Perceptions of professional social media interaction with patients and faculty members - a comparative survey among dental students from Malaysia and Finland.

BACKGROUND: Professional and personal boundaries are blurred with the wide application of social media (SM) in the health professions line of work. Little is known about practice of extending friend requests to patients and faculty members among dental students, which encompass a part of E-professionalism. The aim of this study is to assess the factors associated with the perceptions and practices of interactions with patients and faculty on SM among dental students from Malaysia and Finland. METHODS: Dental students from 4 institutions in Malaysia and Finland completed self-administered questionnaires on the practices and perceptions of SM use. The main variables assessed were the perceptions and practices of student-patient and student-faculty communication on SM, between the two countries. Students' country, age, gender, time spent on SM and perceived importance of communicating dental related aspects over SM were analysed as potential explanatory variables. Crosstabulation was used to estimate the distributions of the response variables by the background characteristics. Multivariate analyses were performed using a dichotomous logistic regression model to investigate relevant associations between the responses and the explanatory variables independent from other factors. RESULTS: A total of 643 students completed the survey in March-April 2021. More Malaysian students agreed with "guiding patients online is a new responsibility for dentists in the digital age" compared to Finnish students (86.4% vs. 73.4%). Similarly, significantly more Malaysian students befriended patients (14.1% vs. 1%) and invited faculty to be friends on SM (73.6% vs. 11.8%). Expectedly, clinical year students befriended patients more than pre-clinical (13.8% vs. 6.8%). Significantly more students who felt 'communication of dental related issues over SM' were likely to extend friend requests to faculty rather than accept patient friend requests. CONCLUSIONS: Social media regulations and socio-cultural practices contribute to dental students' attitudes and behaviour when befriending patients and faculty members on social media. Future dental curriculum should incorporate guidelines for professional communication on social media based on local and cultural needs. Students' should be encouraged to interact with their patients using professional identities on social media.

Preparedness of recent dental graduates and final-year undergraduate dental students for practice amidst the COVID-19 pandemic.

INTRODUCTION: Dental education involves performing clinical procedures on patients under expert supervision. The COVID-19 pandemic has disrupted routine face-to-face teaching-learning-assessment dynamics world over. This study assessed the self-perceived preparedness of dental undergraduate students for practice, whose clinical training was interrupted by the COVID-19 pandemic from dental schools across Malaysia. MATERIALS AND METHODS: This cross-sectional web-based questionnaire survey was done among new dental graduates of the academic year 2019-2020 and the final year undergraduate students (academic year 2020-2021) from dental schools in Malaysia, using the Dental Undergraduates Preparedness Assessment Scale (DU-PAS), from 6th to 26th April 2021. The questionnaire addressed clinical skill competence, and cognitive and behavioral attributes. The number of respondents needed to achieve a confidence level of 95% with margin of error of 5% was 306. RESULTS: A total of 453 (243 final year students and 210 new graduates) responded from dental schools nationwide, with a response rate of 30.6%. The overall mean score for preparedness for dental practice was 76.3±14.7, for clinical skills 39.7±7.3, and behavioral and cognitive attributes 36.5±9.1. New graduates had significantly higher mean preparedness score (78.6±14.4) as compared to students in their final year (74.2±14.7). Performing endodontic treatment on multi-rooted teeth had the lowest perceived competency (29.8%), followed by assessing treatment needs of patients requiring orthodontics (37.1%), prescribing drugs (46.6%) and providing crowns using principles of tooth preservation (48.1%). CONCLUSIONS: Satisfactory scores were obtained for most attributes. The final-year cohort was significantly less prepared for dental practice compared to the newly graduated cohort.

T-shaped toothbrush for plaque removal and gingival health in children: a randomized controlled trial.

