U.S. Dental Officers Highlight the Importance of Toothaches in a Paper on “Hidden Casualties”
In the Middle East, often referred to as the world’s powder keg, wars break out constantly. In addition to the war in Iran—which is currently drawing global attention—conflicts continue in Lebanon, Yemen, and elsewhere. Until just a few years ago, there was a war in Afghanistan, and looking further back, there were also wars in places like Iraq.
The U.S. military, considered the world’s strongest, carries out numerous operations in these regions. In war, combat effectiveness is easily compromised by numerous injuries, such as gunshot wounds. However, illness is just as significant a factor as physical injury. Among these, research findings indicating that toothaches—which are often easily overlooked—can cause significant losses in combat effectiveness are drawing attention.
Recently, the U.S. business media outlet Business Insider published an article on toothaches, which can be a hidden obstacle for troops deployed overseas. According to the report, toothaches and oral infections can impair a soldier’s combat effectiveness and negatively impact the casualty evacuation system and the military medical system. The report cited a paper published in the September–October issue of *Military Review*, a U.S. military journal, which was authored primarily by U.S. Army dental officers.
According to foreign media reports, the latest issue of *Military Review* features an article titled “The Hidden Wounded: Integrating Dental Emergencies into Large-Scale Combat Operations Planning.” The paper’s central argument is clear: a failure to provide timely dental care, leading to severe toothaches, can result in significant losses to combat effectiveness. However, it is reported that most major U.S. Army training exercises do not include dental emergencies in their casualty scenarios. The paper argues that this can make it difficult for soldiers to perform critical tasks—such as eating, clear thinking, and weapon operation—due to toothaches, which can become a “hidden casualty burden.”
Furthermore, dental problems can be treated quickly if a dentist is nearby. However, if there is no dentist, there is no option but to endure the pain. This is easy to understand when you consider situations in the United States and other countries where people have to wait because they cannot receive timely dental care, or travel to other countries with lower medical costs to seek treatment.
Compared to combat injuries, dental issues allow patients to be deployed back to the battlefield immediately after treatment. For this reason, dental care is undoubtedly a highly cost-effective form of combat medical care. However, the authors pointed out that “the capacity for deployable dental medical services is declining.” In addition, the research team recommended that precise modeling of dental emergency scenarios—through war games and other methods—be conducted to accurately predict urgent demand.
In fact, toothaches are a statistically significant issue in war. Business Insider reported that dental emergencies accounted for 19% of the treatments performed at military hospitals near the front lines during the Iraq War. Approximately 16% of U.S. military patients evacuated while fighting against the international terrorist group Islamic State (IS) in Syria and Iraq were due to dental conditions and other non-combat injuries. The authors noted, “Most service members receiving dental care returned to duty after one or two visits,” adding, “Without (dental) facilities, service members would have to travel farther for treatment and could potentially be sidelined from combat for up to a week.”
In particular, during the war in Ukraine, which has been ongoing for several years, soldiers have been unable to receive dental care and have left common cavities untreated for years. The paper points out that, as a result, more than half of all dental emergencies in Ukraine had to be treated by tooth extraction. Dental care—such as fitting dentures—is essential for these soldiers as they transition back to civilian life after the war, and the military must develop plans to address the anticipated demand for dental care in preparation for their return.
War also has a significant impact on civilians’ dental health. According to *The New Arab*, a London-based media outlet specializing in Arab and North African affairs, many people in the Gaza Strip are unable to easily access dental care due to the cost of treatment, and some simply endure toothaches because they cannot afford treatment.
The publication reports that a 38-year-old woman, a math teacher with a background at the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), needs a root canal and a crown. However, she is unable to receive treatment because the cost in Gaza amounts to $1,200 (approximately 1.6 million won). That is more than double the cost in South Korea. In an interview with The New Arab, she said, “Our family relies partly on financial support from my brother living abroad, but due to restrictions on remittance services, money comes in only about once every six months, and that amount is enough to cover our living expenses for two months.” For people like him, dental treatment costing more than 1.5 million won is out of the question. Many people opt for tooth extraction rather than seeking treatment to save their teeth due to cost concerns.
Foreign media have also taken an interest in dentists who fled their home countries due to war and have settled temporarily abroad, where they provide free dental care to refugees and modern dental treatment to local residents. According to a report by Deutsche Welle last February, Sima Mahmoud, a dentist from Sudan, had been involved in a civil rights movement in her home country but was forced to leave. She is currently practicing at a dental hospital in Kampala, the capital of Uganda.
Since the civil war broke out in Sudan in 2023, approximately 100,000 people have fled to Uganda. There are currently 1.8 million refugees in Uganda. Media reports indicate that many of the Sudanese refugees had to flee so hastily that they couldn’t even pack a toothbrush, and many have developed the habit of grinding their teeth at night due to stress or trauma. Nevertheless, the fact that there are dentists volunteering abroad to care for the oral health of their fellow countrymen is undoubtedly a great source of comfort to the refugees.
Writer. Lee Hyun-taek
<. A former newspaper reporter who worked for 18 years at JoongAng Ilbo (>), <, and Chosun Ilbo (>). He is currently working as a freelance columnist and planning his second act in life. In addition to his work in journalism, he has experience working in the public relations and marketing team at JTBC and at Edelman Global Advisory in the United States.
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