Association urges funding increase for facial reconstruction research

Washington鈥擳he Association in graphic Senate testimony urged modest increases in the “woefully inadequate” and declining budget for military dental research into facial reconstruction and the wounds of war.

“We have included in our testimony pictures of such wounds so you can see to what extent it is necessary to restore bone structure to the head and around the eyes, nose, mouth and jaw and the challenges facial skin grafts create,” Dr. Keith Suchy told the Senate subcommittee on defense appropriations. “They are hard to look at and because of that they have not been chronicled in the news like other injuries.”

Dr. Suchy, who chairs the ADA Council on Government Affairs, testified at the subcommittee’s invitation on the little-known research under way at various military facilities on war-related injuries to the head and face. The Association represents more than 155,000 dentists including nearly 3,000 in the military services.

“I thank you, doctor. I can understand what you are trying to tell us,” said Sen. Daniel K. Inouye (D-Hawaii), the World War II military hero who chaired the hearing. The subcommittee took testimony from invited witnesses on military medical, dental and other health care issues.

When the Association last testified to the Senate panel in 2004, said Dr. Suchy, the goal of the fiscally diminished and physically scattered military dental research effort “was simply to keep our deployed troops healthy. While oral health is still one of our priorities, the wars in Afghanistan and Iraq have dramatically changed our dental research agenda.”

By some estimates, 40 percent of the injuries in these conflicts are to the head and face. “These wounds present a unique challenge to dental researchers and the dentists who treat these patients,” Dr. Suchy testified. “The importance of restoring facial appearance cannot be understated. Facial features affect a person’s ability to communicate and embody one’s sense of self. Loss of facial features brings with it adverse psychological effects, and reentering the workforce back home is all but impossible.

“Restoring facial tissue and structure is complicated and the maxillofacial prosthetic materials we use do not adequately mimic natural tissue.”

Dentists and dental researchers at the Naval Institute for Dental and Biomedical Research at Naval Station, Great Lakes, Ill., Walter Reed Army Medical Center in Washington, D.C. and National Naval Medical Center in Bethesda, Md., are working to develop better materials to replace facial skin, ears and noses and fashioning skulls and facial bones using synthetic polymers and titanium mesh screens.

The research shares common federal funding and a common goal of reducing the incidence and impact of dental disease and maxillofacial injury on deployed troops. But the budget for military dental research is small and declining, and the research is unduplicated by the National Institutes of Health or civilian research. Current funding is at $1.2 million, which is 70 percent less than the $4 million available in 2007. The Association requested a $6 million appropriation “to restore and expedite this research.”