A Publication for Members of The Malaysian Dental Association

Malaysian Dental

Association54-2, Medan Setia 2, Plaza Damansara,

Bukit Damansara, 50490 Kuala Lumpur, Malaysia.Tel: 603-2095 1532, 603-2095 1495

Fax: 603-2094 4670Website: www.mda.org.my

E-mail: mda@po.jaring.mymda@streamyx.com

Publication SecretaryDr. Seow Liang LinCo-EditorsDr. Seow Liang Lin Dr Shahida Mohd SaidSecretaryDr Wey Mang ChekTreasurerDr Lee Soon BoonEx-officioDato’ Dr. Low Teong

Note:This newsletter is a publication of the Malaysian Dental Association and opinions expressed herein are that of the authors and do not necessarily reflect the opinion of the editorial board, the MDA council or the said Association. MDA NEWS shall not, without written consent of the Association, to be hired, lent, given or otherwise disposed of by way of trade or affixed to or as part of any publication or advertising, literary or pictorial matter whatsover.

There were still a few things I need to do for you as your President, but is unable to do so as most of the time and resources has been devoted to preparing for the EOGM and its related issues. The most important is of course preparing the private practitioners for the inspection exercise under the Private Healthcare Facilities and Services Act 1986 and Regulations 2006. And I do apologies for not being able to help so far.

The late Tan Sri Taib Andak once told me “When serving in voluntary organizations you can either do nothing and be popular or do something and step on members feet”. I took on the third term of the MDA Presidency to do something and hence step on many feet in the process. This lead to the anonymous faxes, emails and poison letters. I have been a member of the MDA since 1972 or 36 years. It is only in recent years that such cowardly means of communication has surfaced in the MDA.

My Council and I are very proud that we refuse to recognize or act on any of these anonymous communications right from the beginning. Many of you have in private expressed your support for our actions. Even with the threat of an EOGM and possible sanctions I had refused to give in. And I am sure history will judge my decision positively.

Recognising any anonymous communication will set a dangerous precedent for the MDA. It will encourage the current culprits and their accomplices and future aspirants to use this cowardly method to raise their agenda. We are professionals. Come out into the open and fight the issues on a level playing field. The other danger of anonymous communication is they do not assume responsibility for the irresponsible publication of confidential, stolen or false information.

I accept full responsibility for the oversight in making Dr. Xavier Jayakumar a signatory to our bank accounts and all the supporting documents and I do apologies to all of you. However, I made sure the error was corrected immediately when it was brought to my attention. Also I assure you that Dr. Xavier never signed any cheques during the period he was a signatory. An audit of all cheques signed during the period is also being undertaken by the bank at our request to confirm our statement.

In conclusion let me assure all of you that I did what was in the best interest for you as a member, the association and the profession. The EOGM may vote against me and I may have to resign as the President, my sacrifice is for the future of the MDA and I do it with great pride. I believe I am not guilty of what I was accused to have done. Again history and all of you will be the ultimate judge.

Dato’ Dr. Low Teong

President

Message from PresidentDear Colleagues,

This may be my last message to you as President of the Malaysian Dental Association as a sanction motion against me will be tabled at the Extra Ordinary General Meeting on Sunday 17 February 2008. I will resign as the President if the motion is carried.

FEBRUARY 2008

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FEBRUARY 2008 33

the membership with the state of the art knowledge and methodology in Oral Health Care. The Trade Exhibition will be there too with new incentives!

The general guidelines required to keep your Clinics in line with the Private Health Care and Services Act is ready. These have been made as friendly as possible and hover around the basic necessities required to run a good clinical setup. The checks on the Dental side will commence soon and 2008 is widely accepted to be the year on Dental focus. Take time now to check on your requirements instead of going ‘panic stations’ when the time arrives.

The Northern and Southern Zone Annual General Meetings are scheduled for in mid February. I urge the members of the respective zones go out in numbers to support your Zones. It is through the activity of your Zones that the MDA is able to reach out to you more often. We hope the Eastern Zone will bloom and take off in the near future. The region is logistically isolated and requires more than what is available to them presently in terms of representation and benefits.

Till we meet again, adios.

Dr. S. Sivanesan

President Elect

Malaysian Dental Association

Message from President - Elect

We had a successful 15th FDI/MDA Scientific Convention recently under the capable directions of Organising Chairman Dr. Abu Razali and Dr. Mohd Muzafar. All eyes now look towards the 65th MDA/AGM to be held on 20th to 22nd June in KL. Under the Chairmanship of Dr. Haja Badrudeen this event is also being charted along similar lines to charge

Dear Esteemed MDA Members,

It gives me great pleasure to update you on the financial performance of our Association for the year ending 31st December 2007. This preliminary financial account is an unaudited account at this point in time. However, preliminary figures would be useful data for an early assessment of the

Message from HonoraryFinancial Secretary

current financial standing of our beloved Association.

