ARNG Dental Bytes®

MG Patrick D. Sculley, DDS, Consultant and Subject Matter Expert
Copyright 2006 WinMil, LLC

68W: The 68W Tracking System manages 68W MOS transition and certification sustainment. As AMEDD soldiers complete their transition to 68W, this module will capture all the details of sustainment for a unit, location, command, or individual. The system is a powerful tool for generating reports that display information about 6SW transition and exporting the reports for further data manipulation.

Amalgam: The technical name for a filling composed of a combination of metals including silver, tin, zinc, copper, and mercury. Dental amalgams have been in widespread use by dental professionals for over 150 years.

AMEDD HR PORTAL: The MODS Human Resources (MR) Applications provide the Army with a comprehensive tracking and reporting tool to manage a variety of functions. These functions include:

• Providing AMEDD Soldier personnel data from the TAPDB and ACPERS systems (examples include: assignment history. courses and licensures, education. PROFIS eligibility, loss/gains. transitions, force management data, and tracking obligations)

• Creating, reviewing, approving, and distributing Officer Distributions for approval by The TSG for the AMEDD community.

Managing Personnel and Medical Readiness by tracking and filling PROFIS positions (CONUS, OCONUS, and in Theater), backfills and individual augmentees, reserve component 90-day rotations, NG physical status, and volunteers.

Anesthesia: A variety of options exist, which are designed to manage the patient's pain when the dentist performs procedures. Most in-office dental procedures involve the use of local anesthesia which creates a loss of sensation in a limited area.

Appliance: Devices such as retainers, bridges, or complete or partial dentures that are designed to repair or replace teeth. Also used to describe removable orthodontic devices.

AVS: The Automated Voucher System (AVS) facilitates the medical readiness of the Army National Guard (ARNG) and the U.S. Army Reserve (USAR) by providing a web-based means of creating and tracking requests for medical services through the Reserve Health Readiness Program (RIIRP). Users can request vouchers for services such as physical exams, dental exams, and immunizations. AVS is also a management tool for the reserve components (RC) to monitor funding allocated towards RHRP services. Additionally, ARNG users may create vouchers for use at ARNG Medical Detachments (Med Del) with scheduling functionality.

Baby Bottle Mouth: Also known as "Baby Bottle Tooth Decay (BBTD)", is a condition of severe or swift decay of baby teeth usually involving the upper incisor teeth, upper and lower first molars and occasionally the lower cuspids. The condition is associated with prolonged or excessively frequent bottle or breast feeding. Every time a baby is fed sugary or sweet liquids such as milk, formula, fruit juices, even breast milk, the sticky film called plaque that constantly forms on teeth can produce acids that attack and dissolve the tooth enamel, causing tooth decay. It is important to begin the practice of cleaning the baby's teeth as soon as they erupt. Early and regular professional visits can diagnose early problems and help instruct parents on the proper preventive measures for their child.

Bicuspids: Teeth located in the back of the mouth (fourth and fifth from front and center) that assist in chewing. They derive their name and can be identified by their characteristic two points or cuspids. Also called premolars.

Bleaching:  Many patients seek this treatment to lighten their teeth. Treatments can be done at home or at the office. The office procedure can include the use of a whitening agent such as peroxide and a light. A recent study concludes that "peroxide and light treatment significantly lightened the teeth to a greater extent than did peroxide or light alone, with a low and transient incidence of tooth sensitivity."¹ Home treatment typically involves the use of a 10% carbamide peroxide product delivered in a night guard. The home treatment is more time consuming but often less expensive and requires greater discipline on the part of the patient to achieve desired results. A recent study reports that carbamide peroxide agents can result in a decrease in the microhardness of the enamel which was not always completely reversible during the time interval of the study.² Tooth whitening whether done at home or in the dental office should be under the supervision of a dentist.

Bone Loss: The result of prolonged and untreated periodontal disease.

Bone Graft: Treatment where replacement bone is surgically placed in contact with the defective bone to assist in the regeneration of natural bone.

Bridge: A dental appliance used to replace one or more missing teeth. It is comprised of a false tooth or teeth permanently affixed to the adjacent teeth (called abutments). Occasionally only a single abutment is used as a cantilever bridge. It is a fixed appliance that cannot be removed by the patient.

Braces: Fixed orthodontic appliance that corrects irregularities in tooth or jaw alignment.

