Statement of Principles
concerning
 
PERIODONTAL ABSCESS
No. 49 of 2013
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1.         This Instrument may be cited as Statement of Principles concerning periodontal abscess No. 49 of 2013.
Determination
2.         This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the VEA).
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about periodontal abscess and death from periodontal abscess.
(b)        For the purposes of this Statement of Principles, "periodontal abscess" means a destructive process in the bony and ligamentous supporting tissues of the teeth, extending apically and adjacent to a periodontal pocket, and resulting in localised collections of pus communicating with the oral cavity through the gingival sulcus or other periodontal sites.
This definition excludes gingival abscess, pericoronal abscess, periapical abscess, apical periodontitis and combined periodontic-endodontic lesions.
Basis for determining the factors
4.         The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that periodontal abscess and death from periodontal abscess can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
5.         Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.
Factors
6.         The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting periodontal abscess or death from periodontal abscess with the circumstances of a person’s relevant service is:
(a)                having periodontitis at the affected site within the six months before the clinical onset of periodontal abscess; or
(b)               having dental pulp disease of a tooth in the affected region of the periodontium within the four weeks before the clinical onset of periodontal abscess; or
(c)                having a foreign body embedded in the affected region of the periodontium at the time of the clinical onset of periodontal abscess; or
(d)               having trauma to the affected region of the periodontium within the four weeks before the clinical onset of periodontal abscess; or
(e)                having periodontitis at the affected site within the six months before the clinical worsening of periodontal abscess; or
(f)                having dental pulp disease of a tooth in the affected region of the periodontium within the four weeks before the clinical worsening of periodontal abscess; or
(g)               having a foreign body embedded in the affected region of the periodontium at the time of the clinical worsening of periodontal abscess; or
(h)               having trauma to the affected region of the periodontium within the four weeks before the clinical worsening of periodontal abscess; or
(i)                 inability to obtain appropriate clinical management for periodontal abscess.
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(e) to 6(i) apply only to material contribution to, or aggravation of, periodontal abscess where the person’s periodontal abscess was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
8.         In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.
Other definitions
9.         For the purposes of this Statement of Principles:
"a foreign body" means:
(a)        a fixed orthodontic appliance;
(b)        an osseointegrated implant or dental prosthesis, including single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, or posts and cores;
(c)        microscopic materials derived from dental procedures; or
(d)       shrapnel or other exogenous macroscopic material;
"death from periodontal abscess" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s periodontal abscess;
"relevant service" means:
(a)                operational service under the VEA;
(b)                peacekeeping service under the VEA;
(c)                hazardous service under the VEA;
(d)               British nuclear test defence service under the VEA;
(e)                warlike service under the MRCA; or
(f)                 non-warlike service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a)                pneumonia;
(b)               respiratory failure;
(c)                cardiac arrest;
(d)               circulatory failure; or
(e)                cessation of brain function;
"trauma to the affected region of the periodontium" means a blunt or penetrating injury, including surgery, resulting in:
(a)                fracture, luxation, loss or extraction of a tooth; or
(b)               disruption or fracture of the periodontium.
Date of effect
10.       This Instrument takes effect from 3 July 2013.
Dated this   twenty-first   day of   June   2013
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed to this instrument                        )
in the presence of:                               )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON