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.
Direct composite veneers can be used to mask tooth discolorations and/or to correct unaesthetic tooth forms and/or positions. However, these type of restorations are often regarded as one of the most challenging in aesthetic dentistry presumably due to the extent of natural tooth structure that must be recreated. This paper discusses easy application techniques and tips for Ceram.X Duo™, a nano ceramic composite restorative material. Its natural shading system allows the restoration of tooth with both dentine and enamel shade and transforms it into a final direct veneer restoration that mimics a natural tooth.
The objective of this study was to investigate the effect of various luting cement systems on bond strength of fibre-reinforced posts to root canal dentine. 40 extracted single rooted sound premolar teeth were root filled, decoronated and randomly divided into four groups. Fibre posts, Aestheti- Plus™ (Bisco,Inc. Schaumburg, IL, USA) were cemented using four luting cements: Group A (control): Elite 100® Zinc phosphate (GC Corp, Japan), Group B: Calibra ™ Esthetic Resin Cement (Dentsply Caulk, USA), Group C: RelyX ARC Adhesive Resin (3M ESPE), Group D: RelyX Unicem Aplicap (3M ESPE). Each root was sliced into 2 discs representing the coronal and middle portions of the root canal giving rise to 20 specimens per group. Bond strength was determined using push-out tests and data was analyzed using SPSS version 14.0. The mean bond strength of Group A to Aestheti-Plus™ post was 7.71 MPa (±2.51) and Group B was 5.69 MPa (±3.23). Group C exhibited the lowest mean bond strength, 4.29 MPa (±3.53) while the highest bond strength was obtained from Group D, 7.98 MPa (±2.61). One way ANOVA showed significant interaction between all groups (p=.OOI). Post-hoc Bonferroni test reve;iled that bond strength of Group C was significantly lower compared to Group A (p=.008) and D (p=.004). In conclusion, the mean bond strength of Aestheti- Plus™ post to root canal dentine was highest when cemented with RelyX Unicem resin cement followed by Elite 100® zinc phosphate cement, Calibra and RelyX ARC resin cements. However, the bond strengths of Cali bra and RelyX Unicem resin cements were not significantly different from Elite 100® zinc phosphate cement.
Tobacco use is linked with many serious illnesses, such as cancer, cardiopulmonary diseases, as well as with many health problems. Every year, the use of tobacco products causes a heavy toll of deaths and severe human disease worldwide. One of the many health problems linked to tobacco use is its detrimental impact on oral health. Tobacco causes a whole series of oral health problems, ranging from life-threatening (precancerous changes leading to oral cancer) and serious (periodontal disease, teeth decay) to social (bad breath). Tobacco is consumed through the mouth in a variety of forms, varied from smoked tobacco to smokeless tobacco chewing on itself or combined with areca nut. All these forms of tobacco have damaging effects on the oral health. The most significant preventive measure to prevent the oral health problems caused by tobacco use is to stop using tobacco products. The risk of developing oral cancer drops rapidly when a smoker ceases tobacco use. After ten years of not using tobacco, an ex-smoker/user's risk of oral cancers is about the same as that for someone who has never smoked. To stop using tobacco products is not an easy task. Fortunately, there are a number of therapies available to assist in quitting of tobacco. It is important to remember that, while it will be difficult, ceasing to use tobacco has immediate health benefits, including increased life expectancy and reduced risk of tobacco related diseases and conditions.
Arrested root development of permanent te~th can occur due to local factors such as infection and trauma or general factors such as radiation and odontodysplasia. This case report presents a 11 tooth with arrested root development requiring endodontic treatment. Following obturation with MTA, a minor surgical procedure was performed to remove periapical pathologic tissue. The tooth had remained asymptomatic at the 6-month review and the case will be followed-up for at least 2 years to ensure complete healing.
A case is described in which a compound odontoma erupted into the oral cavity in an 8 1/2-year-old girl. The odontoma was initially discovered as a chance radiographic finding 2 years 8 months previously.
