Bernhard Sobotta, Mike T.John, Ina Nitchke: Dental practice during a wor...

Start2007Bernhard Sobotta, Mike T.Jo...


To describe dental treatment needs and demands of crew on a cruise ship during a world cruise.


The routine dental documentation of a two months period at sea on a cruise ship carrying 999 crew was analysed. Age, gender, diagnosis, treatment performed, percentage of emergency and routine procedures, number of appointments, duration of appointment and time since last visit to the dentist were recorded. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile.


Subjects were n = 56 crew with a mean age of 37 (± 12.0) years. Out of 114 patient contacts n = 29 (25 %) were for emergency treatment. Caries and its sequelae accounted for 85 % of time spent treating emergencies and 50 % of routine treatment time. The two most frequent treatment options during emergency appointments were extractions and endodontics. In routine cases fillings and periodontal treatment were dominating. Per 1000 persons per month crew required 14.5 emergency plus 42.5 routine appointments. 80 % of crew had seen a dentist within 12 months before their shipboard dental appointment. Oral health-related quality of life was most impaired in case of emergency patients with a particular emphasis on the diagnosis of pulpal disease.


High numbers of dental emergencies largely due to caries indicated that International Labour Organisation (ILO) recommendations requiring seafarers to be dentally fit were not adhered to. It is suggested that some doctors performing pre-sea medical examinations may not adequately diagnose caries. A pre-sea examination by a dental professional has the potential to reduce the number of emergency port referrals to dentists. Treatment costs and attitude to preventive dental care were identified as barriers impeding the access of low-wage crew to the ship’s dental clinic. Cosmetic dentistry and prophylaxis attracted those crew with an interest in prevention and the ability to pay the fees. In large cruise ships there is a substantial demand for both emergency and routine dental care among crew.

Key words:

Oral health, Maritime medicine, OHIP, Emergency oral care, Caries

Bernhard A.J. Sobotta, Dr. med. dent.
Department of Prosthodontics and Materials Science University of Leipzig,
Nürnberger Str. 57, D-04103 Leipzig, Germany

Mike T. John, D.D.S., Ph.D., MPH, Ph.D, Associate Professor,
University of Minnesota School of Dentistry, Department of Diagnostic and Biological Sciences
6-320d Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455, USA

Ina Nitschke, PD Dr. med. dent. habil., MPH,
Clinic for Geriatric and Special Care Dentistry University of Zurich, Center for Dental and Oral Medicine, Maxillofacial Surgery
Plattenstraße 11, CH-8032 Zürich, Switzerland

Corresponding author:
Dr. Bernhard A.J. Sobotta,
Department of Prosthodontics and Materials Science University of Leipzig,
Nürnberger Str. 57, D-04103 Leipzig, Germany
Tel: +49 341 9721 310, Fax: +49 341 9721 329,