In addition, due to the Covid-19 pandemic, a huge number of our veterans have been unable to be examined by a dentist.

Our veterans deserve better. We must work together to ensure that all our veterans have access to full health services and not only medical.

Lack of access to dental services has a pervasive and expensive impact throughout society as many Americans pay out of pocket for dental care, including veterans.

This pilot program aims to conduct a study in Southern California to precisely assess the feasibility and advisability of furnishing dental care to veterans enrolled in the system of patient enrollment under section 1705 of title 38, United Stated Code, who are not eligible for dental services and treatment, and related dental appliances.

By executing this study for our veteran’s citizens, we will be able to detect dental and oral pathologies and disease including but not limited to oral cancer, periodontal disease, caries/decay, oral handicap of edentulism.

those veterans who are orally disabled and to discover whether the disability affects their cognitive health and vice versa.

Background

An individual should be considered to have a dental disability if pain, infection and lack of stable and functional dentition restricts nutritional intake necessary for growth and energy needs, inhibits participation in life activities or diminishes quality of life.

There is a huge need to improve oral health care of our veterans. Poor oral health status has been significantly associated with mental illness which may be more prevalent in a veteran population and include but not limited to depression, anxiety disorder and post-traumatic stress disorder (PTSD). [Reference: Mr. Darryl Tong et al, Factors affecting oral health status in an elderly military veteran population in New Zealand, Journal of Military and Veterans’ Health, Volume 18 Number 3; July 2010]

This pilot program will help identify those veterans in need of dental care. The main goal of this study managed by the Not-for-Profit 501c3 organization Dentists for Veterans (Oral Disability Rescue) is to provide the best evaluation criteria and methods to assess oral health care in order to better target the veteran’s population in need of urgent care but also to identify means to reduce the dental treatment costs of veterans in United States.

Objectives

To identify treatment needs associated with oral health in a group of volunteer veterans, we need to perform the following:

• A clinical exam
• A radiographic exam
• Enhanced Oral Assessment system exam to aid in the early detection of mucosal abnormalities such as Oral Cancer.
• To assess the cognitive status as associated with oral health.

Patients: Volunteer military veterans in every State of the nation.

Materials and Methods

We will examine a sample of at least 1000 veterans. This will be a prospective study of volunteer veterans responding to announcements made at various VA organizations and hospitals.

A detailed oral and radiographic (x-ray) examination of each patient will be carried out and the treatment needs will be evaluated.

First step: The CPITN is primarily a screening procedure which requires clinical assessment for the presence or absence of periodontal pockets, calculus and gingival bleeding. Use of a special CPITN periodontal probe is recommended. For epidemiological purposes in adult populations, 10 specified index teeth are examined. Individuals are assigned to one of four treatment need categories determined from their CPITN scores. For health services planning, the data provides a basis for estimating overall population needs in terms of treatment categories and the clinical personnel required for periodontal care.

 Second step: A six item dental screening measure called the D-E-N-T-A-L.

The D-E-N-T-A-L queries whether participants have “Dry mouth, Eating or swallowing problems, Not had a dental examination in the last 2 years, Tooth or mouth problems, Altered eating habits because of teeth or mouth, or Lesions or sores in the mouth.”

The criterion standard for need for treatment is determined by a clinical examination. Respondents indicate whether each response applies to them. Positive items are summed; two items (dry mouth and lesions) receive a score of 2 if positive. Persons with scores of 2 or greater are likely to need dental treatment.

Third step is the use of natural tissue fluorescence direct visualization technology to enhance the examination, detection and management of oral soft tissue conditions such as Oral Cancer.

 Fourth step is a radiographic evaluation using first a digital panoramic radiograph and later on, if treatment is needed, the use of peri-apical and bite-wings radiographs.

Fifth step is the evaluation of cognitive status:

Each patient will enter an interview at the end of the screening. During this screening, the cognitive status can be assessed with the Mini Mental Status Exam. The MMSE is a mental status test assessing orientation, immediate and delayed recall, concentration, language, and praxis, with scores ranging from 0 to 30, with lower scores suggesting poorer cognitive function.­­­­­

Amount of investment needed

The charitable non-profit organization Dentists for Veterans is funding the study up to $195 per veteran examined.

Only $95 per veteran needs to be covered by outside funding and donations.

We need to cover fees needed to compensate the clinical staff (dentists, dental assistants and the administrative staff), the personal protective equipment and disposable material.

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