Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong
The Discipline of Paediatric Dentistry was established at the Faculty of Dentistry, University of Hong Kong in 1980. Professor Alan Brooke from London was the Founding Chair Professor of Children’s Dentistry & Orthodontics and designed the first syllabus and clinical facilities in the Prince Philip Dental Hospital. He was succeeded by Professor Stephen Wei Hon Yin who came from the USA where he was Professor and Chair of Pedodontics at the University of California San Francisco in 1984. Prior to his appointment at UCSF, he taught at the University of Iowa from 1967-1983 and was Professor and Head of the Department of Pedodontics from 1967-1983. The current Professor of Paediatric Dentistry is Professor Nigel King who was one of the founding members of this discipline in Hong Kong.
The discipline of Paediatric Dentistry is housed in the same floor as the discipline of Orthodontics and was planned as a joint Department initially. This facilitates the joint supervision and clinical management of all aspects of the growth and development of the child patient’s dental and oral needs from infancy through adolescence. The clinical activities are well supported by fully certified dental surgery assistants who teach the students the use of four-handed sit down dentistry.
Education in Paediatric Dentistry
The undergraduate curriculum in Paediatric Dentistry emphasizes on the development of expertise in providing total patient care for paediatric patients and is closely integrated with the Orthodontics curriculum. Paediatric Dentistry begins in the third year of the undergraduate curriculum with the Paediatric Operative Dentistry Course. This course prepares the dental students with the necessary psychomotor skills to provide quality dental care to children. The Clinical Paediatric Dentistry course starts in the fourth year and continues in the fifth year. The clinical course broadens the students’ knowledge and clinical skills in Paediatric Dentistry through comprehensive patient care and case studies.
For the postgraduate curriculum, the Faculty of Dentistry offers two full-time postgraduate courses in Paediatric Dentistry: a two-year Master of Dental Surgery and a one-year Advanced Diploma in Paediatric Dentistry. These courses form part of the specialist training pathway for Paediatric Dentistry of the College of Dental Surgeons of Hong Kong of the Hong Kong Academy of Medicine.
The Paediatric Dentistry Clinic provides patient care primarily for teaching undergraduate and postgraduate students. Private patients are also seen but they all require a written referral letter and are then seen by the teaching staff.
The scope of dental treatment ranges from preventive, restorative, surgical, prosthodontics, orthodontics to full mouth rehabilitation under general anaesthesia (GA). Comprehensive dental treatment under GA is provided weekly at the Duchess of Kent Children’s Hospital and Queen Mary Hospital.
The Special Needs Patient Clinic in the Discipline of Paediatric Dentistry delivers quality dental services to medically compromised, mentally and physically disabled children who are unable to obtain dental care from the general dental practitioners.
The Discipline of Paediatric Dentistry also contributes its expertise to the Hong Kong Cleft lip and Plate Centre, which is based at the Prince Philip Dental Hospital. Joint consultation meetings are arranged twice a month, which bring together specialists from different disciplines including paediatric dentistry, orthodontics, oral and maxillofacial surgery, oral rehabilitation and speech and hearing science for the care and management of children with cleft lip and palate.
The principal research interests of the Discipline of Paediatric Dentistry are in the following areas: epidemiological studies of early childhood caries; dental anomalies and developmental defects; cleft lip and palate; clinical studies of dental materials; laboratory and clinical studies on remineralization, enamel and bonding agents and oral health of special needs children. Many publications in International Refereed Journal are published each year by the staff and PG students.
Specialist Training Pathways in Paediatric Dentistry in Hong Kong
With the establishment of the College of Dental Surgeons of Hong Kong (CDSHK) in the Hong Kong Academy of Medicine (HKAM), the Dental Council of Hong Kong only recognizes the specialist status of Fellowships and Memberships offered by the CDSHK.
The basic and higher specialist training in Paediatric Dentistry in Hong Kong is a joint endeavour between the Discipline of Paediatric Dentistry at the Faculty of Dentistry, The University of Hong Kong and the Government School Dental Care Service.
The full time specialist training in Paediatric Dentistry leading to the Specialist Fellowship (FCDSHK Paediatric Dentistry) should be for a minimum duration of 6 years, with an Intermediate Examination after 4 years followed by a 2 year Higher Training programme leading to the Exit Examination.
The typical sequence of training is shown below:
- A basic dental degree from the University of Hong Kong or equivalent institution approved by the College of Dental Surgeons of Hong Kong, will be the entry requirement for the full time basic training in Paediatric Dentistry.
- In year 1 of the training programme, the candidate is expected to gain appropriate experience in general/hospital dentistry at the University of Hong Kong and or the Department of Health Dental Services, or other supervised practices.
