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Upgrade, improve and excel

Posted by Stella Pascale on Sunday, 12 June 2016 07:29

Upgrade, improve and excel http://www.hpcsa-blogs.co.za/upgrade-improve-and-excell/

Continuing Professional Development (CPD) is considered to be an essential part of educating practitioners and ensuring that levels of expertise continue to improve.

It is crucial for all healthcare professionals registered in South Africa to ensure compliance with the set standard of CPD activities each year, of which a certain number must be obtained in ethics, human rights and medical law.

There are three levels of CPD activities:
Level 1 – Activities that do not have a clearly measurable outcome and presented on a once-off, non-continuous basis. CPD activities specifically addressing ethics, human rights and medical law will earn two CEU’s for every hour.
Level 2 – Activities that have a measurable outcome, but do not have a full year of earned CEU’s. Level 2 activities include education, training, research and publications. Level 2 CEUs will be awarded according to a table contained in the HPCSA CPD guidelines
Level 3 – Involves activities structured learning programmes, such as formal programmes that are planned and offered by an accredited training institution and which are evaluated by an accredited assessor with a measurable outcome.

Every healthcare professional is required to maintain an official HPCSA Individual CPD Activity Record, which will constitute the individual’s CPD Portfolio, supported by documentary evidence, such as certificates of attendance of CPD activities during the previous 24 months. Random audits are carried out to determine the CEU’s for the 24 months. Below are the CEU’s required for each Profession over a 12 year period

Dental therapy and oral hygiene DA Dental Assistant 15 CEUs (incl 2 ethics CEUs)

For all other professions except those mentioned above, have to obtain 25 CEUs of which at least 5 CEUs must be for ethics, human rights or medical law in a one year period.

Da Vinci link for more information on the system

Posted by Stella Pascale on Thursday, 12 May 2016 06:25


Attachments:

da vinci 2016.jpg 26.5K 12 May 16 06:25

Social Responsibility Award - Paula-Jane Williams

Posted by Stella Pascale on Thursday, 10 March 2016 21:56

Good Afternoon,

 

I have attached the official congratulatory letter for one of your members, Paula-Jane Williams, for the Third Place Entry in our Social Responsibility Awards for 2015.

 

We hope that you can highlight this in your membership outreach.

 

See more details on the program at http://www.ifdh.org/social-responsibility-award.html

 

Please let me know if you have any questions.

 

Sincerely,

Georgia

 

Georgia Anas

Membership Coordinator

coordinator@ifdh.org

cid:image001.jpg@01CF0DCB.D6DFD830

International Federation of Dental Hygienists

100 South Washington St.

Rockville MD 20850, USA

Phone:  240-778-6790, ext 12

Fax:  240-778-6112

Visit our web site at www.IFDH.org

 


Attachments:

2015 Social Responsibility Award Letter & Certificate, 3rd Place - Paula-Jane Williams.pdf 190.3K 10 Mar 16 21:56

DISSEMINATE PRESS RELEASES - DENTAL ASSISTANTS

Posted by System Admin on Wednesday, 17 February 2016 10:45

553 Madia Street
Arcadia, Pretoria

PO Box 205
Pretoria, 0001

Tel: +27 (12) 3389300
Fax: +27 (12) 3285120

Email: dapneyc@hpcsa.co.za
Website: www.hpcsa.co.za


Media Statement

DENTAL ASSISTANTS REGISTRATION

12 FEBRUARY 2016

For immediate release

Pretoria – Dental Assistants are valued and important healthcare professionals that work alongside dental specialists, dentists, dental therapists and oral hygienists in the treatment of patients, allowing for safe and effective oral healthcare delivery.

In order to render safe oral healthcare, there is a global trend and need to professionalisation of Dental Assistants. Based on this, the Dental Assistants Association of South Africa (DAASA) approached the Professional Board for Dental Therapy and Oral Hygiene (PBDOH) in 1995, and after consultation with all stakeholders; including the South African Dental Association (SADA), the registration of dental assistants began in 2005.
The Professional Board for Dental Therapy and Oral Hygiene (PBDOH) created two categories of registration, namely:

  1. Registration which allowed experienced dental assistants (with 5 years or more experience) to gain entry into the register of dental assistants. This was termed the “Grandfather Clause” in May 2008 and this register was opened for three months. However, due to a limited response from a number of eligible dental assistants to register, the PBDOH reopened this register for a further period of six months.
  2. The second category of registration that was allowed for experienced dental assistants was the Supplementary Dental Assistants register. This register allowed for those dental assistants who had less than 5 years’ experience to register in this category, and then write a Board exam, with the last exam being in 2016. This register has now also been closed. This clause excludes qualified Dental Assistants.

