IADH Edu-Blog

2012 iADH Congress in MELBOURNE

2011-10-09T19:00:00.029+01:00

Dear Colleagues,

First of all I would like to tell you that Melbourne will be the new venue for the iADH 2012 and the dates have been changed to the later date of 28-31 October 2012 so as not to clash with the Japanese Congress.
Is the the second most populous city in Australia and a centre for the arts, commerce, industry, education, entertainment, sport and tourism. October is springtime and I hope we could share nice days there . Of course we will have an Educational Session so we could meet there again .

And about the Scipe Task Force ......

I have enjoyed a lot all your posts after Antalya , it was so nice to meet you all there and to have such a successful meeting . Thanks you for your participation and for the hard work done despite the paradisiac resort where the congress was carried out.

Some pictures to share with you .....

Working.......

shelagh leading a work group

alison talking about the delphi study

and playing......

Gabriella, Shelagh and Roberto sampling the delights of the nargile

Last Night in the GLORIA resort

Inma Tomas, Gabriella and Shelagh having a lovely dinner

All the best

Gabriela

My journey to special care dentistry - by Ellie Heidari

2011-10-01T10:54:00.002+01:00

My journey to special care dentistry

I have been thinking a lot about special care dentistry and students after I was privileged to speak to wonderful experienced enthuastistic colleagues worldwide. Why do some students decide to study special care dentistry? Are there any trigger factors? If so, how can we pin point them out? In order to get some answers I had to look at my own special care dentistry journey.

My journey started when I was a little girl and after my great grandmother, Aziz Joon, fell after of one of her regular enjoyable visits to us. She was 85 years old then. I could see on her face that both she and her loved ones who surrounded her knew that this fall would not only bring her pain but also take her precious independence away from her from years to come. They were right. I remember the day Aziz Joon was admitted to my mother’s nursing home after months of operations and unsuccessful rehabilitation regimes.

Aziz Joon was looking at the leaking tap from her bed for few weeks before one day, when the depression abounded her, she asked me to bring her tools in order for her to fix the problem. I was looking at her admirably as she managed to take few steps on her walking frame with my help to the sink. We were happy that day because not only we walked but we also fixed the problem. I remember that warm feeling that wrapped around me and left me ‘high’ for days.

Therefore, it was not a surprise for me that I had a desire to attend to older ladies in the home after school. These ladies had wealth of life experiences that they shared happily with me whilst being prepared for snack time. Some stories brought me tears, some brought burst of joy and laughter, some were repeated and slightly altered on daily basis but all the shared stories made me feel important. The ladies shared the stories with me! And some ladies would have more to eat as I listened and cared for them. I felt that I could make them feel better. What a great warm feeling!

Today, it is the same warm feeling that comes back to me, when I fit a well fitted denture for my older ladies once they finished sharing their life stories with me. I treasure that feeling! I also thank my mother and all the older ladies (God bless their souls) for introducing special care patients to me. I know Aziz Joon would have been proud when I use my tool box to fix my patients problems.

It is a difficult and some may even say an impossible task to identify ‘trigger factors for special care dentistry’ in our students. After all, we are all individuals with different backgrounds and upbringing. Although some part of me agrees with that statement, I feel that we all have/had loved ones or great role model(s) that inspired us to look beyond the problems/challanges, to choose special care dentistry and to be innovative when looking after our patients. If we, as educators, can share our role model(s) with the students, we might direct some of our students’ future journey to a special care dentistry one. Maybe then we have overcome some barriers, to get started on a road to achieve some of our many goals that we have for our students.

Ellie Heidari

Greetings from Brazil

2011-09-29T16:56:00.000+01:00

IADH colleagues and participants ofthe blog.

Initially, we would like to thank the invitation that we received to participate in the Delphi Survey. We are members of the Brazilian Association of Dentistryfor Special Patients (ABOPE), and Dr. Marcello Boccia introduced us to Alison,so we can participate in the research for the IADH - Education Committee. We also know GabrielaScagnet because of the Brazilian Association of Dentistry for Special Patients,since 2006.

Wewould like to show that a little bit of education in dentistry for Special CarePatients in Brazil. Brazil wasthe first country to recognize the specialty of dentistry for patients withspecial needs in 2002. Currently there are approximately 240,000 dentists inBrazil but only 450 are registered as specialists in special care patients.

In a study on the formation of its graduates indentistry for patients with special needs in the metropolitan region of SãoPaulo (15 million inhabitants in the southeast of the country), held in 2010,12 colleges of Dentistry reported the care of patients with special needs, however it seems actually only 5 were spending a few hours to this project!

Otherplaces where you can learn about this subject is within the institutions of specialized in SpecialCare. As the Association of Assistance to Disabled Children (AACD), this is acharitable organization, private, nonprofit organization. Approximately 60% ofthese patients have cerebral palsy. And we work in the Department of Dentistryin this organization, where it performs on average 700 appointments per month.Patients are framed for outpatient treatment, treatment under generalanesthesia or during activities in oral health education.

In 1995, the Department of Dentistryand the Commission of Education and Training (CET), created the internshipprogram in Dentistry in the AACD. We currently run a residency program lasting 11 months, and a training program lasting6 months.

After sixteen years of the program,already trained more than 150 dental professionals, many frominner cities of Sao Paulo, Brazil's other states and even abroad.

The AACD isn’t a learning centeritself, but in recent years has sought to focus on the development of researchand clinical work on behalf of the patients and the scientific community.

We hope to meet you one day

José Reynaldo Figueiredo andDanielle Vieira

Sao Paolo, Brazil

Good memories after Antalya...

2011-09-21T12:18:00.005+01:00

A glass of chanpagne to celebrate the successful workshop
with Roberto Rozza, Ilknur Tanboga, Gustavo Molina and Blanaid Daly

Dear All, It’s so good to hear that everybody went back home with good memories after Turkey meeting. I agree on that we all felt very privileged to be part of the experience as a whole, both academically and socially. I hope the number of joinings get increased and continues afterwards as it gives opportunity to share our knowledge and experiences in this special area. Here’s some pics from my son Murat’s view..

Love from Ilknur..

Dancing Queen

2011-09-16T19:42:00.001+01:00

tripping the light fantastic is our 'dancing queen' Shelagh Thompson with Roberto Rozza from Milan - Italy and their International backing group from Dublin - Ireland, Michigan - USA, Santiago da Compostela - Spain, Cordoba - Argentina, Liverpool - England and Monster - the Netherlands

Please send us your best photos

2011-09-16T19:32:00.002+01:00

Great Picture of SCiPE member Shouji Hironkaka from Showa University, Japan

iADH-Australia is our next milestone

2011-09-16T12:40:00.002+01:00

Well our iADH Facebook community is growing steadily , and is very heartening to see our scipe networks developing using this forum, and scipe members linking up and no doubt staying in touch, planning and sharing news using the social network as well as using the traditional emails. I see with smile that Shelagh and Ted, have finally taken the plunge with Facebook earlier this week, and Ted is even promising us a small film/composite of events in Antlaya.
Dimitris left us a message on facebook, talking about focussing on the next milestone of working towards the iADH Congress in Australia and indeed I am very excited about the prospect of this meeting and all that it will hold for us in scipe as we launch our new curricula with all the learning outcomes and associated documentation. We are hoping that many of you will travel to OZ, to benefit from the scientific meeting, but also to continue to promoting harmonization of teaching in SCD using the new documents within the wider membership of iADH, and of course there are plans for iADH-education activities during the congress.

Regarding booking for the meeting, I have received a plea from Mina, asking people to refrain from booking their flights to Australia for the next week or so, until final dates are confirmed, as it appears that the current date chosen for the meeting clashes with the Japanese Society Meeting, which would have big impact on numbers attending both events.
I will update you all via the BLOG as soon as final dates etc are confirmed - and in the meantime - i will be on a hot line to quantas seeing how the early bird prices are looking and counting up my air miles....it's such a long way to go economy when you are nearly 6 feet tall;)))) and having been upgraded to club class last time - it kind of spoils you for ever more ;)

Finally, Shelagh sent me this very useful link about Motor Neurone Disease which has lots of resources on it including patient interviews etc, which I know that I will find very useful for our e-learning course here in Dublin so maybe will be useful for more of you too

http://www.healthtalkonline.org/Nerves_and_brain/motorneuronedisease/Topic/3443/

regards

Alison

Sue Greening Remembers the SCiPE Task Force Meeting in Antalya

2011-09-13T21:03:00.001+01:00

I am sitting gazing from my window at heavyrain and gales provided apparently by the edge of hurricane Katia whilst feeling that Turkey and all thatlovely sunshine is a very long way away!

It was a privilege to be part of the groupof people who attended the SCIPE workshop in Antalya and I know there are a number of you who were unableto attend but were very much part of the process prior to the workshop. We hopeyou will be able to join in person in future!

We are very pleased to report that the eventwas a great success, thanks in part to the hard work of the participants but verymuch to the efforts of Alison Dougall and Shelagh Thompson who led the group,ably supported by Clive Friedman, Maureen Romer and Gabriella Scagnet!

We all met on the afternoon of Monday 5^thSeptember with some introductory presentations by the leaders and some groupmembers who described Special Care Dentistry in their countries. Clive thenintroduced the dreaded ‘ ice breaker’ which we approached with some trepidation,and which involved telling stories, adding up numbers and spelling, all at thesame time! Difficult enough you might think for those with English as a firstlanguage – I take my hat off to those for whom English was not their firstlanguage! Before long there was much giggling and hilarity and the ice was welland truly broken! From that time onwards we worked in large and small groupsand I do not think I have every worked in such a collaborative environmentconsidering our very different backgrounds!

We worked in small groups on both the Postgraduate curriculum and the Undergraduate curriculum and reached consensus onboth over the three days – quite a feat I think. We also developed a number ofworkstreams for the future to look at ;

Assessments and learning outcomes in the undergraduate curriculum ,
Development of research in SCD and
Further consideration of the postgraduate curriculum

The workshop ended with short ‘Pearls’ (ofwisdom) from members, with tipsranging from Graeme’s acrylic thimble under the glove to act as a fingerprotector and mouth prop, to Lesley’s state of the art new surgery,Gustavo’s ART approach. This was followed by a welcome celebratory glass of fizz tocelebrate a very successful meeting, and we are very grateful to DIACO for providingus with that!

Alison and Shelagh presented an outline ofthe work of the group to the General Assembly during the A.D.E.E. conference andI was very proud to see how far our area of dentistry had come by making animpact on such an eminent organisation. We made a number of very usefulcontacts at the ADEE conference and we hope we raised the profile of SpecialCare Dentistry in the academic world of our profession.

I think we all felt very privileged to bepart of the experience as a whole, both academically and socially. The resortwas fantastic with a number of the group being upgraded to very nice ‘villas’ with pool and jacuzzi (I sadly can’t express Roberto’s excited Italian accent on paper!) It provided a perfect background for usto work and play together – and we certainly did that! The first evening alloweda number of the group members to display their dancing skills at the ‘Airportparty’ and the second evening allowed us to show our diversity in the Karaokesession – group singing and dancing with Copacabana and Dancing Queen as thehighlights!!

Stars of the show ;

Sam – best lead singer in the Barry Manilowtribute band!

Tom and Roberto – best dancing partners!

Gabriella – best nargile addict and back flip (with the clown)

Roberto – best photographer of himself inthe Jacuzzi!

Clive – bravest person for introducing theice breaker and telling us we shouldn’t be so nice!.

Tom and Mina – best scribes

Kevin and Raphaela – best support workers

Graeme – best mind map

Blanaid – best golfer - apparently

Gustavo – most polite man who talked to the unknown 'spy' who joined the group for the photos and the last day!
Shelagh – best group leader
Alison - best Delphi Consensus

Maureen – ‘bravest little soldier’ forleading the group with an upset stomach.

Sue (me) – best English teacher (though Isay it myself) for explaining the intricacies of the comedians on ‘Live at theApollo’ to Roberto over lunch, on his iPad without blushing!

Ilknur - for best rearranging of tables at dinner

Leda - for managing to keep a white dress pristine, despite the turkish buffets

Ted - for best argument for anxiety being a disability

Borge - for his lone and measured view on clinical holding - (wording to amended according to local guidelines ;)))))))

Jacob and Chai - for not turning around and going home to Malaysia when they arrived in the middle of the ice breaker

Dimitris for biggest smile at the sound of champagne corks popping
Darius - biggest appetite
Laura - best up and coming
Inma - best looking boyfriend

Luc - floweriest shirt

June - best ICF explanation

Karen for best table tennis partner

Shouiju - for always being best dressed

Ellie - funkiest mother
Sharat - best statistics by proxy

It was a pleasure to work with you all.Thank you so much to Alison, Shelagh and the other leaders for all their hardwork and enthusiasm. I feel very lucky to be part of the Global Special CareDentistry family which is always totally committed to the patients for whom wecare. I hope we all keep in touch through our growing Facebook group and I lookforward to another get together in Melbourne next year!

Thank you to you all for your great companyand friendship

Love from Sue in Cardiff (and Wales for the Rugby World Cup!)

SCiPE Task force in Antalya

2011-09-10T07:47:00.004+01:00

Thank you to all those wonderful and hardworking individuals who participated in our task force meeting in Antalya and I hope that you had a safe and uneventful journey home. Here is our 'official photograph' I am sure you will have your own memories of the event, which has been judged a huge success, undoubtably due to the openness, honesty and collective will of our group to take this important project forward.