BACKGROUND: To evaluate an experimental T-shaped toothbrush for plaque removal and gingival health when compared to a conventional toothbrush among children. METHODS: This single blind parallel randomized controlled trial was conducted on 8-10-year-old healthy schoolchildren with no history of recent antibiotic intake, proximal caries or more than 3 missing teeth per quadrant. A computer-generated randomization list allocated child to the 2 groups. Each child received detailed instructions for tooth brushing. Gingival health and plaque scores were recorded in school at baseline, 2 weeks, 1 month and 3 months in a portable dental chair by an examiner who was blind to the allocated toothbrush. A general feedback on the use of the T-shaped toothbrush was obtained at 3 months. Data was analyzed using two-way repeated measure ANOVA, Generalized estimating equation and Bonferroni test. RESULTS: A total of 195 eligible children were invited, 110 parents gave consent and 100 children completed the study; 50 in each group. There were statistically significant reductions in mean gingival and plaque scores at each visit when compared to baseline for both toothbrushes (p < 0.05). There were no statistically significant differences between scores for the two toothbrushes at each visit (p > 0.05). Majority of participants gave positive feedback regarding the T-shaped toothbrush. CONCLUSIONS: Both toothbrushes had similar efficacy in removing plaque and improving gingival health among children. The T-shaped toothbrush is an alternative to the conventional toothbrush for oral hygiene in children. Trial registration Retrospectively registered at ClinicalTrials.gov Registry-NCT03989479 18/06/2019.

Pre-schoolers' tooth brushing behaviour and association with their oral health: a cross sectional study.

BACKGROUND: Toothbrushing is an important yet neglected behaviour that affects the oral health of preschool children. Little is reported on parental supervision, an essential aspect of routine effective toothbrushing in this age group. The aim of this study was to evaluate pre-schoolers' toothbrushing behaviour including parental involvement and its association with their oral health. METHODS: This was a cross-sectional study. A total of 92 preschool children (4-6 years) were invited to participate with their parents/guardians. Nine parameters of toothbrushing behaviour were assessed from parental responses (questionnaire) and observation of child and parents/guardians (video recording). Oral examination included recording plaque, gingival and dental caries indices. BORIS software was used to assess toothbrushing parameters and Smart PLS was used to perform association with a second-generation multivariate analysis to create models with and without confounding factors. RESULTS: Girls were slightly more (53%) than boys (47%). Children aged 4 years were slightly more in number (38%), followed by 6-year-olds and 5-year-olds. Nearly, 90% parents had tertiary education and 46% had more than 2 children. Differences were recorded in the reported and observed behaviour. Thirty-five percent parents/guardians reported using pea-size toothpaste amount but only 28% were observed. Forty percent reported to brush for 30 s-1 min, however 51% were observed to brush for 1-2 min. Half the children were observed to use fluoridated toothpaste (F < 1000 ppm) under parental supervision (11%). The mean (SD) plaque score reduction after toothbrushing was 10.80 (2.46), mean pre-brushing plaque score was 90.3 (10.2), mean gingival index was 0.89 (0.65) and mean dental caries status (ICDAS(1-6)) was 18.87 (12.39). Toothbrushing behaviour in terms of toothbrushing technique, duration, pattern and frequency, toothbrush type and grip type, toothpaste type and amount, post-brushing mouth rinsing and parental involvement contributed significantly to plaque score change (86%), dental caries status (73%), gingival index (66%) and pre-brushing plaque score (31%). The significant confounding variables had a small influence on oral health of preschool children. CONCLUSIONS: Preschool children's toothbrushing behaviour was inadequate while their oral health was poor, with a significant association between the two parameters.

Effect of Thermal Cycling on Flexural Properties of Microcrystalline Cellulose-Reinforced Denture Base Acrylic Resins.

PURPOSE: To assess the impact of thermal cycling on flexural properties of denture base acrylic resin reinforced with microcrystalline cellulose (MCC) derived from oil palm empty fruit bunch (OPEFB). MATERIALS AND METHODS: The flexural strength and flexural modulus, following thermal cycling (5000 cycles of 5-55°C) of 3 MCC-reinforced poly methyl methacrylate (PMMA) specimens were compared with the conventional and commercially available high-impact PMMA. The 3 test groups were represented by addition of various weight combinations of MCC and acrylic powders. RESULTS: All 3 test groups with the addition of MCC demonstrated improved flexural strength and flexural modulus compared to the conventional resin, without and after thermal cycling. The highest mean flexural strength corresponded to the specimens reinforced with 5% MCC followed by 2% MCC. CONCLUSION: Addition of MCC derived from OPEFB to PMMA may be a viable alternative to the existing, commercially available synthetic reinforced PMMA resins. The potential application of natural fillers in the fabrication of a reinforced denture base resin needs further study.

Prevalence and patterns of tooth agenesis among Malay children.

