Biomedical subjects

Jeffrey G Chaffin

Publications and source records attributed to Jeffrey G Chaffin.

7 recordsLinked to original sources

PubMed2006

First-term dental readiness.

Army recruits have high levels of dental disease, and traditionally the dental needs of soldiers have not been addressed until the soldiers arrive at their first permanent duty station. Today's expeditionary Army requires that soldiers be fully deployable. This article addresses an initiative (called First-Term Dental Readiness) aimed at providing dental care in the initial training of a soldier's career, implementation of pilot programs at Fort Sill and Fort Knox, and the lessons learned from those pilot programs.

Dental Care↗

PubMed2006

Association of caries and tobacco risk with Dental Fitness Classification.

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Dental Caries↗

PubMed2005

Army junior dental officer retention.

OBJECTIVES: The objectives of the survey were to quantify the extent of indebtedness of junior dental officers and to determine the impact of a loan repayment program on career decisions. METHODS: We designed a customized survey instrument because no preexisting, validated, survey instrument was available. A query was performed in the Medical Operations Data System to identify all captains (0-3) currently on active duty in the Army (N = 348). The survey sample included 64 junior officers with a 2000 date of rank to captain (0-3), of whom only 52 were in the Medical Command Outlook address book or the Army Knowledge Online white pages. The questionnaire was sent out to these targeted junior dental officers through their official e-mail accounts. Dentists assigned to Korea and to dental field units do not use the same e-mail system as the rest of the Dental Command; therefore, their addresses were not available. In an attempt to increase response rates, commanders were asked to emphasize the importance of responding to the questionnaire. RESULTS: From the sample population of 52 officers who were queried directly, 34 responses were received, for a response rate of 65%. However, commanders forwarded the survey to all Dental Command captains and 102 responses were received. The respondents represented 30% of the total Army inventory of captains; 92% of respondents reported that they had dental school loans, with 43% reporting loans in excess of dollar 50,000. The average dental school indebtedness was approximately dollar 60,700. More than 60% of all respondents reported that loan repayment could change their minds about remaining on active duty. Officers not included in the original sample rated the impact of loan repayment statistically higher than did officers in the original sample. CONCLUSIONS: The findings were that the majority of junior Army dental officers had significant student loans and many of these officers indicated that they would consider remaining on active duty if loan repayment or other monetary inducements were offered.

Attitude of Health Personnel↗

PubMed2004

Validity of using a panoramic radiograph for initial dental classification of Army recruits.

OBJECTIVE: The objective of this study was to examine the validity of classifying Initial Entry Training (IET) soldiers into dental fitness classification 2 or 3 based solely on examining panoramic radiographs. MATERIALS AND METHODS: The dental readiness classification, derived from a clinical screening examination versus a panoramic radiological examination, was compared for 1,050 Fort Sill Basic Training recruits during a 1-month period. The dentist who reviewed the panoramic radiograph and determined a dental classification was blinded to the earlier dental classification from the clinical examination. The Spearman's rank order correlation test was used to determine if a statistically significant correlation existed between classifications based on the clinical examination versus classification by review of the panoramic radiograph alone. RESULTS: The project identified that 18% (n = 186) and 23.7% (n = 249) of the sample population had at least one class 3 condition identified from the clinical screening examination and the panoramic radiograph review, respectively. Of the 186 dental fitness category 3 conditions identified from the routine dental screening, 81.7% (152) of them were also identified from the review of the panoramic radiograph. Spearman's rank order correlation test statistic was 0.633 for a p < 0.001, indicating a statistically significant correlation in the identification of IET soldiers with class 3 conditions using a screening examination with a review of the panoramic radiograph. CONCLUSIONS: The findings of this study suggest that panoramic radiograph review can identify IET soldiers with dental fitness category 3 conditions and implies that a policy change may be prudent to allow this type of initial classification.

Data Interpretation, Statistical↗

PubMed2004

Class 3 dental treatment time.

