1 WELCOME and Thanks for coming……. Thanks for coming…….

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

3 Participation in the regional workshops and conferences on HIV/AIDS Thanks to: CHART, I-TECH, University of Washington and NACC Motivation

4 Identification of the problem: –Dental and medical practitioners in the region lacked adequate scientific knowledge about the HIV disease –Dental practitioners are unaware of various oral health implications of HIV disease and other blood borne viral diseases –Stigma and discrimination against people living with HIV disease is widespread among dental practitioners in the region

5 Realized the need for an educational tool targeted at dental practitioners: – A comprehensive educational approach targeted at dental practitioners in the region was needed to ‘educate’ them on general aspects of the disease and –To do justice to the variety and variability of oral diseases experienced by persons living with HIV/AIDS and –Dental practitioners can play a significant role in improving the quality of life –Dental practitioners can play a significant role in improving the quality of life of PLWHA

6 Educational Responsibility: BIG Question: Can we afford to wait for things to happen ? or, Shall we make it happen……….NOW! 25 years after……….Better late than never!.

7 Who? Who should shoulder this ‘educational’ responsibility? Who should shoulder this ‘educational’ responsibility? –MOH? –NGOs? –CHART, NACC? –Medical institutions? –Individuals? Every one has a role Every one has a role

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

9 Our role… On behalf of the UWI School of Dentistry,……I took it upon myself On behalf of the UWI School of Dentistry,……I took it upon myself This is how it all began…. This is how it all began….

10 Who is it meant for? Primary target: Primary target: –All Dental Practitioners in the English Speaking Caribbean Secondary Target: Secondary Target: –Dental Surgery Assistants/Dental Nurses/Dental Hygienists in the Caribbean

11 Not for sale…… Dentists are wealthy (except those who work for the UWI) and can afford to buy copies of books but the fact is…….. Dentists are wealthy (except those who work for the UWI) and can afford to buy copies of books but the fact is…….. Decision: Decision: –Copies to be delivered at their door steps at no cost to the dental practitioners throughout the English speaking Caribbean. This is the only way the information could reach the targeted audience

12 May be a great Idea, but who would fund the project? Project proposal and Sponsorship search in July/Aug 2004 Project proposal and Sponsorship search in July/Aug 2004 Special thanks to: CHART, (Prof. Brendan Bain and his team), NACC, I-TECH (U of W) and Colgate-Palmolive for their spontaneous and generous support Special thanks to: CHART, (Prof. Brendan Bain and his team), NACC, I-TECH (U of W) and Colgate-Palmolive for their spontaneous and generous support

13 Collective effort…… 23 contributors in all: 23 contributors in all: –12 from T&T –2 from Jamaica –1 from Nassau –5 from USA –3 from Australia Thanks for their valuable chapter contributions Thanks for their valuable chapter contributions 18 months later….. to MPC of the UWI 18 months later….. to MPC of the UWI

14 Messages of support for the Caribbean project His Excellency the President of the Republic of Trinidad and Tobago His Excellency the President of the Republic of Trinidad and Tobago Hon. Prime Minister Hon. Prime Minister Hon. Health Minister Hon. Health Minister Chancellor of the UWI Chancellor of the UWI Vice Chancellor of the UWI Vice Chancellor of the UWI Pro-VC and Principal, St. Augustine Campus UWI Pro-VC and Principal, St. Augustine Campus UWI

15 Messages for the book: His Excellency the President of the Republic of Trinidad and Tobago Professor Maxwell Richards wrote (inter alia): His Excellency the President of the Republic of Trinidad and Tobago Professor Maxwell Richards wrote (inter alia): “ I must also acknowledge that this (the book) is a precursor to the establishment of a dedicated dental clinic at the School of Dentistry aimed at treating HIV/AIDS patients”

16 Messages…… Hon. Prime Minister Mr. Patrick Manning wrote (inter alia): Hon. Prime Minister Mr. Patrick Manning wrote (inter alia): “It (the book) addresses a dire necessity in a commendable manner and should go a considerable distance towards improving standards of regional dental practice and our realization of greater success in the fight against HIV/AIDS”

17 Messages….. Hon. Minister of Health Mr. John Rahael wrote (inter alia): Hon. Minister of Health Mr. John Rahael wrote (inter alia): “Oral Care providers now benefit from a source of expert-authored information that addresses the plethora of issues encompassing the reality of HIV/AIDS and oral health care within a Caribbean context”

18 Messages…. Chancellor of the University of the West Indies Sir George Alleyne wrote (inter alia): Chancellor of the University of the West Indies Sir George Alleyne wrote (inter alia): “It is good to see our Faculty in the University of the West Indies deeply engaged in the many aspects of this epidemic…..”