Income

On the income received, major conventions such as the 14th FDI/MDA and 64th MDA AGM Convention remained the major income earner, raking in a combined inflow of about RM 708,000. MPS subscription for the financial year 2007(FY 2007) stood at approximately RM 555,000. Sponsorship made up a sum of around RM 240,000 and membership subscription at about RM 228,000. Other miscellaneous income such as advertisement income, rental income, Direct Access commissions received and interest income contributed the remaining RM 130,000 to make up a grand total income of approximately RM 1.86 million for FY 2007.

Expenditure

Major conventions like the 14th FDI/MDA and 64th MDA AGM Convention incurred high expenses of around RM 452,000 in total for FY 2007. MPS subscription outflow was about RM 559,000 and Secretariat expenses came in at around RM 220,000. Council meetings expenditures were approximately RM 46,000 and the cost of publication of MDA Newsletters and MDJ was close to RM 88,000.

Continuous Professional Development (CPD) seminars and workshops expensed some RM 115,000, while community service projects such as Oral Health Month and community dental service activities incurred around RM 69,000 in cost. General expenditures to upkeep the office equipments, utilities, service fees, couriers, mailing fees, MDA website maintenance fee, internet charges and others cost the Association some RM 78,000 for the whole of year 2007. Depreciation charges on office equipments, previous renovations and others came in at around RM 56,000. Other miscellaneous operating expenses filled in the balance of RM 32,000 for the duration of the FY 2007. Total expenditure registered by the MDA operating account for FY 2007 was RM 1.71 million.

Balance Sheet

Total fixed asset of our Association stood at around RM 1.4 million for FY 2007. The current asset which consists mainly fixed deposits and cash in bank have reached a high of around RM1.92 million as at 31st Dec 2007. However, the accumulated current liability in the book at year ending 2007 rose to around RM 221,000 resulting in net current asset of approximately RM 1.7 million. The net total asset which comprised the total fixed asset and net current asset was at about RM 3.1 million for FY 2007. Analyzing the balance sheet of the Association indicated an extremely high current ratio of above 8, which signifies strong financial margin of safety against economic uncertainties and financial crisis.

Conclusion

An estimated net surplus of approximately RM 150,000 was achieved in FY 2007 and the Association total net asset rose to RM 3.1 million as at 31st December 2007.

Last but not least, I wish to thank you all for the opportunity and support.

Serving the Malaysian Dental Association.

Lee Soon Boon

Hon. Financial Secretary 2007 / 2008

MDA NEWS44

A Simple Guide to Crown Construction

By: Associate Professor Dr. Seow Liang Lin School of Dentistry International Medical University llseow@gmail.com

Fixed prothodontics has become very much an integral part of dentistry, striving to obtain a pleasing dental appearance for our patients. A pleasing appearance comprises harmonious appreciation of the shade, shape and arrangement of the teeth and also their relationship with the gingival, lips and other facial feature i.e the complements of pink and white aesthetics.

Careful planning and precise clinical execution is important to ensure successful clinical outcome. The aim of this article is to consider the principles which influence crown preparation and step by step guide to a single crown construction. An understanding of the materials available for crown construction is important, not only to aid in selection of materials but also allow more effective communication with patients and laboratories. At present, the main categories of materials were metal, ceramics, metal-ceramic and composite resins. Tooth preparations must reflect the basic requirements of these materials in terms of amount of space needed to accommodate the crown and appropriate marginal configuration.

Shillingburg has comprehensively outlined the principles of crown preparation to determine the final shape and form of crown preparation. A fine balance is needed when considering these principles and they cannot be considered in isolation. The seven key principles outlined include:

(1) Conservation of tooth structure- to prevent unnecessarily weakening the tooth and compromising the pulp

(2) Resistance form- to avoid decementation of crowns by vertical or oblique forces

(3) Retention form- to avoid decementation of crowns along the path of insertion

(4) Structural durability- to provide sufficient space/bulk for a crown to prevent fracture, distortion or perforation

(5) Marginal integrity- to prepare gingival finishing line appropriate to the prescribed material to obtain optimum marginal adaptation and minimize microleakage

(6) Preservation of the periodontium- to avoid overcontouring of the crown and enable access to optimal oral hygiene.

