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How’s Your Mental Health?

AUTISM SPECTRUM DISORDER

MARCH/APRIL 2015 ISSUE

What is mental health to you? Is it a term we only use for those who suffer from illnesses such as depression, self-harm and psychosis? Mental health has such erroneous negative connotations and although this is slowly changing much work still needs to be done to change perceptions, even amongst students being trained to work in healthcare, such as ourselves.

I recently participated in a day course on mental health first aid - the first exercise was to provide

as many negative and positive associations with mental health as we could. As you can imagine, the cynics in us all prevailed. Society has conditioned us to be fearful and defensive when talking about the subject of mental health. However, mental health is something we all have and ours exists on a spectrum - from being good to bad.

Continued on page 3

10 CHALLENGES YOU MAY FACE WHEN

TREATING AUTISTIC PATIENTS

BEHIND THE SCENES

THE SECRET GARDEN HALFWAY BALL

BDSA Conference London 2015 By Daniel Tate, BDSA Conference Welfare Officer

In case you haven’t surfaced from hibernation yet, the biggest event of the year is coming to town! 3 Days.

650 Students. 1 Purpose.

FUN. (And learning of course…)

What is the BDSA? It is a student body run by student representatives from each UK dental school. The BDA and BDSA are two separate organisations that work closely together. The BDA is your trade union and professional association, whilst the BDSA looks after the social side of student life. Together, they ensure you get the best dental experience possible.

Lectures The lectures in this year's conference cover a wide range of topics within the dental spectrum. We have Bart’s hosting the Thursday lectures whilst Friday’s are held by King’s keeping you up to speed on life after dental school: 'The Next Step'. Will you graduate? Will you not? To DF2 or not to DF2? We'll have the answer… along with other surprises.

Evening Events Thursday – BDSA T-shirt Bar Crawl (Crawling optional!) – It’s being held in Shoreditch which

is definitely the place to be. Our events team has been hard at work organising exclusivity of venues and more reasonable drink prices (water is available/advised)! Friday – BDSA Themed Fancy Dress – Central London is where we are all heading. Kings theme is Peter Pan! Think Lost Boys, Pirates and Tinkerbell!

Saturday Trade Fayre and Evening Annual Ball Trade Fayre – Location is over at Barts. Our sponsorship team has done incredibly well, getting lots of companies to attend and looking like the biggest student trade fayre in London of previous years! Annual Ball – It is always the climax of any Dental Student Calendar, with an evening full of surprises and more! The theme is being kept completely under wraps. Even the committee don’t know what is going on! All we know is that it is being held at the prestigious venue, The Brewery and it’s not to be missed.

Getting the Conference up and running has required a lot of hard work from the whole team but I know it’ll all be worthwhile when the drinks start to flow each night and I'll be getting those all-important complaints from the hotel about student’s behaviour! My Team for King’s! – Any issues or questions, fire it their way! BDS1 – Hirra “The Scot” Kirmani BDS2 – Rachel “Diablo Sauce (Bodean’s) doesn’t have anything on me” Loke BDS3 – Mandeep “Bhangra” Benning BDS4 – Puja “Grandma” Jethwa BDS5 – Harshini “HP Saucy” Pindolia That’s a general overview of what’s to come at this conference! There are always great memories and stories to be had by all! For up-to-date information and more, visit: www.BDSALondon.co.uk If you have any questions, drop us an email BDSAWelfare2015@gmail.com or come find any of the committee – details are on the website!

THE BDSA CONFERENCE IS

COMING TO LONDON

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Note from the EditorsHello KCL dentists!

This term has already been filled with some memorable events! The 120th Celebration Dinners were thoroughly enjoyed by BDS1-2 and BDS4-5 and whilst there was no birthday cake for our Dental Society, there were some presents- at least for the winners of the raffle organised by Smilesoc (who else thought they were going to be lucky enough to win the iPad?). Whilst BDS3 were missing from the 120th dinners, they were celebrating their own milestone- reaching halfway! Jessica Sze takes us through the planning and organisation that went into the Secret Garden-themed Halfway Ball.

