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Dental Corps, U. S. Navy*
DENTAL CORPS, U. S. NAVY* HE annual report of the SurgeonGeneral of the Navy, which has been published recently, includes a number of interesting comments rela tive to the Navy Dental Corps. In his discussion of the personnel of the medical department, Admiral Stitt includes the following remarks: “ One of the urgent needs of the medical department is an increase in the personnel of the Dental Corps. The apportionment of one dental officer to every 1 ,0 0 0 officers and men of the Navy and Marine Corps, which was arbitrarily determined several years ago, when the Dental Corps was first estab lished, has been found to be totally in adequate to furnish satisfactory and complete dental service to the personnel. At the time this apportionment was pro posed, the real value of dentistry in the naval establishment was not yet known nor was the importance of dentistry in its relation to general health fully un derstood. One of the important ad vances made in medicine during recent years has been the development and recognition of the dental surgeon’s part in the cure, control and prevention of disease. “ The constant demand for emergency treatment by a great number of officers and men precludes the possibility of furnishing dental service which would comprise all that can be obtained from dental surgeons in civil life. The Surgeon-General earnestly desires the ex tension of such service to the personnel of the Navy. “ With the present numerical strength of the Dental Corps, it has been found
T
*Extracts from Report of the Surgeon-Gen eral, U. S. Navy, for the fiscal year 1924. Jour. A . D . A., February, 1925
203
impossible to assign an adequate num ber of dental surgeons to the various naval hospitals for the purpose of prop erly carrying on the important develop ment of group practice. This coopera tive system of treatment, which has the excellent effect of correlating the medi cal, dental and surgical specialists for purposes of diagnosis and treatment, has been recognized as a necessity and is practiced in the leading civil hospitals of this country. “ Another result of the present limited number of dental officers has been the inability of the Bureau of Medicine and Surgery to take full advantage of the appropriations allowed the Medical De partment for postgraduate work when considering the assignment of dental officers to special educational courses. Opportunities for special dental instruc tion have been greatly restricted by the necessity of diverting the smallest pos sible number of dental officers, from actual routine duties. “ This serious per^rmel situation which confronts the bureau is con stantly emphasized by the receipt of in sistent requests for the assignment of dental officers who cannot be supplied. Additional dental officers are needed in the destroyer, mine and special-service squadrons, in the train and light cruiser divisions, at the several Marine Corps bases, naval air stations, and at various navy yards, training stations, and hos pitals. “ The clearly demonstrated inade quacy of the Dental Corps to cope with the situation, together with the general recognition of the importance of den tistry in maintaining general health, would seem to indicate that some action
204
The Journal o f the American Dental Association
should be taken in the near future to increase the strength of the Dental Corps to a number which will insure health and comfort and assist in pre serving the physical fitness of the per sonnel. “ There are no reliable data or sta tistics of assistance in estimating the number of dental officers needed to pro vide adequate dental service, but it is generally considered by officers who have made a study of the subject that one dental officer to every 500 officers and men would be none too many. The bureau is of the opinion that an appor tionment of less than two dental officers to every 1 ,0 0 0 officers and men would prove to be insufficient, and recommends that steps be taken to obtain a new ap portionment of one to 500. It is real ized that legislative action requires con siderable time and that immediate relief cannot be obtained from this source. It is therefore strongly recommended that authority be granted to fill the Dental Corps to its authorized strength of 189. This would make the services of a dental officer available for every 615 officers and men and would relieve to a considerable extent the serious situation now existing. “ The conditions under which the apportionment of one to 1 ,0 0 0 was fixed have changed radically. Today, it is generally recognized that dental service is an important factor in the conserva tion of bodily health and that the physi cal and mental well-being of an indi vidual are in a decidedly large degree dependent upon a healthy condition of the mouth.” In his report of the achievements of the Bureau of Medicine and Surgery during the four years preceding the date of the report, the Surgeon-General fur nishes the following interesting infor mation : “ January 1, 1921, may well be taken as the date from which to calculate the increases in efficiency that have been
made in the Dental Corps of the Navy. During the several years from the estab lishment of the Dental Corps in 1912 until our entry in the World War, dental service in the Navy was in what might be termed a trial or experimental stage. The war was epoch-making for den tistry; its advent brought about an enor mous expansion in the field of that branch of the healing art, and conse quently a general recognition of the value and importance of dentistry in the Naval Establishment, together with an expansion in the size of the Dental Corps. However, such conditions did not make for permanent efficiency. The greatest item of improvement in admin istrative efficiency has been the estab lishment of the Dental Division in the Bureau of Medicine and Surgery. This division, as organized, places all dental activities which are necessarily intercor related under a single head. As now arranged, the Dental Division with an officer of the Dental Corps in charge, has supervision over all matters con cerning the Dental Corps, the details of its administration, including the assign ment and transfer of dental officers, the care of dental property, the supervision of reports and returns, the inspection of dental activities, and so forth, all of which had hitherto been handled in various divisions of the bureau in con junction with the routine administration of other medical department activities. “ The establishment of the Dental Division of the Bureau of Medicine and Surgery is a source of considerable sat isfaction to both medical and dental officers, as the former are relieved of some of their responsibility in purely dental affairs, and the latter are greatly encouraged by having a member of the Dental Corps detailed to care for their technical needs. “ The Navy Dental School opened February 3, 1923, as the dental depart ment of the United States Naval Medi cal School. Its purpose is to furnish