Lots of work to get on with and lots of ideas to bring together within the 3 works streams of undergraduate, postgraduate and learning and scholarship. As soon as Tom gets back from his well deserved holiday - we will prepare the official proceeding and summary of the event. But in the meantime, if you have any good photographs or videos of any aspect of the meeting, I would be very grateful if you could send them to me scipe@iadh.org so that we can maybe share a few photos before that time (especially looking for informal photographs including pictorial accounts of the epic scipe group karaoke evening and the party in Roberto's luxury villa)

regards

alison

IADH Edu-Blog: Helping to shape education - by Gabriella Scagnet

2011-08-30T04:08:00.003+01:00

IADH Edu-Blog: Helping to shape education: When I think of ice ‘breaking’ as a metaphor for getting a group of people communicating and interacting to form a new kind of community a...........looking forward to helping to shape education ...!

Nice to read Clive´s words and his metaphors from the wonder nature and our dreams ... in this case SCD Education ! and agreeing about how our Alison works as an ice "breaking" . We all love you Alison for your effort to concrete the connection of all the members .

I must apologize for not be able to participate as I would like in the blog during this time , but I could accompany all this great group - behind the scene - and I am excited to think that in a week we will meet all together in such an important task . All the Executive Board had to work hard this year in different iADH matters , so I could not have enough time to share some thoughts with all of you but fortunatly , we will have lot of talks in Antalya . I will introduce myself there but for all the member who cannot attend I can tell you that I am working with patients with disabilities since I have got my degree at the University of Buenos Aires in Argentina .

I am specialized in Pediatric Dentistry and in Orthodontic but for these ways that life offers when I was studying pediatric dentistry it was created an Unit of Special care Dentistry for children and the person who could organise was dentist and psychologist ! . I did not know at this time if I would like to dedicate to this field but with the time and the compromise with this population I found a passion to "serve" all those children . Nowadays I am the Chair of the Unit of the Quinquela Martin Hospital of Pediatric Dentistry and with my colleague Dr. Teresita Ferrary we have had created an Unit at the University of Buenos Aires for adolescents and adults , from where we are trying to spread out all the experience we could share.

We can learn all days from our patients , and I am very happy to meet with All you soon and share and learn from each other. Thanks again to your contribution to this important task and specially to my colleagues and friends Alison Shelagh and Clive for all the work done ...and then we must work after the Meeting !!

My warm Regards from Argentina

Gabriela

Helping to shape education

2011-08-29T10:00:00.007+01:00

When I think of ice ‘breaking’ as a metaphor for getting a group of people communicating and interacting to form a new kind of community and what one may do in order for this to happen – I now have a new and somatic appreciation of this process. –
Having just returned from a trip to the arctic on an icebreaker I once again am going to use the wonders of nature to inform my writing and thought processes.

The process by which an ice breaker moves through the ice is actually one of fairly gently engagement – a kind of gently nudging ice reefs aside as it moves slowly thru frozen arctic water’s. On coming to a standstill it actually reverses and then reengages the ice flow from a slightly different direction.

Eventually making its way through what looks like a packed ice field –In this process the abundant eco life force beneath the ice is revealed and suddenly out of no where one sees myriads of birds grabbing at the fish now exposed. If you are lucky you may actually see an occasional polar bear or seal ensconced on one of the ice flows.

In a similar fashion our dear Alison has spearheaded and taken on this ice- breaking endeavor of the scipe education group. Her gentle nudging and always-consistent forward movement has brought together a wide range of educators,

clinicians, and academics releasing untapped knowledge from this diverse and creative group.

Now culminated with final Delphi documents that you will see to be interesting and informative of the collective beliefs and perceptions of the group. For all those who have been involved in this process I will be surprised if you don't already have a feeling of increasing cohesiveness and a better understanding of the gargantuan effort of creating a core syllabus in both undergrad and post grad education for people with disabilities. In under a week we will all be gathering to

continue this process and that so much of that ice has already been moved aside. I half expect that we will now see the many golden bears floating on the ice encouraging completion of a project envisioned so many years ago. I am looking forward to meeting all who will be making their way to Antalya and for those who are unable to get to Turkey acknowledge how essential your input has been in this process. The input has been astounding and surpasses any effort I have seen in the many years I have been connected with iADH. Alison, Shelagh and Gabriella I am sure would echo my comments.

Clive

News from France

2011-08-10T07:21:00.006+01:00

With great disappointment, I have to announce that Prof Martine Hennequin will not be with us in Antalya as planned, due to a close family bereavement. We are all very sad about that and would like to send our best wishes to Martine and her family at this time.

Martine very kindly has sent us all a resume of the picture of the situation regarding education and special care dentistry in France. She was hoping to tell us in person of course as Martine and Dense Faulks are currently in the early to mid stages of setting up a post-graduate course in Special Care Dentistry, to compliment and develop their excellent new under-graduate programme which commenced last year (which you can refer to on the scipe website) - and hopefully we can follow the progress of their planned SCD education development in iADH Sydney.

Martine tells us that the French oral health system is manned by 40539 dentists and 928 stomatologists. Among the dentists, 93% of which are private practitioners and 7% salaried dentists (mostly hospital based, mainly centered on surgical activities). This corresponds to 66 dentists per 100,000 head of the whole population, but the distribution varies among regions . The vast majority of ‘private’ practitioners work within the national health system, which sets fees for most conservative, periodontal and oral surgery treatment.There are no dental hygienists, therapists or dental health educators, and often the dentist works single-handed, without a dental assistant (employment law protects the employee to such an extent that it is extremely expensive for an employer to take on staff). The dental assistants are not taught by the dental faculties but by professional dental organisation affiliated to the dental council.

Over the last few years, administrative policies have been developped regionally to offer facilities for medical general practitioners to treat patients that would previously have been treated in hospital settings. It offers a means of coordinating the provision of care across a region, and their diversity reflects the diversity of local resources on which they are built.

During the last 4 years, several networks have been set up to improve and coordinate access to dental care for people with disabilities (SBDH in Rhône-Alpes, PACA Handident in South-Est of France, Handident Alsace in North-Est, Handident Nord, réseau Albatros in centre France, réseau Rhapsod’if in Paris). Inside this networks, conferences and programms are built to teach both the dentist and dental assistant participating to the networks.

There is no academic control on this teaching.

Since 2011, 3 postgraduate curriculum are organized. After 3 years they will give the label for 3 specialities: 1) oral surgery, 2) orthodontics; 3) dental medicine. Special care dentistry is supposed to be included in the third one. Dental faculties are free to interprete what should be included in this speciality. Further time will give us the opportunity to see what happen with that......

Curriculum Crossroads - generic, flexible or prescriptive

2011-08-07T10:26:00.022+01:00

Colleagues, we are at a very interesting crossroads at our process it seems.
Many of you are taking part in one or both of our Delphi Surveys, and the great thing about the Delphi is that it is an iterative
process that develops according to the views of the group collectively based on feedback between each round. The views of the group rather than the researchers drive the content of each round. and unlike a consensus conference, this is done anonymously and independently, so that the loudest voice or the most senior member present does not unduly influence the proceedings.
The items that you have been given to rank in the survey are directly based on the qualitative information given by the participants in round 1 of each survey - where over 40 participants suggested a collective total of 600 individual items in both cases. The items were then merged according to their similarity or duplication and low frequency items were then combined into broader categories for round 2.

So effectively, the round one items, suggested by yourselves, dictated the items which were made

available for ranking in round two. This meant that low frequency items were merged into larger headings for ranking and items which were mentioned many times in round 1 were listed for ranking individually in the following rounds. This systematically reduced the items to a manageable, practical and realistic number, and incedentally this laborious and taxing process was carried out by three independent scipe researchers from three different countries - they know who they are - and we in the education committee are very grateful to them for their hard work.

For example: at undergraduate level - parathyroid disorders (2 mentions) was combined with 'diabetes and other endocrine disorders' (14 mentions)

then at post-graduate level for example music therapy (3 mentions), hypnosis (2) and acupuncture (1) - were merged in order to be ranked under 'alternative adjuncts to facilitate care'

Regarding your comments during the survey process, they have been most helpful, thank you. At undergraduate level , many of you have indicated, that you think that there is limited teaching time and that smaller or less important items thought still valuable should be outlined only at undergrad level and therefore further merged under broader essential topics at this level.

Hence we devised the ranking exercise in round 3 limited to only 20 items where (with a great deal of consistency I might add) participants have combined their smaller important items together under essential broad headings.

Interestingly, at post-graduate level, although there are over 35 broad items to rank, several comments in round 2, in direct contrast to the undergrad, have requested for many items to be separated out for individual ranking. Such suggestions have included separating out the very low frequency original items such as clinical photography, advanced life support - (currently both included in additional skills training) plus acupuncture and hypnosis and music therapy - (currently within alternative adjuncts to facilitate care).

I think this is a indicating that we are at a crossroads and time to ask if we can ever be that prescriptive globally, or does our syllabus guideline at POST-GRADUATE level need to be more generic to allow for diversity within countries or even universities in the same country.....and also for them to comply with local guidelines, regulations, protocols and practices.

For example if we use broad titles such as 'additional skills training ' - then this category can be used to house a variety of topics which are unlikely to reach consensus globally but might be developed as an individual specialist interest area - for example oro-motor therapy and sedation - then this allows for those countries for example where sedation or oro-motor therapy is a recognized essential advanced clinical skill - but also mindful that there are countries where sedation is not allowed to be practiced by a dentist or oro-motor therapy is carried out by speech and language therapists or by a specialist oro-motor therapy team..

So, should we separate out topics furthermore in round three and look at individual consensus on each item and include or reject them accordingly?

Or should we continue to use broad generic topics in our survey round 3. such as 'alternative adjuncts to facilitate treatment' - so as to give people the flexibility to choose their personal and culturally acceptable adjuncts from a suggested list as guidance e.g. music therapy, hypnosis, acupuncture - and perhaps suggest knowledge of each and perhaps proven competence in just one chosen area.....rather than looking for agreement on all three separately.

The forum is waiting for your comments on this topic, and of course the curriculum conference in Antalya will be the perfect forum where we can debate and discuss and decide on these very subjects based on the findings of the Delphi Survey.We will be closing the participant list for the Antalya meeting on the 19th of August, so its the last couple of weeks to register your booking on the ADEE website. We already have 30 confirmed attendees in Antalya - and are delighted that such a knowledgeable and diverse group will be meeting to discuss the finer points and details at of a curriculum at both undergraduate and post-graduate training including how important and essential items might be taught and evaluated, and what level of knowledge or experience or competence is required in each level..If you can't make it to Antalya please outline your own views on the forum, where we are waiting for you ideas and thoughts. Visit the forum
kind regards
Alison D ......for "d"elphi nowadays ;)))

iADH Happy Magazine

2011-08-02T18:46:00.005+01:00

iADH Happy Summer Magazine is now out!!

Follow this link and read about news and features from around the GLOBE including contributions from SCiPE task force members Gabriella Scagnet (IADH President) from Argentina, Timucin Ari (Editor iADHappy Magazine) from Canada and Sharat Pani from Rhiadh, Saudi Arabia.

Well done to all - it's a great looking summer read ;)))

Summer Magazine

Musings from Down-Under (now temporarily Up-Over)

2011-07-21T17:10:00.006+01:00

Hi Everyone

Thanks to Alison and team for your hard work with SCiPE and the opportunity to write something here.

I’m Graeme Ting, a Special Needs dentist, born and educated in New Zealand. At the moment I am on long service leave and live in the Netherlands. I thought I would write this to introduce myself and also give you some ‘factoids’ about Special Care in NZ. So here goes

Just before I left school I went to my family dentist for a checkup. He asked me what I was going to do when I finished school and I had to admit that I didn’t have a clue. Our careers guidance councillor had asked us the same question a few months earlier and I had somewhat facetiously written on the survey form that perhaps I was going to be the owner of a chain of Chinese grocery stores. I told this to my dentist and he laughed, both he and his father (also a dentist) had cared for several generations of my family and he probably knew more of my family history that I did. “Oh well,” he said, “have you thought of dentistry?” I hadn’t. That was it really, we became good friends but he never really raised the subject again. However he had planted a seed or activated a gene, that has eventually bought me to Special Needs Dentistry.

I tried to keep my head down at Dental School but it didn’t work. The lure of pubs, rugby, cafes, theatre and student life was too much. Maybe I was in good company because I remember the Dean attending one of our 8.30 am. Monday lectures. One where surprisingly the whole class was present - a rare event - and telling us we were “the worst class in the history of the School and we’d better pull our socks up or there would be trouble!” He seemed to be looking at me the whole time. I learnt later that our class wasn’t the only one to receive this pep talk but it must have had some sort of effect because my class now boasts a surprisingly high number of Specialists from its ranks.

Graduation day came. Prior to the traditional capping parade of graduands down the main street, we gathered with our families as a class for the final time. The Dental School common room was packed for prize-giving and speeches from the Dean and other special guests. I stood with my family at the back of the room while the familiar names of the top students were read out and they duly went forward to get their awards. No real surprises - after five years together we were a sort of family and knew who stood where in the academic pecking order of the class. Then out of the blue my name was called to share the prize in Hospital Dentistry! You could have knocked me over with a jet of air from a Triplex. My parents were very pleased but a bit miffed that I hadn’t told them this was going to happen, “but I didn’t know - honestly Mum.”

How did this happen? A prize in Hospital Dentistry? Hospital Dentistry scared me, how could I be good at it? I’m sure it caused irritable bowel syndrome in me when I went to the first floor clinic where the Hospital Department was. There were patients with trauma, disabled patients, patients with cognitive problems that screamed even before you said hello, patients with weird syndromes and patients with medical problems that seemed to want to die when they sat in a dental chair. Maybe the Dental School was trying to tell me something?

To get my revenge for this award I made a plan; I would apply for a Dental House Surgeon post and spend a couple of years in hospital practice (learning how not to kill anyone) and then a couple of years in private practice before embarking on specialist training in some as yet unknown but preferably high paying branch of dentistry. Perhaps Orthodontics? No on-call, nice hours and the greatest emergency seemed to be if an arch wire popped off a bracket. Maybe I could buy a half-decent car?

