Oral alterations in military personal: a narrative review on main findings and implications for oral health And operational efficiency

Authors

  • Letícia Côgo Marques Célula de Inovação Tecnológica da Odontoclínica Central da Marinha, Marinha do Brasil, Rio de Janeiro, RJ, Brasil
  • Raquel Machado Andrade-Losso Célula de Inovação Tecnológica da Odontoclínica Central da Marinha, Marinha do Brasil, Rio de Janeiro, RJ, Brasil
  • Teresa Cristina Pereira de Oliveira Célula de Inovação Tecnológica da Odontoclínica Central da Marinha, Marinha do Brasil, Rio de Janeiro, RJ, Brasil
  • Humberto Jácome-Santos Célula de Inovação Tecnológica da Odontoclínica Central da Marinha, Marinha do Brasil, Rio de Janeiro, RJ, Brasil

DOI:

https://doi.org/10.22491/1983-7550-52-2-R1

Keywords:

Oral health, Oral manifestations, Military health, Military personnel, Prevention

Abstract

Oral health is fundamental to the well-being and performance of military personnel. Factors inherent to military work activities can affect the integrity of personnel’s stomatognathic system. This narrative review examined the literature on the oral alterations in military personnel (especially the Armed Forces) to understand the impacts of these conditions on health and operational performance. An integrative review was conducted through a search in PubMed, SciELO and Google Scholar. Case studies, literature reviews, cross-sectional studies, and clinical trials were selected. The most prevalent oral conditions in military personnel include periodontal diseases, caries, bone and dental trauma, temporomandibular disorders, actinic cheilitis, and oral cancers. These problems directly impact the oral health of military personnel and their readiness for functional performance. Factors such as adverse working conditions, high stress levels, limited access to dental care, excessive sun exposure, irregular eating habits, and lack of time for self-care contribute to the increased prevalence of these conditions. Oral conditions can directly compromise the overall health and operational efficiency of military personnel; therefore, it is essential to implement prevention programs, oral health education, and expanding access to dental care. Results highlight the relevance of investing in technological innovations to meet the needs of military personnel regarding prevention, monitoring, and diagnosis in oral health.

References

1. Kapila YL. Oral health’s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontol 2000. 2021;87(1):11-6.

2. Patinen P, Tanner T, Honkanen J, Tjäderhane L, Päkkilä J, Anttonen V, et al. General- and oral-health-related predisposing factors for interrupting military service in the finnish defence forces. Mil Med. 2023;188(1-2):e260-6.

3. Maculewicz E, Pabin A, Dziuda Ł, Białek M, Białek A. Selected exogenous (occupational and environmental) risk factors for cardiovascular diseases in military and aviation. J Clin Med. 2023;12(23):7492.

4. Suman M, Spalj S, Plancak D, Dukic W, Juric H. The influence of war on the oral health of professional soldiers. Int Dent J. 2008;58(2):71-4.

5. Deutsch WM. Dental events during periods of isolation in the U.S. submarine force. Mil Med. 2008;173(1 Suppl):29-37.

6. Colthirst PM, Berg RG, Denicolo P, Simecek JW. Operational cost analysis of dental emergencies for deployed US Army personnel during operation Iraqi freedom. Mil Med. 2013;178(4):427-31.

7. Ahuja A, Darekar H. Community Dentistry in Armed Forces. Med J Armed Forces India. 2003;59(1):18-20.

8. Andrade-Losso RM, Marques LC, Cunha JDM, Silami MANC, Azevedo ABD. Exposição solar e risco ocupacional: Relação entre carcinoma de células escamosas em lábio, queilite actínica e displasia epitelial oral em militares e dependentes. Rev Nav Odontol. 2024;51(1):13-22.

9. Bornstein MM, Stocker BL, Seemann R, Bürgin WB, Lussi A. Prevalence of halitosis in young male adults: a study in Swiss Army recruits comparing self-reported and clinical data. J Periodontol. 2009;80(1):24-31.

10. Cigic L, Martinovic D, Martinic J, Kovic M, Druzijanic A, Galic I, et al. Increased prevalence of oral potentially malignant lesions among Croatian War invalids, a cross-sectional study. J Clin Exp Dent. 2023;15(9):e734-41.

11. Covington L, Breault L, Hokett S. The application of Periodontal Screening and Recording (PSR) in a military population. J Contemp Dent Pract. 2003;4(3):36-51.

12. Diefenderfer KE, Ahlf RL, Simecek JW, Levine ME. Periodontal health status in a cohort of young US Navy personnel. J Public Health Dent. 2007;67(1):49-54.

13. Bárcena García M, Cobo Plana JM, Arcos González PI. Prevalence and severity of periodontal disease among Spanish military personnel. BMJ Mil Health. 2022;168(2):132-5.

14. Wang G, Zhao B, Kong Y, Ma D, Yang L, Song Y, et al. A preliminary study on submariners with xerostomia Revista Naval de Odontologia - 2025 - Volume 52 Número 2 35 after a 3-month deployment. Medicine (Baltimore). 2020;99(17):e19523.