19 Messages…. Vice Chancellor of the University of the West Indies Professor Nigel Harris wrote (inter alia): Vice Chancellor of the University of the West Indies Professor Nigel Harris wrote (inter alia): “ On behalf of the University of the West Indies, whose mission is to contribute to human resource capacity building in the Caribbean as well as, to the conduct of research and outreach relevant to the region, I congratulate Professor Prabhu and his colleagues for this tremendous effort. Through them, our university has struck a positive note for good health”

20 Messages…. Pro Vice Chancellor and Campus Principal Dr. Bhoendradatt Tewrie wrote (inter alia): Pro Vice Chancellor and Campus Principal Dr. Bhoendradatt Tewrie wrote (inter alia): “This publication undoubtedly provides a most timely guide for dental practitioners that will fill a gap in an area of medical treatment that has been neglected for too long”.

21 Foreword by Professor David Plummer A thought provoking foreword that discusses issues such as stigma, discrimination and some of the reasons for dental practitioners’ refusal to offer dental treatment to HIV patients. A thought provoking foreword that discusses issues such as stigma, discrimination and some of the reasons for dental practitioners’ refusal to offer dental treatment to HIV patients. A ‘must read’ for all dental practitioners A ‘must read’ for all dental practitioners

22 General outline/structure Six Sections in 314 pages Six Sections in 314 pages Section 1 Section 1 General Considerations with special reference to global and regional disease burden and its impact on the Caribbean society General Considerations with special reference to global and regional disease burden and its impact on the Caribbean society

23 Section 2 Virological and Immunological Considerations setting a stage for a better understanding of the basics of transmission and mechanisms involved in the disease process Virological and Immunological Considerations setting a stage for a better understanding of the basics of transmission and mechanisms involved in the disease process

24 Section 3 Clinical and Management Considerations including issues such as voluntary counseling, testing and antiretroviral treatment protocols Clinical and Management Considerations including issues such as voluntary counseling, testing and antiretroviral treatment protocols

25 Section 4 Oral Manifestations and considerations such as Occupational risks, Post Exposure Prophylaxis, and infection control procedures in Dental Practice Oral Manifestations and considerations such as Occupational risks, Post Exposure Prophylaxis, and infection control procedures in Dental Practice

26 Section 5 Practical Dental Considerations providing guide lines for comprehensive and emergency oral care for those living with HIV/AIDS Practical Dental Considerations providing guide lines for comprehensive and emergency oral care for those living with HIV/AIDS

27 Section 6 Problem Solving Exercises. Problem Solving Exercises. –This section includes 8 case studies involving clinical, ethical and occupational risk issues in dental practice *Also included are tables of normal ranges of lab values, glossary of terms and a comprehensive list of useful internet and other resource material

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

29 Dedication “HIV/AIDS in Dental Practice: An illustrated handbook for Caribbean Dental practitioners” “HIV/AIDS in Dental Practice: An illustrated handbook for Caribbean Dental practitioners” Is Dedicated to Persons Living With HIV/AIDS

30 Sincere Thanks to: The sponsors of the HIV handbook: CHART, The sponsors of the HIV handbook: CHART, I-Tech, NACC, Clogate and Palmolive His Excellency Prof Max Richards, Hon. Prime Minister Mr. Manning, Hon. Minister of Health Mr. John Rahael, Chancellor of the UWI Sir George Alleyne, Vice Chancellor of the UWI Professor Nigel Harris, and Campus Principal Dr. Tewarie, for their kind messages His Excellency Prof Max Richards, Hon. Prime Minister Mr. Manning, Hon. Minister of Health Mr. John Rahael, Chancellor of the UWI Sir George Alleyne, Vice Chancellor of the UWI Professor Nigel Harris, and Campus Principal Dr. Tewarie, for their kind messages UNESCO/Commonwealth Professor of HIV Education Professor Plummer for the Foreword to the HIV book UNESCO/Commonwealth Professor of HIV Education Professor Plummer for the Foreword to the HIV book MPC for their excellent quality of printing of the HIV handbook MPC for their excellent quality of printing of the HIV handbook UWI /Faculty /Dental School for their constant support UWI /Faculty /Dental School for their constant support Secretarial staff for typing the manuscripts and other secretarial assistance Secretarial staff for typing the manuscripts and other secretarial assistance CMSE staff for the graphic art CMSE staff for the graphic art

31 Last but not the least…… Thanks to Uma, for her constant support and for accepting so many intrusions into leisure (shopping?) time with such good grace Uma, for her constant support and for accepting so many intrusions into leisure (shopping?) time with such good grace

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