Background: Head and neck cancer is the sixth most common cancer worldwide. It is generally ackno... more Background: Head and neck cancer is the sixth most common cancer worldwide. It is generally acknowledged that the early diagnosis of oral cancer may result in higher 5-year survival rates, less need for aggressive treatment and improved quality-of-life. There is therefore a need for a quantifiable, reliable and competency-based educational tool which can be used to train dentists and other health care providers in the early detection of oral cancers. Aim: To assess the effectiveness of “OralDETECT” spaced repetitive learning method for training dental professionals to become competent in the early detection of oral cancer. Methods: The current study involved training three dental professional groups: Oral Pathology/Oral Medicine/Oral Surgery specialists (x), Periodontists/Restorative dentists (y), General Dental Practitioners (z) and four undergraduate cohorts comprising 259 dental students from 3 different Malaysian dental schools. A structured one-day training program “OralDETECT”...
The purpose of the study was to investigate primary and permanent tooth anomalies of 5-year-old c... more The purpose of the study was to investigate primary and permanent tooth anomalies of 5-year-old children in Taranaki; 1,680 children were examined by school dental therapists, and the presence of hypodontia, hyperdontia, and double teeth recorded. Panoramic radiographs were taken of those children with anomalies of the primary teeth. Anomalies of the primary teeth were detected in 23 children (1.4 percent). Six children (3 boys and 3 girls) had hypodontia, 3 children (2 boys and 1 girl) had a supernumerary tooth, and 14 children (9 boys and 5 girls) had double teeth. Six of the affected teeth (in 4 boys and 2 girls) were diagnosed as fusion, and 8 (5 boys and 3 girls) as gemination. The panoramic radiographs of the 23 children with anomalies of the primary teeth revealed that 14 (60.9 percent) also had anomalies of the succedaneous permanent teeth. Children with hypodontia in the primary dentition all had corresponding permanent teeth missing. In all but three children, only one too...
BACKGROUND: Australia has a disproportionate number of dentists working in its capital city locat... more BACKGROUND: Australia has a disproportionate number of dentists working in its capital city locations relative to its rural locations. Australian Government agencies have initiated two different approaches to partially equalize this workforce imbalance. One approach has been to allow for the placement of dental students from capital city-based universities into a rural work student location. The second, more recent, approach has been to establish dental schools in regional areas. The study has the objective to assess the perceptions and views of both urban and rural-based dental school students on rural placement experience and future rural work. METHODS: Two rural dental schools and one capital city-based dental school were approached, and all consented to their students participating in this survey. The data from the two rural universities were then coalesced and compared to the data from the capital city-based university to quantify the usefulness of the two different approaches ...
Objectives: To describe the preventive dental practices of general dentists in Phnom Penh, Cambod... more Objectives: To describe the preventive dental practices of general dentists in Phnom Penh, Cambodia. Methods: Dentists from 100 randomly selected dental clinics in Phnom Penh were interviewed by one of 3 trained interviewers. Open and closed questions included: background information, knowledge of prevention, resources for prevention, and preventive practices. Data presented are from the results of the first 30 participants. Results: 66.7% of dentists believed prevention was very important. 87% gave oral health education at least several times a week. 42.9% never used F varnish and 48.3% never used resin sealants. When shown a picture of a white spot lesion, 30% said they would provide no treatment, 6.7% would apply fluoride, and 46.7% would restore. 53.3% believed that caries in enamel is reversible. 89.7% said preschoolers should use a F toothpaste, and 90% said this should be low F paste. 70% said women should take F tablets during pregnancy. 85.2% said that all patients should be recalled 6 monthly. 79.3% said that plaque was composed mainly of food particles. 31% were in favor of a sugar tax, and 83.3% in favor of water fluoridation. 68.9% agreed that selling of sugary foods and drinks at schools should not be permitted. 86.3% of dentists suggested having more education on prevention at dental conferences. Conclusions: Cambodian dentists have limited knowledge of dental prevention and the basic principles of cariology and provide only limited preventive interventions for their patients. This survey is the first important step in a campaign to improve preventive practices of Cambodian dentists; actions should be taken to orientate dentists towards implementing evidence-based prevention in their clinics
In 1993 a 4-5 month programme to train rural dental nurses in Cambodia was introduced. Courses ha... more In 1993 a 4-5 month programme to train rural dental nurses in Cambodia was introduced. Courses have now been conducted in 12 of Cambodia's 22 provinces. The dental nurses are trained to provide simple treatment, including local anaesthetic, extractions, ART restorations, and scaling, for all age groups, and also learn how to introduce prevention and oral health promotion activities within their communities. On completion of training nurses are supplied with a set of basic instruments and some materials. Evaluation has shown the programme to be meeting the oral health needs of the rural people where there are no dentists and a number of unique strengths were identified. A recent planning workshop on oral health care in Cambodia to 2005 decided to set up a dental nurses training school in two provincial capitals, and to increase the number of nurses in training. At the same time the annual number of new dentists being trained will be limited to ten. The expansion of the dental nurses training programme will ensure that increasingly more of the population have access to basic preventive and curative dental care, and at a cost which the country can afford.
