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Previous studies found that ethnicity influences oral cancer patients' survival; however, most studies were limited to certain ethnic groups particularly from the West, thus of limited relevance to Asians where the disease is most prevalent. We investigated the relationship between ethnicity and patient survival in multi-racial Malaysia. 5-year survival rate was 40.9%. No statistically significant difference was observed in survival between Malays, Chinese, Indians and Indigenous peoples (45.7%, 44.0%, 41.3%, 27.7% respectively). Increased tumor size, lymph node involvement and advanced tumor were predictive of poor survival. We conclude that ethnicity has no effect on survival or its prognostic indicators.

Aim: To assess the knowledge and perceptions of Malaysian government dentists regarding the shortened dental arch (SDA) concept and its application in clinical practice. Background: The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists’ knowledge and perceptions of the SDA concept can influence its application in clinical practice. Methods: A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software. Results: The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients 5 years of work experience perceived that the SDA concept enables simpler treatment planning (P < 0.05). Finally, a larger number of participants who graduated abroad than who graduated locally observed that patients without molar support had temporomandibular joint problems (P < 0.05). Conclusion: Although Malaysian government dentists have good knowledge and perceptions of the SDA concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs.

Background This 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. Methods This 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. Results Children 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

This study aimed to assess changes in oral cancer patients' health-related quality of life (HRQOL) and the impact of disease stage on HRQOL scores. HRQOL data were collected from seven hospital-based centres using the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) version 4.0 instrument. The independent samples t-test, χ2 test, and paired samples t-test were used to analyse the data. A total of 300 patients were recruited. The most common oral cancer sub-site was tongue and floor of mouth (42.6%). Surgical intervention (41.1%) was the most common treatment modality. Significant differences in ethnicity and treatment modality were observed between early and late stage patients. Pre-treatment HRQOL scores were significantly lower for late than early stage patients. At 1 month post-treatment, the functional and head and neck domains and the FACT-H&N (TOI) summary scores showed significant deterioration in both early and late stage patients. In contrast, the emotional domain showed a significant improvement for early and late stage patients at 1, 3, and 6 months post-treatment. Although HRQOL deterioration was still observed among early and late stage patients at 6 months post-treatment, this was not statistically significant. In conclusion, advanced disease is associated with poorer HRQOL. Although ethnic differences were observed across different disease stages, the influence of ethnicity on patient HRQOL was not evident in this study.

This study examined the concordance in clinical diagnosis of high-risk lesions in the oral cavity and referral decisions between clinical oral examination (COE) and teledentistry.Sixteen individuals with a range of oral potentially malignant disorders (OPMD) and normal oral mucosa were included. Five areas of the oral cavity were photographed by three dentists using mobile phone cameras with 5 MP-13 MP resolutions. On the same day, the patients were given COE by two oral medicine specialists (OMS) and 3 weeks later, they reviewed the images taken using the phone, and concordance was examined between the two by Kappa statistics. The sensitivity and specificity of clinical diagnosis using the phone images were also measured. Pre- and post-program questionnaires were answered by both the dentists and the OMS to determine the feasibility of integrating teledentistry in their clinical practice.The Kappa values in determining the presence of lesion, category of lesion (OPMD or not), and making referral decision were moderate to strong (0.64-1.00). The overall sensitivity was more than 70% and specificity was 100%. The false negative rate decreased as the camera resolution increased. All dentists agreed that the process could facilitate early detection of oral mucosal lesion, and was easy to use in the clinic.This study provides evidence that teledentistry can be used for communication between primary care and OMS and could be readily integrated into clinical setting for patient management.

To assess and compare the dental caries status among children using two methods..The cross-sectional study was conducted in October-November 2017 at five government and two private schools in Bhakkar, Punjab, Pakistan. It comprised children aged 11-12 years. World Health Organisation standards and the modified International Caries Detection and Assessment Systems methods were used were used to determine the dental caries status of each subject. Results of the two methods were compared at all cut- offs where appropriate, using SPSS 17.Of the 183 subjects, 101(55.2%) were boys. Those aged 12 years were 112(61.2%) while 71(38.8%) were aged 11 years. There was no statistically significant difference in values of the Decayed Missing and Filled Surface / Decayed Missing and Filled Teeth index as well as the prevalence of dental caries between two methods (p0.05 each). Intra-examiner reproducibility was higher with the World Health Organisation method compared to the other index used (p0.05).Modified International Caries Detection and Assessment Systems method can be used in epidemiological surveys as it was found to provide results similar to the World Health Organisation criteria at cut-off point 2.

