ITEM No. 24 
FILE No. XXVIII-II 
<eOJPY I 
RESTRICTED 
DENTAL EDUCATION, PRACTICE 
AND EQUIPMENT IN GERMANY 
RESTRICTED 
COMBINED INTELLIGENCE OBJECTIVES 
SUB-COMMITTEE RESTRICTED 
DENTAL EDUCATION, PRACTICE AND EQUIPMENT 
IN GERMANY 
Reported by 
Lt. Col. GEORGE F. JEFFCOTT, D.C. 
Office of the Theater Chief Surgeon, Hq. TSFET 
CIOS Item 24 
Medical 
COMBINED INTELLIGENCE OBJECTIVES SUB-COMMITTEE, 
G-2 Division, SHAEF (Rear) APO 413 
RESTRICTED RESTRICTED 
TABLE OF CONTENTS 
Sajeot Page No, 
Introduction 3 
I. Dental Education 3 
II. Socialized Dentistry q 
III. Carles Control 13 
IV. Dental Plastics 15 
V. Substitutes for Gold 19 
VI. Military Dental Equipment 25 
VII. Interviews with Officials of Gorman Dental Schools 27 
VIII. Dental Burrs 42 
RESTRICTED INTRODUCTION 
The writer of the present report has visited a very large 
number of dental targets In Germany, including dental schools, 
clinics, hospitals and commercial plants, A preliminary 
report of his findings, appears in CIOS Technical Report 
"Medical, Dental, and Veterinary Education and Practice 
In Germany as Reflected by the Universities of Leipzig, 
Jena, Halle and Erlangen", Sections I-VI of the present 
report are essentlaJ-ly summaries based on the Investigation 
of numerous targets. Section VII consists of a portion 
of the Interviews on the basis of which the summaries were 
prepared. These Interviews are published because they 
supply some details not contained In the summaries, and 
also because they present a sample of the spread In 
German dental thought. 
I. DENTAL EDUCATION 
There are In Germany two distinct educational systems 
for dentists; one for "ZahnSrzte", or degree dentists, and 
the other for "Dentlsten" or mechanical dentists. It 
should be noted, however, that the distinction between these 
groups as far as legalized practice Is concerned Is very 
slight. The "Dentist" does all types of work authorized 
for the "Zahharzt" except the giving of Intra-venous Injec- 
tions, the administration of general anesthetics, end major 
oral surgery. The distinction Is largely one of background 
rather than of the types of work done. The training of 
the "Zahnarzt" Is carried on In a university along the lines 
followed In the United States. The "Dentist" receives all 
but one year of his training In dental laboratories or In 
the offices of other dentlsten. No one In Germany defends 
this system whereby men destined for the same work received 
received such widely different training. It grew out of the 
successful attempt of laboratory technicians to have 
legalized for them certain operations within the mouth, 
especially the making of oral prostheses. As the field of 
their activities widened the difference between Zahnarzt 
and Dentist largely disappeared, and In 1933-34 an attempt 
was made to standardize training and do away with the double 
classification. This trend was discouraged by the Nazi 
party, probably in line with their policy of encouraging 
various doubtful schools of medical thought to offset the 
conservative Influence of the established medical profession. 
At present, dentists and Zahnarzte In Frankfurt are drawing 
up a plan for a merger of the two groups, and this trend 
may be expected to spread to other cities. 
The Zahnarzt, who corresponds most closely to the American dentist, began his dental training with the maturum 
certificate, equivalent to our high school course. In a few 
cases men who were considered especially well qualified on 
the basis of intelligence and altitude tests were admitted 
with less than the established requirements In preliminary 
education after extensive interviews with faculty members. 
In a very few cases the state paid expenses of especially 
promising students, but most dental education was at the 
expense of the student. 
The seven semester dental course was divided into a 
three semester "precllnlcal" course and a four semester 
"clinical" course. This course qualified the graduate to 
practice, but if he desired the degree of "doctor", as 
more than half did, he was required to put In an additional 
semester, write a thesis, and pass a special examination. 
During the war, three semesters were given each year so 
that the course could be completed In a lltule over two 
years. 
The precllnical course Included instruction In pros- 
thetic laboratory procedures, dental materials and metall- 
urgy, orthodontia, filling operations on mannequins, 
anatomy (with dissection of head and neck), physiology, 
histology, chemistry and physics. For details as to hours 
of study see nrellmlnary report on dental education. 
After a rigid "physlcum" examination at the end of 
the preainlcal course the student entered the clinic where 
he received instruction In operative dentistry, prosthetics, 
crown and bridge construction, ceramics, Instrumentation, 
dental public health, treatment of fractures, mouth and Jaw 
diseases, dental hygiene, pharmacology, pathology, internal 
medicine, skin and venereal diseases, surgery (general and 
dental), ear, nose and throat diseases, and laryngology. 
This schedule appears comprehensive, but lack of time 
required that many subjects be covered superficially. 
Prosthetic clinical experience was particularly limited. 
Requirements differed but a student often made no more than 
eighteen prosthetic pieces, Including full and partial den- 
tures and bridges. About fifty amalgam fillings were 
usually required, with twenty Inlays and no gold foils. 
Root canal fillings were well up on the list with an 
average requirement of about twenty five. Extractions 
usually varied with the amount of clinical material 
available, but on the whole surgical preparation seems to 
have been better than operative. Detailed courses of study 
have teen reported previously. 
Much of the last semester was spent In preparing for the final examinations, which were given by the school under 
the very general supervision of the state. Questions were 
formulated by the sohool. Succetsful completion of this' 
exam entitled the graduate to practice In any part of the 
Reich. In order to take part in the state Insurance system, 
however, the graduate had to have a certificate from the 
local authorities of the town In which he Intended to 
practice to the effect that his services were needed In 
that town. 
Completion of an additional semester did not affect 
the graduate* s legal status, but did give him the degree 
of "doctor- (doctor of dental medicine). More than half 
the students took the degree. 
No dental Internships were required, nor were they 
routine for men going Into general practice. Men special- 
izing In oral surgery or orthodontia were required to 
spend three, additional years In the clinic of a large 
sohool or hospital handling patients In the desired 
specialty. During the war a shortage of specialists 
caused the government to sponsor courses designed to 
attract men who were already In general practice. These 
courses were given for two weeks out of every six months 
over a period of three years. Thus a man who completed 
the course received 12 weeks of training. He was also 
expected to treat cases In his specialty In his own 
practice and was encouraged to bring his problems to the 
training center for help. Circumstances of war compelled 
the abandonment of these courses In 1944, before any of 
them had gone on to completion, Graduates of these 
courses were not to have been limited thereafter to the 
practice of the chosen specialty, as had previously been 
the case with all specialists registered as such. 
The specialty of prostheses construction does not 
exist In Germany outside of the university clinics. 
The candidate for certification as a "Dentist" began 
his training at an earlier age than did the Zahnarzt, 
with the equivalent of a grammar school education. For 
three years the student worked as an approtlce In a dental 
laboratory, going to a special apprentice school one day 
out of each week. This school was operated by the 
community, and .they were found only In the larger cities. 
The student next spent two years In the office of $ 
practicing Dentist (not Zahnarzt) doing laboratory work 
and observing. During this period he received a small 
salary. He then spent one year, nine hours dally. In an Institute for Dentlsten, where he took Intensive and curtsied 
work In most of the subjects taught In dental schools, 
Including some work In the basic sciences and anatomy. During 
this year the student had to pay his own expenses, for the 
first and last time during the course. He then put In 
another year with a practicing dentist doing dental work, 
receiving a small salary. He was required to pass a state- 
controlled examination at the end of each of the phases 
described above, and successful completion of the last 
examination entitled him to practice anywhere In the Reich, 
He was eligible to work In the state Insurance system and 
an attempt was made to make the relative numbers of Dentlsten 
and Zahnftrzte practicing In any single city roughly approx- 
imate their proportion In the whole population. They were 
not eligible for commissioning In the army. 
Statistics on the relative number of Dentlsten and 
ZahnArzte graduated each year are unavailable, though they 
may be found In Berlin when Americans enter that city. 
Rough estimates place the number of each at about 500 yearly, 
with probably a few more ZahnArzte than Dentlsten being 
graduated. Dental schools outnumbered schools for Dentlsten 
by at least four to one (there were only seven of the 
latter) but the whole enrollment of the schools for 
dentists graduated each year, so that total output was not 
as disproportionate as would appear at first glance. 
Dental education received severe setbacks during the 
war. With mobilization all schools for Dentlsten were 
closed and remained closed for the duration. All 
physically qualified males were taken from the schools 
for ZahnArzta and did not begin to trickle back until 1941 
when It became apparent that Germany*s hope of a short war 
would not materialize and that she must give consideration 
to the long-term health program of the nation. Even then, 
when the army returned selected former students, paying 
their salary as non-commissioned officers but paying no 
school expenses, the total enrollment remained about half 
Its peacetime figure. Between two thirds and three 
quarters of the wartime students were women. Faculty 
members, especially oral surgeons, were taken Into the 
armed services and scattered all over Europe and Africa, 
Bomb damage varied, but wae extensive over the whole of 
Germany, Of twelve schools visited, eight were almost 
completely destroyed, one was three-quarters destroyed, and 
three had escaped serious damage. It Is believed that this 
proportion will hold true over all of Germany, Even the 
above figures do not tell the whole story as the smaller 
universities were the ones which escaped damage. The big schools at Munchen, Freiburg, Dtlsseldorf, Kdln, and Leip- 
zig suffered severe damage, and probably the schools at Berlin 
and Wien will be found to have been destroyed. The three schools 
which escaped damage were the small schools at Erlangen, 
Heidelberg, and Marburg, towns so small that they did not 
Justify heavy attacks. 
Students also lost much time In shelters during air raid 
alerts which occurred almost every day In some areas. 
In almost every school, however, a nucleus of teachers 
Is on h«nd, usually working In an Improvised clinic, and plans 
are being made to reopen the schools as soon as authority 
Is given and the necessary equipment and supplies can be 
obtained. At Miinchen blue prints for a new building were 
already drawn up and It was the opinion of the director 
that the construction could be financed If materials could 
be obtained. How soon this can be accomplished depends 
upon factors which can only be guessed at, at present. 
Officials of the University of Frankfurt expect to open 
the school there In October 1945. 
The relative part to be played by schools for 
Dentlsten and schools for Zahntrzte In Oermany during 
reconstruction Is a decision for the occupying authorities 
and may play an Important part In determining the future 
trend of dental practice in Oermany. 