- Year 2 to 4 should be a full time, structured, institute based training programme in Paediatric Dentistry in approved training institutions.
- Before entry into the Higher Training programme, the candidate must have successfully completed the Intermediate Examination in Paediatric Dentistry of the College of Dental Surgeons of Hong Kong, which is a conjoint examination with the Membership in Paediatric Dentistry of the Royal College of Surgeons of Edinburgh.
- Year 5 and 6 of the Programme should be a structured Higher Training period in an approved programme at a training institute or approved practice in conjunction with a training institute.
- Before accreditation as a trained specialist, the candidate must successfully complete an Exit Examination in Paediatric Dentistry conducted by the Specialty Board in Paediatric Dentistry of the College of Dental Surgeons of Hong Kong of the Hong Kong Academy of Medicine
Government Dental Service for Children of Hong Kong
The Department of Health (DH) of Hong Kong (www.dh.gov.hk) delivers oral health education and promotion programmes and preventive dental care services for the children of Hong Kong through its Oral Health Education Unit (www.toothclub.gov.hk) and School Dental Care Service (www.schooldental.gov.hk).
The Oral Health Education Unit (www.toothclub.gov.hk) of DH has carried out oral health education programmes targeting at young children. The “Brighter Smiles for the New Generation” programme, launched since 1993, aims to encourage children aged 0-6 to develop good oral care habits since early childhood. It also produces different types of specially-designed educational resources to disseminate the message of oral health to pre-school children and their parents through Maternal and Child Health Centres, kindergartens and nurseries.
When children reach primary school age, there is a “Bright Smiles Campus” Programme which is a school-based oral health promotion programme launched in 2009/10 for primary school children to empower them in improving the cleanliness of their teeth. In addition, they can join the School Dental Care Service (www.schooldental.gov.hk). In operation since 1980, the School Dental Care Service provides oral health education, annual dental examination, preventive and basic dental care to primary school children through eight school dental clinics in the territory, to help them develop proper oral care habits since childhood. Dental services are carried out by qualified dental therapists working under the supervision of dental officers.
In order to ensure that school children will continue to take care of their oral health after they have moved on to secondary schools, the Oral Health Education Unit has developed a “Teens Teeth” oral health promotion programme for the secondary school children. Students are trained as Peer Promoters to organize various oral health promotion activities to their schoolmates and to teach Form 1 students the correct tooth cleaning techniques.
For children with intellectual disability, the Oral Health Education Unit is conducting the “Dandelion Oral Care Action” programme in order to promote good oral health among this group of children. The Unit collaborates with schools and parents and teaches them the correct toothbrushing and flossing techniques to take care of the children’s oral health, expecting that the children can be able to clean their own teeth well and maintain healthy teeth and gum when they leave school.
An annual “Love Teeth Campaign” has been launched by DH with the objective of facilitating the development of proper oral health habits and tooth cleaning techniques among the public.
Apart from this, DH updates the webpage of the Oral Health Education Unit (www.toothclub.gov.hk) from time to time, through which the public can have ready access to oral health information. The Department of Health also monitors the level of fluoridation in the communal water supply in order to reduce dental decay among the population.
Specialists Paediatric Dentists in Private Practice
As at June 2015, there is a total of 33 registered Specialists in Paediatric Dentistry in Hong Kong and almost half of them are in private practice. The majority of the patients treated by this group of Paediatric dentists are young children who are not yet eligible for the Government subsidized School Dental Care Service for all the local primary schools of Hong Kong. The service starts at primary one and therefore kindergarten and preschool children who need dental treatment will have to receive dental care in the private sector.
The distribution of decayed primary teeth in 5-year old children was uneven. According to the 2011 Oral Health Survey in Hong Kong, the mean dmft of 5-year old children remained low at 2.5. Almost half of the children (49.3%) in this age group were not affected by tooth decay experience, while 26.2% of the children in this age group had around 81.2% of all the teeth with decay experience. This data represents a small group of high risk children who have many carious teeth in the population. Since they are mostly young and difficult to manage, some form of behavioral management skills coupled with or without sedation would be required before proper dental treatment can be provided. These children will benefit much from seeking treatment with Paediatric dentists.
Another category of Paediatric patients that are often treated in private practice are the special needs group such as children with autism, syndromes and mentally or physically disabled. Special considerations in the clinic set up to accommodate for these children such as sound proof surgeries, ramp for wheelchair, lifts at street level, equipment for sedation and so on are some features that most Paediatric dental clinics will provide.
Severely disabled children with severe dental diseases are also treated in the Hospital under GA by paediatric dental specialists.