Presidio of Monterey Dental Clinic leads the way in digital dentistry

PRESIDIO OF MONTEREY, Calif. (Feb. 15, 2022) – Home to the Army’s subject matter expert on digital dentistry, the Presidio of Monterey Dental Clinic is using technology to take care of people, improve readiness and modernize the Army.

Dr. (Maj.) Michael Kroll, officer in charge of the PoM Dental Clinic and promotable to the rank of lieutenant colonel, not only advises the chief of the U.S. Army Dental Corps on ways the Army should incorporate digital dentistry, but has incorporated the technology at the clinic to the fullest extent possible. In doing so, the clinic has become a leader in digital dentistry.

“To my knowledge, we’re probably the only clinic in the Army dental care system that is fully digital,” Kroll said.

This means service members at PoM, most of whom are students at the Defense Language Institute Foreign Language Center, spend less time at the dental clinic and more time in class performing their missions as military linguists. It also improves the quality of their lives.

Kroll said he loves a quote from Department of the Army Pamphlet 40-507 that reads, “Unsightly oral disease and missing teeth reduces quality of life through negative self-esteem, reduced confidence, and impaired social functioning.”

Many people don’t appreciate the link between their smiles and their social and emotional well-being, Kroll said, but it is important. “At the end of the day we are here to take care of people,” he said.

While digital technology also helps the clinic with record keeping and X-rays, computer-aided design and manufacturing equipment, such as 3D scanners and milling machines, have proven efficient ways to make replacement teeth and dental crowns, for example. In addition, the clinic uses 3D printers to create models, night guards and athletic mouth guards.

Nearly gone are the goopy impressions and uncomfortable trays that made patients gag for three to four minutes, Kroll said. At the clinic, the only time personnel need to make an impression is for dentures, and they are not common; 99.9% of the time, impressions are not necessary.

Kroll said studies vary on how much time it takes patients to receive a crown at an Army dental clinic—some say 250 days on average and others put it as low as 180 days—but he knows how much time it takes most patients at PoM: “I would say over 90% of our restorations are done in a single day,” he said.

Even for those exceptions the clinic cannot finish in a day because, for example, personnel at Fort Gordon, Georgia, have to fabricate a gold crown, with digital technology, the information is easy to send and the crown is back in about eight days, Kroll said.

In fact, PoM Dental Clinic personnel can usually complete a crown in three hours, and while that service member is waiting, personnel take care of other dental needs such as a cleaning, Kroll said.

Patients are not the only ones happy about the time saved, Kroll said.

“When we can get the patient in for a single three-hour appointment and return them back to their commander, not only does that make the commander happy because they don’t have that lost time training, but it should make the taxpayer happy because we’re not paying for all these lost wages,” Kroll said.

It is important to remember that service members are on duty 24 hours a day, seven days a week, so any time away from the mission is money lost to the taxpayer, Kroll said.

Another benefit to digital dentistry is that Army dentists can work with Army veterinarians to more efficiently treat military working dogs, Kroll said.

Kroll said he has used the technology to help veterinarians treat military working dogs at Fort Sill, Oklahoma. Implanting a new tooth in a military working dog, for example, can extend the dog’s career and life.

Kroll said he became interested in digital dentistry during his residency with Dr. (Col.) Michael Mansell, former Army subject matter expert in digital dentistry and now chief of medical readiness integration for the U.S. Army Futures Command.

Mansell fueled his interest in the subject and recommended him for the position when he left for other assignments, Kroll said.

The job includes training residents, and Kroll said it is one of the most rewarding parts of his job.

Looking to the future, Kroll said he only sees digital dentistry becoming more popular in the Army and the military as a whole.

Kroll is one of only two action officers for the Defense Health Agency’s digital dentistry working group, and the position has given him the opportunity to learn about digital dentistry equipment at other military clinics.

“The sprinkling of digital scanners and digital technology is getting to the point where it’s almost ubiquitous,” Kroll said.

While the degree of digital dentistry at the PoM Dental Clinic is not yet the standard across the Army, Kroll said he aims to make it that way. Not only does it save money and time, it also reduces patient wait times, decreases variability in dental restorations and helps control quality.

“Creating change is hard,” Kroll said. “Here at PoM Dental Clinic that change has required the hard work and coordinated effort of local supply technician Gary Christensen, JBLM Dental Health Activity IT Specialist Mr. Phillip Wise, and Soldiers like Sgt. Clayton Baker, Spc. Wilniel Martinez, and Sgt. 1st Class Charles Taupau. The most rewarding part of the digital transformation at PoM is seeing the buy-in from staff, which is the catalyst to lasting change.”