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Introduction: Nutritional requirements of pregnant women differ considerably from those of non-pregnant women. Nutritional status during pregnancy is critical to maintain health, including oral health, and to promote growth and development of the baby. This study assessed dietary pattern, nutrient intake, and oral symptoms among pregnant women. Methods: Seventy-one women with singleton pregnancy attending a public healthcare centre in Malaysia participated in this cross-sectional study. Dietary pattern and nutrient intake of the women were assessed using food frequency questionnaire and 3-day 24-hour diet recall, respectively. Information on sociodemographic and obstetric profiles, and oral symptoms were obtained from self-administered questionnaire. Results: White rice, chicken, green leafy vegetables, granulated sugar, and salt were foods most consumed. Intakes of iron, folate, vitamin C, vitamin D, calcium, iodine, zinc, and fluoride for most respondents were below Recommended Nutrient Intake (RNI). Cavitated tooth (46.5%), bleeding gums (35.2%), pain upon eating and drinking (23.9%), and bad breath (23.9%) were common oral symptoms reported. Significant association was found between complaint of brown, yellow, and white spots on tooth surface with vitamin A intake, and between complaint of bleeding gums with zinc intake. Conclusion: Intake of most nutrients by most respondents in this study was below the RNI. Oral symptoms were common and a few were associated with nutrient intakes. [ABSTRACT FROM AUTHOR]

We determined factors associate with oral health literacy of pregnant women. A total of 203 pregnant women attending Hospital Universiti Sains Malaysia (USM) for antenatal care participated in this cross-sectional study. The Malay version of Oral Health Literacy Instrument (OHLI-M) and a structured self-administered questionnaire were used to obtain variables of interest. The mean OHLI-M score was 73.6 (SD 12.59). Only slightly more than half of our participants had adequate oral health literacy (54.2%), while others were marginal (31.0%) and inadequate (14.8%). Our findings revealed that women with adequate oral health literacy were more likely to be those with higher education qualification and were very satisfied or satisfied with their oral health status. The identification of these predictors highlighted the importance to keep oral health education messages simple and clear for the benefit of individuals with low educational attainment. [ABSTRACT FROM AUTHOR]

Dentistry is a highly stressful program; stress is associated with xerostomia and periodontal disease. Objective: This study aims to investigate the association of perceived stress, severity of xerostomia, and periodontal status in dental students. Methods: This was a two-phase cross-sectional study of 245 Universiti Sains Malaysia (USM) undergraduate dental students. Phase 1 involved administration of the Perceived Stress Scale (PSS-10) and Summated Xerostomia Inventory (SXI). In phase 2, the Community Periodontal Index (CPI) was performed on 150 students to determine their periodontal status. Results: Mean PSS-10 and SXI scores were 19.6 (SD 5.47) and 7.9 (SD 2.04), respectively. Only 7.3% students had healthy periodontium while 17.3% had gingival bleeding, 65.3% had calculus, 6.7% had shallow pockets, and 3.3% had deep pockets. The association of perceived stress, severity of xerostomia, and periodontal status was not significant. Nevertheless, a significant positive correlation was found between PSS-10 and SXI scores (r = 0.318, p < 0.01). Conclusion: Most USM dental students were affected by some degree of periodontal disease, but it was not associated with perceived stress or severity of xerostomia. Students with higher perceived stress had more severe xerostomia. Information from this study could be utilised by the dental school in planning towards providing a stress-free training environment. [ABSTRACT FROM AUTHOR]