KEYWORDS universal health care (UHC), basic package of oral care, inequalities (MeSH), global hea... more KEYWORDS universal health care (UHC), basic package of oral care, inequalities (MeSH), global health, oral health Editorial on the Research Topic Innovating and expanding universal access to oral healthcare
Aim This was to explore the socio-behavioural risk factors for ECC in Cambodia. Early childhood c... more Aim This was to explore the socio-behavioural risk factors for ECC in Cambodia. Early childhood caries (ECC) is a significant health problem in Cambodia. Methods A convenience sample of 362 primary caregiver-child dyads were selected. The children were aged between birth and 6 years old and participated in a structured interview and intra-oral examination. Results ECC was diagnosed in 244 of 362 (65.6 %) children and 178 (50.6 %) had severe early childhood caries (sECC). There were significant associations between caries experience and tooth brushing, dietary, and nursing habits. The odds ratio (OR) for sECC in those children who started brushing before the age of 18 months was 0.41 (CI 0.18, 0.93). However, for those children who continued to breast-feed after the age of 2 years the OR was 5.31 (CI 1.50, 18.79). Conclusions The most prominent risk factors for ECC in the present study were lack of tooth brushing and breastfeeding past the age of 2 years.
International Journal of Paediatric Dentistry, 2021
BACKGROUND The number of child abuse cases is increasing worldwide therefore it is important to e... more BACKGROUND The number of child abuse cases is increasing worldwide therefore it is important to educate individuals having contact with children about it. This includes dentists who play a pivotal role in detecting and reporting these cases. AIM To identify and compare the final year dental student's knowledge, attitudes and practice in relation to child abuse. DESIGN A 38-item and four part online questionnaire was distributed to students of 11 dental schools in 10 countries. SPSS and GraphPad Prism were used for data analysis. The levels of statistical significance were determined using a chi-square test. P ≤ 0.05 was considered to be statistically significant. RESULTS A total of 660 students completed the survey. Fifty-six percent of the students received formal training on child abuse, and 86% wanted additional training. The knowledge of child abuse was significantly higher in Australia, USA and Jordan compared to other countries. The internet (60.3%) was widely used as an information source for child abuse. CONCLUSIONS The study showed that dental students lack knowledge and experience in recognising and reporting child abuse. Most respondents indicated a desire for additional training, therefore dental schools should review what they are currently teaching and make changes as appropriate.
Objectives: To report the results of the 2011 National Oral Health Survey which was conducted to ... more Objectives: To report the results of the 2011 National Oral Health Survey which was conducted to assess the dental caries, sequelae, and selected risk indicators in the population. Methods: A sample of 2028 participants aged 6, 12-13, 15-17 and 35-44 was recruited from Phnom Penh and four provinces to represent age, sex, and urban/rural locations. Examinations were conducted using ambient light and mouth mirrors by standardized examiners. Tooth-specific data were obtained to calculate the number of decayed, missing and filled teeth (dmft) and number of teeth with pulp, ulcer, fistula, and abscess sequelae (PUFA index). Interviews were carried out to collect socio-demographic and behavioral information. T and ƒO2 tests were used to assess statistical differences (ƒ? < 0.05). Results: The prevalence of dental caries was 93% at age 6 years, and 80% at age 12-13, and 35-44 years. At age 6 years, the mean dmft was 9.0 (standard deviation [SD] 4.9) and the mean PUFA 2.7 (SD 2.8); at ag...
