Journal of the Dental Association of Thailand
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Item Item Biofilms in Dental Unit Waterlines(Journal of the Dental Association of Thailand, 2010-03-21) Ruchanee AmpornaramvethBiofilms are community of microorganisms that naturally occur in aquatic environments including dental unit waterlines (DUWL). Biofilms in DUWL harbor microorganisms that can eventually be transmitted to patients and dental health care workers. Although microorganisms found in DUWL’s biofilms are mostly weakly pathogenic, some of them can cause opportunistic infection in immunocompromised patients. There have been efforts to standardize the quality of water from DUWL in several countries. Usually they are based on drinking water standard by which degree of bacterial contamination of less than 200 CFU/ml is considered suitable for human consumption. Many methods for decontaminating DUWL have been proposed. Unfortunately, no currently available single approach can effectively eliminate biofilms. Therefore, it would be necessary to employ combination of methods; for example using anti-retraction valve to prevent retrograde aspiration of oral fluids, flushing of DUWL at the start of each clinic day and between each patient, drying DUWL at night and on weekend, using filter or independent water reservoir filled with sterile water, and the use of chemical disinfectants. Future developments in DUWL technology that prevent biofilms development or DUWL decontamination system which can be integrated into the dental unit are eagerly awaited.Item Item Serotypes of Streptococcus mutans(Journal of the Dental Association of Thailand, 2010-09-01) Jinthana LapirattanakulStreptococcus mutans is considered as a main causative pathogen of dental caries, also known to cause bacteremia and infective endocarditis. Nowadays, this bacterium has been classified into 4 serotypes based on the difference of rhamnose-glucose antigens on its cell wall. The major serotype in oral cavity is serotype c, followed by serotype e and f, respectively. As for serotype k, this serotype has been recently discovered, and its prevalence in oral cavity also seems low. Evidence has shown various defects of adhesion proteins on the cell surface of minor serotype S. mutans. In contrast, these strains possess the ability to cause prolonged bacteremia as well as the property to adhere well to the defective parts of the heart. Thus, the difference in serotypes might be associated with quality and role of pathogenesis mechanisms of this bacterium.Item Osteoporosis Detection on Panoramic(Journal of the Dental Association of Thailand, 2010-09-01) Suwadee KositbowornchaiOsteoporosis commonly in postmenopausal women often results in a fracture of their bone. Many patients with no previous diagnosis of osteoporosis had osteoporotic fracture. It is interesting that these women may receive dental treatment from dentists more frequently than visiting medical practitioners for the problem osteoporosis. If a dentist can take the greatest benefit from a panoramic radiograph, osteoporosis may be early detected. Then, the patient could be referred to a medical specialist in order to prevent the complications of osteoporosis. The purposes of this study were to review the role of panoramic radiograph in routine dental treatment for an initial evaluation of osteoporosis and to discuss the reliability and accuracy of reported panoramic indices. The review of literature found that mandibular bone thickness or porosity on panoramic radiograph can be divided into five indices; mental index, panoramic mandibular index, gonial index, antigonial index and Klemetti index. The sensitivity and specificity of these indices for osteoporosis diagnosis ranged from medium to high. These indices were repeatable and effective even in untrained general dental practitioners, and can be used worldwide. However, some studies suggested to use the panoramic radiograph along with other clinical examinations for the diagnosis of osteoporosis because there are several factors affect the diagnosis of osteoporosis including the quality of radiograph. In conclusionevaluation of mandibular cortical thickness or the shape of inferior cortex of the mandible measured from panoramic radiograph was a simple technique in osteoporosis screening of dental patients, giving the maximum benefit of being radiographed. All indices for detecting osteoporosis on panoramic radiograph are reliable, repeatable, and beneficial for dental patients. Therefore, dentists should be aware of these indices while interpretating panoramicradiographs.Item Noise Level in a Dental Laboratory(Journal of the Dental Association of Thailand, 2010-08-31) Vanida Nimmanon; Pirasut Rodanant; Nuntika Ponpai; Sasipa SringampromAbstractThe objective of this study was to evaluate the noise level producing from the removable prostheses construction process in a dental laboratory. The type of study was an analytical study. Noise level was measured with the precision sound level meter. Eighty-two dental technicians who work at least 8 hours per day were recruited. The mean age of the technician was 32.44 years old. The noise level was recorded at the technician work site and at the center of a working room. Three study groups were designated; design-waxing group, arrangement-polishing group and trimming-curing group. The result showed that there was a statistically significant difference (p =.00) of the mean noise level at the technician work sites among the three study groups. The arrangement-polishing