INFO UPDATE 2023

2023 EDITION P U S A T P E R G I G I A N K A N A K - K A N A K & I N S T I T U T L A T I H A N K E M E N T E R I A N K E S I H A T A N M A L A Y S I A ( P E R G I G I A N ) G E O R G E T O W N MALAYSIA’S A N D VARIOU S M U S T - K NOW U P D AT E S STRATEGIC PLAN FOR O R A L H E A L T H info Update S C A N H E R E F O R R E F E R E N C E S

Mouthwash and Its Effect 04 on Blood Pressure 16 What does it m N e O a H n S t P o 2 u 0 s 22 at - P 20 P 2 K 3 K A & t I A LK G K la M nc (P e ) :08 10Optimax Lite Box 12 Patient Profiling Digital Denture 06Garis Panduan Pengurusan Penyakit & Kondisi Periodontium Serta PeriImplan Pergigian Di Perkhidmatan Kesihatan Pergigian Primer 2022 The 2023 Edition of Info Update has been edited and compiled by Dr Shardhana Morgan and Dr Basiroh Binti Abdullah. We hope all of you are able to enjoy our efforts in improving the readability of this edition. If you have any questions or suggestions for improvement, please feel free to contact us at [email protected] or [email protected]. Content Editorial Team Effectiveness of Bactericidal Properties 05 in Alcohol-Free Mouthwash LP8 14 Jom Hadam! Page 02.

Director’s Note DR NOR HASLINA BINTI MOHD HASHIM DIRECTOR CHILDREN DENTAL CENTRE & TRAINING INSTITUTE MINISTRY OF HEALTH MALAYSIA (DENTAL) Page 03. First and foremost, I’d like to express my gratitude for all the hard work that everyone has shown in the operationalization of PPKK & ILKKM (Pergigian) as a Training Institute and Oral Health Services facility. Being a dental facility and academia at the same time, this institution must align itself with the constantly evolving field of dentistry. The delivery of Teaching & Training as well as Oral Health Services must be in accordance with the latest and updated guidelines and requirements to ensure dental auxiliaries are able to adapt and adopt the knowledge and competency level required by the MOH; and that oral health services are able to meet the standards stipulated in the National Oral Health Strategic Plan 2022-2030. This Info Update 2023 serves as a quick reference and guide for both academic and clinical staff for a better understanding and implementation, as well as monitoring and evaluation. Lastly, I’d like to convey my congratulations to the editorial board for this 2023 edition and look forward to more updates in the years to come. I believe the trainees and community will benefit from this kind of update. Enjoy your reading, and let’s create more avenues for information sharing within our fraternity in the future! NorHaslina.

Mouthwash is a liquid oral hygiene product designed to enhance oral care. It primarily helps prevent bad breath and reduces the risk of gingivitis and plaque buildup. For this article, search terms include blood pressure, hypertension, cardiovascular issues, mouth rinse, and mouthwash. There are three main types of mouthwashes: antiseptic, plaque-inhibiting, and preventive. However, it is important to note that no mouthwash can substitute the routine of brushing with toothpaste. Antiseptic mouthwashes are effective against bacteria, spores, and fungi. The most commonly used is a chlorhexidine-containing mouthwash, typically with a 0.2% concentration. It is often prescribed for use over a period of two weeks to one month, twice daily. Reported side effects of chlorhexidine mouthwash include tooth and oral appliance staining, calculus formation, temporary taste changes, oral dryness, and a burning sensation, which usually resolve after discontinuing use. In terms of plaque control, other mouthwashes may offer benefits, though they are less potent than antiseptic types. Mouthwashes containing fluoride usually pose mild and relatively rare side effects. Recent studies have explored the impact of mouthwash on nitrate (NO3) metabolism and its influence on blood pressure. Investigations into the relationship between mouthwash use and changes in salivary or plasma nitrite (NO2)/nitrate levels and blood pressure have shown that using an antiseptic mouthwash twice daily for three days in hypertensive individuals can lead to a slight increase in systolic blood pressure and a reduction in salivary NO2 levels. While the benefits of mouthwash generally outweigh the risks, it is strictly advised for consumers to adhere to prescription and direction of use. Furthermore, it is imperative to bear in mind that mouthwash does not supplant the indispensable practices of toothbrushing or flossing; instead, it constitutes a commendable augmentation. Nonetheless, mouthwash is not recommended for children under the age of six due to the risk of ingestion. O R A L H E A L T H T E C H N O L O G Y R E V I E W : M O U T H W A S H A N D I T S E F F E C T O N B L O O D P R E S S U R E Summary of key-findings by, Pn. Comalavalli a/p Subrumaniam BLOOD PRESSURE IS AFFECTED BY NITRATE LEVELS IN THE BODY Original review by Oral Health Programme, Ministry of Health Malaysia ANTISEPTIC MOUTHWASH CAN REDUCE SALIVARY NITRATE LEVELS NITRIC OXIDE DILATES BLOOD VESSEL Page 04. REFERENCES HERE 3 2 2