Journal of Health Services Research & Policy, 2022
Objective Oral cancer is amenable to early detection but remains a prominent cause of mortality i... more Objective Oral cancer is amenable to early detection but remains a prominent cause of mortality in the Asia Pacific region. This study aimed to identify barriers to early detection and management of oral cancer in the Asia Pacific region. Methods A mixed-methods approach was employed triangulating findings from a survey and focus groups. The survey was conducted among seven representative members of the Asia Pacific Oral Cancer Network (APOCNET) across six countries. Focus groups were conducted to gain deeper insights into the findings of the survey. Results The identified barriers were a lack of national cancer control strategies and cancer registries and the limited availability of trained health care professionals. Overcoming these challenges in the Asia Pacific region where resources are scarce will require collaborative partnerships in data collection and novel approaches for continuous professional training including eLearning. Further, to overcome the lack of trained health c...
PURPOSE To investigate the associations between early childhood caries (ECC) and maternal factors... more PURPOSE To investigate the associations between early childhood caries (ECC) and maternal factors among 18- to 36-month-old children in one rural province of Cambodia. MATERIALS AND METHODS 121 mother-child pairs (male = 67, female = 54; mean age = 25.18 ± 6.24 months) were recruited at several villages in Stueng Trang district, Kampong Cham province. ECC and maternal caries experience were recorded following WHO guidelines. Maternal factors such as literacy and socioeconomic status, as well as child-rearing behaviours, were assessed through an interview questionnaire of the mothers. RESULTS ECC and maternal caries prevalence were 54.5% and 84.3%, respectively. Statistically significant associations were found between ECC and: breast-feeding after 18 months; sugary food and beverage intake for the child (p < 0.05); maternal caries experience; illiteracy; night-time breastfeeding, bottle feeding, and late introduction of toothbrushing for the child (p < 0.01). A logistic regres...
International Journal of Paediatric Dentistry, 2002
Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment... more Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment) technique under field conditions in developing countries. The ART technique involves removal of caries using only hand instruments, and placing a glass ionomer cement (GIC) restoration. To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia. Clinical field trial. One high school in rural Cambodia. 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate. Subjects were randomly assigned to a dental nurse student for cavity preparation and placement of ART restorations (without cavity conditioning). 92.1% of the carious lesions required class I or class V restorations, and 85.4% were in the lower molars. 89 teeth were filled. At 1 and 3 years 86.4% and 79.5% of restorations were still present. Restorations were assessed by one dentist according to standard criteria. 76.3% of the restorations were judged to be successful at 1 year, and 57.9% at 3 years. Factors which may have affected the success rates included: the material used, technical factors, failure to condition the cavity prior to restoration, and inexperience of the operators. The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years. Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements.
Journal of Dental Anesthesia and Pain Medicine, 2015
Background: The authors studied the hemodynamic effect influent by using the novel high concentra... more Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.
After Phnom Penh was liberated from the Khmer Rouge in 1979, health science education in Cambodia... more After Phnom Penh was liberated from the Khmer Rouge in 1979, health science education in Cambodia had to be completely rebuilt. In this article, the authors report the results of a teaching collaboration between the University of Melbourne (Australia), the International University (Cambodia), and the University of Health Sciences (Cambodia). The main objectives in this collaboration were to provide the opportunity for dental and medical students in Cambodia to attend resourced anatomy workshops and to provide an opportunity for anatomy teachers in Cambodia to gain experience in implementing anatomy workshops of the style that are routinely used in the medical and dental curricula at the University of Melbourne. Experienced anatomy educators from the Department of Anatomy and Cell Biology, University of Melbourne, designed and resourced a series of workshops and then delivered these in collaboration with Cambodian teaching staff in Phnom Penh. The Cambodian students who participated in the workshops were incredibly engaged and enthusiastic. The students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; evaluations (by questionnaire) indicated a very positive response to the workshops. All of the workshop resources were donated to the two universities so that the staff could continue to implement similar workshops, and plans were developed to continue our collaboration by developing more resourced workshops for this purpose in the future. Two staff members from Cambodia will travel to Melbourne to participate in anatomy workshops and dissection classes at the University of Melbourne. We hope that this extension of the collaboration provides further support and impetus for the development of anatomy education in Cambodia in the future.
Aim: Early childhood caries (ECC) has significant public health implications but has received ina... more Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions.Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country.Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to popu...
