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HIV/ I S and Its Significance for the Ental Profession Remember To JOURNAL OF THE CANADIAN DENTAL ASSOCIATION December 2007/JanuaryJC 2008, Vol. 73, No. 10 DAwww.cda-adc.ca/jcda Remember to Register for the ODA Annual Spring Meeting in Conjunction with CDA in Toronto pril 10-12, 2008 HIV/I�S and its Significance for the Dental Profession PM40064661 R09961 ���JCDA • www.cda-adc.ca/jcda • December 2007/January 2008, Vol. 73, No. 10 • 861 Essential reading for Canadian dentists Straumann p/u Nov 07, p. 750 E/F 4/C December 2007/January 2008, Vol. 73, No. 10 Publisher Canadian Dental Association Mission Statement Editor-In-Chief The Canadian Dental Association is the national voice for dentistry, dedicated to Dr. John P. O’Keefe the advancement and leadership of a unified profession and to the promotion of Writer/Editor optimal oral health, an essential component of general health. Emilie Adams Assistant Editor Natalie Blais A S S O C I AT E E DITORS Coordinator, French Dr. Michael J. Casas Translation Dr. Anne Charbonneau Nathalie Upton Dr. Mary E. McNally Coordinator, Publications Rachel Galipeau Writer, Electronic Media EDITORIAL CONSULTANTS David Shaw Dr. James L. Armstrong Dr. Robert J. Hawkins Dr. Richard B. Price Manager, Design & Production Dr. Catalena Birek Dr. Asbjørn Jokstad Dr. N. Dorin Ruse Barry Sabourin Dr. Gary A. Clark Dr. Richard Komorowski Dr. Kathy Russell Dr. Jeff Coil Dr. Ernest W. Lam Dr. George K.B. Sándor Graphic Designer Dr. Pierre C. Desautels Dr. Gilles Lavigne Dr. Benoit Soucy Janet Cadeau-Simpson Dr. Terry Donovan Dr. James L. Leake Dr. David J. Sweet All statements of opinion and Dr. Robert V. Elia Dr. William H. Liebenberg Dr. Gordon W. Thompson supposed fact are published on the authority of the author who Dr. Joel B. Epstein Dr. Kevin E. Lung Dr. Robert S. Turnbull submits them and do not neces- Dr. Daniel Haas Dr. Debora C. Matthews Dr. David W. Tyler sarily express the views of the Canadian Dental Association. The Dr. Felicity Hardwick Dr. David S. Precious Dr. J. Jeff Williams editor reserves the right to edit all copy submitted to the JCDA. Publication of an advertisement does not necessarily imply that CDA B O A R D O F D IR E CTORS the Canadian Dental Association agrees with or supports the claims President Dr. Peter Doig Dr. Jack Scott therein. Dr. Darryl Smith Dr. Colin Jack Dr. Lloyd Skuba Call CDA for information and President-Elect assistance toll-free (Canada) at: Dr. Gordon Johnson Dr. Ronald G. Smith 1-800-267-6354; outside Canada: Dr. Deborah Stymiest (613) 523-1770 Dr. Gary MacDonald Dr. Robert Sutherland Vice-President CDA fax: (613) 523-7736 Dr. Don Friedlander Dr. Robert MacGregor Dr. David Zaparinuk CDA email: [email protected] Website: www.cda-adc.ca © Canadian Dental Association 2007 �over photo: Copyright iStock International Inc. The Journal of the Canadian Dental Association is published in both official languages — Association at 1815 Alta Vista Drive, Ottawa, ON K1G 3Y6. Postage paid at Ottawa, Ont. except scientific articles, which are published in the language in which they are received. Subscriptions are for 10 issues, conforming with the calendar year. All 2008 subscriptions Readers may request JCDA in the language of their choice. are payable in advance in Canadian funds. In Canada — $98 ($92.45 + GST, #R106845209); United States — $135; all other — $225. Notice of change of address should be received TheJournal of the Canadian Dental Association is published 10 times per year (July/August before the 10th of the month to become effective the following month. Member: American and December/January combined) by the Canadian Dental Association. Copyright 1982 Association of Dental Editors and Canadian Circulations Audit Board. by the Canadian Dental Association. Publications Mail Agreement No. 40064661. PAP Registration No. 09961. Return undeliverable Canadian addresses to: Canadian Dental ISSN 0709 8936 Printed in Canada ���JCDA • www.cda-adc.ca/jcda • December 2007/January 2008, Vol. 73, No. 10 • 863 3M ESPE p/u Nov 07 p. 748 E/F 4/C CONT E N T S JCDA JOURNAL OF THE CANADIAN DENTAL A SSOCIATION COLUMNS & DePARTMENTS Editorial . 869 893 President’s Column . 871 Letters . 873 News & Updates . 879 Highlights of the 2007 FDI Annual World Dental Congress . 893 JCDA Special Feature . 897 Partnering to Reverse the Trend: Early Childhood Caries Conference Report CDSPI Reports . 903 You Ask, We Answer . 905 When I search the web for clinical information, how can I avoid getting too many results, many of which are not relevant? Clinical Showcase . 907 897 Gingival Response to Crowns: A 3-Year Report Point of Care . 911 What is the significance for dental professionals of the recently documented case of patient-to-patient transmission of hepatitis B? . 911 What part of the patient record from a general dental practice is most useful for identifying the victims of disaster through forensic odontology? . 917 How can I protect my practice from complaints and malpractice claims? . 