The Brave Behaviour Award
EAPD - 4th Congress Sassari, Italy, Pre-Congress seminar
EAPD - Notice of General Assembly
EAPD General Assembly - Minutes of meeting June, 1996, Bruges
Announcement of EAPD Prize
Application for Membership
Curriculum Guidelines for Education and Training in Paediatric Dentistry
Time is running very fast and very shortly we will meet in Sardinia for our Academy’s 4th Congress. I am sure that as happened with the prior Congresses you have made already plans to attend and support it with your presence and your exceptional scientific work. The Congress strengthens the image and role of our Academy. The preliminary programme with the scientific sessions and the speakers should be in your hands by now. I think it is clear that this is going to be another successful Congress both scientifically and socially. Just be there. There are so many important issues we must discuss and act upon for the benefit of our Academy such as the Fluoride Guidelines and the discussion on postgraduate PD programmes.
Regarding the other issues, we succeeded after the hard work of the members of the Education and Quality Assurance committees to forward their two pending tasks and have some more completed proposals for discussion and approval by the Council. On the other hand, after a hard and close collaboration with the Executive Committee, we succeeded in completing most of the proposals I made two years ago and discussed at the interim meetings of the Executive Committee and Council in Athens last June. Now, some of these proposals are going to come for final approval and therefore your presence and contribution to the process is mandatory.
Dear Colleagues, what I see as more important from now on is not how we could bring new members into our Academy, but how we could keep them active, enthusiastic and supportive. The question that remains though is whether our members are satisfied and really get what they expect from the Academy. How we can feed them better by providing, via different ways all necessary knowledge and material that they need for their better development. How we can make them publicise their views via the Newsletter and interchange their knowledge and ideas with other members or the Board bringing ourselves closer. For this reason. I think it is time to see the development of our "European Journal of Paediatric Dentistry" more effectively and do something about it. There is so much scientific work of high quality that goes to different Journals. Why shouldn't it be in the same Journal, our Journal? Why have other associations. founded after we were, succeeded in having their Journal and we haven’t? Let’s reconsider and try one way or another.
The other parameter that we have not paid that much attention to is to make our members feel important and caring about the Academy. This is something that doesn't come by itself and an effort towards this direction is needed, from both sides - the Board and the Council as well as the members. The question is how we succeed on that. From my point of view, the key word to this issue is "participation": at the European level - like in the General Assembly - or at the local level - in the National group.
No matter what your membership status is, the Academy needs your active participation and contribution. We need your ideas and suggestions in order to have a spherical view and justification of the decisions taken for implementation by the Council.
The Council and the General Assembly run the Academy. The question, though, that we have sometimes come across regarding decisions on very critical issues is: how can we make sure that the opinion of each one of you or each group represented in the General Assembly by few, comes forward and is heard? How can we ensure that the decisions for critical issues taken by the General Assembly represent the majority of our members and are not based on a coincidental majority vote from people who represent themselves and no others? The Constitution, of course, clearly states that these issues should be presented and gain acceptance by the majority present. But, this is not enough and this is one more reason why your presence at the General Assembly is mandatory.
Moreover, your active participation at a local level should be mandatory as well for the better function and strengthening of the Academy. Your participation will bring more ideas; better understanding of your local problems to the Academy and you will be better informed about the actions taken by the Academy. On the other hand, the representative Councillor will have a clearer view of your concerns and he or she will act more efficiently by bringing these views to the Council. Increased participation means a stronger, more active and more efficient Academy that represents and addresses the needs of each one of us.
As I noted in the beginning of this communication, time is running and this is my last communication with you as President through Newsletter. On how I did it and whether I succeeded to fulfil the needs of our Academy and the demands of my Presidency, it is something that our members will decide evaluating my efforts and results of these two year’s work.
As an overall estimation. I think that we managed to complete a considerable number of issues I promised at the beginning of my Presidency. while others have come closer to completion. The close collaboration and the hard work of the Board, the Committee members and the Councillors made everything possible.
Taking this opportunity I would like to express my sincere thanks to all of you and each one separately, whether you were in the Board, in the Council or in different committees for your participation, collaboration and support that you gave me during these two years. I feel that I gained more than I gave to the Academy and I leave very contented, satisfied, and absolute sure of the bright and promising future of our Academy.
In behavioural research dental anxiety is considered to be multi-factorial, not originating from a single cause and consequence relationship. It is, however, unclear which factor or aspect it is that is most prominent in causing the anxiety in a particular child. Our problem, as operating paediatric dentists is that we do tend to point to a single cause as the main reason for a child’s inappropriate behaviour during treatment, forgetting that there can be much between heaven and earth than is dreamed of in our philosophy.
