AF IMT Form 1466D "Dental Health Summary"

What Is AF Form 1466D?

AF IMT Form 1466D, Dental Health Summary - also known as the AF Form 1466D - is a document completed by the dental provider to determine dental health as part of the family member relocation clearance for travel. The form is meant to determine the oral fitness for the prolonged assignment without ready access to dental care of the family member, it is not intended to address the members' comprehensive dental needs.

The latest version of the form was released by the Air Force Information Management Tool (IMT) in August 2017 with all previous editions obsolete. An AF Form 1466D fillable version is available for download below or can be found through the Air Force e-Publishing website. Additional guidelines and tips can be found in AFI 40-301, Family Advocacy Program (FAP).


AF Form 1466D Instructions

Completing the AF Form 1466D starts with identifying a person or entity to fill it out. If the patient is enrolled in the TRICARE Dental Plan, a civilian dentist completes the form. If the patient is not enrolled in the TRICARE Dental Plan, a military dental treatment facility completes the form. The family member needs a doctor's assessment of their dental health for a pending duty assignment. The doctor lists dental examination results stating if:

  1. The patient has good oral health and is not expected to require dental treatment or re-evaluation for 12 months.
  2. The patient has some dental issues, but the doctor does not expect these conditions to result in dental emergencies in the next 12 months.
  3. The patient has oral conditions that the doctor expects to result in dental emergencies within 12 months if not treated. Such conditions include infections (acute oral infections, pulpal or periapical pathology, chronic oral infections, or other pathologic lesions and lesions requiring biopsy), caries/restorations (dental caries or fractures with moderate or advanced extension into dentin, baby bottle tooth decay/early childhood caries, defective restorations that patients cannot maintain for 12 months), missing teeth (edentulous areas requiring immediate prosthodontic treatment), periodontal conditions (acute gingivitis or pericoronitis, active moderate to advanced periodontitis, periodontal abscess, progressive mucogingival conditions, moderate to heavy subgingival calculus, or periodontal manifestations of systemic disease or hormonal disturbances), oral surgery (unerupted, partially erupted, or malposed teeth), disorders or myofascial pain dysfunction requiring active treatment.
  4. The patient is undergoing active orthodontic treatment.

Air Force Overseas Clearance Forms


Download AF IMT Form 1466D "Dental Health Summary"

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