nformation regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
Dental Caries ; Fluorosis, Dental ; Malaysia ; Review [Publication Type] ; Fluoridation

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.

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.

ABSTRACT Most prior oral health-related quality of life (OHRQoL) research concerning temporomandibular disorders (TMDs) had utilised generic OHRQoL measures. This study aimed to translate and validate the Malay version of Oral Health Impact Profile for TMDs (OHIP-TMDs), a TMDs-specific OHRQoL tool, for use in Malay literate populations. The translation and cross-cultural adaptation of the OHIP-TMDs into the Malay language were implemented according to the international guidelines. A convenience sample of 243 subjects completed the Malay OHIP-TMDs (OHIP-TMDs-M) as well as the Malay Short Oral Health Impact Profile (S-OHIP-M), Global Oral Health ratings (GOH-M) and Fonseca Anamnestic Index (FAI-M). The OHIP-TMDs-M was re-administered to a subset of 40 subjects after two weeks for test-retest reliability. Concurrent, convergent and discriminative validity were assessed using Spearman’s rank correlation, Kruskal Wallis and Mann-Whitney U tests with significance level set at p < 0.05. The OHIP-TMDs-M was found to have excellent internal consistency (Cronbach’s alpha = 0.98) and test-retest reliability (intraclass correlation coefficient = 0.99, p < 0.001). A strong and positive correlation with S-OHIP-M (rs = 0.74) was observed, and OHIP-TMDs-M scores differed significantly between subjects with disparate GOH-M ratings (p < 0.001). Furthermore, the OHIP-TMDs-M was able to discriminate between subjects with and without TMDs. The OHIP-TMDs-M was found to have excellent reliability and good validity. It is a promising tool for assessing TMDs-specific OHRQoL in Malay literate populations.
Quality of Life ; Oral Health ; Temporomandibular Joint Disorders

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

Introduction: The McMaster Family Assessment Device (FAD) has been used to measure family functioning in several cultures. The FAD’s 12-item General Functioning Subscale (GF12) provides a general assessment of family functioning. This study aims to assess the cross-cultural adaptation of the FADGF12 scale in the Malaysian population. Methods: The translation and adaptation procedure of the Malay GF12 was based on the dual-panel methodology. This involved a bilingual panel (providing the initial translation into the Malay language) followed by a lay panel (where items are assessed for comprehension and acceptability). A mixed-methods approach with exploratory sequential study design was employed. This study used a mixed-methods approach, combining a quantitative survey of the Malay version of GF12 and a qualitative focus group analysis of dual-panel members. Results: Two hundred and fifty-one parents who have children attending Tadikas (pre-school) responded to the Malay GF12. In the reliability analysis, the internal consistency value was good; in the test-retest analysis, the intra-class correlation values were more than 0.7. In the exploratory factor analysis, two factors were extracted. In the confirmatory factor analysis, a single factor 12-item model did not fit well. Alternatively, a 2-factor-6-item model showed sufficient fit. The two constructs are comprised of Positive and Negative Items. Conclusion The Malay version of GF12 has adequate psychometric properties to measure family functioning in the Malay speaking population.
Factor Analysis, Statistical