Major General Joseph G. Webb, Jr.

MG Webb is Chief, US Army Dental Corps and Deputy Surgeon General

As the Chief, Dental Corps (DC), I am truly excited to have this special opportunity to contribute a series of articles which showcase our great Soldiers, civilians, leaders, and clinicians, all of whom represent the Army Dental Care System (ADCS). I believe the common thread throughout the Army Medical Department (AMEDD) is the integration of all the Corps (to include the support services) and their synergistic relationships. These relationships produce a synchronized system of effective and efficient health care delivered in support of Soldiers and their commanders. The AMEDD Journal is one of many superb partners within the AMEDD and we are appreciative of this opportunity.

From 1775-1901, dental service to Soldiers was provided by hospital stewards (enlisted medics) who by special interest or special training, limited their activities to providing dental care in conjunction with medical officers. In 1901, the Army authorized 30 contract dentists for an Army-wide program of dental care. Ten years later, the contract positions were converted to commissioned officer positions. The Army Dental Corps was officially established on 3 March 1911.

During the past 36 months, the Army's operational tempo has been tremendous and demanded a renewed focus for our personnel and the dental service we provide to Soldiers at home station and deployed in support of the Global War on Terrorism. The ADCS treats over 7,200 patients each day in 173 dental clinics, and is represented by 29 Dental Activities (DENTACs) and 6 Regional Dental Commands, all of which are supported by a single Army Dental Laboratory.

The ADCS professional staff, including our dentists assigned to combat units, consists of 933 dentists, 24 Medical Service Corps officers, 1,115 noncommissioned officers and enlisted Soldiers, 1,788 civilians, and 708 contracted employees. Dental Officers serve in the following Areas of Concentration: General Dentist (63A), Comprehensive Dentist (63B), Periodontist (63D), Endodontist (63E), Prosthodontist (63F), Public Health Dentist (63H), Pediatric Dentist (63K), Orthodontist (63M), Oral and Maxillofacial Surgeon (63N), Oral and Maxillofacial Pathologist (63P), and Executive Dentist (63R).

The ADCS is not limited to clinical care; it is a multifaceted organization supporting the Army, training dentists, and advancing the science of dentistry. We train combat-ready dental technicians from the Dental Science Division. Through Graduate Dental Education and residency training programs, we provide clinicians ready to treat patients in any environment. Our Dental and Trauma Research Detachment and Combat Development Directorate ensure that our materiel and force structure are ready to support the Soldier wherever the requirement exists.

The Dental Command (DENCOM) is the operational element responsible for providing dental care and is currently implementing the following initiatives to increase readiness, improve access to care, and, ultimately, support Soldiers and their commanders:

* First Term Dental Readiness (FTDR). FTDR ensures that newly assessed Soldiers receive dental care to ensure their deployability upon graduation from Advanced Individual Training, One Site Unit Training, or the Basic Officer Leader Course.

* Oral Health Initiative (OHI). The OHI is a Tri-Service effort designed to provide routine dental care with the express goal of completing all dental treatment for Soldiers. The OHI uses allocated funds to refer service members to the private sector for some routine dental care, thereby increasing the dental wellness of the served population. All three services are in the first year of this initiative. Twelve selected Army DENTACs have established private sector care networks to reduce the backlog of dental needs.

* Digital Radiography. The Digital Enterprise Viewing and Acquisition Application (DEVAA) software was developed by DENCOM. DEVAA supplements existing hardware for image acquisition, manipulation and diagnostic viewing. The image management enhancement allows all Army dental digital radiographs acquired in Army dental clinics to be transported and stored in a central image archive. DEVAA software has been deployed to over 80 of the Army's 173 dental clinics worldwide. Army dental clinics will be 100% digitized within the next 12 months.

* Expanded Function Dental Assistant (EFDA). The EFDA program is based on labor-substitution principles using highly trained dental assistants to increase the output of general dentistry teams. Personnel from the EFDA program are completely embedded in both FTDR and Dental Care Optimization (DCO). DCO is a key initiative aimed at increasing access to care by using the best clinical practices. EFDAs are also used extensively to expedite the surge requirements for dental care generated by mobilizations.

The Department of Defense and Army environment we now face includes challenges of Base Realignment and Closure, Army Modular Force, Quadrennial Defense Review, Integrated Global Presence and Basing Strategy, and the military-to-civilian conversion. Internal to Army Medicine, volatility is increased by constrained resourcing, increased use of private sector dental care, recruitment and retention challenges, and a possible transition to the development of a Joint Medical Command. From my recent conversations with our retired Dental Corps General Officers, I am amazed at the similarity of the challenges and issues they faced.

The history of US Army Dentistry provides a constant reminder that the personnel of the ADCS are our most valuable asset. I am very proud to be a part of a great team, doing tremendous work each day. I am confident we will respond with a renewed vigor to work through the challenges. Together we will reshape the future and remain an integral partner within the AMEDD.