Deployed dentistry: keeping servicemembers healthy

Published March 6, 2010
By Staff Sgt. Kelly White
379th Air Expeditionary Wing Public Affairs

SOUTHWEST ASIA -- Each day, as these three Airmen arrive at their work center, they prep the best they can to be the only ones here who can handle the more than a quarter million problems they could potentially be called upon to fix.

"On average, 28 teeth - times the number of people on this base - that's how many things can go wrong," said Capt. (Dr.) Michael DiFelice, 379th Expeditionary Medical Group dentist.

Captain DiFelice and his two technicians, Tech. Sgt. Brenda Barnhart and Staff Sgt. Rodrigo Lara, are primarily responsible for providing care for the roughly 200 permanent-party servicemembers stationed here, however, it's another population on base, deployed and transient servicemembers, that keeps them so gainfully employed.

"Most of what we do is emergency work," Captain DiFelice said. "The routine work - exams, cleanings and maintenance for permanent-party personnel is two to four appointments a day. Everyone else who comes in is on a sick-call."

Sick-call patients - Airmen, Soldiers, Sailors, Marines and sometimes civilians, boost their 2- to 4-patient daily caseload to 14 patients on their busiest days. Some days, there are more patients waiting to be seen than the staff can accommodate during their shift.

"Captain DiFelice will triage patients who come in, prioritizing best he can and taking care of those in pain first," explained Sergeant Barnhart. "When there are more patients than we have time to see, we ask those with less severe problems to come back tomorrow."

Their high number of sick-call patients is attributed to a number of different causes.

"We're finding a lot of members have deployed without having a dental examination before leaving their home station," Sergeant Barnhart said. "Training, and other obligations they have getting ready to deploy, can cause a conflict in priorities, and sometimes they can't get it done.

"It can also be patient-driven," she explained. "People think they'll be fine, then they get here and something will happen that might have actually started a while ago. If they'd have had their dental appointment before they deployed, it could have been caught."
The act of deploying, itself, can contribute to dental problems.

People may develop dental problems from the stress of deploying, namely increased grinding due to job stress, which can lead to fractured teeth or fillings, the captain said.

(Temporomandibular joint) and canker sores are also common, as well as increased cavities from care packages containing a lot of candy, or from having easy access to and eating more desserts and ice cream.

Once their patients leave the examination chair for the day, the staff's work is far from finished. Administrative work associated with patient care is another thing they said demands a great deal of their time and attention.

"When someone deploys who requires a dental exam, I first contact their home station to confirm," said Sergeant Barnhart. "It's possible they were seen but the update hasn't been loaded into our program yet. If, in fact, a person needs their Air Force Dental Readiness Assurance Program exam, I schedule them with Dr. DiFelice.

"If a sick call patient comes in, I can sometimes have part of their dental record sent to me so the doctor has a bigger picture of the treatment history to diagnose future needs," she explained.

The staff, which was only two Airmen-deep less than a year ago, is now at three, primarily because of the amount of administrative work associated with their mission.

"Having that one additional person is a great help because of the multi-tasking we need to do," said Captain DiFelice. "Now, one tech can do cleanings while the other two are working on a patient. Once the patients have been seen for the day, we can take care of the administrative work - creating reports, logging procedures, preparing for meetings and things like that."

Regardless of the reactive mode they constantly function in, they said they strive to promote preventative measures their patients can take.

"Cracked teeth are the bulk of our business," said the captain. "Broken fillings and broken teeth are things that just happen.

"One thing we recommend to be proactive about protecting people's teeth is that they get an athletic mouth guard," he added. "Once a tooth is filled, it's never as strong as it used to be, so it's important that, before they go out to fight night or participate in some other contact sport, we urge them to get a mouth guard."

People interested in acquiring an athletic mouth guard should stop by or call the Dental Clinic. Walk-in hours are Monday, Wednesday and Friday from 8:30 to 10 a.m. and 1 to 2 p.m.; Tuesday and Thursday from 8 to 10 a.m. and 1 to 4 p.m.; and Saturday from 8:30 to 10 a.m.

Chopper Care