Impact of non-surgical periodontal therapy on OHRQoL in an obese population, a randomised control trial.

BACKGROUND: Oral Health Related Quality of Life (OHRQoL) is an important measure of disease and intervention outcomes. Chronic periodontitis (CP) is an inflammatory condition that is associated with obesity and adversely affects OHRQoL. Obese patients with CP incur a double burden of disease. In this article we aimed to explore the effect of Non-Surgical Periodontal Therapy (NSPT) on OHRQoL among obese participants with chronic periodontitis. MATERIALS AND METHODS: This was a randomised control clinical trial at the Faculty of Dentistry, University of Malaya. A total of 66 obese patients with chronic periodontitis were randomly allocated into the treatment group (n=33) who received NSPT, while the control group (n=33) received no treatment. Four participants (2 from each group) were non-contactable 12 weeks post intervention. Therefore, their data were removed from the final analysis. The protocol involved questionnaires (characteristics and OHRQoL (Oral Health Impact Profile-14; OHIP-14)) and a clinical examination. RESULTS: The OHIP prevalence of impact (PI), overall mean OHIP severity score (SS) and mean OHIP Extent of Impact (EI) at baseline and at the 12-week follow up were almost similar between the two groups and statistically not significant at (p=0.618), (p=0.573), and (p=0.915), respectively. However, in a within-group comparison, OHIP PI, OHIP SS, and OHIP EI showed a significant improvement for both treatment and control groups and the p values were ((0.002), (0.008) for PI), ((0.006) and (0.004) for SS) and ((0.006) and (0.002) for EI) in-treatment and control groups, respectively. CONCLUSION: NSPT did not significantly affect the OHRQoL among those obese with CP. Regardless, NSPT, functional limitation and psychological discomfort domains had significantly improved. TRIAL REGISTRATION: ( NCT02508415 ). Retrospectively registered on 2nd of April 2015.

Dentinal tubules occluded by bioactive glass-containing toothpaste exhibit high resistance toward acidic soft drink challenge.

BACKGROUND: Dentine hypersensitivity is a common problem attributed by patent dentinal tubules. Ingredients incorporated in toothpastes aim to occlude patent dentinal tubules to minimize the dentine hypersensitivity. However, frequent consumption of acidic soft drinks may reverse the dentinal tubules' occlusion. In this in vitro study, the efficacy of dentinal tubules occluded by commercially available toothpastes to withstand different durations of an acidic soft drink challenge was investigated. METHODS: One hundred and twenty dentine discs were divided into three groups. The discs from each group were brushed with toothpaste containing bioactive glass, arginine and control toothpaste. Each group was then divided into four subgroups and exposed to acidic soft drink over four different time durations. RESULTS: The scoring and the percentage of occluded dentinal tubules by Novamin-containing toothpaste was significantly better compared with arginine or the control toothpaste. Acidic soft drink challenge reduced the extent of dentinal tubules occlusion along with time. Dentinal tubules occluded by Novamin-containing toothpaste withstand the acidic challenge comparatively for a longer period. CONCLUSIONS: The findings demonstrated that occlusion of dentinal tubules is more efficient by the bioactive glass-containing toothpaste and thus may contribute to its better resistance to acidic soft drink challenge.

Establishing and managing a periodontal biobank for research: the sharing of experience.

Periodontal bio-repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad-based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders.

Awareness And Knowledge Of Smoking And Periodontitis Among Dental Patients

Objective: This study aimed to assess the awareness of periodontal disease and level of knowledgeof the relationship between smoking and periodontal disease amongst subjects who were smokersverses non-smokers. Methods: A questionnaire looking at knowledge of respondents regardinggum disease and knowledge and awareness about oral impacts of smoking on periodontal diseasewas developed and pretested in Dental Faculty University of Malaya. Basic Periodontal Examination(BPE) index was used to assess periodontal status. Results: The questionnaire was answered by130 subjects. Prevalence of smoking was 14.6%. A total of 58.6% non-smokers and 57.9% smokersknew about periodontal disease. However, only 26.1% non-smokers and 10.5% smokers knew thatthe cause for periodontal disease was plaque. More non-smokers than smokers knew that smokingaffected periodontal health (80.2% and 68.4% respectively) (p>0.05) and tooth mobility was an effect ofsmoking on periodontal health (27.0% and 0%) (p<0.05). Regarding source of information on effect ofsmoking on periodontal health, 63.2% smokers and 63.1% non-smokers reported obtaining informationthrough the mass media. However, only 31.6% smokers and 28.8% non-smokers were informed bytheir dentist. Conclusion: The awareness of periodontal disease and knowledge of the relationshipbetween smoking and periodontal disease was low in this selected population of smokers and nonsmokers.

Comparison of two methods in deriving a short version of oral health-related quality of life measure.

OBJECTIVE: To compare two methods of developing short forms of the Malaysian Oral Health Impact Profile (OHIP-M) measure. METHOD: Cross sectional data obtained using the long form of the OHIP-M was used to produce two types of OHIP-M short forms, derived using two different methods; namely regression and item frequency methods. The short version derived using a regression method is known as Reg-SOHIP(M) and that derived using a frequency method is known as Freq-SOHIP(M). Both short forms contained 14 items. These two forms were then compared in terms of their content, scores, reliability, validity and the ability to distinguish between groups. RESULTS: Out of 14 items, only four were in common. The form derived from the frequency method contained more high prevalence items and higher scores than the form derived from the regression method. Both methods produced a reliable and valid measure. However, the frequency method produced a measure, which was slightly better in terms of distinguishing between groups. CONCLUSION: Regardless of the method used to produce the measures, both forms performed equally well when tested for their cross-sectional psychometric properties.