(7) Aesthetic consideration- to provide adequate space to accommodate the materials to gain optimum aesthetics.

Amount of tooth reduction and margin design

To aid in the understanding and application of the principles, a step by step guide of a single crown preparation is presented. This patient presented with a heavily restored upper left maxillary central incisor (Fig. 1). The patient has this restoration replaced twice within the past five years due to fracture and discolouration. The advantages and disadvantages of all-ceramic and metal-ceramic crown were explained to the patient, it was decided to construct a full coverage all-ceramic crown.

Fig. 1 Discoloured large mesio-incisal composite restoration on 21

A silicone putty matrix was taken prior to the crown preparation for fabrication of temporary crown (Fig. 2). If the intended crown form differs from original tooth contour, a putty matrix fabricated using the diagnostic wax-up will be useful to gauge amount of reduction needed. For resin-bonded all-ceramic crown, 2.0mm of incisal reduction, 1.5mm of buccal and 1.0mm of palatal reduction is required. The amount of reduction can be gauged using depth cuts with a knowledge of the appropriate bur end diameter (Fig. 3). The depth cuts must be placed in two planes i.e the gingival and incisal plane following the contour of natural tooth. If this principle is not observed, there will be areas of preparation with inadequate reduction. The depth cuts will then be joined to complete the preparation with long tapered bur of appropriate diameter, taking care not to damage the adjacent teeth. A thin tapered bur should be used initially at the proximal area to obtain clearance (Fig. 4).

FEBRUARY 2008 55

Fig. 2 Silicone putty matrix for contruction of temporary crown and also to gauge reduction

To aid in the understanding and application of the As a general rule when constructing all-ceramic or metal-ceramic crowns, adequate reduction for gingival margin is crucial to achieve pleasing gingival emergence profile and good aesthetics. This is achieved with shoulder width of 1.2mm for metal-ceramic crowns and heavy chamfer of 0.5-0.8mm for resin-bonded ceramic crowns (0.8-1.0mm for porcelain jacket crowns). Ideally, the gingival finishing line should be placed supra-gingivally, but in reality this is often not possible especially in anterior region where aesthetics is critical. In these situations, it can be extend by 0.5-1.0mm but no more than half the depth of the gingival sulcus to ensure the epithelial attachment is not compromised.

Crown preparation finished supra- or at gingival margin can occasionally be recorded without gingival retraction, however retraction cord will provide a more predictable results. Preparations finished within the gingival sulcus will definitely require gingival retraction (Fig. 5). Retraction can be achieved using one or a combination of methods below:

• Retraction cord (plain or impregnated eg. with ferric sulphate solution)

Fig. 3 Depth cuts placed in two planes following the contour of tooth

Fig. 4 Use a thin tapered bur at interproximal area to gain clearance from adjacent teeth

• Double cord technique

• Rotary curettage

• Electrosurgery

Fig. 5 Retraction cord in placed prior to impression taking

MDA NEWS66

For the double-cord technique, a piece of fine retraction cord (eg. black silk) is first placed in the gingival sulcus; a thicker cord will then be placed over the first leaving behind a tag to ease removal. The main advantage of this technique is the first cord remains in placed during impression taking therefore reducing the tendency of the gingival cuff to recoil.

An impression that accurately records all the details of a crown preparation paves the road to the contrucstion of a well fitted crown. Sometimes defects in the impression will only come to light when the cast has been poured. The technician should have the knowledge and courage to inform the dentist of unacceptable defects. The impression materials can broadly categories into elastic and non-elastic materials. The elastics materials can further divide into the hydrocolloids and synthetic elastomers. The elastomeric impression materials was introduced in the 1950s and fast became popular as they possessed ability to overcome main problems associated with hydrocolloids namely poor dimensional stability and low tear strength. The synthetic elastomeric impression materials available currently include polysulphides, polyeter, condensation and addition silicones. Polysulphides has long working time and may be an advantage if impression is needed for multiple preparations, however they are messy to handle and have an objectional odour. Polyeter tend to have fast setting time (snap set) and setting reaction is by addition polymerization, therefore there is no by-product resulting a set material with good dimensional stability. The setting reaction of condensation silicones resulted in a volatile by-product, loss of by-product leads to a measurable weight loss and couple with shrinkage of the impression material on storage. No by-product is produced during polymerisation of addition silicones, thus by far this is the most dimensional stable impression material. It has long been recognise that contaminated impression is a potential source of cross-infection. The British Dental Association has supported that all impressions should at least undergo a disinfecting procedure by immersion in 1% sodium hypochlorite solution for a minimum of ten minutes.

