The window of maximum susceptibility for the development of dental fluorosis for anterior
teeth is during the first two to three years of life. The primary source of fluoride intake for
infants at this age is mainly from the diet including infant formula. Thus, the present work
aimed to investigate the fluoride concentration in commercially available Malaysian infant
formulas that required reconstitution before consumption. A total of 29 infant formulas available in the Malaysian market were reconstituted with deionised water, fluoridated tap water,
and filtered tap water. The fluoride concentration of the infant formulas was analysed directly
using a fluoride ion selective electrode. The daily fluoride intake estimation from the infant
formulas was calculated using the median infant body weight and recommended volumes for
formula consumption from newborn to > 12 months of age. Results showed that the fluoride
concentration of the infant formulas when reconstituted with deionised water ranged between
0.009 to 0.197 mg/L that contributed to the estimated daily fluoride intake ranging from 0.005
to 0.100 mg (total intake per day) or 0.001 to 0.025 mg/kg (total intake per body weight/day).
The fluoride concentration in the selected infant formulas was low, but after reconstitution
with fluoridated tap water, the overall fluoride concentration in infant formulas sample significantly increased (p < 0.001). Nevertheless, the estimated daily fluoride intake from infant
formulas alone did not exceed the lowest-observed-adverse-effect level (LOAEL) of fluoride
at 0.10 mg/kg/day.
Communication is an integral component of effective healthcare delivery to patients, and this includes breaking bad news (BBN). However, clinicians in dentistry are rarely exposed to diseases that can negatively and seriously affect an individual's view of their future and pose a mortality risk, except for oral cancer. The aim of this study was to assess clinician practices in BBN of oral cancer diagnosis in Malaysia. An exploratory sequential mixed-methods study design was used. A qualitative study was conducted among 12 clinicians to gather relevant information regarding their practices in BBN of oral cancer diagnosis using a descriptive-interpretive approach. The themes that emerged were preparation for BBN, BBN setting, communication, emotional aspects, and summarizing the session. These themes were used to develop a questionnaire with 34 items. In the quantitative study, this questionnaire was sent to 87 clinicians who had experienced BBN of oral cancer diagnosis in the past 5 years; the response rate was 100%. An arbitrary cut-off score between the third and fourth quartiles was set to distinguish 'good' and 'poor' practice in BBN among the clinicians. The data analysis was performed using IBM SPSS Statistics version 23.0. Overall, at least two-thirds of the clinicians had good practices in BBN of oral cancer diagnosis. The clinicians' designation (oral and maxillofacial surgery consultant/specialist vs dental officer) and BBN experiences were factors associated with their practices in BBN of oral cancer diagnosis.