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=
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.
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.
There are evidences that chronic oral infections are associated with cardiovascular disease (CVD). Periodontal disease is a common, mixed oral infection affecting the supporting structures around the teeth. It was reported that 75% of the adult population has gingivitis and 20% to 30% exhibits the severe destructive form of periodontitis. Although more than 500 bacterial species inhabit the human oral cavity, only a few Gram negative bacteria such as Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola and Actinobacillus actinomycetamcomitans causes gingivitis and periodontitis. These periodontal pathogen occupy the subgingival space and organize as a bacterial biofilm. The bacterial biofilm will be in direct contact with host tissues along an ulcerated epithelial interface, called periodontal pocket. The break in the epithelial integrity directly exposes the host to bacteria and their products eg. lipopolysaccharide (LPS) endotoxin. (Copied from article).
This case report presents a combined surgical – orthodontic approach to the management of an unerupted maxillary right permanent central incisor in a 13 year-old Chinese male. Radiographic investigations revealed that the tooth was severely dilacerated, most likely as a result of trauma sustained to the upper maxillary right deciduous central incisor at the age of 3 years. After securing adequate space for the unerupted tooth by fixed appliance therapy, surgical exposure of the crown was carried out under local anaesthesia and oral sedation.
A gold chain was bonded to the exposed crown of the tooth. Traction was then carried out and the tooth was successfully brought to its final and correct position in the arch after 36 months of active orthodontic treatment.
Gingival overgrowth is a well-recognized unwanted effect associated with three major drugs / drug groups - phenytoin, cyclosporine and the calcium channel blockers. Cyclosporine is the first-choice immunosuppressant for preventing allograft rejection in patients who have received organ or bone marrow transplants. This report aims to highlight a case in which the patient on cyclosporine therapy had also contracted Hepatitis C virus infection.
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.
The tooth provides a non-shedding surface ideal for microbial and plaque accumulation. Despite being exposed to regular environmental perturbations, the microbial composition and proportions in the plaque often remains in homeostasis and is relatively stable over time. Supragingival plaque sampled from various sites on the tooth surface was pooled and conventionally analyzed for its microbial constituent. Classification of microbial isolates was made based on the characteristics exhibited by the growth colonies, Gram-stained cells, as well as biochemical reactions using the API Identification System kit. Observation was also made of the colony forming units on both non-selective and selective agar culture plates. A variety of bacteria, both of the facultative and anaerobic types, were isolated from the supragingival plaque of the Malaysian population. Among those found to predominate the supragingival plaque include the Gram positive and Gram negative cocci and rods from the genera Streptococcus, Staphylococcus, Actinomyces, Fusobacterium, Corynebacterium, Clostridium, Bacteroides, Veilonella and Lactobacillus. In addition, yeast within the genus Candida was also isolated from the plaque samples.
Forensic odontological examination of a disputed bitemark can furnish the police and the prosecutor with useful evidence to either implicate or exonerate a person in relation to a crime, on the basis that each person’s bitemark is as distinctive as his or her dentition. The aims of this article are (a) to evaluate the extent of which bitemark evidence is reliable as a proof of identification of a biter for the purposes of criminal investigation and prosecution in Malaysia and (b) to make the necessary recommendations (if any) for the purpose of improving the reliability of such evidence. Where a questioned bitemark is not sufficiently detailed, any findings made from its examination shall be highly unreliable and prejudicial. On the other hand, where a bitemark is sufficiently detailed, then any findings made from its examination may be reliable, provided that the forensic odontologists and other practitioners in the criminal justice system are professionally trained to handle the said bitemark. Therefore, police officers must be given a basic training in the field of forensic odontology so that they will be able to appreciate the evidential value of bitemark and contribute to the development of bitemark cases in Malaysia. The relevant authorities governing the dental practice in Malaysia should standardize the methodology and terminology used in bitemark examination and in the reporting of its findings so that confusion and inconsistency among the forensic odontologists are kept absolutely low. Finally, forensic odontologists must be given specialized training in bitemark examination so that the probative value of their findings can be improved.
Introduction: Preclinical teaching using simulation is very beneficial in training dental graduates. The use of laboratory simulation for its undergraduate training during the preclinical years has been used in dental education. Purpose: The aim of this study was to evaluate student’s perception, self evaluation and satisfactory level in preparing duralay burn-out post and core in preclinical fixed prosthodontics sessions.
