ORGANIZATIONAL AND METHODOLOGICAL FEATURES AND MANAGEMENT OF OUTPATIENT DENTAL CARE FOR MILITARY PERSONNEL AND VETERANS DURING WARTIME

  2. 2026
  3. ORGANIZATIONAL AND METHODOLOGICAL FEATURES AND MANAGEMENT OF OUTPATIENT DENTAL CARE FOR MILITARY PERSONNEL AND VETERANS DURING WARTIME

Gurzhiy O. V., Kolomiiets S. V., Kolomiiets B. S.

ORGANIZATIONAL AND METHODOLOGICAL FEATURES AND MANAGEMENT OF OUTPATIENT DENTAL CARE FOR MILITARY PERSONNEL AND VETERANS DURING WARTIME

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About the author:

Gurzhiy O. V., Kolomiiets S. V., Kolomiiets B. S.

Heading:

LITERATURE REVIEWS

Type of article:

Scientific article

Annotation:

Wartime access to dental treatment depends on outpatient services assessing deterioration risk, determining urgency, allocating constrained resources, and maintaining continuity across providers. Military care must meet readiness requirements and rotation schedules despite limited follow-up. Veteran pathways must account for access, treatment completion, rehabilitation, and psychological safety. The aim is to systematize organizational approaches and management principles for wartime outpatient dental care for military personnel and veterans and define their applicability in Ukraine. This review synthesized 55 sources with descriptive, comparative, and structural methods. Evidence was grouped by readiness, triage, mobile care, teledentistry, veteran access, psychophysiological factors, and trauma-informed care. Arrangements were compared by urgency, care level, routing, resources, completion, information transfer, and monitoring. Eight management tasks recurred across the reviewed sources: assessment of dental readiness and deterioration risk; triage and prioritization; selection of care format and level; routing among mobile, remote, civilian, military, and specialized services; allocation of time, personnel, materials, and emergency capacity; treatment completion or a clinically safe interim endpoint; standardized information transfer; and scheduled reassessment. The military pathway prioritizes prevention of deployability-limiting emergencies and functional stability compatible with rotations. The veteran pathway prioritizes accessible entry, reduced administrative and transportation burdens, continuity of multistage treatment, rehabilitation, and trauma-informed communication. Teledentistry and mobile clinics may support assessment and routing but require definitive in-person care and coordinated follow-up. Wartime outpatient dental management should integrate patient-flow planning, coordination, documentation, completion control, and outcome evaluation. This evidence-informed analytical sequence requires implementation studies in Ukraine.

Tags:

care pathways, dental readiness, military dentistry, triage, veterans

Bibliography:

