IIUM Journal of Orofacial and Health Sciences

Oral health care in children with disabilities: A narrative review

2024-03-06T12:21:53+08:00

Children with disabilities face discrepancies in receiving oral health services due to several barriers. This article aims to provide an overview on the oral health status of children with disabilities, impact on Quality of Life of children with disabilities and their family members, approaches in oral health education and/or services, roles of medical/oral health care providers, carers/parents, and special schools/centres, and future aspiration concerning these children. Articles were searched using online databases (Google Scholar, MEDLINE/PubMed) using various terms. Additional articles were searched manually from the reference list of the previously searched articles. Children with disabilities showed a higher prevalence of caries and periodontal disease and had irregular dental visits owing to the limitations encountered by the carers/parents. The psychological and physical health of carers/parents, and the well-being of children with disabilities are interrelated, suggesting the need for a comprehensive support system to address the specific needs of these groups. Oral hygiene care services for these children could be improved using oral health education tools, strengthening dental outreach programs, and/or adopting behaviour modification techniques. Oral health in children with disabilities is a global concern, therefore a holistic approach addressing this problem from the individual to international level, including interprofessional collaboration is imperative.

Tuberculous encephalopathy mimicking limbic encephalitis and large intraparenchymal mass: A case report

2024-03-06T12:21:34+08:00

We report a 17-year-old gentleman presented with acute encephalopathy and neuropsychiatric disturbances. Contrast-enhanced CT and MRI brain revealed bilateral enhancing grey matter lesions involving both basal ganglia with perilesional oedema. The peculiarity of the lesions raising confusions whereby limbic encephalitis and intracranial masses were initially given consideration hence causing a delay in treatment. Tuberculous encephalopathy has different imaging appearances depending on the stage of maturity which will be further discussed here. Definitive treatment for this patient comprises of daily 10-months dose of anti-tuberculous drugs with prompt neurosurgical intervention if required. However, these should be delivered at a timely fashion to improve the outcome for both survival and neurological sequelae.

Upper tract transitional cell carcinoma: An array of imaging conundrum

2024-03-06T12:21:46+08:00

We report a 38-year-old gentleman who presented with painless haematuria for 6-months duration. Contrast-enhanced CT renal revealed a large, calcified intrapelvic mass with calyceal extension confined within the right kidney with moderate pelvicalyceal dilatation but no evidence of synchronous lesion elsewhere. Histopathological analysis showed high grade urothelial carcinoma of the renal pelvis with invasion of renal parenchyma. Upper tract urothelial carcinoma (UTUC) which was once thought similar to urothelial carcinoma of the bladder (UCB), is increasingly being recognized as a different entity. However, heterogenous array of imaging manifestations of UTUC is also increasingly being encountered and pose diagnostic challenges though UTUC is not as prevalent as UCB which is easier to diagnose. Despite distinctive features against renal cell carcinoma (RCC), UTUC may mimic numerous other renal pathologies especially the benign ones hence imaging plays a pivotal role in ascertaining the diagnosis. This disease is usually treated with radical nephroureterectomy with superadded neoadjuvant chemotherapy for high-risk cases. Less invasive endoscopic resection is also offered in certain cases but stringent surveillance of the whole urinary tract as well as post-operative follow-up are mandatory.

Five parapremolars in a non-syndromic patient: A case report

2024-03-06T12:21:38+08:00

Supernumerary teeth or hyperdontia are additional or an excessive number of teeth present in normal deciduous or permanent dentition. The prevalence of supernumerary teeth is between 0.1 and 3.8% in permanent dentition and between 0.3 and 0.8% in deciduous dentition. In Sabah, the prevalence of supernumerary teeth is 10.32% among orthodontic patients. The condition is more common in male patients. A case report involved a fit and healthy 19-year-old male student who presented with multiple supernumeraries. Upon clinical examination, there were three erupted supernumeraries on the bilateral mandibular premolar region, and additional two impacted supernumeraries being discovered after further radiographic investigation. This anomaly was found during an annual dental school checkup program. The patient had congenital absence of the lower left third molar. Primary dental care was carried out such as filling for carious teeth, scaling, oral hygiene reinforcement and regular monitoring. The patient declined any other dental treatment options such as extraction of the non-functioning supernumerary parapremolar teeth, or orthodontic treatment to improve his malocclusion. Currently, the patient is under oral hygiene maintenance with regular dental follow-ups. In a nutshell, the importance of regular dental follow-ups and review is crucial to monitor any signs and symptoms of pathology such as cystic formation of unerupted supernumeraries. Reinforcement of oral hygiene and caries risk assessment should be carried out during reviews to improve and maintain the patient’s quality of life.

