OFFUTT AIR FORCE BASE, Neb. -- At any given time, there may only be approximately 36 orthodontists in the entire U.S. Air Force, stationed at a limited number of bases.

Team Offutt is fortunate that several members of that small career field are stationed here and can help provide relief from a number of conditions and support for other dental services and treatments.

The 55th Dental Squadron's orthodontics section consists of one orthodontist and two orthodontic assistants, one active duty and one civilian. Together, they see and treat anywhere between 150 - 200 patients each month.

"I find all of my cases to be very interesting and rewarding," said Lt. Col. (Dr.) Lara Larson, the orthodontic element chief here. "Cases requiring orthognathic, or jaw, surgery to correct skeletal imbalances are especially rewarding as treatment significantly improves a patient's ability to function as well as his or her facial balance and self confidence."

All Air Force orthodontists go through dental school with an additional two to three years at an accredited orthodontic training program. Doctor Larson attended the Triservice Orthodontic Residency Program at Wilford Hall Medical Center at Lackland AFB, Texas.

This program is for Air Force, Army and Navy military members, although the Air Force may also look in other directions for that training.

"As needed to maintain sufficient numbers of orthodontists, the Air Force also sponsors dentists for training at other accredited orthodontic residencies in the civilian sector," said Doctor Larson.

Orthodontic assistants are trained general dentistry assistants who undergo on-the-job training in this specialty. Their duties include assisting in the placement and removal of orthodontic appliances such as braces and retainers, taking impressions of teeth for diagnostic casts and retainers, and taking x-rays needed for diagnosis and treatments, said Doctor Larson.

"Most of the training we do in this section is on the job training," said Staff Sgt. Jessica Chang, noncommissioned officer in charge of the orthodontic department. "A lot of it is hands on and it takes time to grasp the concept of holding and cutting the wires.

"You have to be confident with what you do and not be nervous. You learn from what the doctor does and the person who is training you."

The orthodontic assistants are responsible for following infection control standards and making sure patients are seen on time and that they are as comfortable as possible, said Sergeant Chang. They also review each chart, double checking procedures and information for accuracy.

Services provided by Air Force orthodontists are almost exclusively for active-duty personnel, with a few exceptions. These services, while not offered for strictly aesthetic or cosmetic purposes, treat cases such as skeletal discrepancies, impacted teeth and other issues that result in the destruction of hard or soft tissue structures. They also provide assistance and support for other dental services that require orthodontic input.

"The availability of care for active-duty members is based on severity," added Doctor Larson. "Air Force regulation provides guidance on treatment categories ... and guides us towards the most severe cases."

With a limited number of personnel in a highly technical medical field and a large demand for their services, orthodontists and their assistants face many challenges, but many also find satisfaction and enjoyment in the skills they have to help others.

"This is a very high paced section," said Sergeant Chang. "We are constantly working. I love staying busy and I look forward to seeing our recurring patients. I get to know most of my patients very well and I try to make it as pleasant as it can be to be seen by us."