Nazi policies did hot make for an Improvement of the 
status of dentistry In Oermany. With a few notable 
exceptions the heads of dental schools have been removed 
by the occupying authorities for political activities, 
and In most cases these men were better politicians than 
scientists. They do not appear to have taken too vigorous 
a part In the operation of the schools In which they were 
located, however. In most oases the constituted faculty 
were allowed to continue their teaching activities without 
Interference as long as they were not outspoken anti-Nazis. 
The time In which the Nazi party was In control before the 
war was not sufficient to allow ,lts policy of preferment 
for party members to be seriously felt In the quality of 
teaching In the schools. 
There Is a general feeling among dental educators, 
however, that dental education In Oermany leaves much to 
be desired. The three and a half year course of study 
does not give sufficient time for a comprehensive coverage 
of the field, and students have had sadly inadequate 
clinical experience when they graduate. Suggestions for Improvement are varied, ranging from short Increases In the 
length of the course, through plans for dental Internships 
or provision for a years practice with another dentist after 
graduation, to suggestions for requiring a medical degree 
as a preliminary to the study of dentistry. The solution 
will probably be found between these extremes. Financial 
returns from the state Insurance system do not Justify a 
long and expensive course of study, and there Is a feeling 
that the economic condition of the population will not 
support the standard of dentistry found In the U. 3. 
The establishment of ’a system for dental Internships 
whereby the young graduate could work a year under super- 
vision of skilled men In accredited clinics, receiving a 
small salary, would probably raise the standard of dental 
preparation and not prove an economic burden on either 
student or public. Certainly every student should take the 
full four years* course for a degree, and the last semester 
should have more time devoted to practical work and less 
to cramming for a final examination and writing a thesis 
on a specialty before the student has an adequate ground- 
work in the essentials of his profession. 
II. SOCIALIZED DENTISTRY 
The social insurance system of Germany was Incredibly 
complex and Its operation was Intrusted to many official 
and semi-official agencies. The following is a discussion 
of the system In its simplest aspects, without spending 
too much time In differentiating between various groups 
doing approximately the same work In different cities or 
within different groups of Insured persons. 
Socialized dentistry in Germany was only a part of the 
comprehensive social Insurance scheme, which included 
medical care, dental care, unemployment benefits, disa- 
bility benefits, accident insurance and old age benefits. 
A levy of about seven percent was made on the salary of 
every employee In the insured class, and the employer paid 
In an amount equal to half that paid by the employee. 
Insurance for every employee making less than three hundred 
marks a month was mandatory. Persons making more than this 
amount could not enroll In the public insurance system 
unless they had previously been members while making less 
than this amount, In which case they could retain membership. 
Other persons making more than three hundred marks monthly 
could enroll In one of the many nrlvate Insurance systems 
or pay medical bills on a fee basis. 
Funds for the various benefits named above were kept In a common account and paid out by the same agencies. The 
laborer paid only on the basis of his salary. Before 1933 
the beneficiary paid according to the size of his family 
as well as according to Income, but with the advent of the 
Nazi party, this extra charge was abolished. Present state 
Insurance plans provide for full care for workers families. 
The central Insurance fund alioted eight marks and 
forty pfennigs quarterly for each Insured employee to cover 
all medical expenses. As nearly as can be determined this 
was about two dollars, though In the absence of a free 
market for the mark It Is difficult to relate the mark to 
the dollar In buying power. This meant that eight dollars 
per Insured family per year had to cover all medical costs. 
(This sum did not Include disability payments for loss of 
time.) 
As originally set up, the Insurance system functioned 
on a purely local basis, with only moderate supervision 
from the central government. With the advent of the Nazis, 
however, the system was centralized In Berlin, so that all 
funds collected were sent to Berlin first, and were sub- 
quently disbursed from there. There was a Relchs office 
for Insurance, and under this a series of "Observers- 
Icherungsamt" having regional control and a more numerous 
series of "Landverslcherungsamt" having authority within 
provinces. 
Within cities and" counties the Insurance system became 
more complex. Within each of these units were found two 
distinct types of Insurance corporation, the "Relchs 
Verslcherungs Ordnung" (Par. 123) type and the "Verslch- 
erung ftr KauftaAnlscheangestelite und Beamte", These 
corporations are usually referred to by their Initials as 
"RVO" and "VKB", These were semi-official organizations, 
with control from higher offices but with a measure of 
local authority. The director was usually nominated 
locally, for Instance, though he had to be approved from 
the central office, 
"RVO" consisted of three separate groups, as follows; 
1. The municipal, or Ortskrankenkasse, group. 
This was the common Insurance group which any 
laborer within the presecrlbed salary range could Join, 
It was operated by local directors determined by the 
community. It functioned Independently of the local govern- 
ment however, except that the municipality guaranteed the 
the adequacy of funds and exercised general control through the director. It was, of course, a non-profit organization, 
and excess funds werd used to operate hospitals and conval- 
escent homes. As In all the public Insurance systems, the 
employees contribution was collected by the employer and 
turned In to the fund. This money was forwarded to the 
central office In Berlin, which In turn paid out fees to 
medical personnel once quarterly, on the basis of vouchers 
submitted for work done. Every employee had to be Insured 
and It was the responsibility of the employer that the 
proper collections were made. Domestic help were not exempt. 
2, Betrlebskrankenkasse groups. 
Many larger commercial organizations (I. CK Farben- 
Industrle, for example) preferred to control their own 
Insurance plans. In such cases benefits for their employees 
could be Integrated Into the public Insurance system. In 
these oases, the company collected the same fees as were 
collected from employees under the Ortskrankenkasse system 
described above. The company did not send these funds to 
Berlin, however, but accounted for them themselves, paying 
to the Berlin fund enough money to cover vouchers turned In 
for treatment for their employees. Their employees went 
to the same dentists and doctors as did other employees, 
and had freedom of choice within the panel, which Included 
most of the medical personnel In the vicinity, As surplus 
funds did not go Into the municipal account, however, these 
companies had to furnish hospitalization for their employees 
at their own expense. This was, Injfact, one of the benefits 
of the Betrlebskrankenkasse groups,' which were more popular 
with employees, In that It was felt that hospitalization 
furnished by the companies, who were more Interested In 
their employees, was on a better scale than In the public 
hospitals. As a matter of fact, however. It had become 
Increasingly common for these company Insurance systems 
to arrange to hospitalize their employees in the municipal 
hospitals, paying a fee therefor. This trend was partly 
to avoid the overhead of operating a hospital and partly 
because It has been found that the municipal hospitals 
get their patients out In less time and thus avoid absentee- 
ism and excessive payments Ibr disability. Many companies 
paid more liberal benefits than did the public system. 
Payment for disability In the public system was limited 
to six months, for instance, while companies often paid up 
to a year. It should be emphasized, however, that the com- 
pany Insurance systems were part of the public system, and 
that no private contracts were made with dentists or 
doctors, and that patients under this plan were treated 
by the same doctors as were the munloloal patients. 3. Innungskrankenkasse groups. 
These were organizations on a craft basis (i.e. 
bakers, tailors) who preferred to operate their own system, 
their groups were operated substantially as were the 
Betrlebs groups operated by large commercial firms, 
* 
The MVKBW group was established for employees of a 
slightly different classification than those Included in 
the "KVO* groups. These were the more highly skilled 
workers, the foremen, engineers, and salaried office 
employees. These people paid the same percentage fees, 
but as their Incomes were generally higher, the fees 
collected averaged more than for ordinary employees. 
This group therefore paid out somewhat higher fees for worn: 
done, though usually limited to fees for prosthetic work. 
Thus the fees paid for fillings were the same as for 
other groups, but “VICE* paid double the common fee for 
dentures. This group also benefited somewhat from 
the fact that they were better medical risks. As medical 
and dental funds were handled together, this meant that the 
saving on medical care could be applied to dental treatment. 
Employees eligible for this group could belong to the 
group for ordinary laborers if they chose, but as there 
was no difference in the fee collected they seldom did so. 
An ordinary laborer, on the other hand, could not belong 
to the "VKB" group. The VKB group paid the full cost of 
dentures, while the "RVO11 group paid only three quarters 
of the cost, 
» 
The patient from any of the above groups who needed 
treatment went to the local public health office and got 
a certificate that he was entitled to treatment. This 
he took to the dentist of his choice, provided only that 
the dentist was enrolled in the KZVD, The dentist took 
the certificate and submitted it at the end of the quarter 
with vouchers itemizing the work done and the amount due. 
Dental matters in regard to the insurance system were 
-handled by a special organization to which every dentist 
doing this work had to belong. This was the "Kassenzahn- 
arztllche Verelnlgung Deutschlands^CKZVD). Its head man 
was Dr, Ernst Stuck, a prominent Nazi, and officers of the 
organization were appointive from the next higher head- 
quarters, on the "Ffthrer” principle. This society published 
weekly paper devoted largely to administrative matters 
(Z ahnArztllche Mltteilung) handled disputes and cooxlnated 
matters affecting both dentists and Insurance groups. It 
was not a scientific body. There was a corresponding 
society for non-degree dentists, the KDVD. Contracts between Individual dentists and the Insurance 
groups were negotiated by KZVD. Peculiarly, these contracts 
may vary slightly from area to area. Thus the fee for 
laboratory work on a vulcanite denture was less In the Rhine- 
land than elsewhere In Germany. The reason for this varia- 
tion Is not clear. It seems to be based on areas rather 
than on location In urban or rural districts. It has 
been said that people In the Rhineland have worse teeth 
than others and that It was therefore necessary, to make 
Insurance Income balance outlay, that fees paid for work 
there be lower. This Is not considered a very probable 
reason, however. Contracts were renegotiated from time to 
time and minor adjustments made in fees to bring expenses 
In line with actuarial experience. 
In addition to the state operated Insurance systems, 
there were In Germany many private systems. These were 
operated for groups able to pay higher fees than were the 
employee groups, and fees charged and paid might therefore 
vary from very low to very high. These groups made their 
own contracts with selected dentists and work performed was 
supposed to be of higher quality. Dentists authorized to do 
state Insurance work could combine that practice with 
private Insurance work, or private practice. 
There Is very little simon-pure private practice In 
Germany. From 50 to 60# of all dentists belong to the 
state Insurance system, and the most treatment not given 
under this plan Is handled under private Insurance plans. 
The KZVD could not make a dentist move to a town 
where It felt he was needed, but they could refuse a con- 
tract If they felt that no additional dentists were needed 
In an overcrowded city, and could thus Indirectly direct 
the flow of dentists to areas where they were most needed. 
It was not considered practical for a young dentist to 
try to make a living In dentistry without a KZVD contract. 