There is still heaps to look forward to. For the very first time, the BDSA Conference is coming to London. Hosted by KCL and Bart’s, we can’t wait to show the other dental schools what London has to offer. Dan Tate, the BDSA Conference Welfare Officer, gives us the lowdown on what we can expect with this highly anticipated event. The BDSA London committee aren’t the only ones who can put on a show though- so can YOU! Articaine, the GKT Annual Dental Revue Show is once again returning and Vedaant shares how you can get involved. We still get the giggles thinking about the ‘Crown Prep’ song last year… the show never fails to keep us entertained.

Whilst there is a lot to come, we still have a few hurdles in the way. Sorry to be a bummer, but we can’t forget about exams, after all dental school isn’t just about the fun-filled events (if only it was). Exams can be a stressful time, heck, the whole of dental school can be and the pressures we face can affect us in different ways. These stresses could even impact your mental health. Some may find Mental Health a difficult issue to discuss but it’s important we bring it out in the open- that’s why we’re talking Mental Health in this issue with Artysha, one of the founders of ThinkMental which is the KCLSU society dedicating to lifting the stigma attached to Mental Health.

With dental love to our dental friends,

The King’s Crown Editorial Team

THE KING’S CROWN NEWSLETTER TEAM

Akta Prabhakar, Chief Editor

Nick Byfield, Special Features

Editor

James Campbell, News Editor

Niki Keyhani, Social Editor

PROOFREADERS Sahar-Tara Aghababaie

Jassan Aujla Priya Champaneri Suneeta Dhokia Danielle Kelly

Vibishan Venukumar

Send us your articles! Please email

thekingscrown@kcl.ac.uk for all communications, including to

submit your own articles.

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How’s Your Mental Health?Artysha Tailor

… I’m Not Crazy

What is mental health to you? Is it a term we only use for those who suffer from illnesses such as depression, self-harm and psychosis? Mental health has such erroneous negative connotations and although this is slowly changing much work still needs to be done to change perceptions, even amongst students being trained to work in healthcare, such as ourselves.

I recently participated in a day course on mental health first aid - the first exercise was to provide as many negative and positive associations with mental health as we could. As you can imagine, the cynics in us all prevailed. Society has conditioned us to be fearful and defensive when talking about the subject of mental health. However, mental health is something we all have and ours exists on a spectrum - from being good to bad.

As dental students it is important that we break through these barriers of negativity for many reasons. Firstly, we are the next generation of healthcare professionals and if perceptions of mental health are to change, it is our responsibility to ensure it filters through the system. Moreover, we have a responsibility to look after ourselves, in order to discharge our duty to look after others - but why would we in particular be affected by mental health problems?

It is important to remember that possessing intelligence and bearing responsibility does not make us invincible. We are just as vulnerable to experiencing mental ill health, from depression to psychosis - it may affect each of us at any time and can be exacerbated by the very real stresses of student life.

Starting university is a time of uncertainty: a new environment, and for some a new home; making friends, pursuing self-actualisation; the pressures of exams and finances. Furthermore, dental degrees are loaded with additional pressures: duties of care and professionalism; the competitive environment, where

threat of failure is a shadow which stalks us all; where tough love is a common teaching method. Each individual handles pressure differently. Some may feel very comfortable with these unique challenges and excel. However, for some this may perpetuate feelings of anxiety and depression, fostering an inability to cope. As a dental student would you feel confident to seek help? Or would the fear of stigmatisation stop you?

My conversations with Prof Mark Woolford made it very clear that students are positively encouraged to seek help if they are struggling with mental health problems. The Institute and College want to help us recover from our issues and care for our patients; their aim is not that we are deemed permanently unfit to practice. To that end, resources available for students are extensive: counselling services, psychiatrists and occupational health. KCL recently even signed the pledge of Time to Change - campaigning to end mental health discrimination.

