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AMEDD Corps History > U.S. Army Dental Corps> Walter D. Vail and the History of the U.S. Army Dental Corps

DENTAL BULLETIN SUPPLEMENT TO THE ARMY MEDICAL BULLETIN

VOLUME 6, NO. 4 (OCTOBER 1935)

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THE DENTAL CORPS*

(Continued from page-153, July 1935 issue).

The Surgeon General having stated “* * * I am open to conviction” concerning the advantages of granting commissions to dentists, Dr. John S. Marshall made the following reply under date of January 15, 1904:

“I have the honor to acknowledge the receipt. of your communication of January 4th, in which you state that my letter in regard to conferring rank and status upon the Contract Dental Surgeons, ‘does not quite make clear what compensating advantages from a commission, the Army dentist will gain, to make up for the two hundred dollars a year he will sacrifice in pay, or how the efficiency of the service will be promoted.’

“In replying to the first part of this question, I would state that from the standpoint of the Contract Dental Surgeon, I believe that the two hundred dollars which he would sacrifice in pay, would be made up to him through his right to commutation of quarters under a commissioned status, his right to forage, retirement for permanent disability or age, and in self-respect. As it now stands, the extra seventeen dollars per month is in lieu of all other emoluments, and works greatly to the disadvantage of the dental surgeons when they are so unfortunate as to be ordered to a post where there are no-available quarters, if they have to remain there for any considerable length of time. Also, many Army Dental Surgeons, if they were entitled to forage, would keep a horse for the sake of outdoor exercise, and I

*(NOTE.—This is the eleventh installment of a series of articles pertaining to the organization of the Dental Corps and the development of the Army dental service. These installments are a compilation of available records with such comment as is necessary to connect the record.—W.D.V.).

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know of no class of professional men who are in greater need of Such-daily exercise to maintain good health, for the cramped and contracted position of the chest, unavoidable while Operating, the close confinement, and the constant breathing of Vitiated and .foul air from standing over patients for so many hour’s each day, tends to produce bronchial and pulmonary diseases. Furthermore, the contract dental surgeon who loses his health in the service, has -no claims upon the Government, even for a pension, and as he has not the status of even an enlisted man, he could not claim admission to the Soldier’s Home, and must therefore, unless he has private means, become a public charge upon the community-from Which he entered the service. If, however, the Corps is placed upon a commissioned status in the regular service, this dreaded outlook is removed, and if he is permitted -to reach the age of retirement in the service, he has the satisfaction of knowing that a grateful country will provide for his declining years, as a reward for his years of service faithfully performed.

“In replying to the latter part of your question,- viz.: ‘or how the efficiency of the service will be promoted’, I would suggest, in addition to the remarks upon the subject upon pages nine and ten of my recent letter, that the efficiency of the service can, in my judgment, be greatly improved by placing the Corps, in all matters professional, under the supervision of qualified officers—qualified technically and of large experience in dental and oral surgery—appointed for that purpose by the Surgeon General.

“Up to the present time in the history of the Dental Corps, the only supervision which has been exercised by the Board of Examining and Supervising Dental Surgeons, has been over the professional examinations of applicants for appointments ; of special requisitions for articles not on the Supply Table; and in making up the Annual Reports Of the Corps for the Surgeon General.

“An occasional inspection into the character and quality of the services being rendered, from the technical standpoint, and also of the property of the Government in the keeping of the dental surgeons, would be of the greatest

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benefit to the Corps, by stimulating them to the highest efficiency. Neither the officers of the Inspector General's Department, the Medical Department, nor the officers of the line, can make such an inspection, which would be of any real value, unless they had been especially trained in the technique of dental and oral surgery, and I venture to say that there is not in the whole Army, an available officer with these qualifications, outside of the Dental Corps.

“In the Medical Corps, the young men are constantly under the supervision of officers of age and experience, but it is not so with the Dental Corps, as it is only in occasional instances, that a dental surgeon has been so placed that his services could be inspected by a member of the Board of Examining and Supervising Dental Surgeons, and I know from experience, that in these instances, it has had a most gratifying and stimulating effect upon these young officers, and the character of their service.

“The younger officers of the Medical Corps have also the fact before them that their promotion depends upon certain professional examinations, that must be passed with credit, in order to secure such advancement in rank, which keeps them up to their work, and stimulates them to studious habits.