In 2014 and 2015, the South African Dental Association (SADA) unsuccessfully instituted legal action against the registration of Dental Assistants. In March 2014, The North Gauteng High Court recommended that unregistered Dental Assistants not be subjected to criminal proceedings and the Dentists not be subjected to unprofessional conduct proceedings until 31 March 2016. This was to allow the Dental Assistants to obtain the necessary qualifications. This means that, the aforementioned High Court had put a moratorium on the criminal prosecution of unregistered practicing Dental Assistants and the prosecution of Dentists for employing unregistered practicing Dental Assistants. The South African Dental Association appealed the judgement, and in November 2015, the Supreme Court of Appeal, confirmed the decision of the North Gauteng High Court that Dental Assistants have to be regulated in order to protect the public and Dental Assistants themselves. 

In order to facilitate the registration of those dental assistants who, as a result of this moratorium, did not register with the Health Professions Council of South Africa (HPCSA), the PBDOH is presently instituting measures that would enable unqualified yet experienced dental assistants to be provisionally registered for a period of two years, with the provision that within a period of two years they complete a Board examination. The Board will offer four examinations per annum over a period of two years, and candidates will be allowed three opportunities to undertake the examination. Successful completion of the Board examination will permit access to full registration, and not a qualification. Whilst being provisionally registered the dental assistant would need to comply with the continuous professional development (CPD) and annual fee payments as required for dental assistants.

The HPCSA will provide additional administrative support to facilitate the registration and examination processes. The registration period will be announced once the regulations have been promulgated by the Minister of Health. Further information will be made available on the HPCSA website.

About the Health Professions Council of South Africa (HPCSA)

The Health Professions Council of South Africa (HPCSA) is a statutory body and is committed to protecting the public and guiding the professions. The mission of the HPCSA is quality healthcare standards for all.

The Council is mandated to regulate the health professions in the country in aspects pertaining to registration, education and training, professional conduct and ethical behaviour, ensuring continuing Professional Development (CPD), and fostering compliance with healthcare standards.

In order to safeguard the public and indirectly the professions, registration in terms of the Act is a prerequisite for practising any of the health professions with which Council is concerned.

Issued by:

Daphney Chuma Senior
Manager: Public Relations and Service Delivery
Health Professions Council of South Africa
Tel: 012 338 9481
Email: daphneyc@hpcsa.co.za

For more information, please contact:
Priscilla Sekhonyana
Communications Manager Health Professions Council of South Africa
Tel: 012 338 9368
Cell: 082 801 6685


Attachments:

1.jpg 22.5K 17 Feb 16 11:13

Last updated Wednesday, 17 February 2016 11:13

Cybercrime Law in South Africa

Posted by Stella Pascale on Wednesday, 4 November 2015 21:38

SA Labour Guide

Your guide to labour law in South Africa
03 November 2015 
  

www.labourguide.co.za


 

 

 

  Cybercrime Law in South Africa 

Cybercrime Law in South Africa

By Fawzia Khan, Fawzia Kahn and Associates

The issue of cyber bullying which was featured in a local Sunday newspaper on 30 August 2015, gave a harrowing and chilling account of a Durban school going teenager’s nightmare, who was bullied by an unknown person on Facebook and other social media network platforms. The teenager was humiliated and degraded by the incessant defamatory messages, which were circulating around these social platforms.

Cyber bullying is a crime and cybercrime is any crime, which involves the use of some electronic equipment or device. Cybercrime and cyber security has now come under the spotlight with the passing of the Cybercrimes and Cyber Security Bill 2015. Currently there are a number of laws dealing with cyber security, which is a mix of both legislation and the common law. The Bill seeks to regulate many of the crimes committed in cyberspace. These include ‘phishing’, hacking, unlawful interception of data, unlawful interference of data, unlawful acts of malware (such as viruses, worms, logic bombs and trojan horses), the unlawful acquisition, possession, provision, receipt or use of passwords, access codes or similar data or devices. Malware have different effects on data, computer devices, computer networks, databases or electronic communications networks.

