The influx of refugees from Vietnam to the industrialized countries has attracted a certain interest to studies describing the oral health status of these population groups. The present study comprises 361 refugees arriving in Malaysia from Vietnam and collected immediately at the refugee camp on Pulau Bidong. Dental caries, calculus, gingival bleeding and loss of periodontal attachment were recorded. Mean dmft increased from 1.3 for 0-2-yr-olds to 7.4 for 3-5-yr-olds. For 6-9-yr-olds mean DMFT was 2.4 while it ranged between 8.5 and 10.10 for the older age groups. The frequency of secondary lesions was high for all age groups. Calculus increased consistently with age, while gingival bleeding was common even in the youngest age group. Loss of periodontal attachment greater than or equal to 6 mm was rare in all age groups except the oldest (45 yr or older). A strategy for oral health care for these population groups is discussed.
Three epidemiological surveys have been carried out in Malaysia since 1971. All showed a high level of caries prevalence. Ninety per cent of school children between the ages of 6 and 18 suffered from dental caries, with a DMFT of approximately 3 and a dft of approximately 2. Ninety-five per cent of the adult population had caries experience, with the mean DMFT being 13.2. Approximately 55 per cent of children showed the presence of gingivitis with the mean number of inflamed gingival units per child ranging from 1.9 to 2.8, while 72.4 per cent of adults had some form of periodontal disease with 29 per cent having pockets deeper than 3 mm. The OHI-S score for adults was 2.2 and 81 per cent used toothbrushes to clean their teeth. A further 5.1 per cent used twigs and fingers with powdered charcoal or salt. One-third of the child population needed orthodontic treatment, with 0.3 per cent examined in peninsular Malaysia having cleft lip or palate or both. In the adult population 10.4 per cent of those examined required some form of orthodontic treatment. Twenty per cent of the children in the survey were in need of dentures; 54.7 per cent of the adults were either in need of dentures or were wearing dentures. Of these 25 per cent had complete dentures. The smoking habit was most commonly associated with pre-cancerous/cancerous lesions with alcohol consumption a close competitor; 114 adults, that is 1.3 per cent of those examined, suffer from leukoplakia but only one case of oral cancer was detected.(ABSTRACT TRUNCATED AT 250 WORDS)
Singapore is an island republic of 616 km2. Four main ethnic groups make up its population of 2.4 million; these are the Chinese, Malays, Indians and others. Singapore's successful housing, industrialization and modernization programmes have caused tremendous changes in the lifestyles and expectations of the people. This very success has rendered some traditional customs impractical and irrelevant. Older Indians and Malay women still chew betel-nut. During the Hindu Thaipusam ceremony a traditional practice of dental interest is the piercing of devotees' cheeks and tongues with slivers of silver. There is no pain, bleeding or permanent tissue damage. The Chinese pick their teeth, crack melon seeds and scrape their tongues every morning. They also drink large quantities of unsweetened tea. Yet they remain caries-prone. Singaporeans have recently adopted the practice of eating at all hours of the day and night. This may have a bearing on their future caries state. Singapore has two categories of dental practitioner: the graduate and the registered but unqualified dentist who is invariably of Chinese descent. The swaged metal crown over sound and diseased tooth structure is frequently the unfortunate trademark of the latter. Often abscesses and cysts develop beneath these crowns. Successful dental health programmes have produced a DMFT of 2.8 in 12-year-old children, which betters the DMF target of 3.0 set by WHO for the year 2000. The progressive outlook of Singaporeans may eventually reduce further the number of traditional practices which are harmful to oral health.
The dental needs, demands and patterns of service utilization were assessed in a randomly selected sample of 750 subjects attending the Dental Faculty, University of Malaya, Kuala Lumpur. Toothache accounted for the most frequent overall dental complaint. However, the most common motives for seeking dental care varied among children (2-12 yr), adolescents (13-18 yr) and adults (19 + yr). The attendance behavior of women is more preventively orientated and more inclined towards rehabilitation compared to that of men. The proportion of normative needs of the patients varies from 7.5% for dentures to 66% for dental caries. About 50% of service utilization for the first visit consisted primarily of extractions in the oral surgery department.