Objectives: This study determined the efficacy of alcohol‐free 0.05% cetylpyridinium chloride (CPC) mouthwash as an adjunct to twice‐daily toothbrushing in comparison with 0.12% chlorhexidine gluconate (CHX) mouthwash and a placebo in reducing plaque accumulation and gingival inflammation. The side effects of the mouthwashes were also determined. Materials and Methods: A double‐blind, parallel, randomized control trial was conducted with 219 university students who were divided into three trial groups using block randomization: CPC, CHX and placebo groups. Clinical oral examinations to assess dental plaque accumulation (modified Quigley‐Hein Plaque Index), gingival health (Löe and Silness Gingival Index) and tooth staining (modified Lobene Stain Index) were performed at baseline and at 6 weeks. Results: Plaque and gingivitis scores were not significantly different among participants at baseline. After 6 weeks, plaque and gingivitis scores between the CPC and placebo groups and between the CHX and placebo groups were found to be significantly different. However, there was no significant difference between the CPC and CHX groups. The staining scores of participants in the CPC group were lower than those in the CHX group, but the difference was not significant. Taste alteration and numbness were more common among participants in the CHX group than in the CPC group. No significant difference in the perception of a burning sensation was observed. Conclusions: The 0.05% CPC mouthwash was as efficient as 0.12% CHX mouthwash in reducing dental plaque accumulation and gingival inflammation with fewer side effects, supporting its use as an adjunct to toothbrushing. [ABSTRACT FROM AUTHOR]

Introduction: Smartphone addiction has been associated with sleeping problems and psychological anxiety. However, little is known about the association of smartphone addiction, sleep quality and perceived stress amongst university students particularly in dentistry. This study investigated the association of these variables amongst dental students in a Jordanian dental faculty. Materials and methods: A sample of 420 undergraduate dental students enrolled for academic year 2017/2018 at the Jordan University of Science and Technology participated in this study. They were given a set of self-administered questionnaires which consisted of questions regarding demographic information, characteristics of smartphone use, assessment of smartphone addiction, sleep quality as well as perceived stress. Results: The mean Smartphone Addiction Scale (SAS) score amongst Jordanian dental students was high (109.9 ± 23.8). The correlation between SAS and Global Pittsburg Sleep Quality Index (PSQI) score was significant (r = 0.137, P =0.005) indicating that the higher the smartphone addiction level, the poorer the quality of sleep. Similarly, a significant correlation was found between Perceived Stress Scale-10 (PSS-10) score and Global PSQI score (r = 0.348, P < 0.001) which implied that students who have higher perceived stress experienced poorer sleep quality. Year 3 students (clinical year), smartphone addiction and perceived stress were determinants of sleep quality. Conclusions: Dental students who have high levels of smartphone addiction or high perceived stress levels experienced poor sleep quality. Identifying smartphone addicts amongst students as well as stressors are imperative measures to allow timely assistance and support in the form of educational campaigns, counselling, psychotherapy and stress management. [ABSTRACT FROM AUTHOR]

Abstract Background We assessed factors influencing patients' satisfaction with their dental appearance and the treatments they desired to improve dental aesthetics. Methods A cross-sectional study was performed out among 235 adult patients who visited the Hospital Universiti Sains Malaysia dental clinic. A structured, interviewer-guided questionnaire was used to identify patient satisfaction with their general dental appearance, cosmetic elements and desired treatments. Results The 235 patients consisted of 70 males (29.8%) and 165 females (70.2%), of mean age 31.5 years (SD 13.0). Of these patients, 124 (52.8%) were not satisfied with their general dental appearance. In addition, 132 patients (56.2%) were not happy with the color of their teeth, 76 (32.3%), regarded their teeth were poorly aligned, 62 (26.4%), as crowded and 56 (23.4%) protruded. Dissatisfaction with tooth color was significantly higher in female than in male patients (odds ratio [OR] of 1.99 (95% confidence interval [CI] 1.13-3.50). Tooth whitening was the treatment most desired by patients (48.1%). Results of multiple logistic regression analysis showed that patient dissatisfaction with general dental appearance was significantly associated with female gender (OR = 2.18; 95% CI: 1.18-4.03), unhappiness with tooth color (OR = 3.05; 95% CI: 1.74-5.34) and the opinion that their teeth protruded (OR = 2.91, 95% CI: 1.44-5.91). Conclusions Most patients in this study were not satisfied with their dental appearance with a greater percentage of females expressing dissatisfaction than males. An age was not associated with satisfaction. Unhappiness with tooth color and feelings of having protruding teeth also had a significant negative influence on patient satisfaction with general dental appearance.

