Cross-cultural adaptation and psychometric properties of the Malay version of parenting and child tooth brushing assessment (M-PACTA).

BACKGROUND: Malaysian preschool children continue to exhibit a high prevalence of dental caries and poor oral hygiene. There is a need to gain an in-depth understanding of oral hygiene habits and design suitable interventions to improve oral hygiene in early childhood. OBJECTIVE: To cross-culturally adapt and determine the psychometric properties of the Malay-translated Parenting and Child Tooth Brushing Assessment questionnaire (M-PACTA). METHODOLOGY: This cross-sectional study involved face and content validation, and forward and back-translation of PACTA. The M-PACTA was then tested for reliability and construct validity on 150 Malaysian parents of children aged 5 to 6 years old. RESULTS: Face validity indicated that the M-PACTA items were clear and easy to understand. For content validity, some words had to be modified in accordance with the recommendations of the expert committees to make it more coherent to Malaysians. Some statements in the parental knowledge scales were modified according to the guidelines applicable in Malaysia. The content comparison of the back translation with the adapted PACTA revealed that all items were semantic and linguistically equivalent. Exploratory factor analyses of M-PACTA suggested a two-factor structure for three scales including child behaviour scale ('non-compliance' and 'avoidance behaviour'), parental attitudes ('lack of concern' and 'attitude of care'), and parental knowledge ('general tooth brushing knowledge' and 'awareness of tooth brushing care') while for the parental strategy scale, three-factor structure was extracted including 'routine positive methods', 'uncommon positive methods', and 'negative methods'. Internal consistencies for all scales were good (α > 0.9). CONCLUSION: M-PACTA did not replicate the construct of the original PACTA. Nonetheless, M-PACTA demonstrated good construct validity, internal consistency reliability, and test-retest reliability within Malaysian context.

Expert consensus on relevant topics for undergraduate paediatric dental curriculum using the fuzzy Delphi method: a new direction for Malaysian dental education.

BACKGROUND: Paediatric dentistry is a branch of dental specialty that focuses on dental care for children from infancy through adolescence. However, there is no standardised national undergraduate paediatric dental curriculum in Malaysia. The present study aimed to identify relevant topics for undergraduate paediatric dental curricula and to determine the appropriate cognitive and psychomotor levels for each topic based on the consensus among paediatric dental experts. METHODS: Potential relevant undergraduate paediatric dentistry topics were initially drafted and revised according to the revised national competency statement. The final draft included 65 topics clustered under 18 domains. A fuzzy Delphi method was used and experts who fulfilled the inclusion criteria were invited to anonymously ranked the importance of relevant topics using a five-point Likert scale and proposed suitable cognitive and psychomotor levels for each topic. Fuzzy evaluation was then performed, and experts were considered to have reached a consensus if the following three conditions were achieved: (a). the difference between the average and expert rating data was ≤ 0.2; (b). the average expert consensus was ˃70%; and (c). the average fuzzy number was ≥ 0.5. Subsequently, the mean ratings were used to determine the cognitive and psychomotor levels. RESULTS: 20 experts participated in the survey. 64 out of 65 paediatric dentistry topics were deemed acceptable. The average fuzzy number ranged from 0.36 to 0.85, while the average Likert score ranged from 3.05 to 5.00. The topic "Dental amalgam" was rejected based on expert consensus since the average fuzzy number was 0.36. The most significant topic was "Pit and fissure sealant", followed by "Preventive advice", "Early childhood caries", "Dental caries in children & adolescent", "Management of dental caries in paediatric patients", and "Consent" which were equally ranked as the second most important topics. According to Bloom's and Simpson's taxonomies, most of the paediatric dentistry topics were rated adequate for undergraduate students at the cognitive level of "Apply" (C3) and a psychomotor level of "Guided response" (P3). CONCLUSION: The current study successfully identified relevant undergraduate paediatric dentistry topics using the fuzzy Delphi method, which can facilitate future educators to improve existing Malaysian undergraduate paediatric dental curricula.

Treatment Outcomes of Pulpotomy in Primary Teeth with Irreversible Pulpitis: A Systematic Review and Meta-Analysis.

AIM: This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. METHODS: This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool. RESULTS: Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference (p > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias. CONCLUSIONS: Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted.