{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T04:06:22Z","timestamp":1745640382439,"version":"3.40.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1-2","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,16]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The Air Force Dental Service is responsible for ensuring that airmen are dentally ready to support military operations worldwide by delivering top-tier dental care. As the military healthcare landscape undergoes significant changes, the Air Force Dental Service has explored innovative approaches to dental care delivery. One consideration involves the potential use of radiographs as the primary tool for assessing service members\u2019 dental conditions, specifically focusing on identifying nondeployable conditions and periodontal health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Providers who previously participated as examiners in the 2018 Air Force Recruit Oral Health Study were recruited to re-evaluate randomly selected de-identified records, this time making assessments exclusively based on radiographs. Their evaluations included Dental Readiness Classification (DRC) determinations, total caries counts, and Periodontal Screening and Recording (PSR) index scores, providers also rated their confidence in these conclusions using a 5-point Likert scale. The study then computed sensitivity and specificity to assess the diagnostic performance of providers using radiographs only compared to the original study results that use the gold standard of radiographs with a clinical examination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Providers exceled at ruling out most DRC 3 conditions, with specificities surpassing 70%. Positively identifying those with DRC 3, particularly radiographically identifying periodontal conditions posed challenges with computed sensitivity rates as low as 8%. Discrepancies in PSR scores also accentuated limitations in relying solely on radiographs, where provider\u2019s radiographically determined PSR scores that matched less than one third of the time. In general, providers had low to very low confidence in their assessments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The study strongly cautions against relying solely on radiographs for determining the dental health of U.S. Air Force personnel. While providers effectively ruled out the absence of certain conditions, the challenge of positively identifying DRC 3 conditions poses significant risks to oral health if such a workflow was utilized. Particularly, the high probability of false negatives would be detrimental to the operational readiness of military personnel. Therefore, results support the continued use of radiographic and clinical examinations for comprehensive dental exams.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae315","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T07:30:58Z","timestamp":1718782258000},"page":"e280-e284","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the Use of Radiographs Alone to Determine Air Force Dental Readiness Classification"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8313-2632","authenticated-orcid":false,"given":"Scott P","family":"Irwin","sequence":"first","affiliation":[{"name":"Dental Research and Consultation Service, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6590-8648","authenticated-orcid":false,"given":"J Brett","family":"Ryan","sequence":"additional","affiliation":[{"name":"Dental Research and Consultation Service, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rondre F","family":"Baluyot","sequence":"additional","affiliation":[{"name":"Minot AFB Dental Clinic, Minot 5th AFB Medical Group , Minot AFB, ND 58704,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida M","family":"Solivan-Ortiz","sequence":"additional","affiliation":[{"name":"Dunn Dental Clinic, 59th Dental Group , JBSA-Lackland AFB, TX 78236,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David K","family":"Schindler","sequence":"additional","affiliation":[{"name":"Dental Research and Consultation Service, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay D","family":"Graver","sequence":"additional","affiliation":[{"name":"Uniformed Services University Postgraduate Dental College , JBSA-Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kraig S","family":"Vandewalle","sequence":"additional","affiliation":[{"name":"Dunn Dental Clinic, 59th Dental Group , JBSA-Lackland AFB, TX 78236,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"issue":"8","key":"2025042508423478900_R1","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.1377\/hlthaff.2019.00336","article-title":"Readiness of medical providers in the military health system: overview of operational and policy considerations","volume":"38","author":"Hutter","year":"2019","journal-title":"Health Aff"},{"article-title":"About the military health system","year":"2024","author":"Military Health System","key":"2025042508423478900_R2"},{"article-title":"Defense Health Reform: Steps Taken to Plan the Transfer of the Administration of the Military Treatment Facilities to the Defense Health Agency, but Work Remains to Finalize the Plan","year":"2017","author":"Farrell","key":"2025042508423478900_R3"},{"year":"2024","key":"2025042508423478900_R4","article-title":"DHA-Polidy Memorandum 23-016 New Standardized Deductions for General Dental Care, Specialty Dental Care, and Graudate Dental Education. 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