The aims of the study were to investigate patient satisfaction and perceived psychosocial benefit from orthodontic treatment and to relate them to factors ajfecting treatment duration and treatment standards. A total of 130 patients (mean age I5 years) who had just completed full fixed appliance therapy (removable appliance) filled questionnaires. There was high proportion of satisfaction with dentofacial appearance (98.5 %), alignment of teeth (100 %), improved mastication (99.2%) and cleaning of teeth (98.5%). About 89.2% would recommend orthodontic treatment to their friends. All surveyed were satisfied with the services provided by the orthodontic staff and kw patients were dissatisfied with the length of each appointment (3.] %), number of appointments (l.5%) and total treatment time (5.4%). The main dissatisfaction appeared to be the long waiting time to be treated during their appointments (10%}. The mean duration of treatment to complete two-arch fixed appliance was I 7.6 months (S.D. 6.8 months) and 89.2% of cases were completed within 24 months. Treatment duration was also associated with pre-treatment ovemet (r=0.23 5), ovetjet d%rence_h·om pre-treatment to post-treatment 0·=0.204} and number of extractions (r=0.305}. Multmle linear regression anahtsis of duration of treatment with these factors accounted for about 7.8% ofthe variability.
Study site: Dental clinic, Kota Kinabalu, Sabah, Malaysia
Introduction: There is generally inconsistent appropriate orthodontic referral among local dentists. Orthodontic indices are not routinely used to assess the need for treatment. The aim of this pilot study is to evaluate the efficacy of the Index of Orthodontic Treatment Need (IOTN) as an educational tool to improve their ability to assess orthodontic treatment need.
Methodology: Local dental officers assessed 30 study models on two occasions (before and after IOTN training) and their findings compared with an expert group for agreement in IOTN scores and referral decisions. Training comprised oral/visual presentation, instruction manuals, ‘hands-on’ and self-study. Kappa statistic (?) was used to assess agreement.
Results: As a group there was no significant improvement in referral decisions after training with only ‘moderate’ agreement (?=0.47), although half of the subjects improved. Agreement was better with aesthetic (?=0.51) than functional (?=0.41) assessment. ‘Sensitivity’ was 82.4% and ‘Specificity’ was 58.2% but both were not statistically significant before and after training.
Conclusion: The IOTN has potential as an educational tool for improving the diagnostic skills of dental officers. More accurate assessment of the Dental Health Component with the IOTN ruler and familiarity with the Aesthetic Component has to be emphasized in future training.
Compliance to delivery of orthodontic appliances within specified times and factors which influenced compliance by dental technicians in Selangor was evaluated. This is a prospective 8-month study of 18 trainee/ trained technicians from 4 main government dental laboratories in Kajang, Klang, Tanjong Karang and Shah Alam. Delivery times specified by orthodontists were 1 day for plastic retainer, 3 days acrylic retainer, 5 days active plates (URA), 10 days functional appliances (FA), 10 days transpalatal arch (TPA) and 10 days for quadhelix. Punctual delivery was recorded as ‘compliant’. Compliance was compared between appliances, clinics, technicians, orthodontists and seniority of technicians. The sample comprised appliances from 365 patients; 38 (10.4%) Tanjong.Karang, 114 (31.2%) Kajang, 191 (52.3%) Klang and 22 (6.0%) Shah Alam. The majority of appliances were retainers (66.3%), followed by URA (13.4%), functionals (9.3%), TPA (9.0%) and quadhelix (1.9%). Mean compliance for all appliances in Selangor was 55%. Plastic retainers had highest compliance (77.8%), followed by acrylic retainers (59.9%), quadhelix (57.1%), FA (47.1%), TPA (45.5%) and URA (24.5%). Senior technicians (>3 years in service) were more compliant than juniors (
The main objective of the study was to determine the oral health status and possible factors influencing oral hygiene in the institutionalized elderly in Sabah. A cross sectional study in all four institutions for the elderly in QM ii Sabah was conducted using oral examination and interview/questionnaires. Qualitative assessment using Focus Group Discussion was carried out in the caregivers of the institutions. Plaque score was used to assess oral hygiene status. A total of 94.0% of inmates were above 55 years old. There were 13.4 % non-respondents in the total sample of 284. Of the n0n—respondents, 42.4 % had mental disorders and this was statistically signnicant. Of those who responded 34.6% had good 33.3% fair and 32.1% poor oral hygiene. 33.5% were completely edentulous, 86.4% had gingivitis which required scaling, 22.0% had decayed teeth and 54.9% required extraction. Gingivitis, decayed teeth and number of teeth for extraction were signwcantly associated with poor oral hygiene. 14.2% had at least one type of oral disease. Dental abscess was the most common muco»cutaneous lesion found. Mental disorders showed a trend towards poor oral hygiene and this was statistically signyicant. Although 40.8% had physical handicap, 23.3% visual impairment and 8.2% hearing impairment, there was no significant association with oral hygiene status. In conclusion, oral health status of the population is poor and treatment needs are high. Although there was high objective need for oral care (88.6%), perceived need was low (32.0%).