The dental health of Nazi German concentration camp survivors

A group of dentists who survived confinement in Nazi German concentration camps joined together for a project conducted in the Warsaw area to examine the dental health of fellow survivors. Apart from an examination of the survivors’ dental health and an inquiry into the diseases they had suffered from in concentration camps, the project also entailed an attempt to collect data on whether they had used the services of the prisoner-dentists working in concentration camp dental surgeries. The aim of this part of the project was to show that dentists who were held as prisoners in Nazi German concentration camps provided dental care for fellow inmates, and sometimes their services proved very effective. One of the official periodicals published a note which said that no one had ever heard of any dental services dispensed to concentration camp prisoners, except for those administered by the so-called “dental stations” whose business was the removal of gold teeth from prisoners killed in the gas chambers. I sent in a protest but it was never acknowledged or published, which I consider an insult to all the prisoner-dentists who worked in the dental surgeries available to concentration camp prisoners. I would like my remarks to compensate dentists who survived Nazi German camps for this slur and present the real facts.

Probably not many other organs in the human body are as sensitive to internal and external factors as the teeth. Any disorders which occur in the body, as well as external agencies which exert an influence on an individual’s metabolism have an effect on the structure of his periodontal tissue and the way it works. Health disorders disturb dentinogenesis, a process which begins when a baby’s primary teeth start to grow and continues throughout an individual’s life until the collapse of his physiological processes in old age. A precise examination of a person’s teeth professionally conducted with the use of a microscope can even tell us the amount of time he spent in unfavourable or bad conditions, and identify the effects of serious psychological experiences and stress on his dental health. Research on animals subjected to changes in their existential conditions and given poor-quality or an insufficient amount of food has shown that serious dentinogenic disturbances emerge already on the third day of the tests. A similar effect, though not so intense and drawn out over a longer period of time, may be observed in humans. So it comes as no surprise that the condition of concentration camp survivors’ teeth has been found to be very poor, though we have also seen some survivors with very good teeth despite the fact that they spent several years in a concentration camp. The results of our dental research should be compared with the medical examinations doctors have carried out in other specialist fields of medicine, to see whether these exceptions to the rule have been observed for survivors with a very resilient immune system in general, or just highly immune teeth.

The deplorable state of survivors’ teeth is due not only to the hard conditions they were in, such as poor food rations, bad hygiene conditions and the fact they could not look after their teeth properly, as well as their poor accommodation and bad working conditions. It is also the outcome of the brutal violence the SS men and functionary prisoners used against them, which could instantly knock out several of a prisoner’s teeth. The unhygienic way food was prepared and distributed as well as the inadequate facilities for personal hygiene in German concentration camps gave rise to the proliferation of inflammatory disorders of the oral mucosa and periodontium which often turned ulcerative. At times, disorders of this kind escalated to an epidemic scale, with symptoms of inflammation spreading to the alveolar bone. Currently, survivors’ periodontal tissue which sustained damage due to inflammatory disorders is showing a very high tendency to undergo further impairment, eventually leading to complete loss of a survivor’s teeth.

A Prisoner’s Face. Artwork by Marian Kołodziej. Photo by Piotr Markowski. Click the image to enlarge.

The cause of noma (oral gangrene), the necrotizing stomatitis affecting the tissue of the oral and upper respiratory region observed in many of the Roma and Jews deported to Auschwitz from Greece was due to nothing but the abysmal conditions in which these people were kept. Noma tended to attack especially children and young people, not many of whom could be saved; indeed, most of them perished in the camp.

Moving on now to a numerical presentation of the data for the dental health of concentration camp survivors, I have to say that the following data are based on the results of a project conducted by a group of Warsaw dentists who examined 418 survivors, 297 men and 121 women.

