NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Dental Treatment.
Paras. 461-63.
SECTION X.—DENTAL TREATMENT.
461. General—The attention of all ranks should be drawn to the
necessity for taking the greatest care of their teeth in order to avoid
needless suffering and inefficiency. The tooth brush is an article of
every British soldier's kit, and it should be used daily, particularly
in the evening to remove particles of food after the evening meal.
Dental officers will instruct soldiers in oral hygiene, both by lec-
tures and by demonstrations to individuals when they come up for
inspection or treatment. Where the dental officer is of opinion that
a soldier is not taking sufficient care of his teeth he will bring the
matter to the notice of the soldier's company commander who is
responsible for ensuring that his men keep their teeth in good con-
dition.
Officers in medical charge of troops will at their periodical inspec
tion of troops in their medical charge inspect the mouths of soldiers.
They will also instruct soldiers in oral hygiene. A special opportunity
exists while soldiers are in hospital to train them in oral hygiene and
also for selecting for treatment by a dental surgeon men who require
it.
462. Employment of civilian dentists.— The dental treatment of
troops will ordinarily be carried out by officers of the A. D. Corps,
but civilian dental surgeons may be employed for the purpose, when
necessary, if the district or independent brigade commander con-
cerned certifies that such employment is absolutely necessary.
In such cases the A. D. M. S. of the district or independent brigade
should settle contract rates with the civilian dental surgeon for the
work to be done. Civilian dental surgeons will not be employed
if an A. D. Corps officer is available.
NOTE.—All British W. Os., N. C. Os. and men employed at Army Headquarters,
whether on the permanent establishment on A. H. Q. rates of pay, or as technical clerks,
are eligible for dental treatment and for the supply of dentures by a civilian dentist, in
the absence of an officer of the Army Dental Corps. A civilian dentist will however be
employed only when the Surgeon to H. E. the C.-in-C. or the Additional Medical Officer,
A. H. Q. certifies that such employment is absolutely necessary.
Conditions of dental treatment.
463. Dental treatment.— Ordinary dental treatment i.e ., scaling,
filling, and extraction of teeth, may be afforded, to the classes of
persons and in accordance with the provisions, specified below:—
(i) British other ranks.—Treatment necessary to maintain
their dental efficiency will be allowed free as far as avail-
able for British W. Os., N. C. Os. and men including un-
attached list ranks and W. Os. of the assistant surgeon
branch of the I. M. D. on the active list in military
employ.
115
Para. 464.
Dental Treatment.
Such treatment will be directed mainly towards the pre-
servation of teeth and no teeth will be extracted which
can usefully be saved.
(ii) Families of British soldiers on the married roll and of warrant
and non-commissioned officers of the Indian Unattached List
in military employment .—The families of British soldiers
on the married roll and of W. Os. and N. C. Os. of the
Indian Unattached List in military employment as well
as Army Schoolmistresses may be given dental treatment
provided they are able to attend at a dental centre or at
the surgery of a civilian dental surgeon engaged for attend-
ance on troops. No charge should be made for the neces-
sary materials supplied for treatment. Dentures, however,
will only be supplied on re-payment.
The treatment is to be regarded as a privilege and not as a
right, and can only be granted when no additional cost
to the State is involved beyond the actual cost of materials.
In no circumstances should additional staff be engaged
in order to provide dental treatment for the above noted
families.
(iii) Os. and I. O. Rs. on the active list in military employ.—
I. Os., W. Os., N . C. Os. and men including sub-assistant
surgeons of the I. M. D. will ordinarily receive dental
treatment as far as available from the medical staff of the
I. M. H. (Difficult and complicated cases will receive
treatment at a dental centre or at the surgery of a
civilian dental surgeon engaged for attendance on troops).
Such treatment will be directed mainly towards the pre-
servation of teeth and no teeth will be extracted which can
be usefully saved.
