Dental Readiness Class 1 Military Personnel Are Not All the Same! A Systematic Review and Meta-Analysis

Dental emergencies (DEs) pose a significant threat to the readiness and operational effectiveness of the U.S. military. Caries, third molars, broken teeth/defective restorations, and pulpal problems account for a substantial 76.34% of all DEs seen at dental treatment facilities during deployments. The authors aim to investigate the effect of common dental treatments on the annual probability of experiencing a dental emergency through a literature review and meta-analysis.

Three unique searches were conducted, one for each of the dental treatments of interest, such that data could be isolated from publications. Gorgas Memorial Library, Ovid, PubMed, ScienceDirect.com, and Wiley Library were searched. Probabilities, odds ratios, hazard ratios, or rates of subsequent complications were isolated into a Microsoft Excel database, and calculations to determine a mean for 95% confidence intervals, odds ratios, and annual failure rates were examined using SAS v9.4 (Cary, NC) or Microsoft Excel.

This review estimates that of patients with retained third molars or restorations, 1.75% of patients with fillings, 11.1% with retained third molars, and 3.16% with root canal treatments will experience secondary complications within 1 year.

Electronic records along with computational capabilities make possible the quantification of risk using data from examination findings. Through continued research into the effects of common dental treatments on the incidence of common DEs, these data and novel artificial intelligence programming could provide military dental officers with additional data to quantify patient risk for DEs even when all necessary dental treatment has been completed. To better facilitate this research and improve quality of care, future records and studies on patient DEs must include the number of patients presenting, a more accurate description of the reason for their visit, and the restorations of each patient.