This wasn’t to be.

It is not that all plans of young graduates are doomed, however, the last part of mine (owning the flash car) was. I became a senior house surgeon and then registrar at Auckland Hospital and through the annual meetingof our national Hospital Dental Surgeons Association (the New Zealand Society of Hospital and Community Dentistry - NZSHCD) met other like minded people in the same field. The NZSHCD was founded around 1947. Initially it was a bargaining organisation for better salaries for hospital dentists but it has grown to foster the provision of Special Care or Special Needs Dentistry in both Hospital and Community settings and shares visions for better quality care and further training especially for graduates new to the “hospital” field.

It was amazing. As a new graduate I found our hospital shared common problems with other hospitals throughout the country. We had common clinical patient management problems, common issues with politics and funding and scarce resources to allocate for patient care. Over-riding all these gloomy problems that was a common “togetherness” for a cause - our patients. The senior NZSHCD members showed that our patients always came first no matter what hospital administrators tried to do. The leaders of the NZSHCD were inspirational teachers and it was a delight and a privilege to work with “thinking people” who always challenged you to do better and reminded you that we are here first and foremost for our patients.

I tried to stick to my plan of attaining that flash car. Off to private practice I went. It was challenging, there was a lot to learn and I learnt a lot. Still no car of substance. One day two years later, mercifully, I got a phone call from my ex- boss at the Hospital. Was I interested in doing some post-graduate training? He could offer me a post as a Junior Dental Officer and I could enrol with the University and do distance learning toward a Master of Dental Surgery degree in Hospital Dentistry. “The pay wont be great, you’ll have to work hard because you’ll be a student and also have to ful-fill service commitments; you’ll be lucky if you get a locker at the hospital and you’ll have to share a desk but there will be limited or no on-call.”

“I’ll be right over” I said, little realising my flash car was getting further away. That was in 1996 and I have worked as a special needs dentist at the hospital ever since. No regrets.....

to be continued........the rise of the Australia and New Zealand Academy for Special Needs Dentistry (ANZASND).

Terminology - ICF

2011-07-15T16:43:00.030+01:00

Comments from the FORUM have stimulated me to write more about the topic of ICF. Some years ago this term ICF was as alien to me as Bariatric was yesterday. I half expect than many are unfamiliar with this terminology and as I examine and view many of the comments recognize that what is most essential in an undergraduate curriculum is not necessarily a disease name such as Autism, or Morbidly Obese, or Cleft Palate but an understanding of the dynamic interplay of what makes such an entity impact the life of the person we are treating. I will try and explain what little I have learned about the ICF to make this point. The ICF ( International Classification of Functioning - Disability and Health ) is the next generation from the ICD 10 or International Classification of Disease. Essentially my understanding is that the WHO classification moved from a Disease Model more to a HEALTH model. THis health model looks at any state of Health ( disease ) from an interactivemulti-perspective approach thatcan at the same time be dynamic in its evolution. Lets look at a Schema of how this may look for example in an individual with Down Syndrome

The Schema here looks at the interactions between the components of the ICF - We can see how the multiple interactions interplay - an individuals functioning in a specific domain is a co

mplex set of interactions between the health condition and the contextual factors -ie environment and personal factors. The contextual factors interact with an individuals health condition and can determine the extent and level of that individuals functioning -and also would impact on treatment considerations for a particular individual.Taking into consideration - these contextual factors the

decision as to how to best serve the best interest of this particular person may be very different to another patient with exactly the same condition of Down Syndrome.

So in this example above improving this individual persons ability to chew may have a far reaching impact on his life more than just the function of chewing. ORAL HEALTH THEN is not just about the mouth - teeth and gums - but the totality of an individuals ability to eat, speak, smile, breathe and swallow. I believe personal factors are not currently included in ICF

as an individual item - and are categorized instead as part of the environmental factors - these would include things like coping style-race - gender -lifestyle -personal motivation.

I can see how applying the same principle to morbidly obese person would impact all of the domains in the schema above perhaps in even more of a profound way. It can be easily seen how the interplay of all these domains would surely result in such an individual requiring the care of someone who has the particular specialty in Special Needs - and how important it is for the undergraduate to recognize this interplay and be able to arrange access to care.

The forum would be a great place to further discuss this issue, especially around Sophia's comment on the BLOG about advocating for the care of individuals.

Please follow this link to continue any discussion or pose any questions you may have about ICF and other concepts. It's influence in SCD on global curriculum design has yet to be truly explored.

Clive

Terminology matters - the new discussion forum

2011-07-14T12:50:00.018+01:00

We have over 2/3 of our undergraduate round 2 responses returned and the survey is proceeding well. The team would like to thank all of you who have taken part so far, and also to those of you who have been so honest and helpful with the comments that have been given en route. Some issues that have been raised are regarding terminology, and before we proceed to round 3 it seems to be important that we define and discuss some of the terminology, so that we are sure as a group of the intended meaning of each term or phrase and therefore can better interpret the item or phrase when being asked to rank it.

We have decided to do this as a discussion forum and if you follow the link at the top of the sidebar in this BLOG you will be taken to the Delphi Discussion Forum where we would be grateful if you would contribute regarding your interpretation of some of the terms in question. Also, this is the forum to highlight any problems that you have experienced yourself with chosen terminology thus far or perhaps highlight terms that you perceive difficulties with the meaning of some of the terms that other individuals in your own member country might experience.

The terms so far highlighted with a 'T' in the survey include:

Please take the time to contribute to the forum if you have a query or a view or can offer your understanding of the terms as they stand. All of the discussion based around choice of terminology will be further explored in Antalya, and decisions made regarding terminology will also be mindful of the information which is gleaned from the forums

kind regards

Alison

Starting afresh - a clean sheet design...........

2011-07-08T16:55:00.026+01:00

This week I have been doing some soul searching, regarding my thoughts about a brand new

curriculum in special care dentistry at undergraduate level. This Delphi exercise has asked me is to look at my beliefs about the knowledge, skills and attitudes I believed were REALLY required to equip a young newly dentist with the ability to serve his local community, including those with
impairments and disabilities living within that community.

This is the question that iADH and scipe have asked of me and indeed all of us in this task-force. Now that the survey is out - I have the time and space to think about my own responses, and the importance of what is being asked of me, before I give that response.

I first thought about the challenges that would be asked of this young dentist when he got into the wide world, and how he could be better prepared to deal with diversity within his patient base.

I asked myself - about what he already knew from his under-graduate teaching to date - I am going to call him a 'he' here so as not to use so many his/her but his gender is unimportant to me.

I listed so many items, but then realized that he already knew many of these - in theory already - that he hadbeen taught them in his surgery and oral medicine and and cariology and periodontology and ethics courses just to name a few, and I asked myself if really believed that limited and precious 'special care' curriculum time should be spent re-teaching these items in the name of special care. Surely better applying this prior knowledge to the context of real patients, with functional and cognitive impairments, and ensuring any face to face time was spent on areas that had currently no coverage in the curriculum as a priority.

Yes my hypothetical student was going to need to remember his cardiac and hematological stuff, yes he need to be mindful of preventing and recognizing hypoglycaemia in an elderly man who had hemiplegia due to a stroke and co-incidentally had diabetes. But, far more than that - he had to know how ensure that that gentleman had all the kit and aids to assist him in maintaining his oral hygiene, and indeed how to match him up with the right technique when his hand could no longer grasp the handle of a brush. You can't do this in a classroom. He need to apply his pre-existing knowledge to the functional limitations of the patient, not have diabetes taught again didactically in the name of "Special Care". What's more how can he learn to apply this knowledge to the context of a patient , if there is no patient in front of him, except maybe a simulator - except a simulator doesn't arrive by ambulance transport so far as I know.;)))

I thought long and hard, in no other subject - would a student be taught the theory but not the practice of something simple that would likely be required of him in his practice thereafter - no one teaches extractions without letting the student put the forceps on a tooth - just reading it in a book instead...so why would they be expected to know and learn how to how to transfer a patient from a wheelchair to a dental chair safely and effectively from a book either?

So I threw away all of my pre-conceptions, as Clive asked me to.

Special care......at undergraduate level?....I needed to think......what I realise is all I have been doing in my list thus far - was trying to advocate everything that had gone before and was actually already covered in an existing curriculum......( i flicked through the profile and competencies of the european graduating student 2010 to check)

My title is Consultant for Medically Compromised Patients, so my learning and area of expertise is principally in this area, with a good helping of psychology training and sedation skills - my patient base includes almost no-one without a complex medical problem - and i teach these subjects in depth at post-graduate level. My list so far includes my own bias, my bias is governed by what I am interested in, and I find that I am passionate that people with medical conditions are no longer denied care because undergraduate on qualification is scared of dealing with a patient on warfarin for even routine care, or same for patients who are who carrying a transmissible virus. This was about attitudes and confidence, not knowledge.

So really what I realized I was talking about in my own list - was not about more info required for students about cardiac problems and immune compromised oral manifestations but was all about practical application of knowledge - and my own interest in promoting care for patients with medical conditions was better dealt within a topic like BARRIERS TO CARE........

So, I started again, and threw away everything as Clive told me to in his last BLOG.....and I realized that the only thing we can work on here is students attitudes and confidence in treating patients such as these, and that really the knowledge base in most areas was there already, and does not need re-teaching - it needs applying to the context of a real live patient.

In fact I realized that I already knew that the best place for students to bring together all of their medicine and surgery and periodontology and cardiology was in a clinic such as a special care clinic where students were no longer protected or guarded from patients with additional challenges, but learned how to organize and understand an INR, that they learned now to adapt a toothbrush for someone who had a motor disorder, and that they learned to chat and interact with someone with an intellectual disability who happened to have a cardiac defect. Or that they visited specialist clinics if they existed so they could see positive role models of people treating disabled people in the community.

So, now its time for me to think and soul search and make some decisions about my own list - now that its time for ranking. My own list of essential elements is getting shorter and shorter.The need for clinical hands on care is getting stronger and stronger and stands in place of many former items on my list of 'essentials'. For me learning about the intricacies of the parathyroid and the rare syndromes requiring specialist care seems not so important at this level and I ask myself will this really be relevant for the General Dentist in his own practice......if he has an interest to pursue then this will be a specialist area for him to study.

So number one for me - for an undergraduate training in special care - is to channel the limited time we have within a curriculum into trying to encourage more competent, non-discriminatory general practitioners to confidently and willingly care for people with common conditions or disabilities living in their communities, by working on attitudes and clinical confidence. So I am finally clear headed enough to think about my own task ahead short and long term. I dearly hope that the curriculum that IADH produces will encourage an approach that embraces my own philosophy for special care, in fact can find a framework to embrace all of our own different perspectives, ideas and local requirements as we teach and nurture our students.

I don't in any way profess to have the answers here so essentially, number two interest for me - will be trying to find out in time - via research networks, which i hope will start to form in Antalya - ways to evaluate and assess teaching methodology - so we can see what works most effectively and efficiently. I need to think less about what I am ready and able and willing to teach and more about what students really need or want to know, and in the way that evidence shows me is an effective way of teaching this subject, in which there is currently little decent and reliable literature to back us up or inform us

yours still pondering

Alison

Speed Bumps cont.

2011-06-21T01:31:00.007+01:00

For those of you who have daughters – by now you will note that mine do not fail to continue being my teacher. If its not about learning to let go with their spending habits it is perhaps more about watching them with their enthusiasm for life and enjoying what the world offers them –“speed bumps be damned”. Traveling across country for a weekend for a music festival or working in a remote safari camp for pennies the barriers that our culture puts on them continuously are merely circumvented and with luck their souls desires are being acted on. Which begs the question? What is the collective soul desire for development of a curriculum in special needs. ? I speak here about the archetypal – desire. How far are we willing to go to circumvent any “ speed bumps- barriers “ put in the way? Each person will move through this journey at his or her own rate and time but together it seems as if things are truly starting to come together. The mere fact that so many people are coming together and have indicated an interest in this journey speaks to the archetypal – collective need for this process.

In speaking with my good friend Steve Perlman (Global Director of Special Smiles for the Special Olympics) he tells me that the AADMD (Academy for developmental Medicine and Dentistry) is currently working on a curriculum for Developmental Medicine for Adults. Like in dentistry pediatrics has done a good job of creating a solid curriculum for the pediatric population for persons with special needs however; it completely falls apart in late adolescence and adulthood. Perhaps to the ire of my pediatric colleagues I wonder if the collective desire is for the development of a curriculum for Adults –(undergrad and post grad) and the focus of the work in Antalya should in fact be the adult population and assume that the pediatric population are well cared for and the desired educational components already ensconced within current curricula. (At least this may be the case in some countries and a byproduct of the Antalya program would be to disseminate a core undergrad pediatric curriculum that have already been well developed in so many countries)

BUT- having just attended the IAPD in Greece and been involved with two excellent programs on special needs at this congress I no longer think that pediatrics is doing that great a job. Yes they are excellent in identifying syndromes and all sorts of problems related to specific medical or developmental challenges but it seems to me that what is totally lacking is any “out the box” thinking where alternative and progressive therapeutic interventions could be introduced.

I challenge and invite all involved in the Scipe initiative- or anyone who reads this blog. Put everything you have learned into a box somewhere in your brain -knowing that it is safe and can always be retrieved. Then begin imagining a different way of doing, being, teaching that lets go of old belief systems so that any curricula that we create – or comes out of Antalya will not have the look of what has been – but will overturn the traditional and stuck current academic world. As you even read this- is your brain fighting and telling you how this cannot be done? How it won’t work or that I am really crazy. That's normal – take this response and put it in a box as well – it can always be easily reactivated.

When Alison sends out to you the request to for your suggestions for a core curriculum – start from the place where you discard current belief systems - what have we got to lose.

Clive

Big steps in Turkey...

