MSP NEWSLETTER

Periodontal Disease: Is it a Threat to Our Community? Dr Shahida Said

Volume 1 Issue 1 http://periodontologymalaysia.weebly.com/ Jan–April 2014

It has been recognised that periodontal disease is

the second most common oral disease alongside

dental caries in Malaysia and worldwide (Petersen

& Ogawa, 2012). In Malaysia, the prevalence of

periodontal disease among adult is 94% (Oral

Health Division. Ministry of Health Malaysia,

2013); where most needed oral hygiene advice

and prophylaxis (90%) while some needed

complex periodontal treatment (18.2%).

Throughout the past years, the prevalence of

periodontal disease among Malaysians has been

observed to increase with age suggesting the

emerging need to also care for periodontal health

in the elderly (Mohd Said, 2005). This certainly

calls more concerted focus in promoting

periodontal ‘fitness’ for life.

Periodontal diseases particularly gingivitis and

periodontitis, are inflammatory diseases inflicted

by bacterial infection in the oral cavity. Defined as

an infectious disease resulting in inflammation

within the supporting tissues of the teeth,

progressive attachment and bone loss, the

disease is characterised by pocket formation and/

or gingival recession (Lindhe et al. 1999).

Although bacteria is the primary aetiology of

periodontal disease, host immune defence can

also be affected by multi-factorial aetiology

including environmental influence, genetic

disorders and general health (Kornman 2008).

Conversely, the impact of periodontal disease not

only involves changes in the oral cavity but also

affect the systemic conditions and general health

(Reyes et al., 2013, Tonetti & Van Dyke, 2013).

Studies have confirmed that periodontal disease

has an independent and strong association with

poor quality of life. Although it is one of the most

preventable infectious diseases in the world,

periodontal disease contribute independently and

significantly on the physical, social and

physiological aspects of life quality of sufferers.

Symptoms such as discomfort, breath odour, smile

appearance and speech resulting from periodontal

tissue changes and teeth positioning in the mouth

may well affect the individuals’ confidence to

socialise and ability to perform optimally in their

routine life activities. Compared to those without

periodontal disease, patients’ claimed that altered

mood and happiness as a consequence from the

disease highly reduced their quality of life by more

than 20% (Bernabé & Marcenes, 2010). The

severity of disease was also shown to have a dose

-response association to patients’ life quality. In

view of this, effective management as well as

practical approaches is needed to improve on the

impact of periodontal disease on the life quality of

the population.

A prospective study involving 145 patients with

periodontitis in Malaysia recently concluded that

quality of life of patients was affected by their

periodontal problem– in terms of their general

health as well as oral health (Mohd Dom et al.,

2012). Furthermore, periodontal treatment

provided at selected government periodontics

clinics in Malaysia is shown to be effective in

improving oral health status and health-related

(Continued on page 3)

MSP– EMS Seminar Dr Farha Ariffin

MSP has co-organized a seminar entitled ‘Scaling New Heights’ on 7 April

2013 with EMS (Galla Dental). The aim of the seminar was to emphasize

the importance of non-surgical periodontal therapy among dentist and post-

basic nurses in Malaysia. The turn up for the seminar was overwhelming as

it was not only attended by the target audience, but also by the final year

dental undergraduate students from UiTM and USIM.

The speakers for the seminar were Dr Alvin Yeo from Singapore and Dr Badiah Baharin from UKM . The

topics presented by Dr Alvin were “Non-surgical

approach to periodontal therapy and

maintenance” and “Peri-Implantitis – Do we

Repair or Maintain?”. Dr Badiah enlightened us

with “Periodontal at-risk patients: How can we

help?”

The evening session was filled with hands-on

exercises on root debridement with mini Gracey’s

and the usage of EMS Air-flow® Master and

EMS Air-flow® powders. The hands-on session

was conducted by Dr Alvin Yeo.

(Continued from page 1)

quality of life of these patients.