Dental Corps, U. S. N avy
postgraduate instruction in dental med icine to officers of the Dental Corps of the Navy and to train and equip men of the Hospital Corps as assistants to den tal officers. Instruction is given in two courses of four months each, commenc ing in February and September. “ The establishment of the school is the result of a recognition of the value of dentistry in the Navy as a factor in the preservation of the health of the person nel and an appreciation of the impor tance of furnishing the very best dental service that the profession affords. “ The school is located on the grounds of the United States Naval Hospital, at Washington, D. C., in a building devoted to other uses during the War, which has been remodeled and equipped to meet the requirements of the instruc tion given. “ The situation of the dental school, in close proximity to the main building of the United States Naval Medical School, is such that its students have the benefit of instruction in basic medical subjects at the medical school proper. These subjects are taught by the officers of the medical school faculty in con nection with the instruction given to medical officers of the regular class. The facilities of the medical school proper are at the disposal of student dental officers, and the joint instruction in bac teriology, medical diagnosis, and similar subjects, is invaluable. “ The dental school has a threefold function. In addition to the instruc tion offered, the institution provides a working laboratory for the construction of special prosthetic appliances which are being gradually introduced as a part of the dental service furnished by the Navy. The third function of the school is to supply dental service to the' United States Naval Hospital, Washington. “ An important department of the school is the prophylactic clinic, where enlisted men of the Hospital Corps are trained as dental hygienists. Upon the
205
completion of a thorough course of in struction, these men are assigned to duty with and work under the supervision of dental officers. “ An important innovation in the den tal service became effective with the establishment of the Navy Dental School, through the adoption of a plan for extending to the officers and men of the Navy the benefits of certain pros thetic procedures. “ In the interests of efficiency and economy, an endeavor has been made to consolidate all dental activities of the larger stations into one central clinic, with an experienced dental officer in charge, and in all cases this has resulted in a considerable saving of supplies and equipment, and a more efficient dental service. “ A larger proportion of dental officers has been maintained at naval training stations than at other places, as it is con sidered especially desirable to make recruits as near dentally fit as possible during their early period of training. “ A system of inspection of the dental activities of the Navy by dental officers was put into effect during the fiscal year, 1923, and the results obtained are most encouraging. The reports of these in spections are a means of furnishing the bureau with information on the charac ter of treatment given, the condition of dental property, and other data which has heretofore been difficult to obtain. It has been found that these inspections do a considerable amount of good and that a number of satisfactory conditions can be traced directly to them. It is believed that they have a decidedly good effect on both efficiency and morale. “ A revision of the dental supply table was completed during the fiscal year 1922. Changes were made by adding many new items essential to the needs of recent developments in dentistry, and items no longer considered necessary were eliminated. Subsequent additions have been made and the allowance tables changed to meet the progressive
206
The Journal o f the American Dental Association
needs of dentistry. Small amounts of non-standard equipment have been bought and sent to selected stations for trial. “ In addition to the major activities that have been outlined above, the dental officer in the bureau, under the direction of the Surgeon-General, has been actively engaged with various unclassified proj ects pertaining to the Dental Corps. Important among these items during the past three years is the following: Prep aration and publication of a complete dental number of the United States Naval Medical Bulletin, which con tained a number of original articles on professional subjects by officers of the Dental Corps. “ As has been pointed out, the Dental Corps has made remarkable progress within the past three years, but it is not
desired to convey the impression that the dental service of the Navy has been developed to the point that is desired or considered necessary to provide all that is needed in the way of dental care and treatment for the personnel. The bureau has been greatly handicapped in carrying out its recently adopted pol icies in regard to dental treatment, by the shortage of dental officers. It is realized, however, that the matter of the size of the Dental Corps is something over which the Bureau of Medicine and Surgery has little control, while it is vitally interested and directly responsi ble for the character of dental service rendered. It is the Surgeon General’s earnest desire that the dental service of the Navy be made to keep pace with, if not lead, professional activities in civil life.”
