Norintan Ab-Murat

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence

BackgroundThe urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community.MethodsA random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997).ResultsThe overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard.ConclusionsThe evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group.

Treatment needs and skill mix workforce requirements for prosthodontic care: a comparison of estimates using normative and sociodental approaches

BackgroundThe traditional measure for assessing dental treatment needs and workforce requirements based solely on normative need (NN) has major shortcomings. The sociodental approach (SDA) to assess needs overcomes some of the shortcomings as it combines normative and subjective needs assessments and also incorporates behavioural propensity (Sheiham and Tsakos 2007).The objective of this study was to estimate and compare prosthodontic treatment needs and workforce requirements, using the normative and the sociodental approaches for different skill mix models.MethodsA cross-sectional study was conducted on 732 university employees aged 30–54 years. Normative prosthodontic need was assessed using the WHO (1997) method. The SDA includes NN and also considers oral impacts, measured through the OIDP index, and behavioural propensity. Estimates of prosthodontic need and dental workforce requirements using the two methods were compared using McNemar and Wilcoxon Signed Rank test respectively. The dental workforce required for prosthodontic treatment based on NN and SDA approaches were then compared using different workforce skill mix models.ResultsThe proportion of subjects needing prosthodontic treatment was lower by more than 90% when the SDA was used compared to NN. The number of dentists required for prosthodontic treatment per 100,000 people were 98.8 using NN compared to 2.49 using SDA. Using a skill mix approach, the requirements for dentists per 100,000 people decreased slightly when more denture procedures were delegated to dental therapists.ConclusionThere were very much lower levels of prosthodontic treatment needs and workforce requirements when using the sociodental approach compared to normative methods.

The impact of anticipatory guidance on early childhood caries: a quasi-experimental study

BackgroundThis study evaluated the impact of anticipatory guidance on the caries incidence of 2–3-year-old preschool children and their 4–6-year-old siblings, as well as on their mothers’ oral health literacy, as compared to the conventional Ministry of Health (MOH) programme.MethodsThis quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother’s oral health literacy was assessed after 3 years of intervention.ResultsChildren and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2–3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p < 0.05). At three-year follow-up, there were significant increments in the oral health literacy scores of mothers in the intervention group compared to the control group.ConclusionThe FDWP is more effective than the standard MOH programme in terms of children’s and siblings’ caries incidence and mother’s oral health literacy.Trial registrationClinicalTrials.gov NCT03478748. Registered on March 26th 2018. Retrospectively registered.

Correlation between numbers of cells in human dental pulp and age: Implications for age estimation

OBJECTIVE The aim of this study was to investigate correlations between dental pulp cell count of odontoblasts, subodontoblasts and fibroblasts and age, within different age groups. Formulation of regression equations using the dental pulp cell count for predicting age was attempted. DESIGN Eighty-one extracted teeth were grouped into two age groups (6-25 years, 26-80 years). The teeth were demineralized and histological sections were prepared for cell count. Regression equations were generated from regression analysis of cell count and tested for age estimation. RESULTS The number of dental pulp cells were found to increase until around the third decade of life and following this, the odontoblasts and subodontoblasts cell numbers began to decline while the fibroblasts seemed to remain almost stationary. The Pearson correlation test revealed a significant positive correlation between the cell number for all type of cells and age in the 6-25 years group (r=+0.791 for odontoblasts, r=+0.600 for subodontoblasts and r=+0.680 for fibroblasts). In the 26-80 years age group, a significant negative correlation of the odontoblasts (r=-0.777) and subodontoblasts (r=-0.715) with age was observed but for fibroblasts, the correlation value was negligible (r=-0.165). Regression equations generated using odontoblasts and subodontoblasts cell number were applicable for age estimation. The standard error of estimates (SEEs) were around±5years for 6-25 years and±8years for 26-80 years age groups. The mean values of the estimated and chronological ages were not significantly different. CONCLUSIONS A significant correlation between the cell count of odontoblasts and subodontoblasts with age was demonstrated. Regression equations using odontoblasts and subodontoblasts cell number can be used to predict age with some limitations.

Self-perceived mental well-being amongst Malaysian dentists

Purpose. To assess Malaysian dentists’ perceptions of their mental well-being. Methods. A self-administered questionnaire was developed based on a conceptual framework of mental health and well-being model. Two aspects were assessed, namely the physiological (two domains) and the psychological (six domains). Participants were asked to rate their experiences of the aforementioned aspects using a 5-point Likert scale ranging from all the time to never. Results. The response rate was 81%. Most of the dentists (61.7%) perceived having positive mental well-being. Under the physiological aspect, most respondents reported that they were ‘generally happy’ (93.3%), but about 30% stated they were ‘stressed physically and emotionally’. Of the six domains under the psychological aspect, positive well-being was observed in the ‘sense of coherence’ and ‘behavioural stress’ domains. Participants who were above 40 years old, married and had children reported having a more positive mental well-being when compared with their counterparts. Conclusion. Overall, most Malaysian dentists perceived having a positive mental well-being. It is crucial, however, to closely monitor and initiate early interventions for those with negative symptoms to ensure the safe practice of dentistry.

Caries risk assessment in school children using reduced cariogram model

Objective: To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children. Methods: Subjects’ caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a three-day diet diary. Results: A total of 226 children participated in this study, giving a response rate of 75%. Most subjects (39.8%) were in the low risk category with DMFT score of 0. The overall mean DMFT score was 1.49 (±0.63). Linear and multiple regressions were performed to evaluate the predictability of caries risk. Previous experience of dental caries was found to be the most relevant predictor of caries risk (40%). Conclusion: The levels of caries risk amongst Pakistani 11-12 year old school children were generally low. Past caries experience was the most significant factor in predicting future caries lesion in this sample population.