Table 1 Estimated total cost for periodontal therapy provided

per year

Oral disease, including periodontal disease, is the

fourth most expensive disease to treat in

industrialised countries (Petersen et al, 2005) such

like Malaysia. It was reported that the cost of dental

treatment covers about 5-10% of public health

spending in high-income industrialised countries and

costs up to billions of dollars in the United States

and European Union (Baelum et al, 2007). In

Malaysia, it was estimated that the cost for

periodontal disease treatment is about RM 465

million per year (T. Mohd-Dom et al., 2014), with 90

% of the cost subsidised by the government (Table

1). This cost was estimated based on society

viewpoint involving the Ministry of Health Malaysia

as the provider, and from patients’ perspective

throughout 2010-2012.

This article has highlighted some important ‘threats’

of periodontal disease to our local community, such

as high prevalence and treatment needs, impact on

individual quality of life and the nation’s economy. It

is hopeful that effective preventive, promotive and

curative measures be continued as a priority

through collaborative efforts between Ministry of

Health, Universities and the private sector (Mohd-

Dom et al, 2013). Involvement of industrial partners

will also enhance the effort for more sustainable

improvement in oral health care for the community.

shahida@dental.ukm.my

BDS, MClinDent Periodontology, PhD

Senior Lecturer & Consultant in Periodontics

Universiti Kebangsaan Malaysia.

Periodontal Health Promotion & Health Service

Research Team.

Provider cost Patient cost Total

Total cost 416,430.77 48,829.42 465,260.19

Percentage 90% 10% 100%

Referencess:

Baelum, V., Helderman, W., Hugoson, A., Yee, R., & Fejerskov, O. (2007). A global perspective on

changes in the burden of caries and periodontitis: Implications for dentistry. Journal of Oral

Rehabilitation, 34(12), 872–906.

Bernabé, E., & Marcenes, W. (2010). Periodontal Disease and Quality of Life in British Adults.

Journal of Clinical Periodontology, 37(11), 968–972. doi:10.1111/j.1600-051X.2010.01627.x

Kornman, K. S. (2008). Mapping the Pathogenesis of Periodontitis: A New Look. Journal of

Periodontology, 79(8 Suppl), 1560–1568. doi:10.1902/jop.2008.080213

Lindhe, J, Ranney, R, Lamster, I, Charles, A, Chung, C.P, T, Flemmig, Kinane, D, Sommerman, M.

(1999). Consensus Report: Chronic Periodontitis. Annals of Periodontology, 4(1), 38.

Mohd Dom, Tuti, Al Junid, Syed, Abd Manaf, Mohd, Abd Muttalib, Khairiyah, Mohd Asari, Ahmad,

Ayob, Rasidah, Yaziz, Yuhaniz, Ishak, Noorlin, Aziz, Hanizah, Kasan, Noordin (2012).

Patient-reported outcomes after one year of periodontal treatment at public specialist dental

clinics in Peninsular Malaysia. BMC Public Health, 12(Suppl 2), A4. doi:10.1186/1471-2458-

12-S2-A4

Mohd Said, S. (2005). Prevalence of Periodontal Disease In Malaysian Population. Malaysian

Dental Journal, 26(2), 105–107.

Mohd-Dom, T., Ayob, R., Muhammad-Nur, A., Ishak, N., Abdul-Manaf, M. R., AlJunid, S. M., Abdul-

Muttalib, K. (2014). Estimating costs of periodontal treatment in public sector dental

specialist clinics. BMC Public Health, 14(Suppl 1), P11. doi:10.1186/1471-2458-14-S1-P11

Mohd-Dom, T. N., Abdul-Muttalib, K., Ayob, R., Lan, Y. S., & Mohd-Asadi, A. S. (2013). Periodontal

Status and Provision of Periodontal Services in Malaysia: Trends and Way Forward.

Malaysian Journal of Public Health Medicine, 13(2), 38–47.

Oral Health Division. Ministry of Health Malaysia. (2013). Fact Sheet. National Oral health Survey

of Adults 2010 (NOHSA2010).

