Poor dental health in British Army Infantry recruits reduces their quality of life: A cross‐sectional survey and retrospective analysis of health records

Abstract

Introduction: Oral Health Related Quality of Life (OHRQoL) is a determinant of an individual's wellbeing and can be affected by dental disease. For military recruits, adverse OHRQoL may result in poor performance, and has safety implications. The aim of this study was to determine the incidence of dental extractions and dental health of a sample of new infantry recruits.Method: Electronic healthcare recordings of tooth extraction incidence was compared to recruits from the general military population. Clinical dental examinations and patient questionnaires were used to determine the prevalence and impact of caries using the PUFA (Pulp exposure, Ulceration, Fistula, Caries) criteria. The association between caries and PUFA lesions with self-reported oral health behaviors and beliefs was explored. Results:The incidence of tooth extraction was 2.4 times higher in new Army Infantry recruits than recruits in the general UK military population. 211 recruits were assessed, with a 100% response rate. 135/211 (64%) had caries, and 37/21117.5% had a PUFA lesion at the time of inspection. Sleep loss was significantly more likely in those with PUFA lesions than those without (OR 5.62, p <0.0001). Conclusions:Those military Infantry recruits with caries and PUFA lesions had worse OHRQoL than those that did not. This was evidenced by poorer sleeping patterns and an inability to perform tasks at work. Treatment of dental disease through extractions was higher in Army Infantry recruits and will likely reduce the number of days taken off sick, but its effect on overall OHRQoL cannot yet be substantiated.

The financial and quality of life impact of urgent dental presentations: A cross‐sectional study

“…Several studies have investigated the impact of acute dental pain on OHRQoL, most of which have included small numbers of participants or used tools which incompletely explored OHRQoL (Almoznino et al, 2015; Cimilli et al, 2012; Currie et al, 2015; Edwards et al, 2022; Shueb et al, 2015). Currie 2015 undertook the most comprehensive study to date, finding diseases of the pulp and associated periapical disease (symptomatic irreversible pulpitis, symptomatic apical periodontitis and acute apical abscess) were the most common and impactful reasons for urgent dental care (UDC) attendance (Currie et al, 2015).…”

“…Orofacial pain can impact patients in several ways, including time off work, the use of pain‐relieving medication, ability to care for dependants, loss of sleep, difficulties eating and talking (Almoznino et al, 2015; Currie et al, 2015; Edwards et al, 2022). Not only does this result in negative functional and societal impact, but several of these will also result in personal financial costs for patients, such as the use of medication, requirement for additional childcare, time away from work, travel and the cost of an emergency appointment.…”

How should we manage severe anxiety towards dental treatment in UK service personnel?

“…One study found that 39% of Army recruits at 18 years old had the literacy level of an 11-year-old,10 compared with 15% of adults in the general population 11. Army recruits typically have poor previous dental attendance, with a recent internal report finding only 22% attended regularly prior to enlistment 12…”

“…Military personnel exhibit high disease levels on enlistment. In 2014, 64% of recruits at the Infantry Training Centre Catterick were found to have active caries compared with a prevalence of 30% of the general population 1 12. A survey of dentists treating military patients found that 62% believe that new recruits identified as suffering significant dental anxiety should not be allowed to join the armed forces 9.…”