International Poster Journal of Dentistry and Oral Medicine, 03/2013

Background: The use of white and red areca nut is indigenous to Southeast Asia. Oral submucous fibrosis is a high risk precancerous condition, with etiological hypothesis of chronic irritant (chewing of betel quid), collagen, genetic or immunological disorder. The aim of the study was to assess the effects of red and white areca nut and betel quid in Wister albino rats. Method: The study was performed on 56 Wister albino rats divided equally into 7 groups. 1 gm of areca nut or quid paste was applied bilaterally on the buccal mucosa on alternate days for 6 months. Applications and subsequent biopsies at 2, 4 and 6 months were done using haematoxylin, eosin and Van Geison's stain for histopathological examination. Results: Keratosis, basal cell hyperplasia, submucosal collagen, vascular change, inflammatory infiltrate were significantly altered in the study group compared to control group (p 0.05). Groups without tobacco showed statistically significant (p 0.05) changes in keratosis, loss of basal layer polarity, basal cell hyperplasia, vascular changes and inflammatory infiltrate compared to the control. Comparison between tobacco groups and control showed statistically significant (p0.05) differences in keratosis, basal cell hyperplasia, submucosal collagen and inflammatory infiltrate. The relative risk (RR) for epithelial dysplastic changes was least in group 2 (1.52) and highest (2.66) in groups 1, 3 and 6. Changes in submucosal collagen showed least RR (1.33) for group 4 and highest (2.66) for group 5. For vascular changes, the least RR (1.5) was seen in group 1 and highest (4.0) in group 3. Conclusion: White variety of arecanut, alone or in combination, revealed more epithelial and connective tissue changes than the red variety. Arecanut, alone or in combination, caused epithelial and submucosal changes; the degree of change increased in combination with slaked lime and tobacco. Palabras clave: Areca nut, Oral Submucous Fibrosis, OSF, Wister albino rats, Tobacco, Betel quid

Introduction: In Malaysia, the government is the major provider of oral healthcare for the primary and secondary school children. Ministry of Health developed a program to improve the oral health status of school children which is referred as Incremental Dental Care. This program covers all school children of primary and secondary government schools in every state in Malaysia. Sekolah Ugama Daris is a private school located in Sungai Petani, Kedah which is not covered by the Incremental Dental Care. Objectives: The main objective of the study is to describe the dental service utilization patterns by private school children in Malaysia and various types of dental treatments done in this group. Methods: A private primary school was selected where oral health care was not provided for past few years. A one day planned oral health education program including tooth brushing drill was conducted in school by year 5 dental students from standard 1 to 5 to improve oral health knowledge and motivate school children regarding oral health in March 2010. Consent forms to show willingness to seek dental care at AIMST University Dental Center were distributed to all students. Groups of 8-10 children whose parents have given consent for treatment were picked up from the school and sent back on selected days of week. All necessary treatments were provided free of charge by year five dental students under the supervision of paedodontist. Data of utilization of services by school children was analyzed in June 2010. Results: Forty eight percent (45 male and 47 female) of 191 of school children had given consent and obtained 418 treatments of various kinds. Three major treatments include GIC restorations (40.7%), Extraction of grossly decayed deciduous teeth (19.9%) and fissure sealant application (11.2%). Conclusion: Other reasons apart from dental fear of child and parents knowledge to seek dental care were not clear where main barriers like cost, accessibility and knowledge were minimized. The amount of disease is high as these children had never utilized dental services previously. The reasons of 52% not utilizing the services to be further sought. Palabras clave: utilization, school children, private

