Volume 2, Number 1. April 2001
Contents
Editorial Working togetherDr June NunnThis issue of the Journal devotes much of its contents to the matter of education - undergraduate and postgraduate. At a time when there is tacit agreement of the need for a specialty of Special Care Dentistry, to record the achievements of those in the field, both under- and postgraduate, is timely. Increasingly our undergraduate students work in the field of Special Care Dentistry for their electives as well as on projects within the rest of the curriculum. In this issue we hear of the endeavours of two who were our prizewinners; Fleur Kellet reviewed the impact of the Disability Discrimination Act on general dental practitioners and Sadaf Khan investigated dental management issues in people with cerebral palsy. As well, two other students detail their work, one on a community dental service in London for those with disabilities and the other, from a New Zealand student, describing a novel approach to the dental care of people with spinal injuries. It is gratifying to see young people entering the profession taking an active interest in what has been viewed as one of the less glamorous specialties. Raising the profile of their work in this sort of forum is one way I see of encouraging this.On the postgraduate front, we have an interesting view from France on the implications for dental education of dentists-related barriers to treatment for people with Down syndrome. And as well, we devote considerable attention to the latest of the BSDH Guidelines on treatment guidelines for the oral management of oncology patients. To complement this there is a paper describing current practice as it relates to the implementation of existing protocols in the UK. Increasingly, in these days of Clinical Governance, evidence-based care is vital and so we welcome these latest Guidelines to the others that are now accessible through the BSDH web site: www.bsdh.org.uk. Whilst we all acknowledge the considerable wealth of experience within our specialty its formal ratification is an important achievement. November 2000 saw three important landmarks in this; the first was the very considerable British presence at the IADH Biennial Congress in Madrid where BSDH members made significant contributions to the scientific sessions. BSDH members were also in evidence as contributing authors to the IADH textbook, launched at the same Congress. Perhaps more significant though, was the achievement of the twelve candidates who were successful in the first diet of the Membership Diploma in Special Needs Dentistry of the Royal College of Surgeons of Edinburgh. For the specialty to progress, it is vital that we have accredited training programmes and external validation of the education and training gained therein. Our congratulations go to the successful candidates and to the examiners for their vision in establishing the qualification. At the same time more and more courses for the education and training of dental nurses in Special Care Dentistry are being established. It is important that colleagues lend their considerable expertise and support to these ventures to help those who may have left formal studying some time ago and for whom academic work, undertaken alone, is a hard task. Special Care Dentistry is after all a lot about teamwork. It is teamwork that has progressed the recognition of the specialty to the stage where we now have a working Joint Advisory Committee for Special Care. We look forward to hearing of the outcome of their meetings with not only representatives of the General Dental Council but also the new Chief Dental Officer who in her previous roles was one of the staunchest advocates of the team approach to holistic dental care. Abstracts Oral care protocols for children receiving treatment for cancerM M Collard and M L HunterDental Health and Development, University Dental Hospital, Heath Park, Cardiff, UKObjectives: To determine to what extent dental preventive advice is incorporated into documentation supporting oral care protocols used in UKCCSG centres. Design: Two Specialists in Paediatric Dentistry examined documentation provided by seven UKCCSG centres. Results: The preventive content of the documentation in use in UKCCSG centres is both inconsistent and generally inadequate. Conclusions: UKCCSG centres should involve suitably trained and experienced dental professionals when drawing up oral care protocols for the children in their care. Key words: Leukaemia, dental care, prevention Dentist-related barriers to treatment in a group of individuals with Down syndrome in France: implications for dental educationPaul J Allison(1), Denise Faulks(2) and Martine Hennequin(2)(1)Faculty of Dentistry, Mc Gill University, Montreal, Canada and (2)Faculty of Dentistry, University of Auvergne, Clermont-Ferrand, France.Aim: The aim of this study was to investigate social, functional and physiological indicators of the receipt of dental treatment in a sample of people with Down syndrome (DS) in France. Method: The Oral Assessment - Down Syndrome questionnaire (OADS) was used to collect data from 204 sets of parents of people with DS. Results: Older age (odds ratio [OR]: 7.8; 95% confidence interval [CI]: 2.9-20.8), annual dental visits (OR: 10.2; 95%CI: 4.0-26.3) and delayed deciduous exfoliation (OR: 2.8; 95%CI: 1.1-7.2) were associated with increased odds for receipt of dental treatment, while annual cardiac clinic visits (OR: 0.2; 95%CI: 0.1-0.5), food spill during meals (OR: 0.4; 95%CI: 0.1-0.9) and habitual tongue protrusion (OR: 0.4; 95%CI: 0.2-1.0) were associated with decreased odds for receipt of dental treatment. Conclusions: These findings suggest that children with DS and cardiac problems and those with indicators of more severe dysfunctional oral problems are less likely to receive dental treatment than their peers without such problems. The results are discussed in relation to attitudes and knowledge of the dental profession and the lack of training of dentists in the field of special care dentistry. Keywords: Down syndrome, dental health service access, dental education, dental care for the disabled Preventing self-inflicted soft tissue trauma: a case report in an adult with severe neurological impairmentJ E GriffithsDepartment of Adult Dental Health, University Dental Hospital, Heath Park, Cardiff, CF4 4XY, UKSelf-inflicted injuries to the oral and peri-oral tissues in association with a number of conditions are more frequently reported in children. Cases are reported in adults with neurological conditions and in the post-anaesthetic state. This report describes the management of an adult with severe physical and neurological impairment. An appliance was successfully constructed to prevent self-inflicted involuntary trauma to the lower lip caused by clenching the lower lip between the anterior teeth. Keywords: Self inflicted injuries, neurological conditions, oral tramua Oral health care for individuals with tetraplegia due to spinal cord injury
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