Awareness, knowledge, attitudes and practices on the management of diabetes mellitus patients with periodontitis amongst Malaysian primary care practitioners

@#Introduction: The bi-directional relationship between periodontitis (PD) and diabetes mellitus (DM) has been confirmed. Medical practitioners (MPs) serve an important role in relaying this information to patients. This study aimed to investigate the awareness, knowledge, attitudes and practices (KAP) in the management of DM patients with PD in primary care clinics under the Ministry of Health (MOH) of Malaysia. Methods: A self-administered questionnaire on KAP in the management of DM patients with PD was posted to 725 medical officers (MOs) and family medicine specialists (FMSs) in MOH clinics in Kedah, Terengganu, Johor and Negeri Sembilan. Collected data were tabulated and analysed using descriptive and regression analyses (simple and multiple). Statistical significance was defined as p < 0.05. Results: A total of 549 MPs responded. The majority of MPs were MOs (92.6%) and female (75.8%). FMSs had a greater awareness of PD when compared to MOs (p = 0.002). All MPs had good knowledge, except for the incorrect notion that excessive sugar causes PD (94.3%). Overall, FMSs had better knowledge when compared to MOs (p=0.026). The majority of MPs agreed that ‘they should update their knowledge on the association between systemic disease and PD’ (89.6%) and claimed that ‘it was not their responsibility to examine DM patients for PD’ (83.1%). Most MPs did not enquire or examine for PD in their DM patients. More FMSs (67.5%) referred patients to dentists compared to MOs (31.6%). Conclusion: Most MPs have sufficient knowledge on PD, but a negative attitude in the management of PD in DM patients. The reasons for not referring included workload and patients refusing referral.

Influence of Scaler Tip Design on Intensity of Pain and Discomfort During Scaling

@#To evaluate patient’s subjective preferences to scaling with narrow probe-shaped EMS Perio Slim PS tips compared to conventional tip based on pain perception using the Visual Analogue Scale (VAS). Ten patients were treated using a piezoelectric ultrasonic device (EMS) and two different scaler tips representing a conventional scaler tip and a Perio Slim PS scaler tip in a split-mouth design. Pain was evaluated after 2 minutes scaling using Visual Analogue Scale (VAS). Data obtained was analysed by SPSS version 19.0 using Wilcoxon test. Pain assessment after treatment confirmed by the Visual Analogue Scale (VAS) showed that the Perio Slim PS scaler tip (maximum pain score: 4, minimum: 2) caused less pain than the conventional scaler tip (maximum: 8, minimum: 3) (p-value = 0.007). Using Perio Slim PS scaler tip caused less pain and discomfort during scaling treatment when compared with conventional scaler tip. Acrylic resin is commonly used to fabricate removable prostheses due to its adequate physical, mechanical properties and cost effectiveness. There has been continuous development of the materials to improve their properties and to widen its application in different clinical setting. To study the history development of the acrylic resin and elaborate on the properties of different types and the processing methods of acrylic resins used to fabricate denture base which are commercially available in the market. This would help the dental clinician in choosing the best material of choice. The authors have summarized the history, development and classification of different type of acrylic resins used in fabricating denture and processing methods based on all the published research available on this topic using published materials available in the Dental Library, University of Malaya and the database (Science Direct, PubMed). Every type of acrylic denture base material has its pros and cons. Therefore, careful selection of material and the processing method is crucial to ensure the best outcome for prosthodontic treatment. Hence, upholding the patients’ best interest and improving their quality of life.

Clinical outcomes and predictors of satisfaction in patients with improved lithium disilicate all-ceramic crowns

Objectives: The aim of this study was to determine the clinical outcomes and predictors of satisfaction in patients with lithium disilicate [LD] ceramic crowns

Subjects and Methods: Clinical outcomes were assessed in 47 patients with 88 LD crowns using modified United States Public Health Service [USPHS] evaluation criteria and survival rates. The questionnaire for predictors included 3 aspects: [a] sociodemographic characteristics, [b] oral health habits [tooth brushing frequency, flossing frequency, and dental visits], and [c] satisfaction of the restorations [aesthetics, function, fit, cleansability, and chewing ability of the crowns, and overall satisfaction]. Frequency distributions were computed using univariate and multivariate analysis. The Student t test and analysis of variance [ANOVA] were used to compare means across variables. Correlation analysis was done to assess the association between continuous variables

Results: The age of crowns was 34.7 +/- 9.7 months. The survival rate was 96.6% at 35.9 +/- 9.2 months. There was a significant association between successful crown function and oral hygiene measures: tooth brushing [ p < 0.001], dental visits [ p = 0.006], and flossing [ p = 0.009]. A strong negative correlation was observed between aesthetic satisfaction [ r = -0.717, p < 0.001] and chewing ability [ r = -0.639, p < 0.001] with crown age. The linear regression model was significant for all predictors [ p < 0.05] except overall satisfaction [ p > 0.05]

Conclusion: The LD crowns had long survival rates of 96.6% up to 35.9 +/- 9.2 months and provided satisfactory clinical performance [low risk of failure]. Oral hygiene habits such as brushing, flossing, and regular dental visits influenced patient satisfaction with LD crowns

Tongue Piercing: experience of piercees and practice of piercers in Klang Valley, Malaysia

@#To explore the phenomenon of tongue piercing in Klang Valley. Semi-structured in-depth interviews were conducted with piercers and those who had their tongue pierced (“piercees”) in Klang Valley. Five piercers and eight piercees were interviewed. Piercees had their tongue pierced at age 16-25 years. Three main reasons for tongue piercing were to enhance appearance, express their individuality, and out of curiosity. They reported that they experienced various immediate and late complications. However, most were aware of and expected the complications. The majority of piercers reported adequate infection control procedures and enquired about the client’s health prior to piercing. Although some clients reported problems, such reports were rare. Tongue piercing is an invasive procedure with some risks, but precautions such as proper infection control procedures minimize the likelihood of encountering serious problems. The reasons for tongue piercing varied between individuals. Although the majority of the interviewed piercers reported cross-infection control, their knowledge of the medical risks associated with tongue piercing varied widely.

Randomized controlled clinical trial of oral health-related quality of life in patients wearing conventional and self-ligating brackets / 대한치과교정학회지

OBJECTIVE: The aim of this randomized controlled clinical trial was to compare oral health-related quality of life (OHRQoL) of patients treated with conventional, active self-ligating (ASL), and passive self-ligating (PSL) brackets in different therapeutic phases. METHODS: Sixty patients (mean age 18.3 years; 29 males and 31 females) requiring orthodontic treatment were randomly and equally assigned to receive conventional (Victory Series), ASL (In-Ovation R), or PSL (Damon 3MX) brackets. OHRQoL was measured with a self-administered modified 16-item Malaysian version of the Oral Health Impact Profile for immediate (soon after the visit) and late (just before the subsequent visit) assessments of the bonding and activation phases. Data were analyzed with the Kruskal-Wallis and chi-square tests. RESULTS: The PSL and ASL groups showed more immediate and late impacts in the bonding phase, respectively; the conventional group was affected in both the assessments. The first activation phase had similar impacts in the groups. After the second activation, the conventional group showed more immediate impacts, whereas the PSL and ASL groups had more late impacts. The commonly affected domains were "physical disability," "functional limitation," "physical pain," and "psychological discomfort." No significant differences in the prevalence and severity of immediate and late impacts on OHRQoL of the patients were noted in any therapeutic phase. CONCLUSIONS: No bracket system seems to ensure superior OHRQoL. This information could be useful for explaining the therapeutic phases, especially the initial one, and selecting the optimal bracket system based on the patient's preference.