2011-06-14T07:00:00.002+01:00

Hi, from Istanbul! We have busy days lately, as the congress season has opened. One of those was, at last week which was held by Association of Turkish Dental Society. All specialist and general practitioners around Turkey gathers together at these annual meetings, shares common problems, discusses research results. ‘Disability’ as a topic still invisible in this meeting but dental materials and implants surgeries are everywhere.
Unfortunately, there’s lack of knowledge about obtaining proper oral health for disabled children in Turkey among dentists. Disability still carries connotations of physical and visible impairments and there are misunderstandings and prejudices around mental illness. In my department, dept of pediatric dentistry of Marmara University Dental School, we have been working on investigating their ‘needs’ and on achieving plus maintaining good oral health since 2000’s with collaboration with private rehabilitation centers and civil organisations. As being the clinical director of Special Smiles ,Turkey Branch of Special Olympics International Organisation, we’ve tried to attend all the sports tournaments of SO, evaluated their oral hygiene status and provided basic oral cleaning kits for their needs since 2003.
Our team gave an excellent introductory presentation in the congress about oral health status of special athletes, highlighting some facts about their oral health attitudes of 924 mentally disabled athletes of year 2010’s tournaments. As we look in the results, most common findings among the Turkish athletes were periodontal problems and posterior carious lesions. But preventive measures and proper filling were poor. However anterior trauma rate is detected low, using mouthguards were still recommended to those risky children during dental screening.
We’re aiming to promote the life quality of disabled children, by this means we’ll keep on working keenly on this subject at both national and international level. Bye for now.

Ilknur Tanboga

World Report on Disability

2011-06-11T10:57:00.008+01:00

Many of you will have no doubt already seen the long awaited Global Report on

Disability from the World Health Organisation (WHO) and the The World Bank which was published this week.

There were of course few surprises for those of us working in this field, however it showed that the proportion of disabled people is rising and now represents 1 billion people - 15% of the global population (grown from an estimated 10% in the 1970's) with 2-4% experiencing serious difficulties in functioning.

Discrimination in healthcare was highlighted as one of the most 'shocking and powerful' issues to come out of the report and Dr Margaret Chan, director general of the WHO said that 'we must do more to break the barriers which segregate people with disabilities'. Despite a robust disability rights movement - this first official global report shows that disabled people are three times more likely to be denied healthcare than other people, with people with intellectual disability being the group most likely to find difficulties in accessing services.

The report provides the best available evidence about what works to overcome barriers to health care, rehabilitation, education, employment, and support services, and to create the environments which will enable people with disabilities to flourish. The report ends with a concrete set of recommended actions for governments and their partners.They importantly recommend better measures to address human resource development within the healthcaresystem and recommend training in issues relating to disability for all undergraduates and continuing education for healthcare providers.

It suggests targeted services and specialist support where required to back up primary health care providers who are trained in order to provide affordable healthcare locally. The release of this document could not be more timely for

our project, and I hope will give strength to those people wanting to develop curriculum to address these very issues. I don't think that in view of this first official global report,it remains viable for dentists to graduate in 2011 onwards without the knowledge and the confidence to treat disabled people who are, according to this report, officially the world's largest minority group......

The WHO report, stresses the importance of research, but also stresses the need to use standardized tools cross borders - for example to use ICF classification of disability in order to allow comparison and use validated and recognized measures with cross border initiatives to increase study group numbers. As an aside, a small sub-group of scipe members will soon be starting on a collaborative project with the EDSA - the european dental students association, to look at developing and piloting a questionnaire looking at the attitudes, training and experience of SCD, which could be further developed into a generic tool to be used within our group in the future. I think that once we have completed the curriculum task in hand and may want to look at other issues such as outcomes - a collaborative research network in SCD education, maybe a very useful role for our scipe group in the future.......

I have added a link to the document for those interested in reading it in full

World Report on Disability in various languages

alison

Around and about - part 1

2011-05-22T11:48:00.018+01:00

Queen Elizabeth enjoying the craic in Cork market

Barack Obama exploring his Irish Roots

I am lazing around today, after a busy couple of weeks and enjoying a sunny peaceful Dublin morning. All last week there was mayhem in town with a visit from the Queen Elizabeth II a Europa League final between rival portuguese teams and tomorrow Barrack Obama arrives for his tour!!!!

I have been on my own mini-tour too, first I visited Liverpool, for a meeting of the dental sedation teachers group, which has representation from every UK and Irish university, and meets twice a year to discuss curricula and teaching in dentist administered conscious sedation for dentistry.
Only two universities in the UK currently produce under-graduates who are competent in intra-venous (midazolam) and inhalation sedation, and in both cases this is taught principally within the special care dentistry department. Most other undergraduate courses include theoretical knowledge and some practical experience, as this is still seen to be a post graduate subject, but is a very popular diploma course within the UK and Ireland.

Home of the fab four

Here in Dublin our undergraduates have a good knowledge base and some limited experience of sedation on graduation - we offer an 18 month part time (once a month) course in conscious sedation for dentists, and our new post-graduate Special Care Diploma which starts this september will also aim to produce graduates competent in providing sedation for more complex special care patients.

Liverpool from the Mersey

But there is something new in the UK - a post-graduate training course for hygienists and therapists in inhalation sedation (nitrous oxide). I am involved in finalizing the new curriculum, and although contentious initially with split opinions as to the suitability of sedation being provided by 'NON-DENTISTS', the first cohort of dental therapists have passed though the pilot training and completed a mentored log book of competency, and are now working independently with nitrous oxide as they provide care. following a treatment plan provided and overseen by a dentist. In the UK hygienists and therapists provide much of the restorative and preventive care for children and adults with disabilities, so this will no doubt aid their provision of care as they add another skill to their toolbox of tricks. Formerly, hygienists and therapists were allowed to provide care whist patients were sedated, but could not provide the sedation itself, which is somewhat difficult in the case of inhalation sedation, so this makes great sense, it is a procedure that consensus has decided is well within their capabilities.

I had time to look around (with some degree of envy I have to admit) the newly refurbished special care department in Liverpool University, led by SCiPE member Lesley Longman and IADH member Avril MacPherson who are both Consultants in SCD.
Their ground floor department is set up with a wheelchair tilter from DESIGN SPECIFIC http://www.designspecific.co.uk/datasheets_pdfs/CP.pdf
Ceiling mounted hoists in every surgery, a two way mirror and viewing gallery
Sedation suite and recovery room
and best of all separate and direct access from the disabled parking bays at the back of the hospital.

I certainly took copious notes, as we too are developing a special care space for teaching in Dublin - for when our new diploma students arrive in September

mucosal atomising device (MAD) for administering midazolam intranasally

I was told by Lesley that undergraduate students at Liverpool spend a week in the unit as part of their training, and that Liverpool run post graduate training in special care sedation, with a post-graduate course in special care dentistry in planning stages. For those interested in intra-nasal midazolam sedation as an adjunct to facilitating care for people who don't allow a cannula without a struggle, then do speak to Lesley in Antalya as she has lots of experience of both practicing and teaching this method of sedation in her university in Liverpool.
I know that in some countries sedation is not taught as a subject within special care, or practices without special license in others. Yet it is an important part of the teaching of special care in many countries too and this is just one example of where local legislation will govern what needs to be taught within a SCD curriculum. I am certain that this will be the subject of much SCiPE debate before a consensus is reached as to how these anomalies and variations can be addressed within a global syllabus.

part two of tour tomorrow......
alison

Caregiver education - oral and dental care for people with disabilities

2011-05-14T16:15:00.004+01:00

Hi from Michigan, USA. In our Hospital Dentistry clinic here at the university, we treat a significant number of adults with special needs, many of who come from facialities where caregivers play a key role in providing daily oral hygiene. Very often, the person who brings the patient to us is not the caregiver who provides oral hygiene, and this makes oral hygiene education less likely to be successful. I have often been frustrated in our poor ability to educate caregivers and have sought possible solutions.
I attended a lecture from Dr. Robert Rada at the recent SCDA Annual Meeting, and he pointed out a YouTube video created by a caregiver at a group home to educate other caregivers who provide oral care. The video is found at http://www.youtube.com/watch?v=bqo2IKScr0Q and the presenter, Anne Kessler, does a wonderful job in providing a very realistic take on oral hygiene. We will now share this video address with caregivers who come with patients and will ask them to share this with other staff at their home who were not able to come to the appointment. I made a website which directs folks not only to this video, but to other resources about oral hygiene on the internet.
Congratulations to Anne Kessler and others involved with the making of that video. She is not a dentist, but her insight and perspective is extremely valuable and one that should be shared with students as we seek to educate them in how to be an effective oral health provider.

The time is right.....global curriculum for special care dentistry

2011-05-05T12:13:00.003+01:00

Dear Colleagues

Well, it seems that word is getting out fast about the proposal to create a global curriculum in Special Care Dentistry. It appears that the time is right........and the sentiment is of interest to many........for so many reasons. Publishers want a core text book, journals want to publish documents, and it seems that many many individuals worldwide are needing guidance in revising their current courses and enhancing their own programmes according to international as well as local influence. Many within our number are wanting to share curriculum ideas and wanting inspiration about new ways to teach their material.......others are interested in finding ways to evaluate their own teaching methodology and form networks to find some evidence for what works and why?..........

This has filled me with optimism, but also, if I am honest, a little trepidation, as it is so important to make sure that we get the best out of our first meeting as a group in Antalya, when there are so many issues to consider and so many avenues to explore.
This weekend the education committee of the IADH will be finalising the timetable for the workshop and we will very soon be sending out a document with the aims, objectives of the meeting and the programme for your perusal.

home in the cotswolds, royal wedding style

So this is a short blog.......it's been a short week......post easter egg hunting followed by monday mayday madness just after the royal wedding mania mayhem means its nearly the weekend again already, and I am off to Cardiff to meet with Shelagh Thompson for a SCiPE planner session, and then to the north of England to meet with teachers of special care and sedation from all of the universities of the UK which is being organised by our SCiPE member Lesley Longman from the University of Liverpool, whom I know you will enjoy meeting in Turkey in September.

Catch up again soon

Alison

DEVELOPING INTERNATIONAL NETWORKS FOR THE ORAL HEALTH OF PEOPLE WITH DISABILITIES

2011-04-22T23:51:00.008+01:00

Gustavo Molina

I sincerely thank Alison, Shelagh, Clive and Gabriela for inviting me to write some thoughts in this blog that I consider a great opportunity to exchange concerns and experiences regarding the field of disability and oral health.

My name is Gustavo Molina. I was born in Córdoba, Argentina, in 1969 when we stamped our feet on the Moon (for the first time?)…, when Kennedy was shot…, when The Beatles were still together…

Since I was in the third year of the Dental Faculty, I was related to some out-reach programmes in special schools, promoting oral health and preventive dentistry as a student. Despite of not having any relatives with a disability, I felt a kind of magnetic attraction to the challenge of developing resources for this particular group of people. There was so much to do, starting from epidemiological research (oral health status and treatment needs), opening our minds to interdisciplinary health team-work, finding ways to approach the patients and solving their oral health problems the best we could.

Someone whispered the name of Castillo Morales when I was visiting one of those schools but I did not pay much attention then. I happened to be traveling abroad when that name appeared again as a landmark in my route and I realized that Rodolfo Castillo Morales was working two blocks away from where I lived!!

I went to visit him as soon as I came back from that trip and he kindly invited me to join him in his appointments. He said he needed a Dentist to collaborate with the Orofacial Regulation Therapy and the use of palatal plates he had been developing in Germany. I did not know what he was talking about. Imagine, I was trying to figure out how to approach caries lesions in patients with spasticity without the need of general anesthesia and that man was concerned in speech, swallowing, chewing, breathing…!!!

It took me some time until I discovered the importance of what Castillo was saying. Actually, I started to measure the dimension of his ideas when, after attending my first IADH congress in Trier (Germany, 1994), I spent three months at Dr. Bo Hedas´ unit in Hedemora (my Swedish family). By that time, Oral Motor Therapy was the “star” in the whole Scandinavia (and Rodolfo Castillo Morales together with Dr. Juan Brondo were the main interpreters).

That indeed was my first connection with the IADH. Since then, I was present in Edinburgh (1996), Yokohama (1998) and Madrid (2000). During the year of 1998, right after IADH Yokohama, I had the pleasure of spending other three months at the TAKO-senteret in Oslo, Norway, hosted by my queen Dr. Kari Storhaug. There I met new friends, PhD students from different corners of the world (Brazil, Belgium, Lithuania, Bangladesh, Saudi Arabia and others), gathering everyday for our lunch break at the Lithuanian canteen. It was amazing to put the “globalization” into practical situations, discussing oral health problems from each cultural perspective. The outcome of those many mealtimes was a wonderful field experience that was carried out in May, 2000, in northern Argentinean aborigine communities, presented as a free paper in IADH Madrid. The name of the project was “DINOH: Developing International Networks for Oral Health”.

By the end of year 2001 Argentina suffered the worst economic crisis and I had to miss Athens (2002) and Calgary (2004). The frustration of loosing contact with colleagues and friends who were pursuing the same aims of improving the quality of life of people with disability was somehow mitigated by the possibility of updating our history by means of e-mails and other internet resources. Then I thought that distances might be shortened if we were able to exchange knowledge, concerns and clinical experiences using all the facilities emerging from the field of communication aids. DINOH project needed a twist in order to adapt to this new context: Gathering people from all over the world costs a lot of money and only a few can afford that.

Fortunately and again thanks to Castillo Morales, I had the opportunity to participate in Göteborg (2006) where I introduced DINOH project aiming to facilitate participation of people from developed and developing regions by means of different web-based resources such as e-courses, forums, library and others. Finally, IADH funded DINOH´s launch and so far, almost five years have already passed with the project slowly reaching its aims.You are welcome to visit www.dinoh.org and go deeper into the project on the site.