Normality tests for statistical analysis in dentistry: A brief notes for researcher

2024-03-06T12:21:24+08:00

The awareness and perception of teledentistry among Malaysian dental professionals in universities and private practices

2024-03-06T12:21:49+08:00

The unexpected outbreak of COVID-19 has caused the temporary collapse and suspension of dental practices around the world. With the emergence of teledentistry, this incident unwittingly pushes for a revolutionary modification in the usual provision of dental care. The purpose of the study was to determine the level of awareness and perception of teledentistry among university and private-sector dental practitioners. This descriptive cross-sectional study used a pre-validated 27-item questionnaire with a 5-point Likert scale to assess the perceptions of university-based and private dental practitioners regarding teledentistry in four domains: the usefulness of teledentistry for patients, its benefits to dental practices, the potential improvements it can bring to dental practices, and concerns about the adverse effects of teledentistry. 150 dental practitioners participated in the research (30% overall response rate). More than 70% of respondents agreed that teledentistry can benefit both dentists and patients by improving communication and treatment monitoring. However, 45–80% of dentists had doubts regarding the technology's dependability, diagnostic accuracy, and patient data privacy. In conclusion, the results of this study suggest that Malaysian dentists are well-informed and prepared to implement teledentistry in their practices. However, additional research is necessary to determine the viability of commercial usage of teledentistry, both in Malaysia and internationally.

Comparative evaluation of remineralization efficacy of ELSENZ and SHY-XT toothpastes on initial enamel lesions: A scanning electron microscopic study

2024-03-06T12:21:56+08:00

The present study was done to evaluate the remineralization potential of two different commercially available toothpaste, namely, ELSENZ and SHY-XT on initial enamel white spot lesion using Scanning Electron Microscope (SEM). The objective of this study is to evaluate and compare the remineralization efficacy of ELSENZ and SHY-XT toothpaste on initial enamel white spot lesion. This study included a total 12 samples of extracted human permanent anterior teeth that were collected from the Oral and Maxillofacial Department in College of Dental Science Amargadh, Bhavnagar, Gujarat. All samples were equally divided in three groups. In group 1, remineralization was done by ELSENZ (fluoro-calcium phosphosilicate) toothpaste, and in group 2, remineralization was done by SHY-XT (nano–hydroxyapatite and fluoride) toothpaste and group 3 was taken as control group in which deionized water was used. At the end of 12 days, pH cycling procedure, remineralization for all the samples were analysed by the scanning electron microscope. Statistical analysis was done by One Way Analysis of Variance to check the difference between the groups and Post hoc analysis was done by Tukey’s test. The result showed that the maximum remineralization occurred in ELSENZ toothpaste group (P<0.00) followed by SHY-XT toothpaste group (P<0.50) and deionized water showed least remineralization potential (P<2.00). From the result of the study, we concluded that ELSENZ toothpaste has more remineralization potential on initial enamel white spot lesion as compared to SHY-XT toothpaste.