Bacteria Types of Mouthwash / Diameter of Inhibition Zone WATSON (mm) ORAL-B (mm) GAMADENT (mm) COLGATE (mm) SAFI (mm) MU’MIN (mm) P. aeruginosa 0 0 0 0 0 0 E-Coli 0.5 0.5 0.5 0.5 0.5 0.5 B. subtilis 3 2 3 1 2 1 S. areus 1 2 1 2 5 2 Introduction Mouthwash, used since ancient times, kills bacteria and neutralizes chemicals causing bad breath. Despite not being a substitute for brushing and flossing, it offers preventive and therapeutic benefits. Non-alcohol variants are safer and preferred in Malaysia, with this study testing their bactericidal effectiveness. E F F E C T I V E N E S S O F B A C T E R I C I D A L P R O P E R T I E S I N A L C O H O L - F R E E M O U T H W A S H Summary of key-findings by, Pn. Sharmila a/p Dharmalingam Original research by Pn. Sharmila a/p Dharmalingam Method In this experiment, standard microbiological methods were used to prepare LB agar and LB broth. A single bacterial colony was mixed in LB broth in a laminar flow cupboard. The broth was then evenly distributed on LB agar in petri dishes using glass beads for consistent bacterial growth. Filter paper discs, impregnated with mouthwash, were placed on these agar plates and incubated at 37°C for 24 hours. The bactericidal properties were assessed by measuring the inhibition zone around each disc. Controls used alcohol-impregnated discs to isolate the effect of mouthwash's active ingredients like Chlorhexidine, Cetylpyridium chloride, and Hydrogen peroxide. The experiment was repeated after four months for accuracy. Results In the initial month, a 24-hour observation revealed no inhibition of P. aeruginosa by the mouthwash, suggesting insufficient concentration. E. coli exhibited a 0.5mm inhibition zone for all six mouthwashes. B. subtilis showed varying inhibition: 3mm with Watson and Gamadent, 2mm with Oral B and Safi, and 1mm with Mu'min and Colgate. S. aureus inhibition ranged from 1mm with Watson and Gamadent, 2mm with Oral B, Colgate, and Mu'min, to 5mm with Safi. Discussion Observations of the inhibition zone at 14, 16, 18, and 24 hours revealed consistent bacteria-free areas. All six mouthwashes demonstrated equal efficacy against E. coli, B. Subtilis, and S. Aureus, with identical inhibition diameters. However, they were ineffective against P. Aeruginosa and in alcoholbased controls, indicating the need for higher mouthwash concentrations for P. Aeruginosa. Repeated bi-monthly tests confirmed these findings and ensured accuracy by eliminating anomalies. Proper mixing and distribution of bacteria were verified, showing a consistent 1mm inhibition zone for E. coli, B. Subtilis, and S. Aureus. Conclusion The observed inhibition zones across various durations confirm the efficacy of the recommended mouthwash concentrations in bacterial suppression, though a higher concentration may be necessary for P. aeruginosa. Despite differing active ingredients, the mouthwashes consistently exhibited similar bactericidal properties. Utilizing bacteria from the School of Biological Sciences, the study suggests the need for further research on more pathogenic oral bacteria. Future investigations should explore the impact of mouthwash on a broader spectrum of microbes, using the established methodologies. This would not only reinforce the findings regarding the bactericidal capabilities of these mouthwashes but also bridge the gap between laboratory results and their clinical implications, offering a more comprehensive understanding of mouthwash effectiveness. Page 05. REFERENCES HERE

