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  1. Anuwar AHK, Ab-Murat N
    Oral Health Prev Dent, 2021 Jan 07;19(1):217-227.
    PMID: 33829719 DOI: 10.3290/j.ohpd.b1179509
    PURPOSE: To develop an evidence-based Clinical Practice Guideline (CPG) on caries management for the Malaysian population using the ADAPTE trans-contextual adaptation framework.

    MATERIALS AND METHODS: A systematic search was conducted to identify all CPGs related to caries management on guideline repository websites and other platforms. The search findings were screened and the quality of the identified guidelines was evaluated using the AGREE II tool. The currency and the content of the recommendations were assessed by multidisciplinary experts for local adaptation.

    RESULTS: Following an extensive assessment, six high-quality CPGs were selected for adaptation. Subsequent to the content assessment, the multidisciplinary experts agreed to adopt 24 recommendations, adapt 55, and exclude two recommendations. The adaptation process generated 21 recommendations for caries management in Malaysia. The formulation of the final evidence-based recommendations for caries management in Malaysia was based on the feedback given by the external reviewers.

    CONCLUSION: The use of the trans-contextual adaptation process is feasible for the development of local guidelines when there are scarce resources and insufficient local evidence. The involvement of the multidisciplinary experts ensures the comprehensiveness of the CPG in terms of its quality and validity and subsequently promotes adherence and ownership of the CPG at the local settings.

  2. Tajudin ANA, Anuwar AHK, Marhazlinda J, Yusof ZYM
    J Clin Pediatr Dent, 2024 Jul;48(4):38-44.
    PMID: 39087212 DOI: 10.22514/jocpd.2024.076
    Disadvantaged schoolchildren from rural and low socioeconomic backgrounds face persistent oral health inequalities, specifically dental caries, and periodontal diseases. This protocol aims to review the effectiveness of promotive and preventive oral health interventions for improving the oral health of primary schoolchildren in these areas. We will search the PubMed, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Library, Web of Science, Dentistry and Oral Sciences databases for studies published from 2000-2023. The review includes randomised/nonrandomised controlled trials and community trials evaluating the effectiveness of promotive and preventive oral health interventions on at least one of these outcomes: changes in dental caries status, periodontal disease status, oral hygiene status/practices, sugar consumption, or smoking behaviours. Two reviewers will independently assess the searched articles, extract the data, and assess the risk of bias in the studies using the Cochrane Risk of Bias 2 (ROB 2) for randomised controlled trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomised controlled trials. Both narrative and quantitative analyses will be conducted. However, only narrative synthesis will be performed if the data are substantially heterogeneous. The synthesised evidence from this review can inform policymakers on evidence-based interventions to improve the oral health outcomes of schoolchildren from rural and low socioeconomic backgrounds. Systematic Review Registration PROSPERO (Registration number: CRD42022344898).
  3. Anuwar AHK, Ng CW, Safii SH, Saub R, Ab-Murat N
    BMC Oral Health, 2024 Mar 18;24(1):346.
    PMID: 38500175 DOI: 10.1186/s12903-024-04094-z
    BACKGROUND: Non-surgical periodontal treatment is the mainstay of periodontal treatment. In Malaysia, the prevalence of periodontal disease is substantial among adults with almost half of them having periodontitis. Therefore, we estimated the economic burden of non-surgical periodontal treatment in specialist clinics in Malaysia.

    METHODS: Relevant data from multiple data sources which include national oral health and health surveys, national census, extensive systematic literature reviews, as well as discussion with experts, were used to estimate the economic burden of non-surgical periodontal management in specialist clinics in Malaysia in 2020. This estimation was done from the oral healthcare provider's perspective in both public and private sectors using an irreducible Markov model of 3-month cycle length over a time horizon of one year.

    RESULTS: In 2020, the national economic burden of non-surgical periodontal treatment during the first year of periodontal management in specialist clinics in Malaysia was MYR 696 million (USD 166 million), ranging from MYR 471 million (USD 112 million) to MYR 922 million (USD 220 million). Of these, a total of MYR 485 million (USD 115 million) and MYR 211 million (USD 50 million) were the direct oral healthcare cost in public and private dental clinics, respectively.

    CONCLUSION: The findings of this study demonstrated substantial economic burden of non-surgical periodontal management in specialist clinics in Malaysia. Being a life-long disease, these findings highlight the importance of enforcing primary and secondary preventive measures. On the strength and reliability of this economic evidence, this study provides vital information to inform policy- and decision-making regarding the future direction of managing periodontitis in Malaysia.

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