Provisional restorations are important to protect freshly cut dentine and prevent tooth movement (Fig. 6). Provisional restorations can be useful in evaluating the aesthetics and occlusal changes before the features are incorporated in the definitive restorations. In general, time taken to temporise a tooth should be similar to the time taken to prepare it to ensure adequate time is devoted to provide a well fitted and well contoured provisional restoration.

Having checked the fit of the crown on the cast, the provisional restoration is removed. The tooth preparation is carefully cleaned of all residues of temporary cements especially in retention grooves. The crown should be tried in without forcing it onto the tooth preparation, all-ceramic crown is fragile prior to cementation. When the crown is fully seated, the main areas to be assessed include proximal contacts, marginal fit, aesthetics and occlusion.

Fig. 6 Care should be taken to provide a well fitted provisional restoration

Fig. 7 All-ceramic crown cemented on 21

The fitting surface of the all-crown was etched with 8% hydrofluoric acid and primed with silane coupling agent prior to cementing with resin luting cement. A pleasing outcome is achieved if all principles of crown construction is carefully observed (Fig. 7).

References:

1. Shillingburgh H T, Hobo S, Whitsett L, Jacobi R, Brackett S E. Fundamentals of fixed prosthodontics. 1997, 3rd ed. Chicago: Quintessence.

2. Cloyd S, Puri S. Using the double cord packing technique of tissue retraction for making crown impressions. Dent Today 1999; 18:54-59

3. Attar, N., Tam, L. E. and McComb, D. Mechanical and physical properties of contemporary dental luting agents. J Prosthet Dent 2003; 89, 127-34.

4. Attia, A. and Kern, M. Fracture strength of all-ceramic crowns luted using two bonding methods. J Prosthet Dent 2004; 91, 247-52.

FEBRUARY 2008 77

Diagnosis and Classification of Periodontal Diseases

By: Dr. Shahida Mohd Said Faculty of Dentistry, Universiti Kebangsaan Malaysia. shahidasaid@hotmail.com

In spite of the rapid advances in oral sciences, periodontal (gum) disease remains as one of the most common oral diseases affecting the general population. It is evident that a large proportion of routine cases are managed by general dental practitioners. Caused by the imbalance between the effects of dental plaque and host susceptibility, and made worse by the presence of many contributing factors, periodontal disease can be a headache to diagnose and manage.

The complexity of the disease mechanism has been the basis for scientific researches to improve understanding of the nature of disease. More importantly, this will lead to improvement in the management of the disease and at the same time enhance quality of life for the patients. Research findings have identified better diagnostic methods and classification of diseases. Yet, one may argue that despite all these efforts, management of periodontal disease has not changed from scaling and root debridement mainly, and eventually, extraction of involved teeth. So, what is the fuss about the different classifications if we end up doing the same, anyway?

Periodontal disease: A complex relationship of causes, risks and effects

Periodontal disease involves destruction of tooth-supporting structures including the ligaments and bone, induced by specific commensal bacterias in the oral cavity. Systemic conditions, when present, will reduce the tissue resistance to bacterial invasion thus cause local irritation to the periodontium. Presence of specific micro-organism in the gingival environment, cigarette smoking and diabetes mellitus have been shown to have negative effects on the periodontium while poor oral hygiene, unhealthy diet and malnutrition, conditions and diseases such as immuno-suppressive diseases, certain medications, stress and poor coping behaviour, alter the plaque retentive quality and/or alter the immune system, thus increase the risk of periodontal disease. More recently, certain traits have been identified in the genes, which are passed on in families with risk of developing periodontal disease.

The understanding the aetiology of periodontal disease also implies that recognition of the signs and symptoms of disease alone is not enough to manage the disease, but it requires also the recognition of the contributing and risk factors, so that they can be removed or altered accordingly. These factors may directly influence the disease process or indirectly associate with other factors to influence the disease process. For instance, cigarette smoking directly changes the integrity and function of periodontal tissue components as well as alters the immune system, thus impairing healing process following periodontal tissue breakdown. Smoking too, alters the environment in the oral cavity, increasing the formation and adherence of plaque.

The aetiology of periodontal disease can be simplified through the diagram below (Figure 1). In health, bacterial plaque and susceptible individuals rest in balance on each side of a seesaw. However, when there is a change in one of these aetiological factors, for instance an increased amount of bacteria in the dental plaque or a decrease in the host immune defence system, the balance will be affected, triggering periodontal tissue inflammation and changes to the supporting structures. Contributing factors that are scattered around the seesaw may affect one or both aetiological factors, resulting in imbalance of its position on the seesaw thus contributing to the severity of the disease occurrence.