Page 06. REFERENCES HERE 2017 Classification of Periodontal and Peri-implant Diseases and Conditions Periodontal Diseases and Conditions Periodontal Health, Gingival Diseases And Conditions Periodontitis Other Conditions Affecting The Periodontium Periodontal Health And Gingival Health Gingivitis:  Dental Biofilm Induced Gingival Diseases: NonDental Biofilm Induced Necrotizing Periodontal Disease Periodontitis Periodontitis As A Manifestation Of Systemic Disease Systemic Diseases Or Conditions Affecting The Periodontal Supporting Tissues Periodontal Abscess And EndodonticPeriodontal Lesions Mucogingival Deformities And Conditions Traumatic Occlusal Forces  Tooth And Prosthesis Related Factors Peri-implant Diseases and Conditions Peri-implant Health Peri-implant Mucositis Peri-implantitis Peri-implant soft and hard tissue deficiencies GARIS PANDUAN PENGURUSAN PENYAKIT & KONDISI PERIODONTIUM SERTA PERI-IMPLAN PERGIGIAN DI PERKHIDMATAN KESIHATAN PERGIGIAN PRIMER 2022 KLASIFIKASI PENYAKIT PERIODONTIUM: 2017 VS 1999 Ringkasan oleh Dr Neoh Zhen Hong, Dr Lee Pei Ling, Dr Tan Lek Jian 1. Mengapakah perlu pengelasan penyakit periodontium perlu dikemaskini ? Klasifikasi penyakit dan keadaan periodontium 1999 telah digunakan dalam bidang Kepakaran Periodontik di Malaysia sejak 20 tahun yang lepas namun, sesetengah penyakit periodontium terutamanya penyakit implan pergigian tidak dimasukkan di dalam klasifikasi tersebut. Hal ini menyebabkan kesukaran dalam pengurusan rawatan dan menjadikannya kurang komprehensif. 2. Bagaimanakah klasifikasi baru ini diwujudkan ? Ini ialah hasil persetujuan pakar-pakar periodontik dan penyelidik terkemuka dunia di dalam bengkel yang dianjurkan oleh American Academy of Periodontology (AAP) dan European Federation of Periodontology ( EFP ). 3. Apakah kelebihan klasifikasi Penyakit Periodontium dan Peri–implant Pergigian 2017 ? Bercirikan “case definition” untuk definisi yang lebih jelas bagi status sebenar kesihatan periodontium pesakit. Aplikasi sistem multidimensi staging (stage I to IV) dan grading (grade A to C) penyakit periodontitis yang menyerupai TNM Classification dalam penyakit kanser di bidang perubatan. Boleh mengenal pasti individu pesakit yang memerlukan rawatan yang intensif untuk mencegah & mengawal penyakit periodontitis. Faktor risiko seperti penyakit diabetes tidak terkawal dan tabiat merokok juga diambil kira dalam menilai progresi penyakit periodontitis. Berupaya mengenal pasti peringkat dan tahap penyakit, darjah keterukan, kompleksiti serta risiko perebakan atau progresi penyakit periodontitis. Merangkumi kesihatan dan masalah berkaitan implan pergigian yang merupakan rawatan yang meluas di seluruh dunia. PELAKSANAAN SARINGAN PENYAKIT PERIODONTIUM DI KLINIK PERGIGIAN PRIMER Tujuan : Mengenalpasti masalah periodontium pada peringkat awal dan memberi rawatan yang diperlukan. Kaedah : 1.Basic Periodontal Examination (BPE) dengan menggunakan WHO CPITN probe untuk semua pesakit yang berumur 18 tahun dan ke atas. Pegawai pergigian hendaklah menerangkan secara ringkas kepada pesakit berkenaan prosedur BPE dan akibat yang mungkin timbul akibat pemproban seperti perdarahan dan rasa sakit/ketidakselesaan. Sebelum menjalankan pemproban, pastikan pesakit tidak mempunyai masalah perubatan ( masalah pendarahan, pesakit yang sedang mengambil ubat cair darah seperti warfarin dan pesakit yang memerlukan antibiotik profilaksis ) 2. Bahagikan gigi kepada 6 sekstan. Semua gigi dalam setiap sekstan diperiksa kecuali molar ketiga. Gigi molar ketiga yang telah tumbuh sepenuhnya boleh digunakan jika gigi molar pertama dan/atau gigi molar kedua tiada. Bagi sekstan yang layak untuk pemeriksaan, ia mesti mengandungi sekurang-kurangnya dua (2) batang gigi. JIka hanya satu (1) batang gigi terdapat dalam sekstan, tandakan (-) pada sekstan tersebut. 3. 4.Probe WHO CPITN digerakkan secara "berjalan di sekeliling" sulkus/poket pada setiap gigi dalam setiap satu sekstan. 5.Kod 0,1,2,3,4 dan * digunakan semasa BPE dan kod tertinggi dicatatkan dalam kad L.P.8. 6.Pengurusan pesakit adalah berdasarkan kod yang direkodkan. 7.Pesakit yang boleh dirujuk kepada Pakar Periodontik ialah pesakit yang mempunyai: Skor BPE 4 Gingival disease, Necrotizing Periodontal Disease dan Other Conditions Affecting the Periodontium (Klasifikasi 2017) Peri-Implantitis Peri-Implant Soft and Hard Tissue Deficiencies

