Volume 7, Number 3. December 2006
Contents
Defining the population requiring special care dentistry using the International Classification of Functioning, Disability and Health – a personal view. Salivary methotrexate following IV therapy for osteosarcoma: a pilot study Hypnosis – alternative, or complementary to conscious sedation in dentistry? A review Continuing Professional Development Programme 163 Guidelines for the delivery of a Domiciliary Oral Health Care Service Oral disease experience of adults with severe disability, prior to receiving dental treatment under general anaesthesia Overview of a hospital based dental programme for persons with special needs Flow rate, pH and buffer capacity in saliva of adolescents with cerebral palsy Editorial 142 Programme 59 General Symposia 70 Symposia 72 Oral Presentations 80 Poster Presentations 96 Index of authors and presenters 132 Continuing Professional Development Programme 137 EditorialSpecial Care Dentistry –a reality This issue coincides with celebrations for the United Nations International Day of Disabled Persons on Friday 3rd December 2006. Under a banner fittingly entitled ‘enable’ the day seeks to ensure full and equal enjoyment of human rights, and participation in society, by persons with disabilities. Earlier this year, in August 2006 the Biennial Congress of the International Association for Disability and Oral Health took place in Göteborg, Sweden. Delegates to the Congress had the opportunity to do just that: to play their part in planning a better future for the oral health of people with disabilities, when oral health care teams from over 40 nations came together to share science, good practice and to support and mentor colleagues in the role of providing oral health care for some of the most vulnerable and sometimes, the most challenging members of society. Our second issue of the year –was devoted to publication of the abstracts from the Congress. For so long a ‘gold standard’ in the way that they have delivered care, the showcasing of the Nordic countries at the conference gave others the opportunity to see the way in which such centres provided oral and dental care in a truly holistic way, as well as novel approaches to education and training. As with the IADH Congress in Calgary in 2004, there was another ambitious programme of funding to bring delegates from less developed countries to the Congress – to learn from them as well as give them a voice in seeking support for disabled people in countries where even basic oral health care is not a feature. Increasingly throughout the world – both developed and developing, there is the realisation that this often disparate group of so called ‘special needs’ patients is only going to get larger and we need to invest in the resources now to ensure that all their health care needs are provided. Alongside other specialties we know that we need to work harder to develop the evidence base for what we do, based as it is currently on good practice honed from years of experience. One has only to read the many abstracts, at this and other conferences to know that there is so much work being done out there, often in isolation from peers, who would help to make the task that much easier; there may be duplication of effort too, so limited are the networks for some people. I would urge you however to make others aware of what you are doing – if nothing else, to prevent researchers from ‘re-inventing the wheel’ and let the wider dental community see that there is much sound and scientifically robust about Special Care Dentistry. Another very heartening aspect of the IADH Congress in Göteborg was the many young people present at the Congress; for some people working in other branches of dentistry there is a real anxiety that we have not built in succession – there are no young, keen clinicians, researchers, academics, prepared to take on the role now occupied by the leaders in our specialty. This is not so for Special Care Dentistry; a vibrant, outward looking body of people with a people-centred approach to what they do. But, they need their seniors to leave a legacy of a sound training framework and a career with prospects, if patients too are not to lose out. There is much to be optimistic about as we approach 2007! June Nunn, Dublin December 2006 Defining the population requiring special care dentistry using the International Classification of Functioning, Disability and Health – a personal view. Denise Faulks1 and Martine Hennequin2 1Hospital Practitioner and 2Professor, Université Clermont1, EA 3847, Faculty of Dentistry, Clermont Ferrand, France, and CHU Clermont-Ferrand, Centre for dental treatment and research, Clermont-Ferrand, Franc. AbstractAims and objectives: The aim of this article is to propose a classification of the population in need of special care in dentistry in relation to the International Classification of Functioning, Disability and Health (ICF), and to extrapolate a definition of the population concerned. A definition of the population requiring special care dentistry is essential in order to gather epidemiological data to describe current health status and to project the economic, medical and social consequences of disability and disease. It is also necessary for the attribution of dental health resources and the planning of services. Salivary methotrexate following IV therapy for osteosarcoma: a pilot study Sarat Thikkurissy1, Paul S. Casamassimo2, Dennis J. McTigue3, Reginald Eswuedo4 and 1 Assistant Professor, 2 Professor and Chief of Dentistry, 3 Professor, 4 Clinical Pediatric Toxicologist, Columbus Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, 5 Professor, Section of Oral Biology Ohio State University College of Dentistry, 305 W 12th Avenue, Columbus, OH 43205, USA AbstractAim: Exposure to antineoplastic drugs poses risk to health providers who may be treating children undergoing cancer or immune therapy. Hypnosis – alternative, or complimentary to conscious sedation in dentistry? A review 1 Staff Grade and 2Clinical Senior Lecturer, in Conscious Sedation and Special Care Dentistry, Department of Adult Dental Health, University Dental Hospital, Cardiff And Vale NHS Trust, Heath Park, Cardiff. CF14 4XY, Wales, UK AbstractThis paper examines the use of hypnosis in general dentistry specifically in a sedation context, briefly looking at the history of hypnosis and our current understanding of it, before going on to describe its use as alternative and adjunct to conscious sedation. Hypnosis is an important and effective adjunct to sedation and this paper aims to give an overview of this relationship. However, there is limited qualitative and quantitative research in the literature examining the relationship between hypnosis and sedation, which makes in-depth discussion difficult. There is therefore a need for good experimental evidence. There will only be sufficient clinical data to move hypnosis from just an experimental interest, and to turn it into a viable treatment option for the mainstream holistic treatment of patients, if clinicians are willing to undertake objective research with this modality. The effects of hypnotic suggestion- motivation, removal of fear and doubt, fixation of attention, relaxation and limited voluntary movements, monotony, and suppression of other ideas, are all useful for patient management. Since these effects come from communication skills which are fundamental to dentistry, it has been suggested that knowledge of hypnotic techniques and principles is important for general patient management by all clinicians, whether or not they wish to use ‘formal’ hypnosis. Guidelines for the delivery of a Domiciliary Oral Health Care Service AbstractThis document forms the basis for developing guidelines in the provision of domiciliary oral health care as part of a special care dental service. Its purpose is to state clearly the aims and objectives of a putative domiciliary oral health care service; to define the criteria by which clients referred to such a service may be assessed, and to formulise as guidelines, the procedures which might be undertaken by such a service. Oral disease experience of adults with severe disability, prior to receiving dental treatment under general anaesthesia Ian O’Leary, Martin Kinirons, Fiona Graham and Caroline Hartnett
Abstract Aim: To investigate the levels of oral disease in adults with disability, requiring treatment under general anaesthesia at Cork University Hospital. Overview of a hospital based dental programme for persons with special needs Ali Sigal and Michael J. Sigal Pediatric Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada AbstractBackground:A review was conducted of a dental programme for people with disabilities located in an acute care hospital, to assess if there was a need for such a programme, based on the demand and profile of the patients and to examine the mortality data for those registered patients that have died. Flow rate, pH and buffer capacity in saliva of adolescents with cerebral palsy Maria Teresa Botti Rodrigues dos Santos1, Walter Luiz Siqueira2 and José Nicolau2 1 The Discipline of Dentistry, Persons with Disabilities Division, Post Graduation Professor, Universidade Cruzeiro do Sul, 2 Oral Biology Research Center, Faculty of Dentistry, Universidade de Sao Paulo; Sao Paulo, BrazilAbstract Aim:To evaluate the flow rate, pH and buffer capacity in saliva of adolescents with cerebral palsy (CP).
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