464. The supply of artificial dentures.—
(i) British officers and members of the M. N. S. and B. O. Rs.
Conditions entitling individuals to the supply of
artificial dentures.
Persons entitled.
( a )
L o s s o f t e e t h c a u s e d b y w o u n d s r e c e i v e d i n
action or by injury in performing military
duty.
Where only part of the necessary dental work
was caused by wound or injury, as mentioned
above, the rest may be performed, provided
any charges incurred are borne by the indi-
vidual concerned.
British officers (including depart-
mental officers of the Commis
sary class) and lady nurses of the
Home or Indian Nursing services.
(b) Such loss of teeth as would cause their
discharge from the service as invalids,
provided that it is certified by a medical or
dental officer that the provision of artificial
dentures would render them cient.
The certifying officer should state which teeth
have been lost and which require replace-
ment.
British W. Os., N. C. Os. and men,
including those of the unattached
list, serjeant-majors of signal
units and W . Os. of the assistant
surgeon branch of the I. M. D.
116
Paras. 465-67.
Dental Treatment.
465. Renewal of and repair to artificial dentures.—When artificial
dentures have been supplied by the State, repairs and renewals will
be carried out when necessary for the following classes :—
(a) British soldiers not below the rank of serjeant who have
been provided with artificial dentures under paragraph
464 (i) ( b).
(b) Those who have been provided with artificial dentures under
the condition laid down in paragraph 464 (i) ( d).
NOTE.—Before any such renewals or repairs are carried out a certificate will be sub-
mitted by a Medical Officer or by an officer of the Army Dental Corps stating whether or
not the loss or damage is due to culpable neglect on the part of the soldier.
If it is certified that the loss or damage is not due to the culpable neglect of the soldier
the necessary renewal or repairs will be carried out at the expense of the State.
If it is certified that the loss or damage is due to the culpable neglect of the soldier,
he will, under Section 138 (4) of the Army Act, be placed under stoppages for the cost of
the necessary renewal or repairs.
The certificate will be sent by the officer granting to the soldier's Officer Commanding
to be filed with the personal documents of the soldier.
466. Fitting of porcelain crowns.—When loss of teeth does not
necessitate the provision of a denture British soldiers may be fitted
with porcelain crowns in such cases as accidental fracture of an incisor
tooth, or where there has been extensive decay of an incisor tooth
leaving a root which can be made sterile, this is always subject to the
approval of the I. A. D. S. in India. The fitting of crowns with the
sole object of improving a man's personal appearance is not permis-
sible.
467. Co-efficiency of mastication.— The following will be used as
a guide in determining whether a soldier has a sufficient number of
teeth in order to enable him to masticate efficiently. The teeth
should be sound or only decayed to such an extent that they can be
soundly restored.
For convenience the teeth in the upper jaw which are in good
functional opposition to corresponding teeth in the lower jaw will be
considered according to their functional values.
Each incisor, canine, premolar and under developed third molar
will have the value of one point.
Each first and second molar and well developed third molar will
have the value of two points, e.g., if the whole of the sixteen teeth
are present in the upper jaw and in good functional opposition to cor-
responding teeth in the lower jaw, the total value will be twenty-two
or twenty points according to whether the third molars are well deve-
loped or not. A soldier should not, as a rule, be supplied with dentures
under the provision of paras. 464 (i) ( b) and 464 (ii) (a ), if his co-
efficiency of mastication is above the eleven points.
Even if his co-efficiency is eleven points or less, he should not be
supplied with dentures under paras, 464 (i) ( b ), 464 (ii) ( a),
unless it is certified by a medical or dental officer that the provision
of dentures would render him efficient.
118
119
E 2
Dental Treatment.
Paras. 468-76.