Page 07. P e m e r i k s a a n d a n s a r i n g a n B P E d i A K l i n i k P e r g i g i a n P r i m e r / O u t r e a c h Skor BPE 3 pesakit sihat dan/atau dengan penyakit sistemik yang boleh diurus * S k o r 0 Skor BPE Tidak Perlu Rawatan Penilaian Periodontik Asas dan Rancangan Rawatan: Rancangan rawatan Terapi Permulaan/ICRT ** Skor Plak Pergigian Penilaian Risiko dan Pencegahan Rawatan bersesuaian dijalankan Penilaian Semula Status Periodontal Pesakit R E S P O N Pendidikan penjagaan higin mulut Penggilapan, penskaleran +/pembuangan pinggir rungkup dan kalkulus subgingiva Rawatan dan nasihat bersesuaian. Rawatan Tamat Skor BPE 3 pesakit dengan penyakit sistemik kompleks Rujuk ke Pakar Periodontik ***Rujuk ke Pakar Pergigian Penjagaan Khas Rujuk UPPKA ****Skor BPE = 3 (setelah 3x rawatan) ****Skor BPE = 3 Tindakan Susulan Progres ke skor BPE = 4 Nota: Gingival disease, Necrotizing Periodontal Disease dan Other Conditions Affecting the Periodontium boleh terus dirujuk ke Pakar Periodontik P A N D U A N P E N G U R U S A N D A N R U J U K A N P E S A K I T S E L E P A S S A R I N G A N B P E 1. Selepas menerima rujukan daripada klinik kesihatan, adalah penting untuk menjalankan pemeriksaan menyeluruh, termasuk mendapatkan sejarah perubatan yang lengkap dan merekod BPE bagi pesakit. 2. Bagi pesakit kencing manis dengan penyakit sistemik, jika Diabetes Mellitus Jenis 2 mereka terkawal dengan baik, mereka boleh dikelola di peringkat primer selagi mereka memenuhi kriteria berikut: 3. Walau bagaimanapun, jika bacaan mereka tidak terkawal, selepas rawatan asas seperti penskaleran supragingiva dan tampalan diselesaikan, pegawai pergigian boleh menghubungi klinik periodontal, mendapatkan tarikh temujanji untuk pemeriksaan lanjut, dan merujuk pesakit tersebut. Penyakit gusi, penyakit periodontal nekrotik, dan keadaan lain yang mempengaruhi periodontium boleh dirujuk terus ke klinik pakar. PENGURUSAN PESAKIT DIABETIK YANG DIRUJUK KEPADA KLINIK PERGIGIAN PRIMER DARI KLINIK KESIHATAN Bacaan HbA1c kurang daripada 6.5% Bacaan glukosa puasa di bawah 11 mmol/L Skor Menurun Skor statik bertambah Skor 1

Oral Cancer Control and Prevention Initiate smoking consumption screening for pre-school children (aged 5 - 6) and interventions to reduce Malaysia's smoking prevalence by 10% by 2023. Incorporate oral cancer screening as part of the clinical examination for patients. Include oral cancer screening and treatment in the PeKa B40 program. Promote mouth self-examination (MSE) and anti-smoking campaigns in the community. Implement a guideline/protocol on smoking cessation by 2024 for dental practitioners to provide smoking cessation services. Adopt a primary and specialist care navigation system by 2024 to improve compliance with treatment for patients with potentially malignant disorders or at risk of oral cancer. Periodontal Disease Control and Prevention Perform Basic Periodontal Examinations (BPE) in incremental dental care for school children. Utilize BPE for periodontal screening during clinical examinations. Follow a periodontal care protocol for effective management of periodontal diseases. Handling Elderly and Patient with Disability (PWD) Comply with the Guideline on Handling Elderly and Patients with Disabilities, to be developed by 2024. Ensure new facilities at ground level adhere to 'universal design' principles (Elderly and PWD friendly). Oral Health Promotion Implement the Standard Chair Side Oral Health Education Module by 2024 to educate on oral hygiene techniques, healthy diets, physical activities, MSE, and anti-smoking. Proactively spread oral health messages through Klinik Pergigian Mesra Promosi and social media platforms. Ensure Safe and Quality Oral Healthcare Service Delivery Raise awareness about current medicolegal/legislation issues among oral healthcare providers through CPD programs. Utilize standardized dental records for clinical examinations by 2024. Conduct periodic audits to ensure compliance with quality standards in dental facilities. Gradually reduce the use of dental amalgam in oral healthcare services. Implement an Electronic Medical Record system for patient dental records. O R A L H E A L T H S E R V I C E S is the first National Oral Health Policy approved by the Cabinet on 18 May 2022. Its goal is to enhance the oral health status and quality of life for Malaysians by collaborating with stakeholders from both public and private sectors. This policy aims to refine the current oral healthcare system by introducing innovative systems, guidelines, and modules while engaging with healthcare providers, including dental training centers, to pursue a unified objective. NOHP outlines the necessary activities to fulfill the Ministry of Health's expectations. National Oral Health Strategic Plan (NOHSP) 2022 – 2030 Summary by Dr Amir Hariz bin Abd Aziz, Dr Nurul Haizan binti Dziauddin WHAT DOES IT MEAN TO US AT PPKK & ILKKM (P)? NOHSP 2022 - 203Page 08.