There are many reasons that might explain people´s reaction to the call for participation. I must say that, as it happens in any association, there are proactive and reactive members. Such a project was meant for connecting professionals who share the same interest or who care for the oral health of people with disabilities. “Participation” is the keyword and I hope that our meeting in Antalya will be the best expression of that word.

DINOH will be a faithful servant

Gustavo Molina

Greetings from Rainy London - Scipe Member Najla Nizarali

2011-04-18T21:39:00.001+01:00

Hello!
My name is Najla and I work full time in the department of Sedation and Special Care Dentistry at Guys Hospital, London. I am very excited about this group and look forward to meeting various members from around the world.

It’s been really interesting reading all your stories, and so I would like to share mine too on how I got here in my career.

Abseiling down Guys Tower - my workplace!!!

I began my dental career in Canterbury Community Dental Services in 2000 as a Dental special care house officer alongside my mentor Dr Graham Manley – the man who introduced intranasal sedation to dentistry in the UK and therefore has helped make treatment acceptable for so many more ‘special care’ patients. There was never a dull day and I felt truly passionate about my work. At the time I didn’t realise how rare that was, and still is!

Following this, I felt the need to explore and expand my dental career. I wanted to experience practicing dentistry in various different settings both within the UK and internationally so that is exactly what I did.

I spent a few years in General Dental Practice where I continued to treat children and medically compromised patients, often with the use of conscious sedation techniques.

In 2003 I spent some time working for the Aboroginal Medical Services in Sydney, Austrailia. Once again I felt that passion for my work that i did back in Canterbury. I met and treated so many interesting people.

teaching at the AghaKhan University in Pakistan

I continued in General Dental Practice upon my return to London and every few months tried to embark on a new adventure. This took me to teaching and developing dental clinics in Khorog, Tajikistan and gaining further experience in Mwanza, Tanzania. I could write a whole book on my adventures in these places! Meeting and interacting with people from different cultures and social backgrounds helped me grow in a way I never thought possible. It reminded me that every person has a lot to give and a lot to learn. That many people are not given the same opportunities in life or health just because they are born into a less privileged society. Therefore by sharing knowledge and experiences, everyone benefits and hopefully this gap can eventually be bridged.

So all this led me back to Special Care Dentistry where I first found passion in what I did.

I started working at Guys Hospital, London in 2007. My full time job here has involved treating ‘special care patients’ such as individuals with disabilities, medically compromised patients, patients with dental phobia etc, undergraduate and postgraduate teaching in both sedation and special care dentistry, and research in the field.

With wonderful support and further studying and experience, I was mediated on to the new specialist list in Special Care Dentistry in 2010.

I am lucky to be able to say that I now feel that passion that I once took for granted on a daily basis. However my love for travel and international education and development has not subsided.

I was invited to lecture on ‘relative analgesia for dentistry’ at the AgaKhan University in Karachi, Pakistan in 2008 and following this, have been invited to teach in Nairobi. I am also currently working with the ‘Global Child Dental Fund’ charity to set up teaching modules in Special Care Dentistry which will be initially tailored for use in Kenya.

I am very excited about my involvement with SCiPE and interacting with members from around the world. I am keen to support development in Special Care Dentistry wherever possible and am looking forward to sharing views and stories.

Unfortunately I will not be able to attend the meeting in September as I am expecting my first baby in August! But i do hope to meet you all very soon at a later date.

Thanks for taking the time to read my blog.

Najla

‘Above all, be true to yourself, and if you cannot put your heart in it, take yourself out of it.’ Hardy D Jackson

SCiPE Workshop booking gone live on ADEE website

2011-04-10T20:42:00.008+01:00

Dear Colleagues

Finally the ADEE site is now able to take our bookings on their site and I attach the link to go the bookings page

ADEE link to online booking

The SCIPE workshop runs immediately before the ADEE congress and will start at 5pm on Monday September 5th and finish on Wednesday September 7th at 5pm

Proposed timetable as follows

Monday evening - welcome and invited speakers presentations and group dinner

Tuesday - group workshops with feedback and member presentations

Wednesday - group workshops and feedback, formulation of ongoing action plans for task force

The SCIPE workshop will be held at the GLORIA resort which is a 5 star hotel on the Turkish Riviera.
http://www.gloria.com.tr/Gloria-Hotels-And-Resorts/Hotels.aspx?otelId=3

It is possible to book this hotel on the ADEE website and they have negotiated a very competitive rate all inclusive - which includes all food and drinks (including alcohol) and snacks and water sports, so although it is pricey on first glance, it makes good financial sense as it includes absolutely everything - especially good value when sharing a twin or double room. Please let me know if you are looking for a room conference 'buddy' to share room costs with and i can help hook you up....

On the ADEE website you will need to book 2 nights accommodation on Monday 5th and Tuesday 6th September, or arrive earlier or stay later if you prefer to take a break and take advantage of this wonderful location.

The cost of the SCiPE workshop is 60 euros per person

For those staying at the GLORIA RESORT lunch and dinner is included in this price

For those staying at other hotels then there will be an additional charge for catering

For those people wishing to stay offsite please note that the resort is BELEK (30km from antalya) and there are many options and other hotels on www.tripadvisor.com

After the scipe workshop the ADEE conference runs from the 7th till the 10th of September in the same resort, all details on the ADEE site. This year is themed about Research and its impact on Education, and I would encourage you to attend and maybe consider submitting a paper or poster too.

Shelagh and I ( and any other interested parties) will will continue to work on the proceedings after the SCiPE workshop finishes and present the results of our task-force meeting to the General Assembly to raise awareness amongst the dental deans and attendees. We will also officially create a Special Interest Group in Special Care Dentistry Education within ADEE that will meet at yearly ADEE conferences to further develop this area and we hope that this group will grow in both number and strength and be very productive as the years progress.

Well, please get booking....looking forward to meeting so many of you in Antalya

Alison

Special Care Dentistry Conference Chicago - Clive Freidman

2011-04-04T23:55:00.006+01:00

Reflections from recent SCD meeting held in Chicago

Well just spent a delightful few days with old friends, new faces and struggled with the famed Chicago winds - Partook in a 3hr gastronomic experience with our president Gabriella and tried to co-opt fresh new faces into joining the Scipe team. Individuals who I talked to were all very interested in the process and are looking forward to seeing the end results. I even attended a number of excellent scientific sessions. For those interested in the scientific program I would urge you to go to the SCD website and have a look at the presentations.

Some of the major issues it seems being faced in the US are not dissimilar to what are being seen globally. Of note is a strong push to recognize people with disabilities – particularly those with developmental disability as being part of what is known as a medically underserved community. If they can be so designated then it open up a huge funding resource for faculty and practitioners who are working with persons with disability. Although special needs is not a specialty in the US there are many GPR residency programs that are now primarily training residents in one year programs to work with persons- adults with disability. For at least some of these hospitals the graduates seem to be following up and treating people in the community. Has this improved over all access to care – one does not yet know?

With respect to advocacy it seems as if the push to equate oral health with general health is not being heard as well as they would have liked. A suggestion made is perhaps a need to start personalizing stories and bringing these stories to people in power. Like everywhere it seems as if the personal individual stories presented by the people rather than the professional seems to be what motivates change at a political level. Which brings to mind a quote –thousands of years ago by Confucius that is still so relevant today.

"To put the world in order, we must first put the nation in order; to

Put the nation in order, we must put the family in order; to put the

Family in order, we must cultivate our personal life; and to cultivate

Our personal life, we must first set our hearts right."

--Confucius (551 - 479 B.C.E.)

How do we reach the hearts of all? –By doing what we do every day - recognizing that the personal truly is the political.

Education continues to be a big issue and creation of web style learning programs and e learning an ongoing process for many. It will be wonderful if we can eventually see all interested parties share and collate this information for easy access by all. If anyone can help do this it is Alison. - Who by the way is taking a well deserved vacation and will be back soon

Clive

SCIPE SURVEY

2011-03-15T20:37:00.000Z

Dear Colleagues
Here is a presentation, detailing some results of the recent scipe task force survey. This presentation outlines some initial fact finding following which we will use a delphi technique to get consensus opinion on the core content of a global curriculum in special care dentistry from our task force which includes exerts in special care dentistry from all over the world.
I hope you find the content interesting
Alison

' INTERNAL' speed bumps

2011-03-14T01:13:00.008Z

In this weeks BLOG - Clive Friedman continues in his exploration of the speed bumps........

Now that you have had a chance to think about the external speed bumps, boulders that one needs to maneuver over, around or through - lets take a brief moment to contemplate those INNER bumps that so often impinge on our ability to move forward or to embrace change

We don't often acknowledge the inner demons that hold us in our own prisons. What am i talking about here. Those internal processes that are created by our lives, our belief systems and our birth stories. Some of us may be so controlling that we are unable to delegate or let others expand into their creative sides, some of us ( I tend to find myself in this place) may be peace makers and cannot tolerate conflict. Some of us want to be loved by everyone and so are unwilling to make a statement or choose a particular side in order not to displease either side. Some of us may be so bull headed as to just barrel on and ignore thoughts or ideas by others. It may even look like having ideas that are so grandiose that implementing them becomes impossible and then we blame the system for its inadequacy.

with the correct vehicle - most bumps are surmountable

I am sure that many such examples exist. Each of these coping mechanisms work very well for us during our formative years however, at some point holding onto them no longer serves either ourselves or our patients. NONE of us are immune -- see if you can recognize your own??
Then of course we can be stuck in our own belief systems - again created by the external speed bumps and the vagaries of the local cultural norms. However, it can be useful to truly look at these and examine them. A personal example may be useful here.
Many years ago, I had the belief that one of the only ways that I could treat many types of behaviour presentations was by the use of restraint. the system I was taught in presented this not only as a useful tool, but reinforced its use by literature and economic explanation blah blah blah.

I of course knowing that I wanted to be the best dentist out there, took up the cause and proved to myself that this belief was in fact the only way to treat and handle certain types of management 'problems'. It is interesting to me to see how reluctant I was to change and how I held onto this belief system and in fact found allies to support me .....

beware of amygdala high-jacking

Alison is going to be sending out results of the survey and following up with more questions. As you contemplate these questions I invite you to think about your responses and question how open you are to change, how your own internal speed bumps impact on your decisions and how this Delphi process can help all of us move into infinite possibilities.

Clive

Flying at 1000......

2011-03-11T17:25:00.001Z

Well, we are delighted to see that yesterday, after just 6 weeks, we passed the 1000 mark on the counter which has been recording hits on our blog.

Even more encouraging than this we know from the stats that we have readers from all four corners of the globe. So we thought that readers of this blog would be interested to know where our global colleagues are logging on from.
This week for example our top hitters were from

CANADA
UNITED STATES
INDIA
ARGENTINA
UK
IRELAND
SPAIN
DENMARK
HONG KONG
ROMANIA
PAKISTAN
BELGIUM
MAURITIUS
INDONESIA
NETHERLANDS
SAUDI ARABIA

We are looking to recruit interested members from under-represented countries to our scipe group in order to look at the possibilities of developing resources for the teaching of special care dentistry online. We are particularly interested for example in hearing from our readers in Pakistan, Indonesia, Honduras, Jordan and Dominica to name but a few. So please, if anyone is currently involved or interested in teaching of special care dentistry in their own country and would like to receive more information about our special interest group then please do get in touch as we would love to hear from you. There is a link on the left column on this page with more information about the work of the IADH and the SCiPE Education Initiative.

Please feel welcome to post your own thoughts or ideas on this blog. Hopefully by working and thinking and challenging our own ideas, together we can surely strive to improve the oral health of patients with disabilities worldwide by educating and training our workforce.....

Have a great weekend

Alison

Action Ground Zero

2011-03-10T07:47:00.004Z

I have been thinking a lot about the benefits of a global curiculum - and our survey has shown that we invidually vary alot on our individual skill mix and special interests, and also in the way in which special care dentistry is provided or available in our member countries - but we are a pretty cohesive group where it comes to thinking about which patients may fall under the umbrella of special care dentistry, so devising a global curriculum that will be of use to many different cultures and situations - does not appear to be impractical or a purely paper exercise for a group such as ours.

We have a great response to Clive's Speed Bumps and today we have posted a BLOG from Srivats Bharadwaj - who lives in India. To be honest his words are the same as most of us could quote from anywhere in the world. We can write curriculum, we can run courses - but we are always limited by the fact that funding for treatment programmes for our target group of patients - and hence dentists being able to make a living or possibly build a career, treating patients with special needs is our biggest speed bump and the principle barrier for people choosing to be trained in this subject ongoing.

National Oral Health Strategies and government policies targeting the oral health of people with disabilities in most countries are sorely lacking. It remains that most in need continue to have the poorest of service provision, which remains ad hoc and the domain of the 'good hearted individual'. I have always maintained that a 'speciality in special care dentistry' is desirable of course - but in reality speciality or no speciality - its the effective and efficient organisation of special care services and the government per capita spend allocated to maintaining the oral health of vulnerable adults that remains the principle factor in improving the oral health of people with disabilities. As we try to establish or expand courses and teaching in special care dentistry in order to train our workforce, it will be clear what action needs to be taken at a National Level as well as a local university level to take this initiative forward and I am sure that the two go hand in hand.....

Lets hear what Srivats has to say.....

Please do add you comments or sent them to me to post on your behalf - we have now had approaching 1000 hits on our BLOG - so we know that people reading it from all over the world..

Alison

Dear Alison , Clive and other friends,

Congratulations on forming this group and thank you very much for making me a part of this great initiative . I was always wondering for the last 13 years if there will be any change in the system around us .When will people understand newer thinking ?

