland Pedley, a dental surgeon, was
allowed to travel to South Africa to work with the armed forces provided there
was no expense to the government. He paid for his travel and took equipment
mostly supplied by Claudius Ash & Sons.4 Treatment was usually
extractions without anaesthetics. In June 1901 the British Journal of Dental
Science reported5 the Secretary of State for War had granted
permission for the army to have the advantage of the services of skilled dental
surgeons and four were sent to South
Africa. It said:
No doubt the present war has brought matters to a head,
especially the fact brought forward in the House of Commons and fairly freely
circulated in the press that a large proportion of recruits were rejected on
account of the defective state of their teeth.
Army dentists would have civilian surgeons’ pay, one pound
per day plus captains’ allowances; the government to provide equipment other
than the dentists’ own instruments. The journal hoped the appointments were a
preliminary to a larger scheme.
Between 1990 and 1902 the British Journal of Dental
Science indicated the considerable public concern about the detrimental
effects of bad teeth on the soldiers’ effectiveness. Pedley reported in March
19016 that disease, neglect, tough beef and hard biscuits played
havoc with the teeth. One young man had only three useful teeth left. Such
people were of no use as fighting men as they could no longer eat service food.
He asked: “Can nothing be done to save the teeth of the Army?” Pedley suggested
a dental surgeon should be attached to each general hospital.
Most defective teeth were in the “militia and yeomanry of
the lower levies”.7 The British Dental Journal suggested it
was probably due to a relaxation of the rules at medical inspections due to
difficulty in finding recruits at the later stages of the war. Many men “were
useless as fighting units”. On 28 October 1902 W Broderick MP, secretary of
state for war, reported to the House that as many as 2,451 were sent home. He
said the dental condition of the army’s rank and file was receiving urgent
attention.