468. Scales of charges payable by soldiers, British or Indian, for
renewals or repairs to artificial dentures originally supplied under the
provisions of one of the foregoing paragraphs.— When a soldier is placed
under stoppages for the replacement or renewal of or repairs to arti-
ficial dentures originally supplied at the expense of the State he will
be charged for the same at such rates as may be settled between the
officer in charge dental centre and the C. M. A. concerned. The rate
fixed should be the cost price of the material used, plus freight charges
and other incidental expenses including the cost of the dental sur-
geon's time and departmental charges.
The dental officer who supplies or repairs the denture will complete
I. A. F. C-868-A. (Issue of equipment on payment), obtain the
signature of the soldier and forward the form, in triplicate, to the
O. C. the soldier's unit. The O. C. will forward two copies with the
pay list to the C. M. A. who will sign and return one copy to the unit.
Duties of officers in charge of dental centres.
469. General duties.—An officer of the A. D. Corps will make a
half-yearly inspection of as many of the troops as possible in the area
served by his centre in order to ascertain their dental efficiency.
470. Selection of units for treatment.—He will select certain units
for treatment and will deal first with those likely to proceed on active
service or service on the frontier. He will then treat next in order
those units which have been longest without dental attendance.
471. Attendance of soldiers at dental centres.— When a soldier is
required to attend at a dental centre for treatment the dental officer
will complete A. F. I-5025 and send it to the O. C. the unit concerned.
472. Soldier refusing treatment.— In the event of a soldier refusing
treatment he will bring the matter to the notice of the O. C. the unit
concerned. If the soldier persists in his refusal the fact will be re-
corded on his dental treatment card and medical history sheet— -
" refused treatment."
473. Examination previous to provision of dentures.—He will care-
fully examine all cases recommended by a medical officer to be pro-
vided with dentures and will append his remarks on I. A. F. M-5.
474. Approval of I. A. D. S. before provision of dentures.— He
will be responsible that no soldier is given treatment with a view to
the provision of dentures or is provided with dentures until the approval
has been obtained of the I. A. D. S. in India ; subject also to the
provisions in para. 464 being fulfilled.
475. Equipment and indents.— He will be responsible for all equip-
ment in the dental centre of which he is in charge. He will submit
indents for dental supplies on I. A. F. Z-2091 through the usual chan-
nels.
Dental records.
476. Medical history sheets (A. F. B. 178) and Dental treatment
cards (A. F. I-5033) British troops.— Records regarding the dental
Paras. 476-81.
Dental Treatment
condition of, and dental treatment afforded to British soldiers are
contained in A. F. B-178, Tables II and VIII and in A. F. I-5033.
These forms are sent to India with every British soldier arriving in
the country. A. F. B-178, Table II contains a record of the dental
condition of the soldier on enlistment or on first inspection by a dental
officer. This record once made will not be altered. A. F. B-178,
Table VIII contains a brief record of dental treatment afforded to the
soldier after enlistment or first inspection.
A. F. I-5033 contains a detailed record of the dental treatment
afforded.
In cases where either of both of these forms have been lost and in
cases where the entries have not been made prior to the soldier's
arrival in India, the officer in charge dental centre is responsible
that, when lost, a new A. F. I-5033 is prepared, that the soldier is
examined at the first available opportunity, that A. F. B-178, Table II
is completed at this examination and that subsequent records of treat-
ment afforded are entered in A. F. B-178, Table VIII and in A. F. I--
5033. In cases where only one form is missing or incomplete the
record should be copied from one to the other.
477. Dental treatment cards (A. F. I-5033)—Indian troops.—
A. F. I-5033 will be prepared and particulars entered for each Indian
soldier treated at a dental centre.
478. Retention of dental treatment cards.—A. F. I-5033 will be
kept at the dental centre where the soldier attends for inspection and
treatment.
479. Disposal of dental treatment card on transfer of a soldier.—
On the transfer of a soldier to another station the O. C. unit con-
cerned will obtain A. F. I-5033 from the officer in charge dental centre
and place it with the soldier's other documents. On the soldier's
arrival at the new station, A. F. I-5033 will be sent to the dental
officer responsible for the treatment of the troops at that station.
