Early Management of Dental Trauma in the Era of COVID-19

Traumatic dental injuries are emergencies that must be treated promptly and properly to reduce the suffering, costs, and time for patients and parents. However, since the coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic on March 11, 2020, most dental care facilities in the affected countries have been completely closed or have been only providing emergency treatment. This can partly be a result of the lack of universal protocol or guidelines regulating the dental care provision during such a pandemic, especially in the management of dental trauma. This lack of guidelines has the potential to both promote the spread of nosocomial COVID-19 through oral health care facilities and deny people in need of immediate treatment. Moreover, ceasing dental care provision during such a period will incense the burden on hospitals’ emergency departments that are already struggling with the pandemic. Therefore, this chapter elaborates on the importance of early management of dental trauma by sharing local guidelines and experience with a proposed algorithm for the early management of dental trauma during the emergence of COVID-19

Oral cancer awareness among dental patients attending polyclinic, kulliyyah of dentistry, International Islamic University Malaysia (IIUM): a preliminary study

Introduction: Oral cancer is the 6th most common cancers worldwide. Malaysia ranks at no-14 in the world with the age adjusted death rate 7.72 per 100,000 populations. Although, survival of early detected oral cancer is high, many people present in late stages because of their low awareness. This study aims to assess the awareness of dental patients on oral cancer and its relation to socio-demographic background

The awareness on emergency management of tooth avulsion injury among primary school teachers

Teachers are most likely to be among the first to see a child immediately if dental injury happens at school. Hence, their intervention greatly influences the prognosis of an avulsed tooth. This study assessed the level of knowledge and attitude on the management of tooth avulsion injury among primary school teachers. This cross-sectional study was done using a pretested questionnaire involving 100 teachers of two primary schools in Kuantan. 81 out of 100 teachers understood that an avulsed permanent tooth should be saved. 45% of the respondents thought that they were able to distinguish between deciduous and permanent teeth. Only 24% of respondents were able to answer correctly on immediate action to be taken when they encountered tooth avulsion injury. 81% of respondents knew that an avulsed tooth has to be held by its crown. However, only 18% chose to replant the tooth back into its socket, and 76% agreed that replantation must be done immediately. Regarding the storage medium for the avulsed tooth, 38% chose to place it in ice, followed by tissue paper (32%). Previous experience of witnessing tooth avulsion injury, knowing the importance of emergency management and female gender were found to improve the teachers’ knowledge on emergency protocols (p<0.05). Overall, the level of awareness on emergency management of tooth avulsion injury among primary school teachers was found to be unsatisfactory (81%). Thus, the teachers should be given more exposure and training on the emergency management of tooth avulsion injury at school. The teachers play a key role in preventing detrimental impact to the children’s dentition and psychosocial development due to the loss of permanent tooth

Assessment of prevalence, length and position of anterior loop of inferior alveolar nerve: a study using CBCT

Introduction: Adequate space is required in the interforaminal region for anterior mandibular surgery, where the anterior loop is located within this region. The aim of this study is to evaluate the prevalence of the anterior loop (AL) of the inferior alveolar nerve, and to measure its length and position in patients attending Kulliyyah of Dentistry using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of mandibles from 70 patients (140 hemimandibles) were selected and evaluated in this retrospective study. A single detector, multiple slits CBCT machine was used for this purpose. The comparison was made based on gender, age and race. The prevalence, position and length of the AL were assessed using Romexis® software version 2.8.0.R. Results: An anterior loop was identified in 16.4% of the examined mandibles and mostly observed on the right side (21.4%). The prevalence of AL was significantly higher in males (69.6%) compared to females (30.4%). The mean anterior loop length recorded was 2.59 mm (± 1.63), ranged from 0.80 mm to 6.00 mm. Most of the loops were found located inferior to the apex of lower right second premolars (60%). Conclusion(s): In this study, the prevalence of AL found is significant and the length of AL was varied greatly. Although AL is an anatomical variation, findings of this study might be useful in determining the safe distance and to preserve the neurovascular bundle before an implant placement or osteotomy in the anterior region of mental foramen

Oral cancer awareness among patients attending university dental clinic in Kuantan, Pahang

In Malaysia oral cancer is the 21st most common cancer in general population. It is 17th most common cancer in male and 16th most common cancer in female. The incidence of oral cancer is predominant among Indian ethnic group where mouth and tongue cancer were among most 10 most cancer for both male and female The study is to assess the awareness of dental patients on oral cancer and its relation to their socio-demographic background. Questionnaires were distributed to the 100 participants to assess their awareness on oral cancer in a university dental clinic in Kuantan, Pahang. Cross analysis, t-test and ANOVA tests were applied to infer the relationship between socio-demographic and awareness level of the respondents. There was a trend for young, good education and income with good awareness about oral cancer, but not significant associated with socio-demographic. The awareness levels of the participants are low and not significantly influenced by socio-demographic status

The role of periodontal regeneration in the management of advanced periodontal defects. Series of case reports

