Interview ADVANTAGE SCOTLAND
Mossey believes Scotland’s unique healthcare system has provided an advantage to his research. “I use it to good effect when I am going around the world. The managed clinical networks we introduced in 2000 are regarded as the gold standard for organising multi-disciplinary care. “Cleft lip and palate was the first registered MCN in Scotland, so we have the longest experience of running that system. It has provided an excellent example to the rest of the world on how to organise cleft lip and palate services. And it has recently been refined – instead of a multi-centre initiative, we now have one overall administrative centre with two surgical sites in Edinburgh and Glasgow, where infants with clefts of the lip and palate receive excellent care.” Alongside this is the Scottish Oral Health Research Collaboration, a unique collaborative research initiative where complementary areas of expertise at universities across Scotland are brought to the same forum to optimise the power and impact of their work.
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parents of cleft lip and palate babies during the time he was on call as a registrar in the Victoria Hospital in Kirkcaldy: “Why did this happen and is it likely to happen again?” It was that basic theme that prompted his decision to focus on genetics when he undertook his doctorate at the University of Glasgow in ı989. “We knew that genetics was a very significant component, but did not know the specific genetic factors. I have been investigating this area since ı994. Equally important to recognise is that most chronic diseases – cancer, cardiovascular disease, diabetes, obesity and respiratory
posts in Dundee. After attaining registrar level, he was offered the opportunity to do specialist training in orthodontics and be first on call for patients born with cleft lip and palate. He subsequently went on to the University of Glasgow to undertake higher specialist training in orthodontics. On completion of his PhD and higher specialty training between 1989 and 1994, he took up a lectureship at Dundee. In 2003, he attained Professorship and
26 Scottish Dental magazine
diseases and so on – have environmental elements as a contributory factor. Birth defects are no different and we have taken that into account in our work as we look at interactions between genes and environment.” According to Mossey, Dundee’s
redesignation is the culmination of ı0-ı2 years of hard work. He said it has come at a very opportune time when the University is looking at inter-disciplinary collaborative initiatives, and it gives additional status to the Dental School, both in the University and the wider world. From a personal perspective, even though
the status throws up new opportunities, Mossey is content to concentrate on tasks
WHO Collaborating Centre status in his area of specialist expertise was achieved by the University the following year. “Birth defects surveillance has revealed that many children born with clefts in the developing world do not survive and raising awareness of how to feed can save their lives,” said Mossey. “We can do very satisfactory surgical repairs at the moment, but we cannot completely eradicate the disorder in everyone.
he has in hand. “I have programmes not only in India but sub-Saharan Africa and Brazil, and although I have been asked to assist in research programmes elsewhere, each opportunity needs to be evaluated in terms of capacity, and these programmes that are running at the moment will continue to be top of my list. “Overall, we are making a very significant
contribution to cleft lip and palate in terms of improving surveillance systems in places where these do not currently exist, improving knowledge on both genetic and environmental risk factors, improving care delivery, and promoting the concept of cleft prevention, which is now becoming a realistically achievable goal.”
“The incremental improvement in knowledge about risk factors gives great hope that we will be able to prevent at least some cases of cleft lip and palate in the future.
“The ultimate humanitarian and scientific objective would be prevention. The knowledge we have gained in the genetic and environmental fields have put us within touching distance of that goal.”
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