Background: Head and neck cancer is the sixth most common cancer worldwide. It is generally ackno... more Background: Head and neck cancer is the sixth most common cancer worldwide. It is generally acknowledged that the early diagnosis of oral cancer may result in higher 5-year survival rates, less need for aggressive treatment and improved quality-of-life. There is therefore a need for a quantifiable, reliable and competency-based educational tool which can be used to train dentists and other health care providers in the early detection of oral cancers. Aim: To assess the effectiveness of “OralDETECT” spaced repetitive learning method for training dental professionals to become competent in the early detection of oral cancer. Methods: The current study involved training three dental professional groups: Oral Pathology/Oral Medicine/Oral Surgery specialists (x), Periodontists/Restorative dentists (y), General Dental Practitioners (z) and four undergraduate cohorts comprising 259 dental students from 3 different Malaysian dental schools. A structured one-day training program “OralDETECT”...
The purpose of the study was to investigate primary and permanent tooth anomalies of 5-year-old c... more The purpose of the study was to investigate primary and permanent tooth anomalies of 5-year-old children in Taranaki; 1,680 children were examined by school dental therapists, and the presence of hypodontia, hyperdontia, and double teeth recorded. Panoramic radiographs were taken of those children with anomalies of the primary teeth. Anomalies of the primary teeth were detected in 23 children (1.4 percent). Six children (3 boys and 3 girls) had hypodontia, 3 children (2 boys and 1 girl) had a supernumerary tooth, and 14 children (9 boys and 5 girls) had double teeth. Six of the affected teeth (in 4 boys and 2 girls) were diagnosed as fusion, and 8 (5 boys and 3 girls) as gemination. The panoramic radiographs of the 23 children with anomalies of the primary teeth revealed that 14 (60.9 percent) also had anomalies of the succedaneous permanent teeth. Children with hypodontia in the primary dentition all had corresponding permanent teeth missing. In all but three children, only one too...
BACKGROUND: Australia has a disproportionate number of dentists working in its capital city locat... more BACKGROUND: Australia has a disproportionate number of dentists working in its capital city locations relative to its rural locations. Australian Government agencies have initiated two different approaches to partially equalize this workforce imbalance. One approach has been to allow for the placement of dental students from capital city-based universities into a rural work student location. The second, more recent, approach has been to establish dental schools in regional areas. The study has the objective to assess the perceptions and views of both urban and rural-based dental school students on rural placement experience and future rural work. METHODS: Two rural dental schools and one capital city-based dental school were approached, and all consented to their students participating in this survey. The data from the two rural universities were then coalesced and compared to the data from the capital city-based university to quantify the usefulness of the two different approaches ...
Objectives: To describe the preventive dental practices of general dentists in Phnom Penh, Cambod... more Objectives: To describe the preventive dental practices of general dentists in Phnom Penh, Cambodia. Methods: Dentists from 100 randomly selected dental clinics in Phnom Penh were interviewed by one of 3 trained interviewers. Open and closed questions included: background information, knowledge of prevention, resources for prevention, and preventive practices. Data presented are from the results of the first 30 participants. Results: 66.7% of dentists believed prevention was very important. 87% gave oral health education at least several times a week. 42.9% never used F varnish and 48.3% never used resin sealants. When shown a picture of a white spot lesion, 30% said they would provide no treatment, 6.7% would apply fluoride, and 46.7% would restore. 53.3% believed that caries in enamel is reversible. 89.7% said preschoolers should use a F toothpaste, and 90% said this should be low F paste. 70% said women should take F tablets during pregnancy. 85.2% said that all patients should be recalled 6 monthly. 79.3% said that plaque was composed mainly of food particles. 31% were in favor of a sugar tax, and 83.3% in favor of water fluoridation. 68.9% agreed that selling of sugary foods and drinks at schools should not be permitted. 86.3% of dentists suggested having more education on prevention at dental conferences. Conclusions: Cambodian dentists have limited knowledge of dental prevention and the basic principles of cariology and provide only limited preventive interventions for their patients. This survey is the first important step in a campaign to improve preventive practices of Cambodian dentists; actions should be taken to orientate dentists towards implementing evidence-based prevention in their clinics
In 1993 a 4-5 month programme to train rural dental nurses in Cambodia was introduced. Courses ha... more In 1993 a 4-5 month programme to train rural dental nurses in Cambodia was introduced. Courses have now been conducted in 12 of Cambodia's 22 provinces. The dental nurses are trained to provide simple treatment, including local anaesthetic, extractions, ART restorations, and scaling, for all age groups, and also learn how to introduce prevention and oral health promotion activities within their communities. On completion of training nurses are supplied with a set of basic instruments and some materials. Evaluation has shown the programme to be meeting the oral health needs of the rural people where there are no dentists and a number of unique strengths were identified. A recent planning workshop on oral health care in Cambodia to 2005 decided to set up a dental nurses training school in two provincial capitals, and to increase the number of nurses in training. At the same time the annual number of new dentists being trained will be limited to ten. The expansion of the dental nurses training programme will ensure that increasingly more of the population have access to basic preventive and curative dental care, and at a cost which the country can afford.
