Of Discipline and Dentistry

Apr-Jun 2016

A p u b l i c a t i o n o f M a l a y s i a n D e n t a l A s s o c i a t i o n

NE

WS

Cleft Patients:Team Management

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Sandakan DentalStudy Night

12

MDA Colgate Oral Health Month

10

Datuk Dr Yim Khai Kee

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Messagefrom the Editor

Greetings from the Malaysian Dental Association. As most of you would probably be aware by now, the 73rd Malaysian Dental Association Annual General Meeting is just around corner on 26th June 2016. Hence, this issue will mark my last issue for my one-year term as the

Honorary Publication Secretary. It was indeed an honour, together with the line-up of committee members to publish our MDA News every quarterly. I am highly indebted to the wonderful and committed committee who have assisted me in many ways to continue to produce our association’s newsletter. I do hope that the incoming new Editor will not only continue this task but to further improve the quality of the publication for the benefit of the members. I also wish to acknowledge the contributions of all the contributing writers who have sincerely obliged to my invitation to prepare the reports and articles, for without them, the MDA News will definitely be incomplete.

Once again, MDA News is proud to feature yet another prominent figure from our dental fraternity to highlight his significant contribution to the society. We have successfully engaged Datuk Dr Yim Khai Kee for an interview recently and we are truly honoured to have this privilege to share his vast experience. He was the President of MDA way back in the early 1980s and has moved on to play an important role in the international arena, such as his involvement with the International College of Dentists, from which he was awarded the status as Regent Emeritus.

Also, as mentioned in our previous issues, members are strongly urged to make full use of the online search engine, EBSCO, to obtain online dental journals. With well over 350 academic journals / magazines / books / monograph under Dentistry and Oral Science Source, this is a golden opportunity not to be missed. Hence, members who have not received their MDA Member Login ID and Password, please kindly contact our secretariat for assistance.

Before I sign off this issue, I would like to express my best wishes and very fruitful tenure to the incoming Honorary Publication Secretary. Members are urged to continuously provide feedbacks / comments to improve the quality of MDA News. As a member from the Eastern Zone, I wish all Sabahans and Sarawakians – “Happy Harvest Festival”. “Kotobian Tadau Tagazo Do Kaamatan”.

Dr Leong Kei Joe

EditorDr Leong Kei Joe

Assistant EditorProf. Dr Ngeow Wei CheongDr Lee Chee Wei

Contributing WritersDr Khairul Bariah Chi AdamDr Yeoh Oon TakeDr Tan Sock HooiDr Eileen Koh Mei YenDr Lee Wei ZinDr Leong Kei Joe

Ex-officioDr John Ting Sii Ong

TreasurerDr Eileen Koh Mei Yen

Advertisement LiaisonDr Ng Su Chin

Malaysian Dental Association54-2, 2nd Floor, Medan Setia 2,Plaza Damansara, Bukit Damansara,50490 Kuala Lumpur, Malaysia

Tel: 603-2095 1532 2095 1495Fax: 603-2094 4670E-mail: mdaassoca@mda.org.my mdentalassoc@gmail.comWebsite: www.mda.org.my

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Note:Views expressed are not necessarily those of The Malaysian Dental Association. The Malaysian Dental Association takes no responsibility for the consequences of any action taken based on any information published in MDA News and neither shall it be held liable for any product or service advertised in the same. No part of this publication may be reproduced without the permission of the publisher.

MALAYSIAN DENTAL ASSOCIATION

InsideFeature

Activities

10 MDA Colgate Oral Health Month

11 Oral Health Month 2016 – NTV7 Bella

12 Sandakan Dental Study Night

14 MDA Southern Zone AGM

15 World Oral Health Day 2016

18 Penang CPD Programme cum MDA Northern Zone AGM 2016

19 Of Discipline And Dentistry - Datuk Dr Yim Khai Kee

23 Cleft Patients: Team Management

26 Centric Relation As We Know It

April-June 2016

5Message from the President

MALAYSIAN DENTAL ASSOCIATION

It’s truly hard to believe that my term of Presidency has almost reached one year. Indeed the night of my Installation as President along with the rest of the council members is still fresh in my memory. As I am

penning down my message here for the MDA News April – June 2016, I know that I will soon have to prepare my transition to Immediate Past President. My term in the Presidency is indeed full of challenges but I must say that I enjoyed every moment of it serving our members to the fullest. The journey in serving the members is indeed a collective effort and not a one-man show, and hence, I wish to take the opportunity to express my sincere gratitude to my line of council members who have been with me through good and bad times. It is indeed a great honour and experience that I will cherish forever.

Despite the extremely busy schedule of the council with international agendas, the association has continued to perform one of its important duties to the general public, our Rakyat, which is promotion of Oral Health Awareness. March 2016, was indeed a very special period for the dental fraternity. Malaysia, together with other countries in the world, was involved in the yearly FDI World Dental Federation’s World Oral Health Day 2016. World Oral Health Day is celebrated every year on the 20th March. It is an international day to celebrate the benefits of a healthy mouth and to promote worldwide awareness of the issues surrounding oral health and the importance of oral hygiene. Malaysian Dental Association took the lead to organise this grand event under the leadership of Dr Ng Woan Tyng, our Honorary General Secretary.

Dr John Ting Sii OngMDA President 2015/2016

MDA News

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Earlier on, also in the month of March 2016, Malaysian Dental Association collaborated with Colgate Palmolive to organise the National Oral Health Month, now in its 13th consecutive year. The launch was held on 9th March 2016 at Empire Hotel, Subang. It is the sincere hope of the association that the outcome from this campaign is aligned with the National Oral Health Plans 2020 goals which is to achieve an overall improvement in the oral health quality of life of Malaysians. As part of this awareness campaign, our Honorary Financial Secretary, Dr Eileen Koh Mei Yen, took part in a live interview on one of our local TV channel, NTV7, together with other experts to share the news on the importance of oral health.