To estimate the frequency and pattern of sugar intake among Pakistani school going children and its association with early carious lesion and caries history.The cross-sectional study was conducted from January to May 2016 in seven schools of Bhakkar district in the Punjab province of Pakistan, and comprised of school children aged 11-12 years. Diet diaries were used to assess the frequency of sugar intake while caries was assessed using the Modified International Caries Detection and Assessment System. Bivariate analysis was used to assess the association of sugar consumption and early carious lesion with selected sociodemographic variables, and regression analysis was performed to evaluate the factor that matters most in caries occurrence.Of the 226 subjects, 115(51%) had early carious lesion. Mean frequency of sugar intake was 5.2±3.2 times per day. Children who consumed sugar between main meals (p=0.01) and within two hours before bedtime (p=0.04) had significantly higher history of having caries. Cariogenic intake before bedtime was significantly associated with overall caries risk (p=0.02).The frequency of sugar intake among the subjects was slightly higher than the recommended level. .

Objective To elucidate ethnic variations in the practice of oral cancer risk habits in a selected Malaysian population. Methods This retrospective case-control study involves 790 cases of cancers of the oral cavity and 450 controls presenting with non-malignant oral diseases, recruited from seven hospital-based centres nationwide. Data on risk habits (smoking, drinking, chewing) were obtained using a structured questionnaire via face-to-face interviews. Multiple logistic regression was used to determine association between risk habits and oral cancer risk; chi-square test was used to assess association between risk habits and ethnicity. Population attributable risks were calculated for all habits. Results Except for alcohol consumption, increased risk was observed for all habits; the highest risk was for smoking + chewing + drinking (aOR 22.37 95% CI 5.06, 98.95). Significant ethnic differences were observed in the practice of habits. The most common habit among Malays was smoking (24.2%); smoking + drinking were most common among Chinese (16.8%), whereas chewing was the most prevalent among Indians (45.2%) and Indigenous people (24.8%). Cessation of chewing, smoking and drinking is estimated to reduce cancer incidence by 22.6%, 8.5% and 6.9%, respectively. Conclusion Ethnic variations in the practice of oral cancer risk habits are evident. Betel quid chewing is the biggest attributable factor for this population.

Background: A comparative cross-sectional study involving oral cancer patients and healthy individuals was designed to investigate associations between retinol, alpha-tocopherol and beta-carotene with the risk of oral cancer. Materials and Methods: This study included a total of 240 matched cases and controls where subjects were selected from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Retinol, alpha-tocopherol and beta-carotene levels and intake were examined by high-performance liquid chromatography (HPLC) and food frequency questionnaire (FFQ) respectively. Results: It was found that results from the two methods applied did not correlate, so that further analysis was done using the HPLC method utilising blood serum. Serum levels of retinol and alpha-tocopherol among cases (0.177 +/- 0.081, 1.649 +/- 1.670 mu g/ml) were significantly lower than in controls (0.264 +/- 0.137, 3.225 +/- 2.054 mu g/ml) (p

To obtain data on the prevalence of oral mucosal lesions (OMLs) among Cambodians, and to assess the relationship between known risk habits of oral diseases with prevalence of oral potentially malignant disorders (OPMDs).This was a population-based, cross-sectional study whereby subjects were adults aged 18 years old and above. A workshop on the identification of OML was held to train and calibrate dental officers prior to data collection in the field. Sociodemographic and risk habits data were collected via face-to-face interview, whilst presence of OML and clinical details of lesions such as type and site were collected following clinical oral examination by the examiners. Data analysis was carried out using the Statistical Package for Social Science (SPSS) version 12.0. The association between risk habits and risk of OPMD was explored using logistic regression analysis.A total of 1634 subjects were recruited. Prevalence of OML for this population was 54.1%. Linea alba was the most common lesion seen (28.7%). This study showed an overall OPMD prevalence of 5.6%. The most common type of OPMD was leukoplakia (64.8%), followed by lichen planus (30.8%). Subjects who only smoked were found to have an increased risk for OPMD of almost four-fold (RR 3.74, 95%CI 1.89-7.41). The highest risk was found for betel quid chewers, where the increased risk observed was more than six times (RR 6.75, 95%CI 3.32-13.72). Alcohol consumption on its own did not seem to confer an increased risk for OPMD, however when practiced concurrently with smoking, a significant risk of more than five times was noted (RR 5.69 95%CI 3.14-10.29).The prevalence of OML was 54.1%, with linea alba being the most commonly occurring lesion. Smoking, alcohol consumption and betel quid chewing were found to be associated with the prevalence of OPMD, which was 5.6%.