Bruxism: Oral habit of clenching and grinding teeth.

Calculus (Tartar): The build-up and mineralization of plaque on tooth surfaces. The bacteria that clings to calculus causes periodontal disease. It cannot be removed by standard brushing or flossing, but must be removed by a dentist or dental hygienist.

Candidiasis (oral): Yeast or fungal infection that occurs in the oral cavity or pharynx or both. Usually seen in immature or compromised immune systems or after use of antibiotics.

Cap: (See Crown.)

Cavity: (See Dental Caries.)

Cleft lip or palate: A congenital opening or fissure occurring in the lip, palate or both.

Congenital anomaly: An unusual condition existing at, and usually before, birth.

Cosmetic Dentistry: The branch of dentistry that serves to modify the appearances of the mouth and teeth. It includes procedures like bleaching, bonding, porcelain veneers, recontouring, braces, and dental implants.

Craniofacial: Pertaining to the head and face.

Crown:  Type of dental restoration designed to fully cover or "cap" a cracked or broken tooth.

Cuspids: Also know as canines, are located third tooth from front and center. They are cone-like in shape and have a characteristically pointed edge.

Complete Tooth Loss: Complete tooth loss (edentulism) is the loss of all natural teeth. It can substantially reduce quality of life, self-image, and daily functioning.

Deciduous Teeth: The primary set of teeth (baby teeth) which are present before they are replaced with the permanent teeth. (See Permanent Teeth.)

Dental Caries:  Tooth decay is the commonly known term for dental caries, an infectious, transmissible, disease caused by bacteria. The damage done to teeth by this disease is commonly known as cavities. Tooth decay can cause pain and lead to infections in surrounding tissues and tooth loss if not treated properly.

DENCLASS: The Dental Classification System (DENCLASS) provides the Army National Guard (ARNG) dentists and dental technicians the ability to document dental evaluations and create dental treatment plans for soldiers identified as Dental Class 3. The module leverages the existing MODS/MEDPROS official data source to create an event with a list of soldiers that do not meet dental readiness standards. Treatment plans can be created, updated, and tracked until soldiers become Dental Class 2 or better. Data entry effort is minimized by auto population of fields that can be derived via various MODS interfaces such as Total Army Personnel Database - Guard (TAPDB-G). DENCLASS provides summary and activity reports detailing what services have been performed and current dental status for personnel on a national, state, or unit level.

Dental Floss: A waxed or unwaxed thread used to remove plaque from in between the teeth, in areas that the toothbrush can't reach.

Dental Hygiene: The promotion of oral health through the habit of keeping mouth, teeth and gums clean in addition to regular visits to the dentist.

Dental Hygienists: Trained professionals who use their knowledge and skills to help prevent and detect oral disease, clean teeth, apply preventive materials to the teeth and instruct patients in all facets of oral hygiene.

Dental Readiness: Determined by a Soldier's oral fitness prior to deployment.

Dental Treatment Anxiety: Feelings of anxiety, nervousness, or fear associated with dental visits.

Dental Visits: Regular use of the oral health care delivery system leads to better oral health by providing an opportunity for clinical preventive services and early detection of oral diseases. Infrequent users of dental services have more decayed teeth, more severe periodontal diseases, and are more likely to lose all of their teeth.

Dentist: The educated, trained and licensed professional who diagnoses oral health problems, plans treatment, and prescribes medication.

Dentin: The yellowish hard tissue layer that makes up the majority of the tooth located under the enamel and the cementum (the layer that protects the root).

Dentures: Dental device made up of artificial teeth and gums.

DoD: Department of Defense

Enamel: The hard, white outer layer of the tooth or "crown."

Edentulism: A condition characterized by not having any natural teeth.

Extraction: Surgical tooth removal.

Filling: Any of a number of materials used to restore a decayed or broken tooth. Filling materials include silver colored amalgam, white colored composite resins, and gold.

Fluoride: A naturally occurring mineral that is used to prevent tooth decay.

Fluoridation Status: State of a community water system in regards to water fluoridation level. Most water contains some amount of natural fluoride. Fluoridation involves adjusting fluoride in the water to the level optimal for the prevention of dental caries. The recommended amount of fluoride in water systems is 0.7-1.2 ppm (parts per million), which is equivalent to 0.7-1.2 mg/L (milligrams per liter).

Gingivitis: Inflammation of the gums caused by bacteria in the mouth. With gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

Healthy People 2010: Healthy People 2010 provides a framework for prevention for the Nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.

Health Care Provider: Person who prevents or treats illness or disability such as a physician, physician assistant, nurse practitioner, nurse, dentist, or dental hygienist.

HRR: The Health Readiness Record (HRR) module is a data interface ad repository for medical and dental actions providing protected health information. HRR module functions capture, sort, store and retrieve paper/radiographic images; they archive, transfer and receive Soldier dental and health records: and they limit and control access to HIPAA Standard (protected) health information.

Implant: A method used to replace missing teeth. It provides a way to have artificial teeth that look natural and feel secure. The implant itself, often made of titanium, is used like an artificial root to support the false tooth or teeth.

Impressions: Process of taking a mold of teeth with a rubbery material that sets as it is in the patient's mouth to preserve an imprint of the teeth and gums. The imprint is filled with plaster to make a replica of the teeth, which is used by the dentist for the construction of crowns, bridges, and other appliances.

Incisor: Are the first and second teeth from front and center; can be identified by their flat edge.

Infection: Invasion of the body and multiplication of pathogenic microorganisms, which can result in tissue damage and disease.

Inflammation: First response of the immune system to injury or infection of body tissue; characterized by swelling, redness, pain, and occasionally loss of function in the affected area.

LOD: The Line of Duty (LOD) module provides a web-accessible comprehensive, user-friendly tool for use at Units, JFHQ-S, and National Guard Bureau to administer and manage LOD determinations, incapacitation pay, medical care, and safety programs. LOD helps the user get organized, complete the electronic DA Form 2173 and DD Form 261, transfer the forms electronically to the next step, and track the LOD Investigation actions. Information available via MODS is used to pre-populate data fields where appropriate. Improved security is provided by the capability to digitally sign specified data elements using a Common Access Card (CAC) provided through the Army CAC/PKI program and government purchased digital signature software.

Maryland Bridge: A type of bridge that consists of a false tooth or teeth reinforced with metal which is bonded to the adjacent teeth.

MND: The Medical Non-Deployable (MND) module provides global visibility of all ARNG soldiers who have been determined by the medical system to have a medical condition which causes them to be non-deployable. The three main components of the module are:

• The Automated Profile
• The MOS Medical Retention Board (MMRB)
• The Medical Specialty Referral

The module provides work flows within the automated profile, referral, and MMRB components while also providing status on Medical Evaluation Boards and Physical Evaluation Boards. The MND system is III PA A compliant

Molars: Are the sixth seventh and eighth teeth from front and center; can be identified by their four or five points or "cusps."

Mouthguard: Protective device for teeth; recommended for use when playing sports to prevent serious oral injury and pain.

Mouthwash: A solution, usually anti-septic, used to clean mouth and deodorize breath. Dental researchers continue to study the effectiveness of antimicrobial mouthrinses. A recent study concludes "that the adjunctive use of antimicrobial mouthrinses can provide significant benefits to patients who can not maintain adequate levels of plaque and gingivitis control."³ Emphasis is on adjunctive use. Antimicrobial mouthrinses are an adjunct to homecare not a substitute. Another study concludes "in conjunction with professional care (prophylaxis) and tooth brushing over six months, rinsing twice daily with an essential-oil containing mouthrinse was at least as good as flossing daily in reducing interproximal plaque and gingivitis."⁴

Naturally Fluoridated Water: Water systems are considered to be naturally fluoridated if they contain naturally occurring fluoride at 0.7 ppm or more.

Nonfluoridated: Water systems are considered to be nonfluoridated if they contain less than 0.7 ppm fluoride.

Novacaine: A specific type of local anesthetic. Often used as a catch-all term for any local anesthetic. Local anesthesia is most commonly used for in-office dental procedures. It provides anesthesia directly to the area in which the dental procedure occurs. This type of anesthesia generally wears off within a short period of time.

OCCHEALTH: The OCCHealth Module is an online web-based program linked to the FOH-NET health care provider network. This is a cost effective and highly efficient information management tool that includes a Budget/Funding database to track funding obligations as exams requests are approved. The OCCHealth Module captures dates and types of occupational health exams such as preplacement, baseline, job transfer, and termination/retirement exams. The standardized OCCHealth module exam specifications meet DoD 6055-5M, Medical Examinations & Surveillance Manual standards.