Dr Noor Aliyah having a private discussion with MDA Council Members and Mr Peter Torrington

Also in the month of March 2016, Malaysian Dental Association has successfully engaged the Malaysian Dental Dealers Association on an important meeting to discuss matters pertaining to heavy dental equipment, such as Dental compressor and Dental X-ray machines, exemption of Good and Service Tax charges on the Dental equipment and related matters pertaining to the Medical Device Act. The meeting was held on 19th March 2016 and was well attended from both associations which shared on the objectives of the associations. It is the sincere hope of Malaysian Dental Association to foster future collaboration in areas deemed appropriate with Malaysian Dental Dealers Association for the benefit of both parties.

April-June 2016

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Group photo MDA – MDDA upon adjournment of meeting

As mentioned earlier in my message, the term of the present council members shall soon come to an end and hence, it is also timely to remind all members of the upcoming 73rd Annual General Meeting 2016. This year’s Annual General Meeting shall be held at Boulevard Hotel @ Midvalley City, Kuala Lumpur, on 26th June 2016. Please kindly visit our MDA Homepage for more information.

Last but not least, once again I would like to take this opportunity to extend my sincere invitation to all members to register for the upcoming Malaysia International Dental Exhibition and Conference (MIDEC) 2016. The organising committee has been working all out to put together another successful international dental meet right at the heart of Kuala Lumpur. Truly an event not to be missed. With this, I wish all of you the very best in all aspects of your life, thank you for your support throughout my Presidency and most importantly, continue your support for the beloved association and the next line of Council Members.

Yours in MDA, John Ting

Press conference after the launching of WOHD 2016.

MDA News

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Dear Esteemed Members of the MDA,

In an extremely connected world that we live in, it is vital for us to always be well informed and up to date especially in our contactability. With this noble aspiration in mind, we sincerely urge all members of the MDA to make sure that your contact details are always current:-

• EMAIL ADDRESS• MOBILE HANDPHONE NUMBER• CURRENT MAILING ADDRESS

This is to enable the MDA to always be able to keep you up to date with the latest information on important issues that affect the dental profession, seminars and talks, conventions both local and international. For Dental Protection Limited members, it is extremely important to keep your contact information always current so that your membership will always be up to date and you will always be covered. There have been several cases where members were hit with patient complaints during the period where they were inadvertently overdue in their subscriptions.

IF YOU HAVE ANY DOUBT ABOUT YOUR CONTACT DETAILS, PLEASE EMAIL THEM WITH YOUR NAME TO THE MDA AT:-

mdaassoca@mda.org.my

or call 603-20951495

THE IMPORTANCE OF KEEPING YOUR MEMBERSHIP CONTACT DETAILS ALWAYS CURRENT

April-June 2016

9

Dear Esteemed Members of the MDA,

In an extremely connected world that we live in, it is vital for us to always be well informed and up to date especially in our contactability. With this noble aspiration in mind, we sincerely urge all members of the MDA to make sure that your contact details are always current:-

• EMAIL ADDRESS• MOBILE HANDPHONE NUMBER• CURRENT MAILING ADDRESS

This is to enable the MDA to always be able to keep you up to date with the latest information on important issues that affect the dental profession, seminars and talks, conventions both local and international. For Dental Protection Limited members, it is extremely important to keep your contact information always current so that your membership will always be up to date and you will always be covered. There have been several cases where members were hit with patient complaints during the period where they were inadvertently overdue in their subscriptions.

IF YOU HAVE ANY DOUBT ABOUT YOUR CONTACT DETAILS, PLEASE EMAIL THEM WITH YOUR NAME TO THE MDA AT:-

mdaassoca@mda.org.my

or call 603-20951495

THE IMPORTANCE OF KEEPING YOUR MEMBERSHIP CONTACT DETAILS ALWAYS CURRENT

Dear Esteemed Members,

Please kindly be informed that beginning of year 2016, our MDA News will be going e-copy and readily viewable online and downloadable from the members site. As such, members who wish to continue to receive their usual hard copies through postal delivery, please kindly fill in the details below and post the completed reply form back to our office at the address stated below.

MDA NEWS 2016 WILL BE

GOING GREENREQUEST FORM FOR CONTINUATION OF POSTAL DELIVERY OF MDA NEWS IN HARD COPY

YES! I would like to continue to receive my hard copy of MDA News

Name of member:

Phone Number: Email:

Correspondence address:

Kindly post the completed form to:

MALAYSIAN DENTAL ASSOCIATION54-2, Second Floor, Medan Setia 2, Plaza Damansara, Bukit Damansara, 50490 Kuala Lumpur, Malaysia.

MDA News

10MDA Colgate-Palmolive CSR Project: Oral Health Month 2016

Report written by: Dr Leong Kei Joe

The launch of the Malaysian Dental Association Colgate Palmolive Oral Health Month 2016 took place at Empire Hotel, Subang, Selangor, on 9th March 2016. This event was officiated by Yang Berusaha, Dr Noor Aliyah

Bt Ismail, Principal Director of Oral Health, Oral Health Division, Ministry of Health Malaysia. Also in attendance is Dr John Ting Sii Ong, President of the Malaysian Dental Association and Mr Peter Torrington, General Manager of Colgate-Palmolive Malaysia.

The Malaysian Dental Association has once again partnered with Colgate-Palmolive Malaysia for the annual national Oral Health Month campaign, which took place throughout the month of March 2016, also in conjunction with World Dental Federation’s (FDI) World Oral Health Day.

The theme for this year’s Oral Health Month campaign is ‘Keep Malaysia Smiling’. This campaign, now in its 13th consecutive year, highlighted its theme of ‘Keep Malaysia Smiling’, to get Malaysians thinking about oral health as an integral part of their general health and well-being, and that oral health means much more than just healthy teeth. This is aligned with the National Oral Health Plans for Year 2020 goals; which is to achieve an overall improvement in oral health and quality of life of Malaysians.

Since its inception, this programme has grown from strength to strength. The number of participating clinics that offer free dental check-ups have increased from 300 in 2004 to over 926 clinics this year. This CSR project also involves registered dental clinic nationwide, from Perlis to Sabah; to give free consultation and dental check-ups. Activities arranged include educational marquees and free dental check-ups for communities, giving all Malaysians a chance to have zero cavities and healthy gums.

