Supernumerary teeth have a genetic predisposition
with a predilection for males. This article reports an
uncommon radiological finding in a non-syndromic
sibling pair who presented with supernumerary teeth
of different morphologies on opposite and different
regions of the dental arches. A 14-year-old Chinese
male presented with a conical supernumerary palatally
placed between the upper right central and lateral
incisors. His older brother had unerupted bilateral
supplemental supernumerary teeth between the roots
of the lower second premolars and first permanent
molars. Trends of the phenotypic presentation of
familial non-syndromic supernumerary cases are
discussed. Familial supernumerary teeth have been
suggested to be due to autosomal dominance or
recessive traits. Variation in the numeral, spatial and
morphological phenotypic expressions suggests a
multifactorial model of multiple genetic, epigenetic
and environmental influences. Clinicians need to be
mindful of the possible phenotypic variations that may
present when treating cases with family history of
dental anomalies.
Long term evaluations of impacts of community
based health promotion programmes are not an easy or
straightforward task to do due to lack of validated and
reliable indices. Objective: To develop and test an index
to measure schoolchildren’s oral health knowledge,
attitudes, and behaviour as a result of a school-based health
promotion programme in Malaysia called the Doktor
Muda (Junior Doctor) Programme (DMP). Materials and
Methods: The index was developed in English based on
the DMP module and translated into Malay. The Malay
version was tested on 174, 11-12 year old schoolchildren.
Psychometric analysis of the index involved content and
face validity tests as well as factor analysis, internal and
test-retest reliability. Results: Factor analysis yielded 3
factors with groups of items viz. oral health knowledge
(OHK), oral health attitudes (OHA) and oral health
behaviour (OHB). The Cronbach’s alpha coefficients of the
three factors were 0.61, 0.73, and 0.64, respectively. The
Kappa coefficients were 0.70, 0.77 and 0.73, respectively
(intraclass correlation coefficients = 0.72, 0.70 and 0.78).
The final questionnaire comprised 33 items, namely; OHK
11 items, OHA 15 items, and OHB 7 items. Conclusion:
The Health Promotion Questionnaire Index (HPQI) to
measure the DMP impact on schoolchildren’s oral health
knowledge, attitudes, and behaviours was empirically
verified to be valid and reliable for use among 11-12 year
old Malaysian schoolchildren.
Water delivered through dental unit waterline system
(DUWS) is often reported contaminated with microbes
dislodged from biofilm that forms within the tubing
of a dental chair unit (DCU). ADM: The study aimed
at evaluating the sanitary level of DCU water from
a teaching dental clinic. Materials: The presence of
pathogenic bacteria which include total coliforms, faecal
coliforms, E. coli, faecal streptococci and P. aeruginosa
were determined using conventional microbiological
methods while PCR technique was used to identify other
microbial contaminants. Result: pH of DCU water was
found slightly acidic at pH 5.4-5.5 and the temperature
was 23°C. Pathogenic contaminants were absent but
the DCU water was highly loaded with Sphingomonas
rhizogenes (17.9%), Sphingomonas dokdonesis
(79.5%), Sphingomonas mucosissima (1.1%) and
Methylobacterium radiotolerans (1.5%). The high load of
microbes that exceeded 200 cfu/ml was of great concern
as it failed to meet recommendation set by the American
Dental Association.
Verruco-papillary lesions (VPLs) of the oral cavity
described in the literature involve a spectrum of conditions
including squamous papilloma, verruca vulgaris, focal
epithelial hyperplasia, condyloma, proliferative verrucous
leukoplakia and verrucous carcinoma. The majority of the
VPLs are slow growing, benign in nature and have a viral
aetiology (1). Mucosal HPV types (HPV 6, 11, 13, 30,
32, 45, 52, 55, 59, 69, 72 and 73) have been implicated
as possible etiological causes for these benign lesions (2)
while virus associated benign mucosal outgrowths are not
too difficult to diagnose either clinically or by microscopy.