15. Hancock EB, Wirthlin MR. An evaluation of the Navy periodontal screening examination. J Periodontol. 1977;48(2):63-6.

16. Joss A, Weber HP, Gerber C, Siegrist B, Curilovic Z, Saxer UP, et al. Periodontal conditions in Swiss Army recruits. Schweiz Monatsschrift Zahnmed. 1992;102(5):541-8.

17. Katz J, Peretz B, Sgan-Cohen HD, Horev T, Eldad A. Periodontal status by CPITN, and associated variables in an Israeli permanent force military population. J Clin Periodontol. 2000;27(5):319-24.

18. Khalilazar L, Khoshdel AR. Oral health profile in Iranian Armed Force: focusing on prevention strategies. J Arch Mil Med. 2016;4(2).

19. Kelbauskiene N, Kelbauskas E, Nedzelskiene I. Evaluation of odontological assistance to soldiers going on a mission, and prognostication of their odontological problems. Stomatologija. 2006;8(2):49-52.

20. Laband PF, Bumsted WD. Premalignant lesions of the lips in soldiers returning from Korea; a preliminary report. Oral Surg Oral Med Oral Pathol. 1955;8(1):64-75.

21. Lew TA, Walker JA, Wenke JC, Blackbourne LH, Hale RG. Characterization of craniomaxillofacial battle injuries sustained by United States service members in the current conflicts of Iraq and Afghanistan. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2010;68(1):3-7.

22. Marker OT, Vigild M, Praetorius F. Oral health problems and treatment needs in Danish military personnel recruited for United Nations service. Mil Med. 1997;162(6):416-21.

23. Melo JCN, Nogueira CM, Lorena EO, Silva WM, Almeida HMPG, Almeida RD. Prevalência de sinais e sintomas de desordens temporomandibulares e lesões buco-dentárias em músicos militares. Rev OARF. 2016;1(1):6-16.

24. Morgan MV, Stonnill A, Laslett AM. Dental caries amongst Royal Australian Navy recruits, 1988. Aust Dent J. 1992;37(3):201-4.

25. Norozy A, Kalantar Motamedi MH, Ebrahimi A, Khoshmohabat H. Maxillofacial fracture patterns in military casualties. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2020;78(4):611.e1-6.

26. Prokhvatilov GI, Shelepov AM, Chernysh VF, Grebnev GA, Nikolaiev VA. The incidence of stomatologic diseases among the reserve officers: the epidemiological investigation. Voen Med Zh. 2006;327(12):17-21.

27. Mombiedro Sandoval R, Llena Puy R. Periodontal status and treatment needs among Spanish military personnel. Med Oral Patol Oral Cir Bucal. 2008;13(7):E464-9.

28. Schlagenhauf U, Rehder J, Gelbrich G, Jockel-Schneider Y. Consumption of Lactobacillus reuteri-containing lozenges improves periodontal health in navy sailors at sea: a randomized controlled trial. J Periodontol. 2020;91(10):1328-38.

29. Senna A, Campus G, Gagliani M, Strohmenger L. Socio-economic influence on caries experience and CPITN values among a group of Italian call-up soldiers

and cadets. Oral Health Prev Dent. 2005;3(1):39-46. 30. Singh A, Bhambal A, Saxena S, Tiwari V, Tiwari U, Singh A. Assessment of periodontal status of Indian police personnel of Central India: a cross-sectional representative study. SRM J Res Dent Sci. 2015;6(3):155.

31. Skec V, Macan JS, Susac M, Jokić D, Brajdić D, Macan D. Influence of oral hygiene on oral health of recruits and professionals in the Croatian Army. Mil Med. 2006;171(10):1006-9.

32. Sonoda C, Sakurai Y, Okoda M, Ebisawa M, Nakashima H, Tsunoda M. Impact of oral health status on perceived dental problems among Japan Maritime Self-Defense Force Personnel. Mil Med. 2022;187(5-6):e678-83.

33. Stoetzer M, Schmidt R, Gellrich NC, See C. Surgical dental treatment for military personnel: where and when? A case report. Mil Med. 2014;179(11):1401-3.

34. Wennström JL, Carlson OG, Liljequist C. Periodontal disease in military aircrew members: a clinical and radiographical study. Aviat Space Environ Med. 1981;52(6):354-7.

35. Zadik Y, Levin L. Oral and facial trauma among paratroopers in the Israel Defense Forces. Dent Traumatol. 2009;25(1):100-2.

36. Zajc I, Brajdić D, Biočić J, Bošan-Kilibarda I, Kopić, V, Siber S, et al. The effect of tobacco use on oral health and dental readiness in the Croatian Army. J Addict Dis. 2011;30(2):159-68.

37. Zhao Z, Li LJ, Huang ZN, Jia BJ, Yang HQ. Investigation of the prevalence of periodontal diseases among naval personnel during prolonged sailing. Shanghai Kou Qiang Yi Xue. 2015;24(1):94-7.

38. Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global Prevalence of periodontal disease and lack of its surveillance. ScientificWorld-

Journal. 2020;2020:2146160.

39. Santos ASF, Lima RFR, Ferreira RC, Alencar GP, Carreiro DL, Silveira MF, et al. Use of oral health services among elderly Brazilians: mediation by tooth loss. Cienc Saude Coletiva. 2022;27(7):2777-88.

40. Borrell LN, Reynolds JC, Fleming E, Shah PD. Access to dental insurance and oral health inequities in the United States. Community Dent Oral Epidemiol. 2023;51(4):615-20.

41. Gordon M, Kusner W, Shifman A, Ronen E, Newbrun E. Assessing the dental treatment needs of an adult Israeli military population. Community Dent Oral Epidemiol. 1986;14(5):244-9.

42. Laccabue M, Ahlf RL, Simecek JW. Frequency of restoration replacement in posterior teeth for U.S. Navy and Marine Corps personnel. Oper Dent. 2014;39(1):43-9.

43. Simecek JW, Diefenderfer KE. An evaluation of U.S. Navy Dental Corps classification guidelines. Mil Med. 2010;175(11):895-900.

44. Wojakowski M, Reinstein B, Shavit I. Research in military dentistry in the Israeli Medical Corps. Refuat HaPeh VehaShinayim (1993). 2017;34(2):12-20.

45. Zadik Y. Barodontalgia: what have we learned in the past decade? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(4):e65-9.

46. Wentz L, Liu PY, Haymes E, Ilich JZ. Females have a greater incidence of stress fractures than males in both military and athletic populations: a systemic review. Mil Med. 2011;176(4):420-30.

47. Rustemeyer J, Kranz V, Bremerich A. Injuries in combat from 1982-2005 with particular reference to those to the head and neck: a review. Br J Oral Maxillofac Surg. 2007;45(7):556-60.

48. Al-Khalifa KS. Prevalence of bruxism and associated occupational stress in Saudi Arabian Fighter Pilots. Oman Med J. 2022;37(2):e351.

49. Dela Cruz GG, Knapik J, Birk MG. Evaluation of mouthguards for the prevention of orofacial injuries during United States Army basic military training. Dent Traumatol. 2008;24(1):86-90.

50. Chisick MC, Richter P, Piotrowski MJ. Put more “bite” into health promotion: a campaign to revitalize health promotion in the Army Dental Care System. Part I. The mouthguard, sealant, and nursing caries initiatives. Mil Med. 2000;165(8):598-603.

51. Sato LYM, Venezian GC. Associação da disfunção temporomandibular e estresse em militares: Association of temporomandibular disorder and stress in military personnel. Rev Nav Odontol. 2019;46(1).

52. Moraes GFS, Antunes AP. Musculoskeletal disorders in professional violinists and violists: systematic review. Acta Ortop Bras. 2012;20(1):43-7.

53. Mello VVC, Martins GM Junior, Caldas AF Júnior. Disfunção temporomandibular em militares: estresse ocupacional como fator de risco. EsSEX Rev Científica. 2019;2(2):45-51.

54. Trize DM, Calabria MP, Frazolin SOB, Cunha CO, Marta SN. A disfunção temporomandibular afeta a qualidade de vida? Einstein São Paulo. 2018;16(4).

55. Cigic L, Martinovic D, Martinic J, Kovic M, Druzijanic A, Galic I, et al. Increased prevalence of oral potentially malignant lesions among Croatian War invalids, a cross-sectional study. J Clin Exp Dent. 2023;15(9):e734-41.

56. Medeiros CK, Lopes ML, Silveira ÉJ, Lima KC, Oliveira PT. Actinic cheilitis: proposal of a clinical index. Med Oral Patol Oral Cir Bucal. 2022;27(4):e310-8.

57. Paulino JNV. Prevalência de queilite actínica e fatores associados: uma revisão sistemática [tese]. Natal: Universidade Federal do Rio Grande do Norte; 2015.

58. Riemenschneider K, Liu J, Powers JG. Skin cancer in the military: a systematic review of melanoma and nonmelanoma skin cancer incidence, prevention, and screening among active duty and veteran personnel. J Am Acad Dermatol. 2018;78(6):1185-92.

59. Vimercati L, De Maria L, Caputi A, Cannone ESS, Mansi F, Cavone D, et al. Non-melanoma skin cancer in outdoor workers: a study on actinic keratosis in Italian Navy personnel. Int J Environ Res Public Health. 2020;17(7):2321.

60. Araújo VS, Godinho EL, Farias LC, Marques-Silva, L, Santos SHS, Rodrigues-Neto, JF, et al. Prevalence of oral mucosal lesions in a brazilian military police population. J Clin Exp Dent. 2015;7(2):e208-11.

Published

2025-10-22

How to Cite

Oral alterations in military personal: a narrative review on main findings and implications for oral health And operational efficiency. (2025). Naval Dental Jounal, 52(2). https://doi.org/10.22491/1983-7550-52-2-R1

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