The reasons underlying the need for extraction of 2765 permanent teeth carried out over a 6 month period in the Out-patient Clinic in the Dental Faculty, University of Malaya, was investigated. The present study showed that dental caries (67.4%) is the leading cause for extraction followed by periodontal disease (19.6%). Caries accounted for the highest proportion of extractions up to the age of 50 whereas periodontal disease becomes the major factor beyond this age. The highest frequency of extractions carried out was between the ages of 21-30.
At the Faculties of Dentistry in Chiang Mai, Thailand (CM), and Kuala Lumpur, Malaysia (KL), 234 and 233 consecutive out-patients of mean ages 33.8 and 31.0 yr, respectively, were examined for the presence of oral mucosal lesions. Tobacco in some form was regularly used by 31.7% and 27.5% of the study populations in CM and KL, respectively. Cigarette smoking was the predominant habit. In CM three persons chewed betel quids and nine smoked banana leaf cigars daily. In addition, there were 24 habitual chewers of tea leaves (miang). In KL six persons chewed betel quids daily. In CM and KL three cases each (1.3%) of tobacco-associated leukoplakias were found. In KL an additional idiopathic leukoplakia was registered. One and three cases of betel related lesions were found in CM and KL, respectively. One case of a squamous cell carcinoma was found in a 45-yr-old Indian woman in KL who had been chewing betel with tobacco daily for many years. High prevalence figures were found for lichen planus, 3.8% in CM and 2.1% in KL, and an extremely high one, 48.3%, in CM for episodes of aphthous ulcers experienced during the last 2 yr. Comparatively low prevalence figures were found for herpes labialis. As could be expected melanin pigmentation was prevalent while only low figures were encountered for denture-related lesions and amalgam tattoos.
Study site in Malaysia: Dental clinic, University of Malaya
At the faculties of dentistry in Chiang Mai, Thailand (CM), and Kuala Lumpur, Malaysia (KL), 234 and 233 consecutive out-patients were interviewed concerning tobacco and chewing habits and examined for the presence of oral melanin pigmentation. Tobacco was regularly used by 32% and 28% of the studied populations in CM and KL. Cigarette smoking was the predominant habit, but the chewing of betel and tea leaves (miang) and the smoking of banana leaf cigars (khi yo) was also registered. The genetically acquired pigmentation dominated. Although nearly all non-tobacco users in the Malay and Indian populations had oral melanin pigmentation, it was found that tobacco smokers had significantly more oral surfaces pigmented than non-tobacco users. Among Thais, the percentage of pigmented individuals was significantly higher among tobacco smokers. It was concluded that tobacco smoking stimulates oral melanocytes to a higher melanin production also in dark-skinned ethnic groups.
Study site in Malaysia: Dental clinic, University of Malaya, Kuala Lumpur, Malaysia
The aim of the article is to report on the perception of utilizers of government dental services towards the preservation of natural teeth for life and relate it to their past utilization pattern and the associated demographic factors. All patients aged 15 years and over attending ten randomly selected government dental clinics in Selangor, Wilayah Persekutuan and Negri Sembilan during the study period of thirty non consecutive outpatients days were interviewed and examined clinically. Five-hundred and fifty subjects were included in the survey. It was found that the majority of respondents (63%)have a.rather pessimistic perception of their ability to preserve natural teeth for life and most have a very poor past utilization behaviour (90%).The most pessimistic and worst utilization behaviour was reported by the Malay ethnic group, the least formally educated and the lowest income group (p O.O1).It is postulated that one of the main reason for this trend among Malay respondents could be due to their lower educational and income status, rather than cultural influences. Further research into the influence of culture on the utilization pattern of the Malays is therefore recommended.