Many if not virtually all Internet users and holders of email addresses have at some time or the other encountered phishing in some form or the other. It’s usually a dodgy email telling us we have won millions or asking us to “update” our personal details by inviting us to go to a specific website to do so. Hacking is another cybercrime. This is where someone unlawfully accesses electronic information. According to the Juta Law website, computer-related fraud is one of the most prevalent crimes on the Internet. As in all cyber-related crime, there is a slim chance of catching the perpetrator. The perpetrator can further use various tools to mask his or her identity. Automation enables offenders to make large profits from a number of small acts.

One strategy used by offenders is to ensure that each victim‘s financial loss is below a certain limit. Small-loss-victims are less likely to invest time and energy to report such incidents to the South African Police Service and the law enforcement agencies do not have the capacity to investigate all cyber related offences but usually prioritize them according to seriousness. The protected legal interest in crimes against the confidentiality, integrity and availability of computer data and systems is the integrity of computer information and data itself.

Some common forms of computer related fraud are online auction fraud, where the perpetrator offers non-existent goods for sale and request buyers to pay prior to delivery, or where goods are bought online and where delivery is requested without the intention to pay; or advanced fee fraud, where offenders send out e-mails asking for recipients‘ help in transferring large amounts of money to third parties and promising them a percentage, if they agree to process the transfer using their personal accounts. The offenders then ask them to transfer a small amount to validate their bank account data, which the offender takes. On the issue of money laundering, the Bill seeks to regulate the transfer of money across countries. The establishment of online casinos has created opportunities for money laundering activities to go undetected. The Bill hopes to overcome that problem.

Copyright infringement also forms part of the Bill. Songs, e-books, files etc., which are protected by copyright, would not be allowed to be downloaded and copied. Civil society is allowed to comment on the Cybercrimes and Cyber Security Bill 2015and later once passed, the Bill will then become law.

Know your rights! The Law Desk of Fawzia Khan & Associates. Giving You the Power of Attorney. Email fawzia@thelawdesk.co.zaor call 031-5025760 for legal assistance at competitive rates.

For more information and/or legal assistance, please contact Fawzia Kahn at fawzia@thelawdesk.co.za/www.thelawdesk.co.za or call 031-5025 670


 


 


 

Rates Discrepancies are Unethical

Posted by Stella Pascale on Thursday, 15 October 2015 09:41

Practitioners must be aware that it is unethical to charge lesser fees for patients paying out of pocket and higher fees for patients covered by medical insurance.

The Health Professions Council of South Africa (HPCSA) has recently been inundated with complaints from the public relating to out of pocket payments even when they are covered by medical insurance.

Patients who opt to pay out of pocket for services rendered by practitioners do so because practitioners charge a lesser fee for patients paying out of pocket and a higher fee for patients covered by medical insurance. The HPCSA has also noted that practitioners are reluctant to provide patients who pay out of pocket with account statements. Having noted the above, the HPCSA wishes to guide practitioners on the following legislative framework:

1. Section 53(2) of the Health Professions Act States that: “Any practitioner who in respect of any professional services rendered by him or her claims payment from any person (in this section referred to as the patient) shall, subject to the provisions of the Medical Schemes Act, furnish the patient with a detailed account within a reasonable period”.

2. Section 59(1) of the Medical Schemes Act states as follows: “A supplier of a service who has rendered any service to a member or to a dependant of such a member in terms of which an account has been rendered shall, notwithstanding the provisions of any other law, furnish to the member concerned an account or statement reflecting such particulars as may be prescribed”.

3. Section 59(2) of the Medical Schemes Act states that, “a medical scheme shall, in the case where an account has been rendered, subject to the provisions of this Act and the rules of the medical scheme concerned, pay to a member or a supplier of service, any benefit owing to that member or supplier of service within 30 days after the day on which the claim in respect of such benefit.

From the above legislative framework, practitioners are advised as follows:

a. Practitioners should charge the same fees for similar services rendered irrespective of how the patient is going to settle the account. It is unethical to charge lesser fees for patients paying out of pocket and higher fees for patients covered by medical insurance.
b. It is within the rights of patients to use out of pocket payment method even when they are covered by medical insurance and such patients should be provided with a detailed account for services rendered.
c. Where patients opt to use out of pocket payment method for services rendered, it is unethical for practitioners to submit claims to the patient’s medical insurance for the same services.

Practitioners are advised to exercise due diligence in this matter, especially with their administrators or accountants.

