When Britain went to war with South Africa’s Boer republics in 1899, it found itself fighting not one but three enemies. There were the Boers themselves. There was disease: typhoid and dysentery claimed more lives than the fighting. And then there was tooth decay, which cost the army almost as many men as the Boers’ bullets did. Although the British army had state-of-the-art weapons, field hospitals equipped with the latest in anaesthetics and antiseptics, and even new-fangled X-ray apparatus that could pinpoint bullets, it saw no need for dentists. The result? The troops’ teeth were so bad they couldn’t cope with army rations. If a man couldn’t eat he couldn’t fight, so thousands languished in camp or were sent home because they had lost their teeth.
There was a time when a soldier’s teeth were a vital part of his kit. In the early 17th century, English army surgeons carried instruments for scaling and extracting teeth along with their bullet extractors and amputation saws. Later that century, the army introduced standards for its recruits that specified, among other things, how good their teeth should be. For some soldiers certain teeth were compulsory: a grenadier had to have enough front teeth to bite open the fuse of his grenade before lighting it. Musketeers also needed good front teeth to pull the wooden caps off their powder cartridges before pouring the charge into their muskets. Incisors were considered to be of such military importance that it was an offence to remove them from a man of military age.
By the mid-19th century, however, the army had dispensed with old-fashioned grenades and swapped muskets for rifles, making soldiers’ teeth less of a priority. Unfortunately, this came at a time when the nation’s dental health reached an all-time low, thanks to an upsurge in sugar consumption in the 18th and 19th centuries. Caries and other dental disease were rife. Understandably, the army worried more about cholera, typhus and yellow fever, mass killers that threatened to jeopardise foreign campaigns. But as the century drew to a close, the government discovered that bad teeth could also seriously diminish a fighting force.
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The nation had been warned. In 1886, George Cunningham, president of the recently formed British Dental Association, lambasted the government over its neglect of its servicemen’s teeth. The number of army recruits with dental disease was appallingly high and their chances of treatment shockingly small, he said. The task of dealing with aching and rotten teeth fell to military surgeons, just as it had centuries earlier. But they knew little about dentistry, Cunningham complained, and unlike their predecessors, they didn’t even carry the most basic tools for the job. In practice, soldiers treated themselves, pulling their own teeth and plugging cavities with whatever they could find – a wad of tobacco, a ball of rubber scraped from waterproof sheets, even cayenne pepper. Whatever relief they got, it didn’t last.
When the Boer war began, the government expected it to be over quickly. But after a series of humiliating defeats in December 1899, it was forced to send more troops. In its rush to recruit, the army abandoned its already skimpy dental inspections, and when its new troops reached South Africa they found their teeth were no match for the tough army rations. “In the unequal struggle between trek ox and biscuit on the one hand and mere human teeth on the other, not five per cent of the men in my company came through scatheless,” reported one officer. “In many cases the damage was slight; in others, where the teeth were naturally weak and brittle, the mischief done was irreparable. Even with an average set, straining on an average biscuit, you never felt quite certain which would be the first to go – your teeth or your biscuit.”
“The troops found their teeth were no match for tough army rations”
So many teeth came off worse in the tussle that the army began to lose an alarming number of men simply because they couldn’t eat. Ironically, the army had laid on the best of medical care. Shamed by its appalling losses to disease and infection during the Crimean war half a century earlier, it introduced antiseptics, proper sanitation and professional nursing care for its men. With such a large force in South Africa, the war office recruited hundreds of civilian surgeons to staff its 10 field hospitals. Yet it saw no need for dentists. Even so, one did make his way to South Africa. Frederick Newland Pedley was London’s foremost dentist, founder of the dental school at Guy’s Hospital and a specialist in repairing jaws. When he heard how many men had suffered serious head injuries he offered to fix jaws shattered by Boer bullets. The war office reluctantly allowed him to go – so long as he understood he wouldn’t be paid, provided all his own equipment and found his own way to South Africa.
Undaunted, Pedley bought everything he thought he could possibly need, including two dentist’s chairs, tools and “contrivances” to fix jaws, and 5000 gallons of laughing gas. In February 1900 he set off with his two-and-a-half tonnes of baggage. When he reached Cape Town, he was told to make his way to Deelfontein, 800 kilometres to the north. “I had a world of trouble,” he wrote later.
At Deelfontein, the hospital was still being set up and at first Pedley’s surgery was a tent. He hadn’t even unpacked when his first case arrived. “I had to seat my patient on a deck chair and support his head against the tent pole,” he later recalled. Soon soldiers were queuing for treatment – but not for war wounds. “Disease, neglect, tough beef and hard biscuit play havoc on teeth. One young man had only three useful teeth left,” he reported. It was soon obvious that thousands of men were suffering from dental problems. “How such patients recover from typhoid fever and dysentery is a mystery. They are of no further use as fighting men… for they cannot eat service food.”
During the war, the army lost 8000 men in battle and almost as many to dental disease. More than 2000 were evacuated because of dental problems, while a further 5000 were found unfit for duty because there were no dentures to replace the teeth they lost. Men without molars swallowed unmasticated lumps of meat, which led to debilitating digestive problems. An inspection of the Cheshire regiment revealed that hardly any men had molars, prompting an urgent request for mincing machines.
Faced with bad teeth on this scale, what could one man do? After 6 months at the front, Pedley returned to London and campaigned for the formation of an army dental corps. The government hired four dentists. One soldier, home from the war in 1901, wrote angrily to the Pall Mall Gazette: “After 21 months of fighting, four dental surgeons have been sent to South Africa to attend to the teeth of the Army. Thus does the War Office put forth stupendous efforts to atone for past neglect.” If the four men treated 30 soldiers a day, seven days a week, he railed, “It should console a man on active service suffering today from toothache in a precious molar, which he can ill afford to lose, to know that he will not be troubled with the agonising pain later than April 1907”.
The war ended in 1902. Twelve years later, when the first world war began, the army still had no dentists. Not one went with the British Expeditionary Force to France in 1914. Pedley travelled to Rouen in case his services were needed. The troops’ teeth, he reported, were worse than ever and “dozens of men daily have to be reported as unfit for service”.
The army paid a high price for ignoring its men’s teeth. During the disastrous Gallipoli campaign in 1915, 600 men from a single infantry division had to be evacuated on account of their teeth.
Eventually, the army saw sense. What prompted this change of heart? Douglas Haig, commander-in-chief of the British forces in France, got terrible toothache, and his staff was forced to send to Paris for a dentist. Within months the army had hired a dozen of its own. By the end of the war in 1918, it had 831. It was another three years before it went the whole way and created the army dental corps.
