APPENDIX D HISTORICAL DATA. Section I. ARMY MEDICAL DEPARTMENT EXPERIENCE FACTORS
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1 APPENDIX D HISTORICAL DATA Section I. ARMY MEDICAL DEPARTMENT EXPERIENCE FACTORS D-1. Table D-1 depicts the total AMEDD centage distribution of total casualties within percentages by type of casualties during the each corps of the AMEDD and of enlisted Korean Conflict. It further depicts the per- personnel. Table D-1. Army Medical Department Battle Casualties, Korean Conflict CASUALTIES KIA WIA MIA CAPTURED TOTAL TOTAL AMEDD MEDICAL CORPS DENTAL CORPS MEDICAL SERVICE CORPS ENLISTED PERSONNEL D-2. Table D-2 depicts the total AMEDD WIA depicts percentage distribution of total woundedpercentages by type of disposition within all in-action dispositions within each corps of the oversea theaters during World War II. It further AMEDD and of enlisted personnel. Table D-2. Army Medical Department Wounded in Action in all Oversea Theaters During World War II WOUNDED DIED OF RETURNED TO DUTY EVACUATED TOTAL WOUNDS WITHIN THEATER TO US WOUNDED TOTAL AMEDD MEDICAL CORPS DENTAL CORPS MEDICAL SERVICE CORPS ARMY NURSE CORPS , VETERINARY CORPS ENLISTED PERSONNEL D-1
2 D-3. Table D-3 depicts the total AMEDD per- distribution of total wounded-in-action disposicentage of WIA by type of disposition within the tions within each corps of the AMEDD and of Far East. It further depicts the percentage enlisted personnel. Table D-3. Army Medical Department Wounded in Action, Korean Conflict DIED OF RETURNED TO DUTY EVACUATED TO US TOTAL WOUNDED WOUNDS WITHIN THE FAR EAST AND HAWAIIAN ISLANDS WOUNDED TOTAL AMEDD MEDICAL CORPS DENTAL CORPS MEDICAL SERVICE CORPS ENLISTED PERSONNEL D-4. Table D-4 depicts the total AMEDD depicts the percentage distribution of total percentage of battle casualties for all oversea casualties within each corps of the AMEDD and theaters by each type of casualty. It further of enlisted personnel. Table D-4. Army Medical Department Battle Casualties all Oversea Theaters, World War II CASUALTIES KIA WIA MIA CAPTURED TOTAL TOTAL AMEDD MEDICAL CORPS DENTAL CORPS MEDICAL SERVICE CORPS ARMY NURSE CORPS VETERINARY CORPS ENLISTED PERSONNEL D-2
3 D-5. Table D-5 depicts AMEDD battle by type of casualty during World War II and the casualties as percent of total US Army casualties Korean Conflict. Table D-5. Army Medical Department* Battle Casualties as Percent of Total US Army** Casualties PERCENT OF PERCENT OF PERCENT OF PERCENT OF PERCENT OF TOTAL THEATER ALL KIA ALL WIA ALL MIA ALL CAPTURED BATTLE CASUALTIES WORLD WAR II ALL OVERSEA THEATERS*** EUROPEAN THEATER PACIFIC THEATERS MEDITERRANEAN THEATER KOREAN CONFLICT * Includes all personnel of the AMEDD (officer plus enlisted). ** Excludes Air Corps personnel and flight officers in World War II and US Air Force personnel in the Korean Conflict. *** Includes battle casualties incurred in Africa-Middle East, Caribbean Defense Command and South Atlantic Alaskan Department, Burma-China-India, theater unknown, and those incurred while en route and not chargeable to any command. These theaters are not shown separately above. D-6. Table D-6 depicts the AMEDD WIA as percent of total US Army WIA by type of disposition in the theater during World War II and the Korean Conflict. Table D-6. Army Medical Department Wounded in Action as Percent of Total US Army** Wounded in Action DIED OF RETURNED TO EVACUATED TOTAL THEATER WOUNDS DUTY IN THEATER TO US WOUNDED WORLD WAR II ALL OVERSEA THEATERS*** EUROPEAN THEATER PACIFIC THEATERS MEDITERRANEAN THEATER KOREAN CONFLICT * Includes all personnel of the AMEDD (officer plus enlisted). ** Excludes Air Corps personnel and flight officers in World War II and US Air Force personnel in the Korean Conflict. *** Includes battle wounds incurred in Africa-Middle East, Caribbean Defense Command and South Atlantic Alaskan Department, Burma-China-India, theater unknown, and those incurred while en route and not chargeable to any command. These theaters are not shown separately above. D-3
