Page 47 - RADC Bulletin 2018

in a DPHC Dental Centre in the firm base developing our clinical skills and ensuring that our population is dentally fit. While working in Medical Regiments the dental team will spend about half the time working in DPHC Dental Centres. In my experience the Dental Teams are clinically very good but some of us, the author included, have lacked exposure to the wider army.
Each Medical regiment has task Squadrons that deliver medical care and these Squadrons are broken down into troops, the Forward Dental Team (FwdDT) will be part of the Medical Reception Station (MRS) troop. A fully equipped FwdDT has all the equipment and consumables to set up
a single chair dental centre with one dentist and one nurse. However, there may be situations where it is not possible to take all the equipment and consumables required
in the heavy role so the dental team can reduce its capability and capacity, and work in the “light” role. The exact make up of the light role will depend on the situation.
If required a Force Dental Group of around three dental teams can be made by using the Contingent Component (CC) by deploying teams from DPHC (Dental) including a Practice Manager.
On most Exercises the MRS will set up a tented facility which can vary from a small, highly mobile, facility to a larger facility with wards, a physiotherapist and a dental team. The dental team tends to work in a 12”
by 12” tent. Recent 4 Armoured Medical Regiment (4 AMR) Exercises that the dental teams have been on have varied from highly mobile Armoured Warfighting to much
larger more static Logistic Exercises. Most Exercises will have a Medical Major Incident, such as a large road traffic collision, and here the better trained and competent you are the more you get to do. When delivering primary dental care, it is not the dental treatment itself that is the problem but dealing with
the conditions (see article on Ex Askari Serpent 18), in particular IPC and patient management, that can be very challenging.
While in Barracks the dental team ensures the dental EME is maintained, as only a
few non dental professionals have a clue what our kit does. Once the new Portable Dental Unit (PDU) replaces the obsolete Dental Operating Unit (DOU) we will be able to provide restorations in a very similar way to the how we do in DPHC (Dental). Much of the other EME is similar to that used in DPHC (Dental).
Like all jobs the more you get involved with the unit the more you get back when you need help.
What might happen in the future?
“Prediction is very difficult, especially if it’s about the future.” - Nils Bohr, Nobel laureate in Physics
Of the six threats identified in the Security Capability Review 2018 two are relevant to the Army. These are the resurgence of a state based threat and the ongoing threat of terrorism, extremism and instability.
What are the implications for the Army?
The state based threat is most likely to
be a peer, think of Russia, so the Army
is re-organizing to be able to fight a war again. This requires very different doctrine, equipment and organizations compared to the recent conflicts in Iraq and Afghanistan. A significant issue is that a peer, such
as Russia, would target large Operating Bases that were a key aspect of the Iraq and Afghanistan campaigns. To counter this, forces would be widely dispersed and mobile, therefore our potential patients would be spread over a wide area. We also have an enhanced forward presence in Latvia, with around 800 British Service men and women, to deter Russian aggression.
To achieve this goal of war fighting at scale 3(UK) Division will have two Strike Brigades and two Armoured Infantry Brigades. Each Brigade will have a Medical Regiment with two task Squadrons; each task Squadron will have one Forward Dental Team (FwdDT). In addition, 16 Air Assault Brigade will have a Medical Regiment with one FwdDT. Therefore, there will be 9 FwdDTs across the army.
The Army’s role in dealing with terrorism and instability will increasingly be done by the use of short term training teams and specialist infantry battalions, who frequently deploy small numbers, to support nations around the world.
What are the implications for the dental care?
With no big operating base
and a dispersed Population at
Risk (PAR), having a dentally fit population will become even
more critical to minimize dental problems on deployment. This
is what we do on daily basis in DPHC (Dental). However, even in well prepared forces, there will be dental emergencies that need to be treated so there will be a need for deployed dentistry. Currently the Medical Regiments are re- organising so that they can support the new doctrine, and those RADC personnel in Medical Regiments will need to understand where we fit in and ensure we work in the most appropriate facilities so we can effectively reduce the impact of dental disease.
We may also need to deploy to areas with large concentrations of troops, such as the enhanced forward presence in Latvia.
likely to be how far forward should we be because the further forward we go the less time troops will have away from role, but the less kit we will be able to have with us and the harder it will be to maintain standards.
It is the author’s own view that we should
try and ensure that we have the personnel, equipment and doctrine to move to our patients rather than expecting them to come to us. This ability for all soldiers, regardless of capbadge, to be able to operate in non- permissive environments is a key driver for the Medical Regiments and there are an increasing number of battle craft exercises to ensure all members of the regiments, including dental teams, are able to survive and fight in the field.
What is certain is that deployed dentistry in the future will face many of the same issues we have faced up to the present day but also have its own unique characteristics, so a knowledge of the past combined with an imagination and drive to deal with new challenges will be essential if military dentistry is to thrive to the benefit of our patients.
CH Stainer, The Somme, Thiepval Memorial to the missing
What is the threat to the UK?
One of the biggest debates is
RADC BULLETIN 2018 45