1.Methods and indices in measuring fluorosis: A review
Archives of Orofacial Sciences 2017;12(2):77-85
exposure during enamel formation. Increased and decreased in fluorosis prevalence may also reflect
to the different ways of measuring the disease. The choice of measuring fluorosis is depends on the objective of
the assessment such as assessing public health significant of fluorosis in the population or assessing the detailed
of biological effects of fluoride. These differences in requirement have led to the adoption of many indices and
assessment methods of enamel fluorosis, which subsequently led to evaluation of examiner agreement between
them. Several indices were developed to measure dental fluorosis in the 20th century. These include fluorosis
specific indices such as Dean’s Index; the Thylstrup and Fejerskov Index; the Total Tooth Surface Index; and the
Fluorosis Risk Index. Non-specific descriptive indices such as the Developmental Defects of Enamel index have
also been used to record fluorosis. Fluorosis has most commonly been recorded using clinical examinations and
photographs. Recent developments have seen the use of a Visual Analog Scale and automated grading systems
such as Quantitative Light Fluorescence emerge as possible enhancements to fluorosis scoring. This article aims
to review existing indices and new methods in measuring dental fluorosis, together with examiner reliability
across different methods and indices.
Fluorosis, Dental
;
Fluorides
2.Tobacco use and attitudes towards tobacco control activities of Malaysian dental students
Nor Azlida Mohd Nor ; Nurulain ISMAIL ; Farhan IBRAHIM ; Ishak Abdul RAZAK ; Norintan AB-MURAT
Archives of Orofacial Sciences 2018;13(1):6-15
Tobacco usage among dental students and the amount of training they received may have an impact on tobacco cessation activities undertaken for their patients. This study aims to assess Malaysian dental students’ tobacco use, exposure to second-hand smoke and their attitude towards tobacco control activities and curriculum. This was a cross-sectional study using a self-administered questionnaire adapted from the Global Health Professions Students Survey (GHPSS). The questionnaire was distributed to all Malaysian fourth and fifth year dental students in four public dental schools (n=372), namely University of Malaya (UM), Universiti Teknologi Mara (UiTM), Universiti Kebangsaan Malaysia (UKM) and Universiti Sains Islam Malaysia (USIM). The data were analysed using descriptive and chi square tests. In total, (n=349) respondents completed the questionnaire, yielding a 93.8% response rate. Although the prevalence of Malaysian dental students who ‘ever smoked’ was 21.2%, the prevalence of current smokers was low (2.3%). About 62% and 39% of students reported having been exposed to second-hand smoke in public and at home, respectively. USIM students were significantly less likely to recall having received training about approaches to smoking cessation (52.9%, p<0.001). Significantly fewer smokers than non-smokers agreed on tobacco banning policy. Regardless of their smoking status, the majority of dental students showed positive attitudes towards dentists’ role in tobacco cessation. Tobacco user among Malaysian dental students was low. There were statistically significant differences between ever smokers and non-smokers’ attitudes towards tobacco banning policy. The majority of dental students showed positive attitudes towards dentists’ role in tobacco cessation.
3.Fake Braces by Quacks in Malaysia: An Expert Opinion
Nor Azlida Mohd Nor ; Wan Nurazreena Wan Hassan ; Mohd Zambri Mohamed Makhbul ; Zamros Yuzadi Mohd Yusof
Annals of Dentistry 2020;27(1):33-40
Dental quackery has been a problem for decades and is becoming a major concern in many countries, including Malaysia. Recent development of a new service offered by quacks in Malaysia is “fake braces”, which alarmed dental professionals. The fake braces appear similar to the professionally fitted orthodontic appliances comprising of archwires that are secured on brackets by coloured ligatures except they are fitted by unqualified individuals who have no formal clinical training. In addition, the orthodontic materials and dental equipment used for this illegal service were substandard and unregulated. Therefore, such fitted appliances are harmful to the teeth and oral health. Efforts to record the extent of fake braces practice and its oral health consequences have been challenging as they are marketed through the social media, and the victims were either reluctant to come forward or did not know the appropriate channel to file a complaint to the health authority. This is an expert opinion paper with the aims to highlight typical presentation of fake braces, modus operandi of fake braces providers, the harmful effects of fake braces on the patient’s oral health, the role of social media advertising in promoting fake braces, and the impacts to the illegal providers.