Fees paid by the Insurance system were so low that 
only hurried treatment for a large number of persons 
dally would bring In a reasonable Income, In estimating 
the following fees In terms of U. S. currency the mark 
should probably be considered as worth about twenty-five 
cents. Its current exchange rate of ten cents Is much be- 
low the actual buying power of the mark. Even at twenty- 
five cents, however. It will be noted that these fees 
would hardly be considered satisfactory In the U, 8. even 
If the dentist were guaranteed all the work he could 
handle, s Local anesthesia 1*2 marks 
Extraction 1.0 * 
Silver filling 1.0 ■ 
Root resection 7.0 ■ 
Post operative care 1.0 ■ each sitting 
Night calls Add 3 marks to above fees. 
General anesthesia .6.0 11 
In general the German population favors the Insurance 
system, feeling that without It dentistry for many of them 
would be out of reach. Enthusiasm of the dentists Is less 
marked, due to the low scale of fees. It Is true that 
dentists In Germany have a generally lower standard of 
living than In the U. S., but this low standard Is shared 
with the rest of the population and Is probably Inevitable 
until the entire German economy Is directed to producing 
for the needs of the people rather than toward preparing 
for war. It Is doubtful If as large a proportion of 
the national Income would go to providing dental care 
under a system of private practice as Is now devoted to 
that end under the state Insurance system. Thus under 
the state Insurance system a large amount of mediocre 
dentistry Is done for many people, while under private 
practice a much smaller amount of better dentistry 
would be done for a much smaller number of people. The 
Germans, people and dentists alike, recognize the fact and 
prefer their present plan. 
Even under the rigid regimentation existing In 
Germany for the past twelve years there have been abuses 
of the Insurance system. Dentists (and doctors) have 
collaborated with patients In submitting bills for work 
not done and in unnecessarily prolonging hospitalization 
or treatment. Such abuses have not been common, however, 
and are not considered sufficiently Important to warrant 
discarding the whole plan. It Is believed that future 
practice In Germany will continue to be carried on under 
this plan or under minor modifications of It. 
It should be noted here that the non-degree dentists 
shared equally In the insurance system with the "Zahnftrzte" 
or degree dentists. It seems probable that a merger of these 
two groups will occur as soon as permanent plans for the 
future can be made, 
III. CARIES CONTROL 
Caries research In Germany has been sporadic and on an 
Individual basis, the nearest approach to coordinated study 
being occasional symposlums at society meetings. Such men as Euler, Wannenraacher, Proll, Korkhaus, Harndt, Klentopf, 
Mathis, Tholuck and Schmitz carried on Independent research 
along lines well known In the U. S. and failed to bring 
out, as far as can be determined In a hurried survey of the 
field, any facts or methods of control not already known 
there. Information regarding the use of fluorides In carles 
control In the U.3, was published In Germany at least as 
early as 1945 but seems to have attracted no attention. No 
educator or dentist Interviewed had ever heard of research 
on fluorine therapy. Similarly, the use of bacillus acldo- 
pholus counts, or the possible role of this organism In 
carles formation, were either unknown or considered 
unimportant. 
Most research has been directed at nutritional studies 
and the effect of vitamin administration, leading to the 
conclusion that coarse, unrefined, fresh foods tend to 
protect against carles. The coarse black bread of the German 
peasant Is thought to be particularly effective In this 
resuect. Proll analysed the literature of 70 authors and 
found the following factors mentioned: 
Factor 
Times 
Mentioned 
Composition of diet 
32 
Action of bacteria 
22 
Vitamin Intake 
18 
Mineral intake 
17 
Environment 
16 
Mastication habits 
16 
Composition of saliva 
15 
Structure of teeth 
15 
Sugar consumption 
14 
•‘Constitution” of patient 
14 
Effects of civilization 
14 
Local formation of acids 
10 
Climate and sunlight 
8 
Mouth hygiene 
8 
Effect of hormones 
7 
Metabolism 
6 
Use of white flour 
6 
13 other causes (including 
calcium and 
phosphorus metabolism) 
35 
The low importance attributed to oral hygiene is 
particularly noteworthy. Oral hygiene is nevertheless 
taught routinely in the schools. Most reliance seems to 
be Disced on administration of Vitamins C and D, but the 
average dentist or dental educator seems to feel that no 
really effective answer to the caries oroblem has yet been 
found. Dentists in Germany almost unanimously feel that the 
diet of German children during the war years was Inadequate 
and that mouth health suffered as a result. There Is no 
statistical data available to confirm or disprove this 
opinion, however. Such statistical data may be available 
in Berlin when that city Is opened to American Investigators. 
Except for a shortage of vitamin products there Is no con- 
crete evidence even that the diet was Inadequate, Certainly 
German children do not show the obvious results of malnutri- 
tion seen In other parts of Europe, 
A bacteriologist of Kdln, Dr, Glnz, Is reported to 
have regarded carles as a specific bacterial Infection, 
but his work was not widely accepted and no published 
reference to It has been found. Personal investigation 
cannot be made as this is outside the American zone of 
occupation. 
IV. DENTAL PLASTICS 
The development of dental plastics In Germany has 
followed lines well known In the U.S, The phenol- 
formaldehyde compounds, the celluloids, resovlns, vinyl 
chlorides and vinyl acetates have been tried and discarded 
until the acrylic resins have been left In practically 
sole possession of the field. 
The principal manufacturer of dental plastics In 
Germany'Is Kulzer & Co, This company Is a subsidiary of 
Degussa (Deutsche Gold und Sllber Schelde Anstalt) which 
In turn has oonnebtlons with I, G, Parbenlndustrle, This 
firm had a large factory with research department and 
dental clinic. In Frankfurt until 1943, when it was com- 
pletely destroyed by bombing. It was said that this plant 
used four tons of raw acrylic resin a month, and supplied 
a large part of Europe, After the main plant was destroyed, 
the company moved to the village of Frledrlchsdorf north of 
Frankfurt and established a small factory, without research 
or clinical facilities, capable of supplying the needs of 
Germany, The firm did not make the raw materials used, 
but purchased the unprocessed acrylic resin from Rohm and 
Haas of Darmstadt, 
I. G. Farbenindustrle produced an acrylic resin 
called "Perpax" (pink) or "Glnglvlst" (clear) but It 
failed to become popular due to poor color. Vague reports 
have been heard that I.G.F. was working on a new denture 
base material but questioning of all persons who might 
have any Information In the matter has brought denials that 
such a product was under consideration, A request for information from the American authorities operating the 
Hdchst plant has brought an unqualified denial that any 
such work was in progress, A request has been made 
through channels for information from the Leverkusen plant 
which is in British territory but it is considered doubtful 
if any important developments will be brought to light by 
this inquiry. 
Heko-Werke of Berlin also produced resin products, 
including a denture base (Neohekolith), a tooth-colored 
resin (Hekodent), a transparent base plate, plastic 
temporary filling material (Hekopercha) and plastic root 
canal points. As this firm was located in Berlin it has 
not been possible to get information regarding their 
products, other than to obtain samples of baseplates, 
root canal points, and temporary filling material. 
Among the denture bases, "Paladon11,made by Kulzer, 
was by far the most popular. In powder and liquid form 
(no ready-mixed acrylics ane marketed in Germany) it 
has a good shelf life and seems to be quite satisfactory. 
The color is not as good as similar products sold in the 
U. S., but was stable and was superior to the I.G.F. 
product, which was too opaque. It was used by the army 
and replaced rubber during the war when rubber became 
scarce. It will probably remain the most used base 
after rubber becomes available because of superior 
esthetic qualities. It was stated to absorb less water 
than vulcanite, but this claim is considered doubtful 
in view of experiments carried out by the Bureau of 
Standards on American products. 
Among the acrylics for crown and inlay work MPala- 
pont11 by the same company also was almost undisputed in 
its field. It came in six shades and a tranfciucent shade, 
from which sixteen color combinations were derived. 
Plastic base plates, which handle very well and make 
a transparent tray with obvious advantages for immediate 
denture work,‘were produced by Heko-Werke and the I.G.F. 
Composition is not known but an attempt is being made to 
get the formula through the I.G.F. Plant personnel at 
Frankfurt, 
Plastic temporary filling material was produced by 
Heko-Werke. This material was apparently not well known 
in Germany and no reports as to its usefulness are 
available. It was tested clinically by one American 
dentist who gave only qualified approval. It softens v 
quickly and seems to adhere well to a dry cavity. It sets very rapidly, however, and seems more difficult to trim in 
the cavity. It is very harfl when set and should be more 
durable than gutta-percha. 
Plastic root canal points were produced by I. G, F. 
at Leverkusen, but do not seem to have been widely used. 
They are claimed to be well tolerated by the tissues and 
their flexibility and stiffness make it possible to force 
them to place more easily than points made of gutta percha. 
Apparently they were not available for a sufficient time 
for clinical reports to be made on them. Samples were 
obtained and are being forwarded. 
Experimentation was being carried on in Germany on 
the use of acrylic resins for direct filling of teeth, 
with polymerization within the cavity. This work was 
being done by Kulzec and further progress was halted in 
1943 with the destruction of their Frankfurt plant. The 
material was not named, though it was referred to as 
"Palapont'1, S.H, " ( Self-hardening), It was never marketed, 
but had been given to universities and individual dentists 
for testing. It was also tested on employees and 
officials of the firm end this reporter has seen the 
material as used in practical cases. 
This material was the same base as was used for 
HPalapont11, corresponding to American products for inlays 
and Jacket crowns. There was no change in granule size 
and the same organic colors were used. It was modified 
only by the addition of an accelerator to the powder which 
reduced the setting time to from ten to fifteen minutes. 
This accelerator was said to be a tertiary amine. Use of 
an infra-red lamp to hasten setting was recommended but 
was not considered absolutely essential. 
The material was given the widest application in 
clinical testing. It was used for all types of fillings, 
including occlusals, compound occulusal-aporoxlmals, 
inclsal-approxlraals, and glnglvals. Most of these fillings 
were placed in 1943 and margins were still good. The 
single ocdusal-approxiraal filling seen, on the m-o of 
the lower first molar, showed no signs of wear and margins 
were good. It was very poorly trimmed, however, and 
seemed to fill the approxlmal space, v/ith considerable 
overhang, It did not appear to have been placed with a 
matrix band in place though it was, claimed that a matrix 
could be used. The material was keot dry for ten minutes 
after being placed in the cavity but was protected by no 
varnish after initial setting had taken place. The filling 
was trimmed after fifteen minutes, A novel application of 
the material was as a cement for the placing of bridges and crowns. Used as the cementing medium for an acrylic Jacket 
crown, for Instance, It was said to adhere so tightly to 
the tooth that It could scarcely be removed even after the 
Jacket crown had been cut away, and It sealed the margins 
of the Jacket crown so that they could scarcely be detected. 
In cases where gold shell crowns had worn through, they 
were simply removed and replaced using acrylic self-hardening 
resin as cement, sealing the holes and giving very tenacious 
adhesion. The material was also used to build up acrylic 
pontlcs In the mouth where porcelain pontlcs had fractured 
away. Cavity preparation was not changed for tWs material. 
