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  1. Nga JDL, Hakim SL, Bilal S
    Subst Use Misuse, 2020;55(12):1943-1948.
    PMID: 32552152 DOI: 10.1080/10826084.2020.1781180
    BACKGROUND: Electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) are noncombustible tobacco products which have been found to generate aerosols containing lower levels of Harmful and Potentially Harmful Constituents (HPHCs) in comparison to conventional cigarettes. Objective: This quasi experimental study measured and compared the end tidal carbon monoxide (eCO) levels of participants after use of ENDS, HTPs and conventional cigarettes. Methods: In total 45 smokers, each smoking at least 10 conventional cigarettes per day for 5 years participated in the study. Based on their preference, participants used only one of the tobacco products (ENDS, HTPs, or conventional cigarette) and were briefed about the product use based on manufacturer's instructions. The eCO levels were obtained at baseline, followed by 5, 10, 15, 30 and 45 min respectively after the product use. Results: There was significant increase in eCO levels for conventional cigarettes as compared to other modes. Peak eCO levels of 20.2 ± 0.86 ppm, 8.8 ± 1.56 ppm and 6.0 ± 1.36 ppm was achieved at 30 min, 15 min and 10 min for conventional cigarettes, ENDS and HTPs respectively. However, the levels were significantly lower in ENDS and HTPs. Conclusion: Even though ENDS and HTPs may have produced significantly lower eCO than conventional cigarettes, the significantly increasing levels over time from baseline which was not shown before is a cause of concern. As of now, their use as an alternate to cigarettes needs to be considered under regulatory framework.
  2. Math S, Nga JDL, Lim HF, Amin M, Pacheco-Pereira C
    PLoS One, 2025;20(2):e0318991.
    PMID: 39946493 DOI: 10.1371/journal.pone.0318991
    OBJECTIVES: To explore dental students' preparedness, experiences and confidence levels in utilizing teledentistry (TD) for patient care during the COVID-19 pandemic and to determine the dental needs and experiences of patients receiving treatment from dental students through TD.

    METHODS: Two online surveys were administered through Google Forms, incorporating both five-point Likert scales and open-ended questions alone for the student questionnaire. The patient questionnaire, available in English and Mandarin, was distributed during or after teleconsultations. Descriptive statistics were used to summarise the data.

    RESULTS: Out of 125 students, 88% (N = 110) were contacted by 318 patients. Of them, 79.1% reported no telecommunication problems, 91.8% faced no language barriers, and 87.2% encountered no technological barriers. Most students (67.3%) agreed they would need further training in TD. Low confidence levels were observed among 26.3% of students in managing crowns and bridges and among 18.2% of students in managing mucosal conditions. From the patient perspective, 76.4% contacted the students via WhatsApp Messages and 21.0% used the Voice Call mode. About 44.0% of patients enquired about the next available appointment. Their most common concern was tooth pain (15.1%) followed by denture problems (9.1%), chipped fillings (6.6%), and crowns and bridge problems (6.3%). Overall, 82% patients reported effective communication during teleconsultation, 85% were satisfied with the questioning process, and expressed satisfaction with the diagnoses provided. However, 10% of patients chose to ignore their concerns, and 5% sought assistance from medical practitioners.

    CONCLUSION: Most dental students were confident in addressing patient concerns but recognized the need for additional training for managing complex cases. Both students and patients reported positive experiences with TD, including effective communication and satisfaction. These findings highlight the importance of integrating TD training into dental curricula, addressing technical and privacy concerns, and improving patient education for secure and effective TD use in routine care.

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