Apart from virus-associated lesions, VPLs harboring
malignant potential such as verrucous carcinoma,
proliferative verrucous leukoplakia and oral verrucous
hyperplasia (OVH) need to be further clarified for better
understanding of their predictable biologic behavior and
appropriate treatment. In particular, the condition referred
to as oral verrucous hyperplasia (OVH) poses a major
diagnostic challenge. OVH represents a histopathological
entity whose clinical features are not well recognised and
is usually clinically indistinguishable from a verrucous
carcinoma (3).
In 1980, Shear and Pindborg classified OVHs into
two clinical variants, a sharp variety comprising of long,
narrow, heavily keratinized verrucous processes which
appears white as a result of heavy keratinization and a
second variant referred to as the blunt variety consisting
of verrucous processes that are broader, flatter and not
heavily keratinized (3). A new pathological entity distinct
from what Shear and Pindborg earlier described has been
found in recent years among betel-quid chewers mainly
from Taiwan. In 2005, Chung et al., in a field survey of
1075 adults noted 9 verrucous lesions which they described
as exophytic outgrowths, which the authors hinted had
hitherto not been reported in the scientific literature (4).
Their Figure: 1 illustrated this newly described “verrucous
lesion”. Subsequently in 2009 Wang et al described a case
series of 60 cases from Taipei and classified these lesions as
plaque-type and mass-type lesions primarily based on their
histopathological features. It was also documented that the
mass-type verrucous hyperplasia may manifest as single
or multiple verrucous whitish pink lesions clinically while
the plaque-type lesions may appear as whitish verrucous
plaques. They also concluded that the terminology OVH
should be reserved to denote only the mass-type lesions
both clinically and histologically and suggested that the
plaque-type lesions should be clinically classified as oral
verruciform leukoplakia and histologically as verruciform
hyperplasia (5).
In an effort to bring uniformity in reporting
these lesions both clinically and histopathologically a
consensus meeting was held in Kuala lumpur, Malaysia
during December 15-18, 2013. A working committee
that included specialists working on oral malignant andpotentially malignant disorders attempted to formulate the
clinical and histopathological criteria of OVH based on
the discussion among the participants in the meeting. The
meeting was attended by 46 participants from 7 countries
and included specialists and trainees in the disciplines
of Oral Medicine and Oral and Maxillofacial Pathology.
Consensus guidelines arising from this meeting is as
follows.
Background: In Malaysia, preschool teachers have long been utilised as oral health educators. However their level of oral health knowledge and effectiveness of the training they received are seldom investigated. This study aims to evaluate the of oral health education seminar (OHE) held for public preschool teachers (KEMAS) in terms of the improvement of their knowledge, practices and attitudes.
Methods: This was a one arm interventional study (before and after survey following OHE seminar intervention). All KEMAS preschool teachers (n=107) in Hulu Terengganu were invited to attend OHE seminar which consisted of 1 hour lecture and 40 minutes OHE demonstration. Pretest questionnaire was collected before the seminar started and post-test questionnaire was collected two weeks later. A self-administered questionnaire used in this study was adapted from “preschool teachers’ knowledge, practices and attitudes towards oral health”, National Oral Health Survey of Preschool Children, 2005. Data were analysed using descriptive and McNemar test, SPSS version 15.0.
Results: Of 107 subjects, only 61 teachers responded yielding to 57% response rate. All subjects were female with mean age of 46 years (SD: 6.03). Overall, there was an improvement of teachers’ oral health knowledge, practices and attitudes after the seminar. Several items seem to have be improved significantly after the seminar, for example knowledge item on factors causing periodontal disease (p=0.03). In terms of practice, all teachers reported they brushed teeth at least twice daily using fluoridated toothpaste and use of dental floss was increased significantly after the seminar (p<0.001). Majority of teachers have positive perceptions on their roles in oral health education.
Conclusion: Oral health education seminar appeared to be effective at influencing certain aspects of teachers’ oral health knowledge, practices and attitudes.
