FORT RILEY, Kansas  –   When Dylan Banks looks into the mouth of a Fort Riley patient, he isn’t just looking at enamel and gums. He is looking at the readiness of the 1st Infantry Division.

Banks is entering his fourth year at the University of Missouri-Kansas City School of Dentistry. In his mid-30s, the Air Force veteran is completing an externship at Fort Riley’s Custer Hill Dental Clinic.

For three weeks, he has traded the academic environment of his civilian dental school for the fast-paced, real-world consequences of Army dentistry. It’s an environment that has shaped his understanding of what the profession is meant to achieve.

“I like the aspect that you’re not bound to choose, you’re not having to look at financials to make a determination on what the best treatment is,” Banks said. “At the dental school, there’s a lot of times we can’t actually do the treatment the patient fully needs because they can’t afford it… but here, that's not a problem.”

In the civilian sector, a dentist’s clinical judgment is constrained by insurance caps, copays, and a patient’s budget. A recommended crown might be delayed for years because the patient cannot afford the out-of-pocket cost.

At Fort Riley, that financial barrier isn’t a factor. LTC Aaron Amano, commander of Fort Riley Dental Activity, explains that this clinical model is essential to military lethality.

“The Army’s goal is readiness,” LTC Amano said. “That means that our goal is to ensure that all Soldiers are dentally deployable, and any conditions that compromise deployment readiness are corrected. That’s how we maintain the lethality of the force.”

If a clinician determines a Soldier needs a procedure to remain mission-capable, the Soldier receives it.

However, that clinical freedom comes with tight, operational timelines. In civilian practice, some procedures can take a few visits and that’s considered routine. But at Fort Riley, a Soldier slated for deployment might not be available for future appointments. Leaving a treatment unfinished could result in an unpredictable situation downrange, potentially requiring a medical evacuation and compromising their safety and well-being.

“You have to assume the worst,” Banks said regarding a Soldier's access to care while deployed. “It requires a different level of clinical judgment... You want to keep people in the best position you can, knowing you might not see them again.”

LTC Amano validated the student's observation, noting that the window of opportunity to treat a Soldier is often small.

“The urgency is there because we have a limited amount of time with the Soldiers,” LTC Amano said. “This is due to training requirements, temporary duty (TDY) assignments, rotations, deployments, and permanent change of station (PCS) cycles.”

As a result, Army dentists must possess the clinical foresight to address problems immediately with treatments that do not require continuous follow-up.

Through its partnership with UMKC, Fort Riley’s Dental Activity provides civilian students like Banks with a one-on-one mentorship experience that accelerates their clinical competency and exposes them to mission-driven dentistry.

Additionally, it shows them a career pathway that offers a different standard of success.

“They’re taking the time to be a part of something,” Banks said, searching for the right words to describe the culture at Custer Hill Dental Clinic. “They're not just here dressed up in scrubs and then go home at the end of the day. They’re fully checked in... fully committed.”

LTC Amano said this environment is what makes military medicine attractive to civilian dentists.

“Working as a Defense Health Agency (DHA) civilian dentist in the military has its pros and cons,” LTC Amano said. “People can make more money in the civilian sector, however, they are bound by what their patients can afford. The military gives a chance for dentists to focus purely on the patient and not worry about selling care.”

As Banks prepares for his final year as a dental student with an expected graduation in May 2027, he said he will take the Army’s focus on functional, necessary care into this future practice. And while he had previously planned on a purely civilian career, his rotation among the Soldiers of the 1st Infantry Division has given him pause.

“It’s definitely crossed my mind more now,” Banks said contemplating a return to Army service as a civilian dentist. “I just want to enjoy what I'm doing and have peace of mind at the end of the day, knowing I actually did help somebody that needed help.”