group showed the highest mean noise level of 74.93+9.52 dB (range =53.40-90.90 dB). The study of the mean noise level at the center of working room showedno statistically significant difference between the arrangement-polishing group and the trimming-curing group, mean noise level were 72.53+7.52 and 70.52+3.90 dB, respectively. The mean noise level of these two groups were statistically greater than that of design-waxing group (p = .00). For individual dental equipments, model trimmer and airblow pipe produced mean noise level of 90.47+3.20 and 87.05+1.01 dB, respectively,which were greater than the safety noise level standard (85 dB). This study suggested that the technicians may be at risk of hearing loss, therefore, specific precautions should be taken to improve their working conditions.Item Child Rearing Process Related to Oral Health of 0-3 Year-old Children: Case Studies in a Community in Thepa District, Songkhla Province(Journal of the Dental Association of Thailand, 2010-09-01) Angkana Thearmontree; Sunisa Wongsanmai; Jaranya Hunsrisakhun; Suleemarn Narumol WongsuphapEarly childhood caries (ECC) is an important problem at the national and community levels of Thailand. Not only ECC is related to the biological factors, but it is also related to social and cultural factors which influencing child rearing process. The objective of this study was to study social and cultural factors that influence child rearing process related to the oral health of children aged 0-3 years in Thai-Buddhist and Thai-Muslim rubber plant growers’ community in one village in Thepa district, Songkhla province. A qualitative study using case studies method was performed. Nine families (4 Thai-Buddhist and 5 Thai-Muslim families) were included in the study. The results showed that social and cultural factors influencing child rearing process in this community included: 1) the “Forty release” value,causing short breast feeding period in Thai–Buddhists (20 days to 5 months), 2) “Respect of the elderly” value, influencing their child rearing process to follow the beliefs and practices of their mothers and ancestors, and 3) the belief that “Right breast is tissue, left breast is water”, causing the mothers to not realize the need for having their children drink water after drinking their breast milk. In addition, the way of life of the rubber plant growers made mothers have less time to take care of their children between early morning and noon because they had to work in the rubber plantations. The easy access to the grocery store in the village and the giving of snacks to the children by their siblings and relations influenced frequent snack consumption of children. These factors were not significantly different between Thai-Buddhists and Thai-Muslims except the value of “Forty release”, which influenced Thai-Buddhists more than Thai-Muslims in this study. The limitation of this study was that few case studies in only one small village were included in the study. Therefore, it cannot be generalized, but it may be transferable to a similar population. However, the results of this study indicate that the influence of social and cultural factors on the child-rearing process should be considered when conducting preventive and promotive oral health programs for children aged 0-3 years. Further qualitative studies in other communities and quantitative studies with larger sample sizes are suggested.Item Knoop and Vickers Diagonal of Microhardness Measurements of Enamel(Journal of the Dental Association of Thailand, 2010-08-31) Chanya Chuenarrom; ScientistThe objective of this study was to compare the diagonal of hardness measurement of tooth enamel by using Knoop and Vickers microhardness methods. Ten molar teeth were measured for diagonal of hardness using a microhardness tester with Knoop and Vickers indenters under 100, 200 and 300 g test loads. Repeated measurement of the diagonal lengths of all indentations were obtained by using a measuring microscope. The diagonal lengths using a microhardness tester and a measuring microscope were statistically analysed using the paired t-test. Knoop and Vickers diagonal of hardness measurements were 23.9-41.6 μm and 65.6-120.47 μm, respectively. However, the paired t-test of the diagonal of hardness values obtained from using a microhardness tester and a measuring microscope indicated that the Knoop diagonals were statistically different(p \< .05). In contrast, Vickers, diagonal of hardness values showed no statistically different (p \> .05). According to the limitation of this study, the Vickers microhardness test had less errors in measuring diagonal of hardness for enamel than the Knoop test.Item Tooth Brushing Activities and Related Factors among Primary Schools in Songkhla, Thailand(Journal of the Dental Association of Thailand, 2010-08-31) Wattana Pithpornchaiyakul; Assistant Professor; Samerchit Pithpornchaiyakul; Assistant Professor; Songchai Thitasomakul; Angkana Thearmontree; Nuchnaree Akarachaneeyakorn; Nongnuch Arkasuwan; Walee Chukadee; Pataraporn YongstarThe oral health surveillance program has been developed since 1988 to solve dental caries and oral disease problems. One important activity in this project was the after lunch tooth brushing activity. However, there were some children who did not regularly participate in this activity. This study was conducted to determine the brushing activity system and the related factors using a cross-sectional study. Ninety primary schools in Songkhla province of Thailand were sampled using a multistage sampling