Dental Health Readiness Among United States Military Service Members in the Millennium Cohort Study

Among U.S. military service members, dental health is one aspect of health assessed regularly and contributes to individual medical readiness for potential deployment. This study examined military characteristics, psychosocial factors, and health behaviors associated with dental readiness across all branches and components.

This cross-sectional study linked 2020-2021 baseline Millennium Cohort Study (MCS) survey data with the service member's most recent dental readiness classification (DRC) within 1 year of MCS survey completion (N = 43,894). DRC was based on a clinical assessment obtained from the Military Health System Data Repository Dental Readiness File. The DRC outcome was dichotomized as fully medically ready (FMR, including DRC 1 or 2) or not FMR (including DRC 3 or 4). Descriptive, bivariate, and logistic regression models were examined among the full sample as well as stratified by service component, guided by an adapted Behavioral Model for Health Service Utilization.

Overall, 5.0% of service members were not FMR, with notable differences by component (active duty [AD]: 4.7%, Reserve/National Guard [R/NG]: 8.8%). In the fully adjusted model in the full sample, service members were significantly (P < .05) more likely to not be FMR if they were in the R/NG (odds ratio [OR] = 3.44, 95% confidence interval [CI] = 2.95-4.00) compared with AD; junior (OR = 1.51, 95% CI = 1.28-1.78) or senior enlisted (OR = 1.18, 95% CI = 1.02-1.36) compared with officers; in the Coast Guard (OR = 5.37, 95% CI = 4.21-6.85), Marine Corps (OR = 5.58, 95% CI = 4.79-6.49), or Navy (OR = 6.46, 95% CI = 5.60-7.47) compared with Army; previously deployed with combat experience (OR = 1.15, 95% CI = 1.01-1.33) compared with non-deployers; current cigarette (OR = 1.16, 95% CI = 1.01-1.33) or vape (OR = 1.16, 95% CI = 1.02-1.31) users compared with non-users; and in poor/fair general health (OR = 1.15, 95% CI = 1.01-1.31) compared with good/very good/excellent general health. Those in health care occupations (OR = 0.55, 95% CI = 0.45-0.68) compared with combat specialists and in the Air Force (OR = 0.73, 95% CI = 0.62-0.86) compared with Army were more likely to be FMR based on DRC. Psychosocial factors (adverse childhood experiences, bullying, discrimination, stressful life events, social support, and positive outlook) were significantly associated with the outcome only in bivariate analyses but not final, fully adjusted models. Similar patterns were observed in the models stratified by service component.

Dental care contributes to the readiness of the force. Military characteristics and current tobacco use (smoking cigarettes and vaping) were risk factors associated with not being FMR based on DRC. Tobacco use is potentially modifiable, and cessation support for all types of tobacco products are needed to address this oral health risk factor. R/NG have more unmet dental needs than AD service members. There are differences across service branches and components, highlighting potential gaps in policies and procedures that should be addressed to facilitate access to dental care services.