The association between dental fitness classification and caries and tobacco risk
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Dental emergencies can negatively affect the ability of the army to perform 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) System evaIuates the oral health status of the soldiers and their current treatment needs and classifies them for dental readiness. Caries risk assessment evaluates past disease and future risk for caries. Tobacco risk assessment is used to record tobacco habits of soldiers. This study was performed to determine if there is any association between the dental fitness classification and caries and tobacco risk. The study population consisted of a sample of 66,484 US Army active duty soldiers. The data used for the study was from DENCOM database that maintain patient visit records obtained from the army dental clinics. The following information was obtained from the database for each soldier, rank, DFC ranking; caries risk assessment, and tobacco risk assessment. All soldiers had their dental fitness classification, 95.1% had caries risk assessment scores and 94.6% had tobacco risk assessment scores. Statistics analyses for the sample were performed. Summary statistics were computed for DFC, caries risk assessment, tobacco risk assessment and rank, DFC was compared with caries risk assessment, tobacco risk assessment and rank using chi-square analysis. Logistic regression models were performed to determine the relationship between DFC, caries risk, tobacco risk and rank. Ninety four percent of these soldiers were DFC1 and DFC 2 and were combat ready or world wide deployable. 5.4% were in the DFC 3 and 1% were in the DFC 4. High caries risk group are 15.5 times more likely to be a part of the 'Immediate treatment needs' group compared to the soldiers in the low caries risk group (95% C1 14.3 – 16.9; P[less than].0001). Soldiers in the 'immediate treatment needs' (DFC 3 &4) group are 1.43 times more likely to be high tobacco risk individuals or tobacco users compared to the 'No immediate treatment needs' (DFC 1 &2) group (95% C1 1.34 – 1.53; p[less than]0.0001). Logistic regression models showed that soldiers in the low caries risk group are 13.4 times more likely of being in the 'No Immediate Treatment Needs' group (95% C1 12.2 – 14.6; p[less than]0.0001) compared to the high caries risk group. Soldiers classified as DFC 3 are 125 times more likely to be in the high caries risk group compared to soldiers classified as DFC 1 (OR = 125;95%CI 111 -143; p[less than]0,0001. This study has shown a clear association between dental fitness classification categories and caries risk wherein soldiers classified as DFC 3 &4 are at higher risk, including caries risk assessment and to a certain extend tobacco risk assessments along with DFC would provide a better way of identifying soldiers at higher risk for dental disease and help the dental providers to better assess the individual soldier's and unit's dental readiness.
PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact firstname.lastname@example.org.Thesis (M.S.D.)--Boston University, Goldman School of Dental Medicine, 2003 (Dental Public Health).Includes bibliographical references : leaves 46-48.
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