NEWSLETTER Number Two June 1995

The use of amalgam in dentistry, and for children in particular, has attracted wide attention recently in many countries. In Sweden during the last 10-15 years there has been intense debate about the effect of amalgam/mercury and general health. The situation in other European countries differs considerably (Second Report on Amalgam in Dentistry. European Opinions and Attitudes, ERO,1995). The National Board of Health and Welfare (NBHW) in Sweden has initiated a number of investigations and scientific reviews on the safety of amalgam - the conclusions of this extensive report are:

'there is no general health hazard from amalgam restorations.'

However, in Sweden the Parliament decided for environmental reasons to eliminate mercury from circulation in nature. This also has implications for dentistry. Therefore the NBHW was asked to suggest a plan as to how mercury (amalgam) should be excluded in dentistry. They recommended a stepwise elimination starting with children and then adults. The Ministry of Health and Social Affairs was asked to negotiate with the Federation of County Councils (responsible for all children's dental care) as to how such a recommendation should be formulated.

On April 20,1995, there was a signed agreement between the Ministry of Health and Social Affairs and the Federation of County Councils, saying that each county council should try and eliminate amalgam in the treatment of children starting on July 1 1995. Amalgam should only be used in very special situations when other types of treatment are not of benefit to the patients. These special situations are defined as:

in cases with heavily malformed teeth where chewing forces would fracture restorations with other materials.

when treatment is performed under general anesthesia and the use of other techniques will mean another session under general anesthesia

if it is not possible to keep a 'dry field' long enough to perform a restoration with an alternative material.

This proposal, with the above clauses, was approved by the Swedish Government on May 11,1995.

They will be of interest to all paediatric dentists throughout Europe. There will probably be further developments in this area and we will keep you up to date on this matter.

Goran Koch

Following the successful format used for the 1994 EAPD Congress, abstracts for the Congress in Bruges will need to be submitted by December l5th,1995. The format will be the same as in 1994, but new abstract forms will be available in September from Luc Martens.

Publication of Training Guidelines

Copies of the Training Guidelines in Paediatric Dentistry are now available for members to obtain and study. They can be obtained from either the Chairman or the Secretary. The aim is that all new and existing programs will conform to 75% of the guidelines and the remaining 25% would be for local and national needs. A second edition has been developed by the committee and will be available at the IAPD meeting in Gotenburg.

Recently the University of Gent has moved to a full time three-year (36 months) program. This conforms to the existing programs in Sweden and elsewhere. The Workshop at the Congress in Athens concluded that all future training courses for specialization in Paediatric Dentistry should be at least three years long.

Accreditation of
Training Programs

The education Committee has now initiated a system where training programs can be visited and accredited by the Academy. The aim is that programs would be assessed as conforming to the EAPD guidelines and also that dentists graduating from these programs

would be entitled to automatic membership of the Academy. This would encourage membership and also make the application process much quicker. Looking ahead to the future and European wide recognition of the speciality there will be a need for programs that meet the necessary standards.

The first step has been to try out a method of visiting and assessment of programs. On April 25 & 26 Professors Koch and Martens visited Leeds Dental Institute for two days. During this trial run visit the clinical facilities, staff support, patient load, didactic course (seminars and lectures etc) and quality of paediatric dental care were looked at. From this experience the necessary documentation will be developed for use at future visits. It is planned that each visit will be carried out by two senior Paediatric Dentists from other European centres. Once the guidelines for visits have been developed they will be published and available for all program directors. Directors of existing programs should write for further details to the Chairman of the Education Committee.

Greek

A recent meeting of the Greek Group of the EAPD decided that the group would meet at least twice a year in order to increase cooperation and to bring about changes in Paediatric Dentistry within Greece. The group will seek recognition of the speciality within general dental practice. This will be achieved by publicity to increase public awareness of the need for high quality care of children with the public at large. They will seek the cooperation of general dental practitioners and also among related specialties such as pediatricians and all other medical specialties that deal with children (ENT, Obstetricians etc).

At the Pan Hellenic Paediatric Dentistry Meeting,19-21 May, Prof. Oulis will lead discussions on the role of Paediatric Dentistry, Prof Papagiannoulis on Law, Ethics and Quality assessment in Paediatric Dentistry and Prof Kouvelas on cooperation between the dental specialties.

Lisa Papagiannoulis

British

At the scientific meeting of the British Society of Paediatric Dentistry, in York in September, 1994, a short meeting was held of the British members of the European Academy of Paediatric Dentistry. This was to discuss the position of Counselor as John Roberts was devoting more of his time to the job of Treasurer.It was decided that Ron Brandt should take over the role of Counsellor for the British Group.