Page 09. REFERENCES HERE 30 AT A GLANCEO R A L H E A L T H C A R E P E R S O N N E L T R A I N I N G C E N T E R Provide training modules for handling elderly patients and those with disabilities. Include medicolegal/legislation topics in the training curriculum. Implement standardized dental records in clinical training by 2024. Introduce the Standard Chair Side Oral Health Education Module to trainees by 2024. Integrate the Electronic Medical Record system into the training program. R E S E A R C H A N D D E V E L O P M E N T Promote research on: The severity of oral diseases or conditions among vulnerable groups. The effectiveness of oral health intervention programs. The health economic impact of disease burden. The use of digital technologies and EMR in enhancing the health and data management of the Malaysian population. The oral health literacy level of the Malaysian population. The cost and mechanical properties of dental amalgam and alternative restorative materials. The use of dental amalgam and alternative restorative materials in MOH facilities.

Page 10. REFERENCES HERE P A T I E N T P R O F I L I N G I N C H I L D R E N D E N T A L C E N T R E & T R A I N I N G I N S T I T U T E M I N I S T R Y O F H E A L T H M A L A Y S I A ( D E N T A L ) , G E O R G E T O W N , P U L A U P I N A N G Research Summary by, Dr Rabiatul Adawiah Muhammad Azzuar DATA ANALYSIS: SPSS 26.0 SYSTEMATIC RANDOM SAMPLING ORAL HEALTH PROFILES: PREVALENCE ( FREQUENCY & PERCENTAGE) The relationship of oral hygiene s tatus with other var iables ; The Mann Whitney U, Krus kal Wal l i s & Spearman Cor relation tes t F inal fac tor s affec ting oral hygiene: Ordinal logi s t i c regres s ion analys i s I N T R O D U C T I O N Patient Profiling – to predict that certain patients are more likely to exhibit certain behaviors or diseases based on their sociodemographic, socioeconomic, or other observable characteristics from analyzed data. Oral Health is fundamental for maintaining high quality of life. It refers to a variety of oral diseases and conditions. Oral hygiene is one of the principal determinants in determining a child's dental or oral health condition. Previous studies have revealed several factors associated with oral hygiene. Profiling the child's oral health data is required to fully understand the scope of this public health issue and to evaluate the efficacy of current and future interventions. Aim: To study the profile of patients attended this institution and to predict the model of oral hygiene by studying the relationship between oral hygiene status and all relevant variables evaluated. Rationale: To facilitate management by understanding the pattern of patients treated at this institution. The profiles will serve as a baseline to assist this institution in planning comprehensive preventive and therapeutic programs. M A T E R I A L S & M E T H O D S Extracted data on variables of interest from 742 selected 7-17 y/o schoolchildren’s dental record in 2019 RETROSPECTIVE STUDY Variables of Interest - Oral Health Profiles: Sociodemographic, oral hygiene status, caries status, gingival status, caries risk level, type of treatments, dental visits, and referral to specialist D I S C U S S I O N The percentage of poor oral hygiene is alarming particularly among primary schoolchildren. This finding is comparable to a study conducted in Jakarta (92.0%). This study revealed a high prevalence of caries, with most of them were from primary schoolchildren. It was in contrast with Malaysia’s goal (66.7% free caries by the end of 2020) and higher than global prevalence (40-60%). In the bivariate and multivariate analysis, both the primary schoolchildren and gingivitis remained significantly associated with poor oral hygiene. This finding is corroborated by a Mexican study, which revealed that younger children had poorer oral hygiene. It is generally known that the accumulation of plaque over time can lead to the onset of gingivitis. Oral health practice and knowledge, dietary habits, and parental supervision are the key reason to be emphasised behind these findings. Manual dexterity improves with age, making younger children less adept at removing dental plaque and still require parental supervision. Young children are more synonymous with a preference for sweet foods and snacks without practising proper oral care practices following the intake.