It was not thought to require any more bulk than silicate 
cement. This reporter saw one dlstal-lnclsal filling on 
a left central Incisor which had been In place over twp 
years. 
In spite of successes In clinical use of the material 
It was not yet considered ready for market, nor Is It 
planned to put It out for sale until the research labora- 
tory of this firm can be reestablished and further experi- 
mentation carried out. Two principal problems remain to 
be solved: 
a. Shades are not permanent. The same organic colors 
are used as are used In Palapont, whose colors are stable, 
so It Is believed that the accelerator Is the cause of the 
trouble. Colors tend to darken with ageing. 
b. There Is some reason to think that pulp damage 
may result In deep cavities. This factor Is uncertain, 
but is thought to require further study to decide whether 
the material actually Is Irritating to the dental pulp. 
It Is believed that. If pulp devitalization actually 
results In some cases, the accelerator Is again at fault. 
There Is no proof for this belief, however. Pending further 
study of this matter. It Is recommended that a cavity liner 
be used In all deep cavities. 
A director of Degussa, Herr Hlrtes, denied reports thet 
similar products were being developed In Prance and Swit- 
zerland, and stated that the Swiss were working with 
samples of the Kulzer product which had been submitted to 
them for testing. 
Complete samples of this product have been obtained 
with considerable difficulty and are being forwarded. 
The processing of acrylics In Germany varies In some 
points from general practice In the U. S. At first casts 
were tin-foiled, but as vulcanization techniques were 
replaced by boiling techniques, the use of any separating medium was gradually abondoned. Present practice is to 
paint the cast and secondary Investment, after boiling out, 
with about three coats of 30$ calcium chloride, allowing 
each coat to sink into the plaster before adding the next 
coat. As explained In a previous report, the calcium 
chloride Is said to raise the boiling point of moisture 
within the flask to a point where no vapor Is formed. 
Another material used is sodium dUicate (water glass) 
which also has been used, with Indifferent results. 
In the U.S, For use with a vulcanizing technique, the 
firm of Heimerle und Lleule of Pforzheim marketed a 
material called •’Vlton" which was a solution of a 
plastic produced by I.G.F. having the trade name of 
,,Cellt,,, As with other I.G-.F. products, the exact nature 
of this material Is unknown, (The director of Heimerle 
U. Meule did not himself know the formula.) Request for 
Information regarding this material was Included in the 
list submitted to the present control of I.G,F, Samples 
have been obtained and are being forwarded. 
Plastic teeth are In common use and were, In fact, 
almost the only tyoe available at the end of the war due 
to the shortage of precious metals for pins. They are of 
good shades, and were well liked. They were made by a 
large number of small firms all over Germany and molds 
were even sold for use by Individual dentists who wanted 
to make their own teeth. DeTrey in Berlin and Wienand 
In Sprendlingen were'the two largest nroducers. Plastic 
teeth produced In Germany were similar In every respect 
to those produced in the U.S, 
SUMLIARY 
No new basic plastics for dental, use have been 
discovered In Germany, 
New applications of plastics which are probably 
known in the U. S. are being made In their use for 
transparent base plates, temporary filling material, and 
for root canal points. 
Results of experimentation with acrylic resin as a 
material for direct filling of teeth Justify the belief 
that this material may ultimately supplant the admittedly 
unsatisfactory synthetic porcelain cements. 
V. FINAL REPORT ON SUBSTITUTES FOR GOLD IN GERMANY 
Before the war such firms as Degussa (Deutsche Gold 
und Sllber Scheldeanstalt), Heimerle u. Meule, Dr, Wienand, 
Heraeus, and C. Hafner oroduced high-carat dental golds 
similar to those used In the U. S. For some years before 
the war, however, the low-carat alloys with palladium became popular for general use because of their economy, 
always a big factor In German dentistry, A general form- 
ula for this type of alloy would be: 
Gold 10# 
Palladium 20% 
Silver 70$ 
This formula was varied by the addition of copper, zinc, 
platinum, or nickel for special purposes. It was used 
for Inlay, crown and bridge work In the cast form, for 
dentures In sheet form, and for clasps In wire form. It 
was seldom used for cast clasps, and this form of construc- 
tion Is, In fact, almost never used In Germany, Some 
typical alloys of this type were: 
Name 
Formula 
Manufacturer 
Phoebus 
Gold 
10*. 
Dr. Th, Wlenand 
(Crowns) 
Palladium 
20* 
Silver 
Copper 
Zinc 
61* 
7* 
2* 
Phoebus 
0-old 
10* 
Dr, Th, Wlenand 
(Inlay) 
Palladium 
Silver 
Copper 
20* 
57* 
11* 
Zinc 
2% 
Econor 
Oold 
10* 
Helmerle u, Meule 
(Crowns) 
Palladium 
Silver 
20% 
70% 
(This alloy was sometimes hardened by 
adding 2% copper) 
Econor 
Oold 
10* 
Helmerle u, Meule 
(Clasp wire) 
Palladium 
18* 
Silver 
Platinum 
70* 
2* 
- 
With the coming of war, gold became Increasingly scarce and 
these palladium alloys became the only ones available. They 
were considered reasonably satisfactory. They did not 
discolor badly and soldered well. They were not strong 
enough nor stiff enough for cast clasps or 3/4 crowns 
though they were used for these purposes where sufficient 
bulk could be attained. Lack of gold and palladium forced 
even these low carat alloy's from the market In 1940. 
No platinum was available after 1939 and was early 
replaced by nickel In high—carat clasp alloys, A clasp metal by C. Hafher of Pforzheim was: 
Gold 75$ 
Nickel 5$ 
Silver 10$ 
Copper 10$ 
This was modified to: 
Gold 75$ 
Nickel 3$ 
Silver 12$ 
Copper 10$ 
The shortage of gold forced these oroducts off the market 
In 1940. 
After 1940 gold or palladium alloys were produced only 
In small quantities on special order when the dentist himself 
furnished equivalent gold scrap. Early In 1940 the type of 
sliver alloy known In the U. S. as ••Acolyte" was resurrected 
under old or new names and of necessity held the non-ferrous 
field during the remainder of the war. They lacked strength, 
discolored (even after gold plating), soldered poorly and 
were generally disliked. They could not be used for clasps. 
Samples of these alloys were: 
Silca 
Silver 
Tin 
Copper 
82# 
15# 
3# 
Degussa 
Dentosll 
Silver 
Tin 
Copper 
Cadmium 
Zinc 
83$ 
6$ 
7$ 
4$ 
traces 
Th. Wienand 
Silver 80$ to 90$ 
Cadmium 2$ to 
n \ Small 
Zinc */-variable 
Copper) amounts 
Heimerle u. 
Heule 
Un-named 
Silver 
Tin 
Zinc 
Copper 
50$ 
40$ 
5$ 
5$ 
C. Hafner 
Even the manufacturers did not consider these alloys as 
anything but makeshift substitutes. 
Vltalllum has been used In Germany almost as long as 
In the U. S. It has not proved widely popular however, 
for reasons which are not clear. The difficulties attending its fabrication are not a factor as they are not 
greater than those connected with steel processing. Another 
reason may be that full cast appliances, for which Vitallium 
is widely used in the U. S. are seldom used in Germany. The 
general feeling seems to be that Vitallium is more complex 
and more expensive than steel, without having any great 
advantage for the types of appliances most popular here, 
Tiie stainless steels have, of course, been known and 
used in Germany since the first world war. The lack of 
precious-metal alloys after 1940 meant that steel became 
the universal dental metal in both military and civilian 
practice during most of the war. For the army, this meant 
that the four laboratory chests for field laboratories 
had to be augmented by two additional chests containing 
the heavy equipment needed for steel fabrication. 
'The principal stainless steels, which were already 
well-known before the war, were: 
Wlpla V2A 
Iron 74$ 
Chromium 18$ 
Nickel 8$ 
Krupp (Essen) 
BH3 (used by army) 
Iron- 72$ 
Chromium 20$ 
Nickel 8$ 
Stelnlechner 
(Vienna) 
Imuzlt 
Made in British- Pontlca-Labor 
occupied territory, (Mulhelm) 
Formula not known 
but said to be similar 
to above. 
Reraanlt Q- 
Made in British- 
occupied area. 
Formula not known 
but said to be 
similar to above. 
Samples forwarded. 
Deutsche 
Edelstahl Werke 
(Krefeld) 
These steels were used in plate form for dentures; as wire 
for clasps; cast for clasps, iniys, pontics, bases for post 
crowns, and occlusals of crowns; In band or prefabricated 
form for full crowns. They were completely unsatisfactory 
for inlays or cast crowns as they did not cast with sharp 
margins and were too hard to allow minor adaptation in the 
mouth-' They required special Investments of aluminum oxide 
and phosphoric acid. They required hydrogen or acetylene 
and oxygen for casting, or the eictrlc arc. Electric arc melting and welding was nreferred to flame melting or 
soldering as it was considered that prolonged heating in 
a gas flame causes separation of carbon crystals and 
weakness at the point heated. The German army included 
a hwry-Itallan-designed (Vulcanus), centrifugal, electric- 
arc casting machines in their la.boratory chests for stain- 
less steel. 
Special solders and fluxes were used routinely, 
though gold solder and borax could be used. Bridge 
design usually called for prefabricated steel crowns 
on both ends as abutments, with oast steel pontics soldered 
or welded in. Inlays and three-quarter crowns were prac- 
tically unknown, or rather, unused, due to lack of 
suitable alloys. Where a dentist had gold scran available 
he sometimes used gold full crowns as abutments with 
stainless steel pontics, soldered with gold solder. 
SUmiARY 
German prosthodontists prefer the high-carat gold 
alloys used in the U, S. They do not exnect these alloys 
to be available in Germany for more than a small percent 
of the population for economic reasons. They consider 
alloys containing 10$ gold and 20$ palladium as acceptable 
and expect this type of metal to be the most widely used 
for cast restorations after the war. Alloys of silver 
and tin, zinc, copper and cadmium are not considered useful 
for any but temporary fillings, of great bulk. Stainless 
steel is well liked as wire for clasps, and in the pressed 
form for denture bases. Its use for other ourposes is 
based only on economy and avallabl-lity. Its use for 
military personnel requires additional complicated and 
very heavy equipment. The types of fixed replacements 
which can be made from steel would be esthetically 
unacceptable in the U. S. 
