“the impacts of

periodontitis; the tissue

damage that results from

the chronic inflammation

in the periodontal tis-

sues is largely irreversi-

ble. Being typically pain-

less, it may remain unno-

ticed for many years un-

less the patient is seen

by a dental healthcare

professional.”

In This Issue

Good Periodontal

Health for Better Qual-

ity of Life

MSP Road show Se-

ries—JB, T-ganu

58th Spring Meeting

of Japanese Soc of

Perodontlogy

Oral health means much more than healthy teeth. World-

wide, periodontitis is a very common condition. Locally, NOHSA

2010 found the amount of severe peri-odontitis has actually in-

creased by more than 3-fold (18.2%) over the past ten years.1 The

reasons for this are probably, to some degree, due to fewer dental

extractions, but also due to an increas-ingly ageing population, with

more complicated medical histories. Malaysia is en route to becom-

ing an ageing population country by 2030, when 15% of its popula-

tion are those aged 60 years and above. 2

There is generally a better understanding of the impacts of

periodontitis; the tissue damage that results from the chronic in-

flammation in the periodontal tissues is largely irreversible. Being

typically painless, it may remain unnoticed for many years unless

the patient is seen by a dental healthcare professional.

Volume 2 Issue 2 http://periodontologymalaysia.weebly.com/ April-July 2015

The con-sequences of periodontitis, such as gingival bleed-

ing, compromised aesthetics, recurrent periodontal infections, tooth

mobility and tooth loss, may all contribute to negative impacts on dai-

ly living and quality of life, with implica-tions for function, comfort, self

esteem, social interactions and food choices. Cont in page 3

The Evening Lecture Series in Johor was held at the Thiste

Hotel JB on Sunday the 19th of April 2015. The theme for the

lecture was “Updates in Periodontics

The organizing committee for the event comprised of

staff from the Periodontial unit of KP Mahmoodiah, Johor

Bahru lead by Dr Chan Yoong Kian.

The lectures were delivered by Dr. Saliana bt A.Aziz

(Periodontal Unit Klinik Pergigian, Klinik Kesihatan Batu Pa-

hat) , Dr. Ma Bee Chai (Oral Surgery Department, Hospital

Sultanah Aminah,Johor Bahru), Dr. Arlene Khaw Bee Hong

and Dr Chan Yoong Kian (Periodontal Unit, Klinik Pergigian,

Klinik Kesihatan Mahmoodiah).

Registration of participants started at 12.30p.m followed

by a sumptuous buffet lunch. There were 28 participants,

comprising of government dental officers, private general

dental practitioners and post-basic dental nurses.

Lectures started at 2.00 pm with Dr. Saliana from Perio-

dontal Unit KP Batu Pahat speaking on Detecting periodon-

tal disease. She highlighted the increase in prevalence

of periodontal disease as reported in the 2010 NOHSA re-

sults and the use of Basic Periodontal Examination (BPE) as

a screening tool for detecting disease. The lecture also

touched on current concepts on risk factors for managing

patients with periodontal disease.

The second lecture Medication-related osteonecrosis of the

jaw – a new clinical dilemma was presented by Dr. Ma Bee

Chai. In this interesting and informative lecture, Dr.Ma gave a

summary of MRONJ, its clinical presentation and staging, various

medication involved and elaborated on the new AAOMS guide-

lines 2014 on MRONJ. Dr Chan gave a short summary of perio-

dontal considerations in MRONJ at the end of the presentation.

Dr. Arlene from Periodontal unit KP MAhmoodiah presented

the 3rd lecture on Management of concurrent endodontic and

periodontal diseases. She emphasized on the importance of

diagnosing and establishing whether the concurrent endodontic

and periodontal diseases are in communication or not. She elab-

orated on the different management of each category of the con-

dition. The afternoon ended with a lively Q & A session at about

5.00 pm. Dr.Chan Yoon Kian

The speakers of the day—Dr.Saliana (upper left), Dr.Ma (centre) and Dr. Arlene ( right)

MSP Roadshow Series ; JOHOR BHARU

The president of the 58th Spring Meeting of the Japanese

Society of Periodontology (JSP) has kindly invited a

representative from The Malaysian Society of Periodontology

to participate as speaker in an International Oral Session of the

meeting at Makuhari Messe International Conference Halls,

Makuhari Chiba Japan.The meeting which was held on May 14

to 16th, 2015 was represented by Dr Badiah Baharin from

Periodontology Department, Faculty of Dentistry, Universiti

Kebangsaan Malaysia alongside with 3 other international

speakers from Laos, Korea and Indonesia. Dr Badiah Baharin

has shared her research finding with the title of Gelam

(Melaleuca Cajaputi) Honey: Potential Malaysian honey in

reducing inflammatory mediator and preventing bone loss in

induced periodontitis rats. Sharing of various cellular and

molecular based research findings in Periodontology during

this session has received positive response by the Japanese

participants through active participation during question and

answer session.