Keywords: attitudes, knowledge, oral health promotion, practice, preschool teachers
The purpose of this study was to determine the
DNA yield and quality from different non-invasive
sampling methods and to identify the method which
gave the highest DNA yield. Method: Thirty-eight
volunteers had been recruited in this study where
blood, buccal cells and saliva were collected using
various collection techniques. Buccal cells were
collected by 1) cytobrush and 2) saline mouth rinsing
or “swish”. Meanwhile saliva was collected by passive
drooling method. Upon processing the white blood
cell (WBC), buccal cells and saliva samples, DNA
extraction was performed according to the
manufacturer’s protocol. Quantification and quality
(DNA ratio at A260/A280) of the extracted DNA were
determined using NanoDropND-1000®. T-test was
performed to compare means between DNA obtained
from various collection methods. Results: DNA yields
from buccal cells collected with cytobrush, “swish”,
saliva and WBC (mean ± SD) were (8.2 ± 5.9)ng/μl,
(28.2 ± 14.9)ng/μl, (5.9 ± 9.5)ng/μl and (105.3 ±
75.0)ng/μl respectively. Meanwhile the mean DNA
ratio at A260/A280 for cytobrush, “swish”, saliva and
WBC were 2.3, 2.0, 1.7 and 1.8 respectively. Post hoc
test with Bonferroni correction suggested that DNA
yield from “swish” technique exhibited the least mean
different as compared to the DNA extracted from WBC
(p
Diagnosis and management of orofacial pain of non-odontogenic origin has always been a challenge to dentists. Inaccurate diagnosis would result in delay of treatment and in cases of orofacial pain, affects patient’s quality of life. Temporomandibular pain dysfunction syndrome is the most common temporomandibular disorder that presents to dental clinics. Trigeminal neuralgia, also known as ticdouloureux is a relatively rare condition that causes electric shock-like pain when the trigger zone is stimulated by triggering factor. Case report: A case of temporomandibular pain dysfunction syndrome in a 52 years old Indian lady that was managed as trigeminal neuralgia for 7 years is presented. Conclusion: The aim of this case report is to make dentists aware of the signs and symptoms of different orofacial pain, so that early and accurate diagnosis can be made and appropriate treatment instituted.
To explore the association between social
support and stress levels in preclinical and clinical dental
students in Malaysia. Method: A cross sectional survey
of dental undergraduate students was conducted at the
Faculty of Dentistry, University of Malaya, Universiti
Kebangsaan Malaysia and Universiti Sains Malaysia.
Stress was measured using the Dental Environment Stress
(DES) questionnaire. A DES-32 item was used to measure
stress for the clinical students and DES-16 item for the
preclinical students. Four questions were used to measure
social support. The total stress scores were standardized
for comparison purposes. Results: A total of 357 (79.7%)
preclinical and 417 (71.8%) clinical undergraduate dental
students responded to the questionnaires. The clinical
students experienced higher stress [mean standardized
DES score = 72.63, SD = 10.64] than preclinical students
[mean standardized DES score = 70.19, SD=12.01]. The
two most stressful items reported by preclinical students
were “fear of failing” and “examination and grades”.
Among clinical students, the two most stressful items related
to academic were “completing course requirement” and
“fear of failing course” and items related to clinical session
were “fear of being barred due to the clinical schedule”
and “patients late or absent”. Multiple regression analyses
revealed that low stress levels among preclinical students
were significantly associated to a lot of contact with
students of the same course. Conclusion: To some extent,
social support does play a role in explaining differences in
perceived stress, in particular among preclinical students.
A preliminary investigation to assess the relationship
in the severity of periodontal disease in diabetics when
compared with non-diabetic subjects. Materials and
Methods: A retrospective, comparative study using
periodontal case notes of 40 subjects (20 Type 2 diabetics,
20 non-diabetics) who were selected based on the
inclusion and exclusion criteria. Severity of periodontal
disease was assessed through number of periodontal
pocket ≥5mm. The results were compared between
subjects whose age, gender and plaque scores are matched
with the test group. Data obtained was then analyzed by
SPSS Version 12. Results: When comparisons were made
between test (Type 2 diabetic) and control (non-diabetic)
groups, there were no significant difference (p>0.05) in
the severity of periodontal disease. However, there was
a clinically mean difference between the two groups.
