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WELCOME andWELCOME and

Thanks for coming…….Thanks for coming…….

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Genesis, scope and objectives of the Handbook: HIV/AIDS in Dental Practice

HIV/AIDS in Dental Practice

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Participation in the regional workshops and conferences on HIV/AIDS

Thanks to:

CHART, I-TECH, University of Washington and NACC

Motivation

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Identification of the Identification of the problem:problem:

– Dental and medical practitioners in Dental and medical practitioners in the region lacked adequate scientific the region lacked adequate scientific knowledge about the HIV diseaseknowledge about the HIV disease

– Dental practitioners are unaware of Dental practitioners are unaware of various oral health implications of HIV various oral health implications of HIV disease and other blood borne viral disease and other blood borne viral diseasesdiseases

– Stigma and discrimination against Stigma and discrimination against people living with HIV disease is people living with HIV disease is widespread among dental widespread among dental practitioners in the regionpractitioners in the region

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Realized the need for an Realized the need for an educational tool targeted at educational tool targeted at dental practitioners:dental practitioners:

– A comprehensive educational approach A comprehensive educational approach targeted at dental practitioners in the targeted at dental practitioners in the region was needed to ‘educate’ them on region was needed to ‘educate’ them on general aspects of the disease and general aspects of the disease and

– To do justice to the variety and To do justice to the variety and variability of oral diseases experienced variability of oral diseases experienced by persons living with HIV/AIDS andby persons living with HIV/AIDS and

– Dental practitioners can play a Dental practitioners can play a significant role in improving the quality significant role in improving the quality of lifeof life of PLWHA

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Educational Educational Responsibility: Responsibility: BIG Question:BIG Question:

Can we afford to wait for things to Can we afford to wait for things to happen ?happen ?

or, or,

Shall we make it happen……….NOW!Shall we make it happen……….NOW!25 years after……….Better late than never!.25 years after……….Better late than never!.

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Who?Who?

Who should shoulder this Who should shoulder this ‘educational’ responsibility?‘educational’ responsibility?– MOH?MOH?– NGOs?NGOs?– CHART, NACC?CHART, NACC?– Medical institutions?Medical institutions?– Individuals?Individuals?

Every one has a roleEvery one has a role

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Our role?Our role?

In view of its dual responsibility In view of its dual responsibility such as training dentists and such as training dentists and providing oral health care, it is providing oral health care, it is only natural that the University of only natural that the University of the West Indies is the most the West Indies is the most appropriate institution that should appropriate institution that should be leading this ‘educational’ be leading this ‘educational’ campaign aimed at practicing campaign aimed at practicing dentists in the regiondentists in the region

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Our role…Our role…

On behalf of the UWI School On behalf of the UWI School of Dentistry,……I took it upon of Dentistry,……I took it upon myselfmyself

This is how it all began….This is how it all began….

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Who is it meant for?Who is it meant for?

Primary target:Primary target:– All Dental Practitioners in the English All Dental Practitioners in the English

Speaking CaribbeanSpeaking Caribbean Secondary Target:Secondary Target:

– Dental Surgery Assistants/Dental Dental Surgery Assistants/Dental Nurses/Dental Hygienists in the Nurses/Dental Hygienists in the CaribbeanCaribbean

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Not for sale……Not for sale……

Dentists are wealthy (except those who Dentists are wealthy (except those who work for the UWI) and can afford to buy work for the UWI) and can afford to buy copies of books but the fact is……..copies of books but the fact is……..

Decision:Decision:

– Copies to be delivered at their door steps at Copies to be delivered at their door steps at no cost to the dental practitioners no cost to the dental practitioners throughout the English speaking Caribbean. throughout the English speaking Caribbean. This is the only way the information could This is the only way the information could reach the targeted audiencereach the targeted audience

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May be a great Idea , but May be a great Idea , but who would fund the who would fund the project? project?

Project proposal and Sponsorship Project proposal and Sponsorship search in July/Aug 2004search in July/Aug 2004

Special thanks to: Special thanks to: CHARTCHART, (Prof. , (Prof. Brendan Bain and his team), NACC, I-Brendan Bain and his team), NACC, I-TECH (U of W) and Colgate-Palmolive TECH (U of W) and Colgate-Palmolive for their spontaneous and generous for their spontaneous and generous supportsupport

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Collective effort……Collective effort……

23 contributors in all: 23 contributors in all: – 12 from T&T 12 from T&T – 2 from Jamaica 2 from Jamaica – 1 from Nassau1 from Nassau– 5 from USA5 from USA– 3 from Australia 3 from Australia

Thanks for their valuable chapter Thanks for their valuable chapter contributionscontributions

18 months later….. to MPC of the UWI18 months later….. to MPC of the UWI

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Messages of support Messages of support for the Caribbean for the Caribbean projectproject His Excellency the President of the His Excellency the President of the

Republic of Trinidad and TobagoRepublic of Trinidad and Tobago Hon. Prime MinisterHon. Prime Minister Hon. Health MinisterHon. Health Minister Chancellor of the UWIChancellor of the UWI Vice Chancellor of the UWIVice Chancellor of the UWI Pro-VC and Principal, St. Pro-VC and Principal, St.

