Accessibility to Oral Health Care Services and Oral Health-Related Quality of Life Among Children with Cerebral Palsy Children with cerebral palsy (CP) are highly dependent on their caregivers to access oral health care services (OHS), which leads to unmet oral health needs that affect their oral health-related quality of life (OHRQoL). This study explored accessibility to OHS and OHRQoL among children with CP attending Community-Based Rehabilitation (CBR) centres in Kelantan by their primary caregivers. A cross-sectional study using Accessibility to Oral Health Care Services (CP2OHS) and Parental-Caregiver Perception Questionnaire (P-CPQ) was conducted on 81 children with CP and their primary caregivers. CP2OHS domains are “ability to perceive”, “ability to engage”, “ability to seek”, “ability to pay”, and “ability to reach”, while PCPQ domains include oral symptoms, functional limitation, emotional wellbeing, and social well-being. Children with CP were mostly males (63.0%), with a mean (SD) age of 10.3 (3.93) years, Gross Motor Function Classification System (GMFCS) Level V (46.9%), and Communication Function Classification System (CFCS) Level III (33.3%). Their caregivers were mainly female (85.2%), aged 43.6 (9.34) years. The mean (SD) total score for CP2OHS was 29.67 (10.81) of –56 to 56 and P-CPQ was 13.21 (5.89) of 8 to 40. There was a significant difference in accessibility scores between tertiary, lower secondary, and primary levels of education (p = 0.009); village and city/ town residents (p = 0.013); and transportation with personal car and motorcycle (p = 0.004). The Pearson analysis revealed a weak positive correlation between accessibility and OHRQoL scores (r = 0.158, p = 0.16) that was not statistically significant. Children with CP posed high CP2OHS scores and low P-CPQ scores, indicating high accessibility to OHS and high OHRQoL. Strengthening OHS utilisation among these children is crucial for a better quality of life for them.

Dental Anxiety and Fear in 13-Year-Old School Students and Their Relationship to Dental Caries Despite receiving school dental service programme since primary school, adolescents were reported to have high prevalence of dental anxiety and fear (DAF) and caries. This study aimed to determine prevalence of DAF and its association with caries among the 13-year-old school students. A cross sectional study was conducted at a secondary school in Kota Bharu, Kelantan. Data was collected using a validated Malay version of the DAF questionnaires (IDAF4C+). Sociodemographic profiles were obtained and caries prevalence was determined using Decayed, Missing and Filled Teeth Index (DMFT). Chi-square analysis were conducted with significant level set at p<0.05. A total of 196 Malay schoolchildren participated with higher proportion of males (54.6%). The mean score of IDAF-4C was 2.24 (SD 0.76). The prevalence of DAF was high at 19.9% (95%Cl:14.3%, 25.5%). Having treatment under unsympathetic or unkind dentist was reported as the most anxiety-eliciting [mean (SD)=3.89(1.38)]. Prevalence of dental caries was 48.0% (95%Cl:40.9%, 55.0%). Students with untreated caries, missing and filled teeth were 23%, 2.6% and 39.3% respectively. No significant association between DAF and caries prevalence was observed. Strategies in helping adolescents to cope with their DAF should be employed to prevent the progression of DAF into adulthood.

This study aims to determine the prevalence of dental anomalies and MSX1 gene 799G>T polymorphism and its association with non-syndromic cleft lip with or without palate (NSCLP) attending Hospital Universiti Sains Malaysia. Clinical and radiological assessments on 37 NSCL±P patients and 80 non-cleft children were done to detect dental anomalies. The buccal cells were collected and polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) was used to identify polymorphism. NSCL±P was higher among males (54%) and mostly unilateral cleft lip and palate (51.3%). The prevalence of dental anomalies in morphology in NSCL±P was 18.9% (95% CI: 5.7%, 32.2%) and non-cleft was 6.3% (95% CI: 0.8%, 11.7%). Hypodontia in NSCLP was 75% (95% CI: 61.2%, 90.2%) and non-cleft was 7.5% (95% CI: 1.6%, 13.4%). There was a significant association between NSCLP and anomalies in morphology (P= 0.04; OR=3.5)) and number (P< 0.01; OR= 40). There was an absence of rare 799G>T polymorphism in all NSCL±P and non-cleft children indicating that all samples contain common 799G polymorphism. In conclusion, the prevalence of dental anomalies in morphology and number was significantly higher in NSCL±P compared to non-cleft children. However, it was not significantly associated with MSX1 799G>T polymorphism.