Registration at the HPCSA

Posted by Stella Pascale on Thursday, 15 October 2015 09:40

You may not practice without registering with the HPCSA, but there are also many advantages to being part of the healthcare community.

Practitioners whose professions fall within the ambit of the HPCSA are obliged to register. In return, the practitioner can rest assured that the profession is safeguarded.

The role of the HPCSA apart from guiding the professions is to:

a) Confer professional status
· The right to practise your profession
· Ensuring no unqualified person practises your profession
· Recognising you as a competent practitioner who may command a reward for services rendered

b) Setting standards of professional behaviour
· Guiding you on best practices in healthcare delivery
· Contributing to quality standards that promote the health of all South Africans
· Acting against unethical practitioners

c) Ensuring your Continuing Professional Development through:
· Setting and promoting the principles of good practice to be followed throughout your career by keeping you up to date with healthcare trends; and
· Improving client care skills.

Practitioners who are not practising their profession may in terms of section 19(1)(c) of the Health Professions Act 1974 (Act 56 of 1974) request that their name be removed from the relevant register on a voluntary basis. A written request should reach Council before 31 March of the year in which the practitioner wishes his or her name to be removed from the register.

Practitioners relocating to other countries are also required to inform the HPCSA prior to the relocation. Several practitioners do not renew their registration when relocating overseas and as a result practitioners are subject to steep restoration fees, which could be avoided, hence, HPCSA is requesting practitioners inform it in time should a practitioner which to were no longer going practice in South Africa.

Practitioners should at all times inform the HPCSA within 30 days of their change of address as indicated in terms of s18(3) of the Health Professions Act (as amended).

To update your details, please contact the HPCSA Call Centre on 012 338 9300 or info@hpcsa.co.za

Insubordination - May an employee refuse to obey an instruction that falls outside of his or her job description

Posted by Stella Pascale on Friday, 25 September 2015 10:44

Insubordination - May an employee refuse to obey an instruction that falls outside of his or her job description

 

May an employee refuse to obey an instruction that falls outside of his or her job description?

By Neil Coetzer, Senior Associate, Employment Law, Benefits & Industrial Relations, Cowan-Harper Attorneys

 It is a well-known principle of our law that employees have a duty of good faith towards their employer. The duty of good faith is a general duty and encompasses various aspects, including the duty of employees to act in a subordinate manner and comply with the directions and instructions of the employer in regard to their daily duties and work. Employers have, however, developed job descriptions in order to allocate certain tasks to certain positions in order to promote efficiencies and to ensure accountability. To what extent does this impact on an employee’s refusal to perform certain tasks which he or she believes falls outside the scope of their job description? 

In Noosi v Exxaro Matla Coal & Others (unreported case JR291/11, 25 June 2015), the Labour Court recently had the opportunity to deal with the issue of insubordination and confirm an important principle in regard thereto. The case involved an electrician who had refused to obey the instructions of the Senior Foreman (and Head of Maintenance) who had instructed him to cease the operation of a conveyor belt which was operating in dangerous conditions. The employee was subsequently charged with, inter alia, gross insubordination and dismissed. He subsequently referred a dispute to the CCMA where the Commissioner found his dismissal to be fair. 

The employee subsequently took the matter on review where the Labour Court found that the test for insubordination is not whether the instructions fall within the job description of the employee, but rather whether the instructions were reasonable and lawful. In particular, the Court aligned itself with the sentiments expressed in Exxaro Coal Mpumalanga Ltd v CCMA & Others (unreported case JR269/11) where the Court held as follows:- 

“...Should it be shown that the instruction was unlawful, it would be the end of the inquiry. If it is found that the instruction was lawful, the expectation is that the employee to whom such instruction was issued should have complied. It will have little, if any, to do with whether the instruction related to the employee’s job description because it will never be a justification for an employee to refuse lawful instructions merely because the instructions are not his or her direct functions.” 

In any event, the evidence showed that the instruction did fall within the employee’s job description and the employees dismissal was found to be fair. 

Employers should regularly revisit job descriptions to ensure that the day to day responsibilities of employees are contained therein. Nevertheless, as shown by this judgment, employees still have an overriding duty of good faith to their employers, whether the instruction falls within their job description or not and a failure to comply with instructions which are reasonable and lawful may be sufficient grounds for a summary dismissal. 

