Comparing tobacco use among incoming recruits and military personnel on active duty in the United States.

OBJECTIVE: To compare the tobacco use profile of recruits with that of military personnel on active duty to determine whether the military environment in some way induces service members to initiate tobacco use. DESIGN AND SETTING: Cross-sectional survey of United States armed forces active duty and recruit personnel in 1994-95. SUBJECTS: 2711 military recruits and 4603 military personnel on active duty. MAIN OUTCOME MEASURES: Comparative cigarette smoking and smokeless tobacco use prevalence between recruits and personnel on active duty controlling for age, sex, and race. Impact of demographic factors on the odds of smoking or using smokeless tobacco. RESULTS: Increases in tobacco use in American military personnel occurred exclusively in men. The highest tobacco use resided with white men on active duty (43% cigarette smoking; 24% smokeless tobacco use) and represents a doubling of tobacco use seen among white male recruits. Among non-white men, tobacco use increased 2-4 times between recruits and personnel on active duty. CONCLUSIONS: Efforts to reduce tobacco use by American military personnel on active duty should focus more on discouraging the initiation of tobacco use.

Factors influencing perceived need for dental care by United States military recruits.

This study explores factors that influence perceived need for dental care among US military recruits. The data were collected on a systematic random sample of 2711 US Army, Air Force, Navy, and Marine Corps recruits between February and July 1994. Participants received a comprehensive oral examination from a dentist and answered perceived need queries on self-administered questionnaires. Using bivariate and logistic regression analyses, we examined the association between demographic and clinical measures and perceived need for dental care. Bivariate results show that, overall, 61% of US military recruits perceive a need for dental care, with statistically significant differences across many demographic and clinical factors. Logistic regression results show that the likelihood of perceived need is influenced by gender, branch of service, dental health class, home region of the US, calculus, bleeding gums, level of decay, and dental utilization.

Dental sealants: prevalence and need in U.S. military recruits.

This paper explores the need for and the prevalence of dental sealants in U.S. military recruits. The data come from the 1994 Tri-Service Comprehensive Oral Health Survey. Data were collected on 2,711 Army, Air Force, Marine Corps, and Navy recruits at one recruit in-processing center per service. Women and minorities were oversampled. Both bivariate and logistic regression analysis were done on the need for at least one dental sealant and the prevalence of at least one dental sealant in recruits. Weighted data (101,072) were used for the bivariate analyses; unweighted data were used in the regressions. Results show that 8.7% of recruits need dental sealants and that 14.8% have dental sealants. Need for dental sealants varies across branch of service only, whereas prevalence of dental sealants varies across age, race, and branch of service. The cost-effectiveness of dental sealants in this population should be established.

Comparing annual dental utilization rates of active duty U.S. military personnel and their employed civilian cohorts.

This study compares annual dental utilization rates between a representative sample of active duty U.S. military personnel (N = 11,765) and a national sample of employed U.S. civilians (N = 10,798). Military data were collected between April 1994 and January 1995 at 26 sites using self-administered questionnaires on a prestratified, random sample of Army, Air Force, Navy, and Marine personnel. Women and blacks were oversampled. Civilian data are from the most recent U.S. oral health survey of working adults. Results show that annual dental utilization rates of service members exceed those of their employed civilian cohorts. Overall, 86% of active duty military personnel have seen a dentist in the past year versus barely half of employed civilians. For service members, annual dental utilization is invariant across age, sex, race, education, branch of service, and rank. Dental health class and perceived need for dental care are inversely related to annual dental utilization.

Dental utilization by spouses of active duty U.S. military personnel.

This study explores dental utilization and access barriers to dental care for spouses of active duty U.S. military personnel as reported by their military sponsor. It also compares dental utilization of spouses and civilians. The data, collected using self-administered questionnaires between April 1994 and January 1995, are from 5,732 Army, Air Force, Navy, and Marine personnel with nonmilitary spouses. Comparative civilian data are from the most recent (1985-1986) U.S. oral health survey of working adults. Results show that dental utilization of military spouses parallels that of civilians. Cost was the most commonly cited barrier to dental care for spouses. Logistic regression results show that the likelihood of a spouse having seen a dentist within the past year is influenced by insurance status, sex, branch of service of sponsor, and rank of sponsor. Insurance status is the strongest predictor of dental utilization for spouses.

The need for and prevalence of dental sealants in active duty U.S. military personnel.

This paper explores the need for and the prevalence of dental sealants in active duty U.S. military personnel. The data come from the 1994 Tri-Service Comprehensive Oral health Survey. Data were collected on 13,050 Army, Air Force, Marine Corps, and Navy active duty personnel at 26 sites. Women and minorities were oversampled. Both bivariate and logistic regression analyses were done on the need for at least one dental sealant and the prevalence of at least one dental sealant in service members. Weighted data (1,669,662) were used for the bivariate analyses; unweighted data were used for the regressions. Results show that 3.6% of service members need dental sealants and that 6.8% have dental sealants. The need for dental sealants varies across age, rank, and branch of service. The prevalence of dental sealants varies across age, race, rank, and branch of service. The cost-effectiveness of dental sealants in this population should be established.