Conclusions: This preliminary investigation indicated
that the severity of chronic periodontitis, as indicated in
periodontal pocketing, increased in diabetic patients when
compared to non-diabetics clinically, although it was not
statistically significant. The finding of this investigation
was thus not conclusive as it was only a retrospective
study using patients’ case notes. However, the results
are now being further investigated with a proper clinical
trial which examines periodontal parameters and diabetic
status (HbA1c) of the subjects to determine the association
between periodontal disease and diabetes mellitus.
The study aimed to assess patient satisfaction with their orthodontic treatment outcome and type of cases accepted for orthodontic treatment at the Faculty of Dentistry, University of Malaya (UM) and to audit the quality of treatment outcome. The standard set were 100% patient should be satisfied with their treatment outcome and less than 5% of the proportion of cases should fall in the “worse/no different’ category with a mean reduction of Peer Assessment Rating (PAR) score being greater than 70%. Records of cases that had completed orthodontic treatment were traced. Survey forms were sent to 150 patients that had met the inclusion and exclusion criteria. Their intact study models were assessed for the Index of Orthodontic Treatment Need (IOTN) and PAR. 21.3% responded to the survey, of which 59.4% had treatment involving fixed appliances and 37.6% had either removable or functional appliances or retainers. 93.8% respondents were satisfied with their dental alignment and 87.5% with the overall treatment results. For the dental health component of the IOTN, 63.3% had ‘definite need’ and 21.1% had ‘borderline need’ for treatment. For the aesthetic component of the IOTN, 24.2% had ‘definite need’ and 32.0% had‘borderline need’ for treatment. For the PAR, 8.0% had an outcome of “worst/no different”. The mean PAR reduction score was 75.3%. In conclusion, although majority were satisfied with their treatment results, there is still a need to improve on the standard of care to address the issues of the minority who were not satisfied with the treatment outcome.
Background: In an academic setting due to financial constrain, it is not uncommon during non-surgical procedures dental students and clinical supervisors wash their gloved hands with disinfectants in between patients or when touching on non-contaminated objects. Whether this practice could cause any deterioration of the glove and expose clinicians and patients to infectious micro-organisms was a concern.
Aim: The aim of this study was to investigate the effect of multiple washes of gloved hands with a disinfectant on the integrity of the gloves. Methods: Three brands of commonly used gloves in a dental school were tested for leaks after multiple washes with a disinfectant. Thirty pairs of each type of gloves were subjected to 0, 1, 5, 10, 20 and 30 washes with a disinfectant solution at a 5-minute interval between each wash. After each washing cycle, the gloves were filled with 1L of water and hanged for 2 minutes to observe any signs of water leaks.
Results: The results showed that the type of gloves and number of washes were significantly associated with the leakage rates (p<0.001). Washing of gloves for more than 5 times were at least 6 times higher to suffer from leakage (OR=6.23, 95% CI=2.14–18.08). Powdered gloves were almost 13 times higher to leak in all washes (OR=12.78, 95% CI= 4.40–37.14) and were almost 25 times more likely to leak when washed for more than 5 times (OR = 24.92, 95% CI = 5.79 – 107.21) when compared to the non-powdered gloves.
Conclusion: The practice of washing gloved hands with a disinfectant deteriorates the integrity of the gloves.
Key words: Cross infection, disinfectant, glove, leakage, micropores
In Malaysia, training to enter dental
nursing profession is only open to women. Ironically,
there are no such gender restrictions on training for
any other health related professions in Malaysia.
Aim: Therefore this study aims to assess the
perceptions of Malaysian Senior Dental Officers
(SDOs) towards the employability of male workers in
the dental nursing profession and to compare findings
from male and female SDOs. Methods: This cross
sectional study was carried out on all SDOs in
Ministry of Health, Malaysia, using a self-administered
questionnaire. Descriptive statistics and a chi square
test were used to address the study objectives. Results:
Of the 112 participants, 78 SDOs returned the
questionnaire, yielding a response rate of 70%. The
majority of SDOs had positive perceptions of the
employment of male dental nurses. It was indicated that
gender is an important indicator for workforce
development, and that the employment of both male
and female dental nurses would enhance productivity.
Almost 70% of SDOs perceived that the productivity
of oral health service would be enhanced by having
male and female dental nurses but 84.6% disagreed
that male dental nurses would be more productive than
female. Two thirds of SDOs disagreed that male dental
nurses would increase satisfaction among male
patients. About 64% of male SDOs disagreed that
dental nursing profession is associated with female
traits. There was no significant difference between
perceptions by male and female SDOs for any
statements. Conclusion: The majority of Malaysian
SDOs have positive perceptions towards the
employability of male dental nurses, and perceived
dental nursing as a suitable profession for both
genders. Training for the dental nursing profession
should therefore be made available for men.
Tooth transposition is a rare developmental anomaly
affecting less than 1% of the population. The
permanent maxillary canine and 1st premolar are the
most commonly affected teeth. Bilateral maxillary
canine-1st premolar transpositions are extremely rare
with only a handful of cases being reported in the
literature. We report one such case of bilateral
maxillary canine-1st premolar transposition in a 28
year old Malaysian female which was associated with
other dental anomalies.
To determine the amount of displacement of a structure
noticed on an image when the tube of a dental X-ray
machine was shifted vertically and horizontally. In
addition, various intraoral images were combined with
dental panoramic images to determine the location of
structures. Our research is based on the parallax
technique which requires manipulation of horizontal
and vertical angulations of the X-ray tube. A metal
object is positioned on the buccal and palatal side of
the maxilla on the canine area of a skull. The X-ray
tube is shifted incrementally to obtain images on
phosphor plates. Subsequently, panaromic and occlusal
images were taken to assist in localization of the metal
object. To obtain a clear image shift of 2-3mm using
the parallax method, there must be an adequate
horizontal tube shift of approximately 30-35 degrees.
When images were used in combination of dental
panoramic images, it was found that the buccally
placed structures can be accurately located with the
periapical or occlusal images. However, the
displacement of images in the palatally placed
structures in panoramic imaging is not fully
appreciated with the principle of parallax method. Tube
movement of 30-35 degrees horizontally is needed for
a 2-3 mm image shift. To successfully localize a buccal
structure, a combination of either periapical or occlusal
images with a dental panoramic imaging can be
employed. However, this combination with panoramic
imaging is limited when looking at palatally placed
structures.
Solanum ferox L. is a plant species which belongs to the Solanaceae family and the genus Solanum. The Solanum genus was found to exhibit anticariogenic activity and was traditionally used to treat oral diseases. However, there is no scientific study done specifically for Solanum ferox L. Hence the aim of the study is to determine the anticariogenic properties of flesh and leaf of ethanolic extract of Solanum ferox L. Alkaloids, flavonoids and tannins were detected in the leaf ethanolic extract via preliminary phytochemical screening. The presence of these phytochemicals may contribute to the anticariogenic activity. Treatment with different concentrations of flesh and leaf of ethanolic extract were used against Streptococcus pyogenes and Staphylococcus aureus via the method of agar well diffusion to indicate zones of inhibition. The antibiofilm activity of the flesh and leaf ethanolic extracts was tested. The flesh and leaf ethanolic extracts possess antimicrobial activity dose-dependently and positive antibiofilm activity against respective pathogens. The flesh ethanolic extract has stronger anticariogenic activity compared to leaf ethanolic extract against respective pathogens. Streptococcus pyogenes exhibited higher susceptibility as compared to Staphylococcus aureus. In conclusion, it has been shown that the ethanolic extract of Solanum ferox L. exhibit anticariogenic properties against Streptococus pyogenes and Staphylococcus aureus.
Fixed functional appliances are non-compliance dependent devices, which can assist the correction of Class II malocclusion. The mechanics of the fixed functional appliances may vary depending on the type of device used. We report the observed biomechanical effects of using the ForsusTM Fatigue Resistant Device (FRD) fixed functional appliance. The patient was a 14-year-old female presented with a Class II division I malocclusion on a Class II skeletal base. The malocclusion was complicated by a 10mm overjet and increased traumatic overbite. She was treated with the ForsusTM FRD appliance worn for 5 months after the alignment with fixed appliances (0.022” X0.028” MBT prescriptions) and finished on a non-extraction base. Dento-alveolar changes were the main contribution to the correction of the malocclusion and simultaneously improved the patient’s profile in the end of treatment. In conclusion, ForsusTM FRD appliance can be suggested to effectively correct Class II malocclusion.
