Impact of rheumatoid arthritis functional status on oral and periodontal health in a multi-ethnic population

Periodontal disease (PD) has both been associated with the pathogenesis of Rheumatoid Arthritis (RA) and is also a comorbidity of RA. The aim of this study was to investigate the impact of the functional status of RA on oral and periodontal health in a multi-ethnic population. This is a hospital-based, multi-ethnic, observational study. Duration of illness, Disease Activity Score (DAS28), seropositivity and other rheumatological parameters were obtained from the records of RA patients attending the Rheumatology Clinic. Oral health examination was conducted on the subjects. Their functional status was assessed using the Health Assessment Questionnaire (HAQ) which includes categories in ‘dressing’, ‘rising’, ‘eating’, ‘walking’, ‘hygiene’, ‘reach’, ‘grip’ and ‘usual activities’. Data were analysed using ANOVA or Kruskal-Wallis test and Pearson’s Correlation or Spearman’s Rank Correlation Test. The 63 RA patients recruited had a mean disease duration of 10.7 ± 9.85 years with a mean of 19.9 teeth (± 7.18). The severity of PD worsens the longer the patients were suffering from RA (p=0.028). A high frequency (70%) of PD with 27% moderate and 27% severe, was observed. A significant association (p=0.035) was found between the ‘eating’ category of the HAQ and the average periodontal pocket depth. This study shows that there is a higher prevalence and severity of PD among RA patients in the selected population. The impact of functional status on periodontal health is mostly in the ‘eating’ category of the HAQ where patients reporting a disability in eating had higher average periodontal pocket depth

Functional Disability and Symptomatic Slow-Acting Drugs for Osteoarthritis in Adults with Periodontitis

Osteoarthritis (OA) patients have decreased functional ability and restricted access to healthcare facilities and are on a spectrum of medications. These can impact their oral health. This study aims to investigate the association between periodontal disease and OA disease parameters, specifically the functional disability and the medications taken. This was a cross-sectional study on OA participants recruited from the Hospital Canselor Tuanku Mukhriz. Periodontal health parameters were obtained from an oral examination of the participants. A Health Assessment Questionnaire (HAQ) was administered to ascertain the functional status of the participants. Out of the 130 participants recruited, 71 (54.6%) had periodontitis. There was a correlation between the teeth count with OA severity, where participants with a greater Kellgren–Lawrence score had less teeth (rs = 0.204, p = 0.025). Participants with a greater degree of functional limitation also had less teeth (rs = −0.181, p = 0.039) and a higher clinical attachment loss (rs = 0.239, p = 0.006). There were no associations found between the symptomatic slow-acting drugs in OA and periodontal health parameters. In conclusion, there was a high proportion of periodontitis in patients with OA. Functional disability was associated with measures of periodontal health. It is suggested that clinicians treating OA patients consider the need for a referral for dental care when managing this group of patients

Graduates’ and employers’ perceptions on competencies obtained from an undergraduate dental curriculum

The effectiveness of a dental curriculum as reflected by the competencies of the graduates is paramount in ensuring its relevance in the rapidly evolving field of dentistry. This work aimed to assess the competencies of dental graduates of the Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM) as perceived by the graduates and their employers on the basis of the core competencies listed in the undergraduate dental curriculum. A self-administered questionnaire consisting of 43 questions based on eight competency domains were sent to all UKM dental graduates of years 2012 to 2015 and to senior dental officers who represented their employers. The eight domains assessed were as follows: 1) gathering information at chair-side, 2) diagnosis, 3) treatment planning, 4) treatment and prevention, 5) community-based, 6) management and administrative, 7) communication and 8) personal management and professional development. a total of 132 graduates (75%) and 18 employers (55%) responded. Only domain E on community-based skills was collectively rated ‘satisfactory’ while the rest of the seven domains had an ‘excellent’ rating by all respondents. With regard to individual skill, basic life support was rated very low for both groups (38.6% graduates and 23.5% employers). A strong association was found between the scores given by the graduates and their employers (p= 0.00). Generally, no difference was found between the scores of graduates from different years. The findings allow an evaluation of the curriculum in a myriad of angles. Although the graduates reported a good level of competency in most domains, the employers were reserved on the community-based skills. Poor competency in the key skill of basic life support in medical emergencies was highlighted and must be addressed in the curriculum or during training at the workplace