In conjunction with this campaign, MDA and Colgate Palmolive representatives were given an opportunity to be on NTV7 Bella Live Show for a live interview. The interview aimed to sustain awareness and interest of the campaign among the public after the launch on 9th March 2016 (for more information on this, please refer to the report prepared by Dr Eileen Koh).

Mr Peter Torrington delivering his speech at the launching of MDA Colgate Palmolive Oral Health Month 2016

MDA Council members, Dr John Ting and Dr Abd Rashid, with Mr Peter Torrington

April-June 2016

11Oral Health Month 2016 Campaign on NTV7 Bella

Report written by: Dr Eileen Koh Mei Yen

Colgate-Palmolive Malaysia, Ministry of Health and the Malaysian Dental Association (MDA) came together to promote the importance of oral health among Malaysians during the Oral Health Month in March 2016. The campaign,

now in its 13th consecutive year, carried the theme “Keep Malaysia Smiling”.

In conjunction with this campaign, MDA and Colgate Palmolive representatives were given an opportunity to be on NTV7 Bella Live Show. The interview aimed at bringing awareness and interest of the campaign among the public following its launch on 9th March 2016. Additionally, MDA was also keen to establish and emphasise the key role that oral health play in general health and wellbeing in line with the National Oral Health Plans for Year 2020 goals.

The TV programme was aired live from the studio on Monday, 14th March 2016 (11am-12pm) for the Bella CONFIDENTIAL block. Three spokespersons were involved in the interview namely Professor Khoo Suan Phaik, Dr Eileen Koh Mei Yen and Dr Cyanthi Seneveratne.

The interview with the spokespersons discussed on how Malaysians should consider oral health and overall wellbeing holistically and that OHM 2016 is intensifying its efforts to educate Malaysians on the matter. Other topics that were discussed include dental cavities, dentine hypersensitivity, gum trauma, and braces.

For the full video clip of the interview on Bella NTV7, you can watch it on Bella(2016) Episode 46 on tonton website or access via the link below :- http://www.tonton.com.my/tvShow?titleId=56ab10022315735e400042f3

Professor Dr Khoo Suan Phaik (far left), Dr Cyanthi Seneveratne (second from the left) and Dr Eileen Koh Mei Yen (third from the left) posing on the set at NTV7

MDA News

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or the first time ever, the Malaysian Dental Association Eastern Zone organised a Dental Study Night at the heart of Sandakan town, Sabah. The Dental Study

Night have been routinely held in various towns in Sabah and Sarawak. Apart from providing continuing professional development to the local dental practitioners, these activities were also aimed at encouraging fellowship and also for MDA membership drive.

The Sandakan Dental Study Night was held on the 23rd May 2016 at Sabah Hotel, Sandakan. Dr Jeremy Lee Ju Kuan, Specialist in Oral Maxillofacial Surgery, spoke on a very timely topic of “Bisphosphonate Related Osteonecrosis of the Jaws” while Dr Lillybia Emily Ebin, Specialist in Orthodontics, shared her paper on the topic

Sandakan Dental Study Night 2016

Dr Leong Kei Joe

Group photo with the participants after the event.

April-June 2016

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Dr Jeremy Lee (centre) with Dr Leong (right) after presentation of letter of appreciation.

Dr Leong presenting a letter of appreciation to Dr Lillybia Emily.

Discussion among some of the dental practitioners at the event.

of “Managing the Developing Dentition”. Malaysian Dental Association Eastern Zone was represented by Dr Leong Kei Joe, who also acted as the facilitator for the evening. The event was well received by the local dental practitioners, with a total participation of 28 dental practitioners (from both public and private sectors) and four dental nurses who were present as volunteers for the evening. The event also provided a golden opportunity for all dental practitioners to meet up with long time acquaintances and to create new ties.

MDA News

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The Malaysian Dental Association Southern Zone held their Annual General Meeting on 20th March 2016 at Double Tree Hotel, Johor Bahru. A total of 37 members participated in the event. The event started off with a talk by Bursa Malaysia. The members were

educated on various investment tools and given an insight into the current economy. The annual general meeting was called to order at 11am. All the related reports were adopted by the members and followed by election of the committees. The elected committees are as followed:

A few issues were raised by members and answered by council members Dr Ng Ben Chuan and Dr Siow Ang Yen. They also briefed the members regarding the Dental Bill and Allied Health Act.

To wrap up the event, certificates and mementoes were given to all the previous committee members of the term 2015/2016 by the president, Dr Ng Ben Chuan.

The meeting was then adjourned at 1pm.

Chairman: Dr Ng Ben Chuan

Honorary Secretary: Dr Lee Wei Zin

Honorary Treasurer: Dr Tan Yuan Yang

Committee Members: Dr Alia Bt Mohd Ghazali

Dr Sharon Hor

Dr Rani Panadam

Dr Chan Ee Mee

Dr Mohd Shah Affendy Bin Mohamed Khalid

Honorary Auditor: Dr Rolland Lim Siong Cheong

Malaysian Dental Association Southern Zone Annual General Meeting 2016

Report written by: Dr Lee Wei Zin

Presentation memento to Dr Siow Ang Yen as appreciation for his contribution in the MDASZ 2015/2016 committee.

Presentation of souvenir to Speaker from Bursa Malaysia.

Presentation of memento to Dr Lee Wei Zin as appreciation for his contribution in the MDASZ 2015/2016 committee.

April-June 2016

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nce again, the Malaysian Dental Association has took another enormous effort, in conjunction with World Oral Health Day, to promote oral health awareness to the

general public in Malaysia. The theme for this year is “It all starts here. Healthy mouth. Healthy body”.

The Organising Chairperson, Dr Ng Woan Tyng, had led the whole working committee, comprising of Malaysian Dental Association, Oral Health Division, Ministry of Health Malaysia, Dental Dean Council and Malaysian Dental Students’ Association to ensure a successful event.

World Oral Health Day 2016 Malaysia

Report written by: Dr Leong Kei Joe

VIPs group photo.

MDA News

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Launching of WOHD 2016 Malaysia by the Guest of Honour.