Abstract Background The facial region has been the most common site of injury following violent episodes. The purpose of this study was to determine the prevalence and pattern of maxillofacial injuries associated with intimate partner violence (IPV) in women treated at a single facility in Malaysia. Methods A retrospective review of 242 hospital records of female IPV victims who were seen at the One-Stop Crisis Centre (OSCC) in Hospital Raja Perempuan Zainab II, Kelantan over a two-year period (January 1, 2005 to December 31, 2006) was performed. A structured form was used for data collection. Information regarding the anatomical sites of injuries, types of injuries, and mechanisms of assault were obtained. Results Most victims were married (85.1%), were injured by the husband (83.5%), and had at least one previous IPV episode (85.5%). Injury to the maxillofacial region was the most common (50.4%), followed by injury to the limbs (47.9%). In 122 cases of maxillofacial injuries, the middle of the face was most frequently affected (60.6%), either alone or in combination with the upper or lower third of the face. Injury to soft tissues (contusions, abrasions and lacerations) was the most common (87.7%). Conclusions This study indicates there is a high prevalence of maxillofacial injuries associated with IPV among women treated at the OSCC in Kelantan, Malaysia.

Abstract Background The aims of this study were to determine factors associated with dental visit and to describe barriers to utilisation of oral health care services among antenatal mothers attending the Obstetric and Gynaecology Specialist clinic in Hospital Universiti Sains Malaysia. Methods A structured, self-administered questionnaire was used obtain information on the variables of interest pertaining to the current pregnancy from 124 antenatal mothers. Results The majority of the mothers claimed that their oral health status was good (67.0%) or very good (2.4%). On the contrary, most of them admitted of having had at least one oral health problem (59.7%) including cavitated (43.5%) and painful teeth (15.3%), bleeding gum (21.0%), and bad breath (10.5%). However, only 29% of the mothers visited dentist during the current pregnancy. Factors associated with the mothers' dental visit were exposure to oral health education before the pregnancy and awareness of relationship between poor maternal oral health and adverse pregnancy outcomes with odds ratio of 4.06 (95% CI: 1.67-9.78) and 3.57 (95% CI: 1.30-9.77) respectively. Common excuses given by most mothers include perceptions of not having any oral health problems (65.9%), long waiting time at the clinic (71.6%), and no immediate treatment given by the dentist (64.8%). Conclusions Utilisation of oral health care services among antenatal mothers was low. Mothers who reported dental visit were more likely to be those who had received oral health education before the current pregnancy and knew of the association between poor maternal oral health and adverse pregnancy outcomes. Dissatisfaction with the services rendered and perceptions of not having any oral health problems were the main barriers.

