US Army dental leaders have raised concerns that military war-gaming exercises fail to account for dental emergencies, which could significantly strain casualty evacuation systems in future large-scale conflicts. In a recent professional article, Army dentists warned that painful toothaches and oral infections—often dismissed as minor issues—could render troops non-mission-capable, consuming scarce medical resources and reducing combat effectiveness.
The concerns come as the military prepares for potential mass casualties in major wars, with dental emergencies already accounting for 19% of treatments at frontline hospitals during the Iraq War and nearly 16% of medical evacuations during operations against the Islamic State in Iraq and Syria. Despite this historical precedent, most of the Army’s major exercises do not include dental emergencies in casualty scenarios, leaving commanders with an incomplete understanding of medical triage demands.
Forward dental teams can quickly treat most dental issues, with nearly all patients returning to duty after one or two visits. However, without nearby dental care, soldiers may face delays of up to a week for treatment, further straining evacuation capacity. The authors of the article emphasized an urgent need for accurate dental emergency modeling in war-gaming to reflect the potential impact of non-battle injuries on military operations.
Declining deployable dental capabilities exacerbate the issue, despite the critical role oral health plays in maintaining troop readiness. Broken equipment and limited supplies have also hindered field dental training opportunities, limiting the military’s ability to prepare for dental emergencies in combat scenarios.
Historical data underscores the scale of the problem. During the Iraq War, dental emergencies represented a significant portion of medical treatments, while operations against ISIS saw dental disease and other non-battle injuries contribute to nearly one in six medical evacuations. The authors noted that pain from dental issues can impair cognitive function, eating, and weapon operation, making even minor oral health problems a potential threat to mission success.
Military leaders have not yet responded publicly to the dentists’ warnings, and it remains unclear whether adjustments will be made to future war-gaming exercises to incorporate dental emergencies. The concerns highlight broader challenges in preparing for non-battle injuries in large-scale combat, where even seemingly minor health issues can have outsized operational consequences.