  1. Barten DG, Tin D, Granholm F, Rusnak D, van Osch F, Ciottone G. Attacks on Ukrainian healthcare facilities during the first year of the full-scale Russian invasion of Ukraine. Conflict and Health. 2023;17(1):57. DOI: https://doi.org/10.1186/s13031-023-00557-2
  2. Haque U, Bukhari MH, Fiedler N, Wang S, Korzh O, Espinoza J, et al. A comparison of Ukrainian hospital services and functions before and during the Russia-Ukraine war. JAMA Health Forum. 2024;5(5):e240901. DOI: https://doi.org/10.1001/jamahealthforum.2024.0901
  3. Armstrong S, Dermont M. Defence dentistry: an occupationally focused health service with worldwide deployable capability. British Dental Journal. 2021;230(7):417-423. DOI: https://doi.org/10.1038/s41415-021-2834-1
  4. Cook RK, Riesberg J, Mendoza AM, Tempel TR. Defining expeditionary dentistry in US doctrine for the era of great power competition and conflict. BMJ Military Health. 2025;171(3):191-192. DOI: https://doi.org/10.1136/military-2024-002705
  5. Mendoza AM, Simecek JW, Colthirst PM, Mitchener TA. A description of the dental health and treatment of Ukraine military at U.S. Army clinics in Germany. Military Medicine. 2025;190(7-8):e1543-e1548. DOI: https://doi.org/10.1093/milmed/usae480
  6. Kanyura OA, Bidenko NV, Kolenko YuH, Filonenko VV, Khrol NS, Shpak DYu. Dosvid nadannia stomatolohichnoi dopomohy v umovakh viiskovoho stanu. Suchasna stomatolohiia. 2022;3-4(111):38-44. DOI: https://doi.org/10.33295/1992-576X-2022-3-38 [in Ukrainian].
  7. Kovalenko VV, Khersonska TB, Galaychuk BV, Borysova YS. Features of using mobile dental clinics in large-scale armed conflict conditions. Ukrainian Journal of Military Medicine. 2025;6(3):52-57. DOI: https://doi.org/10.46847/ujmm.2025.3(6)-052
  8. Edwards D, Ramsey R, Breeze J. How should we manage severe anxiety towards dental treatment in UK service personnel? BMJ Military Health. 2023;169(3):277-279. DOI: https://doi.org/10.1136/bmjmilitary-2020-001701
  9. Tagger-Green N, Nemcovsky C, Fridenberg N, Green O, Chaushu L, Kolerman R. Oral and dental considerations of combat-induced post-traumatic stress disorder: a cross-sectional study. Journal of Clinical Medicine. 2022;11(11):3249. DOI: https://doi.org/10.3390/jcm11113249
  10. Kolenko YG, Volovyk IA, Voronina IE, Dementieva OV, Chumak EA. The influence of the psychosocial stress on oral health status in the conditions of being in Ukraine during the prolonged state of martial law. Wiadomości Lekarskie. 2024;77(8):1593-1602. DOI: https://doi.org/10.36740/WLek202408109
  11. Minervini G, Franco R, Marrapodi MM, Fiorillo L, Cervino G, Cicciù M. Post-traumatic stress, prevalence of temporomandibular disorders in war veterans: systematic review with meta-analysis. Journal of Oral Rehabilitation. 2023;50(10):1101-1109. DOI: https://doi.org/10.1111/joor.13535
  12. Manso de Gustín B, Alvarado-Lorenzo A, Aragoneses JM, Fernández-Domínguez M. The oral health status of Spanish naval military personnel: a retrospective study. Journal of Clinical Medicine. 2025;14(15):5236. DOI: https://doi.org/10.3390/jcm14155236
  13. de la Court AJ, Opdam NJM, Bronkhorst EM, Laske M, Huysmans MCDNJM. Oral health status of Dutch Armed Forces recruits in the years 2000, 2010 and 2020: a retrospective repeated cross-sectional study. BMC Oral Health. 2024;24(1):912. DOI: https://doi.org/10.1186/s12903-024-04687-8
  14. Boiko DI, Shyrai PO, Mats OV, Karpik ZI, Rahman MH, Khan AA, et al. Mental health and sleep disturbances among Ukrainian refugees in the context of Russian-Ukrainian war: a preliminary result from online-survey. Sleep Medicine. 2024;113:342-348. DOI: https://doi.org/10.1016/j.sleep.2023.12.004
  15. Mamai OV, Bilash SM, Boiko DI, Svyryda OS, Oleksiienko VV, Kopytko NS, et al. Stan avtonomnoi nervovoi systemy ta stres u patsiientiv likaria stomatoloha-khirurha pry rozvytku synkopalnykh staniv na ambulatornomu pryiomi. Visnyk problem biolohii i medytsyny. 2023;3(170):493-500. DOI: https://doi.org/10.29254/2077-4214-2023-3-170-493-500 [in Ukrainian].
  16. O’Donald F, Smith M, Sevier-Guy LJ, Heffernan A. An evaluation of a trauma-informed care training programme within a dental hospital. European Journal of Dental Education. 2026;30(3):1274-1281. DOI: https://doi.org/10.1111/eje.70084
  17. Tian V, Chamut S, Klevens RM. Veteran status and oral health indicators in older men: an analysis using the 2016 and 2018 Behavioral Risk Factor Surveillance System. Journal of Public Health Dentistry. 2025;85(4):335-343. DOI: https://doi.org/10.1111/jphd.12680
  18. Bel-Blesa A, Hernández-Donadeu M, Flores-Fraile J, Gómez-Salgado J, El Khoury-Moreno L, Torrejón-Martínez J, et al. Dental health as a determinant of operational readiness in military populations: evidence from Ceuta, Spain. Medicine. 2025;104(50):e46380. DOI: https://doi.org/10.1097/MD.0000000000046380
  19. Muhvić-Urek M, Uhač I, Vukšić-Mihaljević Z, Leović D, Blečić N, Kovač Z. Oral health status in war veterans with post-traumatic stress disorder. Journal of Oral Rehabilitation. 2007;34(1):1-8. DOI: https://doi.org/10.1111/j.1365-2842.2006.01674.x
  20. Wörner F, Eger T, Simon U, Wolowski A. Periodontal disease and tooth wear in a sample of German soldiers with posttraumatic stress disorder. Oral Health and Preventive Dentistry. 2021;19:449-456. DOI: https://doi.org/10.3290/j.ohpd.b1993989
  21. Carter K, McKenzie CT. Bruxism and stress among veterans with Gulf War illness. Military Medicine. 2021;186(1-2):e179-e185. DOI: https://doi.org/10.1093/milmed/usaa374
  22. Unnikrishnan G, Singh A, Purohit BM. Effectiveness of behavioural therapy and inhalational sedation in reducing dental anxiety among patients attending dental clinics: a systematic review and meta-analysis. Evidence-Based Dentistry. 2025;26(1):70-71. DOI: https://doi.org/10.1038/s41432-024-01081-9
  23. Mahood E, Shahid M, Gavin N, Rahmann A, Tadakamadla SK, Kroon J. Theories, models, frameworks, guidelines, and recommendations for trauma-informed oral healthcare services: a scoping review. Trauma, Violence, and Abuse. 2024;25(2):869-884. DOI: https://doi.org/10.1177/15248380231165699
  24. Choi KS, Sohn W, Leadbeatter D. Trauma-informed care practice for dental practitioners: a scoping review. Australian Dental Journal. 2026;71(2):144-159. DOI: https://doi.org/10.1111/adj.70043
  25. Smith M, O’Donald F, Sevier-Guy LJ, Heffernan A. The barriers and enablers to implementing trauma-informed care in dental settings. British Dental Journal. 2025;239(1):21-24. DOI: https://doi.org/10.1038/s41415-025-8906-x
  26. Struthers MW, Kosaraju A, Vandewalle KS. Dental emergency rates at an expeditionary medical facility supporting Operation Inherent Resolve. Military Medicine. 2025;190(7-8):e1564-e1569. DOI: https://doi.org/10.1093/milmed/usae505
  27. Simecek JW, McGinley JL, Levine ME, Diefenderfer KE, Ahlf RL. A statistical method to evaluate dental classification systems used by military dental services. Military Medicine. 2008;173(1 Suppl):51-55. DOI: https://doi.org/10.7205/MILMED.173.Supplement_1.51
  28. Arbuckle PJ, Beltran T, Reifenstahl E. Identifying risk factors for dental emergency visits in the US Army. Military Medicine. 2024;189(9-10):e2134-e2139. DOI: https://doi.org/10.1093/milmed/usae081
  29. Edwards D, Ramsey R, Breeze J, Dermont M. Exploring dentist opinions on the provision of intravenous sedation in primary dental care for UK Armed Forces personnel. Military Medicine. 2020;185(7-8):e1187-e1192. DOI: https://doi.org/10.1093/milmed/usz451
  30. Norris JR, Irwin SP, Park J, Stephens RA, Moss ME, Weintraub JA. Risk indicators of urgent and extensive dental treatment needs in U.S. Air Force recruits. Military Medicine. 2021;186(1-2):e194-e202. DOI: https://doi.org/10.1093/milmed/usaa393
  31. Lee L, Dickens N, Mitchener T, Qureshi I, Cardin S, Simecek JW. The burden of dental emergencies, oral-maxillofacial, and craniomaxillofacial injuries in US military personnel. Military Medicine. 2019;184(7-8):e247-e252. DOI: https://doi.org/10.1093/milmed/usz059
  32. Naysmith KE, Foster Page LA, Tong DC, Thomson WM. Oral health status of New Zealand Defence Force recruits. Military Medicine. 2023;188(3-4):e804-e810. DOI: https://doi.org/10.1093/milmed/usab385
  33. Vaughan M, McGowan T, Mahoney G. Dental disease nonbattle injury rates of deployed NATO militaries in the Middle East region: a scoping review. Military Medicine. 2021;186(7-8):e707-e713. DOI: https://doi.org/10.1093/milmed/usaa487
  34. Mendoza AM, Engel SR, Cook RK, Simecek JW, Colthirst PM, Mitchener TA. The impact of treating Ukraine military personnel at U.S. Army dental clinics in Germany. Military Medicine. 2026;191(1-2):e26-e32. DOI: https://doi.org/10.1093/milmed/usaf136
  35. Wojcik BE, Szeszel-Fedorowicz W, Humphrey RJ, Colthirst P, Guerrero AC, Simecek JW, et al. Risk of dental disease non-battle injuries and severity of dental disease in deployed U.S. Army personnel. Military Medicine. 2015;180(5):570-577. DOI: https://doi.org/10.7205/MILMED-D-14-00364
  36. Vader V, Kosaraju A, Gedge JL, Mitchell TM, Ruff RR, Vandewalle KS. Evaluating the diagnostic inter-rater reliability between virtual and in-person sick-call examinations at a military dental treatment facility. Military Medicine. 2025;190(5-6):e1211-e1215. DOI: https://doi.org/10.1093/milmed/usae509
  37. Siddig RE, Hammad AM, Awooda EM. Teledentistry in the time of conflict in Sudan. Sudan Journal of Medical Sciences. 2024;19(3):401- 407. DOI: https://doi.org/10.18502/sjms.v19i3.13975
  38. Kengne Talla P, Allison P, Bussières A, Rodrigues A, Bergeron F, Giraudeau N, et al. Teledentistry for improving access to, and quality of oral health care: overview of systematic reviews and meta-analyses. Journal of Medical Internet Research. 2025;27:e65211. DOI: https://doi.org/10.2196/65211
  39. McKay LS. The experience of deployed dental teams on Operation Herrick: dentists at war in Afghanistan. British Dental Journal. 2021;230(7):466-472. DOI: https://doi.org/10.1038/s41415-021-2738-0
  40. Alavi SE, Gholami M, Malik L, Matti R, Oktaei S, Al-Najafi F, et al. Assessment of teledentistry in improving access to dental care: a systematic review. Australian Dental Journal. 2025;70(1):4-41. DOI: https://doi.org/10.1111/adj.13045
  41. Scheerman JFM, Qari AH, Varenne B, Bijwaard H, Swinckels L, Giraudeau N, et al. A systematic umbrella review of the effects of teledentistry on costs and oral-health outcomes. International Journal of Environmental Research and Public Health. 2024;21(4):407. DOI: https://doi.org/10.3390/ijerph21040407
  42. Bogale B, Scambler S, Mohd Khairuddin AN, Gallagher JE. Oral health system strengthening in fragile and conflict-affected states: a systematic review. Journal of Global Health. 2024;14:04132. DOI: https://doi.org/10.7189/jogh-14-04132
