Dental risk assessment for military personnel

In 2002, the U.K. Defence Dental Agency adopted a system of dental risk categories to replace the dental fitness categories detailed in NATO Standard Agreement 2466. Personnel were assessed as being at high, medium, or low risk of experiencing dental morbidity during the next year, and a target was set to have no less than 90% of personnel at low or medium risk. The Persian Gulf War in 2003 provided an opportunity to validate the risk assessment of U.K. troops deployed to Iraq (Operation Telic), when their morbidity experience was compared with the assessments of their risk. Data capture on risk assessment was considerably restricted but, for those for whom the comparison was possible, the predictive value of risk assessment appeared to be poor. However, 50% of all troops who were recorded as having experienced serious morbidity had been categorized as high risk. The system requires refinement of diagnostic criteria to maintain the sensitivity of the diagnosis of high risk while reducing the high false-positive assessment rate.