If a mother, frightened herself of the dentist, responds over-protectively to her child’s restlessness during a dental procedure. we open say "Look, the mother infects the child with her own anxiety like a contagious disease" and we forget to ask if perhaps the child has had a bad day, is sickening for an illness or is being bullied at school. We then go with our first impression and if the next treatment goes badly we attribute this to the previous session covering our prejudice with a glaze of cognitive reasoning.
Eventually it is the aim of thorough research to discover the best way to diagnose and treat dental anxiety in children. For us. as operating paediatric dentists. such research is important and basic but will not quickly distract us from our routine clinical views. Recently a child psychologist told me that he could not precisely define the characteristics of an anxious child but he was, however, able to recognise one when confronted with him or her. When questioned further about the characteristics which struck him, an image slowly appeared. This image did not explain the reason for the child’s anxiety but it did create an overall picture with a clear differentiation between a child with a history of a single trauma and a child who had difficulty in getting used to all kinds of new' events in his or her little life.
The Overall Picture
The idea is not vet fully formed but it is important. We have not yet developed a complete computerised programme to name all causes and consequences but children do exist who are afraid of everything and who tend strongly to overreact when faced with even minor stress. every time. These children adapt slowly to new situations and so how will they react at their routine dental check-up when restorative treatment is required or when suddenly - blazing saddles - an unbearable toothache comes on in the night. Such children have very limited coping abilities and even time we have to help and support them to reach beyond the limits of their capabilities.
Consider the story of Samantha (6 years old). She was generally anxious and afraid of everything. She stood in the waiting room, pale shivering and vulnerable, clinging to her mother. On questioning, her mother told us there had been serious problems in brushing Samantha's teeth, cutting her nails, washing her hair and on her going to school for the first three months. Giving nose drops still meant a baffle and it was impossible to persuade her to swallow tablets or to accept a paracetamol suppository.
Samantha’s dental treatment was, of course, the next link in the chain. Her dentist had postponed restorative treatment as long as possible but the balance between de- and re-mineralisation was far from perfect. He had tried repeatedly to apply fluoride to her teeth but, alas, found that this was also a link in the chain of negative events. Eventually he referred her to our special dental care centre.
At the centre we could only explain to Samantha and her mother that we would, in fact, use the necessary restorations to get her used to treatment. Treatment would be characterised by a very structured step-wise desensitisation. We would inform Samantha about all aspects of the treatment but once we said a procedure would take place, we would not postpone this for any reason. Samantha's anxiety would not disappear or probably even decline. but she would be able to learn to cope with it. Exposure to a low level of dental treatment was necessary for her to learn to cope in this way. We pointed out that treatment would be a long-term project and that her mother's co-operation was essential. If we declared that we were going to perform a particular procedure and parents allowed the child to let them put this off, any progress already gained would rapidly melt away.
Samantha became dentist Dave's regular patient. He was nice and friendly. talked and explained things, let her get used to nitrous oxide, repeated the procedure and completed his first filling in session tour. During all this time Samantha sobbed and cried, tried to put off treatment, claiming she was ill, especially in the waiting room and during local anaesthesia. On the other hand. nightmares concerning the dentist had been reduced and Samantha's mother was able to warn her about dental visits half a day in advance.
At the fifth session Samantha walked happily into the clinic. “Today I am going to help you even more” she announced. “Today I am not going to cry during the injection”. “That would indeed be marvellous” said Dave and put her in the chair immediately, taking advantage of the enthusiasm of the moment. And indeed. all went well. No tears. no sighs, no sobs. Impressed, Dave realised that the occasion should be marked by something special. He combined a material reward with an emotive and social one: In his best handwriting he wrote her a “Brave Behaviour Award” (BBA). No one would question that Samantha had earned it.
And the next time .....
The next time Samantha came in with her BBA to prove what she could achieve. But treatment reverted to how it had been originally with a lot of tears and sadness. Samantha was unable to hide behind her award and the BBA could not conceal the fact that she was a generally anxious girl. Last time’s good moment was long forgotten.
