Oral complaints represented a leading cause of specialized outpatient visits at the Chinese level‑II hospital embedded in the MONUSCO southern sector of the Democratic Republic of the Congo (DRC). The hospital provides dental care to deployed military and civilian peacekeeping personnel from multiple countries. Local dental resources and referral pathways in the eastern DRC are extremely limited, obliging the hospital to rely on its own clinical data to plan supplies and services. This study examines how the spectrum of oral diseases changed across three consecutive deployment batches to inform precision dental support during peacekeeping missions.
This is a retrospective, observational analysis of routine outpatient records from the hospital’s stomatology service. The study focuses on three deployment batches for which complete records were available: Batch 23 (1 October 2019–30 September 2020), Batch 25 (1 October 2021–30 September 2022) and Batch 26 (1 October 2022–30 September 2023). Batch 24 was excluded because its records were incomplete. The analytic dataset was de‑identified prior to research use.
All oral outpatient visits recorded during the three included batch periods were considered. Repeated visits for the same disease were excluded after the first visit; specifically, 27 repeated visits in Batch 23, 30 in Batch 25, and 17 in Batch 26 were removed. The final cohort comprised 565 observations: 205 from Batch 23, 154 from Batch 25, and 206 from Batch 26. Extracted variables included diagnosis, age and sex. Data extraction was performed independently by two trained researchers using a standardized case report form; discrepancies were resolved with a third reviewer. The anonymized supporting dataset is provided as S1 Data with the published article.
Clinical diagnoses originally recorded by attending dentists (for example, “caries” or “pulpitis”) were retrospectively mapped to the International Classification of Diseases, Eleventh Revision (ICD‑11) by two trained researchers, with a third reviewer adjudicating disagreements. The study grouped oral conditions into five categories for analysis:
Primary outcomes were the consultation‑based proportions of these five categories across the three batches and trends in selected common diagnoses (caries, pulpitis, periapical periodontitis and gingivitis).
Analyses were conducted using SPSS 25.0. Continuous data (age) were assessed for normality using Shapiro‑Wilk; categorical comparisons used chi‑square tests. Trends across batches were tested with the Cochran–Armitage trend test, and Bonferroni correction was applied for multiple comparisons where appropriate. A two‑sided P value < 0.05 was considered statistically significant. All reported sample sizes and proportions derive from the de‑identified dataset provided with the article.
Across the three included deployment batches, oral outpatient visits consistently accounted for the largest proportion of the hospital’s specialized outpatient caseload: 22.19% in Batch 23, 21.21% in Batch 25 and 25.40% in Batch 26. The final analytic sample included 565 unique first visits for oral diagnoses.
The proportion of diseases of hard tissues of teeth increased markedly across the three batches, rising from 29.27% in Batch 23 to 49.03% in Batch 26. This upward trend reached statistical significance (P for trend < 0.001) and Batch 26 proportions were significantly higher than those in Batches 23 and 25 after adjustment. Conversely, the proportion attributed to periodontal disease declined over time, from 15.12% in Batch 23 to 6.80% in Batch 26, with a significant trend (P for trend = 0.008) and Batch 26 significantly lower than Batch 23. Proportions for disorders of oral mucosa and other oral diseases are reported within the dataset and tables accompanying the article.
Within the category of hard tissue disease, caries was the most frequent diagnosis and its consultation proportion increased from 11.71% in Batch 23 to 30.10% in Batch 26 (P for trend < 0.001). Among diseases of pulp or periapical tissues, pulpitis was the predominant diagnosis; its proportion peaked in Batch 25 at 33.12% and decreased to 20.87% in Batch 26 (P = 0.009). The study also reports on periapical periodontitis and related diagnoses in the supporting tables. Periodontal disease diagnoses, including gingivitis and periodontitis, showed a downward trend across batches as noted above.
This case study of a single Chinese level‑II hospital in the DRC identifies shifting needs in deployed dental services over three consecutive rotations. The increasing share of caries and other hard tissue conditions suggests rising demands for restorative care and materials, whereas the decline in periodontal diagnoses may reflect changing care‑seeking patterns, treatment availability, or population composition across batches. The limited local dental infrastructure and logistical challenges for resupply underline the importance of using local clinical surveillance to prioritize consumables, instruments and skill sets for future contingents operating in similar remote peacekeeping settings.
Limitations include the retrospective design, reliance on routinely recorded clinical diagnoses, the exclusion of Batch 24 due to incomplete records and the fact that the hospital serves only mission personnel rather than the local population. The authors note that all data extraction and ICD‑11 mapping were performed by trained personnel with adjudication to improve reliability, and the anonymized dataset is available to permit replication of the reported analyses.
Analysis of 565 oral outpatient visits across three deployment batches shows a significant increase in diseases of hard tissues of teeth, driven primarily by a rising proportion of caries, and a concurrent decline in periodontal disease. These trends offer preliminary, actionable information to guide procurement and personnel planning for dental services in peacekeeping missions with constrained local support.
The anonymized dataset underlying the study findings is provided as supporting information (S1 Data) with the published article. The study received funding from the Natural Science Foundation of Scientific and Technological Funds for Youth of Gansu; the funder did not influence study design, data collection, analysis, or publication decisions. The authors declared no competing interests.