4.Prevalence of Dental Fluorosis and Its Associated Factors After Cessation of Water Fluoridation
Faizah Abdul Karim ; Zamros Yuzadi Mohd Yusof ; Nor Azlida Mohd Nor
Malaysian Journal of Medicine and Health Sciences 2021;17(No.1):68-76
Introduction: Water fluoridation (WF) was ceased in the state of Pahang, Malaysia, in July 2012. Any changes in
fluoride exposure during childhood can influence the development of fluorosis. Thus, this study aimed to compare
the prevalence of fluorosis between WF-ceased and WF-continued areas in Malaysia, and its associated factors
among 7 and 12-year-old children. Methods: A cross-sectional study was conducted among children in WF-ceased
and WF areas (n=1211). The 12-year-olds in WF-ceased areas were exposed to WF between 4.5 to 6.5 years before
cessation, and it was hypothesised they would have similar fluorosis prevalence as their counterparts who lived
in WF areas. The 7-year olds were born during the cessation period. Examination of fluorosis was performed by a
calibrated dentist using Dean’s criteria and a parental questionnaire was utilised to collect information about demographics and exposure to fluoride. Results: Fluorosis prevalence (Dean’s≥2) was significantly lower among children
in WF-ceased areas than WF areas (p< 0.001). Intra-area comparison indicated that the 12-year olds have higher
prevalence of fluorosis than the 7-year-olds, except for anterior fluorosis scores among those in WF areas. The majority of fluorosis cases were very mild in both areas. Simple logistic regression indicated that duration of exposure to
WF, age, mother’s income and education, age started toothbrushing with toothpaste, and frequency of toothbrushing
were associated with fluorosis. Conclusions: Fluorosis prevalence decreased following water fluoridation cessation.
The null hypothesis that 12-year-olds in both areas would have similar prevalence of fluorosis was rejected. Several
factors were associated with fluorosis.
5.Assessment of Fluoride and pH Levels in a Range of Ready-to-Drink Children’s Beverages Marketed in Malaysia
Aira Syazleen Ahmad ; Nor Azlida Mohd Nor ; Nadia Afiqah Ahmad ; Zamros Yuzadi Mohd Yusof ; Ivor G. Chestnutt
Archives of Orofacial Sciences 2021;16(2):177-189
ABSTRACT
This study aimed to determine the fluoride and pH levels of beverages likely to be consumed by children
in Malaysia and to estimate daily fluoride intake from consumption of these beverages. A convenience
sampling of 120 ready-to-drink beverages were purchased and categorised into 11 groups (UHT
recombined milk, fresh milk [pasteurised], cultured milk [probiotic], yogurt beverages, fresh fruit
juices, fruit flavoured beverages, soy-based beverages, malt-based beverages, tea, carbonated beverages
and bottled waters). Fluoride concentration was measured using a fluoride ion-selective electrode while
the pH level was measured using a pH meter. The fluoride concentration in the beverages ranged from
0.02±0.00 mg/L to 2.77±0.06 mg/L. Tea was found to have the highest fluoride concentration. The
intake of fluoride from consumption of other types of beverages is below the lowest-observed-adverse-effect level (except tea). The pH of the beverages included in the study ranged from 2.20±0.01 to
7.76±0.00. Carbonated beverages (mean pH: 2.98±0.50) were found to be extremely acidic followed
by fresh fruit juices (mean pH: 3.38±0.34) and fruit flavoured beverages (mean pH: 3.90±0.92).
The correlation between fluoride and pH levels was weak, τ = 0.058 and not statistically significant
(p < 0.35). The majority of the beverages had a low fluoride level and their consumption is unlikely to
cause fluorosis except for tea. Almost half of the beverages had a low pH level with carbonated beverages
being the most acidic.
Fluoridation
;
Carbonated Beverages
;
Dental Care for Children
;
Acid-Base Imbalance
6.Factors Affecting Oral Health-related Quality of Life Among the Homeless Population in Malaysia: a Structural Equation Modelling Analysis
Dewi Mayang Sari Kamarozaman ; Norintan Ab-Murat ; Mahmoud Danaee ; Nor Azlida Mohd Nor
Malaysian Journal of Medicine and Health Sciences 2022;18(No.1):83-90
Introduction: Despite the increased number of homeless people in Malaysia, there is limited information on their
oral health status and oral health-related quality of life (OHRQoL). This study aims to investigate the impact of caries
experience, dental anxiety, oral health (OH) knowledge, and OH behaviours on the OHRQoL of homeless adults in
Malaysia, as well as to determine the mediation role of caries experience towards OHRQoL. Methods: A cross-sectional study involving homeless persons was conducted in five states in Malaysia. Dental caries was examined using
Decayed, Missing and Filled Teeth (DMFT) index. Face-to-face interview was conducted to collect information about
OH knowledge and behaviours, dental anxiety, and OHRQoL using validated questionnaires. Meanwhile, descriptive and bivariate analyses were conducted using SPSS. Partial least squares structural equation modelling (PLS-SEM)
was performed to test the hypotheses of the conceptual model with the support of SmartPLS. Results: A total of 192
homeless people completed the questionnaire and oral examination. The majority were male (84.9%), with a mean
age of 43.72 (SD = 11.6). The severity of OHRQoL impact (mean OHIP score) was 18.61(SD = 11.3). There were
significant independent relationships between dental anxiety (β = 0.306, p < 0.001) and caries experience (β = 0.280,
p < 0.001) on the homeless OHRQoL. It was found that the relationship between OH knowledge and OHRQoL was
significantly mediated by caries experience. Conclusion: According to the structural model, caries experience, dental
anxiety, and OH knowledge have significantly impacted the OHRQoL of the Malaysian homeless. These studied
factors should be considered in the adoption of a holistic approach to improve the OHRQoL among homeless people
in Malaysia.