Tooth agenesis in Malay children, hitherto unreported, was assessed retrospectively from orthopantomograms of 834 healthy children aged 12-16 years who attended the Dental Clinic of Universiti Sains Malaysia. All teeth, including third molars, were assessed for agenesis. On an average, 2.3 teeth were missing per child. Missing third molars were found in 25.7% of children with one or two third molars found to be missing in 18.3% of children. Three point two percent of children had missing teeth other than third molars. After third molars, the upper lateral incisors were found to be the most common missing tooth (1.7%), followed by upper and lower second premolars (1.5%). Eight missing upper canines were also seen (1%). Bilateral agenesis was more common than unilateral agenesis. There were no significant differences between males and females. There was a significant difference between missing teeth between the maxilla and the mandible and right and left side, with more missing teeth in the maxilla and on the right side. The odds of any 3rd molar missing were increased 3.3 times when there was any other missing tooth. In conclusion, the prevalence of tooth agenesis among the studied population was within the normal range, but less than some Asian countries. Unlike other Asian countries, the upper lateral incisor was the most common missing tooth. The prevalence of maxillary canine agenesis was higher than most previous reports. Missing teeth were associated with missing third molars, which is likely due to a genetic abnormality.

Cross-cultural validation of Malay version of perceived professionalism among dental patients.

BACKGROUND: Professionalism is a dynamic construct that requires constant revision based on contemporary practices and attitudes. OBJECTIVES: The purpose of this study was to cross-culturally adapt an already validated English questionnaire assessing patient perceptions of professionalism among dentists, into the Malay language. METHODS: An original 24-item questionnaire was cross-cultural adapted in the Malaysian context through two phases. Phase I included content and face validity from experts' evaluation which was followed by translation into the Malay language. Phase II involved psychometric assessment including construct validity and reliability analysis. RESULTS: Expert evaluation indicated that all items demonstrated excellent content validity for the characteristics of relevance (CVI = 0.75-1.00 Kappa = 0.72-1.00) and clarity (CVI = 0.75-1.00 and Kappa= 0.72-1.00). A total of 300 dental patients completed the questionnaire. EFA was done on the first dataset and the second dataset was subjected to CFA which showed composite reliability (CR) ranging between 0.741 and 0.897 indicating acceptable reliability among items. The final questionnaire had 20 items with 3 domains; Patient expectation of a dental care provider, Ethics and Dentist's professional responsibilities, Patient communication and confidentiality. CONCLUSION: This study has successfully validated the questionnaire for patient perception of professionalism in the Malaysian context.

E-Professionalism among Dental Students from Malaysia and Finland.

The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, "e-professionalism," has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. The objective was to explore the perceptions of Malaysian and Finnish dental students on e-professionalism. A survey of 613 Malaysian and Finnish students was performed. The main variables assessed were posting of objectionable or inappropriate content among students, attitudes towards unprofessional online content, perceived online presence, contacts with patients and faculty members on social media, and concerns about social media use. The prevalence of posting clearly unprofessional content was not high among dental students. Revealing information of patients was most common content of clear unprofessionalism. Students from Malaysia contacted patients and faculty members more actively in social media than students in Finland (73.6% of students in Malaysia and 11.8% in Finland had invited faculty members to be "friends"). Malaysian students were more concerned and more likely to react to inappropriate content on social media. Attitude of dental students towards social media use in dentistry were very positive in both countries. Students agreed that guiding patients online is a new responsibility for dentists in the digital age (86.4% of students in Malaysia and 73.4% in Finland). The findings indicate the existence of both benefits and dangers of social media on e-professionalism among students. There is a need to include robust digital professionalism awareness training for students.

The global distribution of permanent canine hypodontia: A systematic review.

