This Sunday, November 11, will be the 100th anniversary of the end of WWI (known prior to WWII as the Great War). As an amateur historian, I’ll be celebrating the Armistice (the formal name for the treaty that ended the war) by dancing to songs like “I Don’t Want To Get Well” or “General Pershing: One Step” at a reproduction Armistice Ball in New Jersey (shameless plug here). After reviewing history-related blogs in my Twitter feed, I was reminded of the horrors of the war. This led me down a sobering path of research: early dental/plastic surgery in the war and other options that existed to help soldiers recover from disfiguring wounds, such as masks (shown above).
When the war broke out, dentists were asked to the front lines in France to check on the soldiers’ health and give the much-needed dental care they had not been receiving at home. Once hostilities commenced, the desperate need for dentists became rapidly apparent.
Writing in the 1950s, Sir Harold Gillies, a British pioneer in the art of facial reconstruction and modern plastic surgery, recalled his war service: “Unlike the student of today, who is weaned on small scar excisions and graduates to harelips, we were suddenly asked to produce half a face.”
To that end, the American dentists assigned to the American Ambulance Hospital at Neuilly (Paris), France decided by September of 1915 to increase its number of dental chairs from one to eight, with two dental labs.
Like Dr. Gillies in Britain, several American doctors were trying desperately to effect the sort of facial reconstructive surgery that was previously unheard of. Dr. George B. Hayes, the Chief Dental Surgeon of the American Ambulance Hospital in France, stated in the Dental Cosmos, that one-fifth of all the wounded he saw had fractured maxillae. He knew the psychological damage such disfiguring wounds would have on the morale of the men.
“The scientific reports of these interesting and important cases will follow later, when they have been duly classified, but in the general revision, it may be fairly stated that the dental surgeons and dental mechanics have risen to the occasion and the value of the work has been duly recognized. They have made it possible for a final plastic operation to return these mutilated wrecks to the world, not as objects of horror or commiseration, but as men presentable, happy, and fit to resume their places in society.” – Dr. George B. Hayes, Dental Cosmos, “Dentistry and the War”, Vol. 57, Issue 12, December 1915, pp. 1396-1400
By the spring of 1916, Dr. Hayes was documenting more cases of severe dental reconstruction in the Dental Cosmos. He was joined by Dr. W.S. Davenport, associate surgeon, and a team of dedicated men and women. These medical practitioners pioneered desperately needed techniques and documented them in the Dental Cosmos, a publication billed as a monthly record of dental science. As the war continued and trench warfare was developed, more men were only exposing their heads and shoulders out of the foxholes to fight, thereby increasing the chances of a horrific facial wound.
“[T]he…soldiers failed to understand the menace of the machine gun,” recalled Dr. Fred Albee, an American surgeon working in France. “They seemed to think they could pop their heads up over a trench and move quickly enough to dodge the hail of bullets.”
Many of the clinical photos of wounded soldiers are very graphic in nature, so I am only posting the least dramatic of them. As Dr. Gillies was performing his lifesaving work, he documented his patients and the photo below is from his medical archive. Many more can be found on the internet.
For the men who plastic surgery could not restore, an option existed: masks. These were created from a combination of castings from the patient, and a reference to a photograph of the man prior to his being wounded.
In the above photo, the top row of masks were created from disfigured soldiers. The bottom was masks were created from photos of the men prior to their disfigurement. The American sculptor, Mrs. Anna Ladd, would then create masks made of thin copper, which she painted in natural colors to resemble the soldier. Then it was fitted on the face. More information on the masks can be found here.
The American Hospital of Paris, the modern iteration of the American Ambulance Hospital, still exists today. Its goal: to provide the best of French and American medical practices to all patients.
This post has only touched on the subject of dental reconstructive and facial surgery in the early 20th century. There are many more in-depth articles to be found. So, as the centennial of the original Armistice Day nears, please take a moment to remember the pioneering dentists, American and British, who made modern plastic surgery possible. Remember also their patients – the brave young men who patriotically answered the call to fight “The War to End All Wars”.