4 Section Il. DENTAL EXPERIENCE FACTORS D-7. General D-8. Maxillofacial Injury Work Load Experience factors derived from previous US Army operations are presented in this section. The data presented here may be useful in planning for dental service in support of future US Army operations. During times of military conflict, dental service resources have been used in the treatment of maxillofacial injuries and disease, the treatment of acute dental emergencies, the maintenance of oral health and fitness of troops, the provision of combat casualty care, and the identification of deceased personnel. These services have been provided to the US Army, other US Forces, allies, indigenous populations, and EPW. Maxillofacial trauma represents a significant part of the total medical work load in an area of operations. (See Table D-7 through D-9. ) In Vietnam it was estimated that 10.1 percent of admissions to hospitals for trauma were for maxillofacial injuries which were treated by maxillofacial surgeons. Of the maxillofacial injuries, 78.2 percent were injury result of hostile action (IRHA) and 21.8 percent were nonbattle injury. Hospital admissions were 84.2 percent of the total maxillofacial injuries reported. Table D-7. Types of Facial Bones Fractured in 1,096 IRHA Patients-Vietnam PERCENT OF ALL PATIENTS WITH BONES FRACTURED NUMBER OF PATIENTS MAXILLOFACIAL INJURIES IRHA MANDIBLE MAXILLA MALAR ORBITAL FLOOR NASAL ZYGOMATIC ARCH Table D-8. Soft Tissue Injuries-Vietnam SOFT TISSUE SITE LACERATIONS AVULSIONS OTHER TOTAL INJURIES RIGHT CHEEK LEFT CHEEK CHIN LIPS FLOOR OF MOUTH TONGUE PA LATE OTHER FACIAL TISSUES ,380 1,324 1, ,537 TOTAL 4,520 1,116 1,229 6,865 D-4
5 Table D-9. Disposition of 2,795 IRHA Patients with Maxillofacial Injuries-Vietnam PERCENT OF 157 PERCENT OF 2,638 PERCENT OF TOTAL DISPOSITION OUTPATIENTS INPATIENTS MAXILLOFACIAL INJURIES IRHA RETURNED TO DUTY DIED TRANSFERRED OR EVACUATED RELEASED TO OWN CARE OTHER DISPOSITION D-9. Dental Emergency Work Load The most credible report of dental emergencies from Vietnam was on Marine personnel. (See The rate of dental emergencies will vary with the Table D-10.) The rate of dental emergencies was amount of predeployment preparation of troops, calculated from this report to be 184 per 1,000 length of deployment, intensity of conflict, and troops per year. Other reports of dental emeramount of in-theater dental maintenance care. gency rates vary. (See Table D-11.) Table D-10. Relative Frequency of Categories of Dental Emergencies Among Navy-Marine Personnel in Vietnam and CONUS, 1970 VIETNAM CONUS CATEGORY (PERCENT) (PERCENT) CARIES PERICORONITIS PERIODONTAL TRAUMATIC PROSTHETIC OTHER Table D-11. Summary of Dental Emergency Rates RATE PER 1,000 PER YEAR VIETNAM FIELD EXERCISES D-5
6 D-10. Dental Services Capability a. World War II. (1) The average number of the five principal dental operations completed per dental officer per year from 1 January 1943 to 31 August 1945 was as follows: Permanent filling l,067. Extractions 232. Dentures 42. Dentures repaired 26. Fixed bridges 3. Table D-12 depicts dental operations completed for each 1,000 men oversea. (2) At the larger dental laboratories in the CONUS, each dental laboratory specialist completed an average of: cases per month in 51.0 cases per month in The decrease in 1944 was probably due to a slackening in demand and because a considerable amount of overtime operation of dental laboratories was carried out during Cases included dentures, repairs, and bridges. (3) The dental laboratory specialist who functions in the field with field-type laboratory equipment is not able to complete many prosthodontic appliances. However, on the average, the dental laboratory specialist in the field is usually able to fabricate 30 cases per month. This includes full and partial dentures, denture repairs, and bridges. Table D-13 depicts prosthodontic operations completed for each 1,000 men oversea. Table D-12. Dental Operations Completed 1 January 1942 through 31 August 1945 (Oversea) ARMY OTHERS MEAN STRENGTH DENTAL OPERATIONS NUMBER PER YEAR NUMBER PERMANENT FILLINGS 12,698,735 1, ,771 EXTRACTlONS 2,562, ,428 FULL DENTURES 101, ,256 PARTIAL DENTURES 360, ,275 DENTURES REPAIRED 278, ,755 FIXED BRIDGES 36, TEETH REPLACED* 3,245, ,110 DENTAL PROPHYLAXIS 2,188, ,694 * By bridges and partial dentures only. D-6