The reasons for seeking dental services from unqualified operators: A qualitative study

2024-03-06T12:21:43+08:00

Dental services are widely available in Malaysia, but individuals are continuously reported seeking the services of non-dentist. This study was aimed at exploring the reasons for seeking dental services by individuals from unqualified operators. A qualitative study was carried out and recruited individuals who sought dental treatment from the operators. The participants were identified from the operators’ online advertisement, social media and using a snowball sampling method. Interviews were conducted face-to-face and through online meetings and recorded digitally. Structured, open-ended, and probing questions were asked using a list of topical guided questions. The recordings were transcribed, and thematic analysis was carried out using Atlas.ti Version 9. The eight participants included in this study had fitted orthodontic appliances and dental veneers, and tooth whitening services done by unqualified operators. The reasons were classified into two main themes. The dental aesthetic reasons are related to the dissatisfaction with teeth presentation including malocclusion, dental spacing and teeth whitening. The theme of non-dental related reasons is categorised into four subthemes: following the trend, cost of services, naïve and access to services. The reasons for seeking dental services from unqualified operators are multifactorial. Individuals who seek services from unqualified operators have a valid need for treatment, but their decision is strongly influenced by non-dental reasons, of which the high cost of treatment at private dental clinics and being naïve about dental services are likely the most important. More public campaigns should be done to educate and raise awareness on the issue to the public.

Distribution of cases encountered in Oral Medicine Undergraduate Clinic: A retrospective analysis

2024-03-06T12:21:40+08:00

Oral medicine (OM) is a dental specialty concerning the diagnosis and non-surgical management of oral conditions closely related to medical disorders. This study aims to evaluate the distribution of OM cases at the International Islamic University Malaysia (IIUM) undergraduate dental polyclinic and to determine its relationship with sociodemographic background via disease category. Students’ OM logbooks across four academic years were used for convenient sampling. Disease categories were based on previously published studies. Total cases were classified into 22 diagnosis codes and analysed using SPSS version 23. A total of 1917 cases were recorded at the undergraduate dental polyclinic across four academic batches, from year 2010 until 2018. OM case with highest frequency was oral ulcer (31%), followed by temporomandibular disorder (23%), and pericoronitis (10%). In contrast, the least common cases were lichen planus (0.4%), oral potentially malignant disease (0.3%), and tumour (0.2%). With regards to age group, second decade age group was reported the most across the observation period. OM cases were higher in females across most disease categories and Malays were the highest ethnicity reported. The current study identified the most common OM cases encountered in IIUM undergraduate dental polyclinic. The findings may portray the disease burden in the Kuantan population in general. Knowledge of common cases is crucial to prepare clinicians with safe and competent management required in clinical practice.

Utilisation trends and oral health-related quality of life among patients attending Visiting Dental Services in Selangor

2024-03-06T12:21:28+08:00

This study aimed to assess utilisation trends and oral health-related quality of life (OHRQoL) among patients attending Visiting Dental Service (VDS) in Selangor, Malaysia. This two-phased study involved a secondary analysis of data from the Selangor VDS's (seventeen VDSs) patient database (2017 to 2019) and a cross-sectional survey among patients from twelve VDSs. A self-administered questionnaire that consisted of a validated Short Oral Health Impact Profile (S-OHIP) scale was used. The S-OHIP score for each participant was calculated using Additive Scores (ADD) that range from being the "least affected" with a score of 0 to the "most affected" with a score of 56. Statistical analysis was done using a t-test and one-way ANOVA, with the statistical significance set at p=0.05. This study found that the adult group and Malay ethnicity recorded the highest attendance from 2017 to 2019. Extraction of permanent teeth was the most frequently provided treatment from 2017 to 2019 (70.2%, 67.6%, 61.2%). A total of 124 respondents from twelve VDSs completed the survey. The mean age was 32.72 ± 9.75 years old. The respondents' mean total score of S-OHIP was 9.69 ± 7.64 and significantly differed by gender (p=0.007). The S-OHIP dimension that mainly affected the respondents was psychological discomfort due to 'food stuck' (18.5%). VDS utilisation trends in Selangor increased from 2017 to 2019, with dental extraction being the treatment in demand. The OHRQoL of patients attending the VDSs was encouraging despite the less-than-ideal condition, highlighting the urgent need for a more permanent solution to VDS.

Cultivating dental excellence: Advancing dental education in Malaysian higher institutions

2024-03-06T12:21:31+08:00