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Military dentists thrive in joint-service training

U.S. Navy Reserve Lt. Cdr. Nathan Ocasio, dentist, Expeditionary Medical Facility Dallas One, Ft. Worth, Texas, and U.S. Air Force Staff Sgt. Stephen Clark, dental technician, 88th Medical Group, Wright-Patterson Air Force Base, Ohio, provide dental care during Innovative Readiness Training Appalachian Care 2019 at Wise County Fairgrounds, Wise, Va., Aug. 19, 2019. Appalachian Care Innovative Readiness Training 2019 takes place Aug. 16-29, 2019, to care for the medically underserved communities of Wise, Virginia while simultaneously conducting deployment and readiness training for military personnel. Innovative Readiness Training is the only hands-on training opportunity authorized to operate within the U.S. During Appalachian Care IRT 2019, medical operations will be staged at one physical location at Wise County Fairgrounds. The Appalachian Care IRT 2019 team provides medical, dental, optometry and veterinary care to assist local health and municipal authorities in addressing underserved and unmet community health and civic needs. Units also conduct critical mission training and logistical movement in order to simulate hands-on deployment readiness operations and health care delivery in the time of crisis, conflict or disaster (Air National Guard photo by 1st Lt. Andrew Layton).

U.S. Navy Reserve Lt. Cdr. Nathan Ocasio, left, Expeditionary Medical Facility Dallas One dentist, Fort Worth, Texas, and U.S. Air Force Staff Sgt. Stephen Clark, dental technician, 88th Medical Group, Wright-Patterson Air Force Base, Ohio, provide dental care during Innovative Readiness Training Appalachian Care 2019 at Wise County Fairgrounds, Wise, Va., Aug. 19, 2019. Appalachian Care IRT 2019 takes place Aug. 16-29, 2019, to care for the medically underserved communities of Wise, Va., while simultaneously conducting deployment and readiness training for military personnel. IRT is the only hands-on training opportunity authorized to operate within the U.S. (Air National Guard photo by 1st Lt. Andrew Layton)

WISE, Va. --

Individuals clad in blue and gray scrubs are moving among rows of dental chairs; sounds of dental drills pierce the air with their distinctive whine. It’s a typical enough scene for any dental clinic except, in this case, there’s nothing ordinary about it.

This is Appalachian Care 2019, a unique U.S. military training mission sponsored by the Innovative Readiness Training program, which falls under the Department of Defense’s Office of the Deputy Assistant Secretary for Reserve Integration. Started in 1994, the IRT unites service members from multiple service branches to test deployment readiness in a hands-on setting with the serendipitous byproduct of no-cost health care for U.S. publics in need. From Aug. 18-26, approximately 130 medical specialists with Appalachian Care are operating at the fairgrounds of Wise County, Virginia, providing dental, optometry, veterinary and general medical care for anyone.

Today, Appalachian Care’s dental clinic is a flurry of activity. The dentists and technicians working here represent the U.S. Air National Guard, Air Force, Navy Reserve and Army Reserve. As reservists, many of the providers also bring professional experience from their civilian practices.

“I’ve done IRT missions before, and it’s pretty typical to throw everybody together like this,” said Air National Guard Lt. Col. Adam Kuipers, 110th Medical Group dentist, Battle Creek Air National Guard Base, Michigan. “Some of us have a lot of experience and some don’t, but that’s what we’re here for: to give our people exposure in areas they don’t normally get to work in and to reinforce our readiness training.”

For these providers, the challenge of leaving their normal clinics and practices to literally set up shop in a fairgrounds barnyard is an experience that stretches, confounds and ultimately grows them into more skilled and well-rounded clinicians. They’re rising to the occasion with visible results including high-quality care for an average of 75 patients a day with grateful smiles all around.

“Obviously, there are challenges when we’re operating in a location other than our clinic back home, but it’s great to get together with five or six dentists I’ve never met before and just chat about how we do our extractions and fillings,” said U.S. Navy Reserve Lt. Cdr. Derrick Call, Operational Health Support Unit San Diego dentist. “There’s an oral surgeon here who just yesterday gave us a tip saying, ‘if you don’t have electrical power to use your drill, there’s another way you can sometimes do what you need to do with a set of forceps.’ I tried it on a patient yesterday and it was fantastic; it just makes you a better clinician having these additional pieces of knowledge -- things you can do to be successful.”

As a dental technician with the 88th Medical Group, Wright-Patterson Air Force Base, Ohio, U.S Air Force Staff Sgt. Stephen Clark says Appalachian Care has given him a greater appreciation for conserving and making the most of available resources, even in an area where he felt his skills were already very strong. Responsible for the cleaning and processing of all dental instruments for the mission, upon arrival in Wise, Clark assessed that a sufficient facility was not available to sterilize dental instruments up to standard.

“I was able to work with services and at the fairgrounds pavilion we created our own, indoor instrument processing facility inside a couple of Conex boxes and it’s working great,” Clark said. “Looking for ways to make the best with what we’ve got, utilizing the resources available and then turning the instruments around as fast as possible so we can maximize our care has been huge. After all, you can only see as many patients as you have instruments for.”

Other participants say Appalachian Care’s distinctly joint flavor of operations has sparked a greater sense of interoperability with colleagues from other branches of the Armed Forces.

“Working in the joint environment is awesome,” said U.S. Army Reserve Spc. Brandi Schafer, 301st Field Hospital dental technician, St. Petersburg, Florida. “It’s really interesting to see how different the branches are, yet at the same time, we’re still all medical, and we have that in common. It’s really interesting finding out the differences between each one, becoming more diverse in our thinking and more open-minded to other ways of doing things.”

For all of the challenges that come with a mission like Appalachian Care, connecting with patients in this type of environment can provide career-defining moments of fulfillment.

“A lot of patients have come in for extractions and that’s an easy fix, but to do some cosmetic or restorative work to fix their smile, which is really the essence of their soul, is great,” said Lt. Cdr. Nathan Ocasio, Expeditionary Medical Facility Dallas One dentist, Fort Worth, Texas. "With poor lighting and difficult seating positions, these are not ideal working conditions, but the dedication of this team is ideal and we wouldn’t have it any other way.”

Ocasio added that for him, overcoming the trials of a field environment makes the success of every satisfied patient at Appalachian Care that much sweeter.

“It’s really good because we bring all these minds together, bounce information off one another, and we learn, have a good time and just take care of people.”

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