Page 11. 74.8% 57.8% 74.4% 92.6% 70.6% 69.9% 54.6% 62.7% 2.3% Variables (%) p value Primary school 74.8 0.001 Secondary school 25.2 Gingivitis 27.1 0.029 No gingivitis 72.9 Variables OR 95% CI p value Primary school 2.751 1.556-4.864 <0.001 Secondary school 1.00 Gingivitis 0.372 0.171-0.813 0.013 No gingivitis 1.00 PATIENT PROFILING PROFILE DATA BASELINE DATA ORAL HEALTH ISSUES R E S U L T S Primary>Secondary Female > Male Malay > Chinese > Indian > Others 1. SOCIODEMOGRAPHIC 2. ORAL HYGIENE Poor Primary schoolchildren 3. CARIES STATUS Caries Primaryschoolchildren 27.1% Gingivitis 4. GINGIVAL STATUS 39.2% Lowcaries 5. CARIES RISK LEVEL Preventive 6. TREATMENT TYPES Restorative Periodontal 57.7% 64.2% 95.7% 1Visit 7. DENTAL VISITS 8. REFERRAL TO SPECIALIST Orthodontic PediatricDentistry TABLE 1: THE RELATIONSHIP OF ORAL HYGIENE STATUS WITH OTHER VARIABLES TABLE 2: FINAL FACTORS AFFECTING ORAL HYGIENE BY ORDINAL LOGISTIC REGRESSION ANALYSIS C O N C L U S I O N The data can be used for future studies and should focus on each component of oral health along with related factors. Patient profiling techniques should be expanded by using specific methodology and technology to convert large amounts of data into useful information for planning and decision making. Based on the patient profiles obtained, the primary schoolchildren's oral health is alarming, primarily in terms of oral hygiene, caries status and gingival status. Hence, this institution should place a greater emphasis on the oral health of primary schoolchildren, particularly in their oral hygiene state.

Page 12. REFERENCES HERE In the realm of dental technology, the Optimax Lite Box (OLB) emerges as a beacon of innovation, conceived by a dedicated team in September 2021. This pioneering device is designed to revolutionize the denturemaking process, outperforming traditional light curing units with its advanced functionality. The team, comprised of a Dental Officer and four Dental Technologists, has not only brought this invention to life but also showcased its potential on prestigious platforms, securing third place at the Anugerah Inovasi Kementerian Kesihatan Malaysia (AIKKM) held in Putrajaya on October 20, 2022, and while proudly clinching a gold medal at the IIIDentEx2022 in Bayview Hotel, Pulau Pinang, on November 14, 2022. The OLB is a solution crafted to address critical challenges in the dental sector, including the shortage and escalating costs of conventional light curing units, as well as the logistical bottleneck these shortages create for students awaiting their turn, thus impeding their learning trajectory. Crafted from black acrylic opaque material, the OLB boasts a pragmatic design measuring 69cm x 17cm x 15.5cm. Its interior is ingeniously divided into three compartments, equipped with a UV light bulb, a timer switch, and an on/off switch, enhancing its usability and efficiency. What sets the OLB apart is its unparalleled efficiency in the production of special trays, a crucial component in denture fabrication. Traditional light curing units can only process two units per 15-minute cycle. In stark contrast, the OLB can produce twelve special trays within the same timeframe, effectively increasing productivity sixfold. This not only translates to a drastic reduction in the number of cycles and time required to produce a significant quantity of special trays but also frees up invaluable time for other essential laboratory tasks. Opti max Lite Box A Report on the Innovation Project ‘Optimax Lite Box’ by Dr Siti Safuraa Opti max Lite Box Gold medalists (from left): Pn Shazrina Binti Mat Jenan, Pn Nor Haziqah Binti Abu Bakar, Dr Siti Safuraa Zahirah Binti Shahidan, En Mohd Salehfuddin Bin Mat Il, En Mohamad Azmi Firdaus Bin Abdul Rahim, En Adrian D’Cruz A/L Balan

