Breaking down the barrier between the active and reserve forces ranks high on the list of Navy priorities as each billet is assessed for its support of warfighting capability. Changing the chain of command for reserve units aligns unit activities with active duty command goals and each department must justify its existence through statistical analysis and evaluation of its ability to serve the fleet. For reserve dentists, this is a blessing and a curse.
It is a blessing because of the professionalism and skill level of the typical reserve dentist, most of whom have their own practices and are constantly looking at their businesses with an eye to efficency. When on active duty providing restorative dental care, reserve dentists show time and again that they are as efficient and productive as their active duty counterparts.
It is a curse because of our role in providing dental examinations for the reserve forces. The bulk of time spent by reserve dental personnel during weekend drill is set aside for the provision of dental examinations. When compared to the amount of treatment that could be provided by dental officers during a routine day in a Navy dental clinic, a day spent providing dental examinations for reservists is not the most effective use of time.
The problem is the annual dental examination requirement, which presently requires reserve dental officers to expend major amounts of time and effort to provide this simple service to reserves. But there is no reason a reservist should have to be examined by a reserve dentist when any reservist can have form DD-2813-the annual examination-filled out by a civilian dentist. Once the form is complete, the reservist can take this to his unit medical coordinator for processing. The process would require reserve personnel to establish a relationship with a civilian dentist. Since most dentists practice preventive dentistry, this simple change would work to improve the dental health of our reserve forces.
If the use of civilian dentists became mandatory instead of an optional way to fulfill the annual examination requirement dental personnel would be free to provide support in another way.
In 2000, dental officers were authorized to provide contributory support to the Marine Corps Recruit Depot, Parris Island, South Carolina, where each summer sees a predictable surge in the numbers of recruits entering the depot. In late summer of 2000, 16 reserve dental officers and 17 dental technicians were incorporated into the Parris Island clinic during this surge period. The results of this experiment were gratifying: Several companies of recruits graduated from boot camp with 100% dental readiness, a level never before achieved.
Establishing this program on an annual rather than experimental basis would provide several advantages to the Navy. The active duty dental corps would have a pool of trained, highly professional officers that could be used when they are needed where they are needed, as opposed to contractor dentists who must be hired for the entire year. Reserve dental officers would have the advantage of bundling three drill weekends into one week of support. The dental corps would have its officers and technicians doing what they do best; providing restorative and specialty care to sailors and Marines. Because reservists can be used for one week at a time, manpower can be applied where it is most needed. This could be recruit depots, or bases like Camp Pendleton or Camp Lejeune, where Marine expeditionary forces must be readied for deployment.
In a recent interview, commander Naval Reserve Vice Admiral John Cotton stated, "We are looking from a One fleet' perspective. . . . the integration of the capabilities of both components (active and reserves)."
The change outlined would improve efficiency and effectiveness of our dental care providers. There are challenges; dropping the annual dental examination would constitute a change in our culture, but it would also represent an increased commitment to our goal of hyper-fit sailors.
Finally, this change dovetails with the Chief of Naval Operation's goals of current and future readiness, quality of services provided to our patients, efficient use of manpower and alignment of the Reserve dental corps to the mission of our Navy.
Capt. Wright is the detachment officer-in-charge of the Naval Regional Dental Clinic, Bethesda, and a consultant to the Veterans Administration Medical Center, Washington DC. He is in private practice in Harrisonburg, Virginia.