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Bad Breath & the Military “Where are we going with this, doc?”

Funny you should ask. As a dentist of 40+ years, 26 in the Navy Dental Corps serving what is called the Blue-side Navy, the Naval Special Warfare and the Green-side Marines, my job was to make sure the Service men and women I treated were pain-free and could function without any dental or oral problems making them ready to be Mission“deployed”, as necessary. From the Medical physician perspective, they have a similar mission, making sure that there are no medical issues that would stop this same Service member from being deployed. The end result is to make the United States Military the best in the world from every aspect of the mission to support.

Since the military’s dental health is my small supportive role, let’s talk about this and how bad-breath comes into play. Bad breath is an indicator of disease. Something is causing an imbalance in bacterial activity that often relates to disease. This disease can be as simple as a tooth cavity, to gum (periodontal) disease to a purulent dental abscess.

Now, a cavity can often be a simple nuisance in the field when deployed on a mission, but it is still a nuisance that can get worse, if left unattended. Periodontal/gum disease (a soft-tissue infection) has several stages, from simple to worse. Unattended periodontal/gum disease if left unattended, can increase from simply red, sore gums, to infection/pus to advanced debilitating pain. That earlier unattended tooth cavity is just like rust eating through steel, tooth decay can later eat through a tooth, into the nerve causing severe distracting pain becoming so advanced to create an abscess creating significant swelling and pain that is often far beyond simple “distracting”.

In simple military structure, there are the Combat-Line forces (the “Tip of the Spear” ) doing the fighting but in the back, and just as important, are the “Support” forces. Typically, from war to war, about one-third to a one-half of a force is Support for the Combat-Line forces. In later years, the Combat-Line forces have decreased as the Support has increased. This may be due to the effectiveness of the Combat-Line forces with newer, more technical equipment that requires more support. Regardless, both Combat-Line and Support forces can not be distracted that ultimately may compromise the “Mission”. Imagine, a Combat-Line soldier having a severe tooth ache. This will take their mind off the down-range enemy compromising or possibly losing the Mission. The same can be said of a Support soldier. Maybe they are in charge of correctly calibrating a very technical part of a helicopter engine where they are losing concentration from dental pain. The lack of proper calibration, could result in the crash/loss of a 20 million dollar helicopter from engine failure or worse, an invaluable trained pilot, who is also the son or daughter to a family.

This tooth-pain “distraction” scenario can be applied to many military conditions so what do you do to take care of a soldier in dental pain? Yes, what do you do? Dope them up with pain drugs where they have no “mission” value? What if you have to move doped-up individual? It might take two additional soldiers to carry such a soldier. Again, the Mission is compromised and also places others in danger.

What about sending them back to the Support area for treatment? It can be done, but now what piece of equipment are you using for them rather than using it for the Mission, the Combat-Line soldiers? Again, the Mission is compromised.

The above adds to the military importance of good oral hygiene and pre-mission deployment dental treatment so as to avoid these scenarios. Years ago, a Military Journal published an article “Sir, it’s only a dental exam?” laying bear the above regarding good dental health and treatment. Something as simply as a distracting toothache, gum disease or abscess can compromise a multi-million dollar mission and potentially place lives at risk. Therefore, when a doctor finds a Service member with bad breath, it may be more than simply offensive to fellow Service member, it can be a military Mission failure.

Steven Jaksha DMD, Odontology, Oral Diseases, Bad Breath Specialist

CDR DC USN (ret) San Diego, CA

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