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Oral diagnosis in the navy
ORAL
DIAGNOSIS
IN THE
LIEUTENANT S. T. KASPER (DC),
NAVY
U. S. N., NEW YORK, N. Y.
T
HE practice of dentistry in the Navy differs very little from your own private practice. Our problems are the same as yours. Until 1912 there was no organized dental service provided by the Navy. I shall attempt to give you a brief outline of the development of the Dental Corps since that time and of the progress that has been made in the dental service provided for the entire Navy personnel. Before 1912 a few dentists were permitted to enlist in the Navy in the highest enlisted grade. They provided regular dental care, but when gold was used for restorations they were allowed to charge for their services. This practice naturally led to abuses. In 1912 legislation was enacted providin g for the appointment of thirty Acting Assistant Dental Surgeons who were to become eligible for regular commissions after at least two years of probationary service. Dentistry in the Navy was thus placed on trial, and its future was to depend on the manner in which these pioneer dental officers conducted themselves and proved the value of their professional services to the Navy. On the whole the welcome which There was one notable exception. these dental officers received was satisfactory. The late Commander Leon Martin was one of our first officers to report for duty in a battleship. This was in 1914. When he reported aboard, the Captain of a dental officer! The Navy has gotten along the ship said to him, “Humph, for a hundred years without dental officers. We did not ask for you and we do not need you, but as long as the Navy Department has sent you, we will Dr. Martin was given an improvised dental office resting on the keep you. ’ ’ gratings over the laundry. In contrast to this reception, the following incident occurred in 1935, twentyone years later. The Admiral of the Special Service Squadron operating in the Canal Zone sent a dispatch to the Navy Department stating that if a dental officer could be assigned to his flagship, he would turn over his own office as space for a dental office. Since 1912 naval dentistry has proved its value and there has been an ever increasing demand for dental officers aboard ships. During this same period dental officers have progressively advanced in rank and at the present time a dental offleer may reach the rank of Captain. One of the questions often asked is: “Why has the Navy such high dental standards t ’ ’ To be accepted for enlistment an applicant must have a minimum of twenty vital, serviceable, permanent teeth, including four opposed molars, two of which are directly opposed on each side of the dental arch, and four directly opposed incisors. Another interesting requirement is that all men in submarine duty must have all their natural anterior teeth. This is necessary because in Oral
head at Diagnosis,
the Eighth Annual Congress in New York, 1941.
of
the
46
American
Society
for
the
Advancement
of
Oral Diagnosis using the Momson teeth.
in the Navy
escape lung a mouthpiece
must be firmly
47 gripped
bv the
AS YOU all know there is a rather high grade of rejection of candidates for the armed services, because of dental deficiencies. Especially has this been brought to the attention of the public since the army draft. In fact the number of rejections in the draft was so high that the original army standards hare been lowered. At one time a naval recruiting officer wrote the Navy Department protesting the high dental health standards required of applicants for enlistment. This letter was referred to Captain H. R. Harvey, then Chief of Dentistry for the Navy, Captain Harvey answered in part as follows: “To the professional eye missing teeth do not mean merely so many vacant spaces to be filled. These spaces have a much more profound significance, It, is the consensus of opinion that dental caries, which is the principal cause of the loss of teeth in youth, is a local manifestation of general malnutrition or of a metabolic disturbance. It so happens that dental caries may be t,he only visible evidence of nut.ritional unbalance, but it is only rea,sonable to suppose that other body tissues are also undernourished and hence less resistant to disease. The picture presented by the dental condition thus protrays to the critical observer the fundamental as t,o whether the body has been or is receiving adequate nntrit,ion without which abundant health and vigor do not exist,.” Another reason for high dental enlistment standards is to make it nnnecessary to provide immediate prosthetic replacement. Our prosthetic department is very much overloaded at all times. Funds are limited and space is not In postponing the time always available for a large prosthetic laboratory. when prosthetic treatment will be needed, the Navy saves time and money. We all know that once the int,egrity of the dental arch is interfered with, we may look forward to progressive dental complications. Therefore, in naval dentistry emphasis is placed on the prevention and elimination ,of future dental disease. This applies to t,he recruit who comes int,o a training station as well as to any enlisted man who seeks dental treatment. Since ships with a complement of 500 men do not carry dental officers, the prevention of possible future dental disorders is particularly important to men who serve on smaller ships. Consequently, partially erupted teeth, and especially erupted teet,h showing Chronic areas of infection are eliminated, gum irritation, must be treated. inflamed gums must be treated and cleared up. We know t,hat Vincent’s infection may develop in unhealthy mouths, and this may spread to other crew members in spite of the fact that, all eatin, v utensils and dishes are sterilized. Chronic irritation at the end of a pulpless tooth calls for immediat,e treatment because these conditions very often become acute under adverse circumstances, such as heavy work, mental strain, or bad climatic conditions. If a man has a weak spot, either physical or mental, the conditions under which t,he Navy is operat,ing today will certainly show it up. An interesting dental fault has come to life with the advent of high altitude Aviators have come down from these flights complaining of toothaches. flying. Upon close examination it was found t,hat the man had either a faulty restoration or a carious toot,h.