Health risks stemming from betel-quid (BQ) chewing are frequently overlooked by people. Updated epidemiological data on the increased BQ use among Asian populations using comparable data collection methods have not been widely available. To investigate the prevalence, patterns of practice and associated types of oral preneoplastic disorders, an intercountry Asian Betel-quid Consortium study (the ABC study) was conducted for Taiwan, Mainland China, Malaysia, Indonesia, Nepal and Sri Lanka. A random sample of 8,922 subjects was recruited, and the data were analyzed using survey-data modules adjusted for the complex survey design. Chewing rates among men (10.7-43.6) were significantly higher than women (1.8-34.9) in Taiwan, Mainland China, Nepal and Sri Lanka, while women's rates (29.5-46.8) were higher than that for men (9.8-12.0) in Malaysia and Indonesia. An emerging, higher proportion of new-users were identified for Hunan in Mainland China (11.1-24.7), where Hunan chewers have the unique practice of using the dried husk of areca fruit rather than the solid nut universally used by others. Men in the Eastern and South Asian study communities were deemed likely to combine chewing with smoking and drinking (5.6-13.6). Indonesian women who chewed BQ exhibited the highest prevalence of oral lichen planus, oral submucous fibrosis and oral leukoplakia (9.1-17.3). Lower schooling, alcohol drinking and tobacco smoking were identified as being associated with BQ chewing. In conclusion, the ABC study reveals the significant cultural and demographic differences contributing to practice patterns of BQ usage and the great health risks that such practices pose in the Asian region. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

– Objective: The aim of this study was to assess (by direct determination) the fluoride (F) exposure from ingested toothpaste among 4–5-year-old Malaysian children. Methods: This was part of a larger study to determine fluorosis status and F exposures. A total of 1343 10–11-year-old subjects were sampled by two-stage systematic random sampling for assessment of fluorosis. Two hundred 4–5-year-old siblings of these index subjects were subsampled for determination of F exposures from ingested toothpastes and other sources. Estimations of F ingested from toothpaste (FI) was made by the method of difference between ‘F in toothpaste taken for use’ and the ‘F in toothpaste used but not swallowed’, by the duplicate technique under normal home conditions. F ions were determined with the combination selective ion electrode. Results: The subjects ingested 32.9% of the toothpaste placed on the brush. Fluoride exposure from ingested toothpaste was highly variable and the mean was 426.9 ± 505.5 μg (SEM 38.9)/48 h, or 213.5 μg/day and 131.9 μg per brushing. Conclusions: The amount of ingested fluoride (FI) per brushing in this study was the lowest of all studies reporting this parameter and was within the pea-size range of 125–250 μg. Because of the highly statistically significant correlations between the FI from toothpaste and the amount of toothpaste dispensed (Pearson's correlation coefficient 0.647, P = 0.000), parents should assume responsibility for placement of toothpaste and limit the amount of toothpaste used.

A compromised oral health condition amongst patients with special health care needs (SHCN) has been associated with the reluctance and shortage of skills of dental professionals in managing such patients. Lack of training and experience at the undergraduate level are reported barriers to the provision of care for this patient cohort. Undergraduate education therefore, plays an important role in producing professionals with the knowledge, skills and positive attitude in treating patients with SHCN. This study aims to determine the level of knowledge, comfort and attitudes of Malaysian undergraduate dental students towards caring for patients with SHCN, as well as their perception on education in this field. A self-administered questionnaire was administered in the classroom style to final year undergraduate dental students in Malaysian public dental schools. Most students were aware of Special Needs Dentistry (SND) as a specialty after being informed by academic staff. The majority of the students demonstrated poor knowledge in defining SND and felt uncomfortable providing care for such patients. They perceived their undergraduate training in SND as inadequate with most students agreeing that they should receive didactic and clinical training at undergraduate level. A high percentage of students also expressed interest in pursuing postgraduate education in this area of dentistry despite the lack of educational exposure during undergraduate years. The study supports a need for educational reform to formulate a curriculum that is more patient-centred, with earlier clinical exposure in various clinical settings for students to treat patients with special health care needs, applying the concept of holistic care in a variable clinical condition.