OBJECTIVE: Dental emergencies take soldiers away from their assigned duties. The objective of this project was to determine the average clinical treatment time needed to correct nondeployable dental conditions using actual treatment times noted in an electronic scheduler. METHODS: The Fort Hood Class Three Intercept Clinic forwarded their daily treatment logs to the Dental Command for each week from November 1, 2002 through February 13, 2003. Clinical treatment times and types of services provided for dental fitness category (DFC) 3 conditions were tracked with the Corporate Dental Application scheduler. RESULTS: The project identified 398 DFC 3 soldiers who were scheduled to receive treatment at the Fort Hood Class Three Intercept Clinic between November 1, 2002 and February 13, 2003. Twenty-three of those soldiers did not receive treatment; therefore, the total sample size was 375. On average, it required 2.2 hours of clinical dental treatment time to make a DFC 3 soldier dentally deployable. CONCLUSIONS: The findings of this study suggest that treating DFC 3 conditions is time-intensive but most DFC 3 soldiers can be treated in approximately 2 hours in an efficient and properly staffed dental clinic. Without proper preventive education and maintenance, these soldiers may develop additional oral disease and may require repeated episodes of increasingly intensive dental treatment.

Appointments and Schedules↗

PubMedDate not supplied

Cost-efficiency of a community dental delivery program for migrant children.

PURPOSE: The purpose of this study was to describe an economically efficient dental prevention and treatment program aimed at migrant children, using dental school students. This dental treatment program aimed to provide comprehensive dental care to migrant children and to provide a unique learning experience for dental students expanding their knowledge of community delivery systems. METHODS: Twenty-four dental students treated 330 migrant children through a 6-week outreach treatment program sponsored by the University of Michigan School of Dentistry, as a part of the Northwest Michigan Migrant Health Program. RESULTS: The program cost $39,907 and resulted in just over $16,000 of Medicaid reimbursements. Factoring in the Medicaid reimbursements, the program cost $71.58 to treat each child comprehensively. CONCLUSIONS: In light of the reported oral health disparities throughout the United States, this program provides an alternative mechanism for efficient and cost-effective oral care in a group that has traditionally had poor oral health.

Child↗

PubMedDate not supplied

Caries prevalence in northwest Michigan migrant children.

PURPOSE: The purpose of this study was to describe the prevalence of dental caries in a sample of Hispanic-American migrant workers' children and compare the results with an earlier Northwest Michigan migrant study to assess if migrant children have benefited from the global caries decline. METHODS: A non-probability convenience sample of migrant farm worker children was obtained from migrant schools in Northwest Michigan during the summer of 1999. Field dental equipment was used to examine caries, fluorosis, and urgent dental needs by 1 examiner. Statistical analysis was performed using SAS software with the student t-test used to test for differences between the samples. Intra-examiner reliability was high for caries at the surface level (kappa = 0.94). RESULTS: The sample consisted of 211 children with 95% ranging in ages from 5 to 13. Mean caries levels were as follows: DMFT = 1.1 (SD 1.6); DMFS = 1.6 (SD 2.5); dft = 3.0 (SD 2.9); dfs = 6.3 (SD 6.7) Fifty percent of children with at least 1 permanent tooth (189) were caries free, with 17% (34) having DMFT values greater than or equal to 3. The large number of caries-free children displayed a skewed distribution of caries where a small proportion of the population harbored the majority of the disease. A statistically significant decrease in caries was evident in permanent teeth (P = .0001) between 1999 and 1982 samples, but no change was realized in primary teeth (P = .7). CONCLUSIONS: Results indicated that the caries decline has extended to this long-neglected migrant group, but only in the permanent dentition. Caries remained moderate to high in the primary dentition and the caries burden was carried by a relatively small segment of the population. Dental treatment programs should be expanded to include preschool children who appear to be at the highest risk for caries.

Adolescent↗