The principal manufacturers of dental alloys are: 
Name Location Products 
(G-old, palladium and sliver alloys) 
Estimated per- 
cent damageto 
olant 
Deutsche G-old und 
Frankfurt 
& 
Palllag 
Q0% 
Sllber Schnelde- 
Pforzheim 
Sllca 
anstalt 
Helmerle u. Meule 
Pforzheim 
Econor 
90% 
Argodent 
Heraeus 
Hanau 
Alba 
Not known 
Th. Wlenand 
Pforzheim 
Phoebus 
99% 
Dentosll 
C, Hafner 
Pforzheim 
Pangold 
99% Name 
Location 
Products 
Estimated ner- 
oent damage to 
plant 
(Stainless Steels) 
Krupp 
Es seii 
V8A 
Not visited 
British area. 
Deutsche 
Krefeld 
Reraanit 
British area. 
Sdelstahl 
Steinlechner 
Vienna 
BH3 
Russian area. 
Pontlca-Labor 
Hulhe1m 
Imuzlt 
British area. VI - GERhAN MILITARY DENTAL E£UIP:.IENT. 
No attempt has been :;ade to evaluate German field 
dental equipment for several reasons* No valuable estimate 
could be arrived at without actually using the eauio.uent 
for a reasonable length of time under field conditions* 
xiiis time v;ae not available* any written report 
on suca equipment would be of less value to the medical 
equipment board than samples of ~ne sets themselves* Several 
complete sets of German dental equipment were forwarded for 
study, first to Paris vine re they were uncrated and set up 
for preliminary examination at the Equipment Laboratory, and 
then to Carlisle Barracks for examination at leisure by 
experts. 
German field dental equipment was much more elaborate 
thsn t.iat furnished American dental officers, with less 
emphasis on tne saving of weight* The 12 chests making up 
the set were arranged so that they complemented each other 
and so that progressively more complete units could be 
built up by tiie addition of the desired chests to the 
simpler units* Thus the simplest unit available consisted 
only of cnests 1 and 2, with a set of drawers for, instruments, 
an operating lamp, a combination foot- and motor dental 
engine, alcohol sterilizer, and head rest and cuspidor to 
be fitted onto an ordinary chair* This unit weighed, with 
the chests, about 230 pounds. According to American 
standards it contained many items of doubtful value, 
especially root canal instruments and proprietary drugs 
of uncertain composition* On the other hand the use of an 
ordinary cnair for cental work was not ss/oisfactory* The 
selection of Instruments was complete, including those 
needed for minor oral surgery, and the operating light 
provided an item badly needed in American sets* 
Tae two cnests o.f the lighter set could be augmented 
by the addition of cnests 3 and 4 to form the medium unit. 
These chests weighed abou'c 510 pounds and Included a cnair 
(140 pounds), additional surgical and additional operating 
instruments* Thus tne medium set, which was most widely 
used, weighed almost 540 pounds and required four boxes. 
It provided a very complete and workable unit, but 
examination at Carlisle will show that many items could be 
omitted without curtailing its efficiency* One obvious 
advantage is tne provision of cnesfc of drawers for all 
regularly used instruments* This was possible by agreement 
among tne instrument manufacturers of tne Ruhr and 
Tuttlingen areas on uniform models for war time production. 
Tnus all Instruments, no matter where made, could be fitted 
into tneir intended location.jin tne chests* The "nandform11 type ..xand Instruments Included have been favorably reported 
by American dentists* 
Tne* heavy set was formed by addin; four laboratory chests 
to the four operating chests of the medium set* These four 
cxiest v.ei hied a total of almost 600 lbs* and provided a. very 
complete laboratory set-up with tables, electric lathe, foot 
latne, vulcanizing and casting and soldering appa.rp.tus* It 
did not provide ecuipment for fclb-tlcasting stainless steel* 
The total we i gat of tne heavy set was almost 1140 pounds* 
To make possible t.ie fabrica.tion of tne widely used stainless 
steel appliances another 2 chests were added, weighing a.bout 
375 pounds, for a. total of 1515 pounds for the heavy set of 
ten chests* 
Cnest Ho* 11, containing a dental x-ray machine ana a 
lit., t proof box for developing films, weighed only 242 pounds. 
Tne machine is very simple, without controls for adjusting 
for line voltage or for changing milllampereage, but took 
sahisfa.ctory pictures and could be set up or dismantled in 
five minutes. 
Chest Ho* 12, weighing 176 pounds, contained only those 
surgical Instruments needed in major oral and plastic surgery. 
Only 200 of tnese chests were made. All 12 cnests weighed, 
tnerefore, a.bout 1933 pounds, or roughly one ton. 
Tne cost of the four chests making up the medium set 
was about 3,000 marks, or 500 dollars at present exchange 
rates* At a valuation of 23 cents on the mark, which is 
closer than tne oresent rate to an estimate of the actual 
buying power of the mark, tne cost would be about 750 dollars* 
1500 of hiese me. ium sets were assembled (according to Emil 
huber, tne agent who assembled tnem,) The four laboratory 
chests cost about 1500 marks, or 375 collars at a 25 cent, 
mark. 400 of tnese laboratory sets were assembled* 400 
stainless steel tetanic sets, 500 x-ray sets, p.nd 200 hea.vy 
sur ical sets were assembled according to Herr huber, but the 
cost of tnese cnests could not be stated with any accuracy* 
(All Herr huber*s records were completely destroyed when his 
plant in Karlsruhe was bombed out* Even the location of the 
plant could not be definitely determined*) 
The best comment on the American dental officer*S 
estimate of the G-erman equipment was tnat he almost always 
used tne captured G-erman ecuipment when available, and managed 
somehow to keep it wit i .aim, in spite of the greater weignt, 
even under combat conditions* Certsinly tce German sets seem 
unnecessarily neavy and complicated, even for a mecnanizfca 
army* On the otaer hand their better selection of^instruments, 
the wreater convenience of aavin ; sets of drawers for instruments, t.ie use of a motor driven engine, and the 
opera tin ; light made ork vf. la set measurably more efficient 
than v;ith tne more limited hut much 11 y.ter America n unit. 
Study of tne German equipment at Carlisle should offer 
suggestions for v/ays in which a compromise can he worded 
out between the jreat v;ei at of the German sets and the 
Inconvenience of the American field set. v-1 ;r .-:r"Ar di-I'tal p:::ccl3. 
• 
Prof. Dr. Ilir.m-.bcth von ac. .nitzor. Professor of 
Cx J;' :c ontla. Heihlbi ru July*. r-slt.--, 
Di • .von ow’.nitzer has under trs-* t ent .bout three 
hundred orthodontia cases in ' cr jrivate practice «.no. in 
the University clinic, She if us in:; a method. introduced 
about tro ;trrs before 'chi var by Dr. Andre son of DemnarK 
end developed V; Dr. Leopold PetrIk of Vienna# 
Briefly ft Andre son technique core lets of tro phases. 
The first phfse comprises the widening of the arches if 
necessary, and the gross moverent of individual or groups 
of t€eth by an exp an sion splint placed on the lingual and 
• orn onl" at night. After a .la first phase ic completed, in 
a yea.r oz* 1c ss, the second phase of treatment begins. This 
phase is the slor d vei n ment of harmony in o. elusion and 
J a'v o V.--1? tionr by ..nr nr of a loosely fittlnr— splint fitting 
both uppers arm loners and morn only at night. This phase 
'r last tvo years and requires few- adjustments# This splint 
is ground so that it acts only as a la roe guide plane for 
all teeth, ohannelin.''*t' em to the final correct position* 
It does not exert positive pressure at any tine, end tee 
teeth grow to their nev mic tions rather than moving under 
compulsion. The splint is so loose that at first it tends 
to fall out at niaht, which is the only time it is worn. 
It ---i suits # Iso in cons Ideradole bite-opening if desired. 
mjorter Is hot an orthodontict, but shown on 
c? sts an sca red good c.nd the occlusion between •ind.iviaual 
teeth seemed better than normally expected, ’while requiring 
a comewhat longer period of treatment, the total com was 
reduced by the Infrequency end simplicity of fca£u.raeno. 
Some patient. not seen for four aoat.ic «e -o - e ?w.fuElon 
o-.’ var .,ro reesed normally curin': t;T-.t time. T-.e icot 
only removable appliances, corn at f ft?3eelea 
to t'*e te~ts. Coat per case varieo from 500 masxs bO 
I'OC marks* It is difficult to translate thus cum in terms 
of American enobeiipe as the- rari has not pad a free .carnet 
„ _ _ i +• v>i>tp"'t '.is zee \«ou-.d be from 
f iriy accultc fe-nrlhlon in terns of buyin- poorer. 
rerc is a s'~ort.me of mtic i. " --m-eiin arif 
ry.-> 'vq- 3c’*uitzer v/as t e only o x in nt.-.c.- ''g fd d*b^c.,,-uen« 
i ■ .atlents *r tm Stra.sbour z.. g.-- °c f-~ ~ y?c 4-e 
bd:fhm®t to increase '.he rr of practicing ortc.oao.-nrets, 
he‘"ifcr'm~ -ovc.mr-.ent sponsored in 1940 a plan T-ereby 
d.-U-:U'- -,V, c-r-n other schools jc.ve courses eo prcC^o.n, dentists. These courses were planned for two weeks every 
six months for three years, for a total of twelve weeks. 
The dentist was expected to treat orthodontia case in his 
own practice,during this three year period a.nd could bring 
casts of his practical cases for guidance and advice. Due 
to the war these courses were discontinued before they 
could be completed. Completion of the course was to 
qualify the dentist for registration as a Fechzahnarzt fur 
Kieferorthopadle, or specialist in orthodontia. It was not, 
however, planned to limit these men to the practice of 
orthodontia as had previously been the case with specialists 
of Sill classes. Previous requirement had been three years 
as assistant in a clinic treating orthodontia cases. 
Three books have been published on the Ahdreson 
technique. These are; 
,fFuhktlonsklef er orthopaedic”. III Auflage-, by Andros on 
and Haupl, published by Johann A. Barth in Leipzig, 1342. 
11 G-eblssregelung mlt Flatten11 by A. Llartin Schwarz, 
published by Urban u. Schv/arzenburg, Berlin/Vienna, 1344. 
MLehrgang der G-eblssrerelung V Teil, Die entwlcklungs- 
bezugliche Bestlmmung der entwicklungsbezugliche Befund11 by 
A. Llartin Schwarz. Urban u. Schwarzenburg, 1944, 
The method as also been applied to bite opening.for 
prosthetic cases as reported by Richard Groks and Leopold 
Petrik in Zeitschrift fur Stomatologic, April 1344. 