For more information please contact Neil Coetzer at ncoetzer@chlegal.co.za or (011)  783 8711 /(011) 048 3000

Article published with the kind courtesy of Cowan-Harper Attorneys www.cowanharper.co.za

 

The Professional Board for Dental Therapy and Oral Hygiene - 2015 - 2020

Posted by Stella Pascale on Wednesday, 2 September 2015 21:51

OHASA would like to congratulate the new members of the HPCSA DTO Board 2015 - 2020. Wishing you a successful Term of Office.

This gazette is also available free online at www.gpwonline.co.za

Government Gazette - 28 August 2015 No 39146

DEPARTMENT OF HEALTH NO.780 

HEALTH PROFESSIONS ACT, 1974 (ACT NO. 56 OF 1974)

Notice is hereby given in terms of section 15 of the Health Professions Act, 1974 (Act No. 56 of 1974) read with the Regulation Relating to the Nominations and Appointment of Members of a Professional Board, that the following persons have been appointed as members of the Professional Boards of the Health Professions Council of South Africa for a five year term of office, with effect from 01 July 2015 - 30 June 2020.

4. THE PROFESSIONAL BOARD FOR DENTAL THERAPY AND ORAL HYGIENE 

CANDIDATE                                             CATEGORY OF APPOINTMENT

1. Mr Madimetja Johannes Maponyane DENTAL THERAPY
2. Mr. Tufayl Ahmed Muslim   
3. Mr. Thifhelimbilu Watson Muthuphei   
4. Ms. Karen Susan Paulse ORAL HYGIENE
5. Ms. Catharina Rachel Brent  
6. Ms. Natasha Swart  
7. Ms. Tebatso Mphanga DENTAL ASSISTANTS
8. Ms. Pinky Sophie Ramela  
9. Dr. Priscilla Brijlal HIGHER EDUCATION SOUTH AFRICA REPRESENTATIVES
10. Ms. Jeanne Oosthuysen  
11. Ms. Nkhumo Tsebe COMMUNITY REPRESENTATIVES
12. Ms. Hellen Motlanthe  
13. Dr. Johan Smit DEPARTMENTAL REPRESENTATIVE

 