“Speed bumps “is still a very modest word that could be used for the situations faced by many J ,they must be called “ROAD BLOCKS”

Sometimes “road blocks “hit you so hard that it impacts your professional life very hard! I have faced several harsh situations which have led to my complete silence and moving away from academics approach.

I strongly feel that we as a group we need to do something more on GROUND ZERO! I do agree that talking ,writing ,discussions, meetings will help a lot but we need to go beyond … act on things and make that change happen.

I have found that humans are very defensive about their borders .My approach to any situation is Global! The first thing that we all need to understand is that it’s not about ….I , ME ,or MYSELF but people should start looking at issues from a Human perspective. Some of our nations come with national, regional,sub-regional,religious,socio-economic,language barriers which are the “speed bumps”…leading to “road blocks”.

It is not surprising to observe that most of us from various countries are facing this common problem of “speed bumps”.The whole problem is with the attitudes of “responsible” people !

In my view what may work is a International team(IT) of experts (who feel strongly for the cause beyond boundaries) under the banner of IADH-SCD Education Panel , visit and make a representation to the Govt, dental councils, health departments ,NGOs ,etc about the “case of need” for Special Care Dentistry.

It should be the responsibility of the local group to inform the “IT”about the strategy and approach that may work for their country based on which the IT can plan the approach and represent the case in the respective nation.

I am sure that with this approach we will be able to do a great deal of service to mankind and also to a lot of professionals who are facing “speed bumps” leading to “road blocks “in their lives and careers.

This approach will help us create a worldwide moment on SCD , identify potential future leaders , in various countries and also enhance our own experience about special needs .

Srivats

Speed Bumps

2011-02-25T14:47:00.001Z

After all these years I finally learned the technique that my daughters have used on me for shopping. Most recently on a shopping spree with my daughter i think i finally figured it out. I know - I am slow - but our kids sure know how to work us. Take dad out to the mall spend at least 5 hrs shlepping him from store to store making sure to keep him for at least an hour in one store trying on stuff -- and for sure by the end of the the fith or sixth hour, irrespective of cost or what it may be, he is now worn down and will agree to just about anything just to get him out of there.
I sincerly hope that this is not the same technique Alison is going to use on us when we finally arrive in turkey and she keeps us holed in a room so that by the time the end of the day comes we will agree to just about anything just to get out of there.

I am wondering if similar processes are not used by the academic beurocracies when attempting to get any kind of change within a system. They put so many roadblocks in ones way that by the end one just either ups and collapses or agrees to whatever compromise that has been suggested ??
Well the powers that be - called it SPEED BUMPS - during the time we recently spent discussing the possibility of bringing in a post graduate program for our school here in London Ontario - the term used was 'speed bumps'. What would these be and look like in attempting to bring to Canada a first.....

Although the specialty of SPECIAL CARE is not recognized as such here one has to start somewhere and with the development of SCIPE - what a unique opportunity to bring to Canada a post grad program. Speaking with the Director and Chair of Graduate programs at a recent meeting Timucin and myself were advised of the commitment that the school has for developing such a program -- to this i say YES!!!! -- and as an aside am trying to anticipate all the speed bumps that we can expect to come across . Each country area will i am sure be presented with similar such barrriers - AND i so look forward to learning more about these and how folk from different countries have dealt with these issues - As much as developing a curricula is important, so it is also a priority to talk about the speed bumps , barriers , etc and how to navigate these systems so that we do not end up like myself in the shopping mall with my daugher . In the meantime we will begin developing a plan to take to the university and hopefully by the time we get to Turkey will have something in place that can be shared as either a model or a sample of what can be used in other countries.

So far thanks to all the great work that Alison has done with what she has so far posted on the SCIPE site - this will make our task that much easier.

So to uncovering speed bumps - it would be great to hear in your comments some of your own experiences. (of course speed bumps means different things to different people -- but let's not go there for now)
Clive

Spring is in the air.....

2011-02-22T18:24:00.020Z

Dear Colleagues,

I am just back from the UK, and at this time of the year, one of my favourite sights is to see the snowdrops in bloom and see the spring bulbs peeping through the earth. Is such an optomistic time, with promise of so much ahead as colour starts to unfold after the grey days of winter.....
As we look towards the future, one of the aims of the IADH education committee, is to develop and encourage access to education programmes in areas where there is little in the way of formal teaching available at present.
Many of you within IADH will know and have met Dr Srivats Bharadwaj who has agreed to be one of our SCiPE representatives for India to look at taking this forward. I am delighted that Shrivats has introduced us to a relative newcomer on the scene to work with on this project, and I would like to take this opportunity to introduce Dr Tejas Melkote and look forward to learning about his ideas about education programmes and content which might suit his own culture in India, and also learning more from this gentleman who is evidently very well versed in the preventive programmes and MID techniques so important in our special care patients.

alison

Dear IADH education committee.

My name is Tejas Melkote and I would like to thank you for inviting me to SCiPE Task Force. I do look forward to sharing my experience thus far in Special Care Dentistry. I also look forward to learning a great deal more from being on the committee itself and working alongside all of the members of the task force.

I live in Hyderabad city, (in Andhra Pradesh state, South India). My introduction to Special Care Dentistry started when I was an Undergraduate student in 2003 at Bangalore and I met Dr. Srivats Bharadwaj. Following that I worked with him in the Special Olympics - Healthy Athletes Program in 2005.
After Graduating, I was inclined towards working with Special Needs groups and I frequented an Institution - "Friends of Camphill-India" at Bangalore on weekends while I interned at Bangalore Institue of Dental Sciences on the weekdays.

It was during this time that I understood the nuances of treating Special Children and I was made aware, for the first time, how deficient and inept my Dental School training was in the area of Special Care Dentistry. I found the experience in treating Special Needs patients challanging, but also rewarding in terms of gaining immense satisfaction which I realised that I didn't feel while treating a so called 'normal' patient.
After fumbling and struggling to learn to treat Children with Cerebral Palsy and Autism, I finally decided that the nearest I could get to learning Special Care Dentistry in India was to do a Masters Program in Pedodontics and Preventive Dentistry as it included Special Needs Dentistry in its syllabus.

In 2007 I pursued a three-year Program in Pedodontics & Preventive Dentistry. During this time, I undertook some short studies on Dental Phobia; and looked at the use of Biofeedback therapy to try to improve the experience and the quality of life of Special Needs patients. I also worked on Silver Diamine Fluoride and explored its use in field programs in India and explored possible strategies to combat "access to dental care" as a handicap. I wrote a short dissertation on Minimal Intervention on Caries Management in Children.

Having completed my Masters in Pedodontics and Preventive Dentistry in May 2010, I started a Pediatric Dental Center in Hyderabad (South India), and I am currently also working at a faculty in the Department of Pedodontics & Prevntive Dentistry, S. D. Dental College, Parbhani. I teach Undergraduate students in their III Year and Final Year and I find that all they need is a little motivation and they find Special Care rewarding

Experience and interest has taught me SCD thus far, and I have relied heavily on resources I can find on the internet, and distance learning programmes due to the lack of training in this area in my own country. I do look forward one day to being formally trained in a certificate course in SCD and ultimately perhaps running one in the future myself.

Thank you for inviting me to SCiPE Task Force. I look forward to meeting all of you in Antalya ( If I can manage to fund myself to getting there).

Best Regards and Greetings from India.

Dr. Tejas Harsha Melkote, MDS

Online Learning

2011-02-18T12:08:00.005Z

As our survey results start to come in it is very interesting and heartening to see the breadth and depth of expertise in our SCiPE group, and also great to see that the majority of the group are planning coming to Antalya to take part in the workshop. We should get some great outcomes from this event I hope, with so much knowledge and expertise in the same place at the same time.
Great, also that we also have more or less equal numbers who prefer to be in one of our four work streams. We seem to have a great balance of skills and experience within our number.

The outcome of the survey shows, there is pretty good consensus on the patient groups that might fall under the umbrella of special care dentistry globally, but that very few of us have experience in every area, although within our number we have at least one member whose special interest covers our named patient groups, so this is great.
Special Care Dentistry is so broad, it is evident that the creation of shared resources, by teams whose special interest lie in a particular area may be a way of sharing our collective knowledge to aid teaching or course development in areas where we do not have such expertise ourselves, and allow us to develop our own knowledge along the way, as we build teams around us. As those who know me will confirm, I am a wet fingered clinical dentist, and I am adamant that there is no substitute for learning hands on and gaining experience this way, but of course our students need to be armed with a sound, up to date and rigorous, theoretical knowledge which is available from many sources nowadays.

In IADH we already have the bones for creating a shared learning area within DINOH so we have the potential to develop this area should we so wish.Therefore, in my own survey response, my top interest was predictably looking at web based learning and development and sharing of resources, I am doing my own preparations to become more versed in how this works before Antalya, in order participate better in this group by being better informed and experienced by that time.

Firstly, I have been studying the format used in an excellent e-learning 'virtual student' website at the University of Birmingham, England, created by Professor Damian Walmsley, who is currently the secretary general of ADEE and is very keen to share his knowledge and enthusiasm to help and advise us in this use of media. He has given me access to this site so I can trawl it and get to know the process better.
That which I most love about the Birmingham site is that it is constantly moving and active, consequently it is used extensively by the students, and is a real hub of activity and scholarship. This has awakened my interest web based learning, which I have to admit, I have found can be somewhat soulless without a personal touch or sense of belonging or community, and just a list of resources or power point presentations and outdated links. I think that the birmingham site has shown me that this web based stuff can indeed be a workable and popular and much used resource.
Our own BLOG - has received over 650 hits in just over a fortnight - so I think we can already see that if something is interesting for us, is part of a community, and give us information we need, then web based activities can be popular, energizing as well as informative.

I am travelling to Cardiff this weekend, again time for more planning and talking with Shelagh, but also to do a course on sharing of open education resources, and learning how to license and credit them correctly (my britishness is coming out - I can see this ;)))
This of course will be very useful for updating our own e-learning undergrad and post grad SCD programme here in Dublin, but for our new IADH activities too.
http://www.medev.ac.uk/funding/workshops/241/view_workshop/

Finally, I am a guest lecturer for the Irish Society of Disability and Oral Heath in a weeks time here in Dublin, and I am going to try and turn this into a podcast, for sharing on DINOH, as an experiment. I will record the lecture, and if this is not a good outcome or is poor quality - or I tell too many jokes during the presentation, or cant answer the questions ;))) then afterwards I will try an alternative method by recording a voiceover to my slides and then downloading the whole thing online as a webcast or podcast - still not sure which is which. Clive has agreed to do the same and experiment with his forthcoming lecture for SCD in Chicago if possible, so we can start building a library.
I see how many hits timucin's autism and music therapy videos get on facebook, and this tells me that people want to see and learn from media with sound and action.
I found on our own Royal College of Surgeons website here in ireland, that they share all of their public lectures and here is a link to an excellent pod cast - (slides and voice) about like after stroke
perfect material for giving our students a good level of knowledge and insight - before seeing patients who have had a stroke and looking at how it might impact on their dentistry, and its right there on the web already.
http://vimeo.com/18867038

Podcasts, and webinars - this is a new thing for me - but I am looking forward to exploring this as for my own part, I just cant get enthused about flicking through slides online unless I am seeing or hearing the lecturer, so I am going to see if this is a success or not.

Have a great weekend, and please keep sending us those survey forms and your comments here on the BLOG if you have not already done so

Alison Dougall

GREETINGS FROM WALES

2011-02-11T18:31:00.002Z

Greetings from Wales

It’s time to introduce myself as the as the 'other' person working with Alison Dougall and Gabriella Scagnet on the IADH Education committee- the back room girl till now!

I am Dr Shelagh Thompson, Reader and Honorary Consultant in Special Care Dentistry at Cardiff University School of Dentistry.

This is my first ever blog....

I am sure you will all agree that Alison has been very successful in developing the SCiPE website, and hosting and updating the SCiPE Task force information. It is obvious from the curricula / reports and educational material downloaded nearly every day, how hard Alison has been working; communicating with many interested educationalists from numerous countries across the globe signed up to working together in Turkey.

I am also delighted that the ADEE committee has been very positive in our hosting a taskforce prior to the ADEE meeting and to Majella Giles from ADEE for her continued support and encouragement.

We also really appreciate the offer of local help for the meeting in ANTALYA from Professor Tanboga from the University of Marmara, Istanbul.

It has been a long term aim of the IADH Executive Committee to develop IADH Guidelines for teaching Special Care Dentistry globally. The work on mapping the curricula has begun as Alison has managed to draw together curricula and examples of course development from many areas of the world. We will be using the expertise of the SCiPE Taskforce at the meeting in Antalya to develop position papers and educational documents with the aim of publishing these and also hosting them as an on-line IADH resource.

I have recently become Editor of the Journal of Disability and Oral Health taking over from Professor June Nunn who very ably devoted an enormous amount of time developing the journal over the last 10 years to be the official journal of IADH and the British and Irish Societies of Disability and Oral Health. We hope there can be collaboration on publication between JDOH and the European Journal of Dental Education the official journal of ADEE.

The IADH Edu-Blog is helping to let us get to know each other before the work begins. I am really looking forward to meeting you all and feel humbled to be part of such a group of highly motivated individuals taking this work forward. I feel it to be part of my 'swansong' and raison d’être and I will explain that to anyone who cares to or has time to listen to me! -preferably in the lovely blue Turkish sea!

On the London eye, celebrating Shelaghs 'special' birthday

Last weekend whilst I was visiting Dublin, Alison and I developed an online survey (actually Alison is the brains on this one) which we would like those of you intending to come to Antalya to complete. This will allow us to have an idea of who will fit where into the various work streams for the work ahead. We also hope that as many of you who are able will join ADEE congress afterwards, as we will present the proceedings from the SCiPE Taskforce at the ADEE/IADH SCD plenary session later in the week.

