1942: Dentistry

War Dentistry.

Rejection of draftees for dental defects averaged 20.9 per cent, and in some localities reached 50 per cent. Accordingly the Army undertook to rehabilitate the dentally deficient after induction. Rejection for dental defects is now allowed only for gross dental infection, the correction of which would entail a long period of treatment and the provision of special diets for recruits.

Although there are 14,000 men under 37 years of age now in dental practice, it was found necessary to induct men up to 44 years, because of the number rejected for physical defects and on other grounds. However, with the assistance of the national Procurement and Assignment Service, and because of voluntary enlistments, in addition to Selective Service inductions, the need for dentists by the armed forces was met and commissions for dentists were discontinued for a number of months. Dental Commissions are now again available for men under 37 years of age.

Approximately 21 per cent of dental laboratory technicians have gone into the armed forces, while laboratory requirements of dentists have increased. It is estimated that the army will absorb less than 18 per cent of the dentists as against over 38 per cent of dental laboratory technicians, increasing the ratio to sixty-three dentists to each technician, against a pre-war ratio of seven dentists to each technician.

Prompt dental treatment and early evacuation of combat casualties have been found most essential. Methods of combatting shock, the use of sulfonamide compounds to eliminate infection, first aid and emergency treatment, the care of gas casualties, hemorrhage, and many other duties form an important part in the training of dental officers.

Treatment of wounds about the jaws, especially those involving bone fractures is now done almost altogether by dental surgeons who receive intensive training at leading dental schools.

Industrial and Civilian Dental Needs.

Dental health in industry came in for its share of attention along with the general effort for bettering health conditions among workers. The sudden shift of civilian population necessitated by the developments of war industries in formerly sparsely settled communities, plus the induction of dentists into the armed forces, resulted in a shortage of dentists in some localities.

Plans for meeting dental needs in these communities are being made now by the U. S. Public Health Service and the Procurement and Assignment Service of the War Powers Commission. This effort has received the cooperation of the War Service Committee of the American Dental Association, which is aiding the work through similar committees appointed by state and local dental societies. The attempt is being made also to prevent, treat and eliminate dental and oral diseases of occupational origin. An example of occupational effects on the teeth and mouth is found in a report of the U. S. Public Health Service which showed two-thirds of Utah metal mine, coal mine and smelter workers, from age 35 to 64 years, to show evidence of pyorrhea.

Dental Progress.

Reports of the leading endowed dental clinics show that so-called 'prevention' is in effect merely the early treatment of dental decay. True prevention was found to require consideration of the sequence and velocity of tooth eruption, the physiologic time for shedding the deciduous (baby) teeth and the restoration of the anatomic form of decayed teeth.

Silver nitrate, long employed by dentists as a means for arresting dental decay in the teeth of children, was shown by dental investigators of the U. S. Public Health Service in a controlled study to have no such effect. Teeth treated by silver nitrate decayed just as often as those not so treated. In another study it was shown that dental caries was more prevalent in communities whose water supply was free of fluorine than in other communities whose drinking water showed a fluorine content of 0.5 parts per million.

Vitamins and calcium were found to play an important role in dental development. Lesions of the lips, gums, tongue and buccal mucous membranes, characteristic of deficiency of vitamin C and of several members of the vitamin B complex, responded to specific therapy.

In the growing child vitamin D and calcium compounds were shown to be important in calcification of growing bones and teeth. Those obtained from foods rather than through medications seem to be better assimilated and retained. The physical character of food and the carbohydrate content of the diet play an important part in the production of caries — as does the lack of cleanliness, quality and quantity of saliva, bacteria, etc. Special vitamin or calcium compound therapy is not indicated in the prevention of caries.

'Speedup' in Dental Education.

Accelerated programs have been adopted by dental colleges for the period of the war. The term hours of instruction devoted to the dental course remain, as heretofore, within a range of 3,800 to 4,400 hours, with proper distribution over a three-year period. The number of students in the thirty-nine dental colleges was 8,355. This is an increase of 635 students over the previous year and is the largest number enrolled in any one year in the last fifteen years. Of the 732 hospitals approved by the American Medical Association for intern and residency training 152 employ dental interns.

Dental Materials and Priorities.

Dental materials have been made available as far as possible for dentists in civilian practice. The National Bureau of Standards, U. S. Department of Commerce, has published the results of 23 years of research on dental materials. This is destined to prove of immeasurable value to the practicing dentist. Among the materials discussed are dental alloys, including amalgam, mercury, gold and base metals, ceramics and cements. Included are also instructions on purchasing and testing materials and the standard Federal and American Dental Association specifications.

Dental plastics, notably acrylic resins, are more widely used than heretofore for filling teeth, in dental bridgework and in dentures, especially in view of the shortage of rubber for making vulcanite dentures. A Bill to make it unlawful to sell 'mail order dentures' has been passed by the House and is now before the Senate of the United States.