The national launch of this event was held at IOI Mall Putrajaya on the 20th March 2016 and was graced by our Guest of Honour, Yang Berhormat Dato’ Seri Dr Hilmi Bin Haji Yahaya, Deputy Minister of Health, Ministry of Health Malaysia.

An estimated of 1,000 people were present at the launch and the event was covered by national press and three local TV stations, RTM, TV1 and 8TV. The roadshow and the mobile dental clinic began on 18th of March 2016. As with previous year, local dental schools participated in a competition to produce a short video presentation to help spread the news of oral health awareness in the social media. A special thanks to the Wrigley Malaysia Company Sdn Bhd for sponsoring and supporting the event. For more information covered in the local daily, please log on to the following link: http://www.thesundaily.my/node/355940

Dr Ng Woan Tyng, Organising Chairperson, delivering her speech at the event.

April-June 2016

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Guest of Honour, Dato’ Seri Dr Hilmi Bin Haji Yahaya (second from left), and MDA President, Dr John Ting (third from left), during presentation of souvenirs.

Performance by Dental Students during the event.

MDA News

18Penang CPD Programme cum MDA NZ AGM 2016

Report written by: Dr Tan Sock Hooi

Penang CPD Programme was held in conjunction with the MDA Northern Zone AGM, on the 6th March 2016 (Sunday). The event held at the Bayview Hotel, Georgetown, Penang started at 8.30am and ended at 4.30pm; it was attended by 100 participants.

We’d like to express our gratitude to both our speakers for delivering four very interesting lectures for this event. Our very prominent speaker, Professor Dr David Ngeow, an Oral Maxillofacial Surgeon and lecturer at University of Malaya, lectured on “Achieving Successful Dentoalveolar Surgery In The General Practice” and “Managing Bone In Implant Surgery: When and How Should We Graft Bone Defects?” Our second speaker, Dr Samuel Tee, an Endodontist from Penang Adventist Hospital, lectured on “The Essential Principles In Endo Practice” and “Regenerative Endodontics”.

The MDA NZ AGM which was conducted before lunch, went on briskly and smoothly. With the previous year AGM minute and reports being accepted and passed, and the committee being dissolved, Dr Chay Siew Han was appointed as the Election Chairperson to conduct the election. The following were elected to hold office in the MDA Northern Zone for the year 2016/2017.

Chairman: Dr Lim Chiew Wooi

Honorary Secretary: Dr Tan Sock Hooi

Honorary Treasurer: Dr Jeannette Wong Xue Ying

Committee Members: Dr Ang Lai Choon

Dr Teh Yik Pin

Dr Gan Pei Jun

Dr Choo Wan Ling

Dr Tan Hooi San

Honorary Auditor: Dr Lim Eng Hin

Chairman, Dr. Lim Chiew Wooi, presenting a token of appreciation to Speaker, Prof. Dr. David Ngeow

April-June 2016

19Of Discipline and Dentistry

Datuk Dr Yim Khai Kee is a humble and yet gregarious man. He has served as the President of MDA from 1980 to 1985 and subsequently, he was appointed as the President of the Asian Pacific Dental Federation from 1993 to 1994 amongst other notable postings. To date, the 80-year-old is the longest serving member of the Malaysian Dental Council. Datuk Dr Yim is a firm believer that one must work with discipline and respect, MDA is privileged to speak to him about his career and experience.

Interviewee: Datuk Dr Yim Khai Kee

Interviewed by: Gwen OngPaul & Marigold

MDA News

20Can you tell us briefly about your background? Why did you choose dentistry?Truth be told, my first love was law but at that time, the University of Malaya Singapore didn’t have the course yet. So the next best thing was to take up medicine but unfortunately, I was not good enough and had to settle for dentistry. I graduated with my dental degree from Singapore in 1961. Then, I underwent training as a dental houseman in Ipoh, Perak for a year before being posted up to Kulim, Kedah. As a fresh graduate, I wasn’t sure of what I wanted to do and soon the daily task became mundane for me. So I decided to apply into the Malaysian Armed Forces, which was looking for a dental and medical officer at that time. The job was not much different from the government service. You are doing the work of a professional dentist as a uniformed officer of the Armed Forces, looking after the dental interest and requirements of the armed forces personnel and their family members.

When we first started at the army, it was called Short Service Commission with an option for three or five years of service. After my fifth year, I was offered a scholarship to study at the University of Dundee, Scotland. I went on to obtain a diploma in public dentistry. Following that, I requested to take up a new course which had just started in London and I managed to obtain a diploma in dental public health from the Royal College of Surgeons of England. Upon returning home, I was promoted to the rank of Major and put in charge of the AF dental clinic in the Ministry of Defence at Jalan Gurney. Subsequently, due to family reasons, I retired from the forces after 15 years and went to join a private group dental practice.

You are the Chairman of the Preliminary Investigation Committee (PIC). What does this role entail? To explain briefly, the practice of dentistry in this country is regulated under the Dental Act and the body that governs it is the Ministry of Health. The Director General is the President of the dental council and the members of the PIC is appointed by the DG to conduct enquiries into complaints received by the council.

When a complaint arises, it goes to the council and president, who will then decide if an investigation is needed. If so, the secretary would assign the case to the PIC and we will look into the circumstances of the

complaint before giving our recommendation to the council.

What patients and dentists don’t realise is that we have no jurisdiction over any member of the public. Our duty is to look after the behaviour and practice of the dentists and make sure that they’re working in accordance with the Dental Act. I think many are not aware of this because they have not familiarised themselves with the Dental Act. Anyone who wants to practise dentistry in this country must be registered with the dental council and must possess a current Annual Practicing Certificate from the council.

What is the process like at the PIC?Currently, we have two PICs consisting of a chairman and six members including a lawyer. A complaint takes a month or so to be processed. We’d need to tell the complainant/practitioner on what is the objective of the PIC. It is important for the patient to realise that the dental

April-June 2016

21council does not grant monetary compensation even if the dentist is found liable.

Our main objective is to see whether the practitioner has contravened any part of the Dental Act in rendering his service to his patient. If the PIC finds that the practitioner has contravened the Act, we will recommend to the dental council that there is a case for the practitioner to answer. However, it is important to note that after receiving our investigation and recommendation, the council has the prerogative and final say to decide whether there’s a case for the practitioner to answer.