The aim of this retrospective study is to report on the prevalence of post-extraction complications among patients attending the Oral Surgery outpatient clinic of the Faculty of Dentistry, University of Malaya over a 12-month period from January to December, 1992. The prevalence of post-extraction complications which required further treatment was only 3.4% (n = 100), out of a total of 2968 patients who had extraction of one or more permanent teeth. Analysis based on complete clinical reports (n = 79) showed that dry socket accounted for nine out of ten cases of post-extraction complications. However the aetiology was largely unknown. No obvious association with medical history could be made. Lower teeth were more likely to have complications. The most common teeth associated with dry socket were the molars (76%) and premolars (19%). The most common molars to be affected are the first, followed by the third and lastly the second molars. A brief review of current aetiological factors of dry socket was discussed.
This study investigated the sociodemographic profiles of patients attending public and private dental clinics and the types of treatment received. Patients (n=454) were interviewed using a structured questionnaire at two public and four private clinics in Sibu District, Sarawak. Generally, Chinese (74.7%), females (60.0%) and urban dwellers (83.7%) were more likely to visit the dentist. Both clinics had more females and more Chinese but private clinics had a lower percentage of female attendees (53.1% versus 67.0%) but a higher percentage of Chinese (85.0% versus 64.5%). Private attendees were younger (mean age of 31.0 years compared to 41.0 years) and from higher income households (median value of MR 2,000 versus MR 900) than public attendees. Treatments were mostly curative and a third of the visits were associated with painful conditions. Age (p=0.006), gender (p=0.003), ethnicity (p<0.001) and household income (p<0.001) were associated with the type of clinic visited. Choice of clinic was not related to having painful conditions (p=0.970). To ensure a more affordable and equitable distribution of oral healthcare, health planners need to identify disparities in the utilization of services and differences between public and private attendees.
The prevalence of cleft lip and palate in human is 1 in 500 live births worldwide. Non·syndromic clefts are a complex trait with both genetic and environmental etiology. The aim ofthe study was to assess the association between maternal exposure to second-hand smoke during pregnancy and ruk of having cleft child. Unmatched case-control study was carried out among Malays in Kelantan.
1 Case and control subjects were denned as mothers of cleft children and mothers of normal children respectively. The cleft children were recruited from the Combined Cleft Clinic at Kota Bharu Dental Clinic. Normal chiMren were selected at Orthodontic Clinic, Kota Bharu. A total of 184 cases and controb with age range from 17 to 50 years were interviewed using the standard craniofacial
registration form. Multiple Logistic Regression modeling was used to estimate adjusted odds ratio of factors associated with non-syndromic oral cleft. Signijicant factors include history of miscarriage (OR: 3.40; 95% C1:1.05, 11 .08) p=0.042; duration of exposure to second-hand smoke for 15-30 minutes (OR: 2.41; 95% C1:1.42, 4.09) p 30 minutes (OR: 5.16; 95% C1:Z.87, 9.28) p
This study was done to determine the prevalence of dental anomalies and facial profile abnormality and its association with the non-syndromic cleft lip and palate (CLP) as compared to the non-cleft children. A comparative cross sectional study was conducted where the case group consist of 98 non-syndromic CLP children-unilateral (UCLP) and bilateral (BCLP) who attended the Combined Clinic at Kota Bharu Dental Clinic (KBDC) while the comparison group comprised of 109 non-cleft children who attended the outpatient clinic at KBDC. Their ages were between 3 to 12 years old. Clinical oral and facial profile examinations were carried out to look for dental anomalies (morphology, number and alignment of teeth) and facial profile abnormality. The prevalence of anomalies in morphology of teeth in CLP (24.5%) and non-cleft (10.1%), number of teeth in CLP (44.9%) and non-cleft (7.3%), mal-alignment in CLP (79.6%) and non-cleft (27.5%) and facial profile abnormality in CLP (26.5%) and non-cleft (9.1 %). There was a significant association between CLP and anomalies in morphology, number, mal-alignment and abnormality in facial profile; (p < 0.05). Therefore, there was a high prevalence and risk of dental anomalies and facial profile abnormality in the CLP children compared to the non-cleft children.