If we are to care for our patients, we must look after ourselves, and that includes our mental health. Just as a broken leg isn't a career-ending scenario, nor is mental ill health - there is no shame in having a mental health problem, and we are to be commended for addressing and overcoming such challenges. Remember that none of us are alone, and there is always help available.

NEWS

Editorial Time to Change is a programme run in England by charities Mind and Rethink Mental Illness to transform public and organisational perceptions of mental illness. A study led by KCL's Institute of Psychiatry showed in 2013 that it has had a significant measurable impact on the level of discrimination. On 10th December 2014, King's College London and KCLSU jointly signed a pledge committing them to reducing mental health discrimination and providing appropriate support.

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SPECIAL FEATURE

Autism is a lifelong developmental disability that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them.Having a brother with severe autism and learning difficulties, I am able to understand and appreciate his needs and the difficulties he deals with in his daily routine. I would like to share ten potential challenges dental professionals could be faced with in treating autistic patients, hopefully giving greater insight into dealing with autistic patients in the dental setting.

1) Autism is a spectrum disorder: People with autism will be affected in vastly different ways, although, they will share some common problems/characteristics. For example, my brother has severe autism with limited language and is dependent on full-time care, however, someone with Asperger’s syndrome (a form of autism) may be highly intelligent and independent. It is important that each patient’s needs are assessed individually and treated accordingly.

2) Communication: A person at the milder end of the spectrum may have normal speech but display inappropriate reactions to certain situations. At the more severe end of the spectrum there may be limited or no speech. It will be useful to find out from their parent or carer the best way to communicate with them e.g. through the use of picture cards. It should also be noted that people with autism find it difficult to interpret facial expression, therefore verbal communication should be clear, simple and literal.

3) Sensory sensitivity: People with autism often have particularly heightened sensitivity. Their vision may be hypersensitive to the dental light or they may not like to be touched, so even a dental examination could prove difficult. Hypersensitive hearing could make it difficult to carry out treatment which involves use of a drill and the strong taste and smell of toothpaste or filling materials may not be well tolerated. They may also be hypersensitive or hyposensitive to pain. Find out from parents or carers if there is anything to which they are particularly sensitive as it is most likely to affect your patient management and be sure to tell the patient what you are doing at every stage.

4) Challenging behaviour: An autistic person may display difficult behaviour. This could include self-injury or aggressive behaviour. Behavioural issues should be discussed with the patient’s parent or carer and referral to a Department of Special Care Dentistry should be considered for treatment in the secondary healthcare setting.

5) Routine: A change in an autistic person’s routine can be very disruptive and cause marked upset and distress. Therefore, it may be helpful to book appointments in advance so that the patient has enough time to plan and prepare, reducing stress and anxiety on the lead up to and during the appointment.

Autism Spectrum Disorder: What are the challenges?

Sarah Sacoor

Sarah is one of our competition winners. Her article will be published in BDJ Student.

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6) Diet: Due to routine, hypersensitivity to some tastes and textures and dietary requirements, autistic people may be quite selective with their diet. For example, my brother has a high carbohydrate diet and needs to eat frequently throughout the day. Although the sugar frequency can be reduced in these patients, their diet cannot be completely controlled and a higher caries rate will be inevitable. Therefore, it would be wise to incorporate prevention of caries as a main focus of the treatment plan.

7) Poor oral hygiene: The texture of a toothbrush and the taste of toothpaste can be a challenge when it comes to maintaining oral hygiene. When someone else brushes my brother’s lower central incisors, he tenses his lower lip making them impossible to brush, however, if he brushes them himself he does not remove an adequate amount of plaque. Therefore, we can only expect good oral hygiene to the best of the patient or carer’s ability. We can, however, try to ensure the patient has enough fluoride exposure through mouthwashes, fluoride varnish or a high fluoride toothpaste.