What are some issues that you’ve noticed in your appointment in the PIC? I’ve been doing this for a long time and I’ve come across many kinds of cases since taking up my PIC appointment in 1984. Dentistry is advancing greatly, new techniques and materials are being introduced; it is important that all dentist must keep up with the changes in order to render the best services to the patients.

With the advancement of the Internet, people are more accessible to a lot of knowledge and now have a different outlook on ethics and demands of the services and the responsibility of the practitioner. We have had cases where the professionals acted aggressively towards their patients and some carried out certain treatments that were unnecessary. On the other end of the spectrum, you have persistent patients who ended up testing the patience of their dentists. Therefore, it is important that the dental practitioners should keep up to date to the new developments and the only way is to attend Continuing Dental Education programmes organised by the authorities for their benefits.

Can you share with us your experience at the PIC? Through my experience, I find that most dentists don’t take the initiative to read or keep up with the Dental Act. As a result, they do things which they shouldn’t have. However, as a member of the medical/dental profession, it is an onus on their part to prepare themselves so that they can give their best services for the benefit of their patients. The Malaysian Dental Association in collaboration with the Medical Protection Society have continuously organised seminars and courses to help dental practitioners in the aspect of good dental practice. My advice is to take advantage of this.

The best course of action is to collaborate, not criticise.

It is important for dentists to realize that they’re only human and can make mistake.

MDA News

22Personally, I feel some dentists are either reluctant or have too much pride in letting others know when they have made a mistake in their work. So, they keep grinding at it which is very common in cases of root canal treatment. It is important for dentists to realise that they’re only human and can make mistake. When this happens, it is normal that they should seek the advice and help of their fellow colleagues or refer the patient to a specialist for a second opinion.

The other common issue I see is criticism from a dentist on the work of another. It is one of the worst things you can do to another professional.

For example, Dentist A faces an issue in solving his/her patient’s problem and that patient have to visit Dentist B for further treatment. Dentist B should not criticise the work of Dentist A in front of the patient. You may disagree with his/her methods but criticism will not help. You’re taught to help out when there’s a problem but if you’re raising the alarm on another person’s work, you’re creating disrepute and trouble for your fellow colleagues. The best course of action is to collaborate, not criticise. A lot of the complaints we received come about because of this.

What is your view on the disciplinary problem with the number of dentists growing rapidly? I think in the training of a dentist more emphasis must be put into the aspects of ethics and jurisprudence so that the new dentists are aware of the problems they will be facing when they come out to practise.

What is your advice to dentists and what do you hope to see in the future with regards to the dental profession? Currently, the standard of the dental practice is good and at par with most advanced countries. The authorities concerned have put into place a very comprehensive programme with regards to the training and practice of dentistry, which augurs well for the country. However, it is imperative that the standard and teaching of dentistry must be maintained or enhanced at all times both for the benefit of the dental practitioners and their patients.

My personal view is that the dental profession is heading in the right direction. The future of dentistry is bright. I commend what the Malaysian Dental Council and MDA are doing. Having said that, I believe when you get the right people to spearhead the initiatives and set the standards of the practice, it will bring confidence to the profession and trade. This in turn will benefit everyone.

April-June 2016

23Cleft Lip and Palate Management: It’s A Team Work!

Report written by: Dr. Khairul Bariah Chi Adam,Lecturer, Oral & Maxillofacial Surgery Unit, Kulliyyah of Dentistry, International Islamic University Malaysia.

A child born with a cleft requires coordinated care from a range of clinical specialists over many years. The defect involves a variety of functions

including mastication, speech, hearing, and social interaction. Therefore, it is difficult for one clinician to deal with all its aspects and make all the best decisions for the child. For this reason, a multidisciplinary team approach is highly recommended. The team approach treatment was developed in the 1930's in response to the 1933 Social Security Act in the Western countries (Sandy et al., 1998, Tulley, 1971).

The main functions of teamwork:i) Various members of the team facilitate each

other's efforts in the treatment of the condition.

ii) It provides a mechanism for referral and records all the treatment carried out on the patient.

iii.) In the combined clinical meetings and combined consultation, the set-up provides an opportunity for the new parents with cleft babies to meet not only the professional team members, but also other members and association such as CLAPAM (Cleft Lip And Palate Association Malaysia) for advice, counselling and exchange of views and ideas.

The question is, how significant is our role in the cleft lip and palate management? It is imperative for us to understand that treatment for cleft lip and palate requires teams of dentists and physicians intensely focused on treatment and rehabilitations. Issues of basic orofacial functions of mastication, respiration and communication are focused on other than patient’s self-esteem and image. The Oral & Maxillofacial Surgeons provides surgical consultation, educational and emotional support for the family. A clear picture must be painted of the treatment that the patient will undergo over the next two decades.

MDA News

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Meanwhile, the rehabilitation and maintenance of the dentition at the early stage is also important. It is crucial that the primary teeth and permanent teeth remain sound, with good oral hygiene. Loss of primary teeth may complicate and prolong future orthodontic treatment. Loss of permanent teeth may mean the outcome of treatment will be compromised. On top of that, it was also reported, almost all cleft lip and palate children will have dental anomalies which may include missing permanent teeth, supernumerary and/or supplemental teeth, teeth of abnormal morphology, hypoplastic teeth, delayed or abnormal eruption and malocclusion. Therefore, Paediatric Dentist as well as general dental practitioner takes the responsibility of educating the parents and patients on oral hygiene, diet counselling and early provision of restorative treatment.

The parents of a cleft child should be advised on:

• dailycleaningofthechild’steeth

• nottosleepwithabottleinthechild’smouth– this habit can result a condition known as “Nursing Bottle Decay”.

For this reason, a multidisciplinary team approach is highly recommended.