A study on the oral health status of 198 factory workers (in Antara Steel, Pasir Gudang, Johor) was carried out in November 1986. The subjects were predominantly male (94%) and Malay (91%) with an average age of 27.4 years. The prevalence of caries was 87.4% with a mean DMFT of 7.1 + 5.4. There were 3 subjects with full upper, lower dentures and 16 subjects with partial dentures. Two subjects examined needed dentures but were not wearing them. Thirty five (17.7%) of those examined needed urgent extractions, and 8 needed emergency treatment for fillings. Enamel opacities were found in 141 subjects (75.6%) but only 9 were aware of these defects. Dental health was very poor with 72% examined needing scaling. Seventeen (9%) had gross supra and subgingival calculus. There was a total of 107 (54%) smokers and heavy nicotine stains were found in 41 (20.7%), of the population examined. Examination of soft tissues showed 111 (56%) subjects with recurrent aphthous ulcers whilst 15 (7.6%) suffered from herpes labialis. Five subjects (2.5%) suffered from denture stomatitis whilst the prevalence of other soft tissue lesions was very low.
The present study analysed the records of 342 elderly subjects aged 55 years and above of different ethnic groups to ascertain the types and level of their unperceived dental needs. The overall percentage of unperceived needs was highest among the Malays (96.1% or 74/77 subjects) and among the men (88.5% or 139/157 subjects). The unperceived need for prosthetic treatment was highest among the Malays and Chinese as well as among women, whereas the unperceived need for treatment for periodontal disease was highest among the Indians. The data for unperceived needs for prosthetic treatment as well as for treatment for caries and periodontal disease were somewhat similar among men. Within each ethnic group, variations among sex in the unperceived needs for the various dental symptoms were also noticeable. Further research is indicated to ascertain the role of traditional and cultural concepts and dogmas in determining the importance attached to the various dental health symptoms within each ethnic group.
The aim of this study is to determine the social impact of oral and facial pain in a sample involving an industrial population. Out of a total of 355 subjects interviewed, nearly one-half claimed to have oral and facial pain in the previous one month prior to the survey. The most common type of pain was that related to hot or cold fluids or sweet things followed by toothache. On the average, the pain lasted for 4.2 days (SD = 4.9) per person in the past one-month. About one in five persons with pain reported that it was severe enough to disrupt sleep. About one in ten persons reporting pain had to take sick leave because of the pain. However, only one in four persons with pain consulted a doctor or dentist. More than one-third tried to cope with the pain and did nothing while the rest tried various means of self-cure. It is therefore postulated that in this population, pain per se is a poor predictor of utilisation of dental services. Further research into pain coping behaviour and how this affects of pattern of utilisation of dental services is indicated in order to formulate a strategy to encourage the habit of seeking prompt dental care by the target population.
Although delays in seeking dental care among patients are frequently observed in daily practice, this problem has never been investigated in other utilization studies. This study attempts to establish the magnitude and severity of the problem of delay in a delivery system where cost is not a major barrier to utilization. 555 users of Government dental services were interviewed. Only 37% of them came promptly within 6 days of perceiving a dental need. The majority (63%) had delayed their dental visit for more than 1 week. In fact, the highest frequency of delay was for more than 1 month. Prompt attendance was found to be associated with people who regularly came for asymptomatic check-ups. In contrast, more than 50% of those who thought they needed fillings and extractions had delayed their visit for more than a month. The main causes of delays were attributed to work commitments and the lack of perceived need for urgent care. Barriers related to transport or financial problems were ranked very low. The implications of these findings are discussed.
Knowledge of prevention can influence preventive dental behaviours. This study surveyed knowledge and preventive dental behaviours on the prevention of dental caries and gum disease among the adult population of the three major racial groups in Singapore. Respondents were asked to rate the importance of several preventive measures against dental caries and gum disease. Questions were also fielded on dental behaviours such as preventive visits to the dentist, toothbrushing and flossing. Results showed that there was a general lack of appreciation for the use of flossing, dental sealants and fluoride supplements. Although a majority of respondents thought that regular dental checkups would be essential for prevention, the proportion who actually saw the dentist for preventive care was significantly lower. Respondents provided inappropriate reasons for brushing their teeth. Differences in both preventive knowledge and preventive dental behaviours among racial groups were evident although these were attributed to differences in education and exposure to product information rather than to racial or cultural factors.
A study was conducted to investigate the relationship between the parents' level of knowledge, and their attitudes to nursing bottle syndrome. Of 284 children aged 2-6 years clinically examined, 153 were diagnosed as having nursing bottle syndrome based on the criterion that at least one upper maxillary incisor was affected by caries. The parents of the 153 affected children were then interviewed by questionnaire. The findings suggested that parents had adequate knowledge and a positive attitude towards maintaining satisfactory dental care for their children. However, these attitudes were not reflected in the dental health of their children. The implications of these findings are discussed.
The preliminary investigation was carried out to assess the severity of malocclusion between two centres, the dental schools in Leeds, United Kingdom and Kuala Lumpur, Malaysia. A total of 99 study models were analysed using the Index ofOrthodontic Treatment Need (lOIN). Thestudy models were ofpatients aged 8to 15years, equally distributed between male and female patients taken from the undergraduate and staff clinics. Forty nine and fifty study models were analysed at the Leeds Dental School and FacultyofDentistry,University ofMalaya,respectively.Fromthisobservation, it appeared that the sample of patients treated at the Faculty of Dentistry, Kuala Lumpur presented approximately 25%higher with casesin the severe end of the malocclusion based on the dental health component and almost 70%more with the aesthetic component. Factors contributing to this finding are discussed.
A house to house survey on elderly subjects aged 60 years old and above was undertaken in a large district in Malaysia. A total of 486 subjects in randomly selected Enumeration Blocks were interviewed and examined. The prevalence of oral precancerous lesions was recorded at 3.3%, of which leukoplakia was the most common. When the ethnic distribution of these oral precancerous and cancerous (OPC) lesions was compared, 72% of those inflicted were Indians. Oral cancer was detected in two subjects (0.4%), both of whom were of Indian origin. Among subjects with OPC lesions, 4.2% were smokers, 12.7% were betelquid chewers, 11.8% had indulged in both habits, whilst one subject had not practised any of the oral habits of interest (0.4%). The findings suggest the occurrence of OPC lesions to be related to betelquid chewing.
Publication year=1996-1997
Chlorhexidine gluconate and hexitidine have been used in many oral health care products as antiplaque and antigingivitis agents. Based on the clinical observations and the plaque and gingivitis scores, chlorhexidine gluconate has been reported to be a better agent. In this study, the anti-adherence properties of chlorhexidine gluconate and hexitidine on individual bacteria strains isolated from a 3-hour plaque (Streptococcus sanguis, Streptococcus mitis 1 and Actinomyces sp.) and on a whole 6-hour plaque culture were determined and compared. The study showed that chlorhexidine gluconate inhibited almost 100 % the adherence of the individual bacteria strains and 87.7 % the adherence of a whole 6-hour plaque culture to the saliva-coated glass surface. Hexitidine appeared to be more selective in its effect. It was shown to inhibit the adherence of S. sanguis and Actinomyces sp. to saliva-coated glass surface by 86.5 % and 51.4 % respectively. Its effect on the S. mitis 1 strains is comparable to that of a whole 6-hour plaque culture where inhibition to adherence were less than 4 % for both.
