The objective of this survey was to understand the current trend of readership of professional dental journals among Malaysian dentists. A total of 225 questionnaires were sent out to Malaysian dentists who attended various dental related conferences throughout Peninsular Malaysia from February 2006 to July 2006. Questionnaires comprised of questions relating to dentists’ socio-demographic status and a list of journal(s) read by them. Malaysian dentists’ view on the content and quality of a particular dental journal, i.e. the Malaysian Dental Journal (MDJ) was also enquired. The details of this finding are highlighted in Part II of this study. A total of 156 questionnaires were returned; the respondents were made up of 61 male and 91 female dentists. Almost 80% of the respondents aged between 20-49 year-old and most respondents (n= 132; 84.62%) only had a basic Bachelor of Dental Surgery or equivalent degree while another 19 (12.18%) had in addition, a post-graduate degree. Almost equal numbers of respondents were working in the Ministry of Health (MOH) or Armed Force (n=73; 46.8%) and private practice (n=74; 47.4%). Also, equal number of respondents (n=67; 42.95%) were found to be working as single-handed practitioner and in a partnership/assistant/working-with-other specialties type of practice Almost two-thirds (n=103; 66%) of the respondents read more than one professional journal, and a majority of them worked in the private sector. The percentage of readers reading more than one journal from the private practice (n=67, 60.0%) was close to twice of that from the MOH (n=36, 35.0%). No specific age-group pattern was present but the least number of subscribers were from those 60 year-old and above (n=3), whereby none of them subscribed to any professional dental journal/magazine. The highest percentage of subscribers were from those in the age group of 40-49 year-old, whereby 86.49% (n=32) of dentists in this age-group subscribed to at least one professional dental journal/magazine. Out of the list of journals/magazines provided, it was found that the MDJ has the most number of readers. The MDJ was most read by dentists in the private practice while the Annals of Dentistry of the University of Malaya was most read by dentists in the MOH. In conclusion, it was found that almost two-third of the respondents read more than one professional journal, with the MDJ receiving the most number of readers. More dentists in the private practice read professional dental journals than dentists in the MOH.
The objective of this part of the study was to understand the current trend on readership of the Malaysian Dental Journal (MDJ) among Malaysian dentists. Their views on the contents and quality of the Malaysian Dental Journal were enquired. We also enquired the reasons they chose-to/chose-not-to read the MDJ. Of the 225 dentists surveyed, the number of MDJ readers was 101; with only 24.75% reading all issues published. The editorial section was rated as “useful” by 70.3% of readers, while 79.2%, 87.1%, 87.1% and 80.2% of readers rated the research article section, the review article section, the case reports section and book recommendation section similarly respectively. Feedback from readers indicated that they wanted more case reports, more review articles on “how to do it” and on medical problems in dentistry. More than half (55.45%) of the MDJ readers preferred to receive the journal in both hard and soft copies. For the non-readers, the most common reasons cited for not reading the MDJ was not being able to access to the journal, followed by not having time to read. Our finding suggested that the respondents preferred to learn from colleagues’ experience and to read article that can improve their clinical knowledge and skill.
This clinical case report describes an aspect of restorative management of worn teeth. It illustrates the use of diagnostic overlay removable partial denture or DORPD, which has the same function as occlusal splint but with advantages of providing immediate aesthetic improvement and function.
The objective of this study is to report the occurrence, demographic and clinical findings of lip mucoceles in children. A restrospective study was conducted at the paediatric dental clinic situated at Hospital Sultanah Aminah, Johor Bahru. The period of study was 3 years beginning 2003 to 2005. Out of 1407 new cases seen over the period of study 17 (1.2%) patients presented with lip mucoceles. All lesions occurred in the lower lip. There was no sex or racial predilection. The average duration of the lesion prior to seeking treatment was 2.8 ± 2.8 months. Most patients (76.5%) first saw a medical practitioner for the problem. No spontaneous resolution of the lesions in any of the patients was noted. The preferred method of treatment of lower lip mucoceles in children is surgical excision of the involved minor salivary glands. Salivary gland mucoceles in children predominantly involve the lower lip and can be treated successfully by complete removal of the involved and associated minor salivary glands.
Actinobacillus actinomycetemcomitans is considered a major pathogen in periodontal disease. The aim of this study was to determine the prevalence of A. actinomycetemcomitans from 46 subjects aged 20-24 years old of who were all periodontally healthy Malays.
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.
Deviations from normal occlusion are known as malocclusion. Orthodontics treatment usually is the choice of management of irregularities and abnormalities of their relation to the surrounding structures i.e malocclusions. Patient or parent commonly seeks orthodontic treatment for aesthetic reasons rather than functional problems such as temporomandibular joint dysfunction. With greater demand for orthodontic treatment due to greater awareness of the people towards dental health, good orthodontic treatment outcome would be expected. Good orthodontic treatment outcome usually related to good clinical management of the patients. (Copied from article).
