Air Force dentist presents innovative military healthcare research at AMSUS

  • Published
  • By Staff Sgt. Frederick A. Brown
  • 9th Reconnaissance Wing Public Affairs
NATIONAL HARBOR, Md. --  

The Coronavirus disease 2019 (COVID-19) pandemic was a challenging time for everyone, particularly for medical facilities and its practitioners. Soaring patient numbers, quarantine closures, and a shortage of healthcare professionals made in-person hospital care difficult for patients of COVID-19 and everyday afflictions alike. This difficulty extended to providing care for active-duty military personnel.

Sick-call is a daily line-up of active-duty service members in need of immediate medical attention, and even before COVID-19, could often involve long periods of waiting to ensure care is provided for every member.

Maj. Vladimir Vader, 9th Operational Medical Readiness Squadron comprehensive dentist, while completing his two-year residency in Advanced Education in General Dentistry, decided to ask the question: Could initial dental sick-call evaluations be completed virtually rather than in-person, and accurately establish a diagnosis and needed follow-up care? This became his residency study titled “Evaluating the Diagnostic Interrater Reliability between Virtual and In-person Sick-call Examinations at a Military Dental Treatment Facility”.

At the time, Dr. Vader was a dentist/resident with the 59th Medical Wing, Joint Base San Antonio-Lackland, Texas, and was looking for ways to provide care for a greater number of patients with pressing dental concerns.

“Virtual dental examinations are known as teledentistry and has emerged as a potentially innovative approach to increasing access to care,” said Dr. Vader. “Research has shown telemedicine and teledentistry as increasing access to and improving oral health, yet there was not much research evaluating the use of teledentistry for virtual emergency examinations in a military environment.”

Dr. Vader’s study evaluated the reliability of virtual emergency examinations by comparing them with in-person examinations for patients seeking emergency dental care at a military dental treatment facility. Approximately, 100 patient-subjects received both virtual and in-person examinations by two different examiners. The examinations were accomplished on the same day in random order and with the virtual examiner and subject in separate rooms. The examiner used a laptop with a camera, microphone and speaker to complete the virtual exam. The in-person examiner has access to all standard modalities in a dental treatment room. After the initial exam, the patient would proceed to the alternate one, with both examiners coming to their own diagnosis.

The results showed high diagnostic interrater reliability in subjects who completed a virtual examination compared to an in-person examination. The conclusion of the study determined that teledentistry is an effective tool for determining diagnosis and improving access to care for dental emergencies at a military dental treatment facility.

Dr. Vader’s research went on to be showcased by The Society of Federal Health Professionals’ (AMSUS) annual meeting from Feb. 12-15, 2024, in National Harbor, Maryland. AMSUS provides education and professional development benefits to support federal health professionals and their missions at the Departments of Defense, Veterans Affairs, Health and Human Services, and Homeland Security, as well as industry partners. This interagency collaboration of federal health professionals promotes federal medicine’s role in advancing healthcare for all Americans.

The Defense Health Agency Research and Engineering Directorate, Clinical Investigations Program Branch, held a poster contest at AMSUS, allowing young career scientists and health professionals an opportunity to present their research. Dr. Vader’s study was selected among the top three submissions to compete for the AMSUS Young Investigator Award, allowing Dr. Vader the opportunity to also a present an oral-presentation of his study along with the poster presentation.

Dr. Vader is currently working with his co-authors and mentors to pilot another study that will expand the research to several dental treatment facilities, where all sick-call appointments will be done virtually.

“This research has the potential to provide active-duty military members with greater access to care through virtual dental sick-call appointments,” said Dr. Vader. “This would increase patient convenience, reduce missed duty time, reduce in-patient expenditure and time, allow more patients to be seen within a shorter amount of time, and triage patients appropriately allowing patients to be scheduled for the appropriate treatment immediately or providing a necessary diagnosis for self-care or any needed prescription pick-up, greatly reducing the influx of patients.”

The findings from Dr. Vader’s studies have the potential of innovating military healthcare beyond dentistry, as well as providing an opportunity for study into the benefits of telemedicine.