Augustine Campus UWIAugustine Campus UWI

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Messages for the Messages for the book:book: His Excellency the President of the His Excellency the President of the

Republic of Trinidad and Tobago Republic of Trinidad and Tobago Professor Maxwell Richards wrote Professor Maxwell Richards wrote ((inter aliainter alia):):

““I must also acknowledge that this (the I must also acknowledge that this (the book) is a precursor to the book) is a precursor to the establishment of a dedicated dental establishment of a dedicated dental clinic at the School of Dentistry aimed clinic at the School of Dentistry aimed at treating HIV/AIDS at treating HIV/AIDS patients”patients”

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Messages……Messages……

Hon. Prime Minister Mr. Patrick Hon. Prime Minister Mr. Patrick Manning wrote (Manning wrote (inter aliainter alia):):

““It (the book) addresses a dire It (the book) addresses a dire necessity in a commendable manner necessity in a commendable manner and should go a considerable distance and should go a considerable distance towards improving standards of towards improving standards of regional dental practice and our regional dental practice and our realization of greater success in the realization of greater success in the fight against HIV/AIDS”fight against HIV/AIDS”

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Messages…..Messages…..

Hon. Minister of Health Mr. John Hon. Minister of Health Mr. John Rahael wrote (Rahael wrote (inter aliainter alia):):

““Oral Care providers now benefit from Oral Care providers now benefit from a source of expert-authored a source of expert-authored information that addresses the information that addresses the plethora of issues encompassing the plethora of issues encompassing the reality of HIV/AIDS and oral health reality of HIV/AIDS and oral health care within a Caribbean context”care within a Caribbean context”

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Messages….Messages….

Chancellor of the University of the Chancellor of the University of the West Indies Sir George Alleyne West Indies Sir George Alleyne wrote (wrote (inter aliainter alia):):

“It is good to see our Faculty in the University of the West Indies deeply engaged in the many aspects of this epidemic…..”

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Messages….Messages….

Vice Chancellor of the University of the West Vice Chancellor of the University of the West Indies Professor Nigel Harris wrote (Indies Professor Nigel Harris wrote (inter aliainter alia):):

““On behalf of the University of the West On behalf of the University of the West Indies, whose mission is to contribute to Indies, whose mission is to contribute to human resource capacity building in the human resource capacity building in the Caribbean as well as , to the conduct of Caribbean as well as , to the conduct of research and outreach relevant to the research and outreach relevant to the region, I congratulate Professor Prabhu region, I congratulate Professor Prabhu and his colleagues for this tremendous and his colleagues for this tremendous effort . Through them, our university has effort . Through them, our university has struck a positive note for good health”struck a positive note for good health”

2020

Messages….Messages….

Pro Vice Chancellor and Campus Pro Vice Chancellor and Campus Principal Dr. Bhoendradatt Tewrie Principal Dr. Bhoendradatt Tewrie wrote (wrote (inter aliainter alia):):

““This publication undoubtedly This publication undoubtedly provides a most timely guide for provides a most timely guide for dental practitioners that will fill a dental practitioners that will fill a gap in an area of medical treatment gap in an area of medical treatment that has been neglected for too that has been neglected for too long”.long”.

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Foreword by Professor Foreword by Professor David PlummerDavid Plummer A thought provoking foreword A thought provoking foreword

that discusses issues such as that discusses issues such as stigma, discrimination and some stigma, discrimination and some of the reasons for dental of the reasons for dental practitioners’ refusal to offer practitioners’ refusal to offer dental treatment to HIV patients. dental treatment to HIV patients.

