The cover of this issue is artist Philip Banister's impression of a photograph of Major Sir Auguste Charles Valadier in the Special Jaw Ward at No. 13 Stationary Hospital in Wimereux, France.
Born in Paris in 1873, Valadier's family emigrated to America in 1876. He studied medicine at the University of Columbia, and qualified as a dentist from the Philadelphia Dental College in 1901. At the outbreak of war Valadier was practising at a fashionable practice in Paris. He volunteered his services to the British Red Cross Society and was dispatched to Abbeville, France. From there he found the British setting up a field headquarters around Boulogne. On 16 October 1914 Valadier was assigned to No. 13 General Hospital, BEF, Boulogne-sur-Mer, a base hospital. He arrived at headquarters in a chauffeur-driven Rolls Royce which he used to carry all his dental equipment.
Valadier recognised that bullet wounds to the face and jaws needed special treatment. He established a face and jaw unit at the No. 13 Stationary Hospital in a converted sugar store. Its location was ideal for transferring patients from ambulance trains to hospital ships bound for England. In May 1917 the hospital was renamed the 83rd Dublin General Hospital and moved nearer the town of Wimereux. Valadier provided the equipment and laboratory technicians for the hospital unit at Wimereux with funds derived from his wealthy practice in Paris.
By May 1917 Valadier and his staff had treated more than 1,000 cases of jaw and facial injuries reporting only 27 deaths. It was here he developed treatment techniques to deal with the problems of facial wounds. He advocated early primary closure of wounds and retention of teeth; even those in the fracture line. Gangrene was combated with frequent irrigations and of sterile water under pressure.
Other military surgeons saw Valadier's work and were inspired to follow. Among them was Captain Harold Gillies, the ENT surgeon chosen to assist Valadier in the operating theatre.
Sir Harold Gillies wrote about Valadier in 1957: 'In Boulogne there was a great fat man with sandy hair and a florid face, who had equipped his Rolls Royce with dental chair, drills and the necessary heavy metals. The name of this man was Charles Valadier. He toured about until he had filled with gold all the remaining teeth in British GHQ. With the generals strapped in his chair, he convinced them of the need of a plastic and jaw unit ... the credit for establishing it, which so facilitated the later progress of plastic surgery, must go to the remarkable linguistic talents of the smooth and genial Sir Charles Valadier'.
With thanks to Rachel Bairsto at the BDA Museum for information on Valadier's life and work.
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Rolls Royce dentist facilitated wartime plastic surgery. Br Dent J 217, 111 (2014). https://doi.org/10.1038/sj.bdj.2014.666