Cross-cultural adaptation of the Oral Health Impact Profile (OHIP) for the Malaysian adult population.

OBJECTIVE: The aim of this project was to develop an oral health related-quality of life measure for the Malaysian adult population aged 18 and above by the cross-cultural adaption the Oral Health Impact Profile (OHIP). METHOD: The adaptation of the OHIP was based on the framework proposed by Herdman et al (1998). The OHIP was translated into the Malay language using a forward-backward translation technique. Thirty-six patients were interviewed to assess the conceptual equivalence and relevancy of each item. Based on the translation process and interview results a Malaysian version of the OHIP questionnaire was produced that contained 45 items. It was designated as the OHIP(M). This questionnaire was pre-tested on 20 patients to assess its face validity. A short 14-item version of the questionnaire was completed by 171 patients to assess the suitability of the Likert-type response format. Field-testing was conducted in order to assess the suitability of two modes of administration (mail and interview) and to establish the psychometric properties of the adapted measure. RESULTS: The pre-testing revealed that the OHIP(M) has good face validity. It was found that the five-point frequency Likert scale could be used for the Malaysian population. The OHIP(M) was reliable, where the scale Cronbach's alpha was 0.95 and the ICC value for test-retest reliability was 0.79. Three out four construct validity hypotheses tested were confirmed. OHIP(M) works equally well as the English version. CONCLUSION: OHIP(M) was found to be reliable and valid regardless of the mode of administration. However, this study only provides initial evidence for the reliability and validity of the measure. Further study is recommended to collect more evidence to support these results.

The impact of oral conditions on the quality of life of the Malaysian adult population: preliminary results.

The aim of this paper is to describe the impact of oral conditions on the quality of life of the adult population of Malaysia. The adapted Malaysian Oral Health Impact Profile (L-OHIP-M) questionnaire was used. A total of two hundred and twenty respondents completed the L-OHIP(M). Overall, slightly more than 50% of the sample had at least one impact reported as either "very often" or "often". The younger age group, Indian ethnic and those who had tertiary education reported more impacts. The preliminary results revealed that a substantial proportion of the sample included in this study experienced frequent psychosocial impacts associated with oral conditions.

Nuclear and cellular volumetric alterations in oral lichen planus and lichenoid lesions: a histomorphometric study.

There is presently no line of distinction between oral lichen planus and other oral lichenoid lesions. The aim of this study is to determine using histomorphometry, the differences between these lesions. Paraffin sections from 7 normal buccal epithelium, 19 oral lichen planus (LP), 14 oral lichenoid lesions (LL) and 7 discoid lupus erythematosus-like lesions (DLE-ll) were selected. The nuclear volume (V(N)) and cellular-volume (V(CELL)) of the epithelium were assessed using an image analyser. The V(N) and V(CELL), derived for both basal and spinal strata in LP and DLE-ll were 2.3 times more than that of normal tissues. There was a significant difference between LP and LL (P < 0.005) and between LL and DLE-ll (P < 0.001), but not between LP and DLE-ll. In conclusion, there appears to be a difference between LP, LL and DLE-ll and V(N) and V(CELL) may serve as potential discriminators between these groups of lesions.

Dental needs of elderly hostel residents in inner Melbourne.

BACKGROUND: The purpose of this study was to determine the oral health status and treatment needs of elderly hostel residents in Melbourne. METHOD: One hundred and seventy-five subjects aged 65+ were selected from 20 hostels within a 10 km radius of Melbourne's central business district. RESULTS: Subjects were clinically examined and interviewed using a standard questionnaire. In the course of the clinical examination, coronal caries, root caries, periodontal disease, denture status and related treatment needs were assessed. The mean age of the subjects was 83.7, the majority of whom were female (80 per cent). About 35 per cent of the sample were dentate. The mean number of teeth present among dentate persons was 13.8, the mean coronal caries experience was 24.9 DMFT and mean root caries was 2.3 R-DF. Of the dentate subjects, 46 per cent required at least one restoration for coronal caries and 30 per cent required at least one restoration for root caries. Most dentate subjects had calculus and none had deep pockets, therefore, indications for periodontal treatment did not include complex care. More than 50 per cent of lower full dentures were retained unsatisfactorily and about half of the total number of subjects required prosthetic treatment. CONCLUSIONS: Although there was a high number of treatment needs, most requirements involved simple technologies that could be delivered by auxiliaries.

A dental-anthropological study of health and illness behaviour among Orang Asli of the Semai Tribe: the perspective of traditional healers.

This observational study investigates and describes the oral health beliefs and illness behaviour in the Semai tribe of Orang Asli community. Data was obtained from a "Key informant interview" method i.e. the village Tok Halaq (Traditional healer). Information about common oral diseases and conditions were illustrated with enlarged pictures of dental caries, periodontal disease, oral cancer and cleft. The most common oral problem was toothache. This is treated by self-medication. However if the pain still persist, the Tok Halaq was consulted to start traditional methods. He will identify the cause. If "germs" were thought to be the cause, he will ask the person to see a doctor. Otherwise, he attempts traditional treatment. If the effort failed after a few days, the person will be advised to see a doctor. It appears that the Tok Halaq plays an influential role in prevention, promotion and the healing process in this community. Hence any effort to promote oral health and prevent oral disease must seek their cooperation. Their beliefs on causes of common oral diseases are described in the text.