technique. Data about brushing activities were gathered by observation and teacher interview. Afterwards, teachers and administrators of four schools which had oral health activities systematically and continuously were in-depth interviewed. This study found that 97% of schools had the after lunch brushing activities. More than 90% of teachers had good attitude and were satisfied with these activities. To conduct a systematic brushing activity; short distance between brushing area and water source, brushing material storage in classrooms, signal for brushing preparation, being monitored by leaders or teachers, and control of brushing time were found to be statistically significantly related to the schools which high number of students participated in the activities (p \< .05). From the in-depth interview, the brushing activities could be effectively conducted because of strong school policies, high attention of the teachers continuously, and monitoring by health workers. This study concluded that there were tooth brushing activities in most of the schools. The systematic brushing activities affected on having a high number students participating in the activities. The relationship and cooperation between tudents, teachers, school administrations, parents, community, and related organizations were important factors required for the success of the oral health activities in schools.Item Consent to the Medical Treatment: Legal Effects of the Dentist’s Liability for Wrongful Act and Criminal Liability(Journal of the Dental Association of Thailand, 2010-03-21) Decha ThamtadawiwatPatient’s consent renders the medical treatment shall not be deemed wrongful act so long as the treatment thereof is within the scope of consent granted, whereby the patient fully awared of the likely results arising therefrom, subject to the fact that the dentist has done so under the normal cause of treatment and without any negligence. In this respect, if and adversely unexpected result occurs, the dentist shall have no liability. If damage is a result of negligence, the dentist shall assume liability and any criminal liability concerned. Prior written consent signed by the patient in order to exonerate the dentist from any damage caused by its negligence shall be deemed null and void, and is prohibited.Item Bond Strengths of Self-Etch Adhesives to Enamel Measured Immediately and 24 Hours after Placement(Journal of the Dental Association of Thailand, 2010-09-01) Vanthana Sattabanasuk; Tanit Jirabundansuk; Nath NuntaratpunIn clinical situations, the bonded interface between tooth substrate and resin-based composite is inevitably subjected to stresses immediately after its placement. The present study aims to evaluate and compare the bond strengths of two self-etch adhesives to enamel measured immediately and 24 hours after placement. Intact, non-carious, non-restored human permanent molars were mesio-distally sectioned into halves. Each half was mounted into stone plaster with middle enamel surface exposed to the environment. The enamel surfaces were ground flat with abrasive paper and restored with resin-based composite using either Clearfil Tri-S Bond or Clearfil SE Bond. Microshear bond strengths were assessed immediately or 24 hours later. Bond strength data were analyzed with two-way ANOVA. The fractured surfaces were observed under stereomicroscope and failure mode frequencies were compared using the Chi-square test. Representative enamel surfaces after each adhesive treatment were examined under scanning electron microscope (SEM). No statistically significant difference in shear bond strengths was detected between the two adhesives (p = .224);however, significantly lower values were revealed at the time immediately after resin-based composite placement (p \< .001) as compared to 24 hours later. Immediately after placement, Clearfil Tri-S Bond specimens were more likely to have failure pathway in adhesive layer than Clearfil SE Bond specimens (p = .001). Under SEM observations, both adhesives created rough enamel surfaces after treatments with acidic monomers.From the results of this study, it can be concluded that enamel bonding effectiveness of both self-etch adhesives was not different; however from each other, shear bond strengths measured immediately were shown to be lower than those measured 24 hours afterward.Item Zirconia Ceramics: The Alternative Choice of Dental Ceramics for Posterior Fixed Partial Dentures(Journal of the Dental Association of Thailand, 2010-03-21) Peerapong Junpoom; Boonlert Kukiattrakoon; Chanothai HengtrakoolThe objective of this article was to explain the quality of zirconia ceramics and their benefits in dentistry. It has better mechanical properties as compared to other ceramic materials when used for all-ceramic posterior fixed partial dentures. The microstructures of zirconia ceramics in tetragonal phase can transform to monoclinic phase as temperature and stress changes. The effect of phase transformation or transformation toughening mechanisms enhances mechanical properties of zirconia ceramics which is suitable for clinical application in posterior fixed partial dentures. In addition, this article review the degradation of zirconia ceramics when exposed to water or other solutions for precaution in selecting zirconia ceramics for clinical uses.Item Situation Regarding the Use of Fluoride Varnish by Dental Personnel in Regional Public Dental Services(Journal of the Dental Association of Thailand, 2010-03-21) Jiraporn TaeweerapichaiThe objective of this descriptive