Objective: To determine the satisfaction with the dentist-patient interaction and factors associated with patient satisfaction among patients attending the outpatient dental clinic Hospital Universiti Sains Malaysia (HUSM). Material and Methods: This cross-sectional study involved 229 patients who attended outpatient dental clinic Hospital USM that located in the East Coast region of Malaysia. A selfadministered Skala Kepuasan Interaksi Perubatan - 11 (SKIP-11) questionnaire was used to assess the satisfaction towards dentist-patient interaction. Systematic random sampling was applied in this study. The data were analyzed using simple logistic regression analysis to determine the factors associated with patient satisfaction with dentist-patient interaction. Results: The mean age of patients was 32.6 ± 13.9 years, 71.6% of them study up to tertiary level, 31.5% came to for dental check up and 23.6% of them had tooth decay. More than half (64.6%) of the patients were satisfactory with dentist-patient interaction. The satisfaction percentage in the distress relief domain was 60.7%, 56.8% in the rapport domain, and 53.7% in the interaction outcome domain. Satisfaction with dentist-patient interaction was significantly associated with the dentists' characteristics such as age (OR = 0.583, 95%CI 0.44-0.76, p=0.001), gender (OR = 0.386, 95% CI 0.22-0.69, p=0.001) and years of service (OR = 0.294, 95% CI 0.15-0.57, p=0.001). Conclusion: The result showed that slightly more than half of the patients who attended the outpatient dental clinic HUSM were satisfied with the dentist-patient interaction, which was found to be influenced by the characteristics of the dentists. Efforts to improve patient-dentist interaction are recommended to ensure delivery of good quality oral health care. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence of positive rheumatoid factor (RF) status, its association with disease severity and functional disability of rheumatoid arthritis (RA) patients. A preliminary, cross sectional study was conducted on 46 RA patients. Blood samples were analysed for erythrocyte sedimentation rate (ESR) and RF levels. Socio-demographic data, disease activity score for 28 joints (DAS28), and modified Health Assessment Questionnaire (mHAQ) score were recorded. The prevalence of positive rheumatoid factor (RF) in RA patients was 63.0%. The mean ± SD for DAS28 Score and mHAQ Score were 3.52 ± 1.13 and 0.47 ± 0.61 respectively. Most RA patients (47.8%) had moderate disease severity and mild functional difficulty (89.1%). Pain severity is the only factor which had significant association with functional difficulty (p=<0.001). However, no significant association between RF status and disease severity (p=0.891) and between RF status and functional difficulty (p=0.269). Positive RF status was prevalent in RA patients. Most patients experienced moderate disease severity and mild functional difficulty. Pain severity had significant association with functional difficulty. However, RF status was not significantly associated with disease severity and functional difficulty. RA obviously affects functional ability of RA patients. Thus, early diagnosis and therapeutic intervention is crucial to prevent long term complication and improve the quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Breastmilk alone is the best food and drink for an infant for the first six months of life. After six months, infants need other nutritious foods, in addition to breastfeeding up to two years and beyond, to meet their growth and development needs. Objective: This study is conducted to determine the knowledge, attitude, and future exclusive breastfeeding intention among final year medical and dental students in University Sains Malaysia Method: Multiple Response Analysis methodologies were used to determine the level of acceptance. The seven domains of knowledge were analyzed to determine the most dominant factor which leads to the acceptance of future intention towards exclusive breastfeeding. The co-occurrence frequency network analysis was used to determine the most frequent event between the studied factors. Results: All the findings from this analysis will be used as an indicator for the general knowledge and attitude towards exclusive breastfeeding focusing on young adults. Conclusion: This study found that most final year medical students in Universiti Sains Malaysia generally have positive future intentions to practice exclusive breastfeeding compared to dental students. [ABSTRACT FROM AUTHOR]

Introduction: Breastfeeding has many health benefits, both in the short term and the long term either to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Objective: To determine the factor that contributes to the future intention of exclusive breastfeeding among final year medical and dental students in Universiti Sains Malaysia (USM) Method: Multilayer Perceptron (MLP) methodology is being applied for assessing the factor which might contribute to the future intention of exclusive breastfeeding. After obtaining the list of the factor from the predictor important, the validation process will take the place through training and testing assessment. The accuracy and significant factor will be determined, and the finding will be used for education purposes and for further research. Results: There are four factors that contribute most to the future intention of exclusive breastfeeding. The main contributer factor to the future intention of exclusive breastfeeding among final year medical and dental students was ethnicity (48%), gender (19%), school (19%) and marital status (14%). Conclusion: The proposed model is very useful for the prediction and for the inferences of patient's management time with the high-risk breastfeeding contributor factors. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of edentulism (total tooth loss) and factors associated with community dwelling elderly in Pasir Puteh, Kelantan, Malaysia. Materials and Methods: A cross-sectional study has been conducted among community dwelling elderly in Pasir Puteh, Kelantan. Upon completion of a face-to-face administered questionnaire of participant's socio-demographic and oral health profiles, the edentulous state was examined and recorded. Data obtained was analyzed using SPSS version 22.0. Results: A total of 600 elderly who participated in this study consist of 371 edentulous and 229 with at least one natural tooth. The prevalence of edentulism was 62.3% (95% CI: 58.3, 66.2). Age, level of education, last dental visit, fear of dental treatment, and denture wearing status were found to be associated with edentulism (p < 0.05). Conclusion: Edentulism was found to be higher among community dwelling elderly in Pasir Puteh, Kelantan. Increasing in age, lower level of education, frequent dental visit, less fear of dental treatment, and wearing a denture were found to be associated with edentulism. [ABSTRACT FROM AUTHOR]