The objectives of this study is to evaluate the suitability of full cup test (FCT), numeric pain rating scale (NPRS), and visual analogue scale (VAS) to assess pain after surgical removal of lower third molar and to identify which of these three pain scales is the easiest to use. A total of 50 patients, age between 18 to 30 years who underwent minor oral surgery for removal of impacted third molar were sampled in Faculty of Dentistry, University of Malaya. The patients were provided with forms containing three pain scales and they were required to mark each pain scales – FCT, NPRS and VAS daily for three consecutive post-operative days. The forms were collected a week later when patients came back for review. The validity between NPRS with VAS, FCT with NPRS and FCT with VAS were tested using Spearman rank correlation coefficient. Results showed that the correlation coefficient values for each pair were very high and significant. The findings when comparing Day 1, Day 2 and Day 3 and the combination for those three days showed no significant differences. No evidences indicated that the findings for Day 1 were more superior in comparison with other days. In conclusion, FCT was as valid as NPRS and VAS. The pain scale which was claimed to be the easiest to use by patients was NPRS, followed by FCT and VAS. However, further studies are needed to investigate the reliability and sensitivity of FCT.
In this study we aimed to determine the adverse effects and pain outcome following carbamazepine
pharmacotherapy to manage patients with classical trigeminal neuralgia. The study was carried out on
patients diagnosed with classical trigeminal neuralgia at the Faculty of Dentistry, University of Malaya.
Medical records of patients diagnosed with trigeminal neuralgia over a period of 11 years from April, 2003
to April, 2014 were reviewed. A total of 49 patients who fulfilled the inclusion criteria were included in
the study. Demographic details, clinical features and blood test reports of the patients were recorded
from the patient’s clinical files. Subjects included in the study were administered the Faces Pain Rating
Scale (FPS) and Numeric Pain Rating scale (NRS) to measure the pain outcome retrospectively. Analysis
and interpretation of results was carried out using SPSS. Hepatic adverse effects were more commonly
seen in our patients (n=39) followed by haematological (n=27), renal (n=23) and non-specific adverse
effects (n=22). However, there was no significant association between the observed side effects and
carbamazepine pharmacotherapy. Analysis of our data using Pearson Chi Square test, showed no
significant correlation between gender, ethnicity and age of the patients with adverse effects. 9 out of
the 49 subjects included in the study were administered the FOS and the NRS. Pain perception after
treatment was significantly decreased (p-0.007) in comparison to pain perception before commencement
of therapy with carbamazepine in the selected group of patients. Even though pain perception decreased
in the selected patients, the data is insufficient to state the efficacy of the treatment as none of the patients
reported a complete relief from their pain. The results of our study showed that there were no significant
haematological, hepatic, renal, and non-specific adverse effects associated with the use of carbamazepine.
The efficacy of this drug in the treatment of trigeminal neuralgia was proven to be satisfactory. It may be
concluded that carbamazepine could be considered as the drug of choice in the treatment of trigeminal
neuralgia.
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
Purpose of the study: The objective of this study was to investigate the existence of the golden proportion between the width of the maxillary anterior teeth of undergraduate dental students at University of Malaya. Materials and method: Standardised photographs of 100 dental students’ smiles displaying only the lips and the teeth were captured. The images were transferred to a personal computer and the width of the maxillary anterior teeth was measured using an Image
Analyzer (Leiqa QWin). Calculations were made according to the Theory of Golden Proportion. The
data were statistically analysed using paired student T-test (α
The aims of this study were to determine the prevalence and factors that influenced smoking behaviours among male adolescents in Kuantan, Pahang. A cross-sectional study was conducted among the form four male students in Kuantan District. Three hundred and twenty three students were randomly selected from eight secondary schools. A self-administered questionnaire was distributed to all the respondents. Almost half of the sample was smokers (45.8%) and half of them were Malays (53.1%). Students whose parents had lower level of occupation were more likely to smoke (58.8%). Among smokers, 34.5% of them smoked since primary school and a majority (91.7%) smoked 10 or less cigarettes per day. Half of them (53.4%) reported that they bought loose cigarettes and most of them used their school pocket money to purchase the cigarettes (81.7%). From the multivariate analysis, it was found that Non-Science Stream classes (OR=3.92, 95% CI= 2.10, 7.32), peers' smoking (OR=6.07, 95% CI= 2.32, 15.92), and attitude towards smoking (OR= 21.93, 95% CI= 9.71,49.51) were significantly associated with smoking habit. The prevalence of smoking among male adolescents was considerably high'in this population. It is recommended that antismoking activities in school be carried out regularly and should involve an active participation from the adolescents themselves since peers have great influence on smoking habits.
