The fluoride content of several brands of infant milk formulas were determined to approximate that available in the water used in its preparation. It was also found that the public water supply contains a mean fluoride content of 0.379 ppm. The daily fluoride intake derived from infant milk formulas in a fluoridated community is discussed in relation to the recommended dosage.
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.
A questionnaire was mailed to 1217 dentists whose names appear in the Dentist Register of 1987 in order to assess their awareness and acceptance of hepatitis B vaccine and their pattern of glove usage. Almost all the respondents (99.6%) were aware of the availability of the hepatitis B vaccine yet only 44.8% have received the vaccine. This is in spite of the fact that the majority (61.2%) of the vaccine non-acceptors have no reservations concerning the vaccine. About 71% and 63% of the vaccine-acceptors and non-acceptors respectively believed that the risk of their contracting hepatitis B was high or very high. About 22% of the vaccine non-acceptors never used gloves when treating patients as compared to 9% among vaccine acceptors. Overall, about 78% of the respondents have experienced needleprick injuries in the 3 years preceding the survey.
The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.
To assess the cross-sectional construct validity of the Malay-translated and cross-culturally adapted FACT-H&N (v 4.0) for discriminative use in a sample of Malaysian oral cancer patients. A cross-sectional study of adults newly diagnosed with oral cancer. HRQOL data were collected using the FACT-H&N (v 4.0), a global question and a supplementary set of eight questions ('MAQ') obtained earlier in pilot work. Of the 76 participants (61.8% female; 23.7% younger than 50), most (96.1%) had oral squamous cell carcinoma; two-thirds were in Stages III or IV. At baseline, patients' mean FACT summary (FACT-G, FACT-H&N, FACT-H&N TOI, and FHNSI) and subscale (pwb, swb, ewb, fwb, and hnsc) scores were towards the higher end of the range. Equal proportions (36.8%) rated their overall HRQOL as 'good' or 'average'; fewer than one-quarter rated it as 'poor', and only two as 'very good'. All six FACT summary and most subscales had moderate-to-good internal consistency. For all summary scales, those with 'very poor/poor' self-rated HRQOL differed significantly from the 'good/very good' group. All FACT summary scales correlated strongly (r>0.75). Summary scales showed convergent validity (r>0.90) but little discriminant validity. The discriminant validity of the FHNSI improved with the addition of the MAQ. The FACT-H&N summary scales and most subscales demonstrated acceptable cross-sectional construct validity, reliability and discriminative ability, and thus appear appropriate for further use among Malaysian oral cancer patients.
The Oral Health Division, Ministry of Health in Malaysia piloted clinical pathways (cpath) in primary care in early 2003. This study investigated the knowledge, perception of cpaths and barriers faced by the clinicians involved in the pilot project. Self-administered questionnaires were sent to the clinicians (n=191). Dentists (67.9%) and dental nurses (70.6%) had good overall knowledge of cpaths. The majority of the clinicians (67.9% to 95.6%) perceived cpath positively in all areas. Only 9.2% of dentists encountered difficulties in using cpath forms compared to 28.4% of dental nurses. A higher proportion of dental nurses (73.5%) compared to dentists (64.8%) were willing to continue using cpath. The majority of dentists (76.7%) and dental nurses (73.1%) were willing to participate in future development of cpaths. Overall, there was evidence of managerial support for the pilot project. A follow-up of the pilot project was somewhat lacking as less than half (43.3%) of the clinicians reported that the state coordinator obtained feedback from them. The findings auger well for the future implementation of cpath should the Oral Health Division decide to adopt cpath routinely in the public oral health care service.
Recent studies suggested that exposure to household smoking (HHS) could be a modifiable risk factor for caries development among children. Majority of the studies were cross sectional in nature. Therefore, a case-control study was designed to test the hypothesis that HHS is a risk factor to caries experience in permanent teeth. Calculation of sample size was based on the ratio of 1 case to 4 controls. Case was defined as a child aged 13-14 years old with caries in at least one second permanent molar and control was defined as a child from the same age and school with no caries second permanent molars. Matching was done for gender and ethnicity. School dental records provided information on oral health status and oral hygiene status. Information on HHS, socio-economic status, child’s smoking status and child’s oral health practices were obtained from a self- administered questionnaire, completed by the children and their parents. The result showed that 55.9% of the case group was exposed to HHS, as compared to 44.1% among the control group. In the final multiple logistic regression model after controlling for important risk factors for caries, children with caries were almost twice as likely to have been exposed to HHS for more than 10 years as compared to children with no caries, (Adjusted OR=1.90 and 95% CI=1.35, 2.60). In addition, children who only received dental care from the school dental service had reduced risk of having dental caries by more than one third (36%) as compared with those who received dental care from school dental service (SDS) as well as had additional dental problem solving visit outside SDS (Adjusted OR=0.64 and 95% CI=0.50, 0.90). It is concluded that exposure to HHS for a long duration (> than 10 years) increase the risk to have caries experience in permanent teeth of children.
Study site: 12 secondary schools, Kelang District, Selangor, Malaysia
A house to house random survey on elderly subjects was undertaken in the District of Klang in Malaysia. The objective of this study was to investigate the prevalence of oral mucosal lesions (OML) among the elderly in this area. The primary units in the sampling frame were the Enumeration Blocks (EBs) as defined under the population census. All households of the selected EBs were considered as sampling units and members aged 60 and above were considered as respondents. There was a slight preponderance of females, with the Malays comprising the majority of the subjects. Of the 486 respondents, mean aged 69.1 +/- 7.3 yr, 111 had at least one oral mucosal lesion, a prevalence of 22.8%. A total of 145 lesions were detected. The prevalence of OML was highest among Indians and least among the Chinese. The most common finding was tongue lesions, recording a prevalence of 10.7%, followed by oral pigmentation (4.9%) and white lesions (4.3%). Denture related lesions were comparatively low at 2.5%. Two cases of oral cancer if representative would give a relatively high prevalence of 0.4%.