Association of caries and tobacco risk with Dental Fitness Classification

Dental emergencies negatively affect the Army during combat. Dental readiness continues to be a primary mission of the Army Dental Care System and is an important part of mobilization. Dental Fitness Classification (DFC) is used to evaluate the oral health status and current treatment needs of soldiers. Caries and tobacco risk assessments were recently added to the annual examination of Army soldiers. The aim of this project was to determine whether any association existed between the DFC and caries and tobacco risk assessments of Army soldiers.

The study population consisted of 66,484 U.S. Army active duty soldiers. The data were obtained from an Army electronic database that maintains all patient visits. The following information was obtained for each soldier; rank, DFC, caries risk, and tobacco risk assessment. Summary statistics were computed and DFC was compared with caries risk, tobacco risk, and rank using the chi2 analysis and logistic regression model.

High-caries risk soldiers were 15.6 times more likely to be a DFC 3 or 4 as compared to DFC 1 and 2 soldiers. DFC 3 or 4 soldiers were 1.43 times more likely to be tobacco users than DFC 1 or 2 soldiers. Logistic regression models showed that high-caries risk soldiers were at 13 times the odds of being a DFC 3 or DFC 4 as compared to DFC 1 or DFC 2. Soldiers who used tobacco products were also more likely to be in higher DFC classification compared to those that did not use any tobacco products.

This study has shown clear associations between DFC categories and caries and tobacco risk wherein DFC 3 and 4 soldiers are at higher risk for future caries and of being tobacco users. This relationship warrants the inclusion of caries and tobacco risk in the overall dental assessment of soldiers.