Quality radiographs of diagnostic value are important in root canal treatment. The dentist who has knowledge and skills in the use of radiographs for diagnostic purposes has a professional responsibility to ensure that the radiographs are obtained with minimum risk of radiation dose to and for the benefit of the patient. This article reviews the effectiveness of radiography techniques required for successful root canal treatment with the patient’s interest in mind. Awareness of effectual radiographic techniques, their constraints and applicable techniques for improvements are discussed. It seeks to reduce potentially harmful ionising radiation dose to patients and optimise the use of X-rays to produce diagnostic radiographs during root canal treatment.
An audit of broken/lost removable appliances was carried out. This study aimed to measure the occurrence of broken/lost appliances over a period of 6 months. It also assessed whether there was any difference in the occurrence rate between patients who paid for treatment and those who received it free of charge. The results indicated that the total number of broken/lost removable appliances was 183, from a total of 472 appliances issued. For paying patients, 59 of 177 patients had at least one broken/lost appliance, giving an occurrence rate of 33.3%. For nonpaying patients, 60 of 112 patients had at least one broken/lost appliance, giving an occurrence rate of 53.6%.
Squamous cell carcinoma (SCC) is the commonest cancer in the mouth. Multiple risk factors, such as smoking, alcohol consumption, irradiation, viruses infection and chronic irritation are thought to be responsible for the formation of oral squamous cell carcinoma. Although SCC can develop through a series of precancerous stages manifested as various degrees of epithelial dysplasia, this is not always the case. p53 is the commonest mutated gene in human cancers. Mis-sense mutation of the gene or complexing of the protein with viral or cellular proteins prolongs its half-life and leads to its detection by immunohistochemistry. This study was designed with the aim of demonstrating any possible relationship between p53 and oral squamous cell carcinoma by immunohistochemical staining techniques. A total of 66 specimens from the oral cavity (10 normal mucosa, 11 hyperkeratosis without dysplasia, 11 mild dysplasia, 11 moderate dysplasia, 10 severe dysplasia and 13 SCC) were examined for the presence of p53. The results show p53 was not expressed in normal mucosa, but was found with increasing frequency in increasingly severe dysplasia and SCC. In conclusion, this study shows p53 mutation is common in oral squamous cell carcinoma and probably occurs early in the multisteps of oral carcinogenesis.
A review of incident oral and maxillofacial biopsies in Kelantan from January 1994 to December 1998 was carried out to evaluate the scope of pathological lesions managed by the two main oral and maxillofacial units in this state. A total of 357 biopsy reports from incident cases of pathological lesions were reviewed. The biopsies were mainly from intra-oral sites (n=326, 91.3%). Females had more frequent oro-facial lesions compared with males (male:female ratio is 0.8:1). The Bumiputera ethnic group had the most number of biopsies (n=321; 90%). The three most commonly observed histopathological groups were the connective tissue hyperplasia (n=90; 25.2%), epithelial dysplasia and neoplasia (n=68; 19%) and salivary gland cysts/mucocele (n=56; 15.7%). The top five most frequent diagnoses were mucocele (n=56; 15.7%), squamous cell carcinoma (n=45; 12.6%), epulides (n=31; 8.7%), pyogenic granuloma (n=25; 7.0%) and fibroepithelial polyp (n=19; 5.3%). Oro-facial malignancies made up almost one-fifth of all diagnoses and squamous cell carcinoma was the most common sub-type. Lymphomas in the oro-facial region (n=8; 11.4%) were more common than basal cell carcinoma (n=7; 10%) and salivary gland malignancies (n=6; 8.5%). Epithelial jaw cysts consisted of 8.7% (n=31) of all diagnoses, where inflammatory types were more common than the developmental types. Odontogenic tumours consisted of 5.6% (n=20) of all diagnoses and ameloblastoma was the predominant type.
Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.
Abscess of the periodontium is a localized purulent inflammation of the periodontal tissues1. It has been classified into three categories which are gingival abscess, periodontal abscess and pericoronal abscess. A periodontal abscess can be defined as a localized purulent infection affecting the tissues surrounding a periodontal pocket that can lead to the destruction of supporting structures4 including tortuous periodontal pockets, furcation involvement, and intrabony defects. The lesion may be acute or chronic abscess. A localized acute abscess may progress to a chronic abscess if the pus drains through a fistula into the outer gingival surface or into the periodontal pocket. (Copied from article).
The aim of present study was to determine if the radiological features noticed on dental panoramic radiographs can ascertain the different variants of ameloblastomas. Methods: A total number of 177 cases of ameloblastoma diagnosed in 5 centers in Malaysia were reviewed. The clinical records of these cases were analyzed with respect to age, sex, ethnicity, diagnosis of the lesions, anatomic site, size, side, year of diagnosis, status of the lesion, and characteristics of the lesions. Detailed radiographic features such as septation, calcification, effect on adjacent structures, periosteal reactions, demarcation and cortication of the border of the lesions were recorded. Results: The unicystic, plexiform and acanthomatous ameloblastomas tend to have unilocular radiolucencies as opposed to the follicular ameloblastoma, which demonstrated commonly multilocular radiolucency with soap-bubble appearance. The well-demarcated borders with thin condensed sclerotic border of the lesions appeared to be more significant in unicystic ameloblastoms. Moderately and poorly demarcated lesions are commonly found in follicular and acanthomatous ameloblastomas. Multiplanar pattern of root resorptions, protrusion of roots into lesions and cortical expansions with intact visible margins are commonly seen in ameloblastomas. Conclusion: The various histopathological patterns are not closely related to any specific radiological appearances in the jaws and there seems to be no direct or obvious correlation between the histopathological patterns of the tumours and the radiological appearance of ameloblastomas.