8) Medical conditions: Many people with autism suffer from other conditions such as epilepsy, dyslexia, dyspraxia, ADHD and gastrointestinal problems. It is important to know their full medical history and how to manage related medical emergencies such as epileptic seizures. They may also be taking medications such as antipsychotics, anticonvulsants and antidepressants which can lead to xerostomia, gingival hyperplasia and bruxism and could impact on patient management.

9) The appointment: The journey itself may be a challenge to the patient and they may already be quite distressed or agitated by the time they have reached their dentist. The time, day and length of the appointment should be planned according to the patient’s needs and enough information given to the patient and their carer for prior planning and preparation. Some autistic patient’s will be specific about the timing of appointments and this should be catered for. For, more severely autistic patients who are aided by full-time carers, consideration for the time it may take to prepare the patient for their day should be taken and carers consulted.

10) Access to services: If the patient exhibits challenging behaviour or will not allow the dentist to examine them it may be necessary to refer them to a specialist for treatments aided by sedation or general anaesthetic. My brother was fortunate to have been treated at Guy’s Hospital, but other areas in the United Kingdom do not have a Special Care Department in the vicinity and the patient may be required to travel long distances for treatment. However, if the patient agrees, treatment can be carried out in general practice, especially if the patient is already comfortable with the setting and the staff.

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BDSA Conference London 2015

What is the BDSA? It is a student body run by student representatives from each UK dental school. The BDA and BDSA are two separate organisations that work closely together. The BDA is your trade union and professional association, whilst the BDSA looks after the social side of student life. Together, they ensure you get the best dental experience possible.

Lectures The lectures in this year's conference cover a wide range of topics within the dental spectrum. We have Bart’s hosting the Thursday lectures whilst Friday’s are held by King’s keeping you up to speed on life after dental school: 'The Next Step'. Will you graduate? Will you not? To DF2 or not to DF2? We'll have the answer... along with other surprises.

Evening Events

• Thursday – BDSA T-shirt Bar Crawl (Crawling optional!) – It’s being held in Shoreditch which is

definitely the place to be. Our events team have been hard at work organising exclusivity of venues and more reasonable drink prices (water is available/advised)!

• Friday – BDSA Themed Fancy Dress – Central London is where we are all heading. Kings theme is Peter Pan! Think Lost Boys, Pirates and Tinkerbell!

Saturday Trade Fayre and Evening Annual Ball

• Trade Fayre – Location is over at Barts. Our sponsorship team has done incredibly well, getting lots of companies to attend and looking like the biggest student trade fayre in London of previous years!

• Annual Ball – It is always the climax of any Dental Student Calendar, with an evening full of surprises and more! The theme is being kept completely under wraps. Even the committee don’t know what is going on! All we know is that it is being held at the prestigious venue, The Brewery and it’s not to be missed.

Dan Tate, BDSA Conference Welfare Officer

SOCIAL

Getting the Conference up and running has required a lot of hard work from the whole team but I know it’ll all be worthwhile when the drinks start to flow each night and I'll be getting those all-important complaints from the hotel about student’s behaviour!

My Team for King’s! – Any issues or questions, fire it their way!BDS1 – Hirra “The Scot” Kirmani BDS2 – Rachel “Diablo Sauce (Bodean’s) doesn’t have anything on me” Loke BDS3 – Mandeep “Bhangra” BenningBDS4 – Puja “Grandma” JethwaBDS5 – Harshini “HP Saucy” Pindolia

That’s a general overview of what’s to come at this conference! There are always great memories and stories to be had by all! For up-to-date information and more, visit: www.BDSALondon.co.ukIf you have any questions, drop us an email BDSAWelfare2015@gmail.com or come find any of the committee – details are on the website!

BDSA Conference London 2015 By Daniel Tate, BDSA Conference Welfare Officer

In case you haven’t surfaced from hibernation yet, the biggest event of the year is coming to town! 3 Days.