Dental quackery has been a problem for decades and is becoming a major concern in many countries, including Malaysia. Recent development of a new service offered by quacks in Malaysia is “fake braces”, which alarmed dental professionals. The fake braces appear similar to the professionally fitted orthodontic appliances comprising of archwires that are secured on brackets by coloured ligatures except they are fitted by unqualified individuals who have no formal clinical training. In addition, the orthodontic materials and dental equipment used for this illegal service were substandard and unregulated. Therefore, such fitted appliances are harmful to the teeth and oral health. Efforts to record the extent of fake braces practice and its oral health consequences have been challenging as they are marketed through the social media, and the victims were either reluctant to come forward or did not know the appropriate channel to file a complaint to the health authority. This is an expert opinion paperwith theaimsto highlight typical presentation of fake braces, modus operandi of fake braces providers, the harmful effects of fake braces on the patient’s oral health, the role of social media advertising in promoting fake braces, and the impacts to the illegal providers.
The canine teeth of the mature ferret have closed apices. They are easily accessible for operating purposes and are sufficiently large, allowing conventional cavity preparation techniques to be prepared using ordinary dental instruments. Handling of the ferret is relatively easy since it becomes quite tame after a period of time. The body weight in male is greater and the teeth larger than those of the female. The cost of purchase and maintenance of the ferret is also inexpensive. For all these reasons, the ferret male is animal of choice in dental experiments.
Natural products have demonstrated various activities beneficial to general health. Flaxseed (Linum usitatissimum) has been reported in many studies for its antimicrobial, antioxidant, and anti-inflammatory effects. Additionally, flaxseed extracts have skin wound healing activity and potential for treating oral ulcers.L. usitatissimum was extracted using 70% ethanol via soxhlet method and gas chromatography mass spectrum (GC-MS) was used to analyze the components of L. usitatissimum extract. The crude flaxseed oil were applied to human oral fibroblasts (HOrF), and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to assess the cell viability after 24, 48 and 72 hours. Scratched HOrF cells were treated with crude flaxseed oil and healing was monitored per wound healing assay. GC-MS indicate that the major components present in L. usitatissimum oil extract are linolic, palmitic and oleic acid. L. usitatissimum crude oil extract showed high proliferation effect on HOrF cells at 24 and 48 hours, while the highest proliferation effect was recorded at 72 hours post-treatment. The wound healing assay results showed that healing activity of HOrF cells occurred as soon as 18 hours post-treatment when treated with L. usitatissimum crude oil extract. L. usitatissimum crude oil extract has proliferating and healing effects on HOrF cell line. Therefore, it can be considered as a potential promising oral wound healing agent.
Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which
aggravated her neuralgic pain.
