Message from the President

With the glorious meeting in Athens,1994, in mind foward to our next congress in Bruges in 1996, I wish all members of the EAPD a prosperous 1995. The Academy continues to grow and we are especially happy that the number of student memberships is increasing. They are the future of our organisation.

We are working in a changing Europe and there are many indications that the care of children has a decreasing priority amongst governments and other dental organisations. This has major implications for child dental care. In this situation the EAPD has an important role to stress and work for quality care in paediatric dentistry. We must all make ourselves visible and heard to authorities and politicians within our own countries and throughout Europe. It is important that every distinguished member of the Academy uses the material developed by our organisation and presents it to the ministries and health authorities as basic rules for a good and effective paediatric dentistrv service.

Thus, we have to work in two ways. Firstly, to strengthen our Academy by forming an all-Europe Organisation of well educated and highly respected paediatric dentists. This is on the way and the guidelines for education and training in paediatric dentistry is one very important aspect in addition to our scientific congresses. The work for acceptance of paediatric dentistry as a speciality in Europe is also a part of this. Secondly we have to work for quality assessment guidelines to be publicised to all colleagues dealing with dentistry for children throughout Europe. This last issue will be brought before the Council of the Academy who will meet in Goteborg on Wednesday June 7th, the day before the opening of the 15th Congress of the International Association of Dentistry for Children. A special invitation will be sent shortly to all Councellors but all members are encouraged to express their views on quality assessment procedures to their own Councellors. It is my belief that quality assurance will be a major task for the future and we will be developing guidelines together with our sister oragnanisations the American, Canadian and Australasian Academies of Paediatric Dentistry.

It is a thrilling future that we have to face, but we all have to work hard at it.

Goran Koch
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Stop Press:

On January 1 st,1995 the European Community was enlarged when Sweden, Finland and Austria joined. As Sweden recognizes Paediatric Dentistry as a dental speciality, this will aid in our campaign for European wide recognition of our speciality. We need two countries within the EC who recognize the speciality.
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Education Committee Report
Training Guidelines in Paediatric Dentistry Completed

At the Athens Congress the Workshop on Postgraduate Training in Paediatric Dentistry completed its work and drew up a set of guidelines for future use. The document gives details as to the recommended requirements for the training of dentists in Paediatric Dentistry. Copies of the manual are available from the Secretary on application.

It is intended that the guidelines should be used to indicate the topics to be covered within a training program. It is recognized however that there will be local needs and so it has been recommended that any one program should con-form to about 75% of the guidelines, leaving 25% of a program to be designed for national requirements.

There was some debate within the Workshop as to whether there should be an additional set of words, as in the draft guidelines, which covered the care of older special needs patients. It was decided that this should not be so and that the definition as given above should be confined to the care of children up to adolescence. It was recognized that the upper age limit may vary from country to country and therefore could not be specified. Similarly the definition of 'special needs' might also vary and should be left open.

The final draft document is being issued as needed to those within the speciality who have training programs. However at the same time it is recognized that this agreement was only a start and that over the next few year's further additions or improvements to the guidelines will be needed. The guidelines were designed initially for a full time two year program, or its equivalent in contact hours over a longer period of time. A three year program was the aim as soon as this could be brought about.

The overall goals of a training program should be:

• To graduate specialists in Paediatric Dentistry who are competent and confident in all areas of Paediatric Dentistry for the growing and developing child.
• To produce specialist Paediatric Dentists to meet the oral health needs of infants children, adolescents and patients with special care needs (where appropriate), and who will continue to seek additional knowledge and skills throughout their careers.
• To produce Paediatric Dentists capable of carrying out scientific investigation in both clinical and basic science aspects of the speciality.
• To produce specialists in Paediatric Dentistry who are able to teach the dental care of children within the speciality as well as for general dentistry and for other health care workers.
  
  
  Recognition of Programs

The encouraging outcome of the Workshop leads on to the next phase which is recognition of training programs. Throughout Europe there are a number of existing courses and others are planned. Because membership in the Academy is based upon completion of a minimum of two years training the logical next step is for the Education Committee to draw up a list of existing programs that meet the guidelines.

During 1995 Directors of Training Programs in Paediatric Dentistry are encour-aged to apply for registration of their program with the Education Committee through its Chairman, Professor Luc Martens. Also during 1995 the concept of visitation and assessment will be explored and tried out.

Main Topics of the New Guidelines

Three levels of competence and understanding were thought to be necessary. There were:

COMPETENT TO:
At this level students should have a theoretical knowledge and understanding of the subject together with an adequate clinical experience to be able to resolve any clinical problems encountered, independently, or without assistance.

KNOWLEDGE OF:
The students should have a sound theoretical knowledge of the subject, but need only have a limited clinical experience.

FAMILIAR WITH:
Students should have a basic understanding of the subject, but need not have direct clinical experience or be expected to carry out procedures independently.

