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July-August 2018

The "Amex" Denture of World War I

by John M. Hyson, Jr. & Joseph W A. Whitehorne - In 1917-18, the U.S. Army revived a denture technique first introduced in 1866 by Dr. James Baxter Bean, the Confederate dental surgeon who established the first military maxillofacial hospital trauma ward in Atlanta, Georgia, during the American Civil War the cast aluminum wartime denture. In the early spring of 1917, the standard removable Vulcanite denture barred voluntary enlistment in the U.S. Army on the basis that such dentures were a liability and subject to breakage. As a result, the Army began experimenting with aluminum as a substitute denture base...


The "Amex" Cast Aluminum Denture of World War I

In 1917-18, the U.S. Army revived a denture technique first introduced in 1866 by Dr. James Baxter Bean, the Confederate dental surgeon who established the first military maxillofacial hospital trauma ward in Atlanta, Georgia, during the American Civil War the cast aluminum wartime denture.

Introduction

In the early spring of 1917, the standard removable Vulcanite denture barred voluntary enlistment in the U.S. Army on the basis that such dentures were a liability and subject to breakage. As a result, the Army began experimenting with aluminum as a substitute denture base.11 French and English scientists had isolated aluminum in the laboratory early in the 19th century and it became commercially available in France in the 1850s. Its high price limited it to special applications until 1886 when scientists in France and the U.S. simultaneously developed a cheaper production method. 4

Dr. James Baxter Bean originally introduced aluminum into the dental profession as a denture base. He was a former Confederate dental surgeon who had organized the world's first maxillofacial military hospital in Atlanta during the American Civil War. 5

In November 1866, Dr. Bean exhibited his cast aluminum plate at the second meeting of the Maryland Association of Dentists in Baltimore. It was recorded in the minutes that this was the "first successful effort known to the association in casting aluminum as a base for teeth .117 No doubt Dr. Bean would have been proud to learn that his 1866 technique had been revived by the U.S. Army under the exigencies of World War I in 1917-18. 1

In June 1917, Ist Lieut. Edward H. Raymond, Jr., D.C., a 1903 graduate of the New York College of Dentistry,9 in conjunction with Ist Lieut. John B. Wagoner, D.R.C., a 1903 graduate of Northwestern University Dental School,9 did the initial wartime research on casting aluminum dentures while at the Presbyterian Base Hospital Unit, British Expeditionary Forces, in France.10 On August 8,1918, Col. Seibert D. Boak, Director, Dental Section, Army Sanitary School, Langres, France, recommended that Lieut. Wagoner deliver a lecture on development of cast all-aluminum plates for soldiers instead of the Vulcanite and porcelain type." 2

The Amex Aluminum Denture

Amex01-350w

The Army called the new cast aluminum denture the "Amex Denture," and it was officially adopted as the "war denture" for the American Expeditionary Forces in France. The newly promoted Capt. Raymond and Maj. Wagoner were given the credit for its development as a Vulcanite substitute.'

The Army cited the unusual wartime conditions as the reason for development of "a standard type denture sufficiently strong to withstand the hardships of masticating field rations, to resist fracture from all ordinary accidents and to prevent malicious distortion or mutilation." The accidental breakage of dentures removed from the mouth at night was more common in the military than in civilian life because of the cramped space and poor lighting in the tents, huts, and dugouts at the Front. The incidence of intentional breakage of dentures to get away from the Front, like the selfinflicted wound, was probably rare, but the metal denture would make it still rarer.10

The Amex denture was inexpensive, easily made of materials procurable in the French market, durable, light in weight, had good thermal conductivity, and was easy to clean; all of which commended its use. The denture consisted of a metal plate with metal teeth all cast together in one piece. The posterior teeth were always cast as part of the denture, but porcelain teeth could be used for the six anteriors, if time for vulcanizing could be spared. The objection to the appearance of full upper dentures with all-metal teeth had to be disregarded in view that war service efficiency outweighed esthetic considerations. Clasps for partial dentures could be incorporated into the casting.10

Actually, all the good qualities the Army cited for the aluminum denture in 1917-18, Dr. Bean had emphasized in his 1867 article "The Aluminum Base," in the Dental Cosmos. These were strength, lighter weight, lower cost, greater durability than Vulcanite, and ease of repair. 1

