The prevalence of tooth loss amongst the elderly is generally very high. Hence mastication and subsequently nutrition is greatly affected leading to the impairment of their general health. Therefore denture construction is an important aspect in the rehabilitation of the oral and general health in most elderlies. However, poorly constructed dentures and lack of maintenance coupled with various other health and healthrelated problems of the elderly, for instance poor general health especially with immunocompromised states, multiple medication intake, xerostomia, reduced mobility, economic status, mental state and ignorance may all lead to discomfort and denture associated lesions in these elderly patients. No regional studies or data on denture-related lesions in the general population have been reported. Previous epidemiological studies of adults in Malaysia (1,2) and other local studies have not investigated lesions of the oral tissues associated with geriatric denture wearers although studies in developed countries, where prevalence of denture usage is high, have noted that denture-related lesions to be the most common group of oral mucosal lesions in the elderly (3-7). As has been reported in most developing countries, the proportion of elderly in Malaysia is also increasing. It has also been noted that the mean number of teeth present decreases as age increases; in those between 15 to 19 years, all 28 teeth are present, 35 to 44 years-old have 23 teeth whereas those above 65 years retain only 12 teeth. Edentulousness increases from 0% to 7.3% to 56.6% in these age groups respectively (2). It is anticipated that with the increasing population of the elderly in Malaysia and the improving economy, the proportion of denture wearers in the population will increase. In view of the lack of investigations in Malaysia focusing exclusively on this group of lesions, it is therefore the aim of this pilot investigation to highlight the prevalence of denture- related lesions in a representative population of the elderly living in the community, both in the urban and rural areas. It may also form a basis against which future studies can be compared.
This study was conducted on Royal Malaysian Navy submariners who were having training in France. It was designed to compare the oral health experiences and practices while under water and on land. Methods Eightysix Royal Malaysian Navy (RMN) submariners, who had undergone at least one cycle (288 hours) of under water training, were selected to participate in a self-administered questionnaire survey. Results Seven percent of the respondents reported oro-facial pain and discomfort; 9.3% reported bleeding gums and 12.8% experienced halitosis while under water. Of those experience oral problems, 82% reported disruption of their daily activities while under water. The study showed that 82.5% of them brush their teeth at least twice a day and 94.2% rinse after meals when there were under water. Meanwhile studies on land showed that 90.7% of them brush their teeth at least twice a day and 96.5% rinse after meals. Flossing was not practiced by most of the respondents. Conclusion It is concluded that brushing and rinsing are practiced regularly by submariners regardless whether they are on land or under water but flossing is not a common practice both on land and under water. Dental emergencies, such as toothache, TMJ pain and discomfort do occur during submarine operations and disrupt their daily activities. This might poses a threat to submarine operations.
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%.
The objective of this study is to share cost analysis methodology and to obtain cost estimates for posterior restorations in public sector dental clinics. Two urban and 2 rural dental clinics in Selangor state were selected. Only cases of 1 posterior restoration per visit by dental officers were included over 6 months. One capsulated amalgam type, 1 capsulated tooth-colored, and 1 non-capsulated tooth-colored material were selected. A clinical pathway form was formulated to collect data per patient. Annual capital and recurrent expenditures were collected per clinic. The mean cost of an amalgam restoration was RM 30.96 (sdRM 7.86); and tooth-colored restorations ranged from RM 33.00 (sdRM 8.43) to RM 41.10 (sdRM 10.61). Wherein 1 USD = RM 2.8. Restoration costs were 35% to 55% higher in clinics in rural areas than in urban areas. The findings demonstrate economy of scale for clinic operation and restoration costs with higher patient load. Costs per restoration were higher in rural than in urban dental clinics. More studies are recommended to address the dearth of dental costs data in Malaysia.
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.
Identification of diagnostic markers for early detection and development of novel and therapeutic agents for effective patient management are the main motivation for cancer research. Biological specimens from large cohort and case-control studies which are crucial in providing successful research outcomes are often the limiting factor that hinders research efforts, especially in developing countries. Therefore, the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS) were established to systematically collect large number of samples with comprehensive sociodemographic, clinicopathological, management strategies, quality of life and associated patient follow-up data to facilitate oral cancer research in Malaysia. The MOCDTBS also promotes sharing among researchers and the development of a multidisciplinary research team. The following article aims to describe the process of setting-up and managing the MOCDTBS.
The role of diet in cancer risk has mainly been investigated based on intake of individual food items. However, food consumption is made up of a combination of various food items. This study aims to determine the association of dietary patterns with oral cancer risk.