Purpose of the study: To discern participants' opinion regarding perceptions, reasons for seeking care, expectations and commonly faced problems during orthodontic treatment. Materials and Method: Structured questionnaires regarding perceptions of orthodontic treatment were distributed to 86 participants with age ranging from 10 to 25 years old. The survey form include patients' personal information and twelve questions which included patient perception towards their own malalignment condition, duration and sources of getting orthodontic treatment, Knowledge of treatment, reasons of seeking treatment, major problems encountered, and type of materials used. Results: The majority of patients undergoing orthodontic treatment are Chinese (69.8%) and females (62.8%). The most common reason for them to seek orthodontic treatment was to improve their esthetics (83.7%) with the perception that they had a decent facial appearance before the treatment (53%). Only 44% of them rated their status similar to IOTN grade 3. Most of them received treatment in private practice (48%) and visited every 3 months (72%) for duration of 1-2 years (70%). Most of them are self-influenced (70.9%) and obtained their information from friends who receive/ are receiving their treatment (79.1%). Pain was the most common complaint (61.6%), followed by difficulty in cleaning (53.5%). Majority are provided with metal braces (76.7%). Conclusion: Patients seek for orthodontic treatment to improve aesthetics. The patient should be informed of the complete treatment plan with emphasis on effective home care. It is also important to evaluate self needs as it will ultimately determine the outcome of orthodontic treatment. Palabras clave: patients perception, orthodontic treatment

Purpose: The aim of this study is to evaluate the satisfaction of patients rehabilitated with an immediate loading full-arch prosthesis (Columbus Bridge Protocol, CBP) and the potential changes made in their quality of life due to this treatment. Materials and methods: Between January and September 2012 we studied 7 patients in need of a full-arch immediate loading rehabilitation of one or both dental arches. Each patient answered a 26-questions questionnaire at a pre-surgical appointment (T0), 1 week after surgery (T1) and 2 months (T2) after surgery. A single dentist realized all the interviews, which lasted in average 15 minutes each. The questionnaires realized were inspired by statement of Oral Health Impact Profile (OHIP). The questions were related to: pain, chewing ability, phonetics, aesthetics, home hygiene procedures, patient satisfaction. For categorical variables differences in the scores at the 3 time points were assessed by Cochran's test. If a statistically significant difference was found, post-hoc pair wise comparisons were performed by McNemar test. For multinomial data differences in the scores were evaluated with Marginal Homogeneity test, comparing each pair individually. A p ≤0.05 was considered statistically significant and a Bonferroni-corrected p-value of 0.017 was considered statistically significant for paired comparisons. Results: A total of 7 cases were assessed and only questions common to all questionnaires were considered for statistical analysis. No statistically significant difference between the 3 time points was noticed for variables regarding pain during chewing, smoking, phonetic difficulty, tense, avoiding smiling, difficulty in relating to others, instruments used for oral hygiene and difficulties to use them. A statistically significant difference between t0 and t2 was observed for the variables regarding satisfaction as regards ability to chew (p=0.023), and between t0 and t1 about satisfaction with the aesthetic appearance of teeth (p=0.041) with better values at t2 and t1 respectively. Conclusions: On the base of this prelimininary evaluation, patients treated with CBP reported a better chewing ability and a greater satisfaction with their esthetic appearance compared to pre-treatment assessments. All the patients were pleased with support and information received by the clinicians and they felt that CBP was an effective therapy for their oral problems. However further investigation on a larger number of patients is needed to confirm these results. Palabras clave: implant supported prosthesis, edentulous jaw, oral health, patient satisfaction, treatment outcome

Many lesions that occur in the mandible have a cyst like radiographic appearence. These lesions are often difficult to differentiate on the basis of the radiographic features alone. The clinical features also helps establish a differential diagnosis, although microscopic examination is required to arrive at a definitive diagnosis. Palabras clave: dentigerous cyst, anterior mandibular swelling

Introduction: The aim of the present study was to determine the caries free proportions, and caries experience in private kindergarten schoolchildren. Materials and Methods: A cross sectional survey of the 5- and 6-year-old kindergarten schoolchildren (n = 66) was conducted in two private kindergartens in Kedah state. Two trained and calibrated dentists examined the children. Dental caries was scored using WHO diagnostic criteria. Each child was examined while seated on a portable chair. Torch light and mouth mirror were used for the examination. The probe was used sparingly on doubtful surfaces. In case of any doubt the tooth was marked sound. No radiographs were taken. Results: The percentage of 5 and 6-year-old children who were caries free (dft = 0) was 60% and 59% respectively. The corresponding mean dft for 5- and 6-year-olds were 1.56 and 1.92. The decayed score was the major component in the mean scores. 10.06% of the children had severe caries affecting more than 5 teeth. Conclusion: The present study provided important information regarding the change in magnitude and severity of dental caries prevalence in preschool children. Though it was relatively a small population, percentage of caries free preschool children were better compared to NOHPS 2005 (23.8%). Dental health topics ought to be included in the schools curriculum in kindergarten along with training of schoolteachers to provide basic dental health education. The preschool teachers can play an important role in building up positive oral health habits in children. Palabras clave: private kindergarten, caries