“Under the present organization of the Dental Corps, there is no such incentive, and I fear that unless their status is improved, and some inducement is held out to them in the form or promotion after examination, that they will, after a time, become lax in their duties, and deteriorate in their professional knowledge and skill, thus lowering the present efficiency of the Corps, while others, who are ambitious, will become discouraged over their future prospects, and resign their positions.

“Dental surgeons of ordinary ability can do much better in civil practice than they can in the Army under a contract system, and many of the Army dental surgeons now realize this fact. The glamour of the quasi military position is wearing off, and some of them are becoming uneasy, and feel that unless something definite is done in relation to

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a commissioned status, their interests will force them- out of the service.

“The number of applicants, however, for these positions, is still very numerous, but the experience of the Examining Board proves that the great majority of the applicants who have. reported for examination, were utterly unqualified for the position to which they aspired, many of them men who had failed in civil practice.

“Trusting that I have so elucidated the points upon which you requested further information, that the arguments presented will carry conviction as to their soundness, I have the honor to remain, * *” (S.G.O. 70760-24).

The above letter was acknowledged and filed for future consideration (S.G.O. 70760-25).

On April 21, 1904, the Hon. E. W. Pettus, U.S. Senate, transmitted H. R. No. 79 to the Surgeon General for his opinion for use of military committee. The Surgeon General replied as follows:

“In reply to your note of today I think the bill mentioned by you should not pass because it is very carelessly and loosely drawn (for instance there is no such rank known in the Medical Department of the Army as ‘Passed Assistant Surgeon’). There is no proper provision for examinations; there is no limit on age at admission (which might result in the appointment of -men to the highest proposed rank and their retirement for age under the general law after a very short service).

“I have written and forwarded for the action of the Secretary of War certain suggestions in regard to legislation for the Dental Surgeons. These suggestions, if adopted, will substantially meet what I understand is the main point desired by the National Dental Association, that is, permanent tenure of office with proper rank, to be increased on length of service proportionate to that in the Medical Department of the Army.

“The present number of Contract Dental Surgeons, while not excessive, appears to be sufficient.

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“My letter on the subject is now in the hands of the Chief of Staff. If you care to see it permit me to suggest that you apply to General Chaffee for a copy. * *” (S.G.O. 106047-A-2).

The letter to the Chief of Staff referred to above reads as follows:

“In considering the Bill (HR. 79) organizing a dental corps composed of officers of various grades and with military rank, this office has hitherto taken the position that rank was not needed to further proper performance of the duty involving on a dental surgeon whose functions are strictly limited to the care &c. of the teeth of officers and enlisted men of the Army. Assurances are, however, given from credible and responsible sources that the possession of rank would result in giving better service than can be procured under the present contract system. This being the case, I have the honor to recommend that a bill be drawn to accomplish this purpose and that it be submitted to Congress for legislation action. The Bills referred to —which are now in Committee—are defective and should not pass.

“In my opinion, the Bill to be proposed should contain provisions to the following effect:

1. Prescribing age limit and professional qualifications.

2. Providing examining boards to determine physical fitness (a board of medical officers) and a dental board (to consist of one dental surgeon now in the military service, to be designated by the Secretary of War, and two dental surgeons nominated to the Secretary of War by the President of the .National Dental Association (who while so serving should be properly compensated), and without the recommendation of these two boards no one shall be appointed.

3. No more than five original appointments shall have the same date of commission. On-being commissioned they shall be entitled Dental Surgeons and shall rank as First Lieutenants. After five years service, those holding this grade who shall have passed a satisfactory physical and professional examination shall rank as Captain, and after an

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additional ten years service, shall, subject to a similar examination, rank as Major. The pay and allowances of Dental Surgeons shall be the same as those of a First Lieutenant, but their right to command should be absolutely limited to the Dental Surgeons and such enlisted men as may be detailed for duty with them, so as to prevent them from assuming command of hospitals.

4. The whole number of Dental Surgeons should not exceed thirty of whom three shall have the rank of Major, five with the rank of Captain and twenty-two the rank of First Lieutenant. (S.G.O. 106047-A-1).

The Surgeon General augmented the views expressed in the above memorandum in 2nd Ind., Dec. 17, 1904, which reads as follows:

“Respectfully returned to the Honorable, the Secretary of War, inviting attention to my letter of April 15, addressed to the Chief of Staff, in which my views are expressed in regard to the organization of the Dental Corps. In addition to the provisions in that letter, the Department is willing to add that 'dental surgeons attached to the Medical Department of the Army at the time of the passage of this act who have rendered satisfactory service for three or more years and who passed the required physical and professional examination and were within the age limit required by regulations at the time their original contracts were signed, may be eligible for appointment in the Dental Corps; provided that before being commissioned they shall pass the physical examination required by regulations of other candidates for commission in the Army.” (S.G.O. 106047-5, 6).