EUROPEAN ACADEMY OF PAEDIATRIC DENTISTRY
4th ANNUAL CONGRESS
PORTO CERVO - COSTA SMERALDA - ITALY
2nd to 5th May 1998
NUTRITION DIET AND DENTAL HEALTH IN CHILDREN
Main Congress Hall
Opening Remarks - Chairman
Prof. D Resta, Italy
Nutrition, Diet and Health
Prof. M. Gibney
Current Concepts of Caries and Relation Effects of Diet and Plaque Control In Caries Prevention
Dr B. Nyvad
Diet and Dental Caries
Dr C. van Loveren
Practical Diet Counselling in Paediatric Dentistry
Dr M. Duggal Univ. Leeds. Leeds, England
NOTICE OF GENERAL ASSEMBLY OF EUROPEAN ACADEMY OF PAEDIATRIC DENTISTRY
There will be a General Assembly of the Academy in association with the Congress to be held in Porto Cervo, Sardinia. The Assembly will be held at 13.00 in the Main Conference Room, on Monday May 4th,1998.
All members of the Academy are entitled to attend and participate at the Assembly. Should there be any reason for members to vote on any nomination or issue, members are reminded that only Active members are entitled to vote.
The proposed agenda for the meeting is as follows:
1. Welcome by President Oulis and opening remarks.
2. Apologies for absence.
3. Minutes of the Assembly held in Bruges.
4. Matters Arising.
5. President’s Report.
6. Secretary’s Report.
7. Treasurers Report.
8. Committee Reports: Credentials, Constitution, Education, Nomination. Finance, Quality Assurance, any others.
9. Election of Officers for the term 1998 to 2000: President-Elect, Secretary, Treasurer
10. Installation of the New President
11. Congress Reports: 1998 - Sardinia, Italy
2000 - Bergen, Norway
2002 - Dublin, Ireland
Proposals for future Congresses.
12. Any Other Business.
This is the proposed agenda. Any member who wishes to add any other item of business should so advise the Secretary in writing before April 15th in order to give time for the printing of the final order of business which will be available at the time of the Assembly.
Outline of Minutes of the General Assembly held on 8th June, 1996, in Bruges.
96.1. WELCOME. Prof Goran Koch welcomed all the delegates and gave a sincere thanks to Prof Martens and his organising committee for such a successful meeting. Council had met on three occasions since the last General Assembly and had continued to develop the Academy. Prof Koch thanked all the members of Council for their support during the previous two years.
96.2 APOLOGIES for absence were received from Profs. Furtado and Krieberg.
96.3 MINUTES of the General Assembly held in Athens in 1994 were approved.
96.4 MATTERS ARISING. The main item arising was the suggestion that membership fees could be paid by credit card. The Treasurer had looked into this matter and it was certainly possible. Council recommended that for the year starting January 1997 payment of the annual subscription could be by credit card. This put to the general Assembly and approved.
96.5 SECRETARY’S REPORT. Prof Curzon reported continued and increasing activity for the Academy. Membership applications were still coming in although not at such a high rate as in previous years. The Academy was now six years old and not surprisingly we were now starting to loose members due to change of practice emphasis, non payment of dues or retirement. Council had approved a new Honorary Prof. Kunzel. The Newsletter was now Edited by Dr Pollard and was being issued several times a year.
96.6 TREASURER’S REPORT. Dr Roberts said that the finances of the EAPD were in very good condition. We continued to spend less than income so that the accrued capital of the Academy steadily increased. The main and most expensive cost was that of the Newsletter which was about £2.200 per year. Total membership was over 300 but paid subscriptions. active and associate, was a lot less because of an increasing number of students and also members in default of their subscriptions.
96.7 COMMITTEE REPORTS. Constitution: Prof Hoskuldsson (Chair) reported that to the Constitution were being completed and more would be needed to ensure that our Constitution was acceptable to the European Union regulations. This was an ongoing process and it was hoped to have most changes completed by 1998.
Credentials: This committee reviewed a number of applications during the year as more dentists applied to join. The process had been speeded up during the past year but problems were still encountered with applications not being in English and with applicants having very varied training pathways. Prof Curzon. (Chair) thanked the members of the committee for their work.
Education: Prof Martens (Chair) reported that it had been a very busy time for the committee which had completed the draft guidelines on training in Paediatric Dentistry. These were now ready and could be obtained from either himself or the Secretary. It was planned to publish these guidelines in due course. Prof Koch paid particular tribute to Prof Martens and the Education Committee members which had had the hardest task for the EAPD.
Scientific Committee: Prof Oulis (Chair) reported that the committee had been very pleased with the large number of papers submitted for the Bruges Congress. The quality had been very high. This was notable as the Academy was still quite young and a high number of submissions of quality compared very well with other organisations.
