The Department of Defense oral health and readiness classification system.

The Department of Defense has an oral health and readiness classification system, which is designed to standardize the dental readiness (deployability), assess oral health, prioritize dental care, and minimize the occurrence of dental emergencies among military personnel. This classification system is a critical component of the individual medical readiness assessment of military personnel and emphasizes the importance of good oral health.

USAF dental readiness classifications and caries-risk assessment.

Assurance of the overall health of all uniformed Department of Defense (DoD) personnel is the responsbility of the Military Health System. To ensure the accomplishment of that mission, the Office of the Assistant Secretary of Defense (Health Affairs) requires that all uniformed personnel be classified according to their wartime dental readiness status. The recording, collection, monitoring, and reporting of this metric enables the effective and efficient management of care of DoD military members. Especially in times of war, there are often occasions for care to be rendered to members of other military Services by USAF dental treatment providers. Therefore, it is vital that dental health classifications among the Services be standardized to minimize confusion and to ensure that appropriate, optimal dental treatment is rendered to all DoD military members. This article discusses how the USAF assesses dental readiness classification and caries risk of military members.

Clinical use of dental classification: U.S. Marines.

This article summarizes some of the challenges encountered and accomplishments achieved by the 2nd Dental Battalion/Naval Dental Center, Camp Lejeune, North Carolina, while preparing U.S. Marines for deployment. Due to the intense operational tempo after recruit training, there is limited access to patients for required treatment prior to deployment. The utilization of Military Medical Support Office funding and other command initiatives introduced during Operation Iraqi Freedom are used to ensure that all Marine Expeditionary Units are deployed with high levels of Operational Dental Readiness.

The Australian experience in dental classification.

The Australian Defence Health Service uses a disease-risk management strategy to achieve two goals: first, to identify Australian Defence Force (ADF) members who are at high risk of developing an adverse health event, and second, to deliver intervention strategies efficiently so that maximum benefits for health within the ADF are achieved with the least cost. The present dental classification system utilized by the ADF, while an excellent dental triage tool, has been found not to be predictive of an ADF member having an adverse dental event in the following 12-month period. Clearly, there is a need for further research to establish a predictive risk-based dental classification system. This risk assessment must be sensitive enough to accurately estimate the probability that an ADF member will experience dental pain, dysfunction, or other adverse dental events within a forthcoming period, typically 12 months. Furthermore, there needs to be better epidemiological data collected in the field to assist in the research.

Dental fitness classification in the Canadian forces.

The Canadian Forces Dental Services utilizes a dental classification system to identify those military members dentally fit for an overseas deployment where dental resources may be limited. Although the Canadian Forces Dental Services dental classification system is based on NATO standards, it differs slightly from the dental classification systems of other NATO country dental services. Data collected by dental teams on overseas deployments indicate a low rate of emergency dental visits by Canadian Forces members who were screened as dentally fit to deploy.

The impact of retained third molars on the deployed airman.

Dental emergencies can significantly affect the mission of the deployed unit. As many as 22% of all emergency department visits at a deployed Expeditionary Medical Support facility can be attributed to dental problems and many of these problems are caused by impacted third molar teeth. Currently, there is no reliable method of predicting when asymptomatic, partially erupted third molar teeth will become painful. Therefore, it is imperative that Air Force dental providers carefully consider the consequences of giving patients a clean bill of health when asymptomatic, partially erupted third molar teeth are present in the oral cavity. Recommendations for future study are presented.

A longitudinal study of dental experience during the first four years of military experience.

This longitudinal study examined changes in oral health and emergency rates of Army, Air Force, and Navy recruits during the 4 years immediately following entry on active duty. In 1998, 1,331 dental records of recruit participants in the 1994 Tri-Service Comprehensive Oral Health Survey were located, and dental readiness classification and emergency data were analyzed. All services were successful in achieving and maintaining operational readiness among 1994 recruits who spent >93% of their first 4 years of military service in a deployable oral health status (Dental Readiness Classification 1 or 2). However, among recruits with initial Dental Readiness Classification 3, only 57.4% achieved class 1 (oral health) at any point during the 4-year study period. An annual dental emergency rate of 749 per 1000 was found among class 3 personnel, 192 per 1000 among class 2, and 85 per 1000 among class 1.

A statistical method to evaluate dental classification systems used by military dental services.

UNLABELLED: The aim of this research project was to develop a systematic approach to evaluate the effectiveness of dental classifications used by military dental services to predict dental emergencies. DESIGN: A retrospective cohort study of U.S. Navy recruits were followed for an average of 3.5 years. Dental records of 1,114 recruits who had their initial dental examination during the calendar year 1997 were collected in 2001. Four hundred sixty-two dental emergencies (DE) were recorded, of which 50 were class 3 patients. The incidence density ratio (IDR) of DE was 2.2 (p < 0.001; class 3 compared to class 1 or 2 patients). The mean times to DE in patients who experienced DE were 92 days (class 3 patients) and 418 days (class 1 and 2 patients; p < 0.001), while the median times to DE were 59 days and 295 days (p < 0.001) for class 3 and class 1 or 2, respectively. The adjusted hazard ratio for DE in class 3 versus class 1 and 2 patients was 1.519 (p = 0.0149). We have concluded that examination of the following statistics is necessary to assess the effectiveness of military dental classification systems: (1) the percentage of DE that occur in class 3 patients, (2) the IDR of DE, (3) the mean time to DE, (4) the median time to DE, and (5) the hazard ratio of DE.

Clinical use of dental classification.

The Dental Classification system used by the uniformed services is supposed to predict the incidence of dental emergencies in the operational setting, at least on the unit level. Since most Sailors and Marines are deployed without close dental support, the sea services have adopted a policy of early treatment of class 3 dental conditions during recruit training. The other services are beginning to do the same. Recently, two factors have emerged that are affecting this early dental class 3 treatment. These factors must be considered when planning to provide early dental treatment. First, changing population and dentist provider demographics in the civilian sector are beginning to affect the class 3 treatment needs of incoming military recruits. Second, attrition from recruit training results in treatment provided to recruits who leave military service before finishing their training. Some view this as a waste of resources, others as a cost of doing business. As operational jointness increases, the three services must develop and use a single dental classification terminology, as well as unified standards and guidelines, both for better research in this area and for the readiness and well-being of our patients.

U.S. Navy dental common access system emergency dental encounter module.

A component has been added to the Dental Common Access System that allows the identification and quantification of dental emergencies experienced by U.S. Navy and Marine Corps personnel. The Emergency Dental Encounter module enables providers and administrators to monitor dental emergency rates by dental class and etiology.

Áreas emergentes en Odontología / No disponible

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La modernización de los hospitales militares: Los Sistemas de Información Sanitaria / No disponible

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