Introduction: Toothbrushing with fluoride toothpaste is the most acceptable and cost-effective way to prevent caries. Knowledge, attitude, and behaviour towards fluoride toothpaste use and toothbrushing are crucial for proper oral hygiene care among children. This study aims to assess the factors associated with toothpaste use and toothbrushing behaviour among 12-year-old children. Materials and methods: This cross-sectional study was conducted among 317 respondents of 12-year-old children in the Tawau district, Sabah. Respondents were chosen in equal numbers of females and males from the urban and rural areas by a non-proportionate stratified multistage random sampling method. The tool used was a self-reported, validated Malay-translated questionnaire. A Chi-square and Fisher's exact tests assessed the association between variables of interest. Results: Most respondents had the misconception that fluoride's function was to make their teeth clean (n=147, 46.4%). Almost all respondents had a positive attitude towards the importance of brushing their teeth (n=314, 99.1%) and using toothpaste (n=311, 98.1%). 52.4% (n=166) of respondents brushed their teeth twice daily and 68.5% (n=217) used fluoridated toothpaste. For the post-toothbrushing behaviour, about 61.5% (n=195) of respondents very often rinse their mouth with water, but only 24.9% (n=79) used mouthwash products. Female (Χ2=5.18, p=0.023), Bumiputera Sabah ethnicity (Χ2=7.99, p=0.039), and urban school (Χ2=5.80, p=0.016) were significantly associated with good toothpaste behaviour.Conclusion: As there was an association between sex, school location, and ethnicity with the behaviour of toothbrushing and toothpaste use, implementing preventive strategies based on effective evidence-based oral health education and promotion is needed to tackle these issues. [ABSTRACT FROM AUTHOR]

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease of the joints with the involvement of other systems. Previous studies have demonstrated its association with chronic periodontitis (CP), a chronic inflammatory disease of tooth-supporting tissues. Positive rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) in RA patients have been found to be associated with CP. The aim of this study is to determine the prevalence of CP in RA patients, and to investigate the association of ACPA, RF status and RA disease activity with CP and non-CP RA patients. Materials and Methods: A comparative cross-sectional study involving 98 RA patients was conducted at Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia. Clinical oral examination was carried out to determine the CP status of RA patients. RF, ACPA and erythrocyte sedimentation rate (ESR) were measured, and the 28-joint Disease Activity Score (DAS-28) was assessed. Results: Forty-five patients (45.9%) were found to have CP (95% CI: 0.36-0.56). No significant difference was observed in the prevalence of positive RF (p=0.989) or ACPA (p=0.431) in CP and non-CP RA patients. There was also no significant association between active RA disease (DAS-28 score ≥3.2) and RF positivity in CP (p=0.927) and non-CP (p=0.431) RA patients as well as ACPA positivity in CP (p=0.780) and non-CP (p=0.611) RA patients. Conclusion: In our cohort of RA patients, we did not find significant associations between elevated RF, ACPA, or active RA disease with the presence of CP. There were also no significant associations between elevated RF or ACPA with active RA disease. [ABSTRACT FROM AUTHOR]