Surgical dental treatment for military personnel: where and when?--a case report.
BACKGROUND
Oral health is essential for combat readiness. The classification for combat readiness includes the Dental Fitness Categories, which are used to estimate a soldier's need for emergency dental care while deployed overseas. When the issue at hand is in regard to unerupted or additional teeth, the treating dentist faces a difficult decision since there is no evidence-based practice guidelines.


METHODS
An otherwise healthy 20 year-old soldier initially presented to his general physician (Role I) with toothache in the lower jaw. The initial referral to a general dentist (Role II) led to a diagnosis of an additional tooth 45; therefore, he was transferred to the oral surgeon (Role III). A computed tomography scan revealed fully retained besides the additional 45, wisdom teeth, and additional wisdom teeth, as well as retained tooth 23. After careful consideration, osteotomies of all retained teeth were performed under general anesthesia. A titanium miniplate was placed for stabilization.


CONCLUSIONS
Despite variability among dentists in assigning a particular Dental Fitness Class, the clinical and radiologic examination must take into account treatment options that may become necessary for unerupted and retained teeth.
Department of Oral and Maxillofacial Surgery, Hanover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hanover, Germany.
Marcus
M
Stoetzer
Department of Surgery, German Armed Forces Hospital, Oberer Eselsberg 40, D-89081 Ulm, Germany.
Roland
R
Schmidt
Department of Oral and Maxillofacial Surgery, Hanover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hanover, Germany.
Nils-Claudius
NC
Gellrich
Department of Oral and Maxillofacial Surgery, Hanover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hanover, Germany.
Constantin
C
von See
D001641:Bicuspid / Q000002:abnormalities / Q000601:surgery; D001860:Bone Plates; D003481:Cuspid / Q000601:surgery; D003803:Dentigerous Cyst / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery; D008889:Military Personnel; D008964:Molar, Third / Q000002:abnormalities / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D014081:Tooth Extraction / Q000379:methods*; D014095:Tooth, Impacted / Q000601:surgery*; D014096:Tooth, Supernumerary / Q000601:surgery; D014097:Tooth, Unerupted / Q000601:surgery*; D055815:Young Adult