Lieutenant
S. T. Kasper
I noticed an interesting fact in China. In Hankow where the complement of men is small and the men therefore get frequent dental examinations, gum infections are very few as compared to Shanghai, where the complement of men is larger and it is impossible to provide the same supervision. The best prophylaxis of dental disorders is frequent examinations and immediate treatment. This is the field in which the Dental Corps is concentrating its greatest efforts. There are 372 regular dental officers and over 300 reserve dental officers on active duty. There is a great increase in the number of recruits passing through various training stations and the training period has been shortened due to the present emergency. Yet every recruit’s mouth is put in a healthy condition before he is sent to the fleet. If the work cannot be completed during the day the man is brought back at night. It is encouraging to note that an increasing number of the enlisted men come of their own volition for periodic examination and treatment. This is in contrast to the earlier days when men came in only if they had a toothache. All the many dental diseases and defects found point back to the fact that somewhere in the past the paGent has either neglected his teeth or was not in a position to get adequate dental care. The Navy recognizes the importance of diet in relation to general and dental health. On board every ship there are men who have studied dietetics and are able to plan well-balanced meals. Scurvy and deficiency disease have been entirely eliminated. Times have changed since the beginning of the Naval Dental Corps, and these changes are no doubt due to the fact that dental service is recognized not only as part of health service, but also as an important factor in morale. Pride in personal appearance plays a part and there is often a noticeable contrast between the well-cared-for teeth of our American sailors and those of foreign navies. Our Naval Hospitals have one to ten dental officers on duty working with the medical officers to return the patient to health. It is routine in Naval Hospitals to have a detailed examination of the oral cavity for foci of infection when a patient is admitted and a report is given to the Medical Officer. In order to uphold a high standard of dental treatment the Navy maintains its own postgraduate dental school in Washington, D. C., in order to bring up to date those men who have had isolated duty either on ships or distant stations. An additional function of the school is to indoctrinate its newly chosen dental officers into the ways and customs of the Navy. The officers under instruction in the Naval Dental School are brought up to date not only on the practical side of operative dentistry, crown and bridge, and prosthetics, but also in oral bacteriology, histology and histopathology. Any officer so inclined is given an opportunity to undertake research work, and a number of noteworthy contributions to the field of dental science have already resulted. With the business or economic angle removed, we join the Navy not only to see the world, but also to practice dentistry under ideal conditions. NOTE: The opinions or assertions contained in this article are the private opinions or assertions of the writer, and are not to be construed as official or reflecting the views of the Navy Department or the Naval Service at large. (Article 113, U. S. Navy Regulations.)
DIAGNOSIS
IN THE
LIEUTENANT S. T. KASPER (DC),
NAVY
U. S. N., NEW YORK, N. Y.
T
HE practice of dentistry in the Navy differs very little from your own private practice. Our problems are the same as yours. Until 1912 there was no organized dental service provided by the Navy. I shall attempt to give you a brief outline of the development of the Dental Corps since that time and of the progress that has been made in the dental service provided for the entire Navy personnel. Before 1912 a few dentists were permitted to enlist in the Navy in the highest enlisted grade. They provided regular dental care, but when gold was used for restorations they were allowed to charge for their services. This practice naturally led to abuses. In 1912 legislation was enacted providin g for the appointment of thirty Acting Assistant Dental Surgeons who were to become eligible for regular commissions after at least two years of probationary service. Dentistry in the Navy was thus placed on trial, and its future was to depend on the manner in which these pioneer dental officers conducted themselves and proved the value of their professional services to the Navy. On the whole the welcome which There was one notable exception. these dental officers received was satisfactory. The late Commander Leon Martin was one of our first officers to report for duty in a battleship. This was in 1914. When he reported aboard, the Captain of a dental officer! The Navy has gotten along the ship said to him, “Humph, for a hundred years without dental officers. We did not ask for you and we do not need you, but as long as the Navy Department has sent you, we will Dr. Martin was given an improvised dental office resting on the keep you. ’ ’ gratings over the laundry. In contrast to this reception, the following incident occurred in 1935, twentyone years later. The Admiral of the Special Service Squadron operating in the Canal Zone sent a dispatch to the Navy Department stating that if a dental officer could be assigned to his flagship, he would turn over his own office as space for a dental office. Since 1912 naval dentistry has proved its value and there has been an ever increasing demand for dental officers aboard ships. During this same period dental officers have progressively advanced in rank and at the present time a dental offleer may reach the rank of Captain. One of the questions often asked is: “Why has the Navy such high dental standards t ’ ’ To be accepted for enlistment an applicant must have a minimum of twenty vital, serviceable, permanent teeth, including four opposed molars, two of which are directly opposed on each side of the dental arch, and four directly opposed incisors. Another interesting requirement is that all men in submarine duty must have all their natural anterior teeth. This is necessary because in Oral
head at Diagnosis,
the Eighth Annual Congress in New York, 1941.
of
the
46
American
Society
for
the
Advancement
of
Oral Diagnosis using the Momson teeth.