Various dental societies adopted resolutions favoring permanent status, rank, pay, etc., for dental surgeons in the Army. Some were forwarded to the Military Secretary, others to the Surgeon General, others to members of Congress, etc. All eventually were received in the office of the Surgeon General. (S.G.O. 106047).

On April 23, 1906, the Senate passed S. 2355, an Act of reorganize the Corps of dental surgeons attached to the Medical Department of the Army. This bill was referred to the House

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and under date of April 28,-1906, the Committee on Military Affairs reported favorably subject to specified amendments. The following is extracted from the committee’s report:

“The Committee on Military Affairs to whom was referred the bill (S. 23.55) to reorganize the corps of dental surgeons attached to the Medical Department of the Army, report the same back to the House with the recommendation that the bill be amended as follows:

* * *

“And that so amended the bill should pass and read as follows: An Act to reorganize the corps of dental surgeons attached to the Medical Department of the Army.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled.

* * *

This act provides for a corps of dental surgeons to be attached to the Medical Department of the Army, not to exceed forty-five in number, and giving the members of this dental corps commissions, and that when originally appointed under this act such dental surgeons shall have the rank of first lieutenant.

The bill requires that the appointees shall be citizens of the United States, between 22 and 30 years of age, graduates of standard American dental colleges, of good moral character and unquestionable professional repute, and shall be required to pass the usual physical examination and a professional examination which shall include tests in practical dentistry and proficiency in the usual subjects in a standard dental college course; but it also provides that dental surgeons attached to the Medical Department of the Army at the time of the passage of this act, provided they were within the age limit at the date of their original contract of service, may be eligible to appointment, three of them to the rank of captain and the others to the rank of first lieutenant on the recommendation of the Surgeon-General, and subject to the usual physical and professional examinations herein prescribed: Provided, That the professional examination may be waived in the case of dental surgeons whose efficiency reports and entrance examinations are satisfactory to the Surgeon-General; and the act also provides that the pay, allowances, and promotions of dental surgeons shall be governed

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by the laws and regulations applicable to the Medical Corps; and their right to command is limited to the members of the dental corps and such enlisted men as may be assigned to service under the dental corps, and their right to promotion shall be limited to the rank of captain after five years’ service and to the rank of major after ten years’ service: Provided, That the number of majors shall not at any time exceed one-eighth nor the number of captains one-third the whole number of such dental corps.

It is further provided that no one shall be appointed to the permanent corps until he has served satisfactorily one year as a contract dental surgeon.

The Surgeon-General is authorized to organize a board of examiners to conduct such professional examinations prescribed. It is also provided that the annulment of contracts made with dental surgeons under the act of February 2, 1901, shall be so timed and ordered by the Surgeon-General that the whole number of contract and commissioned dental surgeons rendering service shall not at any time be reduced below 30.

The injustice of the treatment of dental surgeons in the Army and Navy of the United States has been a matter of serious consideration in the Congress for several years, and for the last nine years the Surgeons-General of the Army have recommended ‘The organization of a dental corps on the lines suggested by this bill;’ and many distinguished general officers and other officers, in the field during the war especially, have noted the great importance of the work of dental surgeons. Colonel Maus, chief surgeon, says:

It was almost impossible to realize the great benefit which resulted to the troops from this department, located, as they were, in the field. Engagements were made as in civil life; and both dentists were kept busy from early morning to late in the night. I was informed by the dentist that he was unable to attend to half of the calls that were made on him.

In my opinion every corps should be provided with a dental department, consisting of one chief dentist with the rank of major, three dentists with the rank of captain, and three assistant dentists with the rank of first lieutenant.

Dr. Fitzgerald, and old army surgeon, stationed at Camp Ramsey during the Spanish war, reports:

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At least half of the trouble from which our men are suffering comes from the teeth.

Later on he wrote, having had some experience dental surgeons in the meantime:

In the treatment of gunshot wounds of the jaw I found the use of a dental surgeon of great assistance, and believe that the service would be rendered more efficient by the addition to its staff of a corps of well qualified dental surgeons.

Gen. Fred. Grant, in the Philippines, states the great importance of the work of the dental surgeons, and says:

I believe that there should be three dental surgeons assigned to this department if possible, but not less than two under any circumstances.

