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[Promotion of orodental health in adolescents in Africa].

Bad dental hygiene in adults is usually the result of bad care during childhood. Within the framework of Health for All, WHO and the International Dental Federation defined global objectives for dental health which allow for monitoring progress in different countries. The most common dental problems, such as dental cavities, can be prevented by simple and inexpensive methods. Dental health is based on dental hygiene, nutrition, fluoride intake and dental service utilisation. Dental health promotion aims to create an environment favourable to the adoption of these healthy behaviours. The principle recommended dental health measures are through fluoridation of water, salt, and milk, a low consumption of sweets, and modification of the amount of sugar in the diet; implementation of monitored dental hygiene activities in schools; the organisation of regular dental services in schools/workplaces; and adopting legislative texts or laws requiring certain measures of prevention. In the past several years, certain African countries have set up national dental health programmes (there were 12 in 1993), However, the implementation of dental health promotion generally doesn't result from a national initiative, but from a regional or local scale. This is largely due to the lack of integration of dental health in activities of education and health promotion in general. Programmes planned at a national level and then implemented at a local level on a multisectoral base have had more success. This article presents examples of dental health promotion activities in several African countries, mainly focusing on programmes aimed at 12-13 year olds in primary school. Programmes from Morocco, Kenya, Madagascar, Côte d'Ivoire, Benin, and Tanzania are briefly presented and show that in Africa, dental health promotion has mostly consisted of the implementation of health education actions and that there are no consistent policies, unlike in other developing countries, for fluoridation of water, salt, and milk. In terms of dental health promotion, WHO recommends the promotion of traditional methods of dental hygiene (such as plants or sticks for cleaning), especially among adolescents living in rural and low income communities. In turn, the identification and promotion of the positive aspects of hygiene and traditional care will allow for the implementation of more culturally acceptable approaches.

Adolescent↗

The discourse of dental hygiene practice in Canada.

Recently the discourse in Canada relating to dental hygiene practice has changed. While dentistry still exercises controlling power over the public's oral cavity, dental hygienists have made inroads through legislative changes. A description of Canadian dental hygiene practice is provided to set the stage for a discussion about current discourse in the dental hygiene profession. Although power is often perceived as a shifting changing set of relations, these can be frozen in abstraction. It is rather like taking a photo of a single moment or event in an ongoing activity. This moment provides a starting point, an event that can be analysed. Four such events are evident in Canadian dental hygiene practice; they include, education, recognition of dental hygienists as primary care providers, the culture of dental hygiene and self-regulation. While all the events are important, self-regulation is critical to the viability and development of the profession. It is the central event that provides the backdrop for effecting change. With self-regulation comes responsibility and accountability for professional actions. It also provides possibilities for changing the discourse in oral care. As oral health care discourse is transformed through legislation and public awareness, the public will, hopefully, be able to directly access dental hygiene services, and dental hygienists themselves might increasingly recognise their importance as contributors in the health care system.

Canada↗

[The Law of Agreement to Medical Treatment (WGBO) in the dental practice: a survey].

On the basis of some pilot studies and several decisions on cases in the Dutch dental disciplinary jurisdiction issues are discussed about the introduction of new legislation in the field of patients rights in dental practice. The following matters are discussed: complaints of patients about the information they got from dentists; opinions of dentists about issues in the field of informed consent: the obligations of a good dentist; issues concerning the answering of difficult patient questions and problems concerning files of dental patients. It is concluded that there might be a discrepancy between the basic assumptions of the new legislation and the practice of dentistry.

Dentist-Patient Relations↗

[Amalgam. XIII. Criticism on dental amalgam: right or wrong?].

Some brief remarks, partly based on Dutch legislation, are made on the dentists' attitude towards the use of dental amalgam. The patient is entitled to ask for dental restorative materials other than amalgam. On the other hand, the dentist is entitled to refuse to apply materials that are, according to the prevailing professional standards, inappropriate in a given situation.

Attitude of Health Personnel↗

Dental care for children with mental retardation: thoughts about the Americans with Disabilities Act.

The Americans with Disabilities Act bars discrimination in public accommodations, housing, employment and health care for people with disabilities. Efforts to "mainstream" (in housing and education) many of the individuals with mental retardation have altered the setting for dental services and place demands for services by dental practitioners in the community. These developments should be considered within the jurisdiction of this new legislation. Demographic characteristics and dental needs of children with mental retardation are reviewed to provide a background for this discussion.

Adolescent↗

Regulating dental nursing in the UK.

There has been much discussion about the impending legislation for compulsory registration of dental nurses. A questionnaire survey of Oxfordshire dental practices found that 60% (153/254) of dental nurses had no formal qualifications. Of these 49% (75/153) were already on a training course or planning to apply for one although those who achieve mediated entry may discontinue training. Overall, 40% (62/153) were planning to apply for mediated entry. Previous research indicates that there may be similarly high proportions of unqualified dental nurses throughout the UK. There are concerns that a rigid training programme and compulsory examinations will compound existing recruitment problems, and create a national shortfall of dental nurses. Proponents believe that formal training will better equip dental nurses to handle the demands of modern dental practice and bring them in line with other auxiliary health personnel. Training needs to be co-ordinated nationally to ensure adequate access and consistent standards. Dental nurses and practices should be consulted and supported throughout the implementation period.

Dental Assistants↗

[Tangential projection for depiction of the anterior regions of the jaws performed with the dental X-ray set].

The tangential projection represents an extraoral projection which with success can be performed with the dental X-ray set. The film is placed lateral to the angle of the mouth in a vertical position level with either the maxilla or the mandible. If a view of the midline is wanted the film is placed parallel with the sagittal plane; if e.g. the canine region is of interest the film is angulated. The central X-ray is directed horizontally and perpendicularly to the film passing (as a tangent) the anterior surface of either the maxilla or mandible. The beam area used for periapical projections is ideal also for this projection. The tangential projection is indicated as a supplemental projection for three-dimensional localization of e.g. supernumerary teeth in the maxillary anterior region and for the buccolingual position of an impacted canine. It is also very useful in combination with frontal projections in the planning of insertion of dental implants. According to the Danish legislation it is not allowed to use the dental X-ray set for extraoral projections unless intensifying screens are used. However, the Danish Institute of Radiation Hygiene has accepted tangential projections using dental X-ray films and omitting intensifying screens in edentulous patients due to their better resolution, which is of particular importance in the planning of implant insertion.

Humans↗