Malaysia has one of the highest smoking rates among men in the world (50% are daily smokers). To bring about any rapid decrease in smoking related disease and deaths will require aggressive cessation programs. It is well known that health professionals can play an important role in assisting patients to quit but it is preferable that they do not smoke themselves and have adequate training. This study examined smoking rates and attitudes among faculty at AIMST University, a private university in rural Kedah, Malaysia. An anonymous survey was distributed to all faculty in five health faculties (medicine, dentistry, pharmacy, allied health professions and applied sciences). The response rate was 78.6% (118 Individuals) and indicated that 13% of faculty were former smokers and 8% were current smokers; interestingly, 4% used pan or smokeless tobacco, which may reflect the proportion of Indian faculty on campus. Users were all male (100%). These figures are considerably higher than reported in Malaysia among medical students (1.6% current smokers; Tee et al; Med J Malaysia 62,p383,2007). Despite these relatively high rates of Tobacco use, there was strong support (94% agreement) for the notion that health professionals should not smoke and should be a role model for their patients, and that health professionals should assist patients with cessation (91%). This latter response is in accord with a survey of dentists in Kelantan, Malaysia, where 99% agreed that they had a responsibility for smoking cessation counseling (Ibrahim et al., Arch Orofacial Sci., 3, p11, 2008). On the other hand, over half (55%) believed that the existing curriculum at AIMST University did not provide enough information on smoking cessation. These findings suggest that there will be faculty support for strengthening instruction for health science students on how to assist their patients with cessation at AIMST University. In conjunction with an enhanced referral system for health professionals to refer patients to the national quitline, which is under discussion, this will represent a small but important step to increase cessation and thus reduce death and disease from tobacco in Malaysia. Palabras clave: smoking, cessation, health care professionals

Introduction: Dramatic decline in the prevalence of dental caries and severity of dental caries is attributed to wide availability of fluoride toothpaste and other sources. The most effective method to prevent caries is the regular use of fluoride toothpaste. The aim of this study was to evaluate self-care routines in a population by identifying knowledge, attitudes and behavior relating to fluoride toothpaste and tooth brushing habits. Materials and methods: Cross-sectional study was conducted where self completed anonymous questionnaire was distributed to final year Medical and Pharmacy students in AIMST University. Results: A total of 129 students from Medicine and Pharmacy have completed the survey. 71.3% of students brushed their teeth twice a day. The percentage of medical and pharmacy students who actually used fluoride tooth paste were 91.9% and 74.6% respectively. 33% of students used full head of toothbrush quantity of toothpaste. 79% confirmed the caries preventive action of fluoride. 76% believed that fluoride can strengthen resistance of tooth surface to caries and fluoride is harmful when the concentration is in excess. Conclusion: Compared to medical students pharmacy students usage of fluoride toothpaste was less. The student population seems to have embraced regular tooth brushing with fluoride toothpaste to a large extent. However, regarding techniques for using fluoride toothpaste effectively, there was a great potential for improvement, especially among university students. The use and knowledge levels were similar to Beijing study. Palabras clave: flouride, tooth paste, knowledge, students

Introduction: A 3-day Oral health campaign with educational activities were organized in November 2011 a in a prominent shopping center in Sungai Petani, Kedah by AIMST Dental Students Association (ADSA). The purpose of the display was to improve oral health knowledge of the local population and to promote the proportion of people using oral health care services. The aim of the study was to assess the effectiveness of the campaign from the visitor's perspective. Materials and Methods: Oral health education posters on causes, prevention and treatment options of oral diseases were on display in English, Bahasa Malaya and Chinese. Painting competition for school children, fun and games activities related to oral health were organized along with free dental screening by dental surgeons. The campaign was promoted using posters, newspaper and radio. A self explanatory structured feedback form developed to capture the effectiveness of the campaign was provided to those who participated in the campaign. Feedback forms were made available in three different languages. Students and staff of AIMST University were excluded and public aged above eighteen years were given the forms. Results: A total of 698 individuals completed the feedback form. 98.4% of individuals agreed that the campaign improved their knowledge on oral health. 96% of the individuals were able to understand the explanations given by the students and staff through posters and other awareness activities. 97% of the public who participated in the study want the campaign to occur often and want similar programmes in their neighborhood. New patient registration at AIMST University Dental Centre has increased in the following week after the programme. Conclusion: A social marketing of oral health campaign including radio ads, posters, and education sessions can effectively draw the attention of population and thereby increase the knowledge, attitudes and utilization of oral health services. Palabras clave: oral health campaign, evaluation