April-June 2016

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References:i. Akcam, M. O., Evirgen, S., Uslu, O. & Memikoglu, U. T. 2010. Dental

Anomalies In Individuals With Cleft Lip And/Or Palate. Eur J Orthod, 32, 207-13.

ii. Arctander, K., Kolbenstvedt, A., Aalokken, T. M., Abyholm, F. & Froslie, K. F. 2005. Computed Tomography Of Alveolar Bone Grafts 20 Years After Repair Of Unilateral Cleft Lip And Palate. Scand J Plast Reconstr Surg Hand Surg, 39, 11-4.

iii. Asher-Mcdade, C. & Shaw, W. C. 1990. Current Cleft Lip And Palate Management In The United Kingdom. Br J Plast Surg, 43, 318-21.

iv. Atack, N., Hathorn, I., Mars, M. & Sandy, J. 1997. Study Models Of 5 Year Old Children As Predictors Of Surgical Outcome In Unilateral Cleft Lip And Palate. Eur J Orthod, 19, 165-70.

v. Baek, S. H. & Kim, N. Y. 2007. Congenital Missing Permanent Teeth In Korean Unilateral Cleft Lip And Alveolus And Unilateral Cleft Lip And Palate Patients. Angle Orthod, 77, 88-93.

vi. Bardach, J., Morris, H. L., Olin, W. H., Gray, S. D., Jones, D. L., Kelly, K. M., Shaw, W. C. & Semb, G. 1992. Results Of Multidisciplinary Management Of Bilateral Cleft Lip And Palate At The Iowa Cleft Palate Center. Plast Reconstr Surg, 89, 419-32; Discussion 433-5.

vii. Becker, M. & Svensson, H. 1998. Morphometry In Digital Photographs: A Promising Technique For Assessing Patients With Cleft Lip And Palate. Scand J Plast Reconstr Surg Hand Surg, 32, 295-9.

viii. Brunnegard, K., Lohmander, A. & Van Doorn, J. 2009. Untrained Listeners' Ratings Of Speech Disorders In A Group With Cleft Palate: A Comparison With Speech And Language Pathologists' Ratings. Int J Lang Commun Disord, 44, 656-74.

xi. Chan, K. T., Hayes, C., Shusterman, S., Mulliken, J. B. & Will, L. A. 2003. The Effects Of Active Infant Orthopedics On Occlusal Relationships In Unilateral Complete Cleft Lip And Palate. Cleft Palate Craniofac J, 40, 511-7.

x. Chmait, R., Pretorius, D., Moore, T., Hull, A., James, G., Nelson, T. & Jones, M. 2006. Prenatal Detection Of Associated Anomalies In Fetuses Diagnosed With Cleft Lip With Or Without Cleft Palate In Utero. Ultrasound Obstet Gynecol, 27, 173-6.

xi. Clarren, S. K., Anderson, B. & Wolf, L. S. 1987. Feeding Infants With Cleft Lip, Cleft Palate, Or Cleft Lip And Palate. Cleft Palate J, 24, 244-9.

xii. Cockell, A. & Lees, M. 2000. Prenatal Diagnosis And Management Of Orofacial Clefts. Prenat Diagn, 20, 149-51.

xii. Cohen, S. R., Kalinowski, J., Larossa, D. & Randall, P. 1991. Cleft Palate Fistulas: A Multivariate Statistical Analysis Of Prevalence, Etiology, And Surgical Management. Plast Reconstr Surg, 87, 1041-7.

xiii. Dames, F., Maier, A., Schutzenberger, A., Stelzle, F., Holst, A., Noth, E., Eysholdt, U. & Schuster, M. 2009. [Intelligibility Of Children With Bilateral And Unilateral Cleft Lip And Palate]. Laryngorhinootologie, 88, 723-8.

xv. De Ladeira, P. R. & Alonso, N. 2012. Protocols In Cleft Lip And Palate Treatment: Systematic Review. Plast Surg Int, 2012, 562892.

• Correctusageofsoother.Ifasoother/dummyisused, it must NOT be dipped in sugar, honey or anything sweet as this can also cause extensive dental decay.

• Snacksanddrinkstakenin-betweenmealsshould NOT contain sugar. Milk, water, fruit, cheese, toast are some examples of sugar-free snack foods.

• Regulardentalvisitwiththefirstvisitataboutthefirst birthday.

The next essential age for the surgical intervention is at the age of 6 to 12 years. Lateral cephalometric as well as routine radiographic assessment is done with clinical examination to assess bony and soft tissue defects. If indicated, orthodontics treatment will be done to expand the arch of the maxilla. Cleft alveolar is usually closed

between ages six and nine. A bone graft is placed in the alveolus to improve the arch form and establish an intact dental arch. This would also allow eruption of the canine which is frequently displaced in the cleft region. Alveolar fistula is also corrected at this stage. The presence of a permanent lateral incisor and the state of cuspid development determine the timing for this step. This is followed by active therapy by the Orthodontist. Cleft patient then, would require restorative treatment for missing teeth or other dental anomalies from Restorative specialist, Prosthodontist as well as general dental practitioners.

In summary, dental practitioners need to be more active in the management of cleft patients because we play a significant role in the cleft team in terms of patient’s wellbeing and development. Cleft management requires teamwork, and we are a significant part of this team.

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April-June 2016

27Centric Relation As We Know It

Report written by: Dr. Yeoh Oon Take. BDS (Malaya) Trainee Lecturer, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya. Currently, Postgraduate, Doctor of Clinical Dentistry (Prosthodontics), Melbourne Dental School, T he University of Melbourne, Australia

Centric Relation (CR), one of the most controversial topic in dentistry is still in debate. The topic sparked around early of the 20th century and until

today, it is still being discussed although not as much as it was in the earlier days (Keshvad and Winstanley, 2000a, Keshvad and Winstanley, 2000b, Wilson and Banerjee, 2004, Jasinevicius et al., 2000). Overall, there was no consensus on the CR definition that was taught in schools all over the world.

The complexity of this topic is well illustrated by the fact that there are more than 40 different definitions that have been proposed by the authors in the literatures, which shall be discussed later (Schweitzer, 1969). However, there was a distinct trend in describing the definition of centric relation. Prior to 1980’s, there was a belief that centric relation record must occurred when the condylar heads were in retruded position, and it is now being considered as a misnomer and impossible to happen in physiological temporomandibular joint placement (Gilboe, 1983). Subsequently, the registration techniques that were proposed later tend to record the superior position of condyle and the emphasis was no longer on the posterior or retruded placement of condyles (Keshvad and Winstanley, 2000a).