The Impact of Oral Health on Overall Health - Marie Ferreira

Posted by Stella Pascale on Tuesday, 11 August 2015 20:39

World Oral Health Day – 20 March 2015
The Impact of Oral Health on Overall Health
Marie Ferreira
Oral Hygienist
Vice Chairperson Professional Board for Dental Therapy & Oral Hygiene
Did You Know?
 Periodontal diseases are among the most prevalent in the world with 70% of the world population thought to be affected by some form of the disease. In addition, up to 900 million people suffer from severe periodontal (gum) disease, which is considered a potential risk factor for severe serious health conditions
 If you smoke you are four times as likely to have periodontal disease as someone who has never smoked
 Pregnant women who have periodontitis, an advanced form of gum disease, may have a seven-fold increased risk of delivering a preterm, low birth weight baby
 Findings suggest that severe periodontitis may be an important risk factor in the progression of diabetes
 Gum disease affects all ages – more than half of all teenagers in the UK have some form of gum disease; 3 out of 4 adults over the age of 35 years suffer from gum disease
 Only 60% of women over the age of 45 can claim to have all their own teeth
 Research suggests that pneumonia can be caused by breathing in bacteria known to cause periodontal disease
What is saliva?
Saliva is a liquid that is produced by our glands, called salivary glands, and released into the mouth. Its role is to keep the mouth moist and to help our bodies swallow food more easily. Saliva also contains enzymes that break down certain types of food. When we sleep, our saliva production rate drops letting our mouths dry out and acid-producing bacteria flourish. So, night-time brushing and rinsing are particularly important to ensure excess bacteria is removed appropriately. When we sleep our salivary glands rest so there is insufficient saliva to wash away bacteria and food debris. This is however a temporary problem, which can be rectified by brushing and flossing regularly and rinsing with an antibacterial mouthwash.
Biofilm (Dental plaque)
Biofilm (dental plaque) is a build-up of various types of bacteria in the mouth. It is a soft white substance that is easily wiped or brushed off the tooth surface. Bacteria are normally present in the mouth, but when their numbers rise too high, we have a problem. Plaque forms within 24 hours of brushing and flossing and, within 48 hours, plaque builds up on the areas that are not brushed and flossed and is easily visible to the naked eye. It starts forming along the gum line and in between the teeth, but in a matter of days can cover a vast surface of the tooth.
Sugars are the main nutrient for the bacteria in plaque. The higher the content of sugar in your diet and more specifically, the longer the sugar is in the mouth, the more rapidly will the bacteria multiply and the greater will be their activity.
Calculus (tartar)
Calculus is a hard deposit and is the result of deposits of calcium and other salts, which are present in normal healthy saliva, within the plaque itself. It is a mineralising process and the speed with which it forms depends on two things:
 How much plaque you leave behind after brushing and flossing
 What the concentration of calcium etc. in saliva is
Calculus consists of up to 80% inorganic salts, mostly crystalline, the major components being calcium and phosphorus. The microscopic structure is basically that of randomly orientated crystal formation. Calculus is invariably associated with periodontal disease. This may be because it is invariably covered by a layer of plaque. Its principal detrimental effect is probably that it acts as a retention site for plaque and bacterial toxins. The presence of calculus makes it difficult to implement adequate oral hygiene.
Disease
Bacteria, viruses and fungi are the cause of disease in the body and bacteria in dental plaque are the cause of tooth and gum disease. Some of the bacteria cause ‘tooth disease’ (tooth decay or caries) and others are the cause of ‘gum disease’. Gum disease is an inflammation that starts in the surface layers of the gum and slowly over time works its way down into the bone around the teeth with various stages of severity, and can be divided into two general categories:
 Gingivitis
 Periodontitis
Gingivitis
This is the first and reversible stage of gum disease. Gingivitis is an inflammation of the gums, which means that it become swollen, reddened and bleeds easily when touched. It is a local reaction to the plaque, not an infection. It can be localised or it can affect the entire mouth. Areas not cleaned for more than 48 hours would develop gingivitis. But at this stage it is totally reversible – good brushing and flossing will clear it all up within a few days. Gingivitis hardly causes any discomfort at all, which is why it is so easy to ignore. Even at later stages there is little pain, except in the case of an acute flare up of infection. Smoking somewhat masks the effects of gingivitis, because smoking reduces the blood flow in the smaller veins and arteries and therefore, less bleeding is evident.
Periodontitis
If gingivitis is allowed to continue untreated over a period of time, it may result in an infection, which spread into the lower layers of bone and tooth attaching fibres. Once the infection has progressed to this level and the bone itself is infected, it is called periodontitis. According to the World Health Organisation (WHO), 10 – 15% of the world population or 600 – 900 million people are suffering from severe periodontal disease.
Pockets
Initially the disease will not be visible from the outside; this is because it manifests first as ‘pockets’ around the teeth. A pocket is the opening next to the tooth which is covered by gum and not visible unless a probe (dental Instrument) is inserted. Such a pocket is usually filled with dental plaque and calculus and other debris and will bleed quite considerably if probed.
The progress of periodontal disease is sometimes so slow that the patient does not even become aware of the various side effects. The teeth become mobile and appear longer as the gum recedes. This is written off to ‘aging’ but it is simply the destructive progress of the disease. There is also a horrible odour that is associated with severe gum disease, but since it develops gradually, the sufferer does not become overly aware of it. On the other hand, the disease progress can be so rapid that tooth loss will occur within a few years. Periodontal diseases are chronic bacterial infections that affect the gums and bone supporting the teeth. Studies have shown that oral bacteria can enter the blood stream and can potentially lead to serious health problems.
Potential effect of moderate to severe periodontitis on the body:
 Stroke 2 times
