History of the Dental Branch

Author

A.N. Other

Subjects

Naval history

Tags

health, Dental

RAN Ships

None noted.

Publication

June 2012 edition of the Naval Historical Review (all rights reserved)

By Commodore Mike Dowsett, RAN (Rtd)

The Fledgling Royal Australian Navy obviously and sensibly inherited its traditions and organisation from the Royal Navy. However, some aspects were distinctly Australian and notably the creation of a uniformed Dental Branch was one. It resulted from the combined efforts of several Royal Navy officers with support from the dental profession, particularly the National Dental Association of Australia, itself in its infancy.

The first advocate for the provision of dental services for the RAN was Commander G.F. Hyde RN, the Commander of the Naval Depot at Williamstown, Victoria. In February 1911 he recommended that …consideration be given in the 1911-12 Estimates for the necessity of providing for the services of qualified Dental Surgeons at the principal depots so that Petty Officers and Men of the Permanent Naval Forces may obtain dental treatment at the lowest possible rates, if not entirely free of charge. At that time men made their own financial arrangements for treatment with approved dentists with the official advice and sanction of the medical officer. Subsequently the Naval Board set aside £500 of the total £2,500 in the 1911-12 medical estimates for dental treatment. The Naval Board requested the Minister for the Navy, at that time visiting the United Kingdom, to obtain information from the Admiralty concerning dental treatment in the Royal Navy. He reported that that there were twelve civilian dentists working in the Royal Navy on full-time duties in certain shore establishments. The first such appointments had been made in 1904. Some of those dental surgeons were required to go to sea with the Fleet from Portland during manoeuvres. No dental surgeons were appointed to foreign stations as men were not drafted for foreign service unless their teeth were in good order and …fit to stand the strain of a two years commission. However, if a man was in danger of being invalided home owing to illness caused by lack of teeth Commodores-in-Charge had the power to sanction treatment at public expense.

In May 1911 Commander C.I. Lewin RN was appointed to implement a boys’ training scheme along similar lines to that existing in the Royal Navy and the reform ship Tingira was purchased from the NSW Government for that purpose. Soon after his appointment Commander Lewin submitted a proposal for free dental treatment for the training ship. The first class of 37 boys joined Tingira in Sydney on 19th June 1912 and from the outset Mr Harding was appointed as Visiting Dentist to the ship, attending on board on three mornings each week. He had to supply his own instruments and materials and was limited to a scale of fees of 5/- (five shillings, $0.50) for each restoration and 1/6 (one shilling and sixpence, $0.15) for each extraction.

In July 1912 the Victorian State Council of the National Dental Association appointed a sub-committee …to formulate a scheme for the proper inspection and treatment of teeth in the Australian Army and Navy. About the same time, Commander Hyde, who had since been appointed as Commander of the Destroyer Flotilla, again urged free dental treatment for all personnel observing that …defective teeth are the most frequent cause of rejection of recruits and that after acceptance in many cases men are put to great expense in maintaining their teeth in an efficient condition, and that the Service suffers when a man deteriorates in general health through the lack of good teeth.

In August 1912 advertisements were placed for the appointment of a visiting dentist to HMA Naval Depot at Williamstown. The conditions of the appointment were that the successful applicant was required to attend at the depot each weekday from 10 am to midday, that he would supply his own instruments and materials, and that the scale of fees would be 5/- for each filling and 1/6 for each extraction. The advertisement prompted an immediate response from the Dental Graduates’ Society of Victoria claiming in a letter to the Secretary for the Navy that the fees were inadequate and suggested that a qualified dentist be appointed on a fixed salary as in the United States Navy. The Society had been aware that the United States Congress had passed an Act in August of that year that established the USN Dental Corps. Despite the Society’s fears there were four applicants for the position and in October Nathan Musther, who practised in Williamstown, was appointed in a temporary position, pending a review in six months.

First recorded survey

In the absence of a dentist specifically appointed to treat naval personnel in Sydney other than on board Tingira it was the practice to send men to the University Dental Hospital where they were given free treatment. Otherwise men were sent to Mr Harding in his suburban practice or to Dr Forster in the city, who had arranged to treat Naval patients at the same rates.

During 1912 Staff Surgeon A. Caw, who was serving in HMAS Encounter, had been in touch with Dr Philpotts of the State Dental Council of Victoria and put forward a recommendation for a full time dental surgeon working on board ships and in depots as required. He suggested that naval practice would give good experience to a young dentist who had just graduated and recommended that the appointment should be for four or five years with an advancing salary during that time. His proposal was in a letter to the captain of Encounter dated September 1912, which is interesting in itself in that it contains details of a survey of 90 members of the ship’s company, this being the first recorded survey of dental conditions in the RAN. In December 1912 Staff Surgeon H.J. Brennand, the District Naval Medical Officer in Sydney, observed that Harding’s monthly account averaged £30, ($60) …an amount which exceeds the salary of some of the senior officers of the ship which hardly seems reasonable. 