in the Navy
escape lung a mouthpiece
must be firmly
47 gripped
bv the
AS YOU all know there is a rather high grade of rejection of candidates for the armed services, because of dental deficiencies. Especially has this been brought to the attention of the public since the army draft. In fact the number of rejections in the draft was so high that the original army standards hare been lowered. At one time a naval recruiting officer wrote the Navy Department protesting the high dental health standards required of applicants for enlistment. This letter was referred to Captain H. R. Harvey, then Chief of Dentistry for the Navy, Captain Harvey answered in part as follows: “To the professional eye missing teeth do not mean merely so many vacant spaces to be filled. These spaces have a much more profound significance, It, is the consensus of opinion that dental caries, which is the principal cause of the loss of teeth in youth, is a local manifestation of general malnutrition or of a metabolic disturbance. It so happens that dental caries may be t,he only visible evidence of nut.ritional unbalance, but it is only rea,sonable to suppose that other body tissues are also undernourished and hence less resistant to disease. The picture presented by the dental condition thus protrays to the critical observer the fundamental as t,o whether the body has been or is receiving adequate nntrit,ion without which abundant health and vigor do not exist,.” Another reason for high dental enlistment standards is to make it nnnecessary to provide immediate prosthetic replacement. Our prosthetic department is very much overloaded at all times. Funds are limited and space is not In postponing the time always available for a large prosthetic laboratory. when prosthetic treatment will be needed, the Navy saves time and money. We all know that once the int,egrity of the dental arch is interfered with, we may look forward to progressive dental complications. Therefore, in naval dentistry emphasis is placed on the prevention and elimination ,of future dental disease. This applies to t,he recruit who comes int,o a training station as well as to any enlisted man who seeks dental treatment. Since ships with a complement of 500 men do not carry dental officers, the prevention of possible future dental disorders is particularly important to men who serve on smaller ships. Consequently, partially erupted teeth, and especially erupted teet,h showing Chronic areas of infection are eliminated, gum irritation, must be treated. inflamed gums must be treated and cleared up. We know t,hat Vincent’s infection may develop in unhealthy mouths, and this may spread to other crew members in spite of the fact that, all eatin, v utensils and dishes are sterilized. Chronic irritation at the end of a pulpless tooth calls for immediat,e treatment because these conditions very often become acute under adverse circumstances, such as heavy work, mental strain, or bad climatic conditions. If a man has a weak spot, either physical or mental, the conditions under which t,he Navy is operat,ing today will certainly show it up. An interesting dental fault has come to life with the advent of high altitude Aviators have come down from these flights complaining of toothaches. flying. Upon close examination it was found t,hat the man had either a faulty restoration or a carious toot,h.
Lieutenant
S. T. Kasper
I noticed an interesting fact in China. In Hankow where the complement of men is small and the men therefore get frequent dental examinations, gum infections are very few as compared to Shanghai, where the complement of men is larger and it is impossible to provide the same supervision. The best prophylaxis of dental disorders is frequent examinations and immediate treatment. This is the field in which the Dental Corps is concentrating its greatest efforts. There are 372 regular dental officers and over 300 reserve dental officers on active duty. There is a great increase in the number of recruits passing through various training stations and the training period has been shortened due to the present emergency. Yet every recruit’s mouth is put in a healthy condition before he is sent to the fleet. If the work cannot be completed during the day the man is brought back at night. It is encouraging to note that an increasing number of the enlisted men come of their own volition for periodic examination and treatment. This is in contrast to the earlier days when men came in only if they had a toothache. All the many dental diseases and defects found point back to the fact that somewhere in the past the paGent has either neglected his teeth or was not in a position to get adequate dental care. The Navy recognizes the importance of diet in relation to general and dental health. On board every ship there are men who have studied dietetics and are able to plan well-balanced meals. Scurvy and deficiency disease have been entirely eliminated. Times have changed since the beginning of the Naval Dental Corps, and these changes are no doubt due to the fact that dental service is recognized not only as part of health service, but also as an important factor in morale. Pride in personal appearance plays a part and there is often a noticeable contrast between the well-cared-for teeth of our American sailors and those of foreign navies. Our Naval Hospitals have one to ten dental officers on duty working with the medical officers to return the patient to health. It is routine in Naval Hospitals to have a detailed examination of the oral cavity for foci of infection when a patient is admitted and a report is given to the Medical Officer. In order to uphold a high standard of dental treatment the Navy maintains its own postgraduate dental school in Washington, D. C., in order to bring up to date those men who have had isolated duty either on ships or distant stations. An additional function of the school is to indoctrinate its newly chosen dental officers into the ways and customs of the Navy. The officers under instruction in the Naval Dental School are brought up to date not only on the practical side of operative dentistry, crown and bridge, and prosthetics, but also in oral bacteriology, histology and histopathology. Any officer so inclined is given an opportunity to undertake research work, and a number of noteworthy contributions to the field of dental science have already resulted. With the business or economic angle removed, we join the Navy not only to see the world, but also to practice dentistry under ideal conditions. NOTE: The opinions or assertions contained in this article are the private opinions or assertions of the writer, and are not to be construed as official or reflecting the views of the Navy Department or the Naval Service at large. (Article 113, U. S. Navy Regulations.)