The persons examined were divided into two groups: 1) a small group consisting of 76 persons who spent less than a year in a concentration camp, and 2) a larger group of 342 persons confined in a concentration camp for over a year and up to five years. Our attempt to draw up a full statistical presentation of our observations taking into account victims’ sex and a more detailed differentiation of the time they spent in a concentration camp proved abortive due to the size of the population examined in the two groups, which were too small to give reliable results, with an unacceptably large margin of error. Hence, we had to stop at compiling a simple numerical and percentage presentation. We also compared the dental health of survivors (chosen from the group by random selection) with that of patients in receipt of clinical dental treatment who had never been held in a concentration camp and were randomly selected for the test from a similar age group as the survivors. Our aim was to determine the effect of concentration camp confinement on survivors’ dental health in their later lives relative to the dental health of patients never held in a concentration camp. Yet again, the small number of cases in the comparison prevented us from drawing absolutely incontrovertible conclusions from the study. However, our observations showed a clear difference between the two groups to the detriment of the survivors. Perhaps that difference would have stood out even more distinctly if we had been able to study a larger population of survivors who had lost many or even all of their teeth due to brutal treatment from the Gestapo and functionaries in the camp. Such a group should entail fellow survivors who had their teeth extracted during interrogations (without the use of an anaesthetic) and those who were beaten or kicked in the teeth on orders from the SS to knock out fillings and crowns made of gold.

The following figures were obtained for the first group, that is for 76 survivors (45 men and 31 women) held in a concentration camp for up to a year (most of them deported there in the aftermath of the Warsaw Uprising of 1944.^* 6 persons (8.3%) lost one of their teeth in the camp; 23 (about 30%) lost two or more teeth; 4 (just under 5%) sustained jaw and facial injuries; 23 (30%) had inflammation of the oral mucosa; and 11 (14%) had inflammation of the oral mucosa and periodontal tissue. Only a small number of persons in this group, just 8 survivors, used the services of dentist-prisoners while in concentration camp detention. Currently, 8 persons from the group (about 9%) require conservative treatment; 4 (4.5%) are in need of dental surgery; and 34 (45%) need dentures. Over 60% of the group require medical treatment.

The plight of the second group, survivors who spent over a year in concentration camps, was much worse. For the sake of brevity, I shall not discuss the detailed results for the group’s division into a male and female sub-group, however, I shall observe that the women were in a far better condition than the men. 27 out of the 342 persons (8%) lost one of their teeth; 171 (50%) lost two or more, or all of their teeth. 28 (8%) including 5 women had broken jaws or sustained other jaw injuries. 141 survivors (40%) suffered from inflammation of the oral mucosa; and 50 (14%) went through inflammation of the periodontal tissue. 179 persons in this group (52%, 87 men and 62 women) had used the dental services available to prisoners in the camp, not only for the extraction of a tooth but also for conservative treatment, or even—in 12 cases—to procure dentures. The majority of survivors in this group are in need of fast and effective dental care. 57 (17%) of them require conservative therapy; 22 (6%) need dental surgery; and 149 (41%) need dentures. They should be given this treatment as soon as possible.

One of the three concentration camp children we examined requires conservative dental treatment.

On the basis of this brief review, we may draw the following conclusions:

1. Confinement in a concentration camp definitely had a negative effect on inmates’ teeth, and the symptoms of pathology resulting from it are the greater the longer the time a prisoner spent in the camp.
2. Concentration camp survivors should receive special dental care and assistance.
3. Concentration camp survivors should have the right to priority in the queue for dental prosthetics, which should be provided to them in dental clinics with the top professional credentials. They should be prioritized in this respect in order to reduce the number of factors with a potentially negative impact aggravating the psychasthenia they are suffering from.
4. Dentists should issue recommendations for the provision of dentures to concentration camp survivors on prior consultation with internists, with priority treatment for survivors with a confirmed diagnosis of a disorder of the digestive system.

***

Translated from original article: Krzywicki, Janusz. “Stan uzębienia u byłych więźniów obozów hitlerowskich.” Przegląd Lekarski – Oświęcim. 1965: 36–37.

In the late summer and autumn of 1944, after the fall of the Uprising, the Germans forced all the inhabitants of Warsaw and its suburbs (about 500-650 thousand persons) to leave their homes, sending civilians to temporary camps such as the one at Pruszków or to concentration camps, and deporting combatants to Germany. Thereafter they razed the city to the ground. https://pl.wikipedia.org/wiki/Dulag_121_Pruszków

Note by Teresa Bałuk-Ulewiczowa, Head Translator for the Medical Review Auschwitz project.

A public task financed by the Polish Ministry of Foreign Affairs as part of Public Diplomacy 2022 (Dyplomacja Publiczna 2022) competition.
The contents of this site reflect the views held by the authors and do not constitute the official position of the Polish Ministry of Foreign Affairs.