Page 13. Economically, the OLB stands out as a cost-effective alternative, with its price per unit and operational costs significantly lower than traditional light curing units. This affordability, coupled with its operational efficiency, positions the OLB as a viable option for dental training institutes and Ministry of Health (MOH) facilities, promising widespread applicability and potential for adoption. The journey of the OLB from concept to accolade-winning innovation is a testament to the team's dedication and ingenuity. As they navigate the path towards patenting their creation, their story is one of inspiration, highlighting the impact of innovative solutions in advancing healthcare technology. Their achievements in competitions underscore the potential of the OLB to contribute meaningfully to the dental field, and the team's experiences serve as a foundation for future endeavors aimed at enhancing organizational efficiency and patient care. In an era where innovation drives progress, the Optimax Lite Box stands as a shining example of how creative solutions can address longstanding challenges, heralding a new age in dental technology with the promise of broader implications for healthcare practices. The team's journey from conception to recognition is a narrative of resilience, innovation, and the relentless pursuit of excellence, setting a benchmark for future innovations in the healthcare sector. OLB can produce twelve special trays within the same timeframe, effectively increasing productivity sixfold Crafted from black acrylic opaque material, the OLB boasts a pragmatic design measuring 69cm x 17cm x 15.5cm.

Page 14. REFERENCES HERE Merujuk kepada Program Saringan Merokok untuk kumpulan sasaran Sekolah Rendah, Sekolah Menengah dan Pesakit Luar. MBK (Mulut Bebas Karies) merujuk kepada pesakit yang mempunyai sama ada: Kegigian campuran dan bebas dari karies (dfx=0, DMFX=0) Kegigian susu sahaja dan bebas dari karies (dfx=0, DMFX=nil) Tiada kegigian susu dan kekal (dfx=nil, DMFX=nil) Kesilapan paling biasa dilakukan oleh Pegawai Pergigian PPKK & ILKKM (P) semasa mengisi L.P.8 - 1 Pin.8/2019 dan L.P.8 - 2 Pin.8/2019 & penjelasannya. Ringkasan oleh, Dr Shardhana Morgan Status Oral: MBK, BK, MBG, TPR, TSL Gigi susu d – bilangan gigi desidus yang ada karies (termasuk gigi yang dikira sebagai SM) f – bilangan gigi desidus yang telah ditampal x – bilangan gigi desidus yang perlu dicabut disebabkan karies dfx – Masukkan jumlah dfx Gigi kekal D – bilangan gigi kekal yang ada karies M – bilangan gigi kekal yang telah dicabut disebabkan oleh karies F – bilangan gigi kekal yang telah ditampal X – bilangan gigi kekal yang perlu dicabut disebabkan karies LP8 - Jom Hadam! BK (Mulut Bebas Karies) merujuk kepada pesakit yang mempunyai sama ada: Kegigian campuran yang bebas dari karies (dfx = 0, DMFX = 0) Kegigian kekal bebas dari karies (dfx = nil, DMFX = 0) Kegigian campuran dan hanya gigi kekal yang bebas dari karies (dfx ≠ 0, DMFX = 0). TPR (Tidak Perlu Rawatan) merujuk kepada pesakit yang tidak memerlukan rawatan dalam tahun semasa, termasuk pesakit yang hanya memerlukan: pencegahan klinikal seperti kes sealan fisur, sapuan fluorida dan pencegahan (PRR Jenis 1) kes ortodontik dan restorasi kompleks yang perlu dirujuk kepada pakar gigi desidus yang mempunyai tampalan sementara dan hampir eksfoliat (berdasarkan jadual pertumbuhan gigi dan umur pesakit) MBG (Mulut Bebas Gingivitis) (GIS=0) : Pesakit yang mempunyai jumlah Skor Index Gingivitis (0) merujuk kepada gusi yang sihat. TSL (Tooth Surface Loss): Pesakit yang didapati mempunyai kehilangan permukaan gigi akibat erosion / attrition / abrasion dan / atau lain-lain (akibat unsur fizikal atau kimia), tidak termasuk di dalam kes trauma. Kes boleh dirujuk kepada pakar jika perlu. Bilangan Gigi Jangan lupa untuk tandakan (✔) jika berkenaan dan tandakan (-) jika tidak berkenaan! Bagi kes edentulus masukkan nilai ‘0’. Tandakan (-) jika tidak berkenaan, i.e. belum ada kegigian susu / kekal. Program Pencegahan & Intervensi Tahun: Isikan tahun setiap kali saringan dilaksanakan Status Merokok, Tanda-Tanda Merokok, Kesediaan Berhenti Merokok, Kesediaan Untuk Intervensi Lanjutan: Tandakan (✔) di ruang yang disediakan jika berkenaan mengikut tahun saringan. Tandakan ( - ) jika tidak berkenaan.