650 Students. 1 Purpose.

FUN. (And learning of course…)

What is the BDSA? It is a student body run by student representatives from each UK dental school. The BDA and BDSA are two separate organisations that work closely together. The BDA is your trade union and professional association, whilst the BDSA looks after the social side of student life. Together, they ensure you get the best dental experience possible.

Lectures The lectures in this year's conference cover a wide range of topics within the dental spectrum. We have Bart’s hosting the Thursday lectures whilst Friday’s are held by King’s keeping you up to speed on life after dental school: 'The Next Step'. Will you graduate? Will you not? To DF2 or not to DF2? We'll have the answer… along with other surprises.

Evening Events Thursday – BDSA T-shirt Bar Crawl (Crawling optional!) – It’s being held in Shoreditch which

is definitely the place to be. Our events team has been hard at work organising exclusivity of venues and more reasonable drink prices (water is available/advised)! Friday – BDSA Themed Fancy Dress – Central London is where we are all heading. Kings theme is Peter Pan! Think Lost Boys, Pirates and Tinkerbell!

Saturday Trade Fayre and Evening Annual Ball Trade Fayre – Location is over at Barts. Our sponsorship team has done incredibly well, getting lots of companies to attend and looking like the biggest student trade fayre in London of previous years! Annual Ball – It is always the climax of any Dental Student Calendar, with an evening full of surprises and more! The theme is being kept completely under wraps. Even the committee don’t know what is going on! All we know is that it is being held at the prestigious venue, The Brewery and it’s not to be missed.

Getting the Conference up and running has required a lot of hard work from the whole team but I know it’ll all be worthwhile when the drinks start to flow each night and I'll be getting those all-important complaints from the hotel about student’s behaviour! My Team for King’s! – Any issues or questions, fire it their way! BDS1 – Hirra “The Scot” Kirmani BDS2 – Rachel “Diablo Sauce (Bodean’s) doesn’t have anything on me” Loke BDS3 – Mandeep “Bhangra” Benning BDS4 – Puja “Grandma” Jethwa BDS5 – Harshini “HP Saucy” Pindolia That’s a general overview of what’s to come at this conference! There are always great memories and stories to be had by all! For up-to-date information and more, visit: www.BDSALondon.co.uk If you have any questions, drop us an email BDSAWelfare2015@gmail.com or come find any of the committee – details are on the website!

In case you haven’t surfaced from hibernation yet, the biggest event of the year is coming to town! 3 Days. 650 Students. 1 Purpose.

FUN (And learning of course…)!

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Behind The Scenes: The Secret Garden Halfway Ball

Jessica Sze

SOCIAL

First thing’s first... VENUE! As the start of September drew close, expectations were high to hunt for the most unique venue for this year’s halfway dinner. The quest began with hours of searching, bookmarking pages, enquiries and emails. Finding a venue that was large enough for a banquet dinner and dance event within Central London was a lot more problematic than originally thought; particularly within budget. After a first round of emails and having given up a little inside, the search progressed on to a second round of emails and a third. Having gone to dozens of venue visits and meetings, the top 10 were soon narrowed down to a few. With cost being such a major factor, negotiation had to be our strong suit. Luckily, our chosen venue was happy to match their competitor’s price (sneaky tactic by us) and the venue was secured!

Next: Theme Choice! Having settled on the theme, ‘The Secret Garden’, the designing of tickets and posters promptly took place. Being the complete opposite of tech-savvy, help was needed to design the promotional material which portrayed a classy yet rustic garden theme. Deciding to really take the theme further, I came across a few unique ideas whilst scouring wedding pages and within no time at all, boxes of hundreds of pinecones and personalised wooden leaves were stacked outside my door, awaiting my arrival from a long day of clinics. Score. Next was table décor, and never have I ever spent so much time comparing prices of dried flowers. With an astonishing number of choices and colours I soon learnt that there was apparently a difference between pods and accents, table confetti and throwing confetti, delphinium and bougainvillea petals and the list went on. Who knew? Faced with a budget, it become a lengthy search for what didn’t blow the bank yet didn’t look like barren shreds of leaves scattered over a table.