Effects of the imbalance between bacterial plaque and host susceptibility vary from one individual to another, and also from one site to another even in the same individual. This may be explained by the contribution of many factors within the individuals that may change the intensity of damage caused by the bacteria to the periodontal environment and degree of susceptibility of the individual or site to the tissue breakdown. This means that even with the same amount of bacterial load present, the severity of the disease may be different in two individuals and two different sites in the same individual.

Specific Micro-organisms Oral Health CareDiet & Nutrition

Bacterial PlaqueTobacco UseMedications

EthnicOral Environment

Psychosocial Behaviours

HabitsSystemic Conditions/Diseases

Genetics/Hereditary

Figure 1: Relationship between aetiological and contributing factors of periodontal disease.

Host Susceptibility

MDA NEWS��

Recognising and classifying periodontal diseases

Assessment of gingival changes including change in colour, size, contour, position and shape, has long been a part of clinical oral examination. GV Black, a name well-known in dentistry, described the redness and swelling of gingiva, suppuration, pain and presence of calculus as signs of gum disease back in 1915, while first documentations of periodontal pocket probing was published in 1924. Even then, several more classifications were introduced to categorise periodontal disease. Terms such as Interstitial Gingivitis, Pyorrhea alveolis, ‘pus pockets’,

‘scurvy of the gums’, periodontosis and periodontitis were used to describe the histopathological changes in gingival and periodontal tissues. Criteria for classification include severity of disease and tissues involved, causative factors involved, age of disease onset and rate of progression. These classifications were continuously introduced over time (Table 1), as new knowledge is acquired and are made to be applied clinically with ease and without multiple interpretations. Nonetheless, regardless of the amount of knowledge we have about the disease, we still know very little on how to diagnose the disease based on the aetiology.

Basis of classification Classifications

Inflammatory disease of the periodontal components; related to cause, either local bacterial factor or systemic

McCall & Box, 1925:• Simple periodontitis• Complex periodontitis

Severe periodontal and bone loss in young individuals Butler, 1969:• Juvenile periodontitis

Age of onset of the disease (except ANUG/P); subclass depending on location, either localised or generalised

Page & Schroeder, 1982:• Pre-pubertal periodontitis• Rapidly-progressive periodontitis• Adult periodontitis• Acute necrotising ulcerative gingivo-periodontitis

(ANUG/P)

Age of onset; location; nature of disease American Academy of Perioodntology (AAP), 1986:Juvenile Periodontitis:• Pre-pubertal periodontitis• Localised Juvenile Periodontitis• Generalised Juvenile PeriodontitisAdult PeriodontitisNecrotising ulcerative gingivo-periodontitisRefractory periodontitis

Risk of patients to periodontal disease; causative factors Johnson et al, 1988:• Childhood peridontitis• Juvenile perioodntitis (localised, generalised)• Post-juvenile periodontitis• Adult onset periodontitis• Periodontitis associated with systemic diseases• Traumatic periodontitis• Iatrogenic perioodntitis

Age; microbial deposits, lymphocyte reaction; rate of progression

Suzuki, 1988:• Subdivision of Page & Schroeder classifications: type

A, type B

Different forms of periodontitis exist; age of onset; location; rate of progression

World Workshop in Clinical Periodontics, 1989:Adult periodontitisEarly-onset periodontitis:A) Prepubertal periodontitis

• Generalised, LocalisedB) Juvenile perioodontitis

• Generalised, LocalisedC) Rapidly-progressive perioodntitisPeriodontitis associated with systemic diseasesNecrotising ulcerative perioodntitisRecfractory periodontitis

Acknowledged subcategories of gingival diseases; eliminated age of onset as a determinant; acknowledged that rate of progression is required

International Workshop for a Classification of Periodon-tal Diseases and Conditions, 1999:- as illustrated in Figure 2

Table 1. Examples of classifications for periodontal diseases.

FEBRUARY 2008 99

Accurate diagnosis is the key to successful management

Through the decades we learn the importance of plaque in the aetiology of periodontal disease and that preventing its formation could avoid the initial and progression of periodontal tissues destruction. Its disease process is yet to be fully understood but we now know by identifying the pathogens and clarifying their interactions with the host, clinical management can be formulated rationally.

Not all gingivitis lead to periodontitis, but if periodontitis exists, it was preceded by gingitivis. Supragingival plaque can be removed easily by simple mechanical plaque control and with help of suitable chemical plaque control agents. However, when subgingival plaque and calculus are established, routine self oral hygiene care is no longer sufficient. Professional intervention through scaling and prophylaxis as well as guidance through oral health education including appropriate oral hygiene instructions is essential. If signs and symptoms of the disease has not been efficiently recognised on time, more tissues will be destroyed and lost periodontal tissues eventually could not be restored.

