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The prevalence of enamel and dentine caries lesions and their determinant factors among children living in fluoridated and non-fluoridated areas

Nor NAM, Chadwick BL, Farnell D, Chestnutt IG

Community Dent Health, 2019 Aug 29;36(3):229-236.
PMID: 31437389 DOI: 10.1922/CDH_4522Nor08

OBJECTIVE: To determine the prevalence and severity of dental caries (at dentine and enamel levels of diagnosis) amongst Malaysian children and to investigate determinant factors associated with caries detection at these different thresholds.
METHODS: This study involved life-long residents aged 12 years-old in fluoridated and non-fluoridated areas in Malaysia (n=595). The survey was carried out in 16 public schools by a calibrated examiner, using ICDAS-II criteria. A questionnaire on socio-demographic and oral hygiene practices was self-administered by parents/guardians. Data were analysed using Mann-Whitney U tests and logistic regression.
RESULTS: The overall response rate was 74.4%. Caries prevalence at the dentine level or at the dentine and enamel level was significantly (p⟨0.001) higher among children in the non-fluoridated area (D₁₋₆MFT⟩0 = 82.4%, D₄₋₆MFT⟩0 = 53.5%) than in the fluoridated area (D₁₋₆MFT⟩0 = 68.7%, D₄₋₆MFT⟩0 = 25.5%). Considering only the decayed component of the index, no significant differences were observed between the two areas when the detection threshold was set at enamel caries (D₁₋₃) (p=0.506). However, when the detection criteria were elevated to the level of caries into dentine (D₄₋₆) there were clear differences between the fluoridated and non-fluoridated areas (p=0.006). Exposure to fluoridated water proved a significant predictor for lower caries prevalence in the statistical model. Children whose father and mother had a low monthly income had a significantly higher dentine caries prevalence.
CONCLUSION: Results confirmed existing evidence of the benefit of water fluoridation in caries prevention. Detection criteria set at caries into dentine shows clear differences between fluoridated and non-fluoridated areas. Exposure to fluoridated water and socio-economic status were associated with caries prevalence.
Retention Evaluation of Fissure Sealants Applied Using Self-Etch and Conventional Acid-Etch Techniques: A Randomized Control Trial Among Schoolchildren

Althomali YM, Musa S, Manan NM, Nor NAM

Pediatr Dent, 2022 Jul 15;44(4):249-254.
PMID: 35999682

Purpose: The purpose of this study was to evaluate the clinical retention capabilities of a self-etch adhesive system (experimental group) and conventional acid-etch (control group) techniques and compare the caries incidence within six months and 24 months of follow-up periods. Methods: A total of 47 healthy children with a mean age of 9.7 years and either sound or noncavitated erupted permanent first molars were included in the trial. A total of 188 molars were randomly assigned in a split-mouth design for the self-etch mode in the universal adhesive or conventional acid-etch. Differences in sealant retention and caries incidence were compared at six and 24 months after sealant placement using a chi-square test. Results: Within 24 months of follow-up, the retention of fissure sealant applied using conventional acid etching (41 out of 66; 62.1 percent) was significantly higher (P<0.05) than that of the fissure sealant applied using self-etching mode in the universal adhesive system (17 out of 66; 25.8 percent). There was no significant difference in caries incidence between the two groups up to 24 months after sealant placement. Conclusion: With 24 months of follow-up, the retention of the conventional acid-etching technique were superior to those of the self-etch technique.
Machine Learning and Deep Learning Approaches in Breast Cancer Survival Prediction Using Clinical Data

Kalafi EY, Nor NAM, Taib NA, Ganggayah MD, Town C, Dhillon SK

Folia Biol. (Praha), 2019;65(5-6):212-220.
PMID: 32362304

Breast cancer survival prediction can have an extreme effect on selection of best treatment protocols. Many approaches such as statistical or machine learning models have been employed to predict the survival prospects of patients, but newer algorithms such as deep learning can be tested with the aim of improving the models and prediction accuracy. In this study, we used machine learning and deep learning approaches to predict breast cancer survival in 4,902 patient records from the University of Malaya Medical Centre Breast Cancer Registry. The results indicated that the multilayer perceptron (MLP), random forest (RF) and decision tree (DT) classifiers could predict survivorship, respectively, with 88.2 %, 83.3 % and 82.5 % accuracy in the tested samples. Support vector machine (SVM) came out to be lower with 80.5 %. In this study, tumour size turned out to be the most important feature for breast cancer survivability prediction. Both deep learning and machine learning methods produce desirable prediction accuracy, but other factors such as parameter configurations and data transformations affect the accuracy of the predictive model.
On the discrimination between facial creams of different brands using Raman Spectroscopy and partial least squares discriminant analysis for forensic application

Asri MNM, Verma R, Ibrahim MH, Nor NAM, Sharma V, Ismail D

Sci Justice, 2021 Nov;61(6):687-696.
PMID: 34802642 DOI: 10.1016/j.scijus.2021.08.006

