Navy Dentistry — Innovative and Collaborative Care

ABSTRACT

The Navy Dental Corps was established in 1912 and has served the Navy globally since. The Navy Dental Corps is comprised of more than 1,300 active duty and reserve dentists who are practicing or training in 14 different dental specialties, in addition to General Dentistry. Navy dentists are stationed at military treatment facilities, clinics, and hospitals located within the United States and various overseas locations. Additionally, Navy dentists can be assigned to a multi-specialty dental clinic, a large teaching hospital, with a Navy Construction Battalion (“Seabees”), Marine Corps battalions (Fleet Marine Forces), or an amphibious assault ship, aircraft carrier, or hospital ship. The primary mission of each dentist is to ensure that Service members are medically ready to deploy; thus, clinic schedules can consist of a great many duties, to include ensuring that providers are ready as well. There are also opportunities for dentists to be the leaders of large medical clinics and hospitals. The Defense Health Agency oversees healthcare delivery, which includes dental care, while the Navy’s Bureau of Medicine and Surgery (BUMED) oversees the readiness of our force. There is alignment between these two organizations while maintaining unique missions of the Department of Defense. In addition, all Navy dental clinics must comply with The Joint Commission’s policies. There are five Navy Medicine accession programs available for those interested in the Navy Dental Corps: Navy scholarship to dental school, Financial Assistance Program for specialty training, Navy Active Duty Delay for Specialists Program, Direct Accession and Reserve Direct Commission Officer.

KEYWORDS:

• Navy
• dentistry
• Ghana
• service
• deployment
• military

Introduction

The Navy Dental Corps was established in 1912 and has served in all areas of the Navy since its inception. The Dental Corps is comprised of more than 1,300 active duty and reserve dentists who are practicing or training in 14 different dental specialties, in addition to General Dentistry. Many active duty Navy dentists choose to pursue specialization through clinical residency training. Dental specialty training programs are offered in-service by board certified military dentists located at a military dental training facility and out-service through public dental institutions. In-service training specialties include Endodontics, Prosthodontics, Oral and Maxillofacial Surgery, Comprehensive Dentistry, Orofacial Pain, Oral and Maxillofacial Pathology, and Oral and Maxillofacial Prosthodontics. Out-service training specialties include Orthodontics, Operative Dentistry, Oral and Maxillofacial Radiology, Public Health Dentistry, Dental and Biomedical Research, and Pediatric Dentistry. After starting a dental residency training program, Navy dentists incur an additional service obligation, termed “payback”. Payback is usually year-for-year for each training program, with a two-year minimum service obligation.

Navy dentists are stationed at military treatment facilities, clinics, and hospitals located within the United States and various overseas locations. Additionally, Navy dentists can be assigned to a multi-specialty dental clinic, a large teaching hospital, with a Navy Construction Battalion (“Seabees”), Marine Corps battalions (Fleet Marine Forces), or an amphibious assault ship, aircraft carrier, or hospital ship. Navy dentists provide direct support to Sailors and Marines and deploy in support of combat operations, disaster relief, and humanitarian assistance missions, providing the best care our nation can offer ashore and afloat. The Navy will relocate the Service member and his/her family, providing services to assist with relocation. Each Service member is assigned a sponsor (fellow servicemember) at the gaining Navy facility who guides them through their command’s check-in process and acquaints the member with the military base facilities, local areas of interest, and supports the new arrival and his/her family through the moving process. This is especially helpful when newly arriving to an overseas duty location, where learning local cultural customs is necessary.

A “Typical” Day in Navy Dentistry

There is no “typical” day for a Navy Dentist. In addition to seeing patients, days attached to a warship include numerous training evolutions to ensure military readiness, the crew is following the ship safety protocols, there is time for rest and recovery, as well as time spent ensuring the dental spaces are cared for properly. While operating at a shore facility, dental specialists often occupy the same spaces and can be easily consulted. While underway, this is not always the case. Dentists can deploy on warships as solo providers or with a team of five officers, as is the case with aircraft carriers.

A day in the life of a dental officer stationed with the United States Marine Corps typically involves providing care in a dental treatment facility with additional exercises to support Marines in the field. Dentists can become certified Fleet Marine Force (FMF) Officers by completing specialized field training.