Treatment at Service expense

In March 1913 a Petty Officer from HMAS Protector was treated in Adelaide by a civilian dentist, having been referred by Staff Surgeon Morris, the District Naval Medical Officer. The subsequent account of £1/3/6 ($2.35) for two restorations and an extraction initiated an exchange of letters between Navy Office and the ship querying the necessity for the expenditure but being assured that the treatment was …essential for the man’s health…it was approved. However, the incident initiated the promulgation of a Navy Order in May 1913 that authorised dental treatment for officers and men of the Permanent Naval Forces at Service expense. Treatment was limited to extractions and amalgam fillings by the Visiting Dentist at Williamstown but Commanding Officers, when absent from Williamstown, could approve treatment in exceptional circumstances.

Following receipt of this Order, Surgeon F.J. Newman who was attached to the RAN College, temporarily located at Geelong pressed for its revision. He stated that there could be no comparison between gold and amalgam as far as aesthetics was concerned and recommended that officers and cadets be allowed to have gold fillings and bridgework. Newman’s proposal was forwarded to the Naval Board prompting the Second Naval member, Captain C. Hughes-Onslow RN, to comment that …Cadet Midshipmen have been thoroughly pampered with their pyjamas and tooth brushes being provided for them. It appears time their parents were called upon to pay something and a more desirable start could not be made than in regard to dentistry. The First Naval Member Rear Admiral Creswell, disagreed, being of the opinion that those at the College should have the same benefits as the men at Williamstown and the boys in Tingira. His views were endorsed by the Minister.

In April 1913 the Naval Board directed Staff Surgeon Darby to attend a meeting of the State Dental Council of Victoria which had been deputed by the National Dental Association of Australia to discuss the appointment of dental surgeons in the RAN. At that time Darby considered that there was insufficient work to warrant a permanent dentist because of the limited number of ratings serving in the RAN. In June 1913 the battle cruiser HMAS Australia and the cruiser HMAS Sydney commissioned in England and sailed for Australia.

Total strength of the RAN was then 3,400, including 900 on loan from the Royal Navy.

Full time dental officer

Late in October 1913 Staff Surgeon Brennand recommended that a small dental surgery be established on Garden Island in Sydney and that a full time dental officer be appointed on a fixed salary. In November 1913, shortly after the arrival in Australia of Australia, the Captain recommended that arrangements should be made for a dentist at each of the principal ports to undertake naval work generally at a fixed rate and that when possible it should be arranged that he could work on board each ship.

The outbreak of the First World War caused the consideration of the appointment of a uniformed dental officer to be set aside as the greater part of the Australian Fleet was away from Australia. Australian ships sought attention from Royal Navy sources when available. In the Royal Navy civilian dental surgeons serving at sea were granted temporary commissions in the Royal Naval Volunteer Reserve for the duration of the war. The training of boys in the RAN continued throughout the war with Mr R.A. Calder succeeding Mr Harding as the visiting dentist to Tingira in August 1914. The transfer of the Naval College to its new Jervis Bay site took place in February 1915 and in September 1915 Mr J.F. Bede Donovan began seeing patients at the College on two days in each week in a purpose built dental surgery. In March 1916 the backlog of dental treatment had been eliminated and, following the resignation of Bede Donovan, Mr M.J. Molony succeeded him attending on one day each week at a fee of £3/3/- ($6.30) per day. He was required to supply his own instruments and materials.

During 1915 the Medical Officer of Encounter examined the teeth of the ship’s company whilst enroute to Singapore and found that at least 50 ratings required immediate attention. He arranged a contract with a civilian dentist in Singapore to carry out the treatment. A renewed plea for an improvement in dental services was made in July 1916 by a Medical Board of Survey in Sydney. The Board had been convened to re-examine a potential boy seaman recruit that had been rejected for dental reasons although described overall as …a most superior type. His appeal for entry was unsuccessful in that the Board considered that it was inadvisable to pass boys who had very defective teeth as …the prospects of Dental Surgeons (Seagoing) being appointed to His Majesty’s Australian Warships are so remote. The Board further noted that …a great percentage of rejections of boys and men will be found necessary until this reform is instituted…at present any man with artificial teeth can buy himself out of seagoing service by breaking several plates.

A month later, Captain Cumberley of the cruiser Encounter observed that on his ship alone 113 were waiting for dental treatment. He pointed out the great waste of time experienced by men having to be sent to the city for treatment and advocated that the men should be treated at Garden Island. Staff Surgeon Sinclair recommended that the United Dental Hospital in Sydney, which was then being used by the Army, be used by Navy patients. Negotiations were commenced but at first the Army wished to take over the responsibility for the treatment of Navy personnel everywhere, both ashore and afloat.

