Oral–Maxillofacial Injury Surveillance in the Department of Defense, 1996–2005

IntroductionOral–maxillofacial injuries can lead to deformity and malfunction, greatly diminishing quality of life and worker productivity. Data suggest that over 10% of civilian emergency room visits are due to craniofacial injuries. The size and scope of oral–maxillofacial injuries in the military is not well understood. This study reports U.S. military rates of oral–maxillofacial injuries, causes of oral–maxillofacial hospitalizations, and recommends approaches to improving surveillance, research, and prevention.MethodsActive duty U.S. military personnel who sought inpatient or outpatient treatment for one or more oral–maxillofacial injuries from 1996 to 2005 were identified in the Defense Medical Surveillance System using ICD-9-CM diagnosis codes associated with oral–maxillofacial injuries. ICD-9-CM diagnosis codes were divided into two categories: oral–maxillofacial wounds and oral–maxillofacial fractures.ResultsThe oral–maxillofacial fracture rates for men were consistently 1.5 to 2 times higher than those for women, with 2000–2005 rates between 1.2 and 1.5/1000 person-years for men and between 0.7 and 1.0/1000 person-years for women. Wound rates for men were similar to those for women for all years examined (p<0.001), with 2000–2005 rates ranging from 11.0 to 14.6/1000 person-years for men and 12.2–14.8/1000 person-years for women. Compared to the over-40 age group, active duty personnel under age 25 had the highest rates of both oral–maxillofacial fractures and wounds (p<0.001). Among those injuries with a cause recorded, fighting (13.5%) was the leading cause of oral–maxillofacial injury hospitalizations in 2005.ConclusionsOral–maxillofacial injuries can and should be monitored using military medical surveillance data. Surveillance efforts would be enhanced by the addition of dental care data. There is also a need for additional quality intervention studies on the strategies to prevent oral and craniofacial injury.