The prevalence of oral mucosal lesions in Malaysia was determined by examining a representative sample of 11,707 subjects aged 25 years and above throughout the 14 states over a period of 5 months during 1993/1994. A two-stage stratified random sampling was undertaken. A predetermined number of enumeration blocks, the smallest population unit in the census publication, was selected from each state. With the selected enumeration block, a systematic sample of living quarters was chosen with a random start. The survey instrument included a questionnaire on sociodemographic characteristics and a clinical examination. The clinical examination was carried out by 16 specially trained dental public health officers and the diagnosis calibrated with a final concordance rate of 92%. The age in the sample ranged from 25 to 115 years with a mean of 44.5+/-14.0. The sample comprised 40.2% males and 59.8% females; 55.8% were Malays, 29.4% Chinese, 10.0% Indians and 1.2% other ethnic groups. Oral mucosal lesions were detected in 1131 (9.7%) subjects, 5 (0.04%) had oral cancer, 165 (1.4%) had lesions or conditions that may be precancerous (leukoplakia, erythroplakia, submucous fibrosis and lichen planus) and 187 (1.6%) had betel chewer's mucosa. The prevalence of oral precancer was highest amongst Indians (4.0%) and other Bumiputras (the indigenous people of Sabah and Sarawak) (2.5%) while the lowest prevalence was amongst the Chinese (0.5%).

A house to house survey on elderly subjects aged 60 years old and above was undertaken in a large district in Malaysia. A total of 486 subjects in randomly selected Enumeration Blocks were interviewed and examined. The prevalence of oral precancerous lesions was recorded at 3.3%, of which leukoplakia was the most common. When the ethnic distribution of these oral precancerous and cancerous (OPC) lesions was compared, 72% of those inflicted were Indians. Oral cancer was detected in two subjects (0.4%), both of whom were of Indian origin. Among subjects with OPC lesions, 4.2% were smokers, 12.7% were betelquid chewers, 11.8% had indulged in both habits, whilst one subject had not practised any of the oral habits of interest (0.4%). The findings suggest the occurrence of OPC lesions to be related to betelquid chewing.

This study aimed to determine the impact of dental caries in terms of Oral Health–Related Quality of Life (OHRQoL) for Cambodian children. The Child Perceptions Questionnaires (CPQ) were cross-culturally adapted and validated for the Cambodian population using a sample of 430 Cambodian children. The participants had a high caries burden, with a mean number of decayed-missing-and-filled deciduous tooth surfaces (dmfs) of 8.8 (SD = 11.1) and a mean DMFS of 3.7 (SD = 5.5) for the permanent dentition. Two in 5 children had at least one pulpally involved tooth. There was a significant difference in mean CPQ8-10 and CPQ11-14 scores by caries experience and by global item response for the respective age-groups, with those in the more severe caries categories scoring higher. Similar gradients were apparent with the CPQ11-14 in the 8- to 10-year age-group. The differences in OHRQoL scores by caries experience demonstrate the construct validity of the CPQ11-14 for the 8- to 14-year age-group.

A house to house random survey on elderly subjects was undertaken in the District of Klang in Malaysia. The objective of this study was to investigate the prevalence of oral mucosal lesions (OML) among the elderly in this area. The primary units in the sampling frame were the Enumeration Blocks (EBs) as defined under the population census. All households of the selected EBs were considered as sampling units and members aged 60 and above were considered as respondents. There was a slight preponderance of females, with the Malays comprising the majority of the subjects. Of the 486 respondents, mean aged 69.1 +/- 7.3 yr, 111 had at least one oral mucosal lesion, a prevalence of 22.8%. A total of 145 lesions were detected. The prevalence of OML was highest among Indians and least among the Chinese. The most common finding was tongue lesions, recording a prevalence of 10.7%, followed by oral pigmentation (4.9%) and white lesions (4.3%). Denture related lesions were comparatively low at 2.5%. Two cases of oral cancer if representative would give a relatively high prevalence of 0.4%.

Background Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs. Methods Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios. Results Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01). Conclusions Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.

This study was conducted to identify the prevalence of stress, types of stressors, consequences of stress and stress relievers among undergraduate dental students at the University of Malaya during the different years of study. A descriptive cross-sectional quantitative study was conducted using a self-administered questionnaire among Bachelor of Dental Surgery students during Years 2 to 5. A 100% response rate was obtained. The instrument asked questions about the preceding academic year. The results of the questionnaire reveal the prevalence of stress was 100%. The most common cause of stress among preclinical students was academic concerns and among clinical students was patient management and clinical performance. Physical and behavioral problems were reported as consequences of stress. Most students overcame stress by having strong interpersonal relationships.

