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  1. Tuti Ningseh Mohd-Dom, Shahida Mohd Said, Zamirah Zainal Abidin
    MyJurnal
    A self-administered questionnaire survey was conducted to investigate the level of dental knowledge among senior medical, pharmacy and nursing students of Universiti Kebangsaan Malaysia, and to determine self-reported practices of oral care. Students were invited to complete a set of questionnaires on knowledge related to causes, prevention, signs and treatment of dental caries and periodontal disease; and practices related to oral hygiene and dental visits. A total of 206 questionnaire forms were distributed. 204 forms were returned complete (response rate = 99%). Dental knowledge scores ranged from 0 (no correct answer given) to 16 (gave all correct answers). The mean knowledge scores between the groups were statistically different (p < 0.05): pharmacy students scored highest (mean = 12.29, 95% CI 11.44, 13.14) followed by the medical students (mean = 12.02, 95% CI 11.33, 12.71) and nursing students (mean = 10.83, 95% CI 10.40, 11.26). Areas that had lowest knowledge scores were signs and treatment of gum disease. With regard to oral care practices, majority cited that they brushed teeth at least twice a day (94.6%) and used toothbrush and toothpaste (97.5%). Not many (21.8%) used dental floss and about half (54.2%) reported visiting the dentist more than twelve months ago. Reasons for dental visits included getting check-ups (64.6%), restorations (45.6%) and emergency care such as extractions (24.0%). In general students had at least a moderate level of dental knowledge but demonstrated poor knowledge in some areas. While most reported good oral hygiene habits, behaviour related to dental visits need to be improved. Findings suggest a need for inclusion of oral health education in the medical, pharmacy and nursing curriculum.
  2. Sharifa Ezat, W.P., Jamsiah, M., Malka, S.A., Azimatun Noor, A., Tuti Ningseh, Noor Izzah, A.S.
    MyJurnal
    Health services are considered to be of good quality if customers’ expectations and perceptions are well balanced. Determinants confirming customers’ expectations will lead to satisfaction, while factors disconfirming it will result in customers’ dissatisfaction, reduced compliance to physicians’ treatment and deterioration in overall disease management. A cross-sectional comparative study was carried out from September till October 2008 to determine population satisfaction with health services provided by the public health clinics in Selangor. A total of 3840 respondents from the urban Health Clinics (HCs) and 4768 respondents from rural HCs were selected applying multi-stage random sampling from 54 HCs in nine districts from Selangor. Self-administrated questionnaires formulated by adopting SERVQUAL method based on modified five dimensions plus four dimensions of Clinics Corporation were used . Results showed the proportion of satisfaction among the population towards services provided by the public HCs was high at 86.1%. From X2 bivariate analysis; satisfied respondents were significantly from Indian and Chinese ethnic community more than the Malays, more among the less educated, the older age category (more than 33 years old) and males’ were slightly more satisfied than females. Patients who visited HCs more than three times were more satisfied than one time visitors. Occupation, marital status and HCs urban-rural locality were not significantly associated with customers’ satisfaction level. All dimensions showed high satisfaction level especially on treatment outcome, except on health care workers (HCWs) caring and professionalism domains. Working as a team was slightly higher in the urban areas compared to rural area. Overall, the SERVQUAL score of all dimensions were higher among the urban respondents albeit not significant. Clients’ perceptions were generally higher than expectations reflecting the high satisfactions among clients at 86.1%. Much improvement needs to be put into training HCWs to be more caring and adapting a professional attitude towards clients. Clients’ satisfactions in the urban and rural HCs were almost equal and did not reflect a decrease of health services priority in the rural areas.
  3. Sujak SL, Abdul Kadir R, Dom TN
    J Oral Sci, 2004 Dec;46(4):221-6.
    PMID: 15901066
    The aim of this study was to investigate the prevalence and psychosocial impact of enamel defects among 16-year-old school children on the island of Penang. The data were collected through a self-administered questionnaire survey and an oral examination, using the Modified Developmental Defects of Enamel Index (FDI, 1992). In all, 1024 subjects were selected using a multistage random sampling technique. About two-thirds of the sample (67.1%) had at least one tooth affected by enamel defects. Enamel opacities accounted for 85.6% of the total condition. Diffuse-type opacity predominated (63.5%). Among subjects who expressed dissatisfaction, 18.8% reported covering their mouths when smiling, 8.7% avoided going out with friends and 39.1% had consulted their dentists. About 17% of the subjects reported that their parents had complained about the color of their front teeth but only 5.7% had experienced being teased by their friends about the problem. Two-thirds of the subjects were affected by enamel defects involving at least one tooth; however, the esthetic perception and psychosocial impact of those affected were minor.
  4. Low JF, Dom TNM, Baharin SA
    Eur J Dent, 2018 10 30;12(4):610-616.
    PMID: 30369811 DOI: 10.4103/ejd.ejd_248_18
    The application of magnification devices in endodontics is mainly meant for visual enhancement and improved ergonomics. This is crucial especially when long hours are spent in a narrow operating space to treat obscure microanatomy. Nevertheless, application of magnification in endodontics has yet to be introduced into the mainstream practice due to various influences in behavioral patterns. By conducting an extensive literature search in the PubMed database, this narrative review paper depicts the present state of magnification devices, their applications within the endodontic practice, factors that influence their usage, the advantages, and shortcomings, as well as the significances of magnification in the field of endodontics. This review paper will encourage clinicians to employ magnification in their practice for improved outcome.
  5. Mohd Dom TN, Ayob R, Abd Muttalib K, Aljunid SM
    Int J Dent, 2016;2016:1891074.
    PMID: 27092180 DOI: 10.1155/2016/1891074
    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.
  6. Ramli H, Mohd-Dom TN, Mohd-Said S
    BMC Oral Health, 2021 Dec 03;21(1):618.
    PMID: 34861857 DOI: 10.1186/s12903-021-01950-0
    BACKGROUND: Siwak is a chewing stick used as an oral hygiene aid associated with Muslim communities across the globe since more than 1500 years ago. Used either exclusively or in conjunction with a regular toothbrush, there is evidence supporting its clinical effectiveness in plaque control, but adverse effects on periodontal health remains inconclusive.