A ‘must read’ for all dental A ‘must read’ for all dental practitioners practitioners

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General General outline/structureoutline/structure Six Sections in 314 pagesSix Sections in 314 pages

Section 1Section 1

General Considerations with General Considerations with special reference to global special reference to global and regional disease burden and regional disease burden and its impact on the and its impact on the Caribbean society Caribbean society

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Section 2Section 2

Virological and Virological and Immunological Immunological Considerations setting a Considerations setting a stage for a better stage for a better understanding of the basics understanding of the basics of transmission and of transmission and mechanisms involved in the mechanisms involved in the disease process disease process

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Section 3Section 3

Clinical and Management Clinical and Management Considerations including Considerations including issues such as voluntary issues such as voluntary counseling, testing and counseling, testing and antiretroviral treatment antiretroviral treatment protocols protocols

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Section 4Section 4

Oral Manifestations and Oral Manifestations and considerations such as considerations such as Occupational risks, Post Occupational risks, Post Exposure Prophylaxis, and Exposure Prophylaxis, and infection control procedures infection control procedures in Dental Practicein Dental Practice

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Section 5Section 5

Practical Dental Practical Dental Considerations providing Considerations providing guide lines for guide lines for comprehensive and comprehensive and emergency oral care for emergency oral care for those living with HIV/AIDS those living with HIV/AIDS

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Section 6Section 6

Problem Solving Exercises.Problem Solving Exercises.– This section includes 8 case This section includes 8 case

studies involving clinical, ethical studies involving clinical, ethical and occupational risk issues in and occupational risk issues in dental practicedental practice

*Also included are tables of normal *Also included are tables of normal ranges of lab values, glossary of ranges of lab values, glossary of terms and a comprehensive list of terms and a comprehensive list of useful internet and other resource useful internet and other resource materialmaterial

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Sincere hope………Sincere hope………

This handbook will make a This handbook will make a difference in the dental difference in the dental practitioners’ knowledge base practitioners’ knowledge base about the HIV disease and about the HIV disease and prepare them for a non-prepare them for a non-discriminatory approach to discriminatory approach to treating Persons Living With treating Persons Living With HIV/AIDSHIV/AIDS

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DedicationDedication

““HIV/AIDS in Dental Practice: An HIV/AIDS in Dental Practice: An illustrated handbook for illustrated handbook for Caribbean Dental practitioners” Caribbean Dental practitioners”

Is Dedicated Is Dedicated

to to

Persons Living With HIV/AIDSPersons Living With HIV/AIDS

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Sincere Thanks to:Sincere Thanks to:

The sponsors of the HIV handbook: The sponsors of the HIV handbook: CHARTCHART, , I-Tech, NACC, Clogate and PalmoliveI-Tech, NACC, Clogate and Palmolive His Excellency Prof Max Richards, Hon. Prime Minister His Excellency Prof Max Richards, Hon. Prime Minister

Mr. Manning, Hon. Minister of Health Mr. John Rahael, Mr. Manning, Hon. Minister of Health Mr. John Rahael, Chancellor of the UWI Sir George Alleyne, Vice Chancellor of the UWI Sir George Alleyne, Vice Chancellor of the UWI Professor Nigel Harris, and Chancellor of the UWI Professor Nigel Harris, and Campus Principal Dr. Tewarie, for their kind messagesCampus Principal Dr. Tewarie, for their kind messages

UNESCO/Commonwealth Professor of HIV Education UNESCO/Commonwealth Professor of HIV Education Professor Plummer for the Foreword to the HIV bookProfessor Plummer for the Foreword to the HIV book

MPC for their excellent quality of printing of the HIV MPC for their excellent quality of printing of the HIV handbookhandbook

UWI /Faculty /Dental School for their constant supportUWI /Faculty /Dental School for their constant support Secretarial staff for typing the manuscripts and other Secretarial staff for typing the manuscripts and other

secretarial assistancesecretarial assistance CMSE staff for the graphic artCMSE staff for the graphic art

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Last but not the least……Last but not the least……

Thanks toThanks to

Uma, for her constant support Uma, for her constant support and for accepting so many and for accepting so many intrusions into leisure (shopping?) intrusions into leisure (shopping?) time with such good gracetime with such good grace

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Special Thanks to:Special Thanks to: Professor Brendan Bain, Professor Brendan Bain, Ms. Barbara McGaw, Ms. Barbara McGaw, Ms. Audi Reid, and Ms. Lorain, of Ms. Audi Reid, and Ms. Lorain, of CHART, Dr. Irvine McKenzie, Dr. CHART, Dr. Irvine McKenzie, Dr. Blossom Anglin-Brown, Dr. Philip Blossom Anglin-Brown, Dr. Philip Mighty, Dr. Peter Figueroa, Mighty, Dr. Peter Figueroa, UWIHARP staff UWIHARP staff and and All of you for accepting the All of you for accepting the invitation and gracing this occasioninvitation and gracing this occasion