Objectives The role of diet in cancer risk has mainly been investigated based on intake of individual food items. However, food consumption is made up of a combination of various food items. This study aims to determine the association of dietary patterns with oral cancer risk. Methods A total of 306 matched cases and controls were recruited in this study. Data on dietary intake were obtained using food frequency questionnaire (FFQ). Factor analysis (FA) was performed to identify dietary patterns based on the intake of nine major food groups, resulting in four factors/components being retained. The odds ratio (OR) was computed for each component using conditional logistic regression. Results The first pattern labelled as modern was loaded with processed foods and snacks, whereas the second pattern termed as prudent was characterized by intake of fruits and vegetables. The third pattern labelled as traditional consisted of beverages and starches, while the fourth pattern termed as combination was loaded with intakes of dairy, fermented/salted and meat/by-products. A significant reduced risk was found for prudent (OR 0.53, 95 CI = 0.280.98), whereas an increased risk was found for both combination (OR 2.43, 95 CI = 1.334.45) and traditional (OR 2.32, 95 CI = 1.234.25) patterns. However, after adjusting for risk habits of tobacco smoking, alcohol consumption and betel quid chewing, only combination (aOR 2.99, 95 CI = 1.555.75) and traditional (aOR 2.08, 95 CI = 1.093.97) patterns remained significant. Conclusion Consumption in the highest tertile of traditional and combination patterns may induce twice and thrice the risk of oral cancer, respectively.

Background Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults. Method This study is part of a nationwide survey on oral mucosal lesions carried out among 11,697 adults in all fourteen states in Malaysia. The questionnaire included sociodemographic information and details on betel quid chewing habit such as duration, type and frequency. The Kaplan-Meier estimates were calculated and plotted to compare the rates for the commencement and cessation of betel quid chewing behaviour. Cox proportional hazard regression models were used to calculate the hazard rate ratios for factors related to commencement or cessation of this habit. Results Of the total subjects, 8.2% were found to be betel quid chewers. This habit was more prevalent among females and, in terms of ethnicity, among the Indians and the Indigenous people of Sabah and Sarawak. Cessation of this habit was more commonly seen among males and the Chinese. Females were found to be significantly more likely to start (p < 0.0001) and less likely to stop the quid chewing habit. Females, those over 40 years old, Indians and a history of smoking was found to significantly increase the likelihood of developing a quid chewing habit (p < 0.0001). However, those who had stopped smoking were found to be significantly more likely to promote stopping the habit (p = 0.0064). Cessation was also more likely to be seen among those who chewed less than 5 quids per day (p < 0.05) and less likely to be seen among those who included areca nut and tobacco in their quid (p < 0.0001). Conclusion Factors that influence the development and cessation of this behaviour are gender, age, ethnicity, and also history of smoking habit while frequency and type of quid chewed are important factors for cessation of this habit.

The purpose of this study was to explore the University of Malaya (UM) dental graduates’ competence in holistic care in real settings from the employers’ and graduates’ perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates’ competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as “poor and of major concern” (if less than 60 percent of respondents scored good or very good), “satisfactory and of minor concern” (60–69 percent), or “excellent” (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient’s family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.

Feedback on satisfaction with dental care is vital for continuous improvement of the service delivery process and outcome. The objective of this study was to assess the satisfaction with school dental service (SDS) provided via mobile dental squads in Selangor, Malaysia, under 4 domains of satisfaction: patient—personnel interaction, technical competency, administrative efficiency, and clinic setup using self-administered questionnaires. Among the 607 participants who had received treatment, 62% were satisfied with the services provided. In terms of domains, technical competency achieved the highest satisfaction score, whereas clinic setup was ranked the lowest. As for items within the domains, the most acceptable was “dental operator did not ask personal things which were not dentally related,” whereas privacy of treatment was the least acceptable. In conclusion, whereas children were generally satisfied with the SDS, this study indicates that there are still areas for further improvement.