OBJECTIVE: To systematically review studies on canine agenesis prevalence in different populations and continents, based on the jaw, sex, location, and associated dental anomalies. METHODS: Electronic and hand searches of English literature in PubMed, Web of Science, Scopus, OpenGrey, and Science Direct were conducted, and the authors were contacted when necessary. Observational studies (population-based, hospital/clinic-based, and cross-sectional) were included. For study appraisal and synthesis, duplicate selection was performed independently by two reviewers. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology checklist, with main outcome of prevalence of canine agenesis. RESULTS: The global population prevalence of canine agenesis was 0.30% (0.0-4.7%), highest in Asia (0.54%), followed by Africa (0.33%), and the least in Europe and South America (0.19% in both continents). Canine agenesis was more common in the maxilla (88.57%), followed by both maxilla and mandible (8.57%), and the least common was mandible-only presentation (2.86%). The condition was more common in females (female:male ratio = 1.23), except in Asia (female:male ratio = 0.88) and Africa (female:male ratio = 1). In Asia, unilateral agenesis was almost twice as prevalent as bilateral, but in Europe, the bilateral form was more common. CONCLUSIONS: The overall prevalence of canine agenesis is 0.30%, with the highest prevalence in Asia, followed by Africa, Europe, and South America. The condition is more common in the maxilla than the mandible, and in females than males (except in Asia and Africa), with unilateral agenesis being more common in Asia and the bilateral form showing a greater prevalence in Europe.

Social Media Usage among Dental Undergraduate Students-A Comparative Study.

Social media use among students has infiltrated into dental education and offers benefits but may also cause problems. The aim of this study was to explore and compare current social media usage among dental undergraduate students from two countries-Malaysia and Finland. A self-administered structured online questionnaire was used. WhatsApp, YouTube, Instagram, Facebook and Snapchat were the services that were most familiar to the respondents from both countries. There were differences between the students from the two countries among the most preferred platforms. The most frequently used applications were WhatsApp (91.1% of students in Malaysia and 96.1% in Finland used it very frequently) and Instagram (74.3% of students in Malaysia and 70.0% in Finland used it very frequently). Students in Malaysia spent significantly more hours per week using the platforms as study tools than students in Finland. Over 80% of the Finnish dental students reported that lack of knowledge was not an issue in social media usage, while 85% of Malaysian students felt that lack of knowledge prevented them from using social media platforms frequently. The findings offer evidence that dental students used social media extensively.

Management of odontogenic infection in paediatric patients: a retrospective clinical study.

PURPOSE: To investigate the outpatient and inpatient management of odontogenic infections among paediatric patients attending a university hospital. METHODS: A retrospective study (2013-2015) was carried out which involved retrieving relevant data from past records (manual/electronic) of paediatric patients (under 18-years-old) who presented with odontogenic infections to the Paediatric Dentistry and Oral and Maxillofacial clinic. Data collected was organised using descriptive statistics with SPSS version 12.0.1. RESULTS: A total of 153 patients were identified, of which 83.7% were managed as outpatients. Odontogenic infections were more common in females (52.9%) and preschool children (58.2%). The most cases were seen in 2014 and maximum number of cases per month was 12. Common presentations were pain (62.1%), intraoral swelling (37.9%) and spontaneous pus discharge from the tooth and/or surrounding tissues (67.3%) with higher involvement of primary right molars. Dental panoramic tomograph was the most common radiographic investigation done. Outpatients were commonly managed chairside with pulpal opening (46.1%) at the paediatric dental clinic and 7% underwent extraction under general anaesthesia in day-care setting. Inpatients were admitted for 3 days on average and most commonly definitive care was extraction under local/general anaesthesia (68%). There were 22.7% outpatients and 72.0% inpatients who were prescribed antibiotics. CONCLUSIONS: Overall, treatment and medications prescribed adhered to current guidelines. There was a tendency to solely prescribe antibiotics in 8.6% of outpatients which is contrary to recommendations.

Dental age estimation in Malaysian adults based on volumetric analysis of pulp/tooth ratio using CBCT data.

Forensic odontology plays an important role in human identification and dental age estimation is an integral part of this process. The aim of the study was to investigate the association between chronological age and pulp/tooth volume ratio in a Malaysian population (Malays and Chinese) from cone-beam computed tomography (CBCT) scans, enhanced with Mimics software. Three hundred CBCT scans of 153 males and 147 females, aged between 16 and 65 years were divided into 5 age groups. Volumetric analysis of the pulp/tooth ratio was performed in maxillary left canines, maxillary right canines and maxillary right central incisors. Simple linear regression and Pearson correlation analysis indicated the strongest coefficient of correlation (R) values for maxillary right central incisors (0.83) followed by maxillary right canines (0.74) and maxillary left canines (0.73). Fisher's Z test indicated that dental age estimation is gender independent. The derived regression equations were further validated on an independent group of 126 teeth. The results indicated mean absolute error (MAE) values of 6.48 and 8.58 years for maxillary right central incisors and maxillary canines respectively. It was also noticed that MAE values were higher among the age groups ranging from 46 to 65 years. This study showed that a volumetric change in the pulp cavity with age is a valuable assessment method for dental age estimation among Malaysian population.