  43. Atanda AJ, Agaku IT, Hayman LW, Hossain MB. Changes in dental visits and expenditures in veterans, older adults, and foreign-born after Affordable Care Act repeal efforts: a quasi-experimental difference-in-differences study. Population Medicine. 2025;7:12. DOI: https://doi.org/10.18332/popmed/202438
  44. Lee J, Muqeet S, Sherman K, White C, Lee KK, Castillo DF. Spinal cord injury veterans’ access to dental care: barriers and limitations. Journal of Spinal Cord Medicine. 2026;49(4):799-805. DOI: https://doi.org/10.1080/10790268.2025.2554016
  45. Ryan JB, Scott TE, McDonough RE, Kaye EK, Schindler DK. Depression and differential oral health status among U.S. adults with and without prior active duty service in the U.S. military, National Health and Nutrition Examination Survey 2011-2018. Military Medicine. 2024;189(1-2):e157-e165. DOI: https://doi.org/10.1093/milmed/usad217
  46. Ryan JB, Scott T, McDonough R, Schindler D, Irwin SP, Badner VM. Oral health risk factors and overall dental treatment needs for incoming Air Force recruits. Journal of Public Health Dentistry. 2023;83(4):371-380. DOI: https://doi.org/10.1111/jphd.12590
  47. Kandhari S, Harper C, Davies T. The role of a deployed British Army dental team on Exercise Immediate Response 24. British Dental Journal. 2026;241(4):256-260. DOI: https://doi.org/10.1038/s41415-026-9880-7
  48. Finlayson TL, Kolaja CA, Castañeda SF, Carey FR, Roesch SC, Beck AN, et al. Dental health readiness among United States military service members in the Millennium Cohort Study. Military Medicine. 2026. DOI: https://doi.org/10.1093/milmed/usag300
  49. McIntosh ZS, Simecek JW. Dental Readiness Class 1 military personnel are not all the same: a systematic review and meta-analysis. Military Medicine. 2026. DOI: https://doi.org/10.1093/milmed/usag304
  50. Bryce G, Smith K, Gibbs N. The standardization of the NATO Dental Fitness Categorization template against dental diseases within the United Kingdom Armed Forces. Military Medicine. 202. DOI: https://doi.org/10.1093/milmed/usag219
  51. Yen ET, Chiu SH, Tsai W, Chang WH, Lai TT. Oral health status in conflict-affected regions of Ukraine: a cross-sectional pilot study during a humanitarian dental mission. BMC Oral Health. 2026;26(1):428. DOI: https://doi.org/10.1186/s12903-026-07764-2
  52. Arbel Y, Hakimov D, Alex L, Rittblat M, Tsur N. A retrospective study of dental trauma in Israeli military personnel in the Swords of Iron War. Dental Traumatology. 2026. DOI: https://doi.org/10.1111/edt.70055
  53. Smith K, Bryce G, Bastos P. The application of military mandibular third molar guidelines in the operative management of mandibular third molars in United Kingdom Armed Forces personnel diagnosed with pericoronitis: a service evaluation. Military Medicine. 2026;191(3-4):e891-e895. DOI: https://doi.org/10.1093/milmed/usaf383
  54. Imani K, Cheng T, Chi DL. Association between disability rating and dental care utilization for low-income veterans ineligible for U.S. Veterans Affairs dental benefits: a pilot study. Military Medicine. 2026. DOI: https://doi.org/10.1093/milmed/usag337
  55. Testa A, Mijares L, Tsai J. Incarceration history, dental care utilization, and oral health difficulties among U.S. military veterans. Journal of Public Health Dentistry. 2026;86(3):301-308. DOI: https://doi.org/10.1111/jphd.70062

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 39-46 pages, index UDC 616.314-085:355.292

DOI:

10.29254/2077-4214-2026-3-182-39-46

2026 Issue 3, 182
care pathways dental readiness military dentistry triage veterans
29.09.2026
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