Validity of using a panoramic radiograph for initial dental classification of Army recruits

The objective of this study was to examine the validity of classifying Initial Entry Training (IET) soldiers into dental fitness classification 2 or 3 based solely on examining panoramic radiographs.

The dental readiness classification, derived from a clinical screening examination versus a panoramic radiological examination, was compared for 1,050 Fort Sill Basic Training recruits during a 1-month period. The dentist who reviewed the panoramic radiograph and determined a dental classification was blinded to the earlier dental classification from the clinical examination. The Spearman's rank order correlation test was used to determine if a statistically significant correlation existed between classifications based on the clinical examination versus classification by review of the panoramic radiograph alone.

The project identified that 18% (n = 186) and 23.7% (n = 249) of the sample population had at least one class 3 condition identified from the clinical screening examination and the panoramic radiograph review, respectively. Of the 186 dental fitness category 3 conditions identified from the routine dental screening, 81.7% (152) of them were also identified from the review of the panoramic radiograph. Spearman's rank order correlation test statistic was 0.633 for a p < 0.001, indicating a statistically significant correlation in the identification of IET soldiers with class 3 conditions using a screening examination with a review of the panoramic radiograph.

The findings of this study suggest that panoramic radiograph review can identify IET soldiers with dental fitness category 3 conditions and implies that a policy change may be prudent to allow this type of initial classification.