survey was to determine the situation regarding the use of fluoride varnish by dental personnel in regional level, types of fluoride varnish, usage problems, and suggestions and opinions needed to promote effective use of fluoride varnish in the future. The survey was conducted between July-September 2006. Questionnaires were mailed to 900 dental personnel in community hospitals, general hospitals, regional hospitals, Somdejprayupraraj hospitals, and provincial health offices of the Ministry of Public Health all over Thailand. Five hundred and sixteen dental personnel returned the questionaires giving a response rate of 57.3%. The majority (86.8%) of the respondents worked in community hospitals. Seventy-nine percent of them were dentists and 20.3% were dental nurses. Sixty-two percent of the respondents have used fluoride varnish. Nowadays, fluoride varnish is used in 51.5% of public dental services. It was reported to use for prevention of tooth sensitivity (36%), for caries prevention in well baby clinic (28.3%), in child development centers (18%) and home visit (5.4%). The most used fluoride varnishes were Duraphat (75%), Bifluorid 12 (16.7%) and Fluor Protector (5.0%) respectively. The reasons that public dental services did not use fluoride varnish in preventive work included no action plan, no budget, or provision. The most common problems for dental personnel who had been using fluoride varnish were lack of cooperation of the children, saliva contamination in posterior teeth during application, uncontrollable food consumption after application, bad taste, and unconcerned parents. It was found that 62.8% of public health personnel trained by dental personnel with experience in using the varnish could apply fluoride varnish in well baby clinic in community hospitals. Most of the dental personnel (78.6%) agreed with using fluoride varnish by public health personnel who have closer contact with 0-3 year-old children in the community, because its application is easy and it does not require dental equipment. Fluoride varnish should be considered to be used as a caries prevention method in preschoolers in community-based services.Item Thai Dental Professional Survey on Tobacco Use and Control(Journal of the Dental Association of Thailand, 2010-09-01) Romanee Kudngaongarm; Chanida ThamsoonthornOne of the strategies to reduce the number of smoking-related deaths was to encourage the involvement of health professionals in tobacco control and cessation counselling. The World Health Organization and the U.S. Centers for Disease Control and Prevention developed the Global Health Professionals Survey (GHPS) to collect data on tobacco use and tobacco control among health-profession students. The aim of this study was to survey the prevalence of cigarette smoking and other tobacco products use, knowledge and attitudes about tobacco use, exposure to secondhand smoke, desire for smoking cessation, training received regarding patient counselling on smoking-cessation technique, and dentists’ role in reducing tobacco use in dental offices. The self-administered questionnaires were sent to 8,266 dentists and 1,522 dental assistants by mail. Dentistresponse rate was 20.7%, and dental assistant response rate was 40.5%. The findings indicated that current cigarette smoking among these dental professionals was 2.4%(dentist rate and dental assistant rate was 2.0% and 3.4%, respectively). The majority,(93.0-95.0%) of the surveyed dentists and dental assistants reported that they should have a role in counselling patients to quit smoking. However, the percentage of dental professionals who actually received formal training in tobacco cessation counselling were 8.6% among dentists and 11.8% among dental assistants. Only 5.5% of dentists had provided smoking cessation section in their dental offices. In summary, Thai dentists and dental assistants had very law rate of tobacco comsumption. They required more trainings on smoking cessation services.Item Cone Beam Computed Tomography in Dentistry(Journal of the Dental Association of Thailand, 2010-03-21) Preeyaporn SrimawongCone beam computed tomography is an extraoral radiography. The cone beam computed tomography radiograph demonstrates the relationship of interested tissue in all three planes and can be reformatted image in three dimensions, which could not be done by other conventional radiographs. This imaging modality is very useful in many dental diagnoses and treatment plannings, for example, dental implant, oral surgery and diagnosis of pathology of the temporomandibular joint and the jaw bone. A cone beam computed tomography machine has been developed by many companies. Each machine has a different specification, but all can be controlled by computer system. Using this system, the image acquisition is done in a short time. However, cone beam computed tomography has the limitation of soft tissue lesion scanning and it produces a relatively high radiation dose to the patient as compared to a conventional radiograph. Therefore, appropriate selection of the patient for using cone beam computed tomography for each patient should be considered.Item Transmission of HIV-1 Via Oral Route: Why is it difficult?