Although there is no new clinical procedure for the non-surgical treatment of moderate or advanced periodontal disease introduced in the recent decades, periodontal disease could now be better treated by arresting and controlling the disease and progression processes.

Current understanding of the nature of disease and behaviour of the periodontal tissues have provided better approaches to access periodontal pockets and ensuring appropriate supportive care to maintain the periodontal health. Refinement in surgical procedures, new findings in biological substances and development of biocompatible materials do not just facilitate better access to cleaning of root surfaces but also enhance the potential of periodontal tissue regeneration.

With the various forms of classifying periodontal diseases, we now can comfortably refer and consult cases with colleagues with the same understanding of the features and factors involved. This will hopefully improve the quality of the management of patients with periodontal diseases and enhance the preventive measures for those who are at risk.

Conclusion

The idea of classifying periodontal disease is to assist practitioners in diagnosing the disease more accurately through recognition of specific features, formulating a management targeted at the removal of causative factors and aiming for a more meaningful result. Through recognition of causative factors and contributing risk factors, primary prevention and timely supportive periodontal care could be beneficial to prevent the progression of disease, or at least reduce the severity of disease before ultimately losing the tooth.

Dental Plaque-induced gingivalDiseases

Non-plaque- inducedGingival Lesions

PERIODONTAL DISEASES

PERIODONTAL

Chronic PeriodontitisAggressive Periodontitis

Periodontitis as a Manifestation ofSystemic Diseases

Necrotizing Periodontal Diseases

Abscesses of the PeriodontiumDiseases

Periodontitis AssociatedWithEndodontic Lesions

Development or AcquiredDeformities &Conditions

GINGIVAL

Figure 2: Classification of Periodontal Disease. American Association of Periodontology (AAP), 1999

References:

1. F Carranza, G Shklar. History of Periodontology. Quintessence Publishing Co., Inc. 2003.

2. H Löe. Periodontal Diseases: A Brief Historical Perspective. Periodontology 2000 1993; 2: 7-12.

3. U Van Der Velden. Purpose and Problems of Periodontal Disease Classification. Periodontology 2000, 2005; 39: 13-21.

4. G.C. Armitage. Development of A Classification System for Periodontal Diseases and Conditions. Annals of Periodontology 1999; 4: 1-6.

5. G.C. Armitage. Periodontal Diagnoses and Classification of Periodontal Diseases. Periodontology 2000, 2004; 34: 9-21.

6. I.L.C. Chapple. Periodontal Disease Diagnosis: Current Status and Future Developments. Review. Journal of Dentistry 1997; 25 (1): 3-15.

MDA NEWS1010

Report of the meeting with YB Datuk Seri Dr. Chua Soi Lek, Minister of Health.

on 6th September 2007

6) CriticalAllowance&EntryGradeofDentalOfficers.

a) - Dental Officers now receive a critical allowance

of 5% of basic salary whereas Medical Officers receive a flat rate of RM 500. The 5% amounts to between RM100 – RM250.

- Dental Officers should be considered as being on par with Medical Officers and should receive the same allowance.

b) Entry Grade for Dental Specialist.

At present dental officers with recognized specialist qualifications join the service at Grade 41. Serving staff after obtaining their specialist qualification are placed at Grade 48. This arrangement discourages overseas dental specialist from returning to join the service.

We would like to seek YB’s assistance to rectify this anomaly.

Decision

Datin Dr Norian to prepare a paper and the Minister will take it up with the relevant body.

7) Compulsory Provision of Dental Treatment for all employees.

The provision of medical treatment to all employees is now an accepted requirement of all employers in both the private and public sector.

The provision of dental treatment to employees is now offered by some employers in both sectors.

The MDA would like to initiate proposals to make it available to all employees.

We seek YB’s assistance and guidance on how to proceed with this project.

Decision

Minister advise us it is going to very difficult but we can initate activities to create the awareness

8) DentalInspectionofForeignWorkers.

Currently all foreign workers are required to undergo a medical check-up and be medically fit to gain employment in Malaysia.

The MDA is of the opinion that good oral health is just as important as many of these workers are involve in looking after children and handling of food.

Again we seek YB’s guidance on the feasibly of the request and how to proceed.

Decision

Minister advise it is difficult but agreed to highlight the issue. MDA to prepare a paper by 1 week for Minister to create the awareness.

