New Year Means Better Dental Care for Calif. Army National Guard
Nearly 100 dentists agree to deliver dental treatment
by Debra Belt

After more than 18 months of collaborative effort, CDA this month delivered a registry of nearly 100 state dentists who have agreed to provide dental care to California Army National Guard Soldiers. The dental registry distinguishes CDA as the first state dental association in the nation to take action to assist the "citizen Soldiers" who currently fulfill more than half of the demand for combat forces.

The priority use of the registry will be as a referral source to mobilizing Soldiers who need expedient dental care. Unlike full-time Soldiers, National Guard and reserve Soldiers find themselves in a "Catch-22" situation where they are ineligible to access services or receive treatment at federal military bases. They become eligible once called to active duty, however at that point, Soldiers are rushed to complete dental treatment and can risk having teeth extracted in order to deploy with their units. Approximately 40 percent of state National Guard Soldiers are without dental insurance, a figure representative of the national situation.

"Dental readiness is the biggest medical issue facing our Soldiers," said Col. Patrick Nolan, DMD, chief dental officer for the Army National Guard. "Sept. 11 dramatically changed the dynamic of National Guard participation. Right now, more than 50 percent of the combat force in Iraq is National Guard. Thousands of Soldiers, many of whom have emergency dental situations, are going through our mobilization sites."

The Deputy Surgeon's Office of the California National Guard reports that 25 percent of Soldiers called to active duty are identified as dental class III and considered nondeployable. The classification means a Soldier requires urgent dental treatment and has a high risk of suffering a dental emergency within 12 months.

Col. Warren Wong, DDS, state dental officer for the California Army National Guard said the registry will greatly enhance the National Guard's ability to provide dental care to California Soldiers once they are alerted for mobilization.

"We have at most 90 days to do 'Soldier readiness processing' once a reservist is alerted for mobilization," Wong explained. "My team conducts dental screenings, and we identify class III situations. However, when we identify problems at this late stage, there is little time to get them corrected."

Wong said that Soldiers have a brief time to return home after the initial processing and previously have been on their own to find dental care.

"This is where CDA and its local dental societies come in," Wong said. "A year ago Soldiers were on their own. Now with CDA's help, we will be able to match Soldiers with dentists in their area who have agreed to provide dental care on short notice."

CDA dentists on the registry also agreed to accept the Soldier's dental insurance, accept a sliding fee for reimbursement, or provide the necessary treatment on a pro bono basis.

"I am very proud that my dental association has elected to participate in this important mission," said Wong, a 24-year CDA member who maintains a private practice in San Francisco in addition to his National Guard service. "The volunteer dentists provide an invaluable community service to our Soldiers who are fighting the war on terrorism, and we are fortunate to have these dentists throughout the state acting as unofficial members of our team."

Nolan noted that CDA's innovative initiative to assist National Guard Soldiers can be used as a national model.

"California has been at the forefront in developing this initiative," said Nolan, who is on a military leave of absence from Nova Southeastern University College of Dental Medicine in Fort Lauderdale, Fla. Although residing in Florida, Nolan maintains membership with CDA. "In my position of overseeing dental operations for 50 states and four territories, I will be looking to extend this program to other states. Expansion of this idea would greatly enhance our limited capabilities to improve Soldier readiness just prior to deployment."

The registry is the result of a collaborative effort among CDA, the California Department of Health Services Office of Oral Health, and the California Army National Guard and is one part of a dental health program seeking to address a series of long- and short-term goals. The registry addresses the short-term goal of providing immediate dental treatment to mobilizing Soldiers. The Army National Guard is also working on a long-term goal of providing an annual dental exam to Soldiers who are not on alert.

"We are working to institute annual dental exams at the unit level and catch dental problems before mobilization," said Helen Nunez-Cruz, dental project coordinator with the Army National Guard and instructor with the Guard's 223 Infantry Regiment. In civilian life, Nunez-Cruz is a consultant with the Department of Health Services Office of Oral Health. "This would provide more time for Soldiers to get dental care. The whole idea is to improve care and save teeth."

Wong added that the CDA registry will be useful in helping the California Army National Guard attain its long-term goals as well.

CDA's participation in the program was approved by the Board of Trustees in August and the House of Delegates in November. The registry was developed after CDA sent a questionnaire early last year to members inquiring about willingness to participate in a program providing reduced-fee dental services to National Guard Soldiers.

The Department of Defense reports that the number currently on active duty in support of the partial mobilization for the Army National Guard and Army Reserve is 159,972. For nearly half of the National Guard workforce, there is little opportunity to receive regular dental care. National Guard Soldiers do qualify for TRICARE, a dental health benefit program for military personnel; however, cost and limited provider access result in minimal participation. Medi-Cal is only available to Soldiers who are married with children, pregnant or disabled.

In California, the National Guard has approximately 8,000 Soldiers currently mobilized, according to Nunez-Cruz.

To get involved

For more information on the California Army National Guard program, or to add your name to the registry, contact CDA Patient Advocate David Pisani at (800) 736-7071, Ext. 4971.

For more dental readiness and oral health information, please visit www.fit2bite.us.

Source: New year means better dental care for Calif. Army National Guard, California Dental Association, CDA News, January 2005
Photos: Courtesy of the National Guard