AMEDD Corps History > U.S. Army Dental Corps > United States Army Dental Service in World War II
Administration of the Dental Service
WORLD WAR I
Until World War I, no representative of the Dental Corps had been assignedfor duty in The Surgeon General's Office (SGO). The affairs of the DentalCorps prior to this time had been administered as part of the routine workof the Personnel Division, SGO. However, on 9 August 1917 the Dental Sectionof the Personnel Division was organized, and Major William H. G. Logan,MC, was appointed as its first chief. Major Logan, who later became colonel,had both the D.D.S. and M.D. degrees. The Dental Section became the DentalDivision on 24 November 1919.1 2
The following dental officers have served as Chief of the Dental Sectionor Director of the Dental Division, SGO, from 1917 to 1942:
Colonel W. H. G. Logan | 1917-1919 |
Lieutenant Colonel F. L. K. Laflamme | 1919 |
Colonel Robert T. Oliver | 1919-1924 |
Colonel R. H. Rhoades | 1924-1928 |
Colonel J. R. Bernheim | 1928-1932 |
Colonel R. H. Rhoades | 1932-1934 |
Colonel Frank P. Stone | 1934-1938 |
Brigadier General Leigh C. Fairbank3 | 1938-1942 |
WORLD WAR II
Dental Division, SGO
During World War II, Army regulations prescribed that "mattersrelating to the dental service as a whole are administered by The SurgeonGeneral with the advice and assistance of the Dental Corps assistant toThe Surgeon General." In 1939 the duties of the Director of the DentalDivision were described as follows: 4
The Dental Corps assistant to The Surgeon General willserve as the Chief of the Dental Division of The Surgeon General's Officeand will be responsible to that officer
1Lynch, C., et al.: The Medical Departmentof the U. S. Army in the World War. Washington, Government Printing Office,1923, vol I, p. 191.
2Logan, W. H. G. : The development of the dental service ofthe United States Army in this country from 8 Apr 17 to 12 Feb 19. J. Am.Dent. A. 20: 1951-1959, Nov 1933.
3The rank of brigadier general in the Dental Corps was authorizedby Public Act 423, 75th Congress, 29 Jun 38.
4AR 40-15, 20 Apr 39.
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for the recommendation of plans and policies for the progressivedevelopment of the dental service, with special reference to measures forthe preservation of the general health of the Army by the prevention andcontrol of dento-oral diseases and deficiencies among persons subject tomilitary control; for advising measures to place approved plans and policiesinto effect; and for giving technical advice to The Surgeon General onall matters pertaining to the dental service.
The Director of the Dental Division,5 as an adviser to TheSurgeon General, thus had no formal authority in his own right. His recommendationswere subject to The Surgeon General's approval and he could not presenthis views directly to higher officers. But while the Director of the DentalDivision exercised very little legal authority over the operation of theDental Service, his advice on purely dental-questions was accepted so routinelythat from a practical point of view he enjoyed a substantial measure ofactual control over the Dental Corps and its activities (figs. 1, 2, and3).
The decision of the Director of the Dental Division was therefore generallyaccepted on the following matters which were, of little concern to otheragencies:6
1. The assignment of individual dental personnel to subordinate majorcommands. [He could not, however, control the assignment of dentists tospecific posts or duties within those commands except in the few installationsdirectly under the control of The Surgeon General.]
2. The selection of items of dental supply for listing in the medical supplycatalog.
3. The development of courses of training for dental personnel, withintime limits prescribed by higher authority.
4. The establishment of professional standards of dental treatment.
5. Professional requirements for commission in the Dental Corps.
6. Types of treatment to be authorized.
However, as a subordinate of The Surgeon General the Director of theDental Division could exercise no powers not enjoyed by The Surgeon Generalhimself, and the latter's authority was by no means unlimited. The SurgeonGeneral exerted great influence in those matters which concerned the MedicalDepartment, but he had to defend his proposals against opposition fromother interested officials, and the right of final decision remained withthe executive branch in the person of the Commanding General, Army ServiceForces; the Chief of Staff or the Secretary of War. Thus when The SurgeonGeneral
5The Director of the Dental Division at thestart of the war and during the early mobilization period was Brig Gen.Leigh C. Fairbank. At the end of his tour of duty on 17 Mar 42, GeneralFairbank was succeeded by Brig Gen. Robert H. Mills. The latter was promotedmajor general on 7 Oct 43, becoming the first dental officer to hold thatrank. When General Mills retired on 17 Mar 46 his responsibilities forpostwar policies and development were assumed by Brig Gen. Thomas L. Smith(later Maj Gen.) who had been dental surgeon of the European theater duringthe combat period.
