Surreal illustration of a fragmented soldier's face symbolizing oral-maxillofacial injuries during wartime.

Hidden Wounds: Understanding Oral-Maxillofacial Injuries in Military Personnel During Wartime

Elliot Brynn in Health & Wellness June 2025 • 4 min read.

"A deep dive into the prevalence and impact of oral-maxillofacial injuries among U.S. military personnel in Iraq and Afghanistan from 2001 to 2014."

In the theater of war, injuries extend beyond the immediately visible. Oral-maxillofacial (OMF) injuries—those affecting the face, mouth, and jaw—represent a significant portion of battle-related trauma. These injuries, which can impact breathing, eating, and communication, accounted for a substantial 33% of military treatment facility visits for battle injuries during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF).

Despite years of conflict, the full scope and impact of OMF injuries on military personnel remain only partially understood. Such injuries not only pose immediate medical challenges, but also potentially lead to long-term functional and aesthetic issues that can affect a service member’s quality of life after deployment. Comprehensive data and analysis are crucial for improving preventative measures, treatment protocols, and support services for affected individuals.

This article explores a detailed surveillance study conducted by COL Timothy A. Mitchener, Rodney Chan, and John W. Simecek, which investigated the incidence and characteristics of OMF injuries among U.S. military personnel deployed to Iraq and Afghanistan from 2001 to 2014. By examining data from the Department of Defense Trauma Registry (DoDTR), the study provides critical insights into the patterns, rates, and service-specific trends of these often-overlooked injuries.

Key Findings: Unveiling the Scope of Oral-Maxillofacial Injuries

Surreal illustration of a fragmented soldier's face symbolizing oral-maxillofacial injuries during wartime.

The study leveraged the Department of Defense Trauma Registry (DoDTR) to identify OMF injuries using specific diagnosis codes. Military personnel included in the study sought treatment at Level III military treatment facilities—the highest level of care available in a combat zone. Data spanned from October 19, 2001, to June 30, 2014, encompassing Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) along with Operation New Dawn (OND).

The research revealed a stark picture of OMF injuries in the war zone, with battle injuries comprising the majority of cases. Here’s a breakdown of some key observations:

Operation Enduring Freedom (OEF):
- A total of 2,504 OMF injuries were recorded.
- The Army bore the highest burden, accounting for 72.7% of these injuries, followed by the Marines at 21.3%.
- Injury rates within the Army ranged from 1.10 to 4.90 per 1,000 person-years.
Operation Iraqi Freedom/New Dawn (OIF/OND):
- The total number of OMF injuries was significantly higher, at 3,676.
- Again, the Army accounted for the majority (76.1%), with the Marines at 19.9%.
- The highest overall OMF injury rate was observed among Marines in 2003, at a striking 42.7 per 1,000 person-years.

These numbers underscore not only the prevalence of OMF injuries, but also the disproportionate impact on different branches of the military and during specific phases of the conflicts. Such detailed data are essential for informed resource allocation and targeted prevention efforts.

Recommendations

The study by Mitchener, Chan, and Simecek highlights the critical need for continued surveillance and improved data accuracy in tracking OMF injuries within the military. These findings are essential for guiding resource allocation, enhancing prevention strategies, and ensuring that military personnel receive the timely and appropriate care they need, both during and after deployment. By addressing these hidden wounds, we can better support the long-term health and well-being of those who serve.

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Everything You Need To Know

What are Oral-Maxillofacial (OMF) injuries, and why are they significant in the context of military operations?

Oral-Maxillofacial (OMF) injuries involve the face, mouth, and jaw, and are crucial because they impact vital functions such as breathing, eating, and communication. In military contexts, especially during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), these injuries are a major portion of battle-related trauma, affecting service members' immediate medical needs and potentially leading to long-term functional and aesthetic challenges. The Department of Defense Trauma Registry (DoDTR) was utilized to track these injuries.

What were the key findings regarding OMF injury rates among different branches of the U.S. military during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom/New Dawn (OIF/OND)?

During Operation Enduring Freedom (OEF), the Army reported the highest burden of injuries with 72.7% of the 2,504 OMF injuries recorded, with injury rates ranging from 1.10 to 4.90 per 1,000 person-years. During Operation Iraqi Freedom/New Dawn (OIF/OND), the total number of OMF injuries was significantly higher at 3,676, with the Army accounting for 76.1%. Notably, the Marines experienced the highest OMF injury rate in 2003, reaching 42.7 per 1,000 person-years. These data underscore the disproportionate impact of conflict on different military branches and highlight the critical need for targeted prevention and resource allocation.

How did the study conducted by COL Timothy A. Mitchener, Rodney Chan, and John W. Simecek contribute to understanding OMF injuries?

The study by Mitchener, Chan, and Simecek, analyzed data from the Department of Defense Trauma Registry (DoDTR) to investigate the incidence and characteristics of OMF injuries among U.S. military personnel deployed to Iraq and Afghanistan from 2001 to 2014. They examined data from Level III military treatment facilities, providing critical insights into the patterns, rates, and service-specific trends of these often-overlooked injuries. Their work highlights the importance of data-driven approaches to improve prevention strategies and enhance the care provided to military personnel.

What specific operations were included in the study, and what was the time frame for the data collection?

The study included data from Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). The data collection spanned from October 19, 2001, to June 30, 2014. This extensive time frame and the inclusion of multiple operations allowed for a comprehensive analysis of OMF injuries over the course of the conflicts in Iraq and Afghanistan.

Why is continued surveillance and improved data accuracy essential for addressing Oral-Maxillofacial injuries in the military, according to the study's recommendations?

Continued surveillance and improved data accuracy are critical for several reasons. They facilitate informed resource allocation, allowing the military to direct resources effectively to where they are most needed. Enhanced data accuracy enables the development of more effective prevention strategies and helps in ensuring that military personnel receive timely and appropriate care, both during and after their deployments. Addressing these hidden wounds directly supports the long-term health and well-being of those who serve, which is the ultimate goal.