9) UseofEPFAccountforHighCostDentalTreatment.

There are various dental treatment like implants, etc that are high in cost. Many patients are unable to afford it. No insurance scheme are currently available to cover such treatment.

The use of ones EPF contribution for such treatment is possible in neighboring countries and is helpful to both the profession and the public.

We seek YB’s guidance on the feasibly of the proposal and how to proceed.

Decision

MDA to write in officially to the Minister for him to follow up

10) IllegalPracticeofDentistry.

This is an area of concern to the profession for many decades. The provisions of the PHFSA makes the arrest of such illegal practitioners easier.

We thank YB for his assurance given to us during the recent 64th MDA-AGM that he will act on the illegal practitioner.

We have assured our members that action will be taken once they report the case to the MDA. The MDA will then become the complainant.

Dinner Meeting with Director of Oral Health Division, MOH Datin Dr Norain Abu

Bakar

Continued from November 2007 issue

FEBRUARY 2008 1111

Decision

Minister agree to continue acting actively in this area and agreed to inform us of the outcome of any complaint submitted by the MDA

11) Workshop of Dental Surgeons Training in Malaysia.

We have informed YB during the 64th MDA-AGM and the Oral Health Division in our discussions of the MDA’s plan to organize a workshop in November 2007.

There will eventually be 11 dental schools in this country. Many in the profession believe there will be an over production of dental surgeons in the country once all 11 schools start graduating students.

The purpose of the workshop is to provide an independent assessment of the needs of the country and provide timely advise to the Government.

The workshop will be a close door event and the Report of the Workshop will be made available only to the Ministry of Health and Higher Education.

We will like YB’s support and blessing for the events.

Decision

Minister gave the permission to proceed with the Workshop and work with the Oral Health Division who have been requested to provide the MDA with the information needed.

12) HealthyLifeStyleNationalOralHealthCampaign.

In addition to the Oral Health Month conducted by Colgate Palmolive Marketing Sdn Bhd, the MDA is working on a healthy life style national oral health campaign to be funded by the Health Promotion Board.

The details and budget are still being worked out and will be submitted soon.

We look forward to YB’s support on the project including launching it.

Decision

Minister agreed to support our request when it is submitted.

13. Request for the residential address of the dental surgeonnottobe listedontheAnnualPractising Certificateforsecurityreasons.

Decision

The Minister agreed and request the MDC to look into this.

A n n o u n c e m e n tThe Council of the Malaysian Dental Association at its 5th Council Meeting has appointed Yang Bahagia Datin Dr. Nooral Zeila Junid as a nominated Council Member to replace Dr. Mahrusah Jamaludin. The Council would like to express utmost gratitude for the service rendered by Dr. Mahrusah and a warm welcome to Dr. Nooral Zeila.

Up and Coming Continuing Professional Education Programmes

1. Ergonomics In Dental Practice: Performance Logic Techniques for Dental Nurses Target: Dental nurses Date: 17th - 18th March 2008 Faculty of Dentistry UKM Contact: Pn Nor Fatimah / Assoc Prof Dr Tuti Ningseh email: adawiyah74nor@yahoo.com Tel: 603 9289 7850

2. Seminar on Qualitative Research Methods in Dentistry Target: Dental academicians, Researchers Date: 14th May 2008 Faculty of Dentistry UKM Contact: Pn Nor Fatimah / Assoc Prof Dr Tuti Ningseh email: adawiyah74nor@yahoo.com Tel: 603 9289 7850

3. Enhancing Children’s Oral Health Though Multidisciplinary Care Event: 6th Conference of Pediatric Dentistry Association of Asia Date: 10th - 12th July 2008 Venue: Berjaya Convention Centre, Kuala Lumpur Website: pdaa2008.um.edu.my/

MDA NEWS1212

15th FDI / MDA Scientific Conventionand Trade Exhibition Report.

The 15th FDI/MDA Scientific Convention and Trade Exhibition was held at Hotel Istana,Kuala Lumpur from 25th – 27th January 2008.

The theme “Same old problems – A new contemporary solution” has been chosen for this particular event, with 3 main components:-

1) Scientific Convention ( Hands On Workshop and Lectures )

2) Scientific Papers Presentation ( Oral and Poster )

3) Dental Trade Exhibition

The organizing committee brought in 9 renowned, international and local speakers, to present 10 lectures over 3 consecutive days and to conduct 3 Hands-on Workshops. A wide spectrum of subjects and disciplines in dentistry had been covered.

The event was officiated by the Guest of Honour, Yang Berbahagia Datin Dr Norain Abu Talib, Director of Oral Health Division, Ministry of Health Malaysia on Saturday, 26 January 2008.