These guidelines were drawn up by members of the Education Committee comprising Franz Frankenmolen, Luc Martens, Satu Alalusuua, Lisa Papagianoulis, Barry Scheer and Goran Dahloff. Preliminary work was completed by the education task force of Goran Koch, Constantine Oulis, Luc Martens and Martin Curzon.The Academy is very grateful for all their hard work on our behalf on this most important task.
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Conference Report
Workshop on: Carbohydrates in Infant Nutrition and Dental Health.
Darmstadt, Germany, November 17-18,1994

The objective of the conference was to review various aspects of infant nutrition, to include the effects of foods and drinks on dental caries in the the child aged six to 24 months. One session was devoted to the dental aspects, chaired by Professor Curzon. The opening paper, given by Dr Pol- lard, introduced the topic of dental development and the multifactorial nature of dental caries. This was followed by a more detailed presentation by Dr Imfeld on the role of carbohydrates in the aetiology of caries and erosion. The different types of carbohydrates were described and it was noted that they are not involved in erosion. The presentations then went on to review in detail the aetiology, prevalence and possible prevention strategies of nursing bottle caries with papers being given by Professor Curzon and Drs Suhonen and van Loveren. The second session looked at the nutritional aspects of carbohydrates for infants. The importance of carbohydrates for energy and possible metabolic problems were discussed. The physiology of and preference for sweet taste was explained in detail. The third session looked at psychological and legal aspects associated with eating. Although children are neophobic, it has been shown that with repeated exposure to foods, many new foods will eventually

be accepted. However, emotional and social development are also factors involved in understanding the developmental aspects of children's eating behaviours. The effect of food television commercials aimed at children were thought to be detrimental as a strong preference for high sugar foods would be developed. A final paper was given on product liability in Germany. The German Supreme Court has ruled that the manufacturer may be held liable for any hazards from possible abuse of a product if warnings have not been clearly stated on the packaging. Dentists can also be held liable for not fulfilling or insufficiently fulfilling the doctor-patient contract if they refuse to treat nursing caries cases or do not treat them appropriately. The workshop was concluded with a lively panel discussion. The meeting was very successful in bringing together paediatric dentists and paediatricians. A further conference on Nursing Caries is obviously needed as this aspect of the dental care of children continues to be present in significant numbers of children despite the overall decline in caries in western societies.

Maxine Pollard
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Speciality Recognition

This continues to be one of the major areas of work for the EAPD and its Council. Our aim is that Paediatric Dentistry be recognized as a dental speciality in a11 countries of Europe.Within the EC the situation is now that Sweden recognizes the speciality for hospital and private practice. The UK and Ireland recognize Paediatric Dentists but only within the hospital service and not in private practice. The General Dental Council of the UK has agreed that it will eventually recognize dental specialities for practice but Paediatric Dentistry will not be one of the first to be recognized. Elsewhere no other country yet has the speciality officially. In Greece strenuous efforts are being made for recognition and we all hope that our colleagues there will be successful. The key to the problem within the EC is to have two countries officially recognizing the speciality. It was unfortunate, for us, that Norway did not vote to join the EC as they recognize Paediatric Dentistry and, together with Sweden, would have made the necessary two countries. At the present time the EC recognizes two dental specialities -

Oral Surgery and Orthodontics. Our task is to gain one other country in the EC that recognizes our speciality so that other countries, through the regulations of the EC, can put pressure on their own governments for recognition. The Council welcomes all help and information that our members can give. At the same time members wanting information to aid them in their efforts should write to the President or Secretary and we will help all we can. Unfortunately while the inclusion of Sweden in the EC aids our cause there is also some not so good news.In France the general dental practitioners are campaigning against speciality recognition of all types. We need to keep our information on this subject as up to date as possible and we ask that all members tell us of developments in their countries as soon as possible. This should be positive as well as negative developments. Finally we ask all members to contact their MEP to find out and change if necessary, their attitude to Paediatric Dentistry.

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Future Meetings

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

INTERNATIONAL POSTGRADUATE
SUMMER COURSES 1995

Teaching Staff:

Dr Jens O Andreason,
Associate Director,
Dept Oral Medicine and Oral Surgery,
University Hospital, Copenhagen, Denmark.

Dr Anna-Lena Hallonsten,
Senior Consultant, Paediatric Dentistry,
Institute for Postgraduate Dental Education,
Jonkoping, Sweden.

Ass Prof. Magnus Hagerdal,
Dept Anaesthesiology,
University Hospital, Lund, Sweden.

Prof. Goran Koch,
Head of Dept Paediatric Dentistry,
Institute for Postgraduate Dental Education,
Jonkoping, Sweden.

Ass Prof. Juri Kurol,
Head of Dept Orthodontics,
Institute for Postgraduate Dental Education,
Jonkoping, Sweden.

COURSE I.
Nitrous Oxide/Oxygen
Inhalation Sedation
Content:

Physiology of pain, respiration
and cardiovascular system

Patient health assessment

Nitrous oxide/oxygen sedation,
pharmacology, clinical use,
equipment and occupational
health aspects

General anaesthesia and other
sedative drugs in dentistry

Supervised clinical use of
nitrous oxide/oxygen sedation

Dates: August 7- 11 (30 hours).
Fee: US$ 1,100

COURSE II.
Clinical Update in Advanced Paediatric Dentistry
Content:

Strategies in caries prevention

Identification of high-risk patients

Treatment planning and
restorative treatment procedures

Disturbances of tooth
development/treatment

Oral pathology and
surgery in children

Dental care of handicapped
and chronically sick children

Pain control and sedation

Rational treatment of traumatic
injuries to the teeth

Treatment solutions for dental
and occlusal disturbances during
development of the dentition:

guidelines for supervision of
the dentition and tooth eruption

best time for treatment

the choice between different
treatment soluions

Date: August 14 - 18 (30 hours)
Fee: US$ 1,100

There are vacancies for 20 participants in
each course. For information and applicant
form etc, please contact:
Mrs Sylvia Johansson
Institue for Postgraduate Dental Education
Fax: +44 36 712235

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