Background Speech care of cleft lip and/or palate (CLP) and craniofacial deformities (CFD) is complex and lengthy and requires collaboration amongst different disciplines. Consequently, it is important to provide academic educational models that include didactics, online learning and clinical exposure in CLP and CFD treatment, and participation in established cleft palate multidisciplinary team management. Objectives To obtain information regarding: (1) the perceived adequacy of CLP and CFD academic education of speech-language therapists (SLTs); (2) the professional services that SLTs offer to CLP and CFD patients; and (3) the educational needs of SLTs in this field. Method A 54-item online survey to collect quantitative data was conducted by telephone and email using a randomised sample of SLTs in different areas of South Africa. Results The questionnaire was completed by 123 SLTs, 70% of whom had more than 10 years of professional experience. Of the respondents, 81% acknowledged their limited clinical exposure during their academic education. Only 42% of the professionals offer treatment for CLP and CFD patients. Of the respondents, 96% agreed on the need to improve CLP and CFD academic education, and the majority recommended certified courses, continued-education workshops and online resources. Conclusion The findings indicate that SLTs academic training is perceived to be significantly limited in the cleft palate and craniofacial fields. Thus, there is a strong need at the undergraduate level for clinical training and exposure to multidisciplinary management. At post-graduate level there is a need to establish an educational strategy to meet the needs of SLTs providing CLP and CFD care. Participants suggested that programmes for continuing professional education, degree courses and online resources be designed to provide practising clinicians with updated information and guidance in management of CLP and CFD patients.

To compare the shear bond strength and bond time of 3M Unitek's APC (Adehesive Pre-Coated) Flash-Free™system applied to metal brackets. An in vitro study was performed on 40 extracted sound human premolar teeth randomly divided into two groups (20 per group) bonded either with Adhesive Pre-Coated Flash-Free metal brackets or metal brackets coated manually with Transbond XT™ light-cure adhesive. Bonding time was measured using a stopwatch. Thermoycling was performed on the samples (500 cycles) to simulate the oral environment between baths of 5°C and 55°C distilled water. Debonding shear bond strength measurements were performed in an Instron universal testing machine. The APC Flash-Free group bonded in significantly (p<0.001) less time (mean 34.06s/tooth) than the manually coated group (mean 55.14s/tooth). Shear bond strength of the manually coated group was significantly (p<0.001) higher (mean 13.32 MPa) than the APC Flash-Free group (mean 10.95 MPa). The APC Flash-Free free system is efficient and allows for reduced chair time during the bonding appointment while attaining a mean shear bond strength of 10.95MPa, which is higher than the minimum shear bond strength of between 4MPa and 7MPa1

Maxillofacial and oral surgeons (MFOS) are trained to manage hard and soft tissue conditions affecting the orofacial region. They, therefore, play an essential role in the health care of  cleft lip/palate (CLP) and craniofacial deformities (CFD) patients. The complex and lengthy nature of CLP and CFD management requires collaboration between different disciplines. Consequently, it becomes increasingly important that the academic education available to MFOS provides in-depth knowledge, multidisciplinary participation and adequate clinical exposure provided by field experts. This study aimed to investigate the exposure and knowledge level of MFOS regarding the management of CLP and CFD. A second objective was to obtain an opinion from practising MFOS about the academic educational needs of those working with CLP and CFD. An online survey and telephone interviews (using a structured questionnaire) were used to investigate the level and scope of the MFOS academic education and to determine their academic needs. The questionnaire was completed by 53 (of 121)  of practising MFOS on the Medpages health care provider database, 64.8% of whom had more than 10 years of professional experience. Of the respondents, 60% showed a good general knowledge of CLP and CFD. However, 66.5% acknowledged that they had received only limited clinical training and exposure, which prevented them from providing adequate services to CLP/CFD patients. Only 41% of the respondents offered primary and/or only secondary treatment for both CLP and CFD patients, and 53.8% of them had participated in multidisciplinary teams. All the respondents agreed on the need for a dedicated training programme(s) in CLP and CFD management, and the majority recommended a subspecialty training either by degree courses or clinical fellowship and / or certification. This study demonstrates that postgraduate academic training and clinical exposure are limited in the CLP and CFD fields. All the respondents agreed that an educational strategy to meet the needs of MFOS providing CLP and CFD care should be established. Participants suggested that part-time clinical and/or degree courses should be developed.

From a scientific perspective, the benefits of vaccination have long been demonstrated with rigorous empirical research1. To the individual being vaccinated, vaccines provide almost invaluable protection against serious infections, but high coverage levels can also create an additional benefit emerging at the population level. This public good of ‘herd immunity’, i.e. heavily reduced transmission of a pathogen in the population because of low numbers of susceptible hosts in the population, is an important layer of protection for those individuals who cannot receive vaccination themselves, those with a dysfunctional immune system, and those whose protection has waned.1 It is mainly for the latter reason that many ethicists believe that vaccination is not merely a matter of personal choice but that it can also be a social obligation.

Orthodontists are essential members of a craniofacial team (American Cleft Palate-Craniofacial Association Team Standards Committee).1 Because cleft lip/palate (CLP) and craniofacial deformities (CFD) vary in severity and facial growth patterns, treatment is complex and lengthy and requires collaboration among different disciplines. Consequently, orthodontists need specialised training in this field to reach the treatment goals of good facial growth, aesthetically acceptable appearance, and dental occlusion. Therefore, it becomes increasingly important to provide adequate training for orthodontists, so they can not only provide efficient treatment but can also undertake a leadership role in the field. To obtain information regarding:• the CLP and CFD academic education of orthodontists the professional services that orthodontists offer to CLP and CFD patients• the educational and training needs of orthodontists in this field A 54-item online survey to collect quantitative data was conducted by means of an interview, using a randomised sample of orthodontists attending the annual scientific conference of the South African Society of Orthodontics. The questionnaire was completed by 53 orthodontists, 54.6% of whom had more than 10 years of professional experience. Of the respondents, 84.8% experienced some clinical exposure in this field during their postgraduate education. Treatment for CLP and CFD patients was offered by 92% of the professionals, but only 21.7% had high confidence in their expertise in treating CLP/CFD patients. Of the respondents, 88% agreed there was a need to improve CLP and CFD education, and the majority recommended fellowship training and certified courses. The rest suggested continuing-education workshops. Most of the orthodontists provided treatment for both CLP and CFD patients despite some of them lacking confidence in treating such cases. The majority agreed that there is a strong need to establish an educational strategy to meet the needs of orthodontists who treat CLP and CFD patients. The respondents suggested that programmes such as fellowship training, degree couses, certified courses, and continuing education workshops could be used.