The techniques for registration consist of two major categories: patient-guided recording and operator-guided recording (Wilson and

MDA News

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Banerjee, 2004). Each of these two categories comprise a few different techniques and some have been proven to be better and more predictable than another.

Another aspect that is inseparable from centric relation is the occlusion. Although centric relation is referred to the maxillomandibular relationship, its position can be affected by the dentition. Hence, different terms have been used to refer to the state of occlusion that occur at different point of jaw relationship.

Before the definition is discussed, one shall be aware of the synonyms that are used to refer to centric relation (Keshvad and Winstanley, 2000a, Keshvad and Winstanley, 2000b, Becker et al., 2000):

• Retrudedcontactposition

• Rearmost Uppermost Midmost (RUM) position

• Median retruded relation

• Posterior border closure

• Relaxed closure

• Bracing position

• Hinge position

• Ligamentous position

• Terminal hinge position

• Retruded axis position

The first two terms are most probably the more commonly used terms besides the term centric relation. However, with a better understanding of the anatomical structure of temporomandibular joint, it was thought that the physiological position, i.e. centric relation should happen when the articular surface of condyle is at the anterior position and contact the posterior slope of the articular eminence (Gilboe, 1983).

Thus, one should avoid the use of the term which contain the word retruded which is misleading. The definition in the Glossary of Prosthodontic (GPT) term has also changed the definition to “the maxillomandibular relationship in which the condyles articulate with the thinnest avascular portion of their respective disks with the complex in the anterior-superior position against the shapes of the

Bilaminar zone

Posterior band

Intermediate/central bearing area

Anterior band

April-June 2016

29

References:i. Becker, C. M., Kaiser, D. A. & Schwalm, C. 2000. Mandibular

Centricity: Centric Relation. J Prosthet Dent, 83, 158-60.

ii. Celenza, F. V. 1973. The Centric Position: Replacement And Character. J Prosthet Dent, 30, 591-8.

iii. Gilboe, D. B. 1983. Centric Relation As The Treatment Position. J Prosthet Dent, 50, 685-9.

iv. Gpt 2005. The Glossary Of Prosthodontic Terms. The Journal Of Prosthetic Dentistry, 94, 10-92.

v. Hanau, R. H. 1929. Occlusal Changes In Centric Relation. Journal Of The American Dental Association, 16, 1903.

vi. Jasinevicius, T. R., Yellowitz, J. A., Vaughan, G. G., Brooks, E. S., Baughan, L. W., Cline, N. & Theiss, L. B. 2000. Centric Relation Definitions Taught In 7 Dental Schools: Results Of Faculty And Student Surveys. J Prosthodont, 9, 87-94.

vii. Keshvad, A. & Winstanley, R. B. 2000A. An Appraisal Of The Literature On Centric Relation. Part I. J Oral Rehabil, 27, 823-33.

viii. Keshvad, A. & Winstanley, R. B. 2000B. An Appraisal Of The Literature On Centric Relation. Part Ii. J Oral Rehabil, 27, 1013-23.

xi. Niswonger, M. F. 1934. The Rest Position Of The Mandible And Centric Relation. J Am Dent Assoc, 21, 11.

x. Posselt, U. 1952. Tudies In The Mobility Of The Human Mandible. Acta Odontol Scand, 10, 19.

xi. Schweitzer, J. M. 1969. Dental Occlusion: A Pragmatic Approach. Dent Clin North Am, 13, 687-724.

xii. Schuyler, C. H. 1969. Freedom In Centric. Dent Clin North Am, 13, 681-6.

xiii. Wilson, P. H. & Banerjee, A. 2004. Recording The Retruded Contact Position: A Review Of Clinical Techniques. Br Dent J, 196, 395-402; Quiz 426.

articular eminences” since the fifth edition which was published in 1987 (GPT, 2005, Keshvad and Winstanley, 2000a). Having said that, the latest GPT also included six other definitions for CR. It is worth noting that among the definitions that were given after 1987, one emphasised on the anterior uppermost placement of the condyle while the other suggested most superior placement and against the distal slope of the articular eminence, which in essential means anterior placement (so that it can contact the distal slope).

The earliest definition for CR that appeared in the literature probably was the one given by Hanau that states “the position of the mandible in which the condylar heads are resting upon the menisci in the sockets of the glenoid fossa, regardless of the opening of the jaws” (Hanau, 1929). There are other simpler definitions such as patient can clench their back teeth (Niswonger, 1934). Regardless of what the definition was, most would tend to include the words rear, retruded or posterior in their definition (Keshvad and Winstanley, 2000a, Keshvad and Winstanley, 2000b).

Gilboe expressed his concern about how people tend to ignore the intra-articular structure (condylar disc) and only defined CR based on the condyle-fossa spatial relationship (Gilboe, 1983). He commented that it was probably due to the limitation of X-ray in detecting the non-osseous intra-articular tissue and often the soft tissue were missing in dry skull. Gilboe further divided the intra-articular tissue into four zones: anterior band, posterior band, central bearing area and bilaminar zone (Figure 1). The posterior band is the part that is rich vascular and nerve tissue and thus would not be able to withstand compressive force. Otherwise, pain and inflammation would develop. On the other hand, the central bearing area is an avascular zone and only consist of dense collagen fibrils. This makes the central zone an ideal structure to receive load.

