A study on parental acceptance towards the use of dental therapists in Malaysian private sectors

Introduction: The objective of this study was to assess parental acceptance and factors that influenced their perceptions towards the use of dental therapists in providing treatment to children in private dental practice settings. Methods: A cross-sectional study was conducted on randomly selected parents of 11-year-old schoolchildren in Selangor using a self-administered structured questionnaire. The survey consisted of three sections: socio-demographic characteristics, dental service utilisation and parental acceptance towards dental therapists in providing seven types of preventive and operative dental procedures. Results: The response rate was 83.1%. Overall, most parents regarded dental therapists providing dental care to their children in private dental care settings as acceptable, particularly on preventive treatment, namely ‘seeking advice on oral hygiene care' (87.8%) and ‘applying topical fluoride' (83.2%). In the multivariate analysis, younger parents and those who had preferences over private sectors were most likely to accept at least four dental procedures to be rendered to their children by dental therapists. Overall, respondents who were younger (OR = 1.40, 95% CI = 1.62, 1.92), lived in urban locality (OR = 1.77, 95% CI = 1.28, 2.45) and had a recent dental visit (OR = 1.51; 95% CI = 1.10, 2.07) were more likely to have an overall positive perceptions towards dental therapists. Conclusion: Most parents regarded dental therapists providing care to their children in private dental settings as acceptable and this was associated with their age, place of residence and past dental experiences

Comparing dental caries status using Modified International Caries Detection and Assessment System (ICDAS) and World Health Organization (WHO) indices among school children of Bhakkar, Pakistan

Objective: To assess and compare the dental caries status among children using two methods. Methods: The cross-sectional study was conducted in October-November 2017 at five government and two private schools in Bhakkar, Punjab, Pakistan. It comprised children aged 11-12 years. World Health Organisation standards and the modified International Caries Detection and Assessment Systems methods were used were used to determine the dental caries status of each subject. Results of the two methods were compared at all cut- offs where appropriate, using SPSS 17. Results: Of the 183 subjects, 101(55.2%) were boys. Those aged 12 years were 112(61.2%) while 71(38.8%) were aged 11 years. There was no statistically significant difference in values of the Decayed Missing and Filled Surface/Decayed Missing and Filled Teeth index as well as the prevalence of dental caries between two methods (p>0.05 each). Intra-examiner reproducibility was higher with the World Health Organisation method compared to the other index used (p<0.05). Conclusion: Modified International Caries Detection and Assessment Systems method can be used in epidemiological surveys as it was found to provide results similar to the World Health Organisation criteria at cut-off point 2. © 2019 Journal of the Pakistan Medical Association. All rights reserved

The impact of anticipatory guidance on early childhood caries: a quasi-experimental study

Abstract Background This study evaluated the impact of anticipatory guidance on the caries incidence of 2–3-year-old preschool children and their 4–6-year-old siblings, as well as on their mothers’ oral health literacy, as compared to the conventional Ministry of Health (MOH) programme. Methods This quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother’s oral health literacy was assessed after 3 years of intervention. Results Children and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2–3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p < 0.05). At three-year follow-up, there were significant increments in the oral health literacy scores of mothers in the intervention group compared to the control group. Conclusion The FDWP is more effective than the standard MOH programme in terms of children’s and siblings’ caries incidence and mother’s oral health literacy. Trial registration ClinicalTrials.gov NCT03478748. Registered on March 26th 2018. Retrospectively registered

Sugar consumption and caries occurrence among Pakistani school children

Objectives: To estimate the frequency and pattern of sugar intake among Pakistani school going children and its association with early carious lesion and caries history. Methods: The cross-sectional study was conducted from January to May 2016 in seven schools of Bhakkar district in the Punjab province of Pakistan, and comprised of school children aged 11-12 years. Diet diaries were used to assess the frequency of sugar intake while caries was assessed using the Modified International Caries Detection and Assessment System. Bivariate analysis was used to assess the association of sugar consumption and early carious lesion with selected sociodemographic variables, and regression analysis was performed to evaluate the factor that matters most in caries occurrence. Results: Of the 226 subjects, 115(51%) had early carious lesion. Mean frequency of sugar intake was 5.2 +/- 3.2 times per day. Children who consumed sugar between main meals (p=0.01) and within two hours before bedtime (p=0.04) had significantly higher history of having caries. Cariogenic intake before bedtime was significantly associated with overall caries risk (p=0.02). Conclusion: The frequency of sugar intake among the subjects was slightly higher than the recommended level