96.8. FUTURE CONGRESSESS. In 1998 Council had approved that the Congress would be held in Porto Cervo, Sardinia (Italy) under the Co-President Prof Guiliano Falcolini. Prof Falcolini made a short presentation of the venue and facilities and hoped to welcome all members of the Academy there. It would be held in early May.
2000: Council had recommended that the Congress in the millennium year would be held in Bergen. The Co-President for that Congress would be Prof Magne Raadal.
2002: A preliminary proposal had been received by Council from Dr Fenlon that the 6th Congress be held in Dublin. This had been provisionally approved.
96.9 ANY OTHER BUSINESS. Prizes: It was reported that the Italian Society of Paediatric Dentistry was inaugurating a prize for an Italian postgraduate student to study at another centre of paediatric dentistry. There was also to be an EAPD prize of about £1.000 to be awarded for the best proposal on a research topic. Each two years a topic would be selected by Council and the first one would be on research related to Behaviour Management of Children. Details as to the submission, assessment and awarding of the prize would be developed and announced when ready. There was also to be a supplementary award to enable the winner of each prize to present the results of the research, two years after the award, at the next Congress.
Congress Levy: Council proposed that at each Congress there be a levy or charge, payable to the central funds of the EAPD. This charge would be per delegate registered at the Congress. The value of the levy would be approved by Council. This proposal was put to the assembly and approved.
96.10 INAUGURATION OF PRESIDENT. Prof Koch installed the incoming President Prof Oulis. Prof Koch remarked that he had been honoured to have been President of the Academy and wished Prof Oulis success for the forthcoming two years of office. Prof Oulis thanked Prof Koch for all his hard work on behalf of the EAPD. Prof Oulis said that there was still much to be done as the EAPD continued to grow. During his term of office he hoped to initiate a number of matters. These included Standing Orders for the conduct of the Academy and also consideration of a place for the EAPD on the Internet. Communication between members and Councillors was important, he felt, and procedures should be put in hand to increase this. He thanked all the members of the Academy who had worked on our behalf and looked forward to a productive period in office. He hoped to welcome all members to the next Congress to be held in 1998 in Sardinia.
There being no other business the Assembly was closed. The next Assembly will be held in Porto Cervo, Sardinia (Italy) at a time and place to be announced.
A prize of £ 1,000.00 will be awarded for the first time at the Congress of the Academy to be held in Sardinia in May 1998. The prize will be awarded to a young dentist, working within Europe, either in postgraduate training, proposing to start training or within two years of completion of training. The prize will awarded to the best submission on a proposed research study on the topic of:
BEHAVIOUR MANAGEMENT IN PAEDIATRIC DENTISTRY
The submission should be single spaced of no more than four (4) pages of A4 paper in 12 point print and should give the Name of the Student and their Sponsor, Background to the study, the Work Study Plan, the Time Table of Research and Key References to support the rationale for the research Only one submission is allowed per student. Four (4) copies of each submission for the EAPD Prize should be sent to:
Hon. Secretary, EAPD Office, 20, Rishworth Street Wakefield, England, WFl 3QS.
Deadline for submissions: APRIL 25th, 1998. All submissions will be considered by the Scientific Committee at the Congress in Sardinia and the winner will be announced at the Banquet on Monday May 4th.
A reminder of the process
Applications for membership should be by completion of the standard application form. These forms should be processed through the Councillor for the country concerned or where there is no Councillor directly to the Secretary of the EAPD. All applications should be:
In English - have a two page (only) curriculum vitae,
Have a copy of the certificate or diploma of training in Paediatric Dentistry
Be countersigned by two existing members of the Academy.
Thus each application should therefore not be more than five pages. Any applications not meeting these requirements will be returned.
Once received, the process is that one set of each application is sent to each of the five members of the Credentials Committee. These members decide whether an application is acceptable and what will be the category of membership - Active or Associate.
The Chairman of the committee, the immediate past-President, collates the opinions of the committee members and sends the result to the Secretary. The new member is advised of acceptance and membership category. A membership fee is payable on an acceptance.
CURRICULUM GUIDELINES FOR EDUCATION AND TRAINING IN PAEDIATRIC DENTISTRY
These guidelines were recently printed in the International Journal of Paediatric Dentistry. The Academy has purchased a substantial number of reprints which are now available. Soon, all Councillors will receive a supply of these reprints but in the meantime all members of the Academy can request copies. To do so please write to the Secretary at the EAPD Office, 20, Rishworth Street, Wakefield, England,
WF1 3BY, or by Fax on +44-113-261-3892. There is no charge for these reprints.