DENTAL CORPS, U. S. ARMY* U RING the fiscal year ending June 30, 1924, the Dental Corps has functioned under the restrictions imposed by the loss of approximately one-third of its commissioned personnel by the Act of June 30, 1922. By this Act, the Dental Corps was reduced in numbers from 237 to 158. The latter number of dental officers were main tained on duty during the greater part of the year. For the period of this report, there were 129,219 persons treated; 236,333 sittings given; 86,469 permanent fillings, 17,041 temporary fillings and 6,119 root-canal fillings inserted; 1,168 crowns, 426 bridges and 1,936 dentures constructed; 40,834 extractions made; 25,354 patients given prophylactic treat ment (removal of calculus and polish
D
*Abstracted from Report of the SurgeonGeneral, U. S. Army, to the Secretary of War for the fiscal year 1'924.
ing of teeth); and 268 crowns, 589 bridges and 758 dentures repaired. Authorization was obtained from the War Department for calling five Dental Reserve Officers to active service for duty at certain Army hospitals engaged in the treatment of beneficiaries of the U. S. Veterans Bureau. Careful selec tion of such personnel was made, and the dental clinics of the following hos pitals were thus augmented by Reserve personnel as follows: Walter Reed Gen eral Hospital, Washington, D. C., one lieutenant; Fitzsimons General Hos pital, Denver, Colo., one captain and one lieutenant; Letterman General Hospital, San Francisco, California, one captain, and Station Hospital, Fort Sam Hous ton, Texas, one lieutenant. It has been found necessary to con tinue the objectionable itinerary service for the past year in order that com mands at the smaller stations might re ceive some dental service. Many dental
T
*Extracts from Report of the Surgeon-Gen eral, U. S. Navy, for the fiscal year 1924. Jour. A . D . A., February, 1925
203
impossible to assign an adequate num ber of dental surgeons to the various naval hospitals for the purpose of prop erly carrying on the important develop ment of group practice. This coopera tive system of treatment, which has the excellent effect of correlating the medi cal, dental and surgical specialists for purposes of diagnosis and treatment, has been recognized as a necessity and is practiced in the leading civil hospitals of this country. “ Another result of the present limited number of dental officers has been the inability of the Bureau of Medicine and Surgery to take full advantage of the appropriations allowed the Medical De partment for postgraduate work when considering the assignment of dental officers to special educational courses. Opportunities for special dental instruc tion have been greatly restricted by the necessity of diverting the smallest pos sible number of dental officers, from actual routine duties. “ This serious per^rmel situation which confronts the bureau is con stantly emphasized by the receipt of in sistent requests for the assignment of dental officers who cannot be supplied. Additional dental officers are needed in the destroyer, mine and special-service squadrons, in the train and light cruiser divisions, at the several Marine Corps bases, naval air stations, and at various navy yards, training stations, and hos pitals. “ The clearly demonstrated inade quacy of the Dental Corps to cope with the situation, together with the general recognition of the importance of den tistry in maintaining general health, would seem to indicate that some action
204
The Journal o f the American Dental Association
should be taken in the near future to increase the strength of the Dental Corps to a number which will insure health and comfort and assist in pre serving the physical fitness of the per sonnel. “ There are no reliable data or sta tistics of assistance in estimating the number of dental officers needed to pro vide adequate dental service, but it is generally considered by officers who have made a study of the subject that one dental officer to every 500 officers and men would be none too many. The bureau is of the opinion that an appor tionment of less than two dental officers to every 1 ,0 0 0 officers and men would prove to be insufficient, and recommends that steps be taken to obtain a new ap portionment of one to 500. It is real ized that legislative action requires con siderable time and that immediate relief cannot be obtained from this source. It is therefore strongly recommended that authority be granted to fill the Dental Corps to its authorized strength of 189. This would make the services of a dental officer available for every 615 officers and men and would relieve to a considerable extent the serious situation now existing. “ The conditions under which the apportionment of one to 1 ,0 0 0 was fixed have changed radically. Today, it is generally recognized that dental service is an important factor in the conserva tion of bodily health and that the physi cal and mental well-being of an indi vidual are in a decidedly large degree dependent upon a healthy condition of the mouth.” In his report of the achievements of the Bureau of Medicine and Surgery during the four years preceding the date of the report, the Surgeon-General fur nishes the following interesting infor mation : “ January 1, 1921, may well be taken as the date from which to calculate the increases in efficiency that have been
