Fifteen years later – with “Trauma” added to DTRD’s designation as a Combat Casualty Care research organization – the three relocated once again under BRAC 2, this time to San Antonio, Texas. As a subordinate command to the Army Institute of Surgical Research, DTRD’s state-of-the-art facilities at the new Battlefield Health and Trauma Research Institute on Fort Sam Houston’s Brooke Army Medical Center campus – also home to the military’s leading burn treatment center – reflected the needs of the ongoing war and expanded scope of what comprises Army dentistry.

“The three military dental research units work synergistically as the Dental and Maxillofacial Trauma Task Areato address common military issues of dental disease and maxillofacial battle injuries, thus establishing requirements of modern combat dentistry,” Williams wrote. “Combat wounds represent additional challenges and risk of contamination due to (a) heavy contamination of dirt, organic debris, and clothing, (b) the nature of wounding and, occasionally, (c) delays in evacuation.

“DTRD brings together experts from a wide range of scientific and clinical fields to create a fertile, multidisciplinary research environment, with the basic goals of decreasing associated complications and improved restoration of maxillofacial injuries. The Army maintains its post as the lead agent for dental research among the Armed Forces, a testament to its leadership in the military dental community and federal services dentistry in general. We are still the largest dental research organization in the Department of Defense and the only research facility dedicated to the study of injuries to the craniofacial complex.”

All of those changes have redefined both DTRD and how and what military dentists do, from the first exam to continuing general care to injury treatment in the field to long-term follow-up care and rehabilitation.

“We are definitely a different group today,” Hale said. “It’s been an evolution and, with our global footprint, it is really a requirement that we not only are expert at the dental level, but working at the international level and understanding nations and people who may not be friendly. We did a lot of work in Iraq, for example, where our dentists were at risk.”

With the U.S. military effort now focused on Afghanistan, where the post-9/11 conflict in Southwest Asia began and conditions for dental care are even more austere, new technologies and procedures remain a top priority for DENCOM. One of those, which began field testing for image quality and portability in 2011, is the Nomad Pro lightweight digital X-ray.

“A lot of the dentists in [Afghanistan] are not working in a fixed facility; they don’t have the luxury of mounting an X-ray system to the wall because they’re in a tent,” according to Col. Chris Evanov, a general dentist with the 257th Dental Company. “I’ve been in the military for over 20 years and I was a little suspicious of the device, but it didn’t take more than a day or two for me to realize that this was great.

“The truth is there are a lot of things we can’t see – and you can’t treat what you can’t see. You can open up your mouth and you might have all 32 of your teeth, but all I can see are your crowns. We don’t have that Superman vision.”

Compared to the image most people have of dentists, the reality that is 21st century military dentistry might be seen by American warfighters – and others who receive their care – as having some “super hero” aspects. But to the Army’s dental officers, reshaped by the demands of OEF/OIF, each step forward, each expansion of their domain from traditional care of teeth to the entire craniofacial complex, is just another day on the job.

“The dentists assigned to forward units also act as triage officers during major events, so the utilization of dental officers is broader, with unique training that prepares us for the field. That includes advanced life support, the Combat Casualty Care course, and all the things we are likely to see on the battlefield as medical specialists supporting needs outside of dentistry,” Williams concluded.

“Dentists in the 21st century have gained a lot more respect in the overall medical community. Our current Corps chief also is the regional medical commander. We have a dental officer serving in the Office of Strategic Communications in the [Army] Surgeon General’s office. So we are now seen more as an important part of the general officer corps, not just as dentists.”

This story was first published in The Year in Veterans Affairs & Military Medicine 2012-2013 Edition.