    OBJECTIVE: This study aims to systematically review the wide range of data and literatures related to siwak practice and its effect on periodontal health.

    METHOD: The review was conducted based on scoping review techniques, searching literature in EBSCOHOST, PubMed, SCOPUS and Google scholar databases using the following search terms: "siwak' or 'miswak' or 'chewing stick" for intervention, and "periodontium or 'periodontal' or 'periodontal health' or 'periodontal disease" for outcome. Articles published between January 1990 to March 2021 and written in English language were included.

    RESULTS: A total of 721 articles collected from the search and 21 of them were eligible for the final analysis. Results of this study was described based on clinical and antibacterial reporting of siwak, method of siwak practice and its adverse effect on oral health. Siwak was found effective at removing dental plaque and improving periodontal health over time although its effect on subgingival microbiota was inconclusive. Presence of gingival recession and clinical attachment loss were much more commonly reported in siwak users, attributable to variations in the methods employed for tooth cleaning using the siwak.

    CONCLUSION: There is substantial evidence that the lack of standardised reporting for effective siwak use may have resulted in contradictory findings about its oral hygiene benefits and adverse effects. As such, future work on safe and effective siwak practice is to be advocated among its users.

  7. Dzulqarnain Ahmad Iskandar Shah, Nursabrina Roslan, Khairun ‘Izzah Zamansari, Tuan Nur Athirah Tuan Mohd Rahimi, Shahida Mohd-Said, Haslina Rani, et al.
    MyJurnal
    The important role of non-dental healthcare professionals (HCPs) in promoting oral health is well-accepted and has received increased attention in recent years. However, greater efforts are needed to train them in ensuring better competency in delivering this role. The aim of the present study is to assess oral health and care knowledge among HCPs by further exploring possible challenges faced by them in managing oral health problems, particularly in regard to patients in a public primary healthcare clinic. In the case of the current research, a focus group discussion was carried out with ten HCPs who are directly involved with patients from different units within the health clinics. In particular, the questions developed for the focus group discussion were divided into two parts: (1) knowledge on oral health and its link to general health, and (2) issues and challenges faced by HCPs in handling patients with oral health problems in their daily routine. The session was recorded on a digital audio tape, the responses were then transcribed, followed by the grouping of the scripts which were then qualitatively analysed. The results revealed that majority of the participants appeared to have good knowledge of general and basic oral health; however, only very few of them were aware of the relationship between oral health problems with systemic conditions. Meanwhile, one of the main challenges faced by HCPs in handling patients with oral health problems is their limited knowledge of oral health problems. Specifically, the main challenges refer to the management of medically compromised patient requiring dental treatment as well as the difficulty in changing the mindset of patients regarding oral health issues, especially in terms of seeking dental treatment. In conclusion, it has been clearly observed that HCPs involved in the present study have good knowledge of general health and oral health but limited knowledge related to oral health to systemic health. Furthermore, they tend to face numerous challenges when dealing with patients, especially due to their limited knowledge of oral health facts and drug prescription for oral problems. Therefore, there is an urgent need of additional training for both HCPs and dental teams for the purpose of enabling both parties to provide coordinated and comprehensive service to patients with oral health problems at the primary healthcare clinics.
    Keywords: Interprofessional collaboration; care coordination; multidisciplinary; oral health knowledge; healthcare professionals
  8. Tuti Ningseh Mohd-Dom, Khairiyah Abdul-Muttalib, Rasidah Ayob, Yaw, Siew Lan, Ahmad Sharifuddin Mohd-Asadi, Mohd Rizal Abdul-Manaf, et al.
    MyJurnal
