The Oral Health of the Irish Army

Abstract

Background Dental services are provided in the Army for operational reasons as a means of collecting dental forensic charting and reducing the likelihood of a dental emergency. Recent data reporting the oral health of soldiers was unavailable and was required to provide services in a planned manner. Aims Firstly, to evaluate the oral health status of soldiers in the Irish Army. Secondly to evaluate the prevalence of determinants of oral health that affect the experience of disease. Thirdly, to evaluate the subjective experience of oral health. Methods Five trained and calibrated dentists examined patients in seven locations and recorded standard clinical indicators. A questionnaire was used to record potential determinants and subjective experience of oral health. Results 777 soldiers were examined and the results were weighted by rank. 99% retained 21 or more teeth, 75.6% had 18 or more sound untreated teeth and 1.6% had a denture. 16.1% had untreated caries, 27.1% had PSR codes 3 or 4 and 22.1% had BEWE≥2. The sample included 7.1% with a DMFT score of zero. 20.7% of the sample smoked, 4% had alcohol misuse, 14.5% brushed less than twice a day and 51.3% had a cariogenic diet. 5.6% reported pain from teeth, 61.4% reported excellent to good oral health and 35.5% reported an OHIP-14 impact at least occasionally in the previous 12 months. Regression analyses indicated that certain groups were at higher risk of dental disease, unhealthy behaviours and impacts including new entrants, soldiers with some secondary education and less frequent attenders. Discussion There were marked improvements in oral health in the Irish Army in the preceding 30 years. The dental health system was effective in reducing the prevalence of diseases and conditions, particularly in advance of deployments overseas. The data collected could help inform a transition from a treatment-oriented system of care to one that prioritises preventative interventions in combination with behaviour change to improve soldier oral health.