Articles and Papers

Dental Decay and Delay

By Major P A J Wright, formerly Grenadier Guards

As early as 1660 regimental surgeons were required to preserve soldiers’ teeth. Surgical chests included instruments for scaling, gum treatment and extraction. Grenadiers in particular had to have strong teeth to bite the cap off the fuse of the grenade before lighting it. Musketeers also needed their front teeth to pull the wooden cap off the powder cartridges before pouring the charge into their muskets. However, with the introduction of breech loading weapons, the need for healthy teeth was no longer so essential. Dental disease was not considered a problem by commanders who were far more concerned by epidemics, such as cholera or typhus, which could decimate an army.

When the Boer War started in 1899 dental decay was a major problem due to the increased consumption of sugar. Of 69,000 men inspected 4,400 were not accepted due to: “loss or decay of many teeth.” The British Dental Association ever since its formation in 1880 had been pressing the government for some form of dental treatment for soldiers, but the request fell on deaf ears. One solution was to ship out a consignment of mincing machines to make the biscuit and beef rations easier to chew. Field medical kits included four dental extraction pliers.

The debilitating pain of toothache and inadequate dental care are vividly described by Brevet Major the Hon A V F V Russell, Adjutant of the 3rd Battalion Grenadier Guards, in letters written to his mother. He arrived at Cape Town on 15 November 1899, was wounded at Belmont a week later and recovered to take part in the fighting at the Modder River and Magersfontein. On New Years Day 1900 he started the new century with toothache and a swollen face: “the same thing as I had at Pirbright some time ago. In the evening Profeit, the doctor, lanced the gum and I was alright although my gum was swollen.”

On 6 May 1901 he was again bothered with toothache: “These hard biscuits make one’s teeth break, and as mine have not been seen to for one and a half years it is not really to be wondered at that they become troublesome.” Four days later the pain was so bad that he rode into Colesberg where: “I bought some cocaine and obtained a blessed relief from my tooth, and so was able to have a very pleasant time. This euphoria did not last and on 13 May, as there was no dentist in Colesberg, he went again to the doctor: “who rammed a great thing into my gum and injected cocaine and morphine which caused instantaneous relief.”

In between operations against the Boers in July Russell managed to visit a dentist at Cradock with mixed results: “He said he must pull out three teeth; he gave me gas and I found he had only pulled out one; he said I struggled so under gas he could do nothing. So I told him to try without gas. He made four more unsuccessful attempts with every different kind of forceps and finally succeeded in smashing up the tooth completely.”

The next day he returned and the dentist pulled out another enormous molar without gas. Although he was assured that, apart from the broken tooth, the jaw was now in order he concluded: “I do not propose visiting the good gentleman again. I don’t somehow think he is a very good dentist.”

On the evening of 31 December 1901 he again had severe toothache and his face was swollen. He wrote: “Again I do not feel cheery. And tonight we are expected to march right out of one year into the next. This will be my second festive season which has gone unmarked.” Peace was declared on 1 June 1902 and in August Russell visited a dentist in Port Elizabeth to get his teeth seen to in the hope of returning to the Battalion: “with my teeth, I trust settled for some time.” Three weeks later on 11 September the Battalion embarked at Cape Town for home. Russell went on to become Assistant Military Attaché in Berlin from 1910 to 1914. He served in World War 1 and, despite his poor teeth, lived until 1966.

During the Boer War Frederick Newton Pedley, a dental surgeon and founder of Guys Hospital Dental School, was allowed to go out to South Africa at his own expense. His first surgery was a tent and he was overwhelmed by soldiers with dental problems. After six months he returned to England and, as a result of his report to the War Office, four dentists were contracted to treat the troops – the first paid dentists to serve the army on active service. Out of 208,000 men in South Africa 6,900 were admitted to hospital for dental reasons and about one third of these had to be sent home.

Now the problem was recognized, but it took a few more years for something to be done about it. There was much talk and various measures were adopted but, in August 1914, the British Expeditionary Force arrived in France without a single dentist. However, Major E R M Fryer, 3rd Battalion Grenadier Guards, wrote about Ypres in July 1917: “On 18th I had the interesting experience of being shelled in the dentist’s chair. This was at the Casualty Clearing Station near St Sixtes, which is a favorite target for naval gunners.” The Royal Army Dental Corps was not established until 1921.