6The practical authority of the Director of the Dental Divisionwas based on custom rather than upon statute, and its extent is thereforea matter of opinion, not subject to documentation. The statements madehere are based on personal conferences with Major General Mills and withmost of the other senior dental officers who served in the Dental Divisionduring the war.
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Figure 1. Brig. Gen.Leigh C. Fairbank, Director, Dental Division, 17 March 1938-16 March 1942
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Figure 2. Maj. Gen.Robert H. Mills, Director, Dental Division, 17 March 1942-16 March 1946
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Figure 3. Brig. Gen.Thomas L. Smith, Director, Dental Division, 17 March 1946-20 April 1950
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recommended, on the advice of the Director of the Dental Division, thatdental officers be furnished tactical units in a ratio of 1 officer foreach 1,000 men, he was overruled when tactical officers convinced the Chiefof Staff that such action would add too much to the noncombat overheadof the fighting commands. Similarly, the recommendations of the Directorof the Dental Division were given serious consideration, though not alwaysaccepted, on the following matters which affected the Dental Service:
1. Dental standards for military service.
2. Personnel requirements for the Dental Service.
3. Tables of organization and equipment for dental installations.
4. Dental reports and records.
5. Plans for dental installations.
6. Personnel authorized to receive dental care.
When the United States entered the war, the Director of the Dental Division,then a brigadier general was responsible directly to The Surgeon General.He was assisted by a. staff of 5 officers and 8 civilian employees. TheDental Division was divided into sections for Finance and Supply, MilitaryPersonnel, Plans and Training, and Statistics, with the following assignedresponsibilities:7
Executive Officer:
a. Supervision of mail and records.
b. Review and recommendations of action on inspection reports.
c. Selection and assignment of dental interns.
d. Coordination of subdivisions of the Dental Division.
Finance and Supply:
a. Recommendations on selection and distribution of dental equipmentand supplies.
b. Recommendations on matters pertaining to construction and alterationof dental installations.
c. Recommendations on claims for dental attendance.
Military Personnel:
a. Initiation of recommendations to the Personnel Division, SGO,for assignment and transfer of dental personnel.
b. Transcription and review of efficiency reports.
c. Classification of personnel. d. Review of applications for commissionin the Dental Reserve Corps.
e. Examination of models of teeth and decisions as to dental qualifications.
70rganization of the Dental Division duringthe war was very informal and subject to change on short notice in accordancewith the number and experience of the assigned personnel. Three days afterthis organization was outlined Brig Gen. Leigh C. Fairbank described fivesections in the Dental Division: (1) Personnel, (2) Professional Service,(3) Plans and Training, (4) Statistical, (5) Miscellaneous.
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Plans and Training:
a. Preparation of manuals and films for training dental servicepersonnel.
b. Preparation of administrative regulations pertaining to the DentalService.
Statistics:
a. Collection of historical data on organization and functioningof the Dental Service.
b. Review of articles for publication and editing of Army DentalBulletin.
c. Review of professional reports.
d. Tabulation of statistical data.
By 30 June 1942 the staff of the Dental Division had reached its maximumstrength of 7 officers (including the Director) and 13 civilian employees.The internal organization of the Division underwent. several changes duringthe war, but they were of a minor nature.8
With the reorganization of the Army in March 19429 all serviceand supply branches were placed under a newly formed "Services ofSupply" (SOS), later called "Army Service Forces; (ASF). Underthis plan The Surgeon General was made responsible to the Commanding General,SOS, rather than to the Chief of Staff, and medical affairs had to be clearedthrough ASF headquarters. Major dental policies therefore had to be passedupon by (1) The Surgeon General, (2) the Commanding General, ASF, and (3)the General Staff, before they could be made effective. The formation ofASF also proved to be the first step in a general decentralization of authorityto the corps areas (later the service commands), a policy which ultimatelyaffected the operation of the Dental Division to a marked degree. Previously,The Surgeon General had had considerable control over the field performanceof medical activities, including the immediate supervision of general hospitalsand the privilege of assigning personnel to specific installations. Inthe Annual Report of Army Service Forces for 1943 it was stated that "Withthe creation of the Service Commands in July 1942, the Administrative Services,for the most part, ceased to have direct control over the field performanceof their particular activity. Instead, responsibility ... was investedin the hands of Service Commanders."10 The Surgeon Generalwas thus limited to prescribing general policies for the Medical Department,the application of which became the responsibility of service commanders.The control of general hospitals was delegated to the service commandsin August 1942.11
8Final Rpt for ASF, Logistics in World WarII. HD: 319.1-2 (Dental Div).