Opportunities exist for some general dentists stationed with Construction Battalions (CBs). Sailors assigned to Construction Battalions are known as “Seabees.” These solo dental assignments allow full integration of the Navy dentist with the battalion and deployments to areas where the Seabees’ construction knowledge and training can be put to good use.

Navy hospital ships USNS Comfort and USNS Mercy are unique to the fleet. These ships can be thought of as floating hospitals and do humanitarian deployments around the globe including annual Continuing Promise and Pacific Partnership engagements. Dental officers representing a variety of specialties and talents are invited to participate in these deployments, representing Navy Medicine and promoting a global force for good.

In addition to deployment opportunities, there are opportunities for dental officers to live overseas in support of our missions in Europe, Africa, Asia, and the Pacific. Naval hospitals and medical/dental clinics exist in these environments not only to take care of Sailors, but to support families living overseas. Daily life includes seeing patients, maintaining readiness of the force, and hopefully some opportunities to travel and experience different cultures.

No matter the duty station, all dental officers work together to support the Navy and its mission.

Opportunities and Benefits of a Career in Navy Dentistry

Those outside of military dentistry often see the hardships that exist in the Navy. This is evident when people say, “thank you for your service.” These kind people are probably thinking of the very real experiences of deployments, and while that kind gesture is always appreciated, the truth is that most of a Navy Dental Officer’s life is fulfilling! The benefits of choosing military dentistry as a career can typically be divided into three main categories: clinical experience, quality of life, and a vast array of professional opportunities.

If an officer wants to pursue other opportunities outside of a strictly clinical pathway these professional opportunities that are encouraged. Leadership within Navy Medicine is the most common pathway pursued. Officers are needed to lead department, clinics, and be the directors for a collection of clinics. There are also opportunities for dentists to be the leaders of large medical clinics and hospitals. The necessary training and support that prepares officers to assume those large responsibilities also opens up some unique professional opportunities when they retire. The Navy Dental Corps also needs dentists to be researchers and educators. Dental educators are critical to the growth of the workforce, as they train in programs for Advanced Education in General Dentistry (AEGD), General Practice Residency (GPR), and almost all specialties. This provides not only an opportunity for those who want to teach, but also for those who want to receive specialty training. Training opportunities exist at the Naval Postgraduate Dental School (NPDS) in Bethesda, MD, at civilian universities, and at other bases around the country. Residents in these programs receive their same pay, are encouraged to seek board certification, and receive significant financial bonuses to stay in the military. The Navy also runs phenomenal continuing education courses on both coasts.

Even though the diversity of career opportunities and positive clinical environments are wonderful, the greatest benefit of a Navy career in dentistry is the quality of life. All active-duty military earn 30 days of paid vacation every year and all federal holidays are observed. There is also a significant that comes from knowing that officers and their families are covered at no-cost for all medical needs and a healthy retirement awaits at the end of your service. A military career may not be for everyone, but for those who are interested, there are enough advantages to make it worthwhile.

Challenges of a Navy Career

To see the world, explore different cultures, and create new life experiences are all popular reasons for dental students and dentists to become Naval Dental Officers. However, achieving those goals comes with challenges. One such challenge faced by many is moving duty stations approximately every three years. While dental officers have input in their location of duty, and the Navy does consider family needs and personal desires, a dental officer does not have complete control of their next duty station. The goal of the Navy is to match up the individual’s wishes with the needs of the Navy, but in the end, the Navy has the final say. With each move, there is the stress that comes along with it. For example, new school enrollment for children, finding housing within the desired school district or desired community, and setting up a new household. Some military members elect to live on station if base housing is available.

Whether living on or off base, there is an initial upside when moving within the Navy dental community. The workplace immediately offers companionship and a place to bond with others. Unfortunately, this may take longer for spouses and children. Being new to the area, finding new friends, and exploring all options for them comes along with the challenge of moving. Although the dental community is a supportive community, this challenge is as individual to a family as is a fingerprint. Countless people have created friendships, and many have developed and maintained a global family because of moving. Children stay in touch with old friends, spouses form lifetime bonds, and the memories created are forever.