to investigate genetic polymorphisms in GSTM1, GSTT1 and CYP1A1 and the association with the risk of oral cancer in the Jakarta population.A total of 81 cases and 162 controls matched for age and sex were selected from 5 hospitals in Jakarta. Sociodemographic data using questionnaires were obtained and peripheral blood samples were collected with informed consent for PCR-RFLP assay. Conditional logistic regression analysis was performed to obtain the association between the risk of oral cancer and GSTM1, GSTT1 and CYP1A1 polymorphisms.GSTM1 and GSTT1 null were slightly overrepresented among cases (60.5% and 45.7% respectively) compared to controls (55.6% and 41.4% respectively), but no statistically significant differences were observed. In contrast, the distribution of CYP1A1 polymorphism was higher among controls compared to cases (52.5 % versus 42.4 %). The odds ratio of null GSTM1 and GSTT1 genotypes was slightly higher compared to wild type genotypes (OR 1.19, 95% CI 0.70-2.02 and OR 1.19, 95% CI 0.72-2.05 respectively). Furthermore, the presence of CYP1A1 polymorphism did not increase the risk of oral cancer (OR 0.70, 95% 0.39-1.25).Genetic polymorphisms of GSTM1, GSTT1 and CYP1A1 may not be risk factors for oral cancer in the Jakarta population.

Patient satisfaction is critical for the growth and prosperity of any oral health service or practice. The success of any oral health service can be assessed by an evaluation of the degree of satisfaction/dissatisfaction of its patients.The aim of this study is to assess satisfaction/dissatisfaction with the oral health services among Non-Commissioned Officers (NCOs) in the Malaysian Armed Forces (MAF).A qualitative study using the Nominal Group Technique was undertaken. Eighty subjects from the Rasah Camp, Seremban were randomly selected from four lists, namely privates, male and female corporals and sergeants and were grouped into 10 discussion groups of eight participants each. Of the 10 groups, four groups comprised male corporals, three groups of privates, two groups of sergeants and one group of female corporals. Two separate discussion sessions were conducted to elicit factors/items causing dissatisfaction and satisfaction expressed by the participants. Every participant then scored all the factors perceived as important by members of the group. The score ranged from 0-9 i.e., the least to the most important. Scores were weighted, and the weighted score of every participant for each item was added. The ratings of the factors were determined by comparing the sum of the weighted scores.The six most important factors/items rated in the satisfaction discussion were modem equipment (9.07), friendly dentist (8.27), pleasant surgery (8.23), good quality treatment (7.93), friendly staff (7.18) and pain alleviation (6.07). These factors were further regrouped into three broad categories i.e. (1) Clinic set-up, (2) Patient-personnel interaction (PPI) and (3) Technical competency (TC). In the dissatisfaction discussion six factors/items were rated i.e. long waiting time (10.39), sequence of treatment not followed (7.18), non-availability of dentist (7.16), unfriendly staff (7.05), poor quality treatment (6.80) and restricted time for treatment (5.98). The three most important categories in the dissatisfaction discussion were (1) Administrative efficiency, (2) PPI and (3) TC.A conceptual model was developed to explain the factors affecting patients' satisfaction/dissatisfaction with the oral health services. It is recommended that a questionnaire survey be undertaken to validate and reflect the entire population of the MAF. Remedial measures highlighted in the areas of dissatisfaction should be addressed accordingly based on the quantitative study.

A total of 537 dentate adults from nine randomly selected government dental centers in three states in Malaysia were interviewed to assess their preference for either exodontia or preservation of teeth when they experience toothache, or have carious anterior or posterior teeth. The assumptions tested were i) patients prefer exodontia rather than preservation when they have toothache, and ii) patients are more willing to have posterior teeth extracted than anterior teeth for caries. Both these assumptions were rejected. Even though the majority of the subjects preferred preservation (59%) when having toothache, exodontia was the treatment of choice in a large proportion of subjects (41%). Significant differences in preference were found among the various ethnic, educational, income, and age groups. However, when ethnicity was held constant, binary regression indicated that the variations observed were determined by education, income, and age groups and not by ethnicity.

The dental needs, demands and patterns of service utilization were assessed in a randomly selected sample of 750 subjects attending the Dental Faculty, University of Malaya, Kuala Lumpur. Toothache accounted for the most frequent overall dental complaint. However, the most common motives for seeking dental care varied among children (2-12 yr), adolescents (13-18 yr) and adults (19 + yr). The attendance behavior of women is more preventively orientated and more inclined towards rehabilitation compared to that of men. The proportion of normative needs of the patients varies from 7.5% for dentures to 66% for dental caries. About 50% of service utilization for the first visit consisted primarily of extractions in the oral surgery department.