Appointment of Surgeon Dentist

In December 1917 applications were called for the appointment of a Surgeon Dentist for service afloat in the RAN at a salary of £365 ($730) per annum. There were twenty-six applicants for the position including one who claimed descent on his mother’s side from Captain Suckling, the maternal uncle of Nelson. Milton Spencer Atwill, a dental officer serving with the Australian Army Medical Corps, was selected. On his release from the Army, Atwill was appointed Surgeon Dentist in the RAN on 8 April 1918 with instructions to report to Garden Island and thence to HMAS Cerberus to await passage to the UK to join Australia which he did in July, thus becoming the first permanent dental officer in the RAN. The Royal Navy established a permanent list of dental officers in 1920.

The Commonwealth Dental Review, the official journal of the National Dental Association, was greatly supportive and noted in its editorial in May 1918 that …taken on the whole, then, the position of Dentist to the Royal Australian Navy is a dignified one, and one which the profession, as a whole, will be pleased to know has been established. It wondered why …only a single appointment has been made. What about all the other ships in the Navy? Do not the officers and men aboard them have dental troubles also?

 Dental Mechanic training

When Atwill joined Australia in July 1918 Sick Berth Attendant George Matheson was lent from the Sick Bay as his assistant. Atwill foresaw the need for dental mechanics and sought approval for Matheson to commence training to be a mechanic. This request was forwarded to the Board for a decision since the course available in England was of three years duration and would have necessitated Matheson’s replacement on board. On learning of the time required it was decided that the project be abandoned and that a special rating of Dental Mechanic be instituted. Dental mechanics would be entered directly with civilian qualifications and recruited in Australia.

On 10 June 1919 Alexander McKinley, a qualified dental mechanic, was entered as a Probationary Sick Berth Attendant for twelve months with the opportunity to be accepted into the Permanent Service as a Dental Mechanic Fourth Class if considered suitable. There was no precedent for uniformed dental mechanics at the time in either the Royal Navy or the United States Navy. McKinley was dispatched to Cerberus to be kitted up and then to Australia for duty with the dental officer. However, his presence in Cerberus was misinterpreted and he remained there until November.

Doubtless he would have continued to serve in Cerberus longer were it not for the favourable impression that he had created with Surgeon Lieutenant Ellis, the Senior Medical Officer. Ellis, in a letter to his Captain which was subsequently forwarded to Navy Office, noted that since his arrival McKinley had been performing the duties of a dental surgeon in the depot, this being the result of verbal instructions from the Director of Naval Medical Services in Navy Office pending the appointment of a dental officer. He continued that …as this rating performs his work in a highly satisfactory manner, I strongly recommend that he be rated a Chief Petty Officer forthwith and given an opportunity in the near future to qualify for the rank of Dental Surgeon Lieutenant, RAN. This letter brought an immediate response from Navy Office and McKinley was transferred to Australia in his then rating of Probationary Sick Berth Attendant. He joined the ship on 2 January 1920 and was advanced to Dental Mechanic Fourth Class on 1 July 1920.

Dental Branch established

In June 1919, shortly after Australia’s return to her home port, Atwill submitted a report calling for a Dental Branch comprised of six dental officers and supported by mechanics and assistants. Atwill’s report was adopted and in August 1919 two additional dental officers (Hugh Wright and Henry Lambert) with the newly adopted rank title of Surgeon Lieutenant (D) were appointed. Atwill’s resignation was accepted in September of that year and he was replaced by Surgeon Lieutenant (D) Donald Austin. Two more dental mechanics were entered under similar conditions to McKinley and in July 1920 a Navy Order formalised the Dental Mechanic rating.

The naval armament reduction decisions of the Washington Conference in 1921 resulted in a reduction of the ships and personnel of the RAN. Australia was placed in reserve at the end of 1921 releasing one dental officer for duty in the recently opened shore training establishment Cerberus at Westernport. Surgeon Lieutenant (D) Austin was borne on the books of HMAS Melbourne for Fleet duties. Unfortunately, he could not be accommodated in a sea-going ship and had no surgery ashore but in 1921 a temporary surgery was fitted in HMAS Psyche.

Dental standards for entry

As the Navy had become wholly responsible for the dental treatment of its personnel, dental standards for entry were reintroduced requiring a minimum of 14 sound teeth excluding third molar teeth. Early in 1922 Surgeon Lieutenant Boake joined the Service and on 1 April 1924 Austin was promoted to Lieutenant Commander. Later in that year two additional dental officers, Woolcott and Ellis Richards, were appointed. In 1927 the training of boy seamen ceased and Woolcott, together with Ellis Richards, left for England to join the new heavy cruisers Australia and HMAS Canberra. At the end of 1929 Austin was promoted to Surgeon Commander (D) and a Branch structure of one Commander, three Lieutenant Commanders and three Lieutenants was approved. In 1929 the beginning of the economic depression saw a general reduction in ships and personnel although the strength of the Dental Branch was not affected. In 1930 recruiting ceased and the total strength of the RAN fell to 3,239. And so ends the early history of the Dental Branch of the RAN, which did not greatly change until the new demands of WWII, but that is another story.