The downside of Navy dentistry, especially compared to the civilian private sector, is that the dental salary is capped. At the heart of it, the Navy is a government organization. Salary pay increases occur because of an increase in rank, years of service, and dental retention bonuses. This means that production and income generation are not factors in salary. The Navy does not focus on income, collections percentages, or production. The core purpose of Navy dentistry is oral health readiness. The Navy patient population must be ready to go over the horizon on ships, under the sea on submarines, and be prepared to deploy if a conflict arises. In addition to your dental salary, if relying on dual income, spousal employment needs to be considered. Not all spouse employment can be as simple as transferring duty stations and finding an immediate job. For example, if your spouse is in a profession licensed by a state government, some steps are required to become licensed in another state.

Another aspect to consider is the entrepreneurial spirit of private practice. This can be dampened as a Navy dentist. Looking to be your own boss can occur within private practice. Unfortunately, this is not possible in the Navy. All military members rotate and move duty stations, resulting in the opportunity to meet and work with leaders and connect with new ones at new duty stations. Eventually, the dental officer will develop and hone their leadership skills in the workplace and newly acquired leadership responsibilities will help shape others.

Like all government organizations, there are group influencers within the Navy and the Department of Defense. Dentistry expectations for standards of care are the same within the Navy and the private practice. Delivering the best healthcare possible is everyone’s goal. However, how that goal is achieved varies, and prioritizing the dental need is where there is a difference. The Defense Health Agency oversees healthcare delivery, which includes dental care, while the Navy’s Bureau of Medicine and Surgery (BUMED) oversees the readiness of our force. There is alignment between these two organizations, but each is unique. In addition, all Navy dental clinics must comply with The Joint Commission’s policies.

How Do You Become a Navy Dentist?

To be eligible for appointment as a DC officer in either the Active or Reserve Components, the applicant must meet the following requirements: ^1–7

1. Citizenship. Must be a citizen of the United States and pass a personnel security investigation.

2. Entry Age. Applicants must be commissioned before their 42nd birthday. On a limited case-by-case basis, the Commander, Navy Recruiting Command (COMNAVCRUITCOM) is granted waiver authority for applicants between ages 42 and 57. Applicants age 58 or older who possess critical skills or experience may be considered for an exception to the age waiver policy if they can complete a full 3-year service obligation prior to reaching age 68.

3. Moral Character. Must be of good moral character and of unquestioned loyalty to the United States as determined by interview and investigation.

4. Physical Standards. Must meet the physical standards for service on active duty as recommended by Chief, Bureau of Medicine and Surgery (BUMED)

5. Availability for Mobilization. Appointments in the Reserve Component are predicated upon mobilization requirements and the applicant’s availability for mobilization. Members of Congress, Federal political appointees, elected State and local government officials and Federal career Senior Executive Service (SES) employees may not be tendered an original direct appointment without prior approval of DCNO (N1).

6. Professional Qualifications.

   • Be a graduate of a fully accredited dental school in the United States, Canada, or Puerto Rico accredited by the Commission on Dental Accreditation

   • Officers desiring an interservice transfer from another Uniformed Service shall be in possession of current clinical privileges granted by their present Service

There are five Navy Medicine accession programs available for those interested in the Navy Dental Corps: Navy scholarship to dental school, Financial Assistance Program for specialty training, Navy Active Duty Delay for Specialists Program, Direct Accession and Reserve Direct Commission Officer.

Navy Scholarship

Two dental scholarships are available for pre-dental and dental students.

1. Health Professions Scholarship Program (HPSP)

• Open to those applying to dental school.

• Tuition + most mandatory books and equipment and National Board Dental Examination (NBDE) Part 1.

• Stipend and possible sign-on bonus.

• Dental participants are commissioned officers as Ensign (O-1) in the Reserve Component of the Armed Forces during school and promote to Lieutenant (O-3) upon graduation.

• Participants receive a Reserve ID Card, which allows entry on military bases, commissary (grocery store), exchange (department store) and recreational facilities.

• Participants incur a year-for-year of active duty obligation, serving a minimum of 3 years.

2. Health Services Collegiate Program (HSCP)

• Open to those applying to dental school.

• Participants are noncommissioned, paid at E-6 rate during school and promote to Lieutenant (O-3) upon graduation.

• Participants receive an ID Card, which allows entry on military bases, commissary (grocery store), exchange (department store) and recreational facilities.