    The paucity of published literature on periodontal treatment needs and services in developing countries has undermined the significance of periodontal disease burden on healthcare systems. This study analyses periodontal status and population treatment needs of Malaysians, and patterns of periodontal services provided at public sector dental clinics. A retrospective approach to secondary data analysis was employed. Data for population treatment needs were extracted from three decennial national oral health surveys for adults (1990, 2000 and 2010). Annual reports from the dental subsystem of the government Health Information Management System (HIMS) provided information on oral health care delivery for years 2006-2010. They were based on summaries of aggregated data; analyses were limited to reporting absolute numbers and frequency distributions. Periodontal disease prevalence declined between 1990 (92.8%) to 2000 (87.2%) but a sharp rise was observed in the 2010 survey (94.0%). The proportion of participants demonstrating periodontal pockets of 6 mm and more increased in 2010 survey after showing improvements in 2000. Individuals not requiring periodontal treatment (TN0) increased in proportion from 1990 to 2000, only to drop in 2010. An increase in utilisation was observed alongside a growing uptake of periodontal procedures (62.2% in 2006 to 73.6% in 2010). Only about 10% of treatment was surgeries. While the clinical burden of periodontal disease is observed to be substantial, the types of treatment provided did not reflect the increasing needs for complex periodontal treatment. Emphasis on downstream and multi-collaborative efforts of oral health care is deemed fit to contain the burden of periodontal disease.
  9. Ramli H, Nor Aripin KN, Mohd Said S, Mohamad Hanafiah R, Mohd Dom TN
    J Ethnopharmacol, 2022 Nov 15;298:115598.
    PMID: 35944735 DOI: 10.1016/j.jep.2022.115598
    ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L. and Azadirachtaindica A.Juss. are listed within the most common sources of miswak or chewing stick that widely used among Western Asia and Muslim populations worldwide. Miswak use in conjunction with toothbrush (adjunctive) has become apparent among the adults. Furthermore, miswak has been reported to have mechanical and pharmacological activities, and benefits to the oral health, by many studies.

    AIM OF THE STUDY: To assess the effectiveness of miswak in maintaining periodontal health among adults.

    MATERIALS AND METHODS: We searched for randomised controlled trials (RCTs) investigating the effect of miswak published in PubMed, EBSCOHOST (Dentistry & Oral Sciences), SCOPUS, and Cochrane Database for Systematic Review (CDSR) from inception to May 08, 2022. The primary outcomes of interest were changes in the periodontal health measured with plaque and gingivitis scores as well as subgingival bacteria load. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach while the estimates of effect were pooled using a random-effects model.

    RESULTS: Ten eligible articles were identified, of which 9 could be analysed quantitatively. The remaining report was included as part of the qualitative analysis. The meta-analysis showed that miswak was comparable with the toothbrush in reducing the mean plaque score (p= 0.08, SMD: 0.39, and 95% CI: -0.05 to 0.83) and mean gingivitis score (p= 0.37, SMD: 0.13, and 95% CI: -0.16 to 0.43). Even higher certainty of evidence for the effect of miswak on mean plaque reduction on labial surface of anterior teeth. However, the adjunctive effect of miswak was significantly more superior for reducing plaque (p= 0.01, SMD: 0.68, and 95% CI: 0.14 to 1.22) and gingivitis score (p= 0.04, SMD: 0.66, and 95% CI: 0.03 to 1.29).

    CONCLUSIONS: Miswak effectively reduced plaque and gingivitis scores to a level comparable to toothbrush when used exclusively. Adjunctive miswak use was particularly effective in improving periodontal health. However, the included studies inadequately reported on the method of toothbrushing using miswak and the frequency of miswak use. Therefore, further clinical studies are recommended to explore on the advantages and proper method of miswak practice for optima outcome and safety.

  10. Mohd-Said S, Mohd-Dom TN, Suhaimi N, Rani H, McGrath C
    Front Med (Lausanne), 2021;8:600769.
    PMID: 34179030 DOI: 10.3389/fmed.2021.600769
    Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations. Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting. Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies. Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18-70). Agreement between assessors was high (Kappa >0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias. Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.
  11. Soo SY, Lee SM, Tew IM, Mohd Dom TN, Yahya NA
    J Prosthet Dent, 2024 Jul;132(1):145-153.
    PMID: 37468369 DOI: 10.1016/j.prosdent.2023.06.003
    STATEMENT OF PROBLEM: A discrepancy between dentists' assessments and patients' expectations during prosthodontic treatment is inevitable. Incorporating dental patients' concerns about their prosthodontic treatment needs is essential during treatment planning, yet studies assessing these needs in adult dental patients are lacking.