Oral Cancer: Includes cancers of the mouth and the pharynx, part of the throat. About two-thirds of oral cancers occur in the mouth and about one-third are found in the pharynx.

Oral cavity: Mouth.

Oral Health 21: The oral health objective of "Healthy People 2010" whose goal is to prevent and control oral and craniofacial diseases, conditions, and injuries and improve access to related services.

Oral Herpes: Comes from the herpes simplex virus and affects the lips, mouth, or throat. Manifestations of the virus are fluid filled swellings (vesicles) which soon break open to leave shallow ulcerations.

Oral Jewelry: The metal or plastic material used for the purpose or oral piercing. Intraoral and perioral piercings have been associated with significant deformities of the gums. Tongue and lip jewelry can lead to gingival recession and other mucogingival defects.⁵

Oral Piercing: Sites include the tongue, the uvula (the soft tissue hanging at the back of the mouth), the lower and upper lips, the cheeks or even a combination of these sites.

Oral Surgeon: A medically trained professional who treats injuries and deformities, extracts teeth and performs surgery of the mouth, jaw and face.

Oral Surgery: Surgery of the mouth, jaw or face.

Orthodontics: The branch of dentistry concerned with irregularities in jaw bone structure, teeth, and bite.

Orthodontist: Prescribes and places corrective devices, such as braces, to align teeth and improve health and appearance.

Partial: It is a removable partial denture device that replaces missing teeth.

Pediatric Dentistry: The area of dentistry that specializes in the dental health of children from birth through adolescence, including children with special health care needs.

Periodontitis: When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.") In periodontitis, gums pull away from the teeth and form "pockets" that are infected. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Permanent Teeth: Erupt once the deciduous teeth have fallen out and are not replaced by any other set of teeth.

Pharynx: Throat.

Plaque: The accumulation of bacteria, microorganisms and their products which stick to the tooth surfaces. Dental plaque is soft and easily removed by brushing and flossing the teeth. Accumulation of plaque can lead to gum disease (gingivitis) and periodontal disease, as well as tooth decay.

Powered toothbrushes: Many patients use powered toothbrushes however all powered toothbrushes are not equally effective and not all are better or even as good as manual tooth brushing. A recent study concludes that "some powered toothbrushes with a rotation-oscillation action achieve a significant but modest reduction in plaque and gingivitis compared with manual toothbrushes."⁶

Private Water Supply: Individual water systems, generally wells and springs, serving one or several residences.

Public Water Supply System (PWS): A public water system provides water for human consumption to the public through piped or other constructed conveyances. A PWS has at least 15 service connections or regularly serves an average of at least 25 individuals daily for at least 60 days out of the year. Ground water sources, surface water sources, or a combination of the two sources may provide water to a PWS. In some cases, one PWS may purchase all or part of its water from another PWS.

Pulp: The tissue inside the tooth which contains the nerves and blood vessels and is the source of nutrients for the tooth.

RC 90-DAY ROTATIONS: The 90 Day Boots on Ground (BOG) Rotation tracks all RC The Reserve Component 90 Day Rotations application tracks and manages the timely rotations of mobilized U.S. Army Reserve and Army National Guard Physicians, Dentists, and Nurse Anesthetists. This application provides monitoring tools for each of the rotations to prevent the soldiers from being activated for extended periods of time. This application facilitates the management of RC and NG health professionals so that they can return to their private practices: which may result in a higher retention rate.

Root Canal: Procedure that involves removing diseased pulp, cleaning and shaping the pulp canal, and then filling the pulp canal with an inert material. Once the root canal is completed the dentist restores the tooth with a crown or other restorative material.

Sealant: A plastic, professionally-applied material that is put on the chewing surfaces of back teeth to prevent cavities. Sealants provide a physical barrier so that cavity-causing bacteria cannot invade the pits and fissures on the chewing surfaces of teeth.

Sensitive Teeth: A painful reaction in one or more teeth triggered by varied temperatures and foods. This pain can be sharp and sudden. It is caused by exposure of the dentin at the neck of the tooth with transmission of stimuli through dentinal tubules to the nerve in the tooth. The condition is also called dentinal hypersensitivity or cervical sensitivity because of its relationship to the exposed dentin at the neck of the tooth.