Materials and Methods: The participants comprised of 104 fourth year dental undergraduates in the Faculty of Dentistry Universiti Kebangsaan Malaysia. The students had undergone preclinical session for endodontics during the 3rd year and had already completed root canal treatment on single rooted tooth. The same tooth was used for preclinical post and core preparation. The gutta percha was partially removed and the root canal was prepared. They then proceeded with the preparation of duralay build-up/pattern based on the lecture, video demonstration and manual given. Once completed and satisfied with their work, students were asked to answer the questionnaires in the simulation manual.
Results: Student response rate was 88.46% (92/104). Majority of the students were satisfied with their canal preparation, with about 5mm gutta percha left apically, appropriately shaped canal with sufficient retention and resistance form. They also thought that the surface of the duralay was good with no voids. With regards to the coronal preparation, majority of them incorporated ferrule effect and prepared preliminary crown preparation. More than half of the students claimed the level of difficulty of this procedure was moderate. Furthermore, majority of them said that the lecture and the preclinical manual were sufficient and helpful. The help from the supervisors was also benefit in preparing duralay burnout post and core.
Conclusions: From this study, majority of fourth year dental students could perform appropriate canal preparation as well as duralay pattern post and core. Only one student did not feel competent and confident in doing canal preparation and duralay pattern post and core. Our teaching methods and aids were proven to help them in preparing these tasks.
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.
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).
Certain beverages e.g. coffee, tea, soft drinks, fruit juices, alcoholic beverages, may affect the physical properties of composite resins. Objectives: The objectives of this study were to: (1) evaluate the effect of different beverages and chilli sauce on the wear resistance of composite resins, (2) evaluate effect of the duration of immersion in the beverages and chilli sauce on the wear resistance of composite resins.
Materials and methods: Disc specimens were fabricated using two different types of composite resins: (i) Filtek Z350 (3M ESPE, USA, nano-filled composite, 40 specimens) and (ii) Solare P (GC Dental Products Corp, Japan, microhybrid composite, 40 specimens). After polymerization, all the specimens were polished using Enhance Polishing System (Dentsply International Inc.,USA). The specimens were air-dried before weighing using Sartorius BP 221S weighing balance (Sartorius AG, Goettingen, Germany). Ten specimens from each type of composite were immersed in distilled water (control group), Coca cola®, orange juice (Peel Fresh®) and chilli sauce (Maggi®) respectively. The duration of immersion was 6 hours and 1 week. A reciprocal compression-sliding system was used to evaluate the wear resistance of the specimens. The specimens were moved back and forth with a loaded counter-body (235g) against sand paper (P1000, 3M ESPE, USA) in running water. The weight of the specimens were measured after 6 hours of immersion and 20,000 wear cycles and also at 1 week of immersion with further 20,000 wear cycles. The wear resistances were tabulated as percentage of weight loss from the specimens. Results were statistically analyzed using one way ANOVA and post-hoc Tukey’s test (p= 0.05).
Results: The results showed that Solare P has significantly lower wear resistance compared to Filtek Z350. There was no significant difference in wear resistance for Filtek Z350 when immersed in chili sauce, Coca-cola® and orange juice in comparison with control group for 6 hours and 1 week. Similar findings were observed for Solare P.
Conclusion: Within the limitations of this study, it was concluded that Solare P has poorer wear resistance than Filtek Z350. The soaking medium investigated and duration of immersion have no influence on the wear resistance of Solare P and Filtek Z350.
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.
Radiology is important in the diagnostic assessment, treatment and monitoring progress of patients having dental and maxillofacial diseases. The central question in dental radiology is whether there is any risk with regard to low doses of radiation and what are the necessary protection needed to prevent any hazardous outcome with X-raying. With the emergence of the new millennium, major changes are happening in the field of science and technology. More efficient equipments are being discovered and more researches are being conducted to elicit better understanding of the radiation process and its effect on the human health. This article will review the latest guidelines for proper radiographic practice from the USA and Europe. It will address topics like the risks from dental radiography, selection criteria, protection for patients and staff, improvement to X-ray equipments, room dimensions and lead lining requirements. We have limited our research to intraoral, panoramic and cephalometric radiographs because these are the radiographs or images that are commonly taken in the general practice setting. (Copied from article).
A case report of a 16 year old male oligodontia patient who presented with a Class I malocclusion on a skeletal I base. He had multiple missing teeth of upper lateral incisors and all premolars except for lower right first premolar. Treatment involved fixed appliance with the aid of mini-implants to mesialize posterior teeth in order to reduce the number of prosthodontic replacement of the remaining missing teeth planned for the future. The application of the mini-implants in the sequence of treatment is presented
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.