919 907 Where does cone beam computed tomography fit into modern dental practice? . 921 Classified Ads . 957 Advertisers’ Index . 964 Oral B Bootlug p/u Nov 07 - p.749 E/F 4/C Please see our advertisement opposite the Editorial page. ���JCDA • www.cda-adc.ca/jcda • December 2007/January 2008, Vol. 73, No. 10 • 865 GlaxoSmithKline p/u Nov 07 p. 807 E/F 4/C CONT E NTS DebATE & OPINION Leadership in Ethics: Where is CDA? ...........................................................925 Barry Schwartz Early Childhood Dental Disease — What’s in a Name? ...........................929 Allan Narvey, Luke Shwart CLINICAL PRACTICE Resin-Bonded Fixed Partial Dentures: What’s New? ...............................933 933 Chris C.L. Wyatt This month, JCDA features 4 clinical articles on the epidemiology, oral manifestations and management of HIV-associated disease: The Third Decade of HIV/AIDS: A Brief Epidemiologic Update for Dentistry ............................................941 Linda M. Kaste, Helen Bednarsh 949 Essential Medical Issues Related to HIV in Dentistry .............................945 Arthur H. Moswin, Joel B. Epstein Changes in the Pattern of Oral Lesions Associated with HIV Infection: Implications for Dentists ...........................................949 Herve Y. Sroussi, Joel B. Epstein Oral Malignancies Associated with HIV......................................................953 Joel B. Epstein “We acknowledge the financial support of the Government of Canada through the Publications Assistance Program towards our mailing costs.” All matters pertaining to JCDA should All matters pertaining to classified advertising All matters pertaining to display advertising be directed to: Editor-in-chief, should be directed to: Mr. John Reid, should be directed to: Mr. Peter Greenhough, Journal of the Canadian Dental Association, c/o Keith Communications Inc., c/o Keith Communications Inc., 1815 Alta Vista Drive, Ottawa, ON K1G 3Y6 104-1599 Hurontario St., 104-1599 Hurontario St., • Email: [email protected] Mississauga, ON L5G 4S1 Mississauga, ON L5G 4S1 • Toll-free: 1-800-267-6354 • Toll-free: 1-800-661-5004, ext. 23 • Toll-free: 1-800-661-5004, ext. 18 • Tel.: (613) 523-1770 • Tel.: (905) 278-6700 • Tel.: (905) 278-6700 • Fax: (613) 523-7736 • Fax: (905) 278-4850 • Fax: (905) 278-4850 Publication of an advertisement does not necessarily imply that the Canadian Dental Association agrees with or supports the claims therein. Furthermore, CDA is not responsible for typographical errors, grammatical errors, misspelled words or syntax that is unclear, or for errors in translations. ���JCDA • www.cda-adc.ca/jcda • December 2007/January 2008, Vol. 73, No. 10 • 867 EDITORIAL P&G Professional Crest Pro-Health Rinse p/u Nov 07 p.752 E/F 4/C EDITORIAL generation of dentists came to naturally expect infection control practices. HIV/AIDS is now considered a chronic con- dition. The profile of sufferers has changed over the past 25 years, with far more women and HIV/AIDS: members of minority communities affected. The pattern of oral lesions associated with HIV Yesterday, Today infection — often the first signs of infection — is also changing. The overall messages in the HIV/AIDS articles are that dentists have a vital and Tomorrow role to play in providing equitable health care to these patients, we must be well informed about the disease and be on the lookout for signs that could lead to early detection. Dr. John P. O’Keefe itting at a departure gate in New York’s While in New York, I attended a very inter- LaGuardia Airport on December 1, I was esting lecture by Dr. Anthony Vernillo of New Sforcibly reminded that it was World AIDS York University predicting that dentists may be Dentists have a Day as I watched a lengthy CNN report about at the forefront of early detection of HIV in- “ vital role to the desperate plight of AIDS sufferers in Africa. fection in the future. With the US Centers for play in providing HIV/AIDS is devastating sub-Saharan Africa, Disease Control and Prevention (CDC) urging where early detection is almost unheard of and care to HIV/AIDS easier means of getting consent for HIV testing, most cannot afford treatment. While Canada is patients, must be with the emergence of rapid testing for HIV affected much less dramatically, Health Canada through swabbing oral exudates and with oral well informed has estimated that at the end of 2002, more care providers being seen regularly by many about the disease than 56,000 Canadians were either infected by patients, Dr. Vernillo believes the dental office and be on HIV or suffering from AIDS. Most shocking is is an ideal location for rapid detection of HIV the lookout for the estimate that almost one-third of infected infection, with follow-up referral to a physician signs that could Canadians did not know it. for definitive diagnosis. Early detection and treatment of HIV is lead to early While there may be many hurdles to over- transforming the quality of life and life expect- come before that becomes reality, Dr.
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