At the meeting of the British Society of Paediatric Dentistry in Windermere papers were given on sedation (relative analgesia) and on health services research. Developments in children's dental care under the system of capitation within the general dental services attracted a lot of discussion. There has been a growing concern in the UK that under capitation, where dentists are paid a fixed sum of money each year, children with high levels of dental disease are not being cared for to the standard necessary.

The concept of a European College of Dentistry has been talked about for some years. With the advent of the European Union an initiative has been taken to enable a full and free discussion on a set of proposals which could be the first step towards the creation of a Euopean College of Dentistry. The European Academy was represented at this meeting by Martin Curzon, John Roberts and Ron Brandt.

The membership continues to grow and by the end of April there were 285 members in the various membership categories. At the same time there are some 12 applications under consideration. The Credentials Committee continues to try and process applications as quickly as possible but applications are not always complete or in the right presentation. Applicants should complete an application form, available from the Secretary, or a Counsellor, and send it with a short two-page curriculum vitae and a copy of the certificate of their training program in Paediatric Dentistry. Applications must be in English.

Discussions are under way with our sister organizations, American, Canadian and Australasian Academies, for a system of recognition of memberships. The aim is that members may attend the respective annual or biannual meetings and to be able to register as members and not visitors. The discussions continue and we will keep members advised of the outcome.

It is with sadness that we report the death of Erik Kisling, an Honorary member of the EAPD, and one of the original group of dentists who did so much for the early foundation of the speciality in Europe. Erik Kisling graduated in Denmark (1939) and was an early advocate of the dental care of children in the Danish Public School Dental Service. Kisling was active in founding the Nordic Pedodontic Society and President of IADC (from 1973-75).

PRE-CONGRESS COURSES

Trauma Update
Friday June 7th
All day program
Professor Jens Andreason,
Royal College of Dentistry,
University of Copenhagen,
Copenhagen, Denmark.

This course will give an update on the latest research and techniques for the treatment of oro-facial trauma in children and young adults.

Sedation in Peadiatric Dentistry
Saturday June 8th
Morning Half Day, 9.00 -13.00
Dr Anna-Lena Hallonsten
Institute for Postgraduate
Dental Education,
Jonkoping, Sweden.

This course is designed to give training and instruction in sedation with particular reference to relative analgesia and intra-venous sedation.

Intercertive Orthodontics
Saturday June 8th,
Morning, Half day, 9.00-13.00
Prof. Luc Dermat.
Dept. Orthodontics,
University of Gent, Belgium.

This course will cover aspects of interceptive orthodontics including six year molar problems and premolar transplants.

"SECOND MILUPA SYMPOSIUM ON NURSING CARIES"

The objective of this pre-congress symposium is to follow on from the first meeting, held in Darmstadt in 1994, with the latest research, prevention and clinical findings. This is a free symposium for all Paediatric Dentists wishing to attend and will be generously sponsored by Milupa.

The Provisonal Program and Speakers will include "Current research" Dr Graham Roberts (London), "Risk Factors" Dr Lillkari Wendt (Jonkoping), "Preventive Strategies and Education" Dr Maxine Pollard (Leeds), "National Nursing Caries Preventive Program in The Netherlands" Dr Til van den Sanden (Nijmegen) and "Restoration of Nursing Caries" Dr John Roberts (London).

CONGRESS PROGRAM

Glass Ianomers and Fluonde Releasung Adhesives

Developmental Disorders in Children

Dental Care of Children in Europe

Oral and poster sessions will be held on all of the, above topics and any others based upon submitted abstracts. Deadline far abstracts will be December 15th. Further details will be in the next issue of the Newsletter.

Europe:
EAPD
1996 June 8-llth Bruges, Belgium
Co-President - Prof Luc Martens
1998 June - date and place to be finalised.
EAPD Congresses are held every other year
to alternate with the IAPD Congresses.
IAPD
1995, 8-11 th June, Goteborg, Sweden
Details: Dr S. Edward, University of Goteborg,
Faculty of Odontology, Medicinaregatan 12
S-41390, Goteborg, Sweden.
Tel: 46 317733146. Fax: 46 36 712235
Nordic Pedodontic Society
1996 Iceland (Date and place TBA)

Overseas:
IAPD
1997 16-21 st Sept. Argentina
1999 (TBA)
AAPD
1995 25-30th May, San Francisco
1996 26-31 st May, Chicago
1997 (Date TBA) Philadelphia
A/NZAPD
1995 25-27th Aug Queenstown, NZ.
1997 (Date TBA) Australia

Newsletter Editor:
Dr Maxine Pollard
Asst. Editors:
Dr Sue Hickson Dr Jack Toumba