The work will not end in Turkey of course, and we are very grateful that ADEE will allow us to establish a brand new SCD Special Interest Group within ADEE for inclusion in future meetings. In addition, a pre-congress seminar in SCD Education has been arranged prior to the IADH Congress in Sydney 2012....

I hope to blog again and thanks for reading it if indeed you have!

Shelagh Thompson , Cardiff

Introducing Sharat Pani our newest SCiPE member from Riyadh, Saudi Arabia

2011-02-06T12:07:00.001Z

'Communication is the real work of leadership
Nitin Nohria

Greetings from Saudi Arabia,

I am an Indian by birth and education, a lecturer of pediatric dentistry at Riyadh colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia; and as Editor of the blog Dentistry for Children with Special Needs, I believe, a 'netizen' of the world. It is indeed a privilege to be a part of SCiPE and looking at the other people here; I get the sense that it would also be fun.

My interest in special needs dentistry began with what was supposed to be a summer ‘job’. Back in 2003, I had just finished my final year BDS exams and was looking for someone who’d take me on as an assistant (until my results came out). Fortunately for me, none of my local dentists thought me a worthy investment. What I did land up with was an opportunity to work as a volunteer at “Vidyasagar”, a school in Chennai, India, for children with special needs. The job offered room and board in return for me helping out with lessons and teaching children how to brush their teeth. The school mainly dealt with children with Cerebral Palsy, but also had a few children with Autism and Down syndrome. By the end of that summer I had decided that I wanted to spend my career working with people with special needs.

In India (and also in Saudi Arabia), where much of special care dentistry is carried out by pediatric dentists, a master’s in pediatric dentistry was the obvious next step. I consider myself extremely lucky to have been able to secure admission into a programme that encouraged its Post-Grads to work with children with special needs. Three years later armed with a degree I found that in a country with a billion people, the gap between those who wish to provide treatment and those who need it is often one of access. “Dentistry for Children with Special Needs”, began as a means to get people, parents and professionals alike together on the internet. Over the past three years I have found that the blog has attracted both parents and students from around the world who look for information, contacts or just friendly advice. The pressures of making a living (as a pediatric dentist) have meant that the blog is not always updated, but we have managed to stumble along, averaging a 1000 readers a month from 67 different countries.

Over the past two years I have taught a course on special needs dentistry for dental hygienists, offer a seminar on special needs dentistry for dental interns and have been actively involved with the clinical management of patients with special needs, but I have found that the greatest success I have had in terms of reaching out to parents and professionals has been my blog. Through SCiPE I wish to highlight the role the internet plays in education today and the risks of misinformation it carries. I also hope to put forward some of the barriers (to education and treatment) faced by us in countries where special care dentistry is not an established specialization. I wish to thank the IADH education committee for their invitation and really look forward to meeting all of you in Turkey

Sharat

Visit Sharat's Blog Here

" Fixer"

2011-02-04T01:31:00.005Z

PLEASE LET ME INTRODUCE MYSELF

My name is Clive Friedman and I am a pediatric dentist working in a private practice setting in London Ontario Canada. I teach part time at the Schulich School of Medicine and Dentistry as well as the University of Toronto. I am a past president of both the IADH (International Association of Disability and Oral Health) and ADPD ( Academy of Dentistry for Disability and Oral Health.) The IADH has created the sub-commitee SCIPE that will be meeting in Turkey in September - please see the earlier Blog by Alison for details of this meeting. Or you can go directly to the following web page for more information.

web.me.com/alisondougall/IADH_EDUCATION/Home.html

I have previously written about the landscape and how important it is to be open to the unfolding process. It is truly amazing to see how this begins to unfold. Individuals who have heretofore not been involved with iADH are coming forward and sharing some of what they are doing. Long time members are sharing the unique programs they have already instituted. Even the wise Roland (who by the way vowed never to get involved in social networking) is sharing his extremely worthwhile thoughts. The possibilities are unfolding and evolving and SCIPE seems to be taking on a life of its own. Thereby creating something that will be far greater than the sum of each persons contributions.. As a further challenge to each of you I offer here a poem that was presented to me a number of years ago entitled the “ FIXER” Read it and decide for yourself where in the continuim you find yourself.

Fixer

A fixer has the illusion of being causal.

A server knows he or she is being used

In the service of something greater,

essentially unknown.

We fix something specific.

We serve always something:

wholeness and the mystery of life.

Fixing and helping are the work of the ego.

Serving is the work of the soul.

When you help, you see life as weak.

When you fix, you see life as broken.

When you serve, you see life as whole.

Fixing and helping may cure.

Serving Heals.

When I help, I feel satisfaction

When I serve, I feel gratitude

Fixing is a form of judgment.

Serving is a form of connection.

Author Unknown.

What is the world view that you come to this process with .. Is it one of DEFICIT thinking (being a fixer) or is it one of COMPETANCY thinking.

Creating curricula is the first step of a process – delivering it and holding both the student and patient as Competant is perhaps the more difficult piece,. Sharing in all of these domains will hopefully take place in ANTALYA helping to create a program that is both unique and different from any other in Dental Facultiies world wide.

For those of you then who have not joined the group and are interested please contact Alison. For those who read these Blogs - please give your input, thoughts, comments.

Clive

Musings of a retired, technically 'incompetant' gem....

2011-02-01T12:03:00.001Z

Today, our BLOG comes from Roland Blankenstein from Sheffield in UK.
Roland recently finished his term as the secretary of IADH and is much loved by all who come into contact with him, so much so - that we are currently trying to twist his arm to come out of his retirement and travel to his beloved Turkey - and visit us in Antalya in September to help administrate and support our SCiPE group meeting - cos it just wouldn't be the same without Roland there.....

Roland is famous for his wise, well observed perspectives and we were delighted that he has fought with technology and is following and contributing to our blog (and our facebook group).
I apologise here and now to my dear Roland for the technological failures of the blog comments box earlier, I hope i have now sorted this out and made it more user friendly and reliable, I am learning on the job here and I think the comments and interaction we receive are so important so hope the glitches are fixed.....

Alison and Clive
I have been reading your blogs with interest and as Alison knows I sent what I have written below to your comments box Clive but the technology beat me - so you may do what you like with the musings ( wise or otherwise) of a retired, technically incompetent, grumpy old man on your BLOG.

Some years ago there was an article published in the British Dental Journal where the authors compared the attitudes of medical and dental students. What they found was that the medical students were far more altruistic; the dental students were interested in money. This did not surprise me; dentistry is more of a business, and it was going to be a nice business at that. When they leave dental school ( with a £20,000 student debt) they were going to go into a nice practice, with nice pictures on the walls and nice staff, and at the end of the day they would get into their nice cars and drive to their nice homes and nice families, and the children would go to nice schools, and in the winter they would have nice skiing holidays and they would all sail into the sunset for evermore. You can add a few more "nices" if you like. Having an overweight person in a wheelchair, drooling and flaying their arms about in the waiting room does not belong to the glitzy image of beautiful veneered and botoxed young models as seen on all the dental commercials.
I used to give a series of talks/lectures to the 4th year students and at the end of the 1st lecture it was always the same every year. The students would file out the room but 1 or 2 would hang back and come and say to me afterwards, almost as if they were embarrassed, that they knew exactly what I was talking about because they had a brother/sister/aunt who was disabled and they could identify with everything I said. These were the students I would met up with again in the clinic---and I had earmarked them ! You are my future hope for special care dentistry !
All these 4th year students had to spend and afternoon or morning with me at one of the special schools I worked in, which was usually at the largest in Sheffield catering for 12-18 year olds with a broad range of disabilities. Their reactions were always interesting. Many of them were quite shocked, some found it difficult to touch or be touched by the children. At the end of the session I would explore with them their feelings about disability. They were young, only about 20 years old and most of them never had any exposure to disabled people, and certainly not to the very disabled ones. I told them look how we struggled for half an hour with some of them; their families have to cope 24/7 and the last thing they need is to be turned away from the door by you the dentist when they come to you for help; they get enough of that already. You may not be able to do much for the patient but my, how grateful the parents are just if you will listen to them. You suddenly are the best dentist in town. I know that listening to parents does not fix the dental problem, nor does it pay the rent, but you are the starting position when something can be done.
So, what I think students need is exposure to disabled people first, then talk to them about the law and the discrimination act. Perhaps then it will make some sense rather that some abstract legislation.
There is in the Sunday Times today an article in the News Review section called " Too wired to talk like a human". I quote a paragraph;" A Michigan University study suggests today's students lack the empathy of their 1970s predecessors and grow both more introverted and narcissistic the more hours they spend on the net. Another study suggests that people deprived of smart phones for 24 hours share withdrawal symptoms with caffeine addicts--raised heart rate, sweat, paranoia." I ask myself, if this is true then we have another far more complicated psychological aspect of student ( and staff) behaviour to deal with when we are trying to kick-start that little bit of empathy that is in all of us.
These are some of my musings about undergraduate teaching in special care dentistry. Humanise the students first; they are still so young. Show them what real life is like for so many people; the theory can come later.
Here ends the reply to your blogs !!!
I wish you both well, and I admire your enthusiasm for SCiPE.
Roland

TANGO AND MORE...FROM PATRICIA DI NASSO IN MENDOZA

2011-01-29T00:58:00.002Z

“The best dancer is the one who listens to the music

…so dance the music not the steps"

Dear Colleagues,

PLEASE, LISTEN TO THE TANGO SOUNDTRACK WHILE YOU READ MY LINES

I’m writing from Mendoza, a province located in west central ARGENTINA, next to the Andes and with the highest peak in South America (Aconcagua). It is called “the land of sun and MALBEC wine”, I greet you happy to share this space with you. I am a professor of the subject Clinic for disabled patients at the Faculty of Dentistry, National University of Cuyo and the Director of the Disabled Patients Dental Care Centre and The Special Baby Dental Care Centre.

I have been teaching for 25 years, I feel very young inside and eager to do and to "INCLUDE."

I always thought that if life gave us the opportunity to study at university where we provide a service to others and improve the quality of people’s lives; then why are we not i extending this to include people with disabilities?

For this reason, since 1990 we have added this important aspect to the curricula of Dentistry and Dental Assistant careers in our university. It is a daily challenge for us, because from the beginning we knew that we wanted not just to teach theory, but to include contact with patients in places, including where people with disabilities are studying or are being rehabilitated. Our aim is to make our future dentists part of those health teams. I am convinced that oral health care should be for everyone. To make this possible, education at universities must include body of knowledge and experiences that allow the students to apply the dental science tailored to each patient, whether they have a severe or mild disability, whether its visible or not, genetic or acquired.

Oral Health for people with disabilities exceeds the scope of general dentistry, dentistry for children and other different specialities. Just as for those subjects, there is a need for the teaching of care of disabled patients with an increasing degree of complexity which begins in the undergraduate and remains up to the postgraduates’ courses plus appearing transversely in all dental specialties and we have seen that this is possible.

WE HOPE TO SHARE IN ANTALYA EXPERIENCES AND KNOWLEDGE.

THESE CAN IMPROVE OUR STUDENTS’ACADEMIC BACKGROUND AND OUR PATIENTS AND FAMILIES’ HEALTH.
http://www.guni-rmies.net/observatory/bp.php?id=186
follow this link to read about the award for innovation which Paty and her team won for their work in education for vulnerable groups
alison

Seizing the moment - news from France

2011-01-29T00:03:00.001Z

Every new beginning comes from some other beginning's end.”

Seneca - Roman Philosopher

I am delighted that Prof Martine Hennequin and Dr Denise Faulks from France have joined our SCiPE group. Alongside their proven research pedigree, I continually watch with interest and admiration their practical ‘no nonsense’ step by step systematic and patient approach to overcoming the hurdles that they (and indeed we all) face in developing clinical special care and sedation services for patients and training for our students.

This week Denise sent us their brand new undergraduate training curriculum for Special Care Dentistry.

Their whole teaching curriculum has been recently overhauled in the Dental School in Clermont Ferrand and so this was the opportunity for the team to seize the moment and introduce a brand new curriculum in Special Care Dentistry from last Sept (2010). Incidentally , they are the only faculty in France who undertake any special care teaching within their undergraduate or postgraduate programmes.

The team explained that they are ‘very limited in what they can do’ as there are only two teachers, who are both hospital rather than university staff. This means that there is not so much clinical teaching in the new programme as they would like - however, interestingly they offer an optional special care module for those that want clinical experience (4 students from each of the 4th, 5th and 6th years approx)

They can't deal with more students than that on the clinic.

I have placed the link to their new french curriculum on the secure page on the site, and am delighted to see yet another excellent piece of work coming from this dedicated french team.

Continuing to add to the working desktop - this week, I will be adding some of the more recent published research papers (as pdf’s) related to education in Special Care Dentistry.

I have been scouring the literature, and there are now many papers looking at the attitudes of students and evaluation of programmes in Special Care - (most of them coming from US and Canada). I was very interested to see that the majority of the programmes - routinely include teaching about either children with special needs or older patients,rather than a cradle to grave continuum of people with disabilities. I am starting to realise more and more that in our global work, we need to consider the challenge of filling the gap which seems to occur after adolescence and before the start of institutionalised older persons care.

Please continue to send us your programmes for the secure site, any interesting papers or articles for the SCiPE group desktop, and any comments you about anything at all to the BLOG.

Alison

pdf’s coming soon

Meggan Krause et al.

Dental Education About Patients with Special Needs: A Survey of U.S. and Canadian Dental Schools

J Dent Educ. 2010 74: 1179-1189.

Lauren Vainio et al.

Patients with Special Needs: Dental Students’ Educational Experiences, Attitudes, and Behavior

J Dent Educ. 2011 75: 13-22.

M Romer et al.

Predoctoral education in special care dentistry: paving the way to better access?

ASDC J Dent Child. 1999 Mar-Apr;66(2):132-5, 85.