9WD Cir 59, 2 Mar 42.
10Annual Report of the Army Service Forces for the fiscal year1943 (cited hereafter as Annual Report . . . Army Service Forces).
11AR 170-10, par 6, 10 Aug 42.
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The service commands were also given increasing authority over personnel.The system of "bulk allotment," in particular, practically endedany control The Surgeon General or the Dental Division might have exercisedover the assignment or promotion of dental officers within the servicecommands. This system has been described as follows:12
Under the system a . . . Service Commander is allotteda total number of officers, nurses, warrant officers, WAAC officers, enrolledwomen, and enlisted men, restricted only as to percentage in grade, orin small installations, numbers in grade.... It removes restrictions uponthe distribution of grades among the personnel of the several arms or services,while preserving the limitations upon the distribution of grades withinthe total organization.
This policy of decentralizing the control of personnel to the servicecommands relieved the Dental Division of much routine detail which couldbe handled more efficiently locally, but it also made the correction ofinequities more difficult when these were found to exist.
On 26 March 1942, the Dental Division was redesignated the "DentalService."13 This change was mainly a "paper transaction"and had no appreciable effect on the operations of the Dental Corps. On1 September 1942, however, a modification was announced which had morefar-reaching results. Up to this time the Dental Division had been an independentbranch of the Office of The Surgeon General, and its director had had directaccess to that official. Now the Dental Service was placed, with a numberof other medical specialties, under a newly organized Professional Servicesgroup. The Director of the Dental Division no longer had direct accessto The Surgeon General, and all the many decisions affecting some 15,000officers had to be passed on by at least three higher officers, and usuallyfour, before they could be put into effect.14 This was not analtogether new experiment since the Dental Division had been placed underProfessional Services in 1931,15 but it had been found advisableto restore its independent status in 1935.16 The Director ofthe Dental Division stated that during the war "The Dental Corps experiencedgreater administrative difficulties while under Professional Service, sinceall recommendations and activities had to be cleared through that Serviceto The Surgeon General. Such clearance through Professional Service requiredtoo much time when time was at a premium."17 The DentalDivision was restored to its independent status on 25 August 1944.18
The Director of the Dental Division claimed repeatedly that there wasgreat need for representation by dental officers in other divisions ofthe SGO dealing with matters affecting the Dental Service. He stated that"The
12ASF Cir 39, 11 Jun 43.
13Annual Report . . . Surgeon General, 1942. Washington, GovernmentPrinting Office, 1942.
14SG OO 340, 1 Sep 42.
15Annual Report . . . Surgeon General, 1932. Washington, GovernmentPrinting Office, 1932.
16Annual Report . . . Surgeon General, 1936. Washington, GovernmentPrinting Office, 1936.
17See footnote 8, p. 28.
18SG OO 175, 25 Aug 44.
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Dental Corps ... is vitally interested in all personnel problems, allsupply problems, all operations and planning, as well as all training problems,"and he recommended that dental. officers be placed in the divisions occupiedwith these activities.19 Under the stress and confusion of wartimeit was very difficult to keep informed of impending actions or changesof policy unless close liaison were maintained. A dental officer was actuallyassigned to the Supply Division from November 1942 to March 1943.20Later, in May 1943, representation was established in the Military PersonnelDivision and continued for the duration of the war.
DENTAL ADMINISTRATION IN CORPS AREAS
(SERVICE COMMANDS)
The administrative status of the senior dental officer in a corps area(service command after 22 July 1942) was analogous to that of the Directorof the Dental Division in the War Department. The corps area commanderhad full executive authority, while the surgeon was his adviser on mattersconcerning the Medical Department. The dental surgeon was, in turn, chargedwith furnishing "advisory and administrative assistance to the corpsarea surgeon on matters pertaining to the dental service in the corps area."21 Specifically, he made recommendations concerning allotmentsand assignment of enlisted men and officers, the proper issue and use ofdental supplies, the adequacy of contemplated construction of dental facilities,the training program for dental officers and enlisted personnel, and thepublication of orders concerning the Dental Service. The corps area dentalsurgeon could not issue orders in his own name, but submitted his problemsto the corps area commander through the surgeon.
