Page 87 - JSOM Summer 2023

TABLE 2 Comparison of Dental Emergencies (DE), Oral-Facial (OF) or Craniomaxillofacial (CMF) Medical Evacuations to Total Medical
Evacuations*
Dental Emergencies OF-Disease, Battle Injury, Non-battle Injury CMF-Battle Injury only
DE/Total Percent OF/Total Percent CMF/Total Percent
Norman 115/2162 5.3% Mitchener 1-374/18036 2.1% Chan* 4020/9530 42.2%
Ballantine 34/642 5.3% Mitchener 2-206/6795 3.0%
Duffy 357/2825 12.6% Mitchener 3-132/5647 2.3%
Macintosh 27/512 5.3%
Toner 10/130 7.7%
Smith 5/44 11.4%
Ziemba 18/565 3.2%
Gunepin 54/338 16.0%
Nice 52/743 7.0%
Deutsch 70/852 8.2%
*Chan et al. only compared to the total of medical evacuations due to battle injury only
the top categories of medical evacuations. Dental emergencies Of the ten civilian and (foreign and US) military dental emer-
ranked in the top ten categories of medical evacuation in all gency studies, seven had adequate information to calculate
six studies and was the number one category of medical evac- rates of dental emergencies needing medical evacuation. Table
uation in the Gunepin et al. French military study. 4 gives those rates (per 1,000 per year). Note that the highest
rate of dental emergencies needing medical evacuation belong
TABLE 3 Dental Emergency Studies that Compared Dental to the French military.
Evacuations to the Top Categories of Medical Evacuations
Norman et al.: Top reasons for medical evacuation (in raw number): TABLE 4 Rates of Dental Emergencies (Per 1000 Per Year)
Injury – “Fractures of the Arm” – 234 Norman et al. N/A
Injury – “Sprains and Strains” – 192 Ballantine et al. 23.4
Illness – (Tie) “Disorders of the Musculoskeletal Systems” –
156 & Injury – “Foreign Bodies” – 156 Duffy et al. 21.6
Injury – “Fractures of the Leg” – 140 Macintosh et al. N/A
Injury – “Contusions” – 132 Toner et al. 0.31
Illness – “Disorders of the Digestive System
(other than dental)” – 124 Smith et al. 20.8
Injury – “Open Wounds of the Limb” – 120 Ziemba 0.88
Illness – “Disorders of the Respiratory System” – 117 Gunepin et al. 41.8
Illness – “Disorders of the Digestive System (dental)” – 115
Nice 0.16
Macintosh et al.: Top categories of medical evacuations due to Deutsch et al. N/A
injury (illness/disease not included)
“Athletic” – 55%
“Soft Tissue” – 17% Discussion
“Dental” – 5.2% As a consequence of the ongoing Coronavirus pandemic since
“Skin/wound infection” – 4%
“Fractures” – 3.7% early 2020, fuel prices have risen dramatically throughout the
world. In addition, the costs to build and maintain air and
Toner et al.: Top categories of medical evacuations (Malaysia only) ground vehicles to transport patients have also risen sharply.
“Injury” – 34.1% In certain cases, there are secondary and tertiary effects of the
“Short term illness” – 31.8%
“Other” – 18.2% pandemic that include parts and supply shortages. This af-
“Dental” – 11.4% fects the capability and speed of air evacuations. Bhaskar et
“Emotional Problems” – 4.5% al. reports that the global supply chain issues have also cre-
Nice: Top medical evacuation categories ated shortages in frontline medical devices, personal protec-
“Injury” – 36% tive equipment, and hospital bed availability – which can be
“Ill-defined” – 8% a more detrimental issue for developing nations and remote
“Infectious disease” – 8% environments that host military deployments and opera-
Tie “Digestive-dental” – 7% and “Mental Disorders” – 7% tions. According to Kumar et al. the pandemic has caused
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Ziemba: Top medical evacuation categories many manufacturing plants to shut down or run at limited
“Combat injuries” – 29% capacity, thus affecting the supply chain of finished goods,
“Respiratory Tract Infection” – 23% and causing shortages in products. Additionally, distribution
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“Complications acute GI infections” – 12% was negatively impacted by new trade and travel restrictions.
Tie – “Mental Health Problems” & “chronic neuralgia” – 11%
“Non-combat injuries” – 4% Another challenge noted in the research was the pandemic’s
“Dental/maxillofacial problems” – 3% impact on the scheduling of trained medical personnel, phar-
maceutical supply chain shortages, and vehicle scheduling for
Gunepin et al.: Top medical evacuation categories both patients and medical workers. Additionally, production
“Dental” – 16% process and standard operation procedures to maintain social
“Anxiety” – 8.6%
“Sprains (ankle/knee)” – 8.0% distancing creates an additional burden as extra time is needed
“Gastroenteritis” – 7.4% to follow new protocols. The combination of these prob-
(Tie) “Dehydration” and “renal colic” – 6.5% lems brought on by the COVID pandemic can lead to many

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