Introduction: High prevalence of periodontitis has been reported in the 21st century. However, the traditional nonsurgical periodontal treatment results in healing by long junctional epithelium. Long-term stability of the teeth requires reconstruction of what have been lost from the soft and hard tissues of the periodontium. Case report: Clinical selection of 4 cases characterised by advanced periodontal defects were selected for this report. Case I, advanced bone loss at distal site of tooth 11 with pus discharge was presented with a history of root perforation during RCT. Case II, severe circumferential bone defect around teeth 11 and 21 with pus discharge and grade II mobility. Significant bone gain and pocket depth reduction were achieved and maintained for both cases at 12 and 6 months respectively after applying bone replacement xenograft and collagen barrier membrane. Case III, implant placement in a narrow ridge width at the extraction site of tooth 44 resulted in alveolar crestal bone dehiscence at the buccal aspect. Case IV, severe bone resorption in the buccal plate due to previous extraction of tooth 12 contraindicates direct implant placement. Substantial bone thickness was recorded in both cases as observed in CBCT 12 months post surgical regenerative treatment providing adequate support for dental implant. Conclusion: Since patients prefer the option of maintaining their teeth over extraction and replacement by dental implants compared to dentures, the regenerative periodontal therapy would offer promising potential for successful periodontal reconstruction even in advanced periodontal defects

Kulliyyah of Dentistry online examination: student’s guide

Online platforms have been used widely ever since the pandemic of Covid 19 hits the world. Among the most active groups using this platform are in the education system. Therefore, the Academic Technical team, Kulliyyah of Dentistry (KOD), International Islamic University Malaysia (IIUM) was established to aid in the technical issues with regards to online learning with special attention to online examination. Therefore, to ensure the information and knowledge on the technology were distributed at all levels, especially in the case of examinations, the team felt that appropriate training and information is vitally needed. In these trainings, lecturers and students were briefed on their roles and calibrated on the use of the Integrated Teaching and Learning Environment (iTa'leEm) for examinations with handouts given as further references. Today, we are glad to present a training manual which is designed for direct application with the online examination compiled from the previous handouts. This manual was developed in close collaboration with the IT department of IIUM and iTa'leEm support team. We hope this manual will be a useful guide to all users in preparation for online exam. The team welcomes comments and further suggestions

The effectiveness of two different at-home tooth whitening products as evaluated by Dino-lite digital microscope

Many desires brighter and whiter teeth in a quicker and easier way but in less expensive way. Therefore, over-the-counter tooth whitening solutions such as toothpaste, mouth rinses, gel, varnish paints, and strips are regarded a good option, albeit their efficiency is questioned. Different types of oxidizing agents such as hydrogen peroxide and carbamide peroxide used in the tooth whitening products as bleaching agents may produce different degree of shade change. Thus, this study aimed to evaluate the effectiveness of two different at-home tooth whitening products related to the changes in tooth shade and enamel surface appearance. Twenty-one samples of extracted human teeth were used in this study. The samples were divided into seven groups and were exposed to two at-home tooth whitening products; Beyond Care (6% hydrogen peroxide) and White Smile (16% carbamide peroxide) according to the recommended guidelines and exceeded the recommended guideline by 3 times and 5 times for each whitening product for 14 consecutive days. Photos of enamel surface appearance and tooth shades of samples were taken using Dino-Lite Digital Microscope and DSLR camera at pre- and post-treatment. Comparison was made using Ivoclar Vivadent shade guide. The results revealed that six samples that were exposed to Beyond Core White (CW) in the respective exposure time showed changes in shade. Meanwhile, only two samples treated with White Smile (WC) showed changes after being exposed to five times the recommended guideline. However, no significant surface change in enamel was observed. Samples with mild fluorosis had shown improvement after being exposed to five times the recommended guidelines for both agents. In conclusion, no shade changes were observed in all samples that were tested using the recommended guidelines. The whitening efficacy of Beyond Core White was found to be superior to White Smile at three and five times the recommended guidelines

The relationship between tooth loss, body mass index, and hypertension in postmenopausal female

Objective: This study aimed to investigate the relationship between tooth loss and the level of blood pressure with the hypothesis that tooth loss is associated with the increase of hypertension in postmenopausal women. Materials and Methods: Sixty postmenopausal female patients aged 51–68 years were included in the study to assess the relationship between tooth loss and the level of blood pressure. The information including sociodemographics, last menstruation period, hypertension history, and the duration of having tooth loss was recorded. Blood pressure was measured using sphygmomanometer and the number of tooth loss was determined. Results: The results showed a more significant tooth loss in hypertension (median: 23 + 4; interquartile range [IQR]: 6) compared to the normotension postmenopausal women (median: 18 + 6; IQR: 12; P < 0.05). Furthermore, obese patients had more tooth loss (median: 23 + 5; IQR: 8) than the overweight patients (median: 19 + 8; IQR: 8). Conclusion: Tooth loss is associated with the increase of hypertension in postmenopausal women which may have a role in the development of vascular diseases

Comparison of sugar acid neutralizing effect among five different toothpastes

Introduction: Toothpastes contain bicarbonate ions that can buffer and counter the attack of acid, thus leads to remineralization. This study aims to compare the sugar acid neutralizing effect among five different toothpastes. Methodology: A cross-sectional study was conducted among undergraduate students of Kulliyyah of Dentistry, IIUM Kuantan with total samples of 57 after inclusion and exclusion criteria. Subjects were instructed to refrain from overnight oral hygiene procedure. The baseline salivary and plaque pH were recorded. The salivary and plaque pH after rinsing with cokes were measured, and the subjects were instructed to brush using assigned toothpaste based on their toothpaste groups. All the pre-brushing, post-coke and post-brushing measurements were compared between the five groups. Salivary pH was measured using portable pH meter while plaque pH was measured using pH strip method. Data was analysed by using SPSS and Amos® with significance level was set at p< 0.05. IREC approval was obtained (ID: IREC 673). Results: There was significant difference in terms of the mean pH after brushing for saliva (p=0.044 0.05). The toothpaste showing the highest pH after brushing is TO-1 toothpaste. Conclusions: The five brands of toothpastes possessed sugar acid neutralizing effect to a certain degree based on the saliva reading