EDITORIAL

 

Collegial Coincidence

 

 

WG Evans

Managing editor, Email:bill.evans@wits.ac.za

 

 

 

"A Brief History of Time" is the famous bestseller book relating the perceptive views of Steven Hawking who set out to understand the Universe, a part of which is Time. He would be intrigued and probably amused that commentators have looked at his dates of birth and of death and have discovered that perhaps Time has played a role... his birth took place exactly on the 139th celebration of the birth of Einstein. His death occurred on the 300th anniversary of the death of Galileo Galilei. Of course one may remark on the coincidence ... but would comment that that is all that it is.. a coincidence. Nevertheless the facts do give food for thought, just as the books by this brilliant physicist give food for (very deep) thought.

Now think of 350,000 and consider 255,000... these are the estimated prevalences of Hepatitis C and of Hepatitis B in South Africa. The annual incidence of Hepatitis C is estimated at 24,500 new cases, while there are some 33,000 new sufferers of Hepatitis B each year. These are figures of great concern. Viral hepatitis is reported to be the seventh leading cause of death worldwide. Hepatitis C and B account for 75% of liver disease. This, the March issue of the Journal, presents a paper dealing with these viral infections, as part of the Theme of the Association, "Oral Manifestations of Infectious diseases." Dentistry has a major role to play in the prevention of transmission of the viruses.

The Association joined international colleagues when World Oral Health Day was celebrated on 20th March 2018. The evocative slogan "Say AHH Think Mouth Think Health" embodies the awareness that Oral Health should not, indeed, cannot, be regarded separately from systemic health. It is therefore paradoxical that the Federation Dentaire International should offer a formal definition of Oral Health which focusses entirely on the craniofacial complex:

• Oral health is multi-faceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex'.

Of course the FDI would not ignore the broader implications and the preamble to their definition includes the words : ".demonstrate that oral health does not occur in isolation, but is an important part of overall health and well-being." Despite this, there remain hints of the traditional separation of the profession of Dentistry from Medicine. If we explore the intent of the Association Theme.Oral Manifestations of Infectious Diseases, it is readily seen that the responsibilities of care of infections do in fact extend across both disciplines : Acute necrotising ulcerative gingivitis; Candidiasis; Dental abscess; Black Hairy tongue; Epizootic stomatitis (Foot and Mouth disease); Herpes simplex virus; Measles; Scarlet fever; Streptococcal pharyngitis; HIV infection; Syphylis; Varicella ; Herpangina; Pericoronitis. Links are also being established between conditions in the mouth and various systemic diseases... periodontitis and diabetes may be an example. One cannot but speculate what deep revelations Steven Hawking may have made in the field of Health!

The Association Theme and the WHO slogan marry well in the month of March. The month may be best known for the famous warning " Beware the Ides of March". That referred to 15th March... Ides meaning "middle." Caesar was dismissive of the precaution ... and died in 44 BC on 15th March under the knives of his Senators... especially one Brutus! If indeed the dire warning still carries impact, let us direct that sentiment and that antagonistic energy to the prevention, if not the assassination, of oral and dental disease. The connubial match of the Theme and the Slogan should never be regarded as a mere coincidence! And a closer collaboration between Medical and Dental colleagues likewisenot merely coincidental but a dedicated collegial approach to shared problems.

 

 

ERRATUM

In the August 2017 issue of the Journal of the Dental Association of South Africa a Position Statement was published under the title " Prevention of infective endocarditis before dental procedures. "

The South African Dental Association acknowledges with concern that the publication of that paper did not properly recognise the authorship. The principal author is Dr David Jankelow, who worked with a number of co-authors, all members of SA Heart, to produce the definitive paper. The Association wishes to retract the implied claim that the Position Statement was that of the Association with the endorsement of SA Heart. The correct and appropriate attribute should be that the policy was formulated by the SA Heart team and endorsed by the South African Dental Association.

The Journal of the SA Heart Association has generously granted permission for the SADJ to republish their paper as it appeared in that Journal in November 2017.

The South African Dental Association regrets the error and records sincere appreciation to SA Heart and especially to the original authors for their empathetic understanding.

Please refer to page 94 Prevention of infective endocarditis associated with dental interventions.