Deutsch Wayne M
Naval Hospital San Diego, San Diego, CA, USA.
Mil Med. 2008 Jan;173(1 Suppl):29-37. doi: 10.7205/milmed.173.supplement_1.29.
Planning of dental support for populations serving in isolation is essential. Many programs of national or scientific interest such as U.S. Navy submarine missions, the manned space program, and research in Antarctica require long periods where dental care is not available. Submariners make an excellent study population due to their relatively large numbers, good health, excellent dental screening, and professional status.
This study examines dental events occurring while underway on 240 submarine patrols from January 1, 1997 to September 30, 2000. A health events database contains medical encounter notes, demographic information, crew rosters, and medical evacuation reports. A special survey database contains information from three surveys conducted aboard 1 submarine during a 101-day submergence. The evacuation database contains medical evacuation data from the Atlantic and Pacific submarine fleets from 1991 through 1999.
One hundred nine initial dental emergency visits and 45 revisits were recorded during these patrols. Of these visits, 48.6% were for an emergency related to an endodontic or caries problem. The incidence rate for all dental problems was 5.0 per 100,000 person-days at sea. Smoking was significantly associated with the occurrence of a periodontal-related emergency and also with the occurrence of any dental emergency. The rate of dental emergencies per 100,000 person-days decreased over time with the rate for the first 7 days being 7.5, days 8 through 14 being 5.5, and after day 14 being 4.6. Dental problems accounted for 6.9-9.3% of all medical evacuations from submarines between 1991 and 1999. The special survey of self-reported dental problems was designed to obtain information on minor conditions that might not be recorded in the medical encounter database. Of the problems reported, 13.1% had a dental problem during the 101-day submergence, 9.8% had a canker sore, and 4.1% had a gum problem.
为处于隔离状态的人群规划牙齿支持至关重要。许多具有国家或科学意义的项目，如美国海军潜艇任务、载人航天计划以及南极洲研究，都需要在长时间内无法获得牙科护理。由于潜艇船员数量相对较多、健康状况良好、牙科筛查出色以及职业地位，他们成为了一个绝佳的研究群体。
本研究调查了1997年1月1日至2000年9月30日期间240次潜艇巡逻航行时发生的牙科事件。一个健康事件数据库包含医疗会诊记录、人口统计信息、船员名单和医疗后送报告。一个特殊调查数据库包含在一艘潜艇101天潜水期间进行的三次调查的信息。后送数据库包含1991年至并999年大西洋和太平洋潜艇舰队的医疗后送数据。
在这些巡逻期间记录了109次初次牙科急诊就诊和45次复诊。在这些就诊中，48.6%是与牙髓病或龋齿问题相关的急诊。所有牙科问题的发病率为每100,000人日海上航行5.0例。吸烟与牙周相关急诊的发生以及任何牙科急诊的发生均显著相关。每100,000人日的牙科急诊率随时间下降，前7天的发生率为7.5，第8至14天为5.5，14天后为4.6。1991年至1999年期间，牙科问题占潜艇所有医疗后送的6.9 - 9.3%。自我报告牙科问题的特殊调查旨在获取可能未记录在医疗会诊数据库中的轻微病症信息。在报告的问题中，13.1%在101天潜水期间有牙科问题，9.8%有口腔溃疡，4.1%有牙龈问题。