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April-June 2016

31

EXTRA PRE-CONGRESS EVENT: 17/07/2016 (Sunday) Endodontic Double Bonus Day (Lecture FOC for MIDEC Delegates) Bali Ungku Aziz, University of Malaya (UM)

PRE-CONGRESS EVENT: 28/07/2016 (Thursday) Soft Tissue Graft & Implant Live Surgery & Hands-on Workshop MAHSA University | 0900 - 1700 Dr. Eric Van Dooren & Dr. Gustavo Giordani

Orthodontic Masterclass: The importance of early orthodontic treatment in the mixed dentition period PWTC | 0900 - 1700 Dr. Loh Kai Woh

3rd MIDEC 2016 Preliminary Scientific Programme

0830-1030

Registration

0900-1030

Endodontic Lecture: Design The Ideal Treatment Plan: Approach & Instruments

Dr. Marco Martignoni

1030-1100

Morning Tea Break

1100-1230

Endodontic Lecture: Post-treatment Endodontic Disease

& Root Canal Retreatment - Biological and Clinical Science

Prof Dr. Paul Dummer

1230-1330

Lunch Break

1330-1700

Endodontic: Microscope & Access Limited Attendance Hands-on Workshops (UM Optech Lab) Prof Dr. Paul Dummer

1330-1700

Endodontic: Reciprocating File: Shape The Canal with One Instrument

Limited Attendance Hands-on Workshops (UM Oral Biology Lab) Dr. Marco Martignoni

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Endodontic Workshop: Effective Instrumentation, Irrigation & 3D Obturation PWTC | 0900 - 1700 Prof Dr. Gianluca Gambarini Soft Tissue & Implant Masterclass PWTC | 1400 - 1700 Dr. Gustavo Giordani

New Ceramic Powder with Oxyapatite (Hands-On for Dental Technicians) OWTC | 0900 - 1700 Hilal Kuday

Dewan Tun Dr Ismail (Hall 1) Dewan Tun Hussein Onn (Hall 2)

TIME TOPIC AND SPEAKER TIME TOPIC AND SPEAKER

0900-1030

New Opportunities for Enhancement

in the Esthetic Zone 1

Dr. Eric Van Dooren & Dr. Gustavo Giordani

0900-1030

Prosthetic Rehabilitation of Oral

Cancer Patients Dr. Pravinkumar G. Patil

1030-1100

Tea Break1030-1100

Tea Break

1100-1230

New Opportunities for Enhancement

in the Esthetic Zone 2 Dr. Eric Van Dooren & Dr. Gustavo Giordani

1100-1230

TBC (Oral Surgery)

Dr. Edwin Heng

1230-1430

Lunch Break1230-1430

Lunch Break

1430-1630

Orthodontic Mishaps -

Causes & Possible Solutions

Dr. Loh Kai Woh

1430-1530

Peri-implantitis: Long Term Clinical

Results of Regenerative Therapy &

Preventions

Dr. Cheol Woong Jeong

1530-1630

Tips & Tricks in Daily Prosthodontics

Prof Dr. Seow Liang Lin

1630-1700

Tea Break1630-1700

Tea Break

DAY 1: 29/07/2016 (Friday)

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Oral Presentation Venue TBA | Morning Session

Hands-on Workshop: Tooth Prep in Non-ideal Situation UKM | 0900 - 1 Dr. Aqeel Saijad Reshamvala

Poster Presentation Dewan Tun Razak 3, PWTC

Dewan Tun Dr Ismail (Hall 1) Dewan Tun Hussein Onn (Hall 2)

TIME TOPIC AND SPEAKER TIMETOPIC AND SPEAKER

Dental Technologists Symposium cum Allied Health Symposium

0800-0930

Clinical Management of Curved

Canals : A Novel 3D Approach to the

Endodontic Therapy

Prof Dr. Gianluca Gambarini

0800-0845

Digital Imaging for Dental Auxiliaries

Dr. Steven Phun Tzy Chien

0845-0930

Dental Photography for Dental

Auxiliaries Dr. Abu Razali bin Saini

0930-1000

Tea Break0930-1000

Tea Break

1000-1130

Occlusal Concept in Full Mouth

Rehabilitation

Dr. Andy Lo Shih-Chieh

1000-1130

Lithium Disilicate Glass Ceramics:

Shades & Ingots Selection for Ideal

Integrations & maximum Aesthetic

Results

Hilal Kuday, CDT

1130-1230

Opening Ceremony Opening Ceremony

1230-1430

Lunch Break1230-1430

Lunch Break

1430-1630

All Ceramic Restorations

Dr. Marko Jakovac

1430-1530

The Regulation of Dental Auxiliaries

and Its Impact on Dentistry

Speaker from MDC

1530-1630

Digital Solution for Today & Tomorrow

& Understanding Materials Optimised

for Digital Dentistry

Hilal Kuday, CDT

1630-1700

Tea Break1630-1700

Tea Break

DAY 2: 30/07/2016 (Saturday)

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Hands-on Workshop: Indirect Restorations (preps, impressions, wax up-mock up, treatment planning) PWTC | 0900 - 1800 Dr. Marko Jakovac

POST-CONGRESS EVENT: 1/8/2016 (Monday) Hands-On Workshop: Endodontic and Post-endodontic Direct Restoration UKM | 0900 - 1300 A/Prof Dr. Patrick Tseng

Hands-On Workshop: The New Concept of Alignment, Bonding and Bleaching (Inman Aligners) PWTC | 0900 - 1600 Dr. Gun Norell

Dewan Tun Dr Ismail (Hall 1) Dewan Tun Hussein Onn (Hall 2)

TIME TOPIC AND SPEAKER TIME TOPIC AND SPEAKER

0900-1030

The Biggest Dilemma: How to Choose

The Right Techniques and Materials in

Restorative Dentistry

Dr. Aqeel Sajjad Reshamvala

0900-0945

Computer Guided Orthognathic

Surgery

Dr. Shamsul Anuar Ahmad

0945-1030

Guidelines for Advertising and

Promotion Speaker from MDC

1030-1100

Tea Break1030-1100

Tea Break

1100-1230

Conservative, Conventional &

Unconventional Endodontics

A/Prof Dr. Patrick Tseng

1100-1230

Dental Photography

Dr. Joan Lim

1230-1430

Lunch Break1230-1430

Lunch Break

1430-1630

Complications in Implant Dentistry:

Etiology, Prevention & Management

Dr. Jeanette Chua Keng Ling

1430-1530

Simple, Appropriate, Aesthetic

Orthodontics for General Dentist

Dr. Gun Norell

1630-1700

Tea Break1630-1700

Tea Break

DAY 3: 31/07/2016 (Sunday)

April-June 2016

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