Brig. Gen. George M. Randall, from Luzon, in 1904, reports:

There are not enough dental surgeons in the department for the work required. The recommendation for an increased number is approved. In this connection I invite attention to the excellent results obtained in the health and comfort of men from the work of dental surgeons, and it is recommended that they be given permanent positions and commissioned rank in the Medical Department.

Col. George F. Chase, commanding the Twelfth Cavalry in the Philippines in 1904, reports and recommends the establishment of a corps of dental surgeons, with commissioned officers as members, and further:

I am convinced that a trained commissioned corps of dental surgeons would be a great improvement upon the present system, and would be an economical measure.

Again, in May, 1904, Col. Marion P. Maus reports, after showing the great importance of the work of dental surgeons:

I strongly urge legislation making a permanent corps of dental surgeons in number suited to the demands of the service, with permanent rank and pay.

The report of Surgeon-General O’Reilly, on the lines of whose recommendation this bill was drawn, and of the General Staff commend the service of the dental corps as “superior services, eminently satisfactory, and highly efficient.”

Gen. John C. Bates twice recommended an increase in the number of dental surgeons.

The following quotations are from reports which merit consideration in connection with this bill:

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(Extract from Surgeon-General Sternberg’s indorsement of Senate Bill 5420, April 29, 1902).

The dental surgeons appointed in accordance with the act of February 2, 1901, are rendering excellent service, and their services are highly appreciated by the officers and enlisted men of the Army. A larger number could be utilized to good advantage, and the permanent retention of dental surgeons as part of the military establishment will, in my opinion, be in the interest of the service. * * * I would suggest that the three dental examining surgeons be given the rank, pay, and allowances of a captain of infantry, and the other dental surgeons the rank, pay, and allowances of first lieutenant of infantry.

Surgeon-General Forwood in an annual report says:

The services of the dental surgeons have been highly appreciated by the officers and enlisted men and have proved very satisfactory to the Medical Department, because they have been able to relieve a great amount of acute suffering and to conserve a large number of teeth and restore them to a healthy condition, thus almost immediately returning to duty many cases that were previously carried for many days upon the company sick list. This has resulted in greatly reducing the loss of valuable time to the service incident to disease of the mouth, teeth, and jaws, and relieving and hastening the curing of such gastric and intestinal disorders as were due to defective mastication and infective and suppurative condition of the teeth and oral cavity. The cost of maintaining the dental corps is small when compared with the relief from suffering obtained and the greater efficiency of the officers and men who have received the services of dental surgeons. Good teeth are an essential factor in maintaining the health of the troops, and consequently their efficiency, and on account of the increased prevalence of dental caries and the abnormal condition growing out of that disease, the dental surgeon has become a necessity to the Army. Early provision should therefore be made for the establishment of a permanent corps of dental surgeons to the Medical Department.

Col. L. M. Maus, surgeon, U.S. Army, in reporting the result of an effort to meet, with an inadequate number of dental surgeons, the dental needs of a division of the Army, says:

It was almost impossible to realize the great benefit which resulted from this department, located, as they were, in the field. In my opinion every corps should be provided with a. dental department, consisting of one chief dentist with the rank of major, three with the rank of captain, and three with the rank of first lieutenant.

Major W. O. Owens, surgeon, U.S. Army, stated to the Senate Military Committee:

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For seven years I have been giving especial attention to the diseases of the mouth and teeth because of their influence on the general health. During the time in which I was in Charge of Corregidor hospital about three hundred soldiers, more or less disabled by dental disorders, were under treatment. I recall one case in particular, a diarrheal trouble of several months’ standing, which resisted treatment until placed under the care of a dentist, whose treatment, directed to the mouth alone, effected a cure and the restoration of the soldier to active duty in two weeks. There were fifteen or twenty similar eases, known as pyorrhea of the sockets of the teeth, with pus bathing the teeth, mixing with food, and entering therewith the alimentary tract. Neglected, such cases cause a pensionable disability.

Thomas S. Latimer, M.D., ex-army surgeon:

There can be no doubt that many soldiers were as effectually disabled by toothache, facial neuralgia, and other ailments, oral and gastric, due to lack of proper treatment, as from any other form of sickness or from gunshot wounds.

Precisely as the exhaustion, exposure, and unsuitability of food incident to an active campaign is the need of good masticatory organs. These being neglected or improperly treated, scurvy, dyspepsia, dysentery, and diarrhea are prone to ensue.