With the comprehensive coverage for various disciplines, this Scientific Convention has attracted 500 registrants. All 3 hands-on workshops were fully subscribed and 35 scientific papers were presented during the event via either mode of oral presentation or poster presentation. The Best Oral Presentation was won by A/P Dr. Seow Liang Lin and the second and third prize went to Dr. Lydia Mason and Dr. Badiah Baharin respectively.

The event had received strong support from the Main Sponsor, Colgate Palmolive; Co-Sponsors and the Trade Exhibitors. The trade exhibitions were fully subscribed.

Credit must be paid where it is due. For this reason, please allow us to take this opportunity to respectfully extend our utmost appreciation to the organizing committee, the council members of MDA, all participants, main sponsor Colgate, co – sponsors and traders for the encouragement, support and guidance. And for those who had directly or indirectly, in one way or another, given their priceless contribution to this event, a very, BIG thank you!

Participants striving to achieve aesthetics restorations at the Aesthetic Direct Composite

workshop conducted by A/P Dr. Chalermpol Leevailoj

The event was officiated by Yang Berbahagia Datin Dr Norain Abu Talib, Director of

Oral Health Division

Participants at the Clinical Photography workshop

Members of the convention organizing team

FEBRUARY 2008 1313

Members of the convention organizing team

Participants listening attentively to lectures

Participants at the registration booths

Participants interacting with Dr. William Cheung at the hands-on workshop

Malaysian Dental Association

65TH MDA AGM MDA/FDI SCIENTIFIC CONVENTION & TRADE EXHIBITION

Date: 20th - 22th June 2008Venue: Hotel Istana

“BLOCK YOUR DATE !!”

UPCOMING EVENT

World renowned speakers from abroad alongside competent local speakers will be there to make your three days of Continuing Professional Develoment (CPD) program an enriching experience.

From Hands on programs to Oral and Poster presentation, they will be will also be there on the agenda.

The Informal nite will be something not to be missed with free flow of spirits and camaraderie second to none. There are plans afoot to have a Formal Nite with top class entertainment.

Register early for the early bird goodies which have been lined up for you. This time around, nothing will be spared to pamper you through the 3 day experience.

MDA NEWS1414

PETALING JAYA Dental Associates - FT / PT (Dental Surgeons and

Orthodontists) at Klinik Pergigian Halina. Opportunity to take over clinic when she retires. Interested,

call 03-2092 1762

Dental Associates (FT / PT) required. Attractive remuneration, flexible working hours. Location :

Cheras / Bangsar. Interested : 016-336 2285

SHOPLOT SUITABLE FOR DENTAL CLINIC FOR RENTShoplot very suitable for dental practice inBandar Puteri Puchong available for rental.

Strategic location and attractive rate. Please kindly contact Dr. Seow 0123307707

A very established Dental Clinic for sale. Doctor retiring. Payment terms negotiable.

Call : Dr. Paul Lee – 03-7877 5577

Dentist wanted by an established clinic in PJ. Good chairside manner and up to date.

Interested please contact: caridentist@yahoo.com”

KUCHING, SARAWAK Contract basis between 3 months to 2 years.

Contact : Dr. Wong at 082-366 288

KOTA KINABALU, SABAH Dental Specialists (FT/PT/Visiting) at Sabah Medical Centre Dental Centre.

Contact : Dr. Ong at 016-837 0048 (H/P) Clinic – 088-223 094

IPOH Assistant Dental Surgeon Wanted

Kuan Dental Surgery, 38 Lorong Taman Ipoh 1, Taman Ipoh Selatan,

31400 Ipoh, Perak. Contact No: 05-5457033

Shop to Let for Dental Clinic Ground Floor, Taman Rinting

Masai, Johor. Rental Rm1600/mth. Pls. contact Chuan 012-295 6783

Urgent !! Dental Speacialists (any specialities)

& Dental Surgeons at Rafflesia Medical Centre Sdn Bhd; Kota Kinabalu, Sabah & their associated

dental clinics. Good & attractive remuneration. More information,

phone / SMS : 016-830 0183. Fax : 088-242 802.

Email : droche@streamyx.com. Website : rafflesiamedicalcentre.com

Dental Clinic for sale at Golden Triangle,KL, good for new/branch practice. Price reasonable.

Enquiry Tel: 03-79567933; fax: 03-79567933

Full or part-time Dental Surgeons required to work in PJ. Favourable teems. Saturday and Sunday off.

Interested please contact, Tel: 03-79567933; fax: 03-79567933

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