On the transfer of the soldier to the Army Reserve or Indian
Army Reserve, the O. C. unit concerned will attach A. F. I-5033 to
the soldier's other documents, and on his final discharge from the Re-
serve the card should be destroyed.
480. Procedure on promotion, etc.— On promotion to commissioned
rank, discharge, desertion or death of a soldier the O. C. his unit will
send the soldier's medical history sheet to the officer in charge dental
centre who will complete Table VIII of that sheet and return it. A. F.
I-5033 will be destroyed.
481. Temporary dental treatment card.—In the event of a soldier
reporting for dental treatment whose A. F. I-5033 is not in the pos-
session of the officer in charge dental centre, a temporary dental
treatment card will be made out. Immediate steps will be taken
to obtain the original card, when details of any treatment entered on
the temporary card will be at once recorded on the original.
120
Dental Treatment.
Paras. 482-88.
482. Dental summary.—(a) A monthly dental summary of work
done during the month by each dental centre will be compiled on
A. F. I-5034 in triplicate by officers in charge of dental centres and sent
on the first day of the succeeding month direct to the D. M. S., D. D.
M. S., Command and A. D. M. S. district or independent brigade area
concerned.
The reports will give figures for each individual station for British
officers, British other ranks, families of British officers and other
ranks, and for Indian troops separately. A separate summary will
be submitted for R. A. F. personnel.
One copy of A. F. I-5034 may be used for all stations served by one
dental officer.
(b) Half-yearly consolidated reports on the above lines, embracing
the first and second six months of the year, respectively, will be sent
in duplicate by the officer in charge of the dental centre direct to the
D. M. S. in India on the 7th July and 7th January. A separate A. F.
I-5034 will be used for each category and figures for each station given.
A brief summary of the arrangements for dental treatment at each sta-
tion should accompany.
The report for the period ending December 31st in each year should
also be accompanied by notes on cases of special interest ; on im-
provements in disease or in the general health effected by dental treat-
ment ; on the influence of climatic or other conditions on the teeth
and gums ; and any other information bearing on dental treatment
which is considered useful. These notes should refer to the entire year.
483. Dental treatment book. —A. B. 469 (Dental Treatment Book)
will be maintained at each dental centre. The name, and particulars
of each patient, will be entered in the index on his first attendance
and details of treatment subsequently entered under the reference
number allotted to him.
484. Dental appliance book. —A. B. 468 (Dental Appliance Book)
will be maintained at each dental centre. The name, etc., of the
patient will be entered in this book immediately approval is given for
provison of dentures, remodels or repairs.
485. Procedure on closure of dental centre. —In the event of a dental
centre being closed A. Bs. 468 and 469 will be sent to the D. M. S.
If the centre is subsequently re-opened these books will be re-
turned.
486. Records to be made by employed civilian dental surgeons.
— W h e n d e n t a l t r e a t m e n t o f a s o l d i e r h a s b e e n c a r r i e d o u t b y a n e m -
ployed civilian dental surgeon the particulars thereof will be recorded
on the dental treatment card by the dental surgeon and on the medical
history sheet by the medical officer.
487. Instructions for recording dental treatment. —Instructions
on this subject are contained in Appendix XIV.
488. Royal Air Force and method of recording dental treatment.—
The rules on these subjects are contained in Section XIII.
121
Paras. 489-93.
Hygiene and Pathology.
SECTION XI.—HYGIENE, PATHOLOGY AND INFECTIOUS
DISEASES.
489. General. —The Director of Hygiene and Pathology at Army
Headquarters is the adviser of the D. M. S. in India on all questions
relating to the health of the Army in India and the administration of
laboratories under his control.
He will maintain touch with Assistant Directors of Hygiene and
Pathology of Commands, and with Deputy Assistant Directors of
Hygiene and of Pathology of Independent Districts.