Nor is there any disability from any injury or sickness, even where not directly connected with imperfect mastication, that is not more protracted when mouth complications exist.

I need scarcely say that no ailments occasion greater suffering than toothache and neuralgia arising from decayed teeth; nor are any more susceptible of prompt and complete relief under proper management. I may add that the regimental surgeon is incompetent to render the Service required.

Major R. L. FitzGerald, when chief surgeon of the Eighth Army Corps, reported:

The distinguished Germany army surgeon, Bernhard von Langenbeck, referring to experience during the Franco-German war, says:

I would not like to again accompany an army in a campaign unless I had beforehand assured myself of having the assistance of technical specialists for cases of injury to the jaws and face. Every hospital practitioner of the present day has by his side a dentist, to whom

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he intrusts the treatment of fractures of the jaw, the prosthetic restoration after resections, etc.

__________

(Extract from the report of Gen. Fred D. Grant, Department of Texas.).

For the best interests of the service, some remarks are deemed necessary in regard to dental surgeons.

While the comparatively recent beginning of dental service in the Army makes the matter still one of an experimental nature only, opportunity has already been offered for sufficient observation to-warrant the conclusion, not only that the dental surgeons should be indefinitely continued, but largely increased, in order to meet the full demands of the service.* * * (Experience and statistics quoted).

In my opinion, after careful investigation, the principal needs of the service, with respect to dental surgeons, are: First, more dental surgeons; second, a suitable operating room at each post; third, some positive and practicable method compelling enlisted men to give proper attention to personal care of the teeth. I believe that there should be three dental surgeons assigned to this department, if possible, but not less than two under any circumstances.

(Extract annual report of Brig. Gen. George M. Randall, commanding Department of Luzon, 1904).

The chief surgeon reports: * * *

That there are not enough dental surgeons in the department for the work required. His recommendation for an increased number is approved. In this connection I invite attention to the excellent results obtained in the health and comfort of men from the work of dental surgeons, and it is recommended that they be given permanent positions and commissioned rank in the Medical Department.

The Military Secretary,

War Department, U.S. Army, Washington, D.C.

(Through military channels).

Sir: I have the honor to recommend that such action may be taken by constituted authority as may be deemed advisable leading to the establishment of a corps of dental surgeons with commissioned officers as its members. There are at present not enough contract dental surgeons to meet the demands of the service. The Twelfth Cavalry, now under my command, has no dental surgeon on duty with it, and has not had since July 1, 1904. The officers and men of the regiment are continually asking for authority to go to Manila for dental treatment, thus depriving the Government of their services and entailing upon them a considerable expense. My experience with troops in the past in isolated places with no means at all of dental treatment, and especially now in the Philippines, teaches me that the care of the teeth is as essential to the health and efficiency of troops as is the care of other

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portions of the body; in short, a man with bad teeth is almost sure to have bad general health in addition to great discomfort. The present system of employing dental surgeons is an excellent step in the right direction. I am convinced that a trained commissioned corps of dental surgeons would be a great improvement upon the present system and would be an economical measure.

Very respectfully,

Geo. F. Chase,

Lt. Colonel Twelfth Cavalry, Commanding

Regiment.

The Military Secretary,

War Department, Washington, D.C.

(Through military channels).

Sir: I have the honor to invite attention to the importance of dentists in the Army, especially at remote stations, in order that officers and enlisted men may have proper treatment.

While in command at Camp Marahui, Mindanao, certain officers, including myself, and a number of enlisted men suffered very much from the want of such service. Later, however, a dentist was provided, and great relief and benefit were realized.

There are times when the services of a dentist are as necessary as that of an army surgeon. From my experience in the service, including all parts of the United States and dependencies, I can testify to the importance of this branch of the service and to much suffering from want of it.

The dental surgeons that I have known are experienced and excellent men. I would strongly urge that their positions be made permanent, the number increased, and that they be given rank equal to that of assistant surgeons, they being in their profession fully as important. * * * I strongly urge legislation making a permanent corps of dental surgeons in number suited to the demands of the service, with permanent rank and pay.

I have the honor to be, very respectfully, your obedient servant,

Marion P. Maus,

Colonel Twentieth United States Infantry, Commanding.

While the Military Committee, in recommending the passage of the bill, have been guided by a purpose to meet an urgent need of the Army on sound business principles, it is nevertheless gratifying to your committee to incidentally accord a small measure of recognition to a profession whose members have contributed much to the public weal and to suffering mankind everywhere. (End of Committee Report).

(To be continued)