 Chronic respiratory diseases 2 – 5 times
 Coronary artery diseases 2 times
 Adverse pregnancy outcomes 4 – 7 times
 Diabetes 2 – 4 times
While inflammation can help fight disease, that assistance comes at the cost of suspending the body’s normal immune processes. In the short term this is often a legitimate trade-off, but in the long term it causes progressive damage. When inflammation is misdirected, autoimmune diseases may result.
There has been increasing attention paid in recent years to the possibility that oral bacteria and oral inflammation, particularly periodontal disease, may influence the initiation and/or progression of systemic disease processes. This, of course, is not a novel concept. Indeed, the focal-infection hypothesis, which grew from the principles of infectious disease first established by Koch and Pasteur in the mid-19th century, put forth the notion that the invasion of the bloodstream by bacteria from a localized infection (such as periodontal diseases) could spread to distant organs and tissues to cause disease. In fact, this hypothesis was so convincing to practitioners of the time that tonsillectomy and full-mouth extractions enjoyed widespread implementation to treat many diseases, regardless of whether or not infection could be proven to be the cause. However, because it became clear that it was impossible to correlate with confidence a particular systemic disease with a preceding oral infection or dental procedure, the focal-infection hypothesis fell from favour by the middle of the 20th century. Yet, interest in the systemic effects of periodontal disease was reignited in the early 1990’s by a series of case-control and other epidemiologic studies that demonstrated statistical associations between poor oral health and several systemic diseases.
Atherosclerosis is the most common cause of coronary artery disease. The World Health Organization (WHO) statistics for 1993 showed cardiovascular disease to be the number-one cause of death in developed countries, accounting for 47% of all deaths in those countries. In 1999, a study was published in a Dental Journal presenting new evidence to suggest that atherosclerosis was associated with inflection and inflammation. This first study tied the herpes viruses to changes in blood vessel walls. Since then, cytomegalo virus (CMV) and C. pneumonia (Cp) have been found in blood vessel walls associated with atherosclerosis. Researchers at the University of Belgrade in Serbia evaluated artery samples for the presence of microorganisms. Samples were taken from 15 patients undergoing coronary bypass surgery. Involved coronary arteries and mammary arteries used to create the bypass graft were evaluated. Mammary arteries are used for bypass as they seem to be protected from the process of atherosclerosis. No periodontal pathogens were found in the mammary vessel samples. Periodontal pathogens were found in nine of the 15 coronary artery samples (60%). CMV was found in 10 (67%) coronary artery samples and seven (47%) mammary artery samples. Cp was detected in five (33%) coronary artery samples and six (40%) mammary artery samples.
The researchers speculate that since the periodontal pathogens were found in the coronary artery samples and not the mammary samples and CMV and Cp were found in both, the periodontal pathogens may be the more likely bugs to cause atherosclerosis. These findings add to our understanding of the perio/heart-disease link. Establishing and maintaining oral health is important to prevent the movement of oral bacteria to the coronary arteries.
Lung diseases, such as pneumonia and chronic obstructive pulmonary disease (COPD) also have been associated with poor oral health. It is possible that dental plaque may serve as a reservoir of infection for respiratory pathogenic bacteria. In subjects stratifies by periodontal attachment loss, those with more severe attachment loss tended to demonstrate less lung function than those with less attachment loss.
There also has been interest in the association between periodontal inflammation and adverse pregnancy outcomes. Unfortunately, adverse pregnancy outcome, such as premature birth and low birth weight, are quite common events. During parturition, the uterus is influenced by the hypothalamus through the production of oxytocin, which stimulates uterine contraction. Prostaglandins that are produced by the placenta also stimulate uterine contraction, which normally leads to birth in the 3rd trimester (37 weeks). It is thought that chronic infections drive the inflammatory process, which leads to the release of inappropriate levels of prostaglandins and TNF-a, which prematurely stimulates uterine contraction to promote preterm birth.
It has been suggested that periodontal infection and the release of lipopolysaccharides and other biologically active molecules drive the process of inflammation. This elevates the levels of prostaglandins and TNF-a in the crevicular fluid. Lipopolysaccharides released from the oral cavity into the bloodstream may stimulate prostaglandins in the placenta, causing preterm birth. It is also possible, such as in atherosclerosis, that cytokines in the periodontium may lead to elevated peripheral blood cytokine levels and stimulate hepatic production of acute-phase proteins that may influence the birth process.
Clinical research conducted in the United States indicates that pregnant women who have periodontal disease are seven times more likely to have a baby that is born too early and too small. Low birth-weight babies are more susceptible to breathing problems, anaemia, jaundice, mental retardation, cerebral palsy, congestive heart failure and malnutrition.
Conclusion
Oral Hygienists and Dental Therapists aim to promote quality oral health care. Through clinical services, education, consultative planning and evaluation, they seek to prevent oral diseases, provide treatment for existing diseases and assist people in maintaining an optimal level of oral health. Their primary concerns as primary oral health care practitioners are the promotion of overall health through the prevention of oral diseases.
There is growing acceptance that oral health is an essential component of overall health, renewed emphasis on setting and attaining oral health goals, and increasing recognition that oral hygiene services are an important element in attaining these goals. To reach the highest possible level of oral health, prevention is essential. To improve and maintain good oral health, try to visit your oral health practitioner at least twice to three times a year, because the status of your mouth affects your overall health and wellness.
References
 World Health Organisation http://who.org
 International Federation of Dental Hygienists http://www.ifdh.org


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