Petersen, P. E., Bourgeois, D., Ogawa, H., Estupinan-day, S., & Ndiaye, C. (2005). The Global

Burden of Oral Diseases and Risks to Oral Health. Bulletin of the World Health

Organisation, 83(9), 661–669.

Petersen, P., & Ogawa, H. (2012). The Global Burden of Periodontal Disease: Towards Integration

with Chronic Disease Prevention and Control. Periodontology 2000, 60, 15–39.

Reyes, L., Herrera, D., Kozarov, E., Roldá, S., & Progulske-Fox, A. (2013). Periodontal Bacterial

Invasion and Infection: Contribution to Atherosclerotic Pathology. Journal of Periodontology,

84(4 Suppl), S30–S50.

Tonetti, M. S., & Van Dyke, T. E. (2013). Periodontitis and Atherosclerotic Cardiovascular Disease:

Consensus Report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases.

Journal of Periodontology, 84(4 Suppl.), S24–S29.

“Breakthrough In Periodontal Therapy Using Laser”

Speaker: Dr Samuel B Low (DDS, M.S, M.Ed) Date: 4th April 2014 Venue: Armada Hotel, Petaling Jaya Time: 9.00 am– 5.00pm CPD Points: 4 points (Lectures) 6 points (Lectures & Hands-on)

MSP Roadshow

Seremban 2013 Dr Noorlin Ishak

This event was held on Saturday, 26

October 2013 in Hotel Seri Malaysia,

Seremban. The organizing committee

comprised of Dr. Uma, Dr. Renu and

Negeri Sembilan team. The speakers

were Dr. Badiah Baharin, senior lecturer

from Dental Faculty, UKM and Dr.

Rosrahimi Abd. Rahim from Ministry of

Health, Klinik Pergigian Cahaya Suria,

Kuala Lumpur.

The turnout was encouraging despite

being held in the evening. Most

participants were private practitioners from

nearby Seremban city and they were

actually hungry for more information. They

showed much interest in Periodontology

and asked many questions on how to deal

with periodontal patients especially on

new techniques and advances in

periodontal treatment.

Dr. Rosrahimi spoke on “Incooperating

Perio in General Practice”, whilst Dr.

Badiah delivered “Beyond Routine: Oral

Hygiene and Periodontal Disease”.

Both speakers gave informative lectures on managing patients with

periodontally compromised teeth in general dental practices. No matter

how advanced the treatment given to the patients, e.g. dental implants,

crown or bridges, they cannot be sustained if the foundation, i.e gums, are

not healthy. We cannot build suprastructures eg crowns, bridges and

dental implants on an unhealthy foundation. The root of all failures of

these suprastructures are dental plaque. Thus patients need to be told on

adequate plaque control i.e effective toothbrushing and interproximal

cleaning. Gums should be treated prior to any suprastructure construction

and healthy gums should also be maintained while the suprastructures in

place to ensure its longevity.

We are happy to announce that 4 of our member periodontists from Ministry of Health have been promoted to ‘Gred

Khas C’. They are Dr. Sa'diah Yusoff , Dr. Sabariah Binti Abdullah, Datin Dr. Indra Nachiappan and Dr Uma

Subrama niam. Congratulations also to Professor Dr Fouad Al-Bayaty for recently being promoted to a Pro -

fessor in UiTM.

‘Achieving Aesthetics Around Dental

Implant’ Seminar Dr Badiah Baharin

A one day seminar and hands-on with the theme of ‘Aesthetic around dental implant’ was held in Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM) which was organised by Malaysian Society of Periodontology and fully sponsored by Dentacare Sdn Bhd.

The event was held on the 4th

October 2013 and was attended by 54 dentists and specialists which also included 15 postgraduate students from UKM. The main speaker was Assistant Professor Dr Sompop Bencharit from Department of Prosthodontics, School of Medicine University of North Carolina, America who conducted the lecture and hands-on sessions.

The morning lecture session highlighted topics on implant options for partially and complete edentulous patients, implant provisionalization and development of trabecular metal implants. After lunch, participants had the opportunity to experience various impression techniques on abutment and fixture for crowns and overdentures.