Malaysian dental therapists' job motivation, job satisfaction, intention to leave and perceived future roles

Objective: To assess Malaysian dental therapists’ job satisfaction, motivation, turnover intention and perceived future roles, following recent changes in the regulations that allow them to provide dental care within their scope of practice in the private sector. Methods: A self-administered questionnaire was distributed to public dental therapists who were selected using a stratified random sampling technique. Questions included items on social structure, job satisfaction and motivation (based on the Warr-Cook-Wall scale), turnover intention (based on four cognitive processes) and perceived future roles. Multiple logistic regression was used to assess the predictors of dental therapists’ turnover intention. Results: Overall, a majority (>90%) of the participants had high job satisfaction and job motivation, with total mean scores of 45.70 ± 6.86 and 21.16 ± 2.63, respectively. A total of 8.3% intended to leave the public sector to work in a different organization. Of those who chose to remain as a dental therapist in the next five years, only 7% considered working in the private sector. The significant predictors for turnover intention were educational attainment, years of working experience, job satisfaction level and future preferred working sector. Conclusion: Although the newly introduced Dental Act allows dental therapists to expand their roles to the private setting, very few intended to do so. This could be related to them having a high level of job satisfaction and job motivation while serving in the public sector

Parents’ acceptance towards the use of dental therapist in the private sector – a quantitative study

Objectives: To assess parents’ acceptability towards the use of dental therapists’ (DT) in providing treatment to children in private settings and to explore factors associated with their perception. Methods: A cross-sectional study was conducted among 1260 randomly selected parents of 11 years old schoolchildren in Selangor. A self-administered structured questionnaire was used, which consisted of three sections: sociodemographic characteristics, dental service utilisation and acceptance towards DT in providing seven types of preventive and operative dental procedures. Data were analysed using SPSS version 22.0 software using both descriptive and inferential statistics. The p-value was set at 70%). Almost three-quarter (71.4%) of parents having high acceptance; accept more than or equal to five procedures. In multivariate analysis, parents who have high acceptance were those who were younger (OR=1.71, 95% CI= 1.26-2.32), lived in urban (OR=1.71, 95% CI= 1.23-2.36), Bumiputra in origin (OR=1.92, 95% CI= 1.08-3.43). However, mothers (OR=0.71, 95% CI= 0.52-0.95). and those who were unsure the presence of dental clinic nearby their home (OR=0.45, 95% CI= 0.24-0.87) were less likely having high acceptance. Conclusion: This study pointed out parent’s have high acceptance towards DT in providing treatments to their children in the private dental clinics and were associated with their sociodemographic status

Self-perceived mental well-being amongst Malaysian dentists

Purpose. To assess Malaysian dentists’ perceptions of their mental well-being. Methods. A self-administered questionnaire was developed based on a conceptual framework of mental health and well-being model. Two aspects were assessed, namely the physiological (two domains) and the psychological (six domains). Participants were asked to rate their experiences of the aforementioned aspects using a 5-point Likert scale ranging from all the time to never. Results. The response rate was 81%. Most of the dentists (61.7%) perceived having positive mental well-being. Under the physiological aspect, most respondents reported that they were ‘generally happy’ (93.3%), but about 30% stated they were ‘stressed physically and emotionally’. Of the six domains under the psychological aspect, positive well-being was observed in the ‘sense of coherence’ and ‘behavioural stress’ domains. Participants who were above 40 years old, married and had children reported having a more positive mental well-being when compared with their counterparts. Conclusion. Overall, most Malaysian dentists perceived having a positive mental well-being. It is crucial, however, to closely monitor and initiate early interventions for those with negative symptoms to ensure the safe practice of dentistry

Tobacco use and attitudes towards tobacco control activities of Malaysian dental students