KEYWORDS universal health care (UHC), basic package of oral care, inequalities (MeSH), global hea... more KEYWORDS universal health care (UHC), basic package of oral care, inequalities (MeSH), global health, oral health Editorial on the Research Topic Innovating and expanding universal access to oral healthcare
Aim This was to explore the socio-behavioural risk factors for ECC in Cambodia. Early childhood c... more Aim This was to explore the socio-behavioural risk factors for ECC in Cambodia. Early childhood caries (ECC) is a significant health problem in Cambodia. Methods A convenience sample of 362 primary caregiver-child dyads were selected. The children were aged between birth and 6 years old and participated in a structured interview and intra-oral examination. Results ECC was diagnosed in 244 of 362 (65.6 %) children and 178 (50.6 %) had severe early childhood caries (sECC). There were significant associations between caries experience and tooth brushing, dietary, and nursing habits. The odds ratio (OR) for sECC in those children who started brushing before the age of 18 months was 0.41 (CI 0.18, 0.93). However, for those children who continued to breast-feed after the age of 2 years the OR was 5.31 (CI 1.50, 18.79). Conclusions The most prominent risk factors for ECC in the present study were lack of tooth brushing and breastfeeding past the age of 2 years.
International Journal of Paediatric Dentistry, 2021
BACKGROUND The number of child abuse cases is increasing worldwide therefore it is important to e... more BACKGROUND The number of child abuse cases is increasing worldwide therefore it is important to educate individuals having contact with children about it. This includes dentists who play a pivotal role in detecting and reporting these cases. AIM To identify and compare the final year dental student's knowledge, attitudes and practice in relation to child abuse. DESIGN A 38-item and four part online questionnaire was distributed to students of 11 dental schools in 10 countries. SPSS and GraphPad Prism were used for data analysis. The levels of statistical significance were determined using a chi-square test. P ≤ 0.05 was considered to be statistically significant. RESULTS A total of 660 students completed the survey. Fifty-six percent of the students received formal training on child abuse, and 86% wanted additional training. The knowledge of child abuse was significantly higher in Australia, USA and Jordan compared to other countries. The internet (60.3%) was widely used as an information source for child abuse. CONCLUSIONS The study showed that dental students lack knowledge and experience in recognising and reporting child abuse. Most respondents indicated a desire for additional training, therefore dental schools should review what they are currently teaching and make changes as appropriate.
Objectives: To report the results of the 2011 National Oral Health Survey which was conducted to ... more Objectives: To report the results of the 2011 National Oral Health Survey which was conducted to assess the dental caries, sequelae, and selected risk indicators in the population. Methods: A sample of 2028 participants aged 6, 12-13, 15-17 and 35-44 was recruited from Phnom Penh and four provinces to represent age, sex, and urban/rural locations. Examinations were conducted using ambient light and mouth mirrors by standardized examiners. Tooth-specific data were obtained to calculate the number of decayed, missing and filled teeth (dmft) and number of teeth with pulp, ulcer, fistula, and abscess sequelae (PUFA index). Interviews were carried out to collect socio-demographic and behavioral information. T and ƒO2 tests were used to assess statistical differences (ƒ? < 0.05). Results: The prevalence of dental caries was 93% at age 6 years, and 80% at age 12-13, and 35-44 years. At age 6 years, the mean dmft was 9.0 (standard deviation [SD] 4.9) and the mean PUFA 2.7 (SD 2.8); at ag...