made in the Dental Corps of the Navy. During the several years from the estab lishment of the Dental Corps in 1912 until our entry in the World War, dental service in the Navy was in what might be termed a trial or experimental stage. The war was epoch-making for den tistry; its advent brought about an enor mous expansion in the field of that branch of the healing art, and conse quently a general recognition of the value and importance of dentistry in the Naval Establishment, together with an expansion in the size of the Dental Corps. However, such conditions did not make for permanent efficiency. The greatest item of improvement in admin istrative efficiency has been the estab lishment of the Dental Division in the Bureau of Medicine and Surgery. This division, as organized, places all dental activities which are necessarily intercor related under a single head. As now arranged, the Dental Division with an officer of the Dental Corps in charge, has supervision over all matters con cerning the Dental Corps, the details of its administration, including the assign ment and transfer of dental officers, the care of dental property, the supervision of reports and returns, the inspection of dental activities, and so forth, all of which had hitherto been handled in various divisions of the bureau in con junction with the routine administration of other medical department activities. “ The establishment of the Dental Division of the Bureau of Medicine and Surgery is a source of considerable sat isfaction to both medical and dental officers, as the former are relieved of some of their responsibility in purely dental affairs, and the latter are greatly encouraged by having a member of the Dental Corps detailed to care for their technical needs. “ The Navy Dental School opened February 3, 1923, as the dental depart ment of the United States Naval Medi cal School. Its purpose is to furnish
Dental Corps, U. S. N avy
postgraduate instruction in dental med icine to officers of the Dental Corps of the Navy and to train and equip men of the Hospital Corps as assistants to den tal officers. Instruction is given in two courses of four months each, commenc ing in February and September. “ The establishment of the school is the result of a recognition of the value of dentistry in the Navy as a factor in the preservation of the health of the person nel and an appreciation of the impor tance of furnishing the very best dental service that the profession affords. “ The school is located on the grounds of the United States Naval Hospital, at Washington, D. C., in a building devoted to other uses during the War, which has been remodeled and equipped to meet the requirements of the instruc tion given. “ The situation of the dental school, in close proximity to the main building of the United States Naval Medical School, is such that its students have the benefit of instruction in basic medical subjects at the medical school proper. These subjects are taught by the officers of the medical school faculty in con nection with the instruction given to medical officers of the regular class. The facilities of the medical school proper are at the disposal of student dental officers, and the joint instruction in bac teriology, medical diagnosis, and similar subjects, is invaluable. “ The dental school has a threefold function. In addition to the instruc tion offered, the institution provides a working laboratory for the construction of special prosthetic appliances which are being gradually introduced as a part of the dental service furnished by the Navy. The third function of the school is to supply dental service to the' United States Naval Hospital, Washington. “ An important department of the school is the prophylactic clinic, where enlisted men of the Hospital Corps are trained as dental hygienists. Upon the
205