    PURPOSE: The purpose of this study was to develop and validate a novel instrument, termed the questionnaire on perceived prosthodontic treatment needs (PPTN), that assesses perceived prosthodontic treatment needs in adults.

    MATERIAL AND METHODS: The PPTN was developed following a literature review, consultation with healthcare workers, and patient interviews. It included 15 questions and a self-rated need for prosthodontic treatment, categorized on a Likert scale. A cross-sectional descriptive study was completed on 193 dental patients seeking or receiving prosthodontic treatment.

    RESULTS: Three perceived prosthodontic treatment need factors were identified (psychosocial impact, esthetic concern, and function) by using exploratory factor analysis. A higher PPTN score indicated greater perceived prosthodontic treatment needs. The identified factors represent 67.8% of the variance with eigenvalues of >1. The PPTN had a high degree of internal consistency and reliability, as the final questionnaire received a Cronbach alpha of 0.75 and an intraclass coefficient of 0.75 with a 95% confidence interval of 0.68 to 0.80 (F(192, 576)=3.94, P

  12. Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.
  13. Rusly NFS, Jamil NA, Mohd-Dom TN, Rani H, Mohd-Said S, Mohd-Norwir NA, et al.
    Healthcare (Basel), 2022 Oct 26;10(11).
    PMID: 36360470 DOI: 10.3390/healthcare10112129
    There were massive interruptions, including patient visits for dietary advice and dental services, during the COVID-19 outbreak. This study assessed the feasibility of an online diabetes wellness programme among periodontitis patients with type II diabetes mellitus. Patients were grouped into the intervention group (IG) and control group (CG). At baseline and week 12, all patients answered online questionnaires on diabetes-related knowledge, physical activity, and oral impacts on daily performances (OIDP). Body weight and waist circumference were self-measured with guided instructions. Diet recalls were used to estimate dietary and added sugar intake. All patients received a weekly educational video, but the IG attended three e-consultation sessions with a dietitian (weeks 1, 3, and 8) and a dentist (week 8) via video call. A semi-structured interview was conducted to collate qualitative feedback among the IG participants at the end of the programme. A total of 24 periodontitis patients (14 IG and 10 CG) participated in this study. Among the IG patients, significant improvements in diabetes knowledge, body weight, BMI, calories, carbohydrates, fat, and added sugar intakes were observed at week 12. The CG patients only had a significant reduction in carbohydrate intake post intervention. No changes were reported in physical activity level and OIDP for both groups. Feedback received from the IG participants included convenience, practical, preferred approach during the pandemic, increased awareness and knowledge, and favourable lifestyle changes. This study demonstrates that an online diabetes wellness programme with healthcare professionals is feasible and can facilitate knowledge and lifestyle improvements that can be adapted during the crisis situation.
  14. Muhammad Azami NA, Abdul Murad NA, Mohammed Nawi A, Salleh SA, Periyasamy P, Kori N, et al.
    J Infect Dev Ctries, 2021 12 31;15(12):1816-1824.
    PMID: 35044938 DOI: 10.3855/jidc.15277
    INTRODUCTION: During the second wave of the coronavirus disease 19 (COVID-19) pandemic, Malaysia reported several COVID-19 clusters related to healthcare workers. Thus, addressing and understanding the risk of exposure in healthcare workers is important to prevent future infection and reduce secondary COVID-19 transmission within the healthcare settings. In this study, we aim to assess exposure and prevention practices against COVID-19 among healthcare workers at the Hospital Canselor Tuanku Muhriz, a university teaching hospital based in Kuala Lumpur, Malaysia.

    METHODOLOGY: A total of 571 healthcare workers at COVID-19 and non-COVID-19 wards as well as the emergency department and laboratory staff at COVID-19 testing labs were recruited. The presence of novel human coronavirus (SARS-CoV-2) and IgM/IgG antibodies were confirmed in all healthcare workers. The healthcare workers responded to an online Google Forms questionnaire that evaluates demographic information and comorbidities, exposure and adherence to infection prevention and control measures against COVID-19. Descriptive analysis was performed using Statistical Package for the Social Sciences 24.0.

    RESULTS: Three healthcare workers (0.5%) tested positive for SARS-CoV-2, while the remaining 568 (99.5%) were negative. All were negative for IgM and IgG antibodies during recruitment (day 1) and follow-up (day 15). More than 90% of the healthcare workers followed infection prevention and control practices recommendations regardless of whether they have been exposed to occupational risk for COVID-19.

    CONCLUSIONS: The healthcare workers' high level of adherence to infection prevention practices at this hospital helped reduce and minimize their occupational exposure to COVID-19.

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