Journal of Health Services Research & Policy, 2022
Objective Oral cancer is amenable to early detection but remains a prominent cause of mortality i... more Objective Oral cancer is amenable to early detection but remains a prominent cause of mortality in the Asia Pacific region. This study aimed to identify barriers to early detection and management of oral cancer in the Asia Pacific region. Methods A mixed-methods approach was employed triangulating findings from a survey and focus groups. The survey was conducted among seven representative members of the Asia Pacific Oral Cancer Network (APOCNET) across six countries. Focus groups were conducted to gain deeper insights into the findings of the survey. Results The identified barriers were a lack of national cancer control strategies and cancer registries and the limited availability of trained health care professionals. Overcoming these challenges in the Asia Pacific region where resources are scarce will require collaborative partnerships in data collection and novel approaches for continuous professional training including eLearning. Further, to overcome the lack of trained health c...
PURPOSE To investigate the associations between early childhood caries (ECC) and maternal factors... more PURPOSE To investigate the associations between early childhood caries (ECC) and maternal factors among 18- to 36-month-old children in one rural province of Cambodia. MATERIALS AND METHODS 121 mother-child pairs (male = 67, female = 54; mean age = 25.18 ± 6.24 months) were recruited at several villages in Stueng Trang district, Kampong Cham province. ECC and maternal caries experience were recorded following WHO guidelines. Maternal factors such as literacy and socioeconomic status, as well as child-rearing behaviours, were assessed through an interview questionnaire of the mothers. RESULTS ECC and maternal caries prevalence were 54.5% and 84.3%, respectively. Statistically significant associations were found between ECC and: breast-feeding after 18 months; sugary food and beverage intake for the child (p < 0.05); maternal caries experience; illiteracy; night-time breastfeeding, bottle feeding, and late introduction of toothbrushing for the child (p < 0.01). A logistic regres...
International Journal of Paediatric Dentistry, 2002
Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment... more Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment) technique under field conditions in developing countries. The ART technique involves removal of caries using only hand instruments, and placing a glass ionomer cement (GIC) restoration. To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia. Clinical field trial. One high school in rural Cambodia. 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate. Subjects were randomly assigned to a dental nurse student for cavity preparation and placement of ART restorations (without cavity conditioning). 92.1% of the carious lesions required class I or class V restorations, and 85.4% were in the lower molars. 89 teeth were filled. At 1 and 3 years 86.4% and 79.5% of restorations were still present. Restorations were assessed by one dentist according to standard criteria. 76.3% of the restorations were judged to be successful at 1 year, and 57.9% at 3 years. Factors which may have affected the success rates included: the material used, technical factors, failure to condition the cavity prior to restoration, and inexperience of the operators. The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years. Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements.
Journal of Dental Anesthesia and Pain Medicine, 2015
Background: The authors studied the hemodynamic effect influent by using the novel high concentra... more Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.
After Phnom Penh was liberated from the Khmer Rouge in 1979, health science education in Cambodia... more After Phnom Penh was liberated from the Khmer Rouge in 1979, health science education in Cambodia had to be completely rebuilt. In this article, the authors report the results of a teaching collaboration between the University of Melbourne (Australia), the International University (Cambodia), and the University of Health Sciences (Cambodia). The main objectives in this collaboration were to provide the opportunity for dental and medical students in Cambodia to attend resourced anatomy workshops and to provide an opportunity for anatomy teachers in Cambodia to gain experience in implementing anatomy workshops of the style that are routinely used in the medical and dental curricula at the University of Melbourne. Experienced anatomy educators from the Department of Anatomy and Cell Biology, University of Melbourne, designed and resourced a series of workshops and then delivered these in collaboration with Cambodian teaching staff in Phnom Penh. The Cambodian students who participated in the workshops were incredibly engaged and enthusiastic. The students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; evaluations (by questionnaire) indicated a very positive response to the workshops. All of the workshop resources were donated to the two universities so that the staff could continue to implement similar workshops, and plans were developed to continue our collaboration by developing more resourced workshops for this purpose in the future. Two staff members from Cambodia will travel to Melbourne to participate in anatomy workshops and dissection classes at the University of Melbourne. We hope that this extension of the collaboration provides further support and impetus for the development of anatomy education in Cambodia in the future.
Aim: Early childhood caries (ECC) has significant public health implications but has received ina... more Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions.Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country.Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to popu...
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Papers by Callum Durward