The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
Collaborative learning: a peer group teaching in oral hygiene instructions activity
Introduction: The objectives of this survey were to investigate whether an oral health education activity through collaborative learning and peer group teaching by students would give a positive impact and to evaluate its effectiveness, sufficiency and relevancy of the activity content.
Methods: Three third year dental students in each group were assigned to demonstrate to their group mates the myriad of oral hygiene device for plaque removal and how they are used. Fifteen students were appointed each as a ‘toothbrushing specialist’, ‘flossing specialist’ and interdental toothbrush specialist’ respectively. The others acted as participants in the group. The students then teach each other in the group on how to use these oral hygiene measures. A self-administered questionnaire assessing the activity outcome was given to fifty-two third year dental students who attended the demonstration. The data were entered in the computer using the SPSS version 12.0 for analysis.
Results: Overall response rate was 100%. Slightly more than half of the students felt confident to teach their patients effective toothbrushing and flossing and able to indicate the usage of interdental toothbrush. Most of the students preferred a small group teaching rather than a larger one. The result shows that student’s knowledge, attitudes and practices on effective oral hygiene has gained.
Conclusion: Collaborative learning in the clinical environment appears to give positive impact on the dental student’s ability to impart oral health education to their patients.
The aim of the study was to assess the potential role of dentists as smoking cessation counsellors in their practice. The target group comprised of all public and private sector dentists in the Federal Territory of Kuala Lumpur (FTKL) and Selangor. Data were collected via a twenty-six item questionnaire which was mailed to 831 dentists. A response rate of 67.1% was obtained. Results revealed that the majority of the respondents (97.8%) perceived that in addition to providing oral care, dentists should also be interested in their patients’ general health. Generally, about two-thirds of dentists (69.1%) and especially those from the public sector (76.4%) considered that they have an important role to play as smoking cessation counsellors. However, less than half of the respondents (40.3%) perceived that patients do not expect smoking cessation advice from their dentists. Yet, more than half of the respondents (55.1%) provided advice or helpful hints in order to motivate their patients to quit smoking. About 65% of the overall respondents did explain to their patients regarding the health risk due to smoking and its detrimental effects. Perceived obstacles to smoking cessation include lack of information between dentistry and smoking cessation (86.1%) followed by lack of training and lack of time.
The general aim of this study was to examine the patients’ perception of dental extractions. The specific objectives were to understand the purpose of extractions from the patients’ point of view, to find out the relationship between age and type of teeth extracted and to compare the patients’ perceptions with clinical indications for dental extraction. The survey was done using self administered, structured questionnaires to collect information. From the survey we found that toothache (33%) and the presence of cavities (34%) were the main reasons for extraction from the patients’ point of view. Besides that, the number of patients requiring extractions decreased with age. The main clinical indication for tooth extraction was caries (73%) and of these, 29% of restorable teeth were extracted.
Cancer causes approximately 12% of all deaths throughout the world and is the third leading cause of death in developing countries. In Malaysia, Indians have the highest incidence of mouth cancer compared to other races, and females are more affected compared to males.
Objective: The main objective of this study was to analyze the cases of oral cancer treated in the dental department of Penang hospital, Malaysia and to determine the risk factors associated with oral cancer.
Methodology: We reviewed the medical reports of all the patients with oral cancer treated in the dental department of Penang General Hospital from 1994 to 2004.
Results: There were 46 cases of oral cancer treated by the dental department of Penang General Hospital during this time period. 22 were males and 24 females. The mean age of the patients was 61.2 years old. Indians comprised the majority of the cases (n=23; 50%) followed by Malays (n=12; 26.1%) and Chinese (n=11; 23.9%). Of these cases, 54.3% (n=25) had used quid, 39.1% (n=18) smoked cigarettes and 32.6% (n=15) consumed alcohol. Indians made up 76% (n=19) of all quid users (p=
The assessment of pulp vitality is a crucial diagnostic procedure in the practice of endodontics. Dentists should establish their treatment decisions based on good sound information and in the best interests of the patients. Therefore, a definite diagnosis must be established with comprehensive investigation and records before any treatment is carried out1. Since the dental pulp is enclosed in an opaque tooth, the assessment of tooth vitality is undertaken indirectly by: looking for clinical or radiological evidence of pulp necrosis or apical periodontitis; investigating nerve conduction; or examining the blood flow. (Copied from article).