To commemorate the centenary of the start of the Great War, the BDJ has commissioned a special cover series for Volume 217.

Art Editor Melissa Cassem explains the inspiration behind the series: 'We had seen some amazing objects when researching the Odontological Collection cover series [Volume 216] at the Hunterian Museum at the Royal College of Surgeons of England. We felt that these items and others from the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) collection and the BDA Museum would make a really interesting cover series. A set of covers exploring dentistry during WWI will highlight what an incredibly important time it was for dentistry, especially maxillofacial surgery'.

The artist

The cover of this issue, Volume 217 issue 1, depicts a WWI field treatment tent. Artist Philip Banister, who will create all 12 covers for Volume 217, has produced this original watercolour based on a black and white photograph (pictured).

Philip has been a freelance illustrator for 30 years: 'My watercolour style has evolved over that time but my love of history has remained a constant. People and buildings with some feeling for drama or mystery have become my specialities and I particularly enjoy illustrating stories, classic literature and historical subjects. There have been huge changes in the practicalities of work over the years but I'm still an old-fashioned pencil and brush artist. The difference now is that my work is scanned and sent to the client in minutes – although original artwork is supplied if required'.

Wartime dentistry

A photograph of a WWI field treatment tent, used as the inspiration for the cover of volume 217 issue 1 of the BDJ

Rachel Bairsto, Head of Museum Services at the British Dental Association (BDA), provides some historical background on the first cover:

At the outbreak of the First World War there were no adequate facilities for the dental treatment of the soldier at home and no provision in the field except for occasional extractions by medical officers. It took Sir Douglas Haig to suffer from toothache on operations and discover that a dentist from Paris had to be sent for. As a result 12 surgeons were sent to France in November 1914. They served at casualty clearing stations (CCS) where they had few facilities for the full range of dental care they were expected to provide and no equipment for the making and repairing of dentures.

Casualty clearing stations were usually a mix of tents and huts with only a minority of beds in buildings. By 1916, as more general surgery was undertaken, many stations had become well equipped with an X-ray lorry and triaging.

Casualty clearing stations were usually a mix of tents and huts with only a minority of beds in buildings. By 1916, as more and more general surgery was undertaken, many casualty clearing stations had become well equipped with an X-ray lorry and triaging.

C. V. Walker, dental surgeon in the Army Medical Corps (AMC), wrote on his arrival at casualty clearing station no. 23: 'He lined up the [dental] patients like an officer taking a parade – looked each from head to toe and said “Have you been through the chair?” The surgery was a place of hessian canvas and poles and the remarks of patients could be plainly heard.'

The 'surgery' was equipped to provide for extractions and basic restorative work. The kit was packed in three boxes: a large one containing the necessary instruments; another containing the portable chair; and a small one with nitrous oxide gas and apparatus. The box with the chair served as a footrest as revealed in the photograph. Also shown is a bracket table with a metal spittoon and a treadle drill. On top off the shelves a bottle of Lysol, used for instrument sterilisation, can be seen next to a sterilising vase. Electricity for lighting was provided by a generator.

One of the first dentists sent to France, J. M .Barnes, was able to use the pathology laboratory attached to the CCS and identified the first case recorded in the war of Vincent's Angina (ANUG). Owing to its prevalence amongst the troops, the term 'Trench Mouth' was commonly used.

The soldiers were transported by field ambulances to the CCS. However, provision for dentures or their repair necessitated a return to base camp where larger dental centres with laboratory facilities were eventually established. Dentures were frequently broken or lost resulting in soldiers away from the front. It wasn't until 1916 that mobile dental clinics were introduced which avoided the evacuation of troops from the front lines for minor dental ills.

Future covers

The cover of Volume 217 issue 2 will be based on a photograph of a standard issue WWI soldier's toothbrush.

Other forthcoming covers in the series will feature key dental and oral surgeons of the period, namely Kelsey Fry, Charles Valadier and Harold Gillies, in addition to patients with war facial injuries at the Queen's Hospital in Sidcup.