Soft tissue lesion: An abnormality of the soft tissues of the oral cavity or pharynx.

Special Needs Patients: Patients with diseases or disorders such as diabetes or cancer who have particular needs with regards to oral health.

Teeth Cleaning: A dentist or dental hygienist removes soft debris, stain, and hard deposits (calculus or tartar) on the teeth that cannot be removed by brushing and flossing. Regular teeth cleaning by a dentist or dental hygienist helps prevent periodontal diseases.

Tooth Brush: A soft bristled brush used to clean plaque and other debris from the teeth.

Tooth Fairy: A fictional character who is said to collect the deciduous teeth that have fallen out as children grow and leaves money in exchange.

Tooth Loss: Occurs when the supporting bone of the teeth break down due to advanced periodontitis or due to the extraction of unrestorable decayed or fractured teeth.

Tooth Paste: A paste or similar substance used for dental hygiene. It is usually made from sodium monofluorophosphate, color, flavoring, fluoride, foaming agents, detergents, and humectants (prevent the paste from hardening).

Tooth Root: Located in the socket of the bone and houses the nerves and blood vessels that provide nutrients to the tooth.

Tooth Whitening: (See Bleaching.)

TMJ: The temporomandibular joint connects the lower jaw, called the mandible, to the temporal bone at the side of the head.

TMJ Disorders: Disorders that include discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles; a dislocated jaw or displaced disc, or injury to the condyle; or osteoarthritis or rheumatoid arthritis in the jaw joint.

TRICARE Dental Program (TDP): Dental program that is part of the DoD Military Health System; the dental insurance provider of the United States Military.

Tooth Decay: Tooth decay is the commonly known term for dental caries, an infectious, transmissible, disease caused by bacteria. The damage done to teeth by this disease is commonly known as cavities. Tooth decay can cause pain and lead to infections in surrounding tissues and tooth loss if not treated properly.

Trismus: An inability to open the mouth completely. It can be caused by muscle, nerve or joint damage or inflammation.

UCCI: United Concordia Companies, Inc., manages the TRICARE Dental Program.

WARRIOR TRANSITION: The Warrior Transition application provides Commanders at all levels with a web-accessible, real-time, comprehensive tracking system designed to manage Warrior Transition Unit (WTU) Soldiers. These soldiers are RC Soldiers mobilized on USC orders in support of contingency operations who were injured and diverted from his/her normal mobilization mission, demobilization processing, or medically evacuated from theater, who is in need of medical evaluation, treatment, and disposition including definitive health care for medical conditions identified, incurred or aggravated while in an active duty status; USAR and NG personnel in an active duty status if their medical condition required treatment that could not be completed in less than 30 days; and active duty soldiers who were injured while in support of the Global War on Terrorism (GWOT).

Water Pick: Hygiene device that provides a pressurized stream of water for the purpose of removing food and other debris from teeth.

Wisdom Tooth: Also known as third molars, are the last teeth to erupt. This occurs usually between the ages of 17 and 25. The dentist might suggest surgically removing the wisdom teeth to prevent or correct typical problems associated with them such as inflammation or crowding.

Xerostemia: Also know as "Dry Mouth", is the condition of not having enough saliva to keep the mouth wet. Insufficient saliva can lead to the development of tooth decay or other infections in the mouth. Dry mouth can also interfere with proper nutrition if one cannot chew and swallow certain foods.

Xylitol: Is a natural sugar alcohol that helps prevents cavities by inhibiting the growth of bacteria that causes tooth decay. It is equal in sweetness and volume to sugar and the granular form can be used in many of the ways that sugar is used.

X-ray: The common name for radiographs, are an essential tool for dentists to properly diagnose your oral health. They allow dentists to see beyond what can be seen visually and provide the ability to diagnose dental disease in the early stages - before it has advanced to the point of causing discomfort and destruction. They assist in determining presence and degree of dental caries, periodontal disease, abscesses and abnormal growths, such as tumors or cysts.

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¹JADA, VOL 134, February 2003.
²JADA, VOL 134, October 2003.
³JADA, Vol 134, October 2003.
⁴JADA, VOL 134, March 2003.
⁵JADA, Vol.134, July 2003.
⁶JADA, VOL 134 September 2003.