• Full benefits + pay/retirement clock runs while in program!

• Does not pay tuition (you pay it yourself with your yearly military income)

• Participants incur a year-for-year of active duty obligation, serving a minimum of 3 years.

Financial Assistance Program

The Navy Financial Assistance Program (FAP) is designed for dentists in residency and fellowship training in select Critical War Time Specialties in which Navy Medicine has manning needs.

• Receive an annual grant.

• Monthly stipend for participants.

• Participants are in the Individual Ready Reserve (IRR) while in the program.

• Participants receive a Reserve ID Card, which allows entry on military bases, commissary (grocery store), exchange (department store) and recreational facilities.

• Participants incur a year-for-year of active duty obligation, serving a minimum of 2 years.

Navy Active Duty Delay Specialists Program

The Navy Active Duty Delay Specialists (NADDS) program allows graduated dental students or Navy dental officers the option to defer the fulfillment of their active duty obligation for dental school in order to receive graduate residency education in a critical shortage specialty in the civilian sector.

• Participants are in the Individual Ready Reserve (IRR) while in the program.

• Participants receive a Reserve ID Card, which allows entry on military bases, commissary (grocery store), exchange (department store) and recreational facilities.

• Participants receive pay and compensation from the civilian educational facility, not the Navy.

• Upon completion of the authorized residency training the participant starts or resumes active duty to complete the deferred period of active duty obligation or for 2 years, whichever is longer.

Direct Accession

The Direct Accession (DA) program allows graduated and practicing dentists to apply for a direct commission into the Active Component (AC) of the Navy Dental Corps.

• Commissioned as a Lieutenant (O-3) or higher, based on experience and education.

• Upon acceptance, members receive orders to a military location to begin active duty service.

• May be eligible for an accession bonus.

• Participants incur a minimum of 3 years active duty service obligation.

Direct Commission Officer

The Direct Commission Officer (DCO) allows graduated and practicing dentists to apply for a direct commission into the Reserve Component (RC) of the Navy Dental Corps.

• Commissioned as a Lieutenant (O-3) or higher, based on experience and education.

• Minimum requirements are two weeks Active Duty Training each year and Drill one weekend/month.

• Additional training may be available.

New members of the Navy Dental Corps are required to attend Officer Development School (ODS) in Newport, RI. ODS is a five-week program that provides a comprehensive and intense introduction to the responsibilities of Navy Dental Corps Officers. Dental Officers learn about the military structure of the U.S. Navy, its traditions and customs, leadership development, and military etiquette. Note, ODS is not offered to DCOs.

After graduation from dental school and ODS, HPSP, HSCP, and Direct Accession participants can apply for a Post-Graduate One Year program (PGY-1) in AEGD or GPR located at military training facilities. New graduates not participating in a PGY-1 accept orders to a Navy dental facility for a Credentialing Tour. After PGY-1 and Credentialing Tour, Dental Officers accept orders to a world-wide dental assignment. All other active duty dental officers, FAP, NADDS, and DA, accept orders to a world-wide dental assignment.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Daniel Hammer

Daniel Hammer, DDS, FACS, is an Oral and Maxillofacial Surgeon with Certificate of Added Qualification in Head and Neck Oncology and Reconstrcutive Surgery. He is Vice Chair of the Department of Oral and Maxillofacial Surgery at Naval Medical Center San Diego.

Eric Evans

Eric Evans, DDS, MS, is a Comprehensive Dentist and Facilitator of the Naval Leadership and Ethics Course for the Navy Prospective Commanding Officers and Executive Officers in Newport, Rhode Island.

Jayson Huber

Jayson Huber, DDS, MS, is a Comprehensive Dentist and Program Director of the Comprehensive Dentistry Residency at the Naval Postgraduate Dental School in Bethesda, Maryland.

Katherine Cheng

Katherine Cheng, DDS, MS, is a Comprehensive Dentist and currently Head of US Navy Dental Corps Policies and Procedures at the US Navy Bureau of Medicine and Surgery in Falls Church, Virginia.

Kathi Buss

Kathi Buss, DDS, DPH, is a Public Health Dentist and Navy Dental Corps Career Planner at the US Navy Bureau of Medicine and Surgery in Falls Church, Virginia.