7 (4) Authentic theater reports during World War II show that the proportion of oversea personnel wearing prosthodontic appliances was about 10 percent. On a worldwide basis, however, it is estimated that 15 percent of all military personnel wore dentures. b. Korean Conflict. Figures are not available covering the Army dental service for the entire Korean Conflict; however, the annual report of the Dental Surgeon, Eighth United States Army, 1952, includes the data in Table D-14. Dental officers in Korea in the year 1952 averaged about 115 to 120 permanent fillings per month. c. Vietnam Conflict. Important dental treatments are depicted in Table D-15. d. Other Experience. (1) A mobilization exercise at an Army reception station in 1982 indicated that under time of great demand on the reception station 50 inductees could be processed per hour using five panoramic x-ray machines, one highspeed automatic film processor, five enlisted dental specialists, one NCOIC and one dental officer to read films. The rate of x-ray film retakes and wastage required 1,140 films per 1,000 troops. When x-ray machines were not available, each dental officer with one enlisted dental specialist to record could in-process patients at the rate of one patient per 3.5 minutes (17 patients per hour). (2) The total treatment capability of the Army Dental Care System for all beneficiaries in FY 1980 is depicted in Table D-16. Table D-13. Prosthodontic Operations Completed per 1,000 Men (Oversea) YEAR FULL PARTIAL DENTURES DENTURES REPAIRS TOTAL YEARLY AVERAGE Table D-14. Important Dental Treatments, Eighth US Army, 1952 DENTAL TREATMENTS NUMBER TOTAL RESTORATIONS (FILLINGS, CROWNS) 253,652 TOTAL TEETH REPLACED BY BRIDGES AND PARTIAL DENTURES 36,258 SURGICAL TREATMENTS (INCLUDE EXTRACTIONS AND FRACTURE REDUCTIONS) 302,465 GENERAL INPATIENT ADMISSIONS 8,508 OUTPATIENT ADMISSIONS 133,720 SITTINGS 493,441 EXAMINATIONS 334,712 D-7
8 Table D-15. United States Army Dental Patient Visits in Vietnam, FY 1968* FY 1969 FY 1970 FY 1971 FY 1972 FY1973** RESTORATIVE FIXED PROSTHETICS REMOVABLE PROSTHETICS ORAL SURGERY PERIODONTICS ENDODONTICS ORAL HYGIENE (PROPHYLAXIS) ORAL DIAGNOSIS (EXAMINATIONS) TOTAL DENTALPATIENTS TREATED VIETNAMESE EXAMINATIONS (CIVIL ACTION} 167,057 3,869 31, ,348 13,206 8,221 64, , ,952 44, ,045 9,710 55, ,935 16,766 13, , , ,974 59, ,249 12,064 39, ,868 13,653 12, , , ,321 NR 156,259 8,139 26,957 96,632 5,569 8,815 63, , ,554 NR 54,431 4,110 8,786 31,637 1,563 4,287 33,808 56, ,365 NR 8,715 1,054 1,453 4, ,648 13,355 39,131 NR * Last three quarters only. ** First three quarters only. LEGEND NR FY Not recorded Fiscal Year Table D-16. Total Patients Treated in US Army Dental Care System, FY ST QUARTER 2D QUARTER 3D QUARTER 4TH QUARTER HSC 720, , , ,132 Europe 198, , , ,983 Korea 24,666 30,827 18,997 16,292 D-8
9 D-11. Dental Care Requirements Dental care needs include all treatment to put the individual in optimal oral health. 19). a. Recruits (see Table D-17). b. Active duty (see Tables D-18 and D- Table D-17. Dental Needs of Army Recruits 1981 Survey Mean Treatment Time Requirements by Total Sample and by Army Component in Hours REGULAR ARMY RESERVE NATIONAL GUARD TOTAL SAMPLE RESTORATIVE* ENDODONTIA FIXED PROSTHODONTIA REMOVABLE PROSTHODONTIA EXODONTIA ERUPTED IMPACTION PERIODONTIA PROPHYLAXIS CALCULUS REMOVAL EXAMINATION TOTAL HOURS * Includes only those recruits having bitewing radiographs, 1,773 Regular Army; 405-Reserve; and 537 National Guard. Table D-18. Distribution of Treatment of Active Duty Army 1978 Survey Time Requirements for Each Treatment Category by Rank Group* RANK GROUP TREATMENT CATEGORY E1 E4 E5 E6 E-7 E9 W1 W RESTORATIONS* EXTRACTIONS ENDODONTICS CROWN AND BRIDGE FULL DENTURES PARTIAL DENTURES PROPHYLAXIS/SCALING SUBGINGIVAL CURETTAGE GINGIVECTOMY * Figures presented are in hours and represent the time needed to deliver the particular needed care to the average individual in that group. D-9
10 Table D-19. Distribution of Treatment of Active Duty Army 1978 Survey Time Requirements for Each Treatment Category by Basic Branch/Career Management Field* COMBAT SUPPORT/ TREATMENT CATEGORY COMBAT SERVICE SUPPORT RESTORATIONS EXTRACTIONS ENDODONTICS CROWN AND BRIDGE FULL DENTURES PARTIAL DENTURES PROPHYLAXIS/SCALING SUBGINGIVAL CURETTAGE GINGIVECTOMY * Figures are in hours and represent the time needed to deliver the particular needed care to the average individual in that group. It does not mean that every individual requires that much treatment time to satisfy his or her dental needs. D-10
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