Introduction: Autism spectrum disorder (ASD) is associated with behavioural problems which may affect children’s oral health statuses. Caregivers have crucial roles in caring for these children’s oral health. Thus, this study is aimed to evaluate the effectiveness of the Oral Health Care for Children with ASD (OHASD) Module in improving caregivers’ tooth-brushing difficulties in children ASD. Methods: Quasi-experimental study on caregivers of children with ASD aged 7 to 12 years who were registered at the Psychiatry Clinic Hospital Universiti Sains Malaysia (USM), Kelantan. The sociodemographic data obtained, and behavioural problems were assessed. Tooth-brushing difficulties were evaluated at pre- and six months post-intervention using OHASD Module. Data were analysed using IBM SPSS 26.0. Results: A total of 32 Malay children with ASD including their caregivers participated in this study. Caregivers were mostly mothers (78.1%) and children were mostly boys (84.4%), with mean age (SD) of 39.1 (4.19) and 8.8 (1.52) years respectively. Parent-reported questionnaire using the Modified Checklist for Autism in Toddlers (M-CHAT) showed 65.6% of children were highly sensitive to noises, 53.1% sometimes stared at nothing or wandered without purpose and 59.4% were unable to imitate caregivers’ faces. Significant differences between pre- and post-intervention for items; children who liked to close their mouths, turn their heads in different directions, did not understand the purpose of tooth-brushing (P<0.05). Conclusion: OHASD Module is useful in assisting caregivers in practising daily tooth-brushing of children with ASD.

Nowadays, tobacco companies target to recruit new smokers among adolescents due to this age group was easy to be influenced by smoking behaviours. This narrative review aimed to explore the possible impact of smoking among adolescents. Knowing the negative impacts of smoking might result in avoiding continuing the habit or preventing from initiation of the habit. The literature search on PubMed, SCOPUS, and Epistemonikos database with related search terms of “adolescents”, “smoking” and “impact”. Only papers published within the year 2017 to 2021 and in the English language were included. However, articles without full text were excluded from this review. Fourteen articles were selected and divided impacts into three categories which are effect on oral health, effect on general health and other impacts. Possible impacts of smoking among adolescents were identified, and it could be beneficial in the development of customized smoking prevention or smoking cessation intervention for adolescents.

Introduction: Dental caries and impaired salivary function are very common but undertreated. The aim of this study was to investigate the oral health status and salivary parameters of stroke patients. Methods: A cross-sectional study was carried out on 54 stroke and 54 non-stroke patients attending rehabilitation treatment at Hospital Universiti Sains Malaysia. Decay, Missing and Filled Teeth (DMFT) index and plaque scores were used to evaluate patients’ oral health. Salivary parameters such as salivary cortisol, salivary flow rate, pH and buffering capacity were measured. Salivary cortisol was analysed using Cobas E6000 automated immunoassay. Results: Among the 54 stroke patients, the majority were Malays 72.2% and 63.0% were male, with a mean age of 48.1 (14) years. There was a significant difference of dental caries between stroke patients, at 17.6 (4.26), compared to 15.7 (5.38) for non-stroke patients (p=0.042). Only 53.7% of stroke patients had good oral hygiene, compared to, 85.2% among non-stroke patients’ (p-value= 0.001). Salivary parameters showed no significant differences (p>0.05). However salivary cortisol levels were higher in stroke patients 5.2(5.1) nmol/L) than in non-stroke patients 4.0 (3.6) nmol/L). There was no significant correlation between salivary parameters and DMFT index (P>0.05). Conclusion: Stroke patients had more dental caries and poor oral hygiene compared to non-stroke patients. Salivary parameters showed no significant difference between stroke and non-stroke patients.

Introduction: School students are young adolescents who are in a period of acquiring good oral hygiene habits that are practised as they grow up. This study aimed to determine the association between oral health knowledge, attitude and practices (KAP) of the adolescents and their dental plaque maturity status. Methods: A cross-sectional study was conducted among 174 school students aged 13 to 14 years in Kota Bharu, Kelantan. The oral health knowledge, attitude and practices were assessed by self-administered questionnaires, while the dental plaque maturity status was assessed using GC Tri Plaque ID gel TM (TPID). The data were analysed using IBM SPSS version 24.0. Results: The mean (SD) for knowledge and attitude score of the students were 4.69 (1.44) and 3.63 (0.63), respectively. The mean (SD) dental plaque maturity score (DPMS) of the students was 1.02 (0.55). Students who had answered correctly on sugar and practised tooth brushing twice daily had significantly lower mean DPMS as compared to those who had answered incorrectly and practised tooth brushing less than twice daily (p<0.05). Conclusion: Adolescents participated in this study had moderate oral health knowledge and good oral health attitude. Correct knowledge regarding sugar and toothbrushing routines of at least twice a day significantly associated with the dental plaque maturity status.

Introduction: Dental unit waterline system (DUWLS) decontamination is an important infection control in dental practice. This study aimed to determine knowledge and attitude towards DUWLS decontamination and its associated factors among undergraduate and postgraduate dental students in Universiti Sains Malaysia. Methods: A cross-sectional study was conducted using a validated questionnaire administered online using Google Forms to assess the knowledge and attitude of dental students towards DUWLS decontamination. Descriptive and inferential statistics using independent t-test, Pearson, and Spearman correlation were carried out using SPSS version 24.0. Results: A total of 169 dental students participated in the study, and the majority were female (71.6%) and Malay (59.2%). The mean (SD) age was 23.2 (0.93) and 34.4 (2.65), for the undergraduates and postgraduates, respectively. The mean (SD) knowledge scores for the undergraduates and postgraduates were 11.6 (4.23) and 18.0 (2.82), respectively, whereas the mean attitude scores were 51.3 (7.86) and 54.6 (4.74), respectively. The postgraduates had significantly higher mean knowledge and attitude scores than the undergraduates (p<0.001). The significant factors associated with the undergraduates’ knowledge were received information and guidance and their personal experience in managing DUWLS (p<0.05). However, only received information on DUWLS was significantly associated with the postgraduate’s knowledge score (p=0.011). Age factor had a significant association with the attitude score among the postgraduates (p=0.014). Conclusion: The knowledge regarding DUWLS decontamination was relatively moderate in both groups. However, both groups showed a favourable attitude towards DUWLS decontamination. Significantly higher knowledge and attitude scores were presented among the postgraduates than the undergraduates.

Introduction: Oral health status among visually impaired (VI) children have shown to be poorer when compared with their normal peers. This preliminary study aimed to determine the oral health status of VI children and knowledge, attitudes and practices of their caregivers. Methods: A preliminary, cross sectional study were conducted on VI children and their caregivers attending Ophthalmology clinic Hospital USM. The assessment of oral hygiene was done using Sillness-Loe plaque index and dental caries using DMFT/dft index. Self-administered, validated questionnaires on knowledge, attitudes and practice towards a child’s oral health was distributed to the caregivers. Results: A total of 27 VI children along with their caregivers participated in this study. The mean age of VI children and their caregivers was 11.4(3.05) and 41.7(7.10) respectively. The children showed a fair oral hygiene status. The median(IQR) for caries experience for deciduous teeth (dft) and permanent teeth (DMFT) was 0.0(5.00) and 1.0(4.00) respectively. Caries prevalence among VI children was high at 85.2% (95% CI:70.86% - 99.51%). The caregivers showed a relatively good attitude and practice towards their child’s oral health with mean(SD) score of 23.2(2.95) out of 28 and 12.8(2.15) out of 19 respectively in comparison to low oral health knowledge of 5.5(1.50) out of 11. Conclusion: The oral hygiene status was fair with high prevalence of dental caries. Based on the score, although the caregivers showed to have minimal understanding on children’s oral health, their attitude and practice towards children’s oral health are relatively high.

Autism Spectrum Disorder (ASD) is a neurodevelopment disorder with an unidentified etiology and wide-ranging functional impact. This narrative review aimed to identify various behaviours and oral health problems among children with ASD, recognize the barriers towards oral health care, and identify the strategies for oral health care management. Online databases (Scopus, PubMed and Google Scholar) were used by using various search terms. All types of articles with different level of evidence were included. Articles which were not in English and were not available in full text were excluded. Various behavioural problems among ASD contributed to various oral healthcare challenges that lead to compromise oral health status. Caregivers and dental professionals have to identify these problems towards strategizing an effective oral health management for them. Therefore, this narrative review provide an insight towards controlling the oral health problems faced through preventative and practical approach for the chidlren with ASD.