Desquamative gingivitis (DG) is a manifestation of a number of mucocutanenous disorders, one of it being oral lichen planus (OLP). OLP is an autoimmune disease. The aetiology for this condition is unknown, but there are few factors associated with its occurrence, for example alcohol drinking, smoking, allergic reaction to certain medications or restorative material. DG lesions increase the long-term risk for plaque-induced periodontal disease. At the same time, dental plaque and calculus cause gingival OLP resulting in the erosive disease. This report presents the management of a case of oral lichen planus associated with desquamative gingivitis with periodontitis. The expertise involved are from the oral medicine, periodontic and prosthodontic clinics. The uniqueness of the case management was the introduction of single tufted brush, Tepe® compact tuft toothbrush, to perform “solo brushing technique”. It was able to remove plaque effectively and did not cause irritation to the gingivae. Patients presenting with mucocutaneous disorders which exarcebates other oral conditions requires multidisciplinary management. Proper treatment planning will significantly improve their oral health related quality of life.
This paper attempts to review epidemiological studies of oral cancer and precancer in Malaysia. The defmitions of prevalence, incidence, risk habits and oral cancer and precancers were discussed to better understand' the different types of studies conducted, which would be important in making comparisons between studies. Currently, epidemiological data on oral cancer in Malaysia are sketchy. The only incidence data for oral cancer in Malaysia was reported by Hirayama in 1966, 35 years ago. He estimated that 3.1 new cases per 100,000 population were diagnosed for the year 1963. A number of histopathological data of oral and maxillofacial biopsies were reported. Oral cancer accounted for one-fifth of all oral biopsies. A national study on oral mucosal lesions in Malaysia carried out in 1993/4 reported that there was a variation seen in the occurrence of oral premalignancy among the ethnic groups. The Indians and the indigenous people of Sabah and Sarawak were identified as high risk groups for oral cancer and precancer. It was also observed that both of the ethnic groups chewed betel quid. In conclusion, the epidemiological studies have provided useful data, which may be used in planning for future oral health programmes and research towards enhancing Malaysia's on-going effort in preventing the occurrence of these diseases.
The study aimed to compare mechanical properties and surface characteristics of initial and working
aesthetic archwires with their conventional counterparts. High Aesthetic Sentalloy (full rhodium coating
nickel-titanium; Dentsply GAC) represented the initial aesthetic archwires; and FLI TRU-CHROME
(labial PTFE-coated stainless steel; RMO) as the working aesthetic archwires; together with their
conventional counterparts were analysed. A three point bending test was conducted using a universal
testing machine (AGS-X SERIES, Shimadzu, Japan) to determine the load-deflection characteristics of
archwires. Surface hardness was evaluated by Vickers microhardness test (HMV-FA, Shimadzu, Japan).
A 3D Optical Surface Texture Analyzer (ALICONA, InfiniteFocus Real3D, Belgium) and a Field Emission
Scanning Electron Microscope (FESEM, FEI Quanta 250, USA) were used for surface evaluation.
Results showed that load-deflection characteristics of High Aesthetic Sentalloy archwires did not differ
from its control, whereas FLI TRU-CHROME archwires exhibited higher loading and unloading forces
than its counterpart. No statistically significant difference in surface hardness was found between FLI
TRU-CHROME and its control archwires. The coating surfaces of both aesthetic archwires were rougher
than the non-coated conventional archwires, with similar roughness between non-coated surface of FLI
TRU-CHROME archwires and its counterpart. FLI TRU-CHROME archwires showed a distinct coating
thickness but coating layer is undefined in High Aesthetic Sentalloy archwires. In conclusion, the aesthetic
rhodium coated nickel titanium archwire has similar mechanical properties as control nickel titanium
archwire without being adversely affected by the addition of the coating layer. The aesthetic coated PTFE
stainless steel archwire has higher load response which could be an advantage as rigid wire in working
stage of orthodontic treatment. Based on their performance, their use could be recommended in cases
where aesthetic aspect is crucial and where the friction aspect is not critical as their surface roughness
values increased.