To date, fluorides has remained to be the best means of controlling dental caries. Fluoride is given either systematically via fluoridated water or topically through other supplements including toothpastes. In recent years increasing prevalence of enamel defects or fluorosis is observed in both populations receiving or not receiving water fluoridation. It is suspected that excessive ingestion of a "standard" 1000 to 1500 ppm fluoride from toothpastes might be a contributing factor to the presence of such defects. In Malaysia, reports of enamel defects occurring amongst 12 to 16 year-old schoolchildren ranged between 67 to 88 percent. Where water fluoridation is available, the amount of fluorides received from the home is between 0.3 to 0.5 ppm F. However, almost all toothpastes sold locally contains fluoride, the content of which is unknown to the consumers. This study reports on the analysis of fluoride levels carried out on 20 toothpaste samples sold locally. Results showed that fluoride levels in all 20 samples ranged between 20 to 1970 ppm F. Only two of the 20 samples analyzed, however, indicated having a level anywhere near the "standard" level. In addition, only two type~ of children's toothpaste with a fluoride concentration of 20 and 450 ppm F were commonly available as compared to adult toothpastes in all the samples studied.
The objectives of this study were to measure the Furcation Entrance Dimensions of first and second permanent molars in Malaysian samples and to compare the Furcation Entrance Dimensions with the blade widths of periodontal Gracey’s curette used for root surface instrumentation. A total of 199 extracted permanent teeth were measured, which comprised of 51 mandibular first molars, 51 mandibular second molars, 45 maxillary first molars and 52 maxillary second molars. Furcation Entrance Dimension was measured using calibrated test gauges. Results showed 51.91% of Furcation Entrance Dimension was
The objectives of this study were to assess the practice of molar root canal treatment (RCT) among general dental practitioners (GDPs), confidence level of GDPs in performing molar RCT and to identify factors that influence their confidence in managing molar RCI. One hundred questionnaires were distributed to GDPs in Kuala Lumpur and Selangor. Fifty questionnaires were delivered by mail and the remaining fifty were hand-delivered. All data was coded and verified. Fiftysix OOPs rcsponded to the questionnaires. Only fortyfive questionnaires were accepted (n=45) as eleven OOPs had never performed molar RCI. Most of the OOPs followed the standard quality guidelines while performing molar RCT except for vitality testing (36.4%) and rubber dam usage (27.3%). In this study, 100% of the GDPs were confident in making diagnosis of perinidicular diseases and 95.4% were confident in performing molar RCT from history taking until obturation. Patients' tolerance and availability of instruments and materials (97.7%) were two factors that most influence the GDPs' confidence level. The. least influcncing factor was undergraduate training (78.1 %). Attending seminars and lectures on endodontic, large number of molar teeth treated for ReT, patLents' affordability to pay for RCT and postgraduate training also influencc GDPs' confidence to a certain degree. From this study, it can be concluded that majority of OOPs complied standard quality guidelines except for vitality testing and rubber dam usage. Most of them were confident in performing molar RCT and were greatly influenced by the availability or"instruments and materials in their clinic and patients' tolerance in receiving molar RCI.
Background: Majority of root canal treatment in Malaysia was provided by general dental practitioner. The purpose of this study was to evaluate the knowledge and practice (canal’s preparation, use of materials) by them. Methods: A questionnaire was structured and distributed to 120 registered general dental practitioners in selected areas in Perak, Johor and Klang Valley regarding the provision of root canal therapy in their practices. The questionnaires were hand delivered and collected after 1 to 2 weeks. Results: Reply rate was 95% (n=114). The result demonstrated that 62% respondents indicated that they performed the root canal therapy (RCT) themselves. Out of these only 26% included molars in the treatment. Three quarters of them (77%) used step-back technique and 54% used stainless steel instruments to prepare the canals. The majority of the respondents (69%) used calcium hydroxide as intracanal medicaments. Only 30% used rubber dam for isolation whereas the rest used cotton rolls. The numbers of routine radiographs taken were two for anterior teeth and three for molar. Half of the respondents indicated that they usually completed the RCT for the anterior tooth within two visits whereas three visits were needed for the molar tooth. The results were analyzed descriptively. Conclusions: This study indicates that most of the general dental practitioners’ do not comply with quality standards guidelines such as use of rubber dam as isolation. Cotton roll was the most popular isolation method. In spite of this, most of the respondents tend to update their knowledge and practices with current techniques and materials.