completion of a thorough course of in struction, these men are assigned to duty with and work under the supervision of dental officers. “ An important innovation in the den tal service became effective with the establishment of the Navy Dental School, through the adoption of a plan for extending to the officers and men of the Navy the benefits of certain pros thetic procedures. “ In the interests of efficiency and economy, an endeavor has been made to consolidate all dental activities of the larger stations into one central clinic, with an experienced dental officer in charge, and in all cases this has resulted in a considerable saving of supplies and equipment, and a more efficient dental service. “ A larger proportion of dental officers has been maintained at naval training stations than at other places, as it is con sidered especially desirable to make recruits as near dentally fit as possible during their early period of training. “ A system of inspection of the dental activities of the Navy by dental officers was put into effect during the fiscal year, 1923, and the results obtained are most encouraging. The reports of these in spections are a means of furnishing the bureau with information on the charac ter of treatment given, the condition of dental property, and other data which has heretofore been difficult to obtain. It has been found that these inspections do a considerable amount of good and that a number of satisfactory conditions can be traced directly to them. It is believed that they have a decidedly good effect on both efficiency and morale. “ A revision of the dental supply table was completed during the fiscal year 1922. Changes were made by adding many new items essential to the needs of recent developments in dentistry, and items no longer considered necessary were eliminated. Subsequent additions have been made and the allowance tables changed to meet the progressive
206
The Journal o f the American Dental Association
needs of dentistry. Small amounts of non-standard equipment have been bought and sent to selected stations for trial. “ In addition to the major activities that have been outlined above, the dental officer in the bureau, under the direction of the Surgeon-General, has been actively engaged with various unclassified proj ects pertaining to the Dental Corps. Important among these items during the past three years is the following: Prep aration and publication of a complete dental number of the United States Naval Medical Bulletin, which con tained a number of original articles on professional subjects by officers of the Dental Corps. “ As has been pointed out, the Dental Corps has made remarkable progress within the past three years, but it is not
desired to convey the impression that the dental service of the Navy has been developed to the point that is desired or considered necessary to provide all that is needed in the way of dental care and treatment for the personnel. The bureau has been greatly handicapped in carrying out its recently adopted pol icies in regard to dental treatment, by the shortage of dental officers. It is realized, however, that the matter of the size of the Dental Corps is something over which the Bureau of Medicine and Surgery has little control, while it is vitally interested and directly responsi ble for the character of dental service rendered. It is the Surgeon General’s earnest desire that the dental service of the Navy be made to keep pace with, if not lead, professional activities in civil life.”
DENTAL CORPS, U. S. ARMY* U RING the fiscal year ending June 30, 1924, the Dental Corps has functioned under the restrictions imposed by the loss of approximately one-third of its commissioned personnel by the Act of June 30, 1922. By this Act, the Dental Corps was reduced in numbers from 237 to 158. The latter number of dental officers were main tained on duty during the greater part of the year. For the period of this report, there were 129,219 persons treated; 236,333 sittings given; 86,469 permanent fillings, 17,041 temporary fillings and 6,119 root-canal fillings inserted; 1,168 crowns, 426 bridges and 1,936 dentures constructed; 40,834 extractions made; 25,354 patients given prophylactic treat ment (removal of calculus and polish
D
*Abstracted from Report of the SurgeonGeneral, U. S. Army, to the Secretary of War for the fiscal year 1'924.
ing of teeth); and 268 crowns, 589 bridges and 758 dentures repaired. Authorization was obtained from the War Department for calling five Dental Reserve Officers to active service for duty at certain Army hospitals engaged in the treatment of beneficiaries of the U. S. Veterans Bureau. Careful selec tion of such personnel was made, and the dental clinics of the following hos pitals were thus augmented by Reserve personnel as follows: Walter Reed Gen eral Hospital, Washington, D. C., one lieutenant; Fitzsimons General Hos pital, Denver, Colo., one captain and one lieutenant; Letterman General Hospital, San Francisco, California, one captain, and Station Hospital, Fort Sam Hous ton, Texas, one lieutenant. It has been found necessary to con tinue the objectionable itinerary service for the past year in order that com mands at the smaller stations might re ceive some dental service. Many dental