Like the Director of the Dental Division in the SGO, the corps areadental surgeon exercised considerable influence over the actual operationof the Dental Service in spite of formal limitations on his authority.His recommendations were normally accepted without question in respectto:22
1. The assignment of officers to subordinate installations, within theauthorized total strengths.
2. The authorization of equipment and supplies for dental installations.
3. The operation of central dental laboratories and the dental servicesof general hospitals.
4. The construction of dental facilities.
19See footnote 8, p. 28.
20WD SO 300, par 10, 4 Nov 42.
21See footnote 4, p. 22.
22Statements concerning the powers of corps area dental surgeonsare of course not applicable to all service commands at all times. Somedental surgeons enjoyed greater authority, some less. The summary givenhere represents only the combined opinions of many senior dental officersinterviewed during the war.
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5. Directives concerning clinical treatment.
His advice concerning the following was considered seriously, but notnecessarily accepted if opposed by other staff divisions:
1. Total requirements for enlisted and commissioned personnel.
2. Allotments of personnel for training.
3. The promotion of dental officers.
At the start of the war general hospitals were operated directly underThe Surgeon General, but after August 1942 they became the responsibilityof the service command surgeon, and the service command dental surgeonexercised more or less direct control over their dental services.23Central dental laboratories were operated under corps area and later, servicecommand, supervision during the entire war.
Prior to October 1940 the duties of corps area dental surgeons wereperformed, in addition to their normal functions, by senior dental officersassigned in the vicinity of corps area headquarters,24 thoughit was provided that full time officers would be assigned in time of war.Dental surgeons were specifically assigned to the corps areas beginningin October 1940, and a revision of Army regulations in December 1942 providedfor routine peacetime assignment of service command dental surgeons.25
The Director of the Dental Division believed that service command dentalsurgeons were somewhat hampered by their lack of direct contact with otherstaff divisions. They could present their views only through the surgeon,and they received only the information relayed to them by that officer.The Director of the Dental Division reported that service command dentalsurgeons were limited in their authority and that they had insufficientassistance to enable them to perform their office duties and at the sametime maintain the necessary supervision in the field.26
DENTAL SECTION OF THE AIR SURGEON'S OFFICE,
ARMY AIR FORCES27
Prior to 28 January 1942, dental affairs in the Office of the Air Surgeonhad been administered by the particular division most concerned, i. e.,personnel affairs by the Personnel Division, etcetera. On that date a DentalSection was established and Lieutenant Colonel George R. Kennebeck wasassigned as Deputy for Dental Service.28 The need for dentalrepresentation in the Office of the Air Surgeon had been pointed out bythe Dental Division in Sep-
23See footnote 11, p. 28.
24See footnote 4, p. 22.
25AR 40-15, 28 Dec 42.
26See footnote 8, p. 28.
27Kennebeck, George R.: Dental service of the U.S. Air Forces.Mil. Surgeon 101: 385-392. Nov 1947. (A more complete history of the AirForce Dental Service was (Jan 48) being written by Lt Col Walter J. Reuter.)
28WD SO 2, par 16, 2 Jan 42.
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tember 194129 but action was delayed by the opposition ofthe Air Surgeon himself.30 The new Dental Section assumed stafffunctions for that part of the dental service assigned to the Air Forcesnot in theaters of operations. The Dental Division, SGO, continued to prescribegeneral policies and procedures applicable to the Army Dental Service asa whole, but it no longer acted on those problems peculiar to the Air Force.The functions of the new division were specifically outlined as follows:
1. Review reports of dental activities with the Army Air Forces.
2. Review articles submitted by dental officers with the Army Air Forcesprior to publication in professional journals.
3. Initiate timely recommendations for changes in types and allowancesof dental supplies and equipment.
4. Make recommendations to the Officers' Section, Personnel Division, regardingassignment, reassignment, and promotion of dental officers with the ArmyAir Forces.