(Journal of the Dental Association of Thailand, 2010-09-01) Wipawee NittayanantaTransmission of human immunodeficiency virus type 1 (HIV-1) via oral route is considered to be uncommon. Several factors at mucosal surfaces and in saliva may play roles in local defense against the viral infection of target cells. The objective of this article was to review local innate immunity that contributes to the oral resistance against HIV-1. Oral epithelial cells play significant roles in local innate immunity. They provide physical barrier and also produce antimicrobial peptides that possess anti-HIV-1 activity. This article described mechanisms of HIV-1 transmission, role of epithelial cells and antiviral mechanisms in the oral cavity including human beta-defensins (hBDs) in HIV-1 transmission at mucosal surfaces.Item Apple Cider Vinegar and Muscle and Arthritis Pain : A Case Report(Journal of the Dental Association of Thailand, 2010-03-25) Jintakorn KuvatanasuchatiThis review’s object was to present the experience which the author had from using apple cider vinegar to alleviate muscle pain. Pubmed and websites were searched. And some information was evidence from the author’s personal experience. Using apple cider vinegar to alleviative muscle pain, the author has saved the health care cost of expensive drugs. The vinegar helped reducing the use of anti-inflammatory drugs which a physician prescribed for one time, consequently decreased side effects of the drugs. Later the medications were not needed for pain. Beter health was obtained from using the vinegar. In conclusion, this article may be useful to a dentist who has muscle pain and arthritis and anyone else who has the pain.Item Prevalence of Finishing Line Location of Prepared Teeth for Cast Posts and Cores and Types of Previous Restorations(Journal of the Dental Association of Thailand, 2010-03-25) Napapa AimjirakulThe purpose of this study was to determine the prevalence and characteristics of supra- and subgingival finishing lines on different tooth surfaces prepared for post and core restoration. Sixty endodontically treated teeth were prepared for cast posts and cores with chamfer finishing lines. Before post and core preparation, the lowest height of the clinical crown (LHCC) from the gingival margin was measured on each surface for comparison with LHCC after preparation. The results showed that the number of subgingival finishing line for post and core preparations (80.0%) was greatly higher than those with supragingival finishing line (20.0%). Most of the preparations with subgingival finishing line (N=48) involved the distal surfaces (75.0%). One-way ANOVA and Tukey’s post hoc test showed that there was a significant difference between LHCC’s before and after preparation on the buccal surface (p=.012). There was a high prevalence of subgingival finishing line on the proximal surfaces. In order to achieve excellent restorations, tooth preparation and impression taking should be carefully considered. Hence, this study strongly suggested further research on which impression material would be most suitable for recording subgingival finishing line.Item Long Term Effect of Dental Unit Waterline Decontamination by Combining Sodium Hypochlorite with Chlorhexidine Gluconate of ICX™(Journal of the Dental Association of Thailand, 2010-03-25) Ruchanee Ampornaramveth; Kanittha Charoenrakphakdee; Bussarakum Kanokvorapan; Phatsachai MongkonsukwatThe purpose of this study was to observe the long term effect of dental unit waterline (DUWL) decontamination by combining shock treatment with Sodium hypochlorite (NaOCI) followed by continuous treatment with Chlorhexidine gluconate (Chlx) or ICM™ for 2 months. Twelve dental units were treated every 2 weeks with 0.005% NaOCI as shock treatment and divided into 3 groups. The first and the second groups (4 units each) were then treated continuously with 0.005% Chlx, or ICX™, respectively. The other group (4 units) was kept as control. Water from each DUWL was DUWL was sampled to observe total number of recoverable aerobic bacteria (CFUs). Data were analyzed by the Mann-Whitney U test. After shock treatment every 2 weeks for 2 months, the average CFUs in control group were reduced only for a short period and rapidly increased after each treatment. Continuous treatment with Chlx was slightly more effective than shock treatment alone but could not maintain the CFUs below that of ADA standard level of no more than 200 CFUs/ml. Continuous treatment with ICX™ significantly reduced CFUs to lower than standard level until day 9 after shock treatment. CFUs gradually increased to higher than standard level at the end of the 2nd week. Average CFUs from each single day after shock treatment in every cycle indicate a significant reduction in recoverable numbers of bacteria in Chlx and ICX™ group compared to control group. In conclusion, these data indicate that combining shock trratment with 0.005% NaOCI and continuous treatment with ICX™ was more effective in controlling DUWL contamination than shock treatment alone or in combination with Chlx.Item Humanized Dentistry(Journal of the Dental Association of Thailand, 2010-03-25) Atisak ChuengpattanawadeeNowadays, Humanized Health Care is the current interesting topic among public health community in Thailand. To introduce this concept, this study’s objective was to review literature about Humanized Dentistry. The review included articles about Humanized Health Care, perspectives of public health workers in the realm of medical anthropology, and patients’ experiences of dental treatment published in contemporary Thai literature. This article provided an initial suggestion that Humanized Dentistry should begin with concerning in the complicated and variety meaning of human body and life. And, patient’s emotion should be acknowledged during any dental procedure.
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