How to Provide the Evidence Base for Techniques and Interventions that Ensure Equal Treatment Outcomes for People with Disability
In dentistry over the last fifty years, major technical advances have led to improved quality of dental treatment and improved ability to maintain oral function and aesthetics over the life span. In the same period, the disability movement has achieved enormous progress in terms of the recognition of persons with disability as valued citizens in their own right; BUT little advance have we seen in Special Care Dentistry. So why is there still massive inequality in the quantity and the quality of dental treatment provided for people with disability? Why so much unmet need? Why so many extractions? Why is the basic right to an equivalent level of care not being met in oral health care? Why is special care dentistry perceived as the discipline of compromise – where ‘better than nothing’ is the bottom line? SCD does not seem to meet patient expectations of equivalent level of care. Some reasons are given for this scenario: 1) Lack of teachers and researchers; 2) Lack of clinical innovation and sharing of applied experience; 3) Lack of interdisciplinary work; 4) Lack of evidence base How to address this situation? Through academic disciplines and clinical specialty or by increasing attractiveness and recognition of SCD as a growing speciality. There are three mandatory actions for Special Care Dentists: Thinking outside the box, lay down the dogma; Integration of SCD into all other disciplines – throw down the challenge! and create the base of evidence. This lecture will flow from philosophical discussion of voids and opportunities in this discipline to a call for action with clinical case presentation.
Dr Molina has been Chair Professor in Dental Materials Sciences (2009-2022) and Chair Professor in Special Care Dentistry (2018-2022) at the Dental School, Faculty of Health Sciences, Universidad Católica de Córdoba (Argentina). He has also been Associate Professor in Dental Materials Sciences (2005-2022) at The Faculty of Dentistry, Universidad Nacional de Córdoba (Argentina). He is the former Director of the Dental School, Faculty of Health Sciences, Universidad Católica de Córdoba (2013-2016).
He holds two PhD’s and a number of peer reviewed publications (Scopus h-index 11). His first doctorate was in the field of Craniofacial Research related to oral characteristics of Argentinean aborigines with Down Syndrome. The doctoral thesis was defended in 1998 at the Faculty of Dentistry UNC. A second PhD was defended in 2014 at the Radboud University Nijmegen (The Netherlands) related to the use of minimal intervention dentistry in Patients with Special Needs. In the last years he participated as an expert in several international consensus related to Dental Materials (Consensus on the use of glass ionomer cements), Cariology (Consensus on Management of caries lesions in Latin American and Caribbean countries) and Special Care Dentistry (Guidelines for oral care in patients living with EB).
He initiated and ran the DINOH project (Developing International Networks for Oral Health) between 2006 and 2016. This project was an online library of resources for researchers and teachers of SCD with a grant from the International Association for Disability and Oral Health (iADH). He has been the Chair of the iADH International Advisory Committee (2018-2020) and is currently chairing the iADH Scientific Committee. Dr. Gustavo Molina is the President elect of the iADH and will become the president of the association from August 2022. He has more than 30 years of experience in providing a full range of care for people with disabilities. He worked under the direction and surveillance of Dr Rodolfo Castillo Morales, the world leader in Oral Motor Therapy and developed resources to aid and promote the use of Oral Motor Therapy across Europe and South America. His main clinical and research topics of interest deal with non-restorative and minimally invasive caries treatment options, mainly applied to vulnerable groups. His aim is to achieve equitable access to care and equity in quality treatment outcomes for these groups.