Introduction: A free public dental screening was conducted in a three day oral health campaign in November 2011. For the collection of data on oral health status of the public attending free screening campaign with limited facilities and time, we require a composite index to measure the treatment need and to briefly advice the patients on their oral health status. The aim of the study is to assess the oral health status of the individual attending the screening campaign using Oral Health Index. Materials and Methods: Screening of patients was done by dental surgeons using disposable mouth mirror and probes with the patient seated in a portable dental chair. Each screening session lasted for an average of five to ten minutes. A comprehensive Oral Health Index (OHX) for measuring all diseases in oral cavity was used to summarize oral health status of a person. A question on smoking was also included along with OHX index and a brief intervention of smoking cessation was given to those patients who smoke and willing to quit. Results: A total of 415 patients of all age groups were screened (Males 52.29%; Females 47.71%). In all the age groups dental appearance (34.0%) is considered to be major concern with respect to pain and chewing ability. A very small number of them had oral mucosal lesions (0.24%) and a 25.04% of them had occlusal problems that require treatment. About 54.46% of them have coronal caries with 7.23% having caries in more than five teeth. Periodontal treatment need is the highest with 63.61% requiring some form of periodontal treatment. 26.75% need some form of prosthodontic treatment. Conclusion: Use of OHX in measuring oral health status has provided overall treatment needs of patients with ease of measuring and identifying the treatment need. Palabras clave: OHX, oral health screening

Introduction: There is a recognized need to deliver oral health information to people during clinical encounters to enable them to develop personal skills in managing their own oral health. Compared to other modes of Oral health education chair side oral health education has been proved to be more effective. The aim of the study is to assess the self reported data on chair side oral health education provided by clinical year dental students. Materials and Methods: A questionnaire was distributed to all BDS students of year 4 and 5 (n=99) during the academic year 2011/2012. The students filled the anonymous questionnaire in the class after lecture. The response rate was 78.9% (n=78). The questions consisted of average number of patients treated, information on nature, time, frequency, methods and aids used in chair side oral health education. Results: 85.9% had always given chair side oral health education when others gave it sometimes only. Clinical time (66.7%) was the most reported barrier by the students for them to educate their patient others being language (37.2%), stress and proper aids. Most of them educated their patients after treatment and had spent on average 5-10 minutes. Aids commonly used to educate patients were models (88.5) and students think they need more audio visual aids to be available in clinic. Conclusion: It may be concluded that most of the dental students were giving chair side oral health education. Audio visual aids and models were mostly used for chair side education. Traditional approaches to individual oral health education had been shown largely ineffective and there is a need to develop an effective model for chair side oral health promotion that incorporates this evidence and allows oral health professionals to focus more on the underlying social determinants of oral disease during the clinical encounter. Palabras clave: chairside oral health education

Introduction: Arden G. Christen was the one to first mention the dentist's role in helping patients to stop smoking in 1970. Among the health care professionals dental team have a greater opportunity to advise their patients to stop smoking. Providing a brief intervention by dentist or health care professional has been recognized as one the cost-effective method of smoking cessation. Materials and Methods: Patients attending a three day free dental screening campaign were asked about their smoking status and interested candidates who wanted to quit smoking were given the advice. A 4As approach was used to record the current smoking status and willingness to quit was recorded. A brief advice (five to ten minutes) and encouragement to stop smoking was given along with explanation of adverse oral health effects of smoking with the help of posters. Results: 45 out of 419 who attended free dental campaign are smokers. 84.4 % of the smokers (all males) have shown willingness to quit and underwent the brief tobacco cessation advice. More than fifty percent of them are smokers for 10 years or more. 68.4% of them have made previous quit attempts and mostly the reason being health concern. More than a quarter (26.4%) of them have said that they were not aware of adverse effects of smoking while many suggested that counseling would help them quit. Conclusion: Relatively small populations of smokers who have indicated high interest in quitting have utilized the service. Form the public health education point of view advertising the ill effects of smoking to population is still required and availability of counseling services to the interested population has to be increased. Palabras clave: smoking cessation, dental students