The duties of Assistant Directors and Deputy Assistant Directors
of Hygiene and Pathology and of officers of the Military Medical Ser-
vices in connection with hygiene and pathology are detailed in Sec-
tion II.
LABORATORIES.
490. (a) A command laboratory is under the administration of the
D. D. M. S. of the command. For location see Appendix XXIII.
( b) District and Brigade Laboratories.—These are under the ad-
ministration of the A. D. M. S. of the district or independent brigade
area and are located in stations as detailed in Appendix XXIII.
491. Nature of Work.—These laboratories are maintained:—
(i) to carry out pathological and bacteriological work which
cannot be undertaken in the clinical side rooms of hospitals
or which requires special training for its performance,
(ii) for the investigation of, and for research in, matters affecting
the health of troops.
Command and District Laboratories are in addition training
centres for members of the I. M. D. in laboratory methods and tech-
nique.
492. Equipment.—The equipment of laboratories is as laid down
in Regulations for the Equipment of the Army (India) and is in charge
of the officer in charge of the laboratory.
An annual money allowance is given to laboratories to meet ex-
penditure on equipment, materials, etc. An additional allowance
may be made by the D. M. S. in India ( vide para. 175, Pay and
Allowance Regulations, Part II).
493. Clinical side rooms. —Clinical side rooms are authorised for
British and Indian military hospitals of 50 beds and over and are for
the examination of blood films, sputum, urine, etc., by officers in
medical charge of cases. Their equipment is as laid down in Regula-
tions for the Equipment of the Army (India), Part 2, Sections V-A
and V-B.
122
Hygiene and Pathology.
Paras. 494-99.
494. (a) The Military Food Laboratory, Kasauli.—The Military
Food Laboratory, Kasauli, and its personnel are under the direct
administration of the D. M. S. in India. The laboratory is maintained
for the examination of food stuffs and investigations connected there-
with.
(b) The Enteric Laboratory, Kasauli. —The Enteric Laboratory,
Kasauli, and its personnel are under the direct administration of the
D. M. S. in India.
Vaccination and Small-pox.
495. Recruits.—All recruits, whether bearing marks of small-pox
or not, will be vaccinated within 3 days of joining the unit to which
they are posted on enlistment. The officer in medical charge of the
unit will be responsible that this is done and that the necessary in-
formation regarding vaccination and re-vaccination is recorded on the
soldier's medical history sheet and in the vaccination register.
Gurkha recruits at Gorakhpore and Ghoom recruiting depôts will
be vaccinated at the depôt immediately they are accepted as fit.
496. Immunity.—In cases where vaccination or re-vaccination
fails, two further vaccinations should be carried out at intervals
of one month to ensure that failure to "take" is due to acquired
immunity. An entry to this effect will be made in documents re-
ferred to in the preceding paragraph.
497. Families. —Every effort should be made to ensure that the
wives and children of all ranks are sufficiently protected by vaccina-
tion. Children should be vaccinated as infants and again at the
age of seven years. Officers in medical charge of families will twice
yearly in June and December ascertain the vaccination state of families
in their charge.
498. Vaccination state of units.—Officers in medical charge of
troops will, twice yearly in June and December, satisfy themselves that
every officer, other rank and follower under their care is sufficiently
protected against small-pox, i.e.—
(a) has been successfully vaccinated within the last five years, or
(b) shows evidence of immunity by 3 unsuccessful vaccinations
(carried out at intervals of one month) within the last
five years.
(c) bears distinct marks of small-pox.
In the case of other ranks and followers, this will be done by exami-
nation of the man in conjunction with his medical history sheet.
Those found to be unprotected will be vaccinated, unless this pro-
tection is refused.
499. Special re-vaccination.—In the presence of an epidemic,
re-vaccination will be recommended in all cases in which there is not
satisfactory evidence of successful vaccination within the last two
years.
123