Comparison of two methods of dental age estimation in 7-15-year-old Malays.

BACKGROUND: Numerous methods of age estimation have been proposed. The Demirjian method is the most frequently used, which was first applied in a French Canadian population in 1973. The Willems method is a modification of the above and was applied in a Belgian population in 2002. OBJECTIVES: The objectives of this study were to test the applicability of the two methods, namely Demirjian and Willems, for age estimation in a Malay population, and to find the correlation between body mass index and the difference between the dental age and the chronological age. MATERIALS AND METHODS: A cross-sectional study involving 214 boys and 214 girls, selected by a simple stratified random sampling method was carried out. The orthopantomograph was used to score the seven left mandibular teeth, and the calculated maturity score was used to obtain the Demirjian dental age. Willems dental age was estimated using the tables proposed in the Willems method. Results. The Demirjian method overestimated the age by 0.75 and 0.61 years, while the Willems method overestimated the age by 0.55 and 0.41 years among boys and girls, respectively. In boys, the body mass index was significantly correlated to the difference in age using the Willems method. CONCLUSION: Further modification of either method is indicated for dental age estimation among the Malay population.

Dental age estimation employing CBCT scans enhanced with Mimics software: Comparison of two different approaches using pulp/tooth volumetric analysis.

The methods of dental age estimation and identification of unknown deceased individuals are evolving with the introduction of advanced innovative imaging technologies in forensic investigations. However, assessing small structures like root canal volumes can be challenging in spite of using highly advanced technology. The aim of the study was to investigate which amongst the two methods of volumetric analysis of maxillary central incisors displayed higher strength of correlation between chronological age and pulp/tooth volume ratio for Malaysian adults. Volumetric analysis of pulp cavity/tooth ratio was employed in Method 1 and pulp chamber/crown ratio (up to cemento-enamel junction) was analysed in Method 2. The images were acquired employing CBCT scans and enhanced by manipulating them with the Mimics software. These scans belonged to 56 males and 54 females and their ages ranged from 16 to 65 years. Pearson correlation and regression analysis indicated that both methods used for volumetric measurements had strong correlation between chronological age and pulp/tooth volume ratio. However, Method 2 gave higher coefficient of determination value (R2 = 0.78) when compared to Method 1 (R2 = 0.64). Moreover, manipulation in Method 2 was less time consuming and revealed higher inter-examiner reliability (0.982) as no manual intervention during 'multiple slice editing phase' of the software was required. In conclusion, this study showed that volumetric analysis of pulp cavity/tooth ratio is a valuable gender independent technique and the Method 2 regression equation should be recommended for dental age estimation.

Exfoliative cheilitis: report of a case.

Exfoliative cheilitis, one of a spectrum of diseases that affect the vermilion border of the lips, is uncommon and has no known cause. However, factors such as stress and some psychiatric conditions are associated with the onset of the disease. This condition is disabling because esthetics and normal functions such as eating, speaking and smiling are compromised. The lack of specific treatment makes exfoliative cheilitis a chronic disease that radically affects a person"s life. This report attempts to further investigate the clinical course of the disease and provides detailed illustrations of the cyclical nature of the disease.

Measuring service quality of public dental health care facilities in Kelantan, Malaysia.

UNLABELLED: This study investigates patients' expectations and perceptions of service quality in public dental health care and measures their "satisfaction gap." This descriptive study involved 481 dental outpatients in Kelantan, Malaysia. A modified SERVQUAL 20-item instrument was used to assess patients' expectations before and perceptions after receiving dental treatment. The "satisfaction gap" was then measured. RESULTS: showed that patients visiting for management of dental pain were more satisfied (P = .007) than those visiting with appointment. The most significant service quality dimensions were related to responsiveness, assurance, and empathy of the dental health care providers. There was a significant difference between the patients' expectations and their perceptions of service provided (P < .01) with regard to all dimensions. In conclusion, dental service providers should give emphasis to the compassionate and emotional aspects of care and to remember that they are integral components of quality service.