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In
1917-18, the U.S. Army revived a denture technique first introduced
in 1866 by Dr. James Baxter Bean, the Confederate dental surgeon who
established the first military maxillofacial hospital trauma ward in
Atlanta, Georgia, during the American Civil War the cast aluminum
wartime denture.
Introduction
In the early spring of 1917, the standard removable Vulcanite
denture barred voluntary enlistment in the U.S. Army on the basis
that such dentures were a liability and subject to breakage. As a
result, the Army began experimenting with aluminum as a substitute
denture base.11 French and English scientists had isolated aluminum
in the laboratory early in the 19th century and it became
commercially available in France in the 1850s. Its high price
limited it to special applications until 1886 when scientists in
France and the U.S. simultaneously developed a cheaper production
method.
4
Dr. James Baxter Bean originally introduced aluminum into the dental
profession as a denture base. He was a former Confederate dental
surgeon who had organized the world's first maxillofacial military
hospital in Atlanta during the American Civil War.
5
In November 1866, Dr. Bean exhibited his cast aluminum plate at the
second meeting of the Maryland Association of Dentists in Baltimore.
It was recorded in the minutes that this was the "first successful
effort known to the association in casting aluminum as a base for
teeth .117 No doubt Dr. Bean would have been proud to learn that his
1866 technique had been revived by the U.S. Army under the
exigencies of World War I in 1917-18.
1
In June 1917, Ist Lieut. Edward H. Raymond, Jr., D.C., a 1903
graduate of the New York College of Dentistry,9
in conjunction with Ist Lieut. John B. Wagoner, D.R.C., a 1903
graduate of Northwestern University Dental School,9
did the initial wartime research on casting aluminum dentures while
at the Presbyterian Base Hospital Unit, British Expeditionary
Forces, in France.10
On August 8,1918, Col. Seibert D. Boak, Director, Dental Section,
Army Sanitary School, Langres, France, recommended that Lieut.
Wagoner deliver a lecture on development of cast all-aluminum plates
for soldiers instead of the Vulcanite and porcelain type."
2
The Amex Aluminum Denture
The Army called the new cast aluminum denture the "Amex Denture,"
and it was officially adopted as the "war denture" for the American
Expeditionary Forces in France. The newly promoted Capt. Raymond and
Maj. Wagoner were given the credit for its development as a
Vulcanite substitute.'
The Army cited the unusual wartime conditions as the reason for
development of "a standard type denture sufficiently strong to
withstand the hardships of masticating field rations, to resist
fracture from all ordinary accidents and to prevent malicious
distortion or mutilation." The accidental breakage of dentures
removed from the mouth at night was more common in the military than
in civilian life because of the cramped space and poor lighting in
the tents, huts, and dugouts at the Front. The incidence of
intentional breakage of dentures to get away from the Front, like
the selfinflicted wound, was probably rare, but the metal denture
would make it still rarer.10
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The Amex denture was inexpensive, easily made of materials
procurable in the French market, durable, light in weight, had
good thermal conductivity, and was easy to clean; all of which
commended its use. The denture consisted of a metal plate with
metal teeth all cast together in one piece. The posterior teeth
were always cast as part of the denture, but porcelain teeth could
be used for the six anteriors, if time for vulcanizing could be
spared. The objection to the appearance of full upper dentures
with all-metal teeth had to be disregarded in view that war
service efficiency outweighed esthetic considerations. Clasps for
partial dentures could be incorporated into the casting.10
Actually, all the good qualities the Army cited for the aluminum
denture in 1917-18, Dr. Bean had emphasized in his 1867 article
"The Aluminum Base," in the Dental Cosmos. These were strength,
lighter weight, lower cost, greater durability than Vulcanite, and
ease of repair.
1
The Amex casting flask was developed from a model made of a
section of a "Soixante Quinze" (75 mm) shell. The materials
required for the denture were aluminum ingots, pink baseplate wax,
casting wax for tooth forms, investment compound of pulverized
ilex and plaster of Paris, and DuTrey's Anterior Diateric teeth.
Old newspaper soaked to a pulp was to be used as a substitute for
fiber asbestos in the lid of the casting flask. The average
all-metal denture weighed 22 gm. and cost about six or seven cents
for the metal. On November 7, 1918, all the A.E.F. dental
laboratories were ordered to begin fabrication of the war denture.8
Conclusion
Apparently, the Armistice of November 11, 1918 halted the mass
production of these "war dentures" as examples are very rare. In
fact, the extensive denture collection of the National Museum of
Dentistry in Baltimore, Maryland does not include a single
specimen. However, the National Museum of Dentistry does have a
World War II aluminum denture with a bizarre history. In 1942,
Fabian Dewine Ream and his family were captured in the Philippine
Islands and interned by the Japanese. During the course of the
internment, Mr. Ream lost so much weight that his mandibular
denture no longer fit his mouth. When an aluminum pot fell into
his possession, Ream, although not a dentist, decided he would
make his own denture. With the assistance of an interned dentist,
Ream made an impression of his mouth from candle paraffin. In
order to invest the mold, he heated some old discarded gypsum
wallboard to drive out the moisture and make plaster of Paris.
Next, he melted down the aluminum pot in an old blacksmith forge
and cast the denture by putting the invested, burned-out mold in a
bucket and used a rope to swing it around his head centrifugal
casting alA the dental technique. Although it took two tries, he
finally got a decent casting and finished it with a penknife. His
only problem was getting used to the thermal conductivity of the
metal when taking hot liquids. Fabian Ream wore this denture (Fig.
1) for the duration of the war and even after his release in 1945.
Finally, his family convinced him to see a dentist and get rid of
his "metallic smile." Fabian Ream died in 1967, but his aluminum
denture lived on as a "family icon" until it was donated to the
Dr. Samuel D. Harris National Museum of Dentistry in 1999.'
Unwittingly, he is part of a dental tradition going back to the
Civil War generation
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