Today, Navy Dentistry has grown to nearly 14 specialties, with more than 1,300 active and reserve officers providing care for service members, retirees and beneficiaries. More than 100 Navy dental officers serve as faculty, residents or staff at either Walter Reed National Military Medical Center (WRNMMC) or the Naval Postgraduate Dental School (NPDS), a directorate of Navy Medicine Professional Development Center (NMPDC), a tenant command at Naval Support Activity Bethesda (NSAB), according to Navy Capt. (Dr.) Glenn A. Munro, who serves as NPDS dean and director of NMPDC. Moving into its next century of dentistry, the Navy Dental Corps celebrates the pride of its past, and sets the foundation for the course of its future — a future led by dentists like Navy Lt. (Dr.) Gregory M. Gittleman, who recently completed a two-year Comprehensive Dentistry Residency at NPDS.
"The Journal" followed Gittleman for a look at "the day in the life" of a Navy dentist as he prepared to leave for his first duty station, U.S. Naval Hospital, Guam.
After beginning his Monday morning with a 7 a.m. Officers Quarters for a plan of the week, Gittleman heads to Operatory Room 2482 to see his first patient of the day: Hospital Corpsman 3rd Class Hadetamu Desta, a lab tech in transfusion services at WRNMMC. The dentist draws a picture on a dry erase board to explain an upcoming gum surgery and uses a camera to take photos of his patient. He said photography is an important learning tool for students at the NPDS.
The Naval Dental Corps officer reviews X-rays. His patient doesn't have enough bone for a graft and his military career ends in November. Gittleman must change his original treatment plan — not uncommon for a military dentist.
"There are unique circumstances [which] come up that challenge a person [to go beyond] the textbook answer on treatment," Gittleman said.
One patient may deploy much sooner than expected, another travels frequently. A military dentist must find different options for a patient, like those for a wounded warrior without enough manual dexterity to remove a dental prosthesis, Gittleman explained.
"You have to be creative and really work with the patient, talk with them and figure out what the best treatment is for them," he said. Changing variables are routine challenge for military dentists.
After Desta leaves with a handshake and a smile, Gittleman explains a casting technique with Hospitalman Shand Gilbert, a new dental assistant. "At some moments of the day you're the teacher, sometimes you're the student," the Navy dentist said. "As dentists, we're always learning."
Gittleman heads to the office to complete his notes immediately while they're still fresh in his mind. It's 8:20 a.m. He stops to answer a question from Dr. Benjamin Gantt, a second-year comprehensive dental resident. Gittleman graduated from the same program two months earlier.
It's 9:30 a.m., and Gittleman consults with his next patient, retired Air Force Col. Gerald Volloy. The retired colonel said he attended the Naval Postgraduate Dental School's June graduation in full uniform, to honor the residents and show his gratitude.
"I've been a patient here for over five years and I couldn't have had better care anywhere in the world; this is an outstanding program, manned by outstanding students. They pick the best to be here, and Dr. Gittleman is one of them," Volloy said, flashing a grin. "I've got a better smile now than when I [first] walked in."
Gittleman returns to his office to complete notes, and then it's back to the room to refine a set of porcelain veneers for a patient. It's 10:20 a.m. He dons a set of lighted-magnifying glasses and uses a tiny hand tool to add character details.
"Real teeth aren't perfectly smooth," he said, interrupting his close inspection. He'll return the veneers to the lab one last time for another glazing. "If you don't have time to do it right, when will you have time to do it again?"
"Looks good," said Navy Capt. (Dr.) Scott Kooistra, who runs the Operative Dentistry department at the school. The expert on dental implants with 18 years of service as a Navy dentist will join Gittleman for the placement of the veneers.
Gittleman heads to the office at 11:10 a.m. for a quick lunch and makes some phone calls to confirm moving arrangements of his household goods to Guam. He looks forward to seeing the world as a Navy dentist. As the son of a retired Air Force surgeon and former Air Force nurse, he knew he would join the military one day.
Retired Navy Cmdr. Curtis Reaves is his next patient, at 1:15 p.m. The prostate cancer survivor sought to become a patient at the Naval Postgraduate Dental School after his radiologist told him about the NPDS program which provides patient care. Military medicine, the NPDS, and Dr. Gittleman have been very good to him, the retired commander explained.
After completing notes in his chart, Gittleman takes a moment for conversation in the lobby to say goodbye to the commander. Most likely this will be the last time Gittleman sees him before the lieutenant goes to Guam.
At 2:30 p.m., the Navy dentist reviews a cast of Desta, his first patient that day, with Bernadette Kasozi, a dental assistant at the Naval Postgraduate Dental School. The cast will be used to make a retainer for Desta. Gittleman will end his day completing paperwork, and reading a recent academic journal article that may help with the Sailor's treatment plan.
Spending some time in the dry lab removing excess material from a mold, Gittleman refines the cast before dropping it off to the dental lab for the mouth guard. Next, he's off to discuss a case he will transfer to Cmdr. (Dr.) Daniel Barcomb, a dentist with the Public Health Service completing his second year as a resident at the school.
As a resident, Gittleman saw four to six patients a day; less than the average military dentist who sees about one patient per hour. He said NPDS residents move a little slower, to do bigger, more challenging cases so that when they graduate and go to their assignments they can be the subject matter experts, the leaders in the field, the ones who get the tricky cases, and provide answers to the tough questions.
Munro called Gittleman one of the new "super-trained" dentists leading the Naval Dental Corps into its next century. "He represents the best of the best. Our future is even brighter."