Dr. Bernhard Kramer. Head of the Dental Society (KZVD) 
of Reidclher 
Dr. Kramer is head of the local dental society at 
Heidelberg in an informal capacity as the society is actually 
a of the group and its headquarters is in that 
city. Dr. Kramer is in wenerfi practice end is not connected 
with the University. He may be regarded as an average german 
dentist, maintaining a good practice consisting partly of 
insurance prrctice end partly of private patients. r.is 
opinions are not reccesaril" mu- prescr.tr.tivs- os ' ■ -e most 
advanced German dental science, but represent Ger-rn denm.stry 
as actually practiced. 
In Heidelberg the wZahna,rztelf (degree •. entists) outnumber 
thettDentistenrt (non-decree dentists) t’ o to one, r id 
Dr. Kramer believed the two groups '-ixi am. Ij -p r / 
one cl'ss, v-’ith common educational rcquiuw-mcntc. o .c-.i a v* 
was *’ndc r way in 19-73 hut ~:tS not c no our a 'to. 'C-~e x.-j.zx 
party. Crrlcs is believed to be the result of poor diet and 
poor oral hygiene. Thinks'these two factors" are of about 
equal Importance* Does not have much confidence in the 
ability to control carles by diet and hygiene, however, 
indicating some other unknown factor* 
Focal infection from teeth is m cause "heart 
disease, kidney disease, rheumstism a*nd nerve diseases." 
Practices a simple root canal technique without rubber dam 
or bacteriological check, sealing in antiseptic (chlorphenol) 
for two treatments and filling the Canada with gutta percha. 
Not sure of result from .health standpoint. 
oulfa drugs are .used internally in cases of developed 
infection but are not used prophylactically nor locally. 
Periodontoclasia is believed due to "inner constitution" 
of pf-tlents, old age, or lack of adequate diet, especially 
Vitamin C. Treatment of moderate cases if by prophylaxis 
and relief of traumatic occlusion. Late cases are treated 
by Oinglvectoray. Patients are ,_iven a paste csdled "Ceblon" 
which contains vitamin C and is massaged into the Gums twice 
daily. 
Dr. Kramer thinks the acrylic resins are good for 
denture bases but are not sufficiently tested for crown 
and inlay work. He has not heard of the use of acrylic 
resin and liquid for direct insertion in cavities followed 
by polymerization by the use of the infra-red lamp. 
He routinely used steel for crowns and prosthetic work. 
He uses palladium alloys, when available, for inlays. 
7/ould prefer gold. 
Preventive dentistry has been carried or. by* bi-annual 
examinations of school children followed by treatment by ■ tie 
school dentist, and by instruction in home care. Before the 
war, poorer children in Heidelberg were given an accessory 
"ration" by an American Quaker organization. This ration 
also contained vitamins C and D and was believed to help 
dental health. 
Dr. Kramer thinks, the state insurance system is good 
— tient but does not _ivc the d entist nuch_ incentive 
to improve his technlcue by post-graduate study 
remain the same for good;or poor work and most den bists are 
husv throughout the working clay. The more eixecoive 
incentive is to et out more work by seeing as many patients 
r.s oorsible in time. The system does provide for., 
every citizen at least minimal dentistry. Through its control of licenses it also insures that smeller towns will 
have adequate dental care. 
The state dental system provides replacements only if 
less than five teeth remained above and below, in occlusion. 
(Total of at loa.st ten occluding teeth,)' 
Mr* Neumann. Karlsruhe. 
hr. Neumann is currently directing the school for 
MDentistenH (non-degree dentists) in Karlsruhe, in the 
absence of Ur. Emil Kimnich who has moved to Baden Baden, 
pending opening of the school* 
There are seven schools for dentisten in Germany at 
Berlin, Dresden, Diisseldorf, Frankfurt, Karlsruhe, Munich and 
Vienna* They graduated about 550 students yearly before the 
war* Durlnm the war they were closed except for their 
operating clinics* Their graduates were not commissioned in 
the army. There are said to be about 20,000 dentisten in 
Germsny but this figure is believed to be too high by the 
undersigned. Exact figures are unavailable outside of 
Berlin, if there* 
The School at Karlsruhe was said to be the largest in 
Germany with a.bout 130 students* Only.5$ were women, as 
women did not like the required preliminary qualification 
as a laboratory technician* 
Cnl'r one year was put in in the Institute for dentisten, 
but seven years were required for qualification after 
completion of grade school, as follows: 
3 years as apprentice in a commercial laboratory, with 
one day weekly spent in a special apprentice school. 
2 years in the office of a practicing "dentist” (non-degree) 
1 year In institute for Dentisten* In this year 4 hours 
were put in, class work daily and 5 hours were put in in the 
clinic* Studies included physics, chemistry, anatomy (general 
and special) surgery* X-ray, operative procedures, end 
prosthetic technique* 
1 year in the office of a prectlcing dentist. 
During his apprenticeship in the lab the student received 
no j/tjm During his first two years in a dental office, 
got a small salary* While in the institute he paid f *e school 
a small fee* After graduation he again received a small sr.ie.ry wnlle working with a licensed dentist* Each stage of 
*iis study was followed by a state«*»controlled examination* 
The school' Itself is privately owned* Only the examins/- 
tlon are state~controlled* 
Mr. Neumann estimates that the ratio of “Dentlsten" to 
11 Zahn&rzteM in Q-ermany Is 2 to 5* This ratio agrees roughly 
with those suggested from other sources* 
The licensed graduate could legally perform all dental 
operations except (a) intra«*venous therapy (b) general 
anesthesia (c) major oral surgery* 
Prof* Dr. ,Peter_P*_Krantz. Munchen* 
Dr. Krantz, who has a medical' and dental degree, is 
director of the dental school of the University of Munich, 
a,-fiosltion he has occupied since 1929, He is also professor 
of oral surgery* Other full professors are Dr* Carl Pal6k 
(prosthetics), Frau Dr. Kostes (ceramics), and Dr. Carl Plepe 
(operative and periodontoclasia)* Dr. Plepe is in custody as 
a nazi* Other members of the staff are available* 
The medical school of the university is 50# destroyed* 
The dental school is 100# destroyed and at present is operatlnj 
only a small clinic in temporary quarters. Before the war thli 
school was second in size only to the one in Berlin. 
The dental school had a maximum enrollment of 1923 of 
780 students* This number dropped gradually to about 250 at 
the beginning of the war* The cause of this drop has- been 
discussed in other reports* The positions open for dentists 
has decreased considerably by 1938* Of 250 students in 1938, 
40# were women and 20# were foreign students, chiefly from 
the Balkans. It was not known how many dentists graduated 
yearly during the war. 
In 1940, Dr* Krantz was taken into the military service 
end served until April, 1944, most of the time as chief of 
the m axl11o~fac1a1 service of a Luftwaffe hospital in Paris. 
Enrollment in the school dropped immediately after-the start 
of hostilities to a totsl of about 50 students, of whom 60# 
were women, 20# foreign students, 10# disqualified males, 
and 10# military in student companies* 
Dr. Krantz believes the trend toward more women In 
dentistry will continue* He does not believe tnat the fee 
scale in socialized dentistry had much effect on enrollment, 
but that difficulty In getting a place to practice after graduation was a limiting factor# A dentist could participate 
in Insurance practice only if an opening was certified by 
local authorities# 
Dr. Krantz was pessimistic about dental education in 
Germany, past and future# He says students came from tne 
Gymnasiums (high school) poorly prepared, due in part to time 
lost to parades and political activity# He believes that a 
four year course is sufficient for general practice if the 
time is well used# He believes an Internship is essential 
for specialists# In tnis school oral surgeons took one year 
of additional schooling and then put in two years as assistant 
in the clinic# This was the system followed at Wien also# 
Dr# Krantz says tnat general practice in Germany is to require 
3 years in a hospital or clinic treating Jaw cases, after 
which a certificate from the clinic will authorize reglstre.tion 
as a specialist without special examination* This statement 
is not in accord with that of the director of the dental school 
of Jena, but was emphatically stated to be correct# Tnis 
question will be investigated further# 
Operative requirements in the clinic years of the dental, 
school in Munich, which were set by the professor in charge, 
were as followsi Fihst yean 
4 bridges 
12 full or partial dentures 
13 amalgam fillings 
9 amalgam fillings rebuilding crown of tooth 
9 silicate fillings 
9 cement fillings 
28 root canal fillings 
11 Inlays 
5 gold foil fillings (if patients could be obtained) 
13 prophylaxis 
During the second clinic year the student worked on cases 
as they were assigned or as he individually prefered, except 
tnat no prosthetics v/ork was done after tne first year unless 
by tne students special preference# 
The Nazi regime did not interfere with operation of the 
school# Only once did a party representative interview 
members of the staff* Dr* Piepe was said to be a strong party 
mPn and not a good scientist# 
The scnool was most noted for its oral surgical department, 
which attracted many students from the. Balkans. 
Caries prevention was based on improved diet and hygiene# Krante believes diet of the mother le most important If 
first molar is forming then* He believes hygiene is more 
important than diet, and that there is also a hereditary 
factor of unassessed importance# He believes the diet of 
the past 12 years has not been wholly adequate* 
Krantz states that there existed in Germany a 
dental research council which acted as a clearing house 
for information but which did not Itself finance or direct 
investigations* Yearly meetings were held but only to 
discuss in a general way one specific problem each year* 
The last meeting was held in 1939* There were no standing 
committees* Chief researchers in caries were Dr. Euler of 
Breslatr, Dr. Schroeder in Berlin (deceased). Dr* Graz of 
Vienna, and Dr* Mathis (last location unknown.) The inves- 
tigation of these men apparently followed the lines of 
investigation most common in the U.S* regarding effect of 
diet* Their work has been reported in the literature, 
files of which are being forwarded to the Army Medical 
Library* 
There was in Germany no council for passing on the 
merits of products offeree, for sale to the dental profession* 
At present, maxillo-faclal cases in Munich are treated 
at the Luftwaffe hospital. There are at present 
only 10 cases under treatment* Air raids did not result in 
many maxillo-faclal cases, probebly due to the nature of the 
injuring force* Persons were subject to crushing injuries 
over large areas of the body, but seldom to high velocity 
missiles* 
Very new and favorable cases of facial wounds were 
treated with immediate closure without drainage. More often 
immediate closure was done with rubber dam drains* Unfavo- 
rable cases, either because of elapsed time or severe tissue 
destruction, were left open until danger of Infection was 
past (ten or more days)* 
Bone grafts of the Jaw were usually taken from the 
crest of the ileum* Ribs were not used. These grafts were 
usually taken as free grafts wlthout previously imbedding 
them In the tissue of the abdomen* The bed for the graft 
is prepared up to 14 days before the graft is to be placed* 
The bed is left open with a drain in place. It is claimed 
that this procedure reduces bleeding at the time of 
operation, makes a cleaner field, and that granulation of 
the exposed bone ends in the bed promotes rapid union and 
reduces infection* Dr. Krantz claims that Dr* Ertl of 
Budapest is the proponent of this method. He claims good 
results in his own experience* Simple Jaw fracturee ere usually treated witn splints 
or acrylic rosin. Simple fractures in tne mid line are 
usually immobilized only with bandages♦ Inter-maxillary wiring 
is used Infrequently# When used it is applied with rigid 
1 mobilization for two weeks, after which only 11 semi-immobili- 
zation” is kept up, for another two weeks* Direct fixation 
with pistes or pins is not practiced* Circumferential wiring 
of edentulous cases is occasionally, but rarely, used# 
Sulfa dru s are used tic ally in severe esses, 
especially vv.jere bone is exposed# 
Novocain is used routinely for local anesthesia* 
Pantocain nas been used but no advantage is seen for it. 