The objective of this study was to evaluate compliance :0 the cliencs’ charter in a dental clinic and factors that may afect the updating of the charter. Our clients’ charter states that registration time is within IO minutes and waiting-mom time before being seen by the dentist is within 30 minutes. Convenience sampling was carried our over two weeks. Only patients above 12 years treated by dental officers were included. Data recorded included registration and wrziting-room time, treatment time, punctualiry afpaniems and workload of ajcicers. There were a total of 532 patients (407 walk»in/outpatients, 125 appointments). Results show that the mean waiting-mom time for all paticnm was nor compliant to the clients' charter (42.7 x 23.8 min for walking flll 44.9 : 32.7 min for appointments). Only 33% were seen within 30 min whilst about 23% waited for more than 60 minutes. All The mean registration time (17.9 1- 12.8 min) was ncmcomplianr everyday except on Thursdays where there were very few patients. Waiting time for elderly patients was not statistically significant from the younger patients. About 36% of appointment ariems were seen within 30 minutes; althou h hal 0 them were late, Exmzctivns, dentures and examination and diagnosis took the shortest time wrzh about 88%, 91% and 98% completed within 30 minutes respectwely. There was variable individual speed and number of patients managed by different operators, although the majority was flrsnyear dental officers. Factors that may contribute waiting time included number of patients per day, operator and punctualizy of patients.
The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
Root canal treatment (RCT) requires high level of technical skills of the dentist. Its outcome is an important part of evidence-based practice and become the basis of treatment planning and prognostic considerations. Adequate removal of micro-organisms and prevention of recolonization of residual micro-organisms through the placement of root filling with satisfactory coronal seal ensures success. This retrospective record review study aimed to investigate the practices of RCT in Hospital Universiti Sains Malaysia (HUSM) Dental Clinic, Kota Bharu, Kelantan. It involved 333 randomly selected patient records at the HUSM Record Unit. Data was obtained by careful analyses of daily treatment progress sheets and analyzed using SPSS version 12.0. A total of 2996 RCT cases were seen and 59.8% of patients were females. The age range of patients varied from 14 to 64 years. The maxillary anterior teeth were most commonly treated (52.6%). Most operators (99.1%) used step-back technique and 97.6% used files to prepare root canals. The most commonly used material for obturation and sealing was gutta-percha and epoxy resin-based sealer (AH26). About 82.9% used calcium hydroxide as intra-canal medication. About 25.5% of cases had no periapical pathology, 65.8% with pre-existing periapical radiolucencies healed in 1-3 months whereas 2.1% of cases with periapical pathology eventually healed after a year. About 6.9% cases failed after retreatment. The number of radiographs taken was two to four pieces. RCT is a useful intervention to maintain longevity of teeth. Decision making and current updates of methods and materials are essential among practitioners as well as administrators to ensure success.
A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
The objective of this study is to share cost analysis methodology and to obtain cost estimates for posterior restorations in public sector dental clinics. Two urban and 2 rural dental clinics in Selangor state were selected. Only cases of 1 posterior restoration per visit by dental officers were included over 6 months. One capsulated amalgam type, 1 capsulated tooth-colored, and 1 non-capsulated tooth-colored material were selected. A clinical pathway form was formulated to collect data per patient. Annual capital and recurrent expenditures were collected per clinic. The mean cost of an amalgam restoration was RM 30.96 (sdRM 7.86); and tooth-colored restorations ranged from RM 33.00 (sdRM 8.43) to RM 41.10 (sdRM 10.61). Wherein 1 USD = RM 2.8. Restoration costs were 35% to 55% higher in clinics in rural areas than in urban areas. The findings demonstrate economy of scale for clinic operation and restoration costs with higher patient load. Costs per restoration were higher in rural than in urban dental clinics. More studies are recommended to address the dearth of dental costs data in Malaysia.
The purpose of this study was to evaluate the periodontal status distal to the adjacent second molar following the extraction of a partially or fully impacted mandibular third molar at Klinik Pergigian Pakar Hospital Universiti Sains Malaysia (KPPHUSM) from April of 2008 until June of 2008.This was a prospective study which involved the clinical and radiological study of patients. In this study, convenience sampling method had been used. The sample size was 22 patients aged 18-32 years old with inclusion criteria. The outcomes measured in this study were periodontal pocket depth (PPD), clinical attachment level (CAL) and alveolar bone height (ABH). Subjects were examined at distal surface (disto-buccal, mid-distal and disto-lingual) of second molar for PPD and CAL before and 3 months after the impacted adjacent lower third molar extraction. OPG was taken each before and after the third molar removal. These data were analyzed using SPSS version 16 and Wilcoxon-signed-ranks test was used to compare the PPD, CAL and ABH pre and post operatively. All the results were not significant with p >0.05. For PPD, median = 3mm pre and post extraction. CAL median= 2mm pre and post operatively and ABH median of 3.10mm (before) and 2.8mm (after) the third molar removal. From our study, we concluded that there were no significant changes of PPD, CAL and ABH at distal side of second molar after 3 months of the adjacent impacted lower third molar removal.
Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Introduction : Major flooding that occurred in Segamat District at the end of 2006 and early 2007 was a natural disaster that has left impact on physical and mental well-being of the victims. The aim of this study is to see the impact of the major flooding to the mental health of the health staff in Segamat District.
Methodology : Cross sectional study was conducted among Segamat health staffs who were involved in the major floods. Structured questionnaire was used to assess the mental health status of the victims. Result : There were 119 health staffs from the district health office, Hospital Segamat, dental clinic and Community Nursing School were interviewed in this study. A total of 6.7% respondents claimed to have stress related symptoms with women were more effected than men. Nurses and married respondents were found to be more stressful in this study.
Conclusion : Based on findings, therefore, top management has to pay more attention to the welfare of the health staff, directly or indirectly, in particular on the psychological aspect. By giving emphasis on continuous in-service training and counseling as well as other relevant support, stress-related symptoms could be minimized which in turn lead to higher individual productivity.
The prevalence of periodontal abscesses in emergency dental clinics was found to be between 8%-14%. The purpose of this study was to study the clinical features of periodontal abscesses seen in a specialist periodontal unit. There were 14 patients with equal distribution of gender. The mean age was 39.6 years. Twelve upper teeth (86%) were found to be involved as compared to two lower teeth (14%). There were more posterior teeth involved, a total of nine teeth (64%) as compared to five anterior teeth (36%). The mean pocket depth associated with the abscesses was found to be 7.4mm. There were ten buccal sites (71%) as compared to four palatal sites (29%). Average temperature of patients was 36.9° C. Only one patient was found to have cervical lympadenopathy (7%). The teeth involved were found to be mostly mobile with mobility of grade I to III (71%).
OBJECTIVES: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area.
SUBJECTS AND METHODS: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents.
RESULTS: One hundred eighty-one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P
Mitochondrial DNA (mtDNA) is a hereditary material located in mitochondria and is normally maternally inherited. Mutational analysis performed on mtDNA proved that the mutations are closely related with a number of genetic illnesses, besides being exploitable for forensic identification. Those findings imply the importance of mtDNA in the scientific field. MtDNA can be found in abundance in tooth dentin where it is kept protected by the enamel, the hardest outer part of the tooth. In this study, two techniques of mtDNA extraction were compared to determine the efficacy between the two techniques. Teeth used for the study was collected from Dental Clinic, Hospital Universiti Sains Malaysia. After the removal of tooth from the tooth socket of the patient, the tooth was kept at -20C until use. Later, pulp tissue and enamel was excised using dental bur and only the root dentin was utilized for the isolation of mtDNA by crushing it mechanically into powdered form. MtDNA was extracted using the two published methods, Pfeifer and Budowle and then subjected to spectrophotometry DNA quantification and purity, Polymerase chain reaction (PCR) amplification of hypervariable-two region of mtDNA, followed by DNA sequencing to analyze the reliability of the extraction techniques. In conclusion, both techniques proved to be efficient and capable for the extraction of mtDNA from tooth dentin.