The study of early orthodontic screening and referral practices by dental therapists in Malaysia

In Malaysia, the orthodontic treatment needs of schoolchildren are high. Effective orthodontic treatment delivery depends on timely referrals of cases that have undergone an appropriate screening process. Dental therapists are among the first to identify any malocclusion in Malaysian primary school...

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Bibliographic Details
Main Author: Nie, Lim Yen
Format: Thesis
Language:English
Published: 2024
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Online Access:http://eprints.usm.my/60922/1/LIM%20YEN%20NIE%20-%20FINAL%20THESIS%20%20P-SGM000221%28R%29-E.pdf
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Summary:In Malaysia, the orthodontic treatment needs of schoolchildren are high. Effective orthodontic treatment delivery depends on timely referrals of cases that have undergone an appropriate screening process. Dental therapists are among the first to identify any malocclusion in Malaysian primary schoolchildren. This study aimed to determine the prevalence of early orthodontic screening and referral practices by dental therapists among primary schoolchildren. The association between dental therapists’ referral practice and the training of dental therapists were determined. A cross-sectional study was conducted among 360 dental therapists in Malaysia. The questionnaire tool was adapted from the study of Lim et al. and translated into Malay. The adapted and translated questionnaire was pre-tested. The following variables were gathered using an online self-administered questionnaire: (1) the socio-demographic profile, (2) orthodontic screening and referral practices, (3) training of dental therapists, and (4) views on orthodontic treatment. A stratified random sampling was done. Descriptive analysis and bivariate analysis (Fisher’s Exact Test and Spearman correlation) were conducted on collected data using IBM SPSS (version 26). In addition, SPSS Modeler (version 18.0.0) was used to visually explore the co-occurrence frequency of the variables via the web graphs. This survey obtained a response rate of 97.8% (n=352). The study revealed that less than one-quarter of the dental therapists (22.7%) performed orthodontic screening on all primary schoolchildren, and almost one-third (32.7%) did not routinely do orthodontic screening. The common orthodontic assessment done during the orthodontic screening was overjet (92.8%), the presence of spacing or crowding (92.4%), overbite (86.9%) and the presence of crossbite (78.9%). Almost half of the dental therapists (47.7%) preferred dentists’ advice during screening instead of using guidelines (32.9%). More than half of them (65.6%) referred less than five patients per month, while almost one-quarter (24.1%) did not refer patients. Dental therapists used a variety of referral documents. The average orthodontic referral number is associated with exposure to orthodontic theory, practice and experience with orthodontic diagnosis during their career. In conclusion, this study obtained a high response rate. The orthodontic screening rate of dental therapists in all primary schoolchildren is poor. Variation in referral documents is identified. A standardized referral form from the school to the primary dental clinic is recommended to ensure timely monitoring and treatment of diagnosed cases. Oral health personnel working with schoolchildren are strongly encouraged to use a proforma in orthodontic screening and participate in continuing professional development (CPD).