The Amex casting flask was developed from a model made of a section of a "Soixante Quinze" (75 mm) shell. The materials required for the denture were aluminum ingots, pink baseplate wax, casting wax for tooth forms, investment compound of pulverized ilex and plaster of Paris, and DuTrey's Anterior Diateric teeth. Old newspaper soaked to a pulp was to be used as a substitute for fiber asbestos in the lid of the casting flask. The average all-metal denture weighed 22 gm. and cost about six or seven cents for the metal. On November 7, 1918, all the A.E.F. dental laboratories were ordered to begin fabrication of the war denture.8

Conclusion

Apparently, the Armistice of November 11, 1918 halted the mass production of these "war dentures" as examples are very rare. In fact, the extensive denture collection of the National Museum of Dentistry in Baltimore, Maryland does not include a single specimen. However, the National Museum of Dentistry does have a World War II aluminum denture with a bizarre history. In 1942, Fabian Dewine Ream and his family were captured in the Philippine Islands and interned by the Japanese. During the course of the internment, Mr. Ream lost so much weight that his mandibular denture no longer fit his mouth. When an aluminum pot fell into his possession, Ream, although not a dentist, decided he would make his own denture. With the assistance of an interned dentist, Ream made an impression of his mouth from candle paraffin. In order to invest the mold, he heated some old discarded gypsum wallboard to drive out the moisture and make plaster of Paris. Next, he melted down the aluminum pot in an old blacksmith forge and cast the denture by putting the invested, burned-out mold in a bucket and used a rope to swing it around his head centrifugal casting alA the dental technique. Although it took two tries, he finally got a decent casting and finished it with a penknife. His only problem was getting used to the thermal conductivity of the metal when taking hot liquids. Fabian Ream wore this denture (Fig. 1) for the duration of the war and even after his release in 1945. Finally, his family convinced him to see a dentist and get rid of his "metallic smile." Fabian Ream died in 1967, but his aluminum denture lived on as a "family icon" until it was donated to the Dr. Samuel D. Harris National Museum of Dentistry in 1999.' Unwittingly, he is part of a dental tradition going back to the Civil War generation.

References

  1. Bean, J. B. The Aluminum Base. Dent Cosmos, 1867, ns, 8:470-73.
  2. Boak, S. D. Director, Dental Section, Army Sanitary School, American Expeditionary Forces (thru channels), August 8, 1918, Folder no 1, Box 1780, Entry 395, Record Group 120 (American Expeditionary Forces), National Archives and Records Administration (hereafter cited as AEF, E, RG _, NARA).
  3. Circular Letter No 13-B, The Amex Denture (Cast Aluminum), Office of the Chief Surgeon, AEF, September 30, b 1918, Folder no 1, Box 1780, E 395, RG 120, NARA.
  4. Haines, G. K. Micromysteries: Stories of Scientific Detection. New York, Dodd, Mead & Co., 1988. p. 21-22.
  5. Hyson, J. M., and Foley, G. P. H. James Baxter Bean: The first military maxillofacial hospital. J MD State Dent Assoc,1997, 40: 77-81.
  6. Kuttner, N. R. Letter to SD Swank, National Museum Dentistry, June 12, 1999.
  7. Maryland Association of Dentists. Dent Cosmos, 1867, ns, 7: 376.
  8. Oliver, R. T. (for Chief Surgeon, AEF), memo, November 7,1918, Folder no 1, Box 1780, E 395, RG 120, NARA.
  9. Polk, R. A. Polk's Dental Register and Directory of the United States and Dominion of Canada. Detroit, RL Polk & Co, 1928,14th ed. p. 511, 663. 10. Raymond, E. H. A Type of denture for Army use. Dent Cosmos, 1918, 60: 516.

DR. HYSON is Director of Curatorial Affairs, Dr. Samuel D. Harris National Museum of Dentistry,
Associate Professor, Oral Health Care Delivery, Baltimore College of Dental Surgery, Dental 
School, University of Maryland, 31 South Greene Street, Baltimore, Maryland, 21201-1504.

DR. WHITEHORNE is Professor of History, Lord Fairfax Community College,
Box 47, Middletown, Virginia, 22645.

Article orginally published in the Journal of the History of Dentistry
Vol. 49, No. 2/July 2001 copyright ©2001, all rights reserved

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