Page 86 - JSOM Summer 2023

16-week period from October 2014 to March 2015, global made up 2.1% of total MEDEVACs. There were 374 of these
oil and gas industry workers attending a 1-day course at a types of MEDEVACs out of theater. Disease of the oral facial
training facility in Aberdeen, Scotland were provided with a region accounted for 158 MEDEVACs (42%). Battle injuries
questionnaire in order to identify the prevalence of medical accounted for 136 (36%) of these MEDEVACS. Non-battle
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evacuations occurring among this population. Of the total injuries accounted for 80 (21%). In 2005, disease, battle in-
44 reported evacuations, five were related to dental issues juries and non-battle injuries involving oral–facial structures
(11.4%). made up 3.0% of total MEDEVACs. There were 206 of these
types of MEDEVACs out of theater. Battle injuries accounted
Medical Evacuations Occurring in Military Populations for 109 (53%) of these MEDEVACS. Disease of the oral facial
The first study of the military studies was titled “A survey of region accounted for 64 MEDEVACs (31%). Non-battle inju-
US Navy medical communications and evacuations at Sea” by ries accounted for 33 (16%). Lastly, in 2006, disease, battle
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Nice. This was a nine-month study from 1 December 1982 injuries and non-battle injuries involving oral–facial structures
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to 31 August 1983. The population of interest was all United made up 2.3% of total MEDEVACs. There were 132 of these
States Navy surface ships, Pacific fleet submarines, and all types of MEDEVACs out of theater. Battle injuries accounted
ships of the Military Sealift Command. A total of 743 medical for 78 (59%) of these MEDEVACS. Non-battle injuries ac-
evacuations were reported during this study period, of which counted for 31 (23.5%). Diseases of the oral facial region ac-
17% of were due to digestive problems, particularly due to counted for 23 MEDEVACs (17.5%). 18
teeth and supporting structures or appendicitis. Of more in-
terest, 52 cases (7% of the total) were due to non-injury re- The study entitled “Analysis of the causes of medical evac-
lated dental problems. Nice broke down the cases and was the uation of injured and sick soldiers of the Polish Military
only military study of DE medical evacuations (US or foreign) Contingent in the Islamic State of Afghanistan taking part
to do so. The author provided raw numbers, and the leading in International Security Assistance Force Operations” by

category was “infection” with 26 medical evacuations (50%). Ziemba described medical reports of the Polish Military Con-
“Undiagnosed pain”/“unspecified pain” accounted for 13 tingent that took part in Operation Enduring Freedom from
(25%), “wisdom teeth” accounted for nine (17%), and “car- January 2010 to December 2011. The author reported that
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ies” accounted for four DE medical evacuations (8%). 3,278 soldiers suffered from acute inflammations of teeth or
periodontium and complications of these inflammations. The
The next study was titled “Dental events during periods of cause of evacuation among 18 (0.5%) of these soldiers were
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isolation in the US submarine force” by Deutsch et al. The due to more severe dental conditions, which included dental
aim of the study was to examine dental events that occurred osteomyelitis, segmental mandibular/ maxillary necrosis, and
on 240 submarine patrols from the time period of January persistent inflammation of the masticatory apparatus. In total,
1997 to September 2000, which contained medical evacua- 565 medical evacuations occurred, of which 3.0% were due to
tion data from the Atlantic and Pacific submarine fleets from dental reasons.
1991–1997. Of the total such evacuations, 6.9% were due to
dental reasons among the Pacific fleet, and 9.3% of total med- The last study was titled “Medical evacuation of French Forces
ical evacuations were due to dental reasons among the Atlantic for dental emergencies: Operation Serval” by Gunepin et al.
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fleet. In this study, medical evacuation data occurring from Febru-
ary 2013 to May 2013 was reviewed to identify the frequency
Another study was titled “Ten years of war: A characteriza- of medical evacuations that was required for French soldiers
tion of craniomaxillofacial injuries incurred during operations during Operation Serval. Data revealed that 338 total evacu-
Enduring Freedom and Iraqi Freedom” by Chan et al. In ations occurred, of which 54 (16.0%) were due to dental pa-
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this study, the Joint Theater Trauma Registry was reviewed to thology. Notably, dental reasons were the top cited reasons for
identify the types of battle injuries occurring among Depart- medical evacuations during this five-month period. 4
ment of Defense personnel deployed to Iraq and Afghanistan
during October 2001 to March 2011, the time period of Op- Among military personnel, DE/OMF issues were frequently
erations Enduring Freedom and Iraqi Freedom. Based on the among one of the top categories of medical evacuations, rang-
data obtained in the study, a total of 9,530 battlefield injury ing from 2–16% of all such evacuations. Among oil and gas
medical evacuations occurred out of theater, of which 4,020 industry workers, 5.3–14.6% of medical evacuations were
craniomaxillofacial battle injury related medical evacuations dental related, while one study of wilderness expeditions found
occurred. Maxillary and mandibular fractures due to battle that DEs ranked as the third most frequent type of injury that
injuries were frequent – 824 in total which made up 20.4% required medical evacuation. Table 2 shows the comparison
of craniomaxillofacial battle injury medical evacuations and of dental emergency, oral-facial, and craniofacial battle injury
8.6% of total battle injury medical evacuations. 15 medical evacuations to the total number of medical evacua-
tions. Percentages are then calculated. The Chan et al. study
The next study was titled “Air medical evacuations of Soldiers only looked at medical evacuations due to battle injuries of the
for oral-facial disease and injuries” by Mitchener et al. This craniofacial region. Chan et al. compared those numbers to the
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research was a series of studies conducted in 2003–2004, 2005, total number of medical evacuations due to battle injury only.
and 2006 to identify the nature and causes of serious oral-facial The study did not look at the total numbers due to non-battle
(or OMF) illnesses and injuries among US Army personnel de- injury or disease.
ployed to Iraq and Afghanistan. The US Air Force Transporta-
tion Regulating and Command & Control Evacuation System Only six dental emergency studies compared the frequency of
database for MEDEVACS was reviewed in the three mentioned dental emergency evacuations to other types of medical evacu-
study years. In 2003–2004, it was found that disease, battle in- ations. For these six studies (three civilian, two foreign military,
juries, and non-battle injuries involving oral–facial structures and one US military), Table 3 compares dental evacuations to

84 | JSOM Volume 23, Edition 2 / Summer 2023