An historical perspective on early progress of Queensland water fluoridation 1945-1954: sheep, climate and sugar.

BACKGROUND: Queensland's virtual rejection of artificial water fluoridation sets it apart from other Australian states, yet the early fluoride environs has been scantily recorded. METHODS: This paper used archives, literature review, personal interview and the traditional historic method. RESULTS: The connection between Queensland artesian bore water and caries resistance was postulated as early as 1912. Four decades later, two Queensland-specific factors influenced the planning to fluoridate community water supplies. The first (1945-1950) was confusion between the high levels of fluoride in artesian water supplying the pastoral industry and the scientific concept of artificial water fluoridation of communal supplies. The second (1952-1954) involved further scientific investigation involving water consumption patterns, occupational dehydration and fluid homeostasis within a sub-tropical climate. The role of the Australian Dental Association Queensland Branch (ADAQ) in early fluoride politics was minimal. Four early protagonists are identified--two dentists, an engineer and the sugar industry. CONCLUSIONS: Queensland had its advocates for artificial water fluoridation of communal supply as a means of caries prevention. Interest came from the dental, medical and engineering professions, and from the sugar industry. However, these efforts met with indifference based on confused extrapolation of the artesian experience (1945-1952) and hesitancy (1952-1954) due to contemporaneous concerns about human fluid homeostasis in Queensland's sub-tropical climate.

Treatment delays in paediatric dento-alveolar trauma at a tertiary referral hospital.

BACKGROUND: Paediatric dento-alveolar trauma is a common event. Delays in treatment can have adverse effects on long term outcomes and the aim of this study was to quantify the treatment delays in paediatric dento-alveolar trauma in a tertiary referral hospital. METHODS: All cases of paediatric dento-alveolar trauma over a two year period from July 2000 to June 2002 were identified and the charts were reviewed retrospectively. All children presenting to the emergency department with dento-alveolar trauma within 48 hours of injury during the time period were included. RESULTS: Forty-three patients were identified. The average age was 5.51 years, though there was a bias towards one and two year olds. Males were injured 1.5 times more frequently than females. There was an average delay of 9.6 hours between injury and treatment for all patients. Transit time from outside practitioners to hospital and waiting times in hospital made up the greatest delays. Children injured an average of 2.37 teeth and only 14 per cent were uncomplicated crown fractures. CONCLUSIONS: Children who present to children's hospitals for treatment of dento-alveolar trauma have more severe injuries than those treated elsewhere. They have large but potentially reducible delays between injury and treatment.

Ethical dilemmas confronting dentists in Queensland, Australia.

BACKGROUND: This paper details contemporary ethical dilemmas encountered by Queensland dentists. METHODS: An age-stratified sample of 499 dentists resident in Queensland was surveyed. The questionnaire contained scenarios of five common ethical dilemmas. In addition, open-ended questions sought the respondent's most frequent, difficult and recent ethical dilemmas, and where they would seek guidance in dealing with ethical problems. RESULTS: Respondents acknowledged the patient's rights in treatment decisions and the dentist's right to refuse demands for inappropriate treatment. However, responses varied in the extent to which dentists may influence treatment decisions. Few respondents would ignore evidence of poor dental treatment but they are evenly divided in choosing to inform the patient, the dentist or both. Poor quality treatment is the most frequent and difficult dilemma, and half have experienced this problem recently. Requests by patients for fraudulent receipts occur in a third of responses. Dentists develop ethical values from multiple sources but for help with dental ethical problems, 90 per cent of respondents would consult another dentist. CONCLUSIONS: Of the ethical dilemmas discussed in this survey, those relating to poor quality treatment confronted most respondents. Also the actions of dentists in dealing with these dilemmas were most varied.