Periodontoclasia is treated by early gingivectomy* 
Advanced cases are not believed curable* Gringivectomy lie 
considered as the conservative treatment, not a last resort 
for severe cases* 
Dr. Krantz mentioned an operation for correction of 
labially prominent anteriors in adults. He stated tnat this 
operation was common and had been practiced in Germany for 
many yesrs* If all six anteriors are to be moved back, 
vertical cuts are made in the mucous membrane vertically 
between tne cuspids and first bicuspids on tne labial surface# 
t.ie labial gingivae are reflected to a level above the apices 
of t. e upper anteriors, and tne segment of bone hoi din; the 
teetn is by cutting with a chisel or bur between 
tne cuspids and horizontally over t e apices of tne teeth# 
Tnis block Ox’ bone is tnen pushed back to the desired position 
snd immobilized v/itn a labial aren wire* The lowers are 
prevented from strikin ; tne uppers bv Insertion of a splint 
over t.xt lower posteriors, wnicn is left in until reattaenment 
tikes piece, about a montn# It is claimed that devitalization 
of tne teetn dots not occur and tn t results are good* 
Individual teetn, or two or tnree teet are moved if required# 
When individual teetn vertical cuts are made on the 
1. blal 'surface between t ,c tootn to be moved and tne adjoining 
teetn* In addition he lingualgingival tissue, lingual to the 
tooth, is reflected upward from tne bone and sufficient bone 
removed witu a bur to make it possible to pusn the tooth back 
tne reruired amount* Tnis method is only practiced for adults 
vn.ere ort .odontic. is not considered feasible# It is to be 
understood t.w t tne undercl -ned is merely reporting tnis method 
f nd does not indorse or condemn it* Sectioning- of tne neck 
of tne condyle of tne ramus of the mandible are also practiced 
for cases where oosltlonln : of the mandible is required, 
following procedures known in tne U.S. Osteonyelltis is treated, with x-ray dosages of 150 to 
200 R given eight or ten times at intervals of 48 hours# 
Said to give rapid relief of pain, with decreased healing 
time* Data on KVP and filtering not known to Dr. Krantz* 
Dr. Krantz believes there is increasing awareness of 
the dangers of focal infection among German dentists* 
He says he is also becoming convinced of the impossibility 
of sterilizing and keeping sterile the root canals of multi- 
rooted teeth* He believes extraction of dead teeth is 
safest* He thinks it will be some time, however, before 
German dentists will adopt a more careful attitude in 
selecting teeth for treatment, partly /because of past 
training and partly because of pressure from patients* 
At present, treatment is attempted for almost any type of 
case, frequently by pulp amputation without further treatment 
of the canals, beyond sealing in a mummifying agent* 
Tne provocation method of diagnosing focal Infection 
in a suspected tooth (disoussed in previous reports) by 
fneans of diathermy or vibration is practiced and taught, but 
Is not considered more than an indication of the condition 
Of the tooth and is not relied upon* 
Dr. Krantz thinks the public Insurance program in 
Germany has not worked out well, though he does not seem 
to base his reaction on definite facts* He says vaguely 
that it is too big and has too much overhead* More concre- 
tely, the fees are too low to encourage good work, the 
dentist and patient are encouraged to conspire to defraud 
the system by reporting work not actually done, and the 
dentist tries to sell the patient work not paid for by the 
Insurance system to get a larger margin of profit* Dr. Krantz 
favors a system of private practice for average patients, 
with university or charity clinics for those unable to pay 
a reasonable fee* (It seems generally accepted by most 
German dentists, however, that the Insurance scale of fees, 
low as it is, represents about tne maximum that average 
Germans can, or will, pay)* 
Prof* Dr. Ottoman Jonas. Freiburg. 
Dr. Jones was in Leipzig until 1936, when he came to the 
University of Freiburg, He does oral surgery, prosthetics 
and orthodontia* He waa a professor at Freiburg (prosthetics) 
until the end of the war, when Prof* Dr. Fritz Farber was 
relieved for Nazi activities, and Dr. Jonas became acting 
director* Dr* Emig was instructor in operative dentistry. 
Freiburg had one of tne" larger dental schools in Germany*. Its students numbered about 500 until tne war, without the 
drop noted after 1934 in most schools* Dr. Jonas says he 
brought many students here from Leipzig in 1936, at the time 
when the decrease in most schools was most evident* This 
sounds Improbable but t iere seems to be no other explanation, 
and is borne out by the fact that the school at Leipzig 
dropped more rapidly (75$) than most schools in this period. 
During the war, Freiburg maintained a student body of 
about 150, 80$ of whom were women, the remainder military 
and disqualified males. During the v/ar three semesters work 
were given each year so that a student could graduate in a 
little over two years* More than half took ah extra semester 
to get the doctor*s degree* 
Students at Freiburg put in two semesters only in clinical 
prosthetic work during which time they completed a total of 
18 pieces (bridges, full or partial dentures,) Dr. Jonas did 
not know how much operative was required. 
In Freiburg there are about 30 degree dentists and about 
20 "dentisten" or mechanical dentists* During the war only 
ten dentists were taken from Freiburg and there was no 
difficulty in. getting dental care #until tne town was badly 
damaged in November, 1944* Gold and acrylic resin were 
scarce but there v/qs no shortage of alloy or rubber* This 
contradicts newspaper reports in tne US that only most 
urgent emergency work was authorized and that alloy for 
amalgam was very scarce. (One small firm in Pforzheim claimed 
the French confiscated about a ton of silver from their 
factory alone). 
The dental school was completely destroyed in November, 
5-944, 
Dr. Jonas believes tne state insurance system is better 
turn private practice, at least for the patients* He 
believes tne low fees force rapid work, however, and favors 
the operation of clinics on a salary basis* He cites tne 
example of tme fee for a root-canal filling, which brings 
twenty-five cents at present exchange, or about sixty vjents 
at old exchange rates* A root-canal file alone costs about 
one third of this sum, Berlin, Breslau, Hamburg, and other 
larger cities, operated such insurance clinics on a salary 
basis, but most work was done on a fee be sis. 
Preventive dentistry was based on hygiene end diet. 
The latter emp.: sized principally vitamins C & D* Ko evidence 
was -iven that Vitamin C affected caries, but it was apparently jiven vital tne idea tnat it might help anyway. 
J/’i train C was also given for periodontoclasia, but 
Ci.ilci reliance was placed on a. forcible spray using oxygen 
as the compressed gas. The solution used was though 
unimportant. Said to nave a silver solution but it is not 
clear Just what form of silver was used. 
Only Novocaine was used for local anesthesia. Tne 
standard a.crylics were used for denture and bridge work. 
Acrylics were not used for polymerization within the cavity. 
Vitonlak, an I.G-.F. product (made up into solution at 
Pforzheim, helmerle u. Neule) was used instead of tin foil 
for vulcanization. Said to be satisfactory. A bottle was 
obtained and will be forwarded witn a separate write-up. 
Dr. Karl Falck. University of Ifnich. 
Dr. Falck is professor of prosthetics in tne University 
oi Munich. he was Questioned particularly regarding the 
substitutes for gold used in Germany during the war.- 
At first tne shortage i>f gold-was met by alloying writh 
increasing ratios of silver and palladium. Tnese alloys 
were generally satisfactory but gold early became unobtainab1e. 
At tnis time t.?.e palladium**silver alloys came into use, a sample 
formula for which was: 
Palladium 25$ 
Silver 65% (information from manufacturer 
Gold 2% Indicates that the percents e 
Base Metals, largely copper Q$ of gold ran nearer \0$) 
This material was marketed as "Palliag", “Alba11 or 
"Econor", made respectively in Frankfort, Hanau a.nd Pforzheim. 
These alloys were widely used and ’..ere considered satisfactory. 
Tney were used for inlays or in sheet fori? for denture bases. 
They were not used for cast clasps. Tne metal was said not 
to blacken in tne mouth and could be soldered. 
Later palladium (obtained from Canada.) became scarce and 
owner alloys ckme into use. One of these (Silca) contained;' 
Silver 32% 
Tin 15$ 
Copper 5% 
Tnis metal discolors badly, has sufficient edge strength, 
end cannot be soldered sa.tisfg.ctorily as the solder line 
breaks down in tne mouth. It was used for inlays, crowns 
and pontics. 
rrn Other alloys of alluminum, tin or zinc and silver were 
used but were brittle and unstable (Deufa metal). 
The most common materials in use at the end of the war 
were tne stainless steels. These steels xiad adequate strength 
and held up well in the mouth but were difficult to fabricate 
and in the cast form were not accurate enough for inlays or 
3/4 crowns* Among the stainless steel were: 
Wipla or Krupp V?H 
Fe 74$ 
Or 18$ 
Ni 8$ (for swaging or in wire form only) 
BH-z (Made in Vienna, name of company net known) 
Fe 72$ 
Or 20$ 
Ni 8$ 
Vitallium 
Ponticar-muzit (a complicated formula of Cr, Ni, Cu and Fe, 
made by Rochling in Ruhr.) 
These metals reouired hydrogen or acetylene and oxygen, 
or the electric arc, for casting* The electric arc was 
considered best for taose containing iron to prevent the 
separation of carbon crystals under prolonged heating; also 
to prevent tne absorption of hydrogen* None of these metals 
cast accurately enough for inlay work and all required a 
specia.l investment, flux and solder* T .e steels were usually 
cast in an investment of AI2O3 and phosphoric acid* Krupp!s 
was called •’Pyrofen". An investment for both steel and 
vittalium was "Neo-kredolite11, mp.de in Breslau* 
Dr. Falck states that models for e.crylic work are 
painted v/itn a 30$ solution of calcium chloride as the only 
protective medium during curing. This solution is painted 
with a brush onto t ,e hot, dry cast after boiling out tne 
wax* It is applied and allowed to absorb about three times* 
Tne theory of its use is that the affinity of CaCl2 for water 
is such that no vapor exists inside the flask* It also 
raised the boiling point of water to a degree that steam is 
not formed inside tne flask* This method is reported for 
testing if desired* Undersigned can only state that good 
results were claimed for it. 