Tobacco usage among dental students and the amount of training they received may have an impact on tobacco cessation activities undertaken for their patients. This study aims to assess Malaysian dental students' tobacco use, exposure to second-hand smoke and their attitude towards tobacco control activities and curriculum. This was a cross-sectional study using a self-administered questionnaire adapted from the Global Health Professions Students Survey (GHPSS). The questionnaire was distributed to all Malaysian fourth and fifth year dental students in four public dental schools (n=372), namely University of Malaya (UM), Universiti Teknologi Mara (UiTM), Universiti Kebangsaan Malaysia (UKM) and Universiti Sains Islam Malaysia (USIM). The data were analysed using descriptive and chi square tests. In total, (n=349) respondents completed the questionnaire, yielding a 93.8% response rate. Although the prevalence of Malaysian dental students who 'ever smoked' was 21.2%, the prevalence of current smokers was low (2.3%). About 62% and 39% of students reported having been exposed to second-hand smoke in public and at home, respectively. USIM students were significantly less likely to recall having received training about approaches to smoking cessation (52.9%, p < 0.001). Significantly fewer smokers than non-smokers agreed on tobacco banning policy. Regardless of their smoking status, the majority of dental students showed positive attitudes towards dentists' role in tobacco cessation. Tobacco user among Malaysian dental students was low. There were statistically significant differences between ever smokers and non-smokers' attitudes towards tobacco banning policy. The majority of dental students showed positive attitudes towards dentists' role in tobacco cessation

Dental students as smoking cessation counsellors: Patients' and providers' perspective

Introduction: This study assesses dental students' and patients' perceptions on the role of dental students as smoking cessation counsellors as well as the patient's quit rate at the University of XX. Materials and methods: Self-administered questionnaires were distributed to all senior dental students (n=154) in XX University and telephone call interviews were conducted on their patients (n=169) who received smoking cessation counselling from September 2010 to June 2013. Results: Response rates for dental students and patients were 68.2% and 67.3% respectively. Most of the dental students in this study were females (72.3%) whereas the majority of patients were males (97.6%). An average of six months follow up indicated that 22.5% of patients had quit smoking, 65.3% reduced the number of cigarettes smoked and 6.5% had relapsed. About a third of patients surveyed (33.1%) believed that smoking cessation counselling was extremely helpful compared to what students perceived (5.7%, p<0.01). A higher percentage of patients (89.9%) rated the smoking cessation counselling performance as "excellent", as compared to students' rating (58.1%, p<0.01). The majority of the dental students and patients agreed that students should enquire about patients tobacco usage, information regarding the effects of smoking on oral health should be transmitted to patients and that quit smoking assistance should be offered. Conclusion: Smoking cessation counselling conducted by dental students seemed to be effective in assisting patients to reduce the number of cigarettes smoked and in quitting smoking. To some extent, both patients and students had positive attitudes towards smoking cessation counselling

Future market changes for Malaysian dental therapists: a qualitative study amongst dental therapists in the east of peninsular Malaysia on their career motivation and expectations

Introduction: The dental workforce in most countries is facing unprecedented changes. Malaysia has responded by approving the legislation for the registration of dental therapists under the Dental Act 2018. Aim: To identify the potential market changes of future dental professionals in Malaysia from the perspectives of dental therapists in East Peninsular Malaysia on their career motivation and expectations. Material and methods: Dental therapists from two dental organisations in East Malaysia were invited to participate in an audiotaped semi-structured interview (n=26); using a pre-tested topic guide. The qualitative data was transcribed and analysed using a Framework Analysis. Results: Dental therapists have moderate to high perception of knowledge and awareness with the provision of the Dental Act 2018. The expansion of the working sector and patients’ age-group has changed their short and long-term career expectation; mainly professional goals, working pattern and sector (public or private). Furthermore, the respondents’ perceptions are influenced by financial factor and work-life balance. Nevertheless, the Malaysian dental therapists share the same career motivations as the dentists. Conclusion: Dental therapist’ views on their career motivation and expectations broadly mirror their dentist counterpart and dental therapists in other countries. Their implications for the future, including possible uncertainties, particularly in regards to the privatization of the workforce were identified; and the tension of balancing practitioners/public health needs with their professional career expectations. This research highlights the influence of dynamic changes in market policy regarding workforce mobility and the importance of flexible strategies for the training, recruitment and retention of dental therapists