Maryam J. Dehaitem et al.

Dental Hygiene Education About Patients with Special Needs: A Survey of U.S. Programs

J Dent Educ. 2008 72: 1010-1019.

Loan P. Dao et al.

General Dentists and Special Needs Patients: Does Dental Education Matter?

J Dent Educ. 2005 69: 1107-1115.

H. Barry Waldman et al.

Preparing Dental Graduates to Provide Care to Individuals with Special Needs

J Dent Educ. 2005 69: 249-254

Nancy T. Keselyak et al.

Evaluation of an Academic Service-Learning Course on Special Needs Patients for Dental Hygiene Students: A Qualitative Study

J Dent Educ. 2007 71: 378-392.

Introducing Sobia Rafique, SCiPE member from University of London

2011-01-28T23:56:00.000Z

‘Coming together is a beginning. Keeping together is progress. Working together is success’ Henry Ford

Hello everyone,

Happy New Year and greetings from London! I am Sobia and am now into the third week of my brand new job at King’s College Hospital in London as Consultant in Special Care Dentistry in the Department of Community Special Care Dentistry. I have been told that I am consultant number 32 in the country since the establishment of the Specialty of Special Care Dentistry in 2008. Perhaps this could be my lucky number from now on!

Having been based at Guy’s Hospital, University of London in the Department of Sedation and Special Care Dentistry where I gained much of my own training over several years I am now settling into this new role and familiarising myself with a different, but equally welcoming environment. Equally exciting is my involvement with the SCiPE group where I am looking forward to meeting other members of the international team and finding out, sharing views and providing support about the Special Care set up in various countries.

I must admit on reflection, I often think ‘How on earth did I ever get here?’ considering I had no specific undergraduate training in Special Care Dentistry as the Speciality did not exist in this country until October 2008. In fact, the first Specialist Trainees in Special Care Dentistry have only recently entered approved and salaried training programmes (commencing 2009) which are fully funded by a Deanery of post-graduate education

So one might be asking with no undergraduate training and no Specialty how did I become involved in Special Care Dentistry? Well a bit of an accident really albeit a ‘happy’ one as I like to refer to it, or perhaps……… a twist of fate?

Having qualified with a BDS, I was unable to secure a one year vocational training position in general Dental Practice due to a shortfall in posts that year. Eager to keep up my dental skills I applied for a salaried Community Dental Officer post in one of the Government funded National Health Service Clinics. The role of Community Dental Officer in the UK included providing dental treatment to children as well as adults with special care requirements who were unable to access primary care dentistry in general dental practice. Whilst I was really pleased to accept this post I was equally apprehensive about treating patients with ‘special needs’ (as it was termed back then) having had no training. Despite this apprehension, I settled in well with excellent support.

Fortunately, through good mentorship I managed to complete this first year and keen to develop further skills and knowledge in this particular field, I entered a two year MSc programme in Sedation and Special Care Dentistry through King’s College London University (based in the Department of Sedation and Special Care Dentistry at Guys Hospital Trust), having to fund my training myself by doing a post in general dental practice at the same time that I was training.

On completion of my masters in 2001, sadly there was still no Specialty in SCD and still plenty of strong opposition to it as other specialties felt that they were already treating these patients adequately in their own different departments. Indeed, research showed quite the contrary in the UK where special care patients had a high level of ‘unmet need’ and many paediatric special care patients were being lost as adults without a seamless transition of care to a specialist adult service. ‘A Case of Need Proposal for A Specialty in Special Care Dentistry’ was put forward by A Joint Advisory Committee for Special Care Dentistry in 2003 outlining a need for the Specialty and good practice.

With a postgraduate qualification, I began work as a Community Senior Dental Officer (a more responsible step up from Community Dental Officer post I had held previously) - with a responsibility for special care patients in Government Public Service Clinics.

However, I was still very much aware of a lack of teaching and training in Special Care Dentistry, so that when the opportunity arose in 2004, I was really pleased to accept a full time post in the Department of Sedation and Special Care Dentistry at Guy’s Hospital NHS Foundation Trust where I had completed my own MSc. The Department, jointly with Community Special Care Dentistry at King’s College, has a nationally rare role in delivering both undergraduate as well as postgraduate Special Care dental training.

A main reason for accepting this post was its teaching role in enhancing student confidence to treat special care patients, having recognised my own vulnerability and inexperience on qualification. Over time, I developed other particular areas of interest in medically compromised patients, including managing haematology patients as well as Head and Neck Oncology / bisphosphonate patients, and contributing towards research in these areas.

My other role through King’s College London University was being the course co-ordinator for the MSc in Sedation and Special Care Dentistry, both organising and delivering teaching. This was a truly interesting period as FINALLY at long last the Specialty of Special Care Dentistry was approved by the General Dental Council (GDC) in the UK and I was accepted onto a Specialist List in 2009. This meant that our existing two year Masters course was incorporated into the GDC approved training programme for Special Care Dentistry.

I felt really privileged teaching the first group of funded and salaried Specialist Trainees in Special Care Dentistfy the UK.

Reflection period over!

Now in my VERY new position at King’s College Hospital, as a Consultant I will be able to treat Special Care patients in both a primary care community setting as well as a secondary care setting within the hospital itself using holistic management skills including sedation, all whilst overseeing and teaching students. Having dabbled in education as well as research who knows where the road might lead? Anyhow, that’s enough from me and as someone once said :

‘Teamwork : Simply stated , it is less me and more we’

I shall end on that note and look forward to meeting you in September

Sobia

SCiPE Group Workshop - Antalya 5th-7th September 2011

2011-01-28T23:44:00.000Z

Original Post 15th Jan 2011

We have an active SCiPe Group!!!

For those of you who have not been on the site lately I am delighted to tell you that thus far we have a confirmed working party of 35 individuals from 25 different countries from all corners of the globe, Shelagh and I expect for this to grow to approximately 40 people as we continue to explore areas from which we do not currently have representation.

Shelagh and I are in close contact regarding all areas of planning but we have decided between us, that we will each lead on a different SCiPE area during the coming months as we lead up to the workshop. I will be concentrating on communication media and web-based activities and for the workshop event planning itself, and arrangements around this.

Shelagh will take the lead on the pre-workshop work group plans and activities. Most of you will have received an email from Shelagh, as she springs into action this week, informing you of the beginning of ‘action SCiPE group’ so watch this space.

There is a SCiPE members secure log in area on the site which will act as a desktop for the documents on which we will be working. If you do not have a username and password for this area please contact me. I would also be grateful if you would check the title and spelling of your name, and whether we have attached your preferred e-mail contact in this secure area, this can be shown by hovering your mouse over your name.

Finally, this week I will be finalising the arrangements for the workshop event itself but would be grateful if you would note these dates in your diary.

SCiPE Workshop - 5th-7th September - from late afternoon on the 5th till late afternoon on the 7th September 2011

ADEE Congress - which some may choose to attend afterwards - 7th-10th September 2011 which is in the same venue.

Talking of venue, we have negotiated a great all inclusive rate for workshop, accommodation and full board at the GLORIA HOTELS resort in Antalya. I am not entirely sure whether it will prove conducive to achieving our best work with that wonderful location as a distraction, however, I am also an optimist and realise, from experience, that most probably the very best ideas will be inspired by chilling out post workshop in that very jacuzzi pictured above, and long-lasting and effective international networks created over those fabled turkish buffets

The link to the SCiPE Workshop event is here

http://web.me.com/alisondougall/IADH_EDUCATION/Workshop.html

More information will be appearing on that site soon but please do take time to visit the site and perhaps consider booking your flights, also from experience i have found that Turkish Airlines is excellent (despite their misguided sponsorship of Manchester United rather than Arsenal Football Club) and great bargains can be had by booking early.

The resort is 30 mins away from Antalya airport, so a fight arriving early afternoon should leave plenty of time to check in by the time we start in the evening with our welcome and introductory sessions

Kind regards

Alison

Greetings from Jordan

2011-01-28T23:30:00.000Z

"The way to get started is to quit talking and start doing"

Original POst 31/12/2010
I would like to take this opportunity to wish everyone a Happy New Year full of Joy and Happiness and Hope.

I have spent an incredible two weeks in Jordan, first working at the Al Basheer Government Hospital and the King Hussein Military Hospital in Amman, and then on holiday for ten days seeing the highlights of this fascinating country and culture.

Jordan and Ireland have many similarities, despite their physical outward appearances, Jordan being prinicipally muslim, landlocked and one of the most water short countries in the world and less wealth than its oil rich neighbours and ireland being a mainly catholic island famed for its rain and with a struggling economy!!!!. However, despite this they have similar populations at around 6 million with 60% living in urban areas, almost identical land mass, similar literacy rates of 94% Jordan and 96% Ireland, similar life expectancy of 76 (Jordan) 78 (Ireland) etc etc.

I was here with the World Haemophilia Federation, and was delivering a training workshop over three days for multi-disciplinary teams from haematology talking about the importance of oral health for the quality of life, doing some clinics and training sessions and and also importantly discussing the economic value of preventive oral health programmes and promoting the use of local measures to arrest bleeding rather than over use of factor concentrate which is still scarse and very expensive in the Middle East.

The World Federation of Hamophilia, run a 5 year GAP programme, for countries where care for persons with haemophilia is not optimal relative to their GDP. It is very effective and 12 countires have come through the programme this far, in year one is about establishing a y year twinning programme (Jordan is twinned with Canada) lobbying local government for funding, setting up voluntary groups and organisations to empower patients, establishing a national patient register, establishing treatment centres of excellence, and training the multi-disciplinary team - including in year four......and after much lobbying by our dental committee.....dentistry!!!

I met with the Minister for HEALTH, and he signed the strategy for haemophilia, and he recognised the importance and value of good oral health for patients with medical conditions and sanctioned the permitted use and supply of factor concentrate, fibrin glue and tranexamic acid (cyclokapron) for dental care in the government funded public sector, and included oral care into the comprehensive care strategy framework.

The standard of dental care I witnessed in the two hospitals in Jordan was excellent - with state of the art facilities and many resident specialist programmes, and excellent paediatric programmes. They were interested in the haematology, I was here to talk about, but they were more interested in Special Care Dentistry as a subject, as they knew there was a big hole developing for their patients after adolescence. I lectured to many dentists and on my final day they scheduled an extra talk on special care dentistry for their residents and specialist dentists and the Jordanian Dental association as it was a new concept...... and despite only one days notice 200 people turned up to an evening lecture.

Their healthcare is funded by three sources, the government funded state system, the military funded system which serves over a third of the population and the private sector which is funded by insurance. When I visited the Bedouin communities living in the deserts in South Jordan, I also learned that they thought nothing of traveling several hundred kilometers to Amann to the government funded Al Basheer Hospital, so traveling a distance to specialist services was not so much of a barrier as it is in the western world where we expect services on our doorstep.

These dentists in Jordan , worked in teams, had the infrastructure including RA and GA, the funding and the interested personnel to provide special care dentistry, but no training available and little baseline knowledge and they had fear of treating patients with special needs. The paediatric dentists said that they held onto disabled adolescents as long as they could - but to treat adults they said they would need to send people abroad to train, because they did not currently have the local expertise amongst their number, but in the meantime they needed basic training via e-learning and visiting lecturers and other methods to further their interest.

This journey has made me think even more broadly about what role the IADH has in providing curriculum guidance, local pressure and flexible training opportunities in Special Care Dentistry for forward thinking countries such as Jordan who are new to the subject. There is a chicken and egg situation. Special Care cannot develop until people are trained, but the World Federation for Haemophilia has shown me that local lobbying for funding streams for these patients alongside training the workforce is fundamental to ensuring patient care.

There is much to do in 2011,

Wishing you all again a Happy New Year and looking forward to working with you all and getting to know you better

Alison

Inspired by winter storms - Clive Friedman

2011-01-28T23:10:00.000Z

"Today , like every other day, we wake up empty and frightened. Don't open the door to the study and begin reading. Take down a musical instrument" Rumi

original post 16/12/2010
I am sitting here in the warmth and comfort of my home – looking out at what once again is a wild winter storm with unrelentless snow that has again blanketed the earth here, and adorned the trees in all her glory. A beauty paralleled by another stark environment of the desert – the two polar opposites. Exactly one year ago I was walking in the dessert of Namibia – where ones foot prints vanish within minutes from the blowing winds recreating the landscape as if no one had been there. . The environment has always been a place where I have found analogy for life and what occurs to me at this time is how this these two environments bring one to a place of stillness and aliveness like none other. Its like it allows time to stop for a moment and it is easy to be fully present to the space and energy that exudes forth. It is not that it covers over but it allows one – me – to see the incredible beauty of what is around me without getting caught in the minutiae of daily life. So while I wait for the powers that be to respond to education initiatives am aware of the slowly gathering collective consciousness of need for improved access to care and that it is important for me to be patient and surrender to the process that needs to unfold for change to take place. It is about recognizing the beauty of the diversity out there – and nature has taken its time to show this in a manner in which only it knows how.

So what do I learn from the snowstorm or the desert. To be with its presence: not to confront or fight it but to accept and await the slow peeling back of its folds. So too with this educational initiative to be with it and allow the strength of the collective to take it forward. To continue working on the ground work and inviting as many of the readers of this blog as possible to write their own stories – experiences and personal triumphs so that the collective (in Jungian terms) becomes visible and thus more powerful.

Its like god the divine or whatever you want to name this prefix – felt it time to give us all a break from the crazy energy of xmas and invites us to just stop and surrender to the awe of each moment. Perhaps it is this lesson in being present to the now and in doing so surrendering and living fully – into what I know iADH is capable of.

As I write this a sense of peace descends upon me and I have a deep knowing that what will need to happen in whatever way will transpire so may all of you have a wonderful holiday season and may this be an invitation to look inside of yourselves and share your stories.

Clive Friedman