And the winner of the Halfway Awards is... Designing the Halfway Awards with our DTI (Ken, who was absolutely great!) was... interesting. A lot of things occurred behind the scenes before such a shiny trophy was complete. From spray painting them in the middle of the streets under a lamppost, to inhaling what I hope wasn’t toxic clouds. The final product was worth it.

Ball Day The day of the Ball began at 3pm for me. With so many people setting up tables and chairs, and with everything I had booked rolling in at their scheduled times to set up, I was having a mini breakdown inside. I was pushed for time to set up and decorate all the tables, but thankfully Jess Ah-Kye was there to help me out with all the last minute adjustments! Still with my trainers on, and having lost track of time, staff and students started to arrive whilst I rushed to get ready. The Ball began and the reception was flowing with glamorous Halfway-ers. Hoping that everything ran smoothly throughout the night, my job was finally done. Overall, it was a pleasure to organise such a grand event for our wonderful year to commemorate being halfway there!

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Volunteer this Christmas for Crisis- there are many roles you can be involved in. Check their website at http://www.crisis.org.uk/

pages/volunteer-christmas.html

ARTICAINEVedaant Patel

SOCIAL

That’s right, we’re back. The best (and only) GKT Annual Dental Revue Show.

So what is Articaine? Well in a nutshell, we make the Annual Dental Revue. It’s the show at the end of year, where we get to take the mick out of anything and everything that’s gone on in the dental school and current affairs. With jokes ranging from a few impressions of our beloved tutors to the recreational use of dental material, there is always something everyone can relate to.

What has happened so far and what’s the plan this year? There was the “Overhang” two years ago and “Hari Patel and the Spittoon of Doom” last year. Between the two shows around £3000 was raised for various charities and we want to add to that this year, in support of “The Dental Wellness Trust”. The committee has been assembled and the team is hard at work to produce one of the funniest dental shows KCL has ever had.

So what’s so good about it? Overall being in the show was one of the best things I’ve done at Uni. The rehearsals were always a laugh with the sketches constantly changing as everyone pitched in.Some of my highlights include: - 1. Watching some random Asian dude being a bit too intimate with a chair 2. Being on stage with the ‘The Legend’, that is Bill Bould 3. Learning how to sing and dance with my fellow untalented (if what we performed actually

counts as that) 4. The dental version of R.Kelly Ignition- ‘Crown Prep’ (much better than the original) 5. Trying to learn a group dance (with the guys failing hilariously)

When and where is the show this year? Thursday 11th June after everyone’s main exams. The show will be hosted at our own Greenwood Lecture Theatre, with the after party at Guy’s Bar.

So how can I be apart of it and isn’t it all a bit intimidating Try outs have been set for March 4-5th in the spit and surrounding rooms (look out for posters with further details). The best bit is anyone and everyone can try out and minimal talent is actually required (a good thing too, otherwise I definitely wouldn’t have made it). As for any nerves on the show night, a lot of us hadn’t been on stage before and everyone was so supportive and helpful, so it wasn’t really an issue. Worse case scenario liquid confidence is always on hand.

Where can I find out more? This year we have a new fancy-schmancy website (with a blog and everything) that will have all the up to date details of the show (http://articainekcl.wix.com/dentalcharityrevue). The committee members are spread throughout the years so it will be easy enough for you to find out who they are and ask them any questions. Myself (Treasurer – BDS5), Rhamatalah Ayoade (Director – BDS4) and Niktash Keyhani (Producer – BDS3) are all very approachable and will answer any of your questions (no matter how small).

Additionally if you’re not convinced of what we do, check out our promotional video online, inspired by a sketch from the show last year (Crown Prep – The Ledermix) and get involved in the next one by joining what has become our Articaine family.