Determining the origin of cosmetic traces is an important aspect of forensic investigations, that helps linking a suspect to a crime. Such type of evidence can help further narrow down the undergoing investigations. This paper reports the first use of Raman Spectroscopy (RS) coupled with the exploratory principal component analysis (PCA) and supervised partial least squares-discriminant analysis (PLS-DA) in facial creams. 40 facial cream samples of 8 different brands were studied in this work. Preliminary assessments through visual inspection of their Raman spectra revealed the presence of oxides, titanium dioxide, castor seed oil, and beeswax. Also, the peaks of alkyne groups were indicative of the presence of talc or mica compounds. The exploratory PCA correctly segregated the samples into 8 clusters and the supervised PLS-DA model correctly classified them into 8 classes. Further evaluation of the performance of the trained PLS-DA model resulted in perfect classification shown by the receiver operating characteristic (ROC) curves. The PLS-DA model also resulted in 100% accuracy of correctly assigning the brand on the face wipes on each of the five substrates viz. cotton, dry and wet tissue paper, nylon substrate, and polyester. This validation was done treating these samples as unknowns. The study has a potential for use under actual forensic casework conditions.
Fulltext Retrospective analysis of dental treatment under general anesthesia among children with early childhood caries in Malaysia

Ibrahim NA, Nor NAM, Azizi NZ, Hamzah TNNT, Dziaruddin N, Musa S

J Clin Pediatr Dent, 2023 Jul;47(4):46-53.
PMID: 37408346 DOI: 10.22514/jocpd.2023.034

Many children are affected by early childhood caries (ECC) with some requiring dental treatment under general anesthesia (GA). In pediatric dentistry, GA is one of the established methods of behavior management. GA data is useful for understanding the caries burden among young children. This study aimed to determine the trends, patient characteristics, and types of treatments conducted under GA among young children in a Malaysian dental hospital over a 7-year period. A retrospective study using pediatric patient records from 2013 to 2019 was conducted on children aged 2-6 years (24-71 months) having ECC. Relevant data were collected and analyzed. In total, 381 children with a mean age of 49.8 months were identified. Some of the ECC cases were associated with abscesses (32.5%) and multiple retained roots (36.7%). Over a 7-year period, there was an upward trend of preschool children receiving GA. Of the 4713 carious teeth treated, 55.1% were extracted, 29.9% were restored, 14.3% had preventive procedures, and 0.4% were pulp treated. Mean extractions were significantly higher among preschoolers compared to toddlers (p = 0.001), while preventive treatment was markedly higher among toddlers. In terms of the type of restorative materials, almost similar distribution was observed between the two age groups with 86.5% treated using composite restorations. Dental treatment under GA was more frequently used among preschoolers than in toddlers, with extractions and restoration with composite resin being the common treatment options. The findings can help decision-makers or relevant parties address the burden of ECC and enhance oral health promotion activities.
Fulltext Exploring Malaysian schoolchildren's perception of the advantages and disadvantages of the ToothPoly board game: a qualitative study

Abdul Razakek NFS, Yusof ZYM, Yusop FD, Obaidellah UH, Kamsin A, Nor NAM

J Clin Pediatr Dent, 2024 Jan;48(1):101-110.
PMID: 38239162 DOI: 10.22514/jocpd.2023.096

The effectiveness of children's oral health education (OHE) is determined by the appropriateness of the educational materials used, which can influence their attitude towards oral health. However, there is a lack of studies exploring the benefits of OHE materials from the perspective of schoolchildren. This study aimed to explore schoolchildren's opinions on the newly developed ToothPoly board game as an OHE tool. A qualitative approach using focus group discussions (FGDs) was conducted among 44 schoolchildren aged 12 years old from a public school in Malaysia. Convenience sampling was employed to recruit the schoolchildren. The ToothPoly board game was playtested and FGDs were conducted after the playtesting session ended. Data collection and analyses were performed concurrently until data saturation was reached. The data were transcribed and coded using Atlas.Ti software version 9.1.3 followed by the framework method analysis. Mixed opinions were observed among the schoolchildren with a majority expressing favourable opinions on the advantages of the ToothPoly board game as an OHE tool. Five themes emerged from the advantages aspect, i.e., fun and enjoyable, promote focus, attention and oral health-related learning, attractive board game features, and enhance peer interaction. Meanwhile, two themes emerged that were related to the disadvantages of the board game, i.e., "competition with online games and media" and "not practical for a large group activity". The findings showed that the ToothPoly board game was perceived as a useful, interactive, and enjoyable tool to learn about oral health in small groups. The findings of the study highlight the importance of tailoring OHE activities to fulfil the needs of specific target groups to ensure its acceptance and future success.
Fulltext Effectiveness of the school-based oral health promotion programmes from preschool to high school: A systematic review

Bramantoro T, Santoso CMA, Hariyani N, Setyowati D, Zulfiana AA, Nor NAM, et al.

PLoS One, 2021;16(8):e0256007.
PMID: 34379685 DOI: 10.1371/journal.pone.0256007

BACKGROUND: Schools offer an opportunity for oral health promotion in children and adolescents. The purpose of this study was to conduct a systematic review of the influence of school-based oral health promotion programmes on oral health knowledge (OHK), behaviours (OHB), attitude (OHA), status (OHS), and quality of life (OHRQoL) of children and adolescents.
METHODS: A systematic search on the PubMed and Embase databases was conducted to identify eligible studies. The last search was done on April 24th, 2020. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools.
RESULTS: Of the 997 articles identified, 31 articles were included in this review. Seven studies targeted students in preschools, seventeen in elementary schools, and seven in high schools. Most of these studies revealed positive outcomes. Some studies showed that the school-based oral health promotion programmes showed better OHK, OHB, OHS, and OHRQoL.
CONCLUSION: Positive results were obtained through oral health promotion programmes in schools, especially those involving children, teachers, and parents.