5. Exercise professional supervision over dental personnel with the ArmyAir Forces.
The Air Surgeon's Office did not directly control the dental serviceswith Air Force units in theaters of operation; these were under the supervisionof theater chief surgeons. However, Air Force commands in foreign theatersdid have dental staff officers who were responsible for the dental serviceof air units, under the theater chief surgeons. Dental personnel for theAir Force were commissioned by the Army and requisitioned as needed fromThe Surgeon General.
ADMINISTRATION OF THE DENTAL SERVICE
IN CAMPS AND STATIONS
In subordinate installations in the Zone of Interior the senior medicalofficer retained his status as adviser to the commanding officer, but heusually became commander of the hospital or dispensary as well, thus exercisingcontrol not only over the making of policies, but over their direct applicationat the operational level. The dental surgeon, on the other hand, did notbecome commanding officer of the dental clinic, and legally he continuedto enjoy only the right to make recommendations to the surgeon concerningthe dental service. In practice he might be delegated almost complete authorityby the latter, but such authority was a privilege, not a right, and itvaried widely in different installations.
The dental surgeon of a camp or station generally had reasonably effectivecontrol over the following activities:
29Memo, Brig Gen. Leigh C. Fairbank for SG,25 Sep 41, sub: Dental Service for the Air Corps. SG: 703-1.
30Memo, Col. David N. W. Grant for Exec Off SGO, 1 Oct 41, sub:Dental Service for the Air Corps. SG: 703-1.
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1. The assignment of dental enlisted and commissioned personnel to dutieswithin the dental clinic.
2. The supervision of treatment given. Army regulations provided that "exceptas otherwise prescribed herein, the selection of professional proceduresto be followed in each case, including the use of special dental materials,will be left to the judgment of the dental officer concerned."31
3. Initiation of requisitions for supplies for the dental service.
4. The conduct of dental surveys.
5. The technical training of personnel assigned to the dental service.
His recommendations were customarily given serious consideration inrespect to the following, but they were not always accepted, and underunfavorable circumstances they might practically be ignored:
1. Requirements for dental personnel or facilities.
2. Promotion of personnel assigned to the dental clinic.
3. Leave or furlough privileges for personnel of the dental service.
4. Efficiency reports on dental personnel.
The dental surgeon often had little to say about the following:
1. The use of clinic personnel for duties outside the dental clinic.
2. Training of dental personnel, outside of training rendered in the dentalclinic.
ADMINISTRATION OF THE DENTAL SERVICE,
ARMY GROUND FORCES
When the Army Ground Forces (AGF) was established in 1942 as a separatecommand of the Army no provision was made for a complete medical staff.A small division for Hospitalization and Evacuation was included in Headquarters,AGF, but it was expected that most medical functions would be performedby The Surgeon General. No dental officer was assigned to AGF headquarters.Under The Surgeon General, the Dental Division had authority to prescribepolicies for the entire Army, including AGF and Army Air Forces (AAF),but operation of the Dental Service for such a large part of the ArmedForces inevitably involved emergency situations requiring immediate action.Lack of liaison with AGF headquarters delayed solution of some of theseproblems and increased the difficulty of arriving at decisions based onfull and accurate information. An attempt was made to have a dental officerassigned to AGF in the spring of 1945, but it met with no success. TheDirector of the Dental Division later claimed that lack of liaison withAGF had hampered the Dental Service significantly.32
31AR 40-510, par 1, 19 Feb 40.
32See footnote 8, p. 28.
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ADMINISTRATION OF THE DENTAL SERVICE
IN A THEATER OF OPERATIONS33
A theater dental surgeon made recommendations to the theater chief surgeonconcerning plans and policies for the dental service of the entire area,including the Air Forces. He advised in respect to requirements for suppliesand personnel; he consolidated and forwarded dental reports for the theater;and he made the inspections required to assure a high standard of dentalcare in compliance with the directives of his own and higher headquarters.The theater dental surgeon was also, very often, the dental surgeon ofthe communications zone and in that capacity he supervised the operationof the hospital dental services in that communications zone, the dentaltreatment of service personnel, and the operation of central dental laboratories.
Theaters necessarily enjoyed considerable independence of action, andthe theater dental surgeon, under the chief surgeon, had a great deal offreedom in planning for the dental service, as long as personnel allotmentswere not exceeded and major regulations and policies were not violated.As in other headquarters, however, he was subordinate to the theater chiefsurgeon and he could act only with the approval of that officer.
33See chapter VIII.