Page 15. Faktor Risiko Kod 0 Kod E Kod 1 0 Rendah Sederhana Sederhana 1-2 Rendah Sederhana Sederhana >3 Sederhana Tinggi Tinggi 2a Gigi tiada, bukan kerana karies 3a Ada tampalan, bukan kerana karies 4a Untuk cabutan, bukan kerana karies C Corona P Pontik TSL Tooth Surface Loss (Attrition, Abrasion, Abfraction, Erosion) EDD Kecacatan Enamel / Dentin, Hipomineralisasi Molar / Insisal SM Space maintenance ialah gigi susu yang ada karies (d) tetapi tidak boleh ditampal dan tidak dicabut kerana tiada kesakitan dan / atau tanda-tanda infeksi 8 Tampalan Ulangan 8a Tampalan Amalgam 8b Tampalan Sewaran 8c Karies sekunder 9 Ada FS E10 Perlu FS 11 Ada PRR Jenis 1 E12 Perlu PRR Jenis 1 E13 Perlu FV 14 Fraktur 0 Sihat 1 Pendarahan Selepas Pemproban 2 Ada Kalkulus & Faktor Retensi Plak 3 Kedalaman Poket Gingiva 3.5mm - 5.5mm 4 Kedalaman Poket Gingiva ≥ 6.00mm * Melibatkan percabangan (furcation) Langkah 1: Tandakan kod yang tertinggi Karies (Sekurang-kurangnya 1 gigi dengan Kod 1 atau Kod 4) Karies Awal (Sekurang-kurangnya 1 gigi dengan Kod E) Sound (Jika tiada gigi Kod 1, 4 atau E) Langkah 2: Tandakan (✔) pada faktor risiko yang berkenaan T E R TIN G GI Jangan lupa untuk merujuk semula Skor Kebersihan Mulut (KM = C / E)! Jangan lupa untuk tandakan (-) jika tidak berkenaan! Penilaian Risiko Karies Langkah 3: Penunjuk Risiko Karies Contoh: Kod tertinggi pesakit adalah E, dan mempunyai 2 faktor risiko, penunjuk risiko karies pesakit adalah SEDERHANA Langkah 4: Lawatan Susuian Tinggi: Setiap 3 bulan Sederhana: Setiap 6 bulan Rendah: Setiap 12 bulan Pencartaan Gigi Kod Carta Gigi Basic Periodontal Examination (BPE) Catatan klinikal perlu terperinci dengan butiran berikut: 1.Masa menunggu dan bacaan tekanan darah 2.Aduan pesakit 3.Sejarah aduan 4.Sejarah kesihatan pesakit 5.Pemeriksaan luar dan dalam mulut 6.Skor kesakitan (pain score) jika perlu 7.Ujian / Siasatan yang dilakukan serta catatan penemuannya 8.Diagnosis 9.Pelan Rawatan, yang diikuti oleh persetujuan pesakit Catatan pengurusan pesakit jJika preskripsi atau sijil sakit diberikan, nombor siri juga harus dicatatkan.) 10. 11.Tarikh temujanji seterusnya jika ada.

The fabrication of conventional complete dentures, a century-old practice, involves a time-intensive process encompassing primary impressions, definitive impressions, jaw relation records, clinical tryins, and final denture placement. However, recent advancements in digital denture systems have revolutionized this process by enhancing accuracy and efficiency, thereby reducing the number of required clinical visits. These advancements leverage technologies such as computer-aided design/manufacturing (CAD/CAM) and three-dimensional (3D) printing. The process begins with the digital capture of the patient's oral cavity and jaw relations using advanced light scanning technology. This digitalization allows for the precise construction of dentures, starting from scanning the oral cavity to transferring all necessary clinical data into a computer for design and fabrication. E M B R A C I N G T H E F U T U R E : D I G I T A L D E N T U R E S Article by Sathia Mohanadas, Mohd Farouk Mubarak, Shazrina Mat Jenan & Haziqah Abu Bakar Digital dentures offer numerous benefits over traditional methods. They are more efficient, provide a more accurate base fit, and offer better retention. This technology is less labor-intensive and reduces the need for multiple clinic visits, cutting down on clinical chair time. Furthermore, it eliminates denture base polymerization shrinkage and allows for the fabrication of additional dentures using previously saved data, enhancing patient-related outcomes. Intraoral scanning, an integral part of digital denture fabrication, presents several advantages over conventional impressions, such as improved patient comfort by eliminating gag reflex, and streamlines laboratory processes like cast preparation and shipping without needing physical casts. Software companies are actively developing user-friendly interfaces to make these digital systems more accessible. However, the digitization of denture tissue surfaces is still evolving, with effectiveness depending on the specific system used. Integration of intraoral scans with facial scans and the incorporation of virtual face-bows and articulators are promising developments on the horizon. SCAN HERE FOR REFERENCES