In recent years, the concept of a Health-Promoting School has received much interest. In Malaysia, dental nurses are ideally placed to play a lead role in promoting Oral Health within the school setting. This study aims to provide information on the knowledge, perception and perceived role of Oral Health Promotion in schools, among dental nurses. A postal questionnaire was used to measure dental nurses' knowledge, perception and perceived role of Oral Health Promotion. The majority (60%) of dental nurses had good knowledge of Oral Health Promotion. Generally, they perceived that they play an important role in promoting Oral Health in schools. However, a sizeable proportion (25%) did not think they had a role to play in working together with school authorities to provide children with healthy food choices in school canteens. The majority (60%) of dental nurses did not perceive Oral Health Promotion to be important as a whole. They had a good perception of the concepts: it supports behaviour change, it has appropriate goals, it integrates oral health and general health and relieves anxiety. However, they had a poorer perception of the concepts; diverse educational approaches, participation, focus on prevention, early intervention, "spread of effect" of dental health education and "make healthier choices the easier choices". Years of service was not significantly associated with knowledge and perception of Oral Health Promotion. Dental nurses should be reoriented towards a more holistic practice of Oral Health Promotion. Workshops that invite active participation from dental nurses should be conducted to equip them with the necessary knowledge and skills.
A cross-sectional study was conducted to ascertain the relationship between parental oral health perception on the importance of the deciduous dentition and the dental caries status of their preschool children. Clinical oral examination of the preschool children was performed and self-administered questionnaires were given to the parents to be completed. Four hundred and eight preschool children were examined and 390 of their parents responded to the self-administered questionnaire. Those parents who brought their children for regular dental check-up at least once a year; favoured restorative treatment and practised tooth brushing habit before bedtime were more likely to have children with significantly lower mean 'dft' as well as higher proportions of caries free mouth (> 50 %). Those children who started early in practising tooth brushing also had better dental caries status but the differences were not significant. However, there were no significant and appreciable differences in their mean 'dft' with respect to the frequencies of tooth brushing per day. It was concluded that parents with better oral health perception as reflected by those parents who (a) practiced regular dental check-up for their children; (b) favoured restorative treatment for their children's decayed deciduous teeth; (c) ensured their children brushed their teeth before bedtime are associated with better dental caries status of their preschool children.
This observational study investigates and describes the oral health beliefs and illness behaviour in the Semai tribe of Orang Asli community. Data was obtained from a "Key informant interview" method i.e. the village Tok Halaq (Traditional healer). Information about common oral diseases and conditions were illustrated with enlarged pictures of dental caries, periodontal disease, oral cancer and cleft. The most common oral problem was toothache. This is treated by self-medication. However if the pain still persist, the Tok Halaq was consulted to start traditional methods. He will identify the cause. If "germs" were thought to be the cause, he will ask the person to see a doctor. Otherwise, he attempts traditional treatment. If the effort failed after a few days, the person will be advised to see a doctor. It appears that the Tok Halaq plays an influential role in prevention, promotion and the healing process in this community. Hence any effort to promote oral health and prevent oral disease must seek their cooperation. Their beliefs on causes of common oral diseases are described in the text.
This is a preliminary survey on cast partial denture designs in the commercial dental laboratories. This survey was carried out for a month in three commercial dental laboratories in Klang Valley and Shah Alam which produce metal dentures in cobalt-chromium. One hundred and ten questionnaires with the designs were collected and analysed. The framework design on the cast was transferred into the design sheet section of the questionnaire. The aim was to investigate communication regarding denture design between clinicians and dental technician and the dentists' dependency on the technician. The design of cobalt-chromium partial dentures in relation to oral health was also assessed. The results indicated that 43.6% of the dentist who used the three laboratories delegated their removable partial design work to the dental technician. More than half of the dentists had some communication with the technicians, and only 18.2 % of the dentists prescribed clear instructions with details of components regarding denture design. Continuing dental education on partial denture design for both clinicians and dental technicians would be of value to provide reinforcement in the knowledge of the basic concept on denture designing. Communication and understanding between both parties would probably improve the quality of cobalt-chromium dentures constructed.
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.