Full denture techniques are sketchy* Impressions are 
usually ta.ken in plaster in a stock tray, though occasionally 
a preliminary trpy is made arid t e impression completed in 
compound so that muscle trimming* can be done. The denture 
space is determined by closin'- until lips touch lightly# Centric is determined by naving patient swallow and 
close or by having patient hold tongue well back wnen closing. 
The G-ysl tracing is not used. Plain line articulators are 
almost universal. Dr. Falck states tnat most students leern 
very little about prostnetlcs while in school and in view of 
the fact tnat tney were required to make only six full or 
partial dentures, txiis opinion seems well-founded. 
Dr. Josef Konler. Heidelberg. 
Dr. Kohler is principal dentist in the dental school 
of the University of Heidelberg, though witnout official position. 
Former director was Prof. Dr. Karl Schraidhuber, now under 
arrest as a member of the SS. Tne present acting director 
is the cnief of tne ear, nose and throat department and is 
not a dentist. Others prominent in the dental faculty were: 
Dr. Alexander Ritzert, assistant in oral surgery, under 
arrest as an SS member. 
Dr. Fritz Kullman, assistant in charge of prostnetlcs, 
now a prisoner of war. 
Prof. Dr. Elsbeth von Schnitzer, professor of Orthodontia. 
Dr. Weissenfels, assistant in surgery till 1936, now 
an oral surgeon in the city giving one hour of lecture time 
weekly. 
Enrollment figures were not available, but in tne years 
immediately before the war, the number of students p.veraged 
about a Hundred. With tne outbreak of war tnis number of 
students dropped, at once, to 30 - 40, of whom twenty to 
twenty-five were women, five were military students, and the 
rest were pnysically disqualified males. Tne number of 
students w.iicn could be accepted annually was fixed by tne 
government beginning with 1937. No courses were given for 
dental officers in the Army. 
Very little damage was suffered to buildings but the 
staff were badly scattered during and after ti.e war. The 
course of study was not much affected by tne war until 1945. 
As in other schools, the required course for r degree 
was 3ir years. Host students went for an additional half 
year to take the degree of ‘'Doctor*1 in audition to tne 
required title of “Z&hnarzt11. Dr. Kohler believed students 
should have three or four montns practical experience after 
graduation under a practicing dentist. He believes a system 
of internship or a requirement that all students have a 
degree in medicine would be even better. 
Before tne war, semesters were short (3 to 3s months) so that students had nearly five months free out of tne 
year* Some worked in tne clinic in this free time, others 
went to tnelr nomes. During tne war three semesters were 
crowded into each year so that the seven semesters reauired 
only 2* years* 
Clinical requirements for students were as follows; 
1st Semester: 
15 amalgam fillings 
10 cement or silicate fillings 
6 Inlays 
5 prophylaxis 
10 root canal fillings 
3 full dentures 
4 denture repairs 
2nd and 3rd Semesters (combined) 
20 amalgam fillings 
20 cement or silicate fillings 
15 root canal fillings 
20 inlays 
7 propnylaxis 
1 apicoectomy 
Extractions as available. 
Prosthetics work could be done during tne third semester 
if desired and time was available. Considerable time was left 
in the t drd semester for study for final examinations. 
Very little research work was done in tne Heidelberg 
University Dental School for some years before the war. 
Preventive dentistry was based on early treatment and 
diet. A proprietary product of Lierck called Calcipot D. 
containing calcium phosphate and Vitamin C & D was given to 
private patients but witn uncertain results. A student 
claimed to have esta’ol -i. —iC/Cl GliO G AJ. S tence of circulation in 
the enamel by sealing in a solution of fuschin in a root canal 
of a devital tooth in situ. After three days the tooth was 
extracted and sectioned and it was claimed that tne dye had 
penetrated through tne full thickness of both dentine and 
enamel. Details of this work are lacking and it was not 
published. 
Periodontoclasia was treated early -ith relief of 
traumatic occlusion and prophylaxis, followed by the use of 
an iodoform or sulfonamld paste (or orthoform) in tne pockets. 
Llore severe c<.ses were trer ted by gingivectomy. 
Hovocaine and or corbasil was used for local 
anesthesia. Pantocaine washesed for topical anesthesia but was considered too toxic for injection. No other anesthetics 
were experimented with. 
Cnemotaerapys The common sulpha drays were used prophy- 
lactically in severe bone injuries', both internally end by 
dusting in tne wound. A proprietary product of Knoll AG5-, 
Ludwigshafen, called "Saltnion" was being experimented with 
and was tnougnt to be very effective against tne same organisms 
as are affected by sulfatniozol. Tne material is used only 
locally as a. solution on :auze backs. No work had been done 
on tne benzyl derivatives developed by tne Kai;:er Vilhelm 
Institute in Heidelberg. 
Dr. Kullnam had worked with acrylic eyes but the results 
were not known to the dental staff* 
Fractures were treated routinely with a.crylic splints. 
Inter-maxillary wiring, direct bone plating or external fixation 
with pins are not used, though tne headcap is used when 
,indicated* Bone grafts were‘formerly made from tne crest 
of the ileum, the tibia (esteo-periosteal) or from a rib* 
how only the ileum is used, with fixation by steel wire. 
Wire is removed i;i 8 weeks. 
mentioned tmat both Swiss and French have acrylic materials 
for direct filling of cavities, but details are not known. 
Has neard of nollow bur cooled by C0& but does not know by 
whom developed, and nas never seen one. 
Dr. Rossle. University of Hrlan :en. 
Dr. Rossle is an assistant in surgery in the dental 
scnool. Prof. Dr. Edwin Kauberisser was director of the 0 
dental scnool and has been. <: erested f or Naai activities* 
Dr. Heinz Pascxfke is acting director but was not available 
at tne time of interview* Dr. Otto Winkelmeier is professor 
of operatives and Dr. Rossle is acting head of the surgical 
department. 
This was one of the smaller schools in G-ermany* They 
had a maximum of about ISO students in 19C2-22, dropping off 
gradually to about SO students wnen the present war began. 
During this war the number of students dropped to about 
twenty women and dlsquailfied males, plus a variable but 
small number of military* About 75fi of students were women. 
Students from/Rostock and Cologne were taken in temporarily 
pending repairs to schools tnere. 
Tne dental scnool was not damaged by air raids but 
classes were interfered wltikeonsiderably during 1941 and 
1945 by air raid plerts. ho research was carried on ct Sri an .;en durlnon for 
some years before one war. 
Dr. Rossle believes the dental insurance system pays 
fees so low as to bis courage good v/or’e. C trier wise he approves 
of it. , 
During t..ic war t .ere were no restrictions on dental 
practice in Lrlcngcn except tr.osn due to shortages of gold 
and rubber. 
VIII - GAS*-COOLLD DAh-.AL BURS. 
In an early July issue of "Stars and 3trices" there 
appeared an article stating that an Army dentist (Capt. John 
a. Leblanc, 407th Infantry) had found, hollow dental burs in 
Crifhorn, Germany, wnich were cooled by a stream of air and 
v;hich were et< tec to me he cavity prep: ration painless, 
ho previous record of any cucn device m.d been found 
on visits to bur manult .ctwrers, universities, or cental 
open. uOrs, cno. i..v e 0.1 l, u 0 s* 2 ps were jf,i!ieii to ge g c .11 
available infos mation. An attempt was first made to reach 
mis unit by phone, but this proved impossible after two 
days of effort, rn ' a trip was made two hundred miles to tne 
last known location of tne unit. On arrival it was found 
that tne unit had moved from the area the previous day to 
a point near tne Czecnos1ovahian border, A letter rcones ting 
details, drawings, and samples if possible, was sent to Capt. 
Leblanc, but v.aen anctncr investigator from tnis office was 
found to be. vein; into trust area ne v:as rerg tested to get 
tne necessary information. 
This invest! g.tor (Ac..lor Galvin, AAC) found tne following 
information: 
1. Gapt. Leblanc had seen t ie apparatus in tne office of 
a German civilian dentist in Gif nor n end iad used it on a very 
few patients in hi;- own unit. Two of these patients were 
available at t .c time of m.j::r Galvin's interview and reported 
tnat tney n.d "felt no pain". It is not hno'rn wnat types of 
cavities were excavated for these patients, 
2. Tne report carried in "Stars and Stripes" was 
Inaccurate in that tme burs t a:mselves were not hollow, and 
there was no circulation throw, fi f..\e bur. The handpiece, 
which was the important item, was cooled b,r means of a copper 
coilftnrough whlcn a stream of carbon dioxide gas circulated, 
T-.e bur was cooled only by conduction of neat away from the 
cutting edge t rovgn the shank. In view of tne low 
-onductivity of steel tne effectiveness of this method is open to question* (Experiments in the U*S./University of 
Illinois?/have shown that tne cut tin'* edge of a bur may 
develop temperatures up to 3C0 degrees, while tne shank 
remains relatively cool.) 
3* The handpiece in question is not a daman invention. 
It was developed and patented in Switzerland* Tne dentist 
in G-ifhorn had no part in tne development or production 
of tne apparatus* 
4* Capt. Lebla.nc did not know the name of tne dentist 
in G-ifhorn, nor did he nave samples or drawings of the 
equipment* He did not know the name of the manufacturer 
in Switzerland. 
Subseouent questioning of dentists, supply men, and 
university personnel over most of the American occupied 
area of (Germany failed to bring out any knowlec -e of tne 
apparatus beyond one or two vague rumors that such 
equipment had been heard of in Switzerland or Sweden* 
In the absence of definite clinical data., the 
effectiveness of this apparatus in controlling pain is 
open to question. It is a matter of common experience, 
of course, that even tne touch of an explorer may cause 
intense pain in a sensitive cavity, and tne use of even 
a perfectly cooled bur in such a cavity could hardly be 
painless. If additional information is considered of 
sufficient importance, it would seem that, as the item 
is patented in Switzerland, sucn information could be 
readily obtained through American commercial representatives 
there* Q-ifhorn itself is now, and was at tne time of the 
publication of tne article, in British occupied territory. 
A report has also been received from Dr. Charles 
B. Jones, an American civilian expert on metallurgy and 
surgical instruments tnt he saw recently in a "metal- 
lurgical laboratory" (name unknown) in London dental burs 
which were hollow and designed to be filled v;ith metallic 
sodium to speed conduction of neat alon; the snank* It is 
claimed that his device nas been used in aircraft motors, 
•where valve stems have been so treated. This information 
was given to Colonel Thomas Smith of tne Office of tne 
Chief Surgeon, Hq, USBET (Rear) who was making a trip 
to London, during wnicn he intended to get additional 
information on this matter.