Here are five items I believe would change the overall oral health of our Army:
1. Pit and Fissure Sealants. On all occlusal surfaces of every new recruit and every new LT in OBC. Regardless of caries risk. Caries is a carbohydrate modified bacterial infectious disease. Let’s eliminate it’s ability to live in our population.
2. Remove all partially erupted/malposed third molars indicated for removal – before soldiers leave basic training. I see more symptomatic third molars on sick call than any other dental issue. That isn’t surprising considering most of our patient population falls in the 18-25 year old range. We have an underutilized 4 month exodontia program. Let’s train dentists to do this and station them to run exodontia clinics at our major training installations.
3. Offer whitening to every soldier in uniform. It’s not expensive, it takes up almost no chair time, and there is some (limited) evidence that it can have an effect on decreasing the bacterial load in the oral cavity. Soldiers are more likely to take care of something they are proud of and think is cool. My biggest disease cases are soldiers who have just given up because they are embarrassed of their smile or who have never known what it is like to smile with confidence. Give them a smile they are proud of and they will want to take care of it.
4. Cleanings twice a year. Currently soldiers can have one dental prophylaxis per year unless they have periodontal disease. Although the “twice a year” cleaning schedule was essentially invented by insurance companies and is not really evidence based, it would increase patient encounters for our soldiers. This would create a potential for earlier diagnosis of caries and periodontal issues and shift dental care from treatment to prevention. We would definitely need more hygienists to handle this item.
5. Bring patient education into the 21st century. Come to any dental clinic and you might be lucky to find a handful of outdated trifold pamphlets on how to take care of your teeth, etc in the waiting room. No one reads them. Take a look around. All our soldiers are on their Blackberrys and iPhones. Let’s use facebook, twitter, and user friendly websites to get information to our young soldiers in a more effective manner. Education leads to prevention. Prevention leads to lower disease and non-battle injuries (DNBI) in the force.
Imagine what the dental readiness of our fighting force would look like in five years if these five items went into effect tomorrow?
Army Dentistry 