Fibrohistiocytic neoplasms are a diverse group of tumors that exhibit fibroblastic and histiocytic differentiation. The biphasic cell population is believed to arise from histiocytes. Though oral lesions are rare, Benign fibrous histiocytoma frequently involves buccal mucosa and vestibule. The important diagnostic distinction is the separation of the benign tumor from malignant fibrous histiocytoma, a high grade sarcoma commonly involving maxillary region & sinonasal tract and other aggressive forms of histiocytic lesions. The diagnosis frequently relies upon immunohistochemistry. The histologic features play a minor role in prediction of the biologic behaviour of these neoplasms. The aim of this poster is to present the histiocytic neoplasms reported in our institution and to discuss the main diagnostic criteria of these neoplasms with immunohistochemistry markers, including the differential diagnosis to differentiate from other histiocytic lesions of the jaw. Palabras clave: Fibrohistiocytoma, Biphasic cell population, immunohistochemistry markers

Background: The yeasts of the Candida genus represent an important part of the normal oral microflora, including dental plaque. Their ability to produce organic acids during the fermentation of carbohydrates participates in the cariogenic effect of dental plaque. Aim: The study aims to evaluate the occurrence of yeasts, especially C. dubliniensis in dental plaque samples obtained from children affected by Early Childhood Caries (ECC). Design: In this study, 240 samples from patients suffering from ECC and 255 samples from healthy children were examined. Phenotypic methods (chlamydospore formation, characteristic growth on CHROMagar Candida and Staib Agar, growth at 45 °C and latex agglutination) and the genotypic method (PCR with the species-specific primer pair targeted to act1 intron and universal primer pair) were used for the differentiation between C. dubliniensis and C. albicans. Results: We isolated 167 yeast strains from patients with ECC (positivity 69.6 %) and only 97 yeast strains from control samples (38.0 %). The differences in yeast colonization of teeth between the two groups are significant (p>0.01). Of the total amount of 167 yeast strains isolated from ECC samples we identified 31 strains (18.5 %) of C. dubliniensis. The situation in the control group was different; only 2 C. dubliniensis strains (2.1 %) were identified. Conclusion: The results show that teeth of children with ECC are colonized with yeasts more frequently than teeth of healthy children. C. dubliniensis is a frequent part of dental plaque in ECC-affected children in contrast with healthy children. The study was supported by the project 1M0528. Palabras clave: Pedodontics, ECC, oral microbiology, Candida sp., C. dubliniensis

Aims: To assess the relationship between caries experience of 13- to 15-yr-olds and the education level of their parents/step-parents; and the relationship between enamel opacity prevalence and antibiotics (ATB) administration in early childhood in a retrospective case-series. Design: Randomly selected children from an ELSPAC cohort in Brno (n=780) were orally examined and their dental status (D3MFT [WHO 1997]) and enamel opacities (Dean's fluorosis index) were recorded. Data on parental education level and ATB administration were retrieved from the ELSPAC database. Correlations between DMFT vs parental education level, ATB administration during the following periods: birth-8 mo, 8-18 mo and 18-36 mo vs enamel opacities and D3MFT were calculated in SPSS.10® (Base, Regression) tool using a multilevel regression model. Results: Mothers'/stepmothers' (but not fathers'/stepfathers') education level significantly negatively correlated with D3MFT scores of children. The history of ATB administration was not significantly correlated with the prevalence and severity of enamel opacities or caries experience. Conclusion: The study confirmed a significant correlation of the education level of mothers/stepmothers and caries experience in children, while the correlation of ATB administration with enamel opacities and caries experience was not significant. Palabras clave: Pedodontics, caries, oral health, parental education, ATB administration