Factors influencing perceived need for dental care by active duty U.S. military personnel.

This study explores factors that influence perceived need for dental care among active duty U.S. military personnel. The data were collected on a prestratified random sample of 12,950 (76% response rate) service members between April 1994 and January 1995. Participants received a comprehensive oral examination from a dentist and answered queries concerning perceived need on self-administered questionnaires. Using bivariate and logistic regression analyses, we examined the association between demographic and clinical measures and perceived need for dental care. Bivariate results show that half of all U.S. military personnel perceive a need for dental care, with statistically significant differences across race, rank, education, branch of service, dental health class, and dental utilization. Logistic regression results show that the likelihood of perceived need is influenced by age, race, rank, branch of service, dental disease, dental health class, and dental utilization. Extensive dental decay is the strongest predictor of perceived need in this population.

Comparing dental utilization of United States of America military recruits with their employed civilian cohorts.

This study compares the dental utilization of United States of America (USA) military recruits with that of their employed civilian cohorts. Military data were collected between February and June 1994 at one recruit in processing site per service, using self-administered questionnaires on a prestratified, systematic, random sample of 2369 Army, Air Force, Navy, and Marine recruits. Women and blacks were oversampled. Civilian data come from the most recent oral health survey of working adults in the USA. Results show that annual dental utilization rates of military recruits equal or are less than those of their employed civilian cohorts. Overall, 38% of recruits have seen a dentist in the past year, while 30% have not seen a dentist in 3 or more years. Such low consumption of dental care suggests that dental utilization habits prior to service entry do not contribute appreciably to the high dental utilization rates seen among active duty US military personnel.

Factors influencing dental utilization by U.S. military recruits.

This study identifies factors that influence dental utilization by U.S. military recruits prior to entering military service. Data were collected between February and June 1994 at one recruit in-processing site per service using self-administered questionnaires. A prestratified, systematic, random sample of 2,711 Army, Air Force, Navy, and Marine recruits was drawn. Women and minorities were oversampled. Using logistic regression to determine what factors contribute to the likelihood of recruits having seen a dentist over the past year reveals that the likelihood is greater for females, singles, Air Force personnel, Native Americans, and the better educated; the likelihood is less for recruits who are black, above 19 years old, from the Midwest, Southwest, or Pacific regions of the U.S., and who perceive a need for dental care. Education is the strongest predictor of dental utilization prior to entering military service.

Comparison of DNA probe and ELISA microbial analysis methods and their association with adult periodontitis.

The purposes of this study were two-fold: to compare the DNA probe and enzyme linked immunosorbent assay (ELISA) microbial identification tests and correlate the levels of microorganisms with adult periodontitis. A single plaque sample were taken from each of 2 sites in 52 patients. Twelve of these patients were also sampled during and after treatment. The experimental site had clinical indicators of disease (bleeding on probing, probing and attachment loss of > or = 6 mm) and the contralateral site (control) was clinically healthy. A total of 176 plaque samples were collected, divided, processed, and sent for both types of quantitative microbial analyses. All of these samples were used to compare the DNA probe and ELISA methods while only the initial 104 pretreatment sites were used to correlate microorganisms/method with clinical indicators of adult periodontitis. DNA probes were used to assay for A. actinomycetemcomitans, P. gingivalis, P. intermedia, E. corrodens, F. nucleatum, T. denticola, and C. rectus. An ELISA utilizing monoclonal antibodies was used to assay for P. gingivalis, E. corrodens, T. denticola, and C. rectus. Comparison of the two methods revealed that the ELISA test identified P. gingivalis and C. rectus significantly more often than the DNA probe method and that T. denticola was detected more frequently with the DNA probe. The sensitivities and specificities varied widely among organisms and by test. P. gingivalis, as identified by ELISA, had the highest degree of sensitivity and specificity (0.90 and 0.82 respectively) to clinical indicators of adult periodontitis.

Reasons for placement and replacement of dental restorations in the United States Navy Dental Corps.

This study investigated the reasons for placement and replacement of dental restorations in the United States Navy Dental Corps. The relationship between restoration longevity and the reasons for replacement of restorations was also studied. Data on newly placed dental restorations were collected from restorative dentists working at 11 Naval Dental Clinics located throughout the United States. Participating dentists at each clinic were asked to collect data for all restorations they placed during a two-week period. Data on 4633 restorations were collected from 88 dentists. The most common reasons for placement of restorations varied by age category. Primary caries was the most common reason for patients 18-34 years of age, while noncarious reasons for placement were most common for patients 35 years of age and older. The most common reason for replacement of restorations was secondary caries. For all replacement reasons amalgam restorations had greater longevity than composite resin restorations.

Determining the HIV status of patients of three HIV-positive Navy dentists.

The prevalence of human immunodeficiency virus infection has caused the risk of HIV transmission in the health care setting to become a major public concern. Navy medical records were reviewed to investigate the HIV status of 2,887 patients treated by three HIV-positive dentists.