The Japanese Society of Periodontology was establised in

1957 with a total of 9718 members which comprised of

dentists, dental hygienist, dental technicians and others. Every

year two meetings are held during Spring and Autumn which

the society opens an invitation to international speakers from

Asian countries to share their research work in the field of

Periodontology. The meeting also gave great oppurtunity to

meet the president of American Academy of Periodontology

(AAP) who is Dr Joan Otomo Corgel whom JSP has

collaboration with AAP in many of the society’s activities. The

society has also an international relationship with Korean

Academy of Periodontology, Chinese Academy of

Periodontology and Asian Pacific Society of Periodontology.

The president of JSP is looking forward to establishing

international collaboration with Malaysian Society of

Periodotology in near future. Dr. Badiah Baharin

Dr Badiah with Indonesian and Korean speakers

Dr Badiah presenting her

research finding

Smoking is the princi-pal environmental risk factor for periodonti-tis. It has been esti­mated that over 50% of all cases of chronic periodontitis can be attributed to cigarette smoking. The Global Adult Tobacco Survey (GATS) indicated that more than 40% of Malaysian men smoke (total of 4.7 million )

There is an independent association between moderate to

severe periodontitis and an increased risk for the develop-

ment or progression of diabetes. Periodontal interventions

may provide beneficial effects on diabetes outcomes in

some patients, so regular comprehensive periodontal eval-

uations should be part of an ongoing diabetes manage-

ment program.

While some studies suggest a modest association be-

tween maternal periodontitis and adverse pregnancy out-

comes, there is currently insufficient evidence that perio-

dontal therapy can be recommended as a means to im-

prove pregnancy outcomes. Periodontal therapy is consid-

ered safe in pregnant women and can result in improved

periodontal health, but dental professionals are urged to

adhere to general obstetric guidelines that suggest elective

procedures should be avoided in the first trimester.

Evidence suggests a relationship between periodontitis

and other systemic diseases, including chronic obstructive

pulmonary disease, pneumonia, chronic kidney disease,

rheumatoid arthritis, cognitive impairment, obesity, meta-

bolic syndrome and cancer. However, additional studies

are needed to better understand these associations

Smoking is the principal environmental risk factor for periodontitis. It has been esti-mated that over 50% of all cases of chronic periodontitis can be attributed to cig-arette smoking. The Global Adult Tobacco Survey (GATS) indicated that more than 40% of Malaysian men smoke (total of 4.7 million adult smokers). Cont. in page 4

periodontal disease, specifically periodon-titis, to other systemic diseases, including diabetes, cardiovascular disease and adverse pregnancy outcomes. The reports also outline clinical recommendations for dental profes-sionals to use when treating patients at risk for, or presenting with, certain medical condi-tions.

6

There is strong epidemiologic evidence that

periodontitis provides an increased risk for

future cardiovascular disease. Dental profes-

sionals should discuss other risk factors for

cardiovascular disease with their patients,

including hypertension, obesity, and tobacco

use. The treatment of periodontitis in patients

with a history of cardiovascular disease

should follow the American Heart Association

guidelines for elective procedures.

Periodontal disease and systemic health

There is enormous evidence that poor oral health, espe-

cially the extent and severity of periodontal disease, in-

crease the risk of a variety of systemic conditions.

Initially, bacteria were thought to be the factor that linked

periodontal disease to other conditions in the body; how-

ever, recent studies demonstrated that inflammation may

be responsible for the association. Thus, treating inflam-

mation may not only help manage periodontal diseases

but may also help with the management of other chronic

inflammatory conditions.

Periodontal disease and diabetes are directly and inde-pendently associated chronic dis-eases of high preva-lence in the population. The National Health and Morbid-ity Survey (NHMS) 2011 has shown that the prevalence of diabetes in Malaysia has increased by 31.0% in the space of just 5 years, from 11.6% in 2006 to 15.2% in 2011, and is projected to rise to 21.6% by 2020.

3

Diabetes is associated with increased risk of periodonti-tis by 2-3 folds. Periodontal disease is known as the 6

th

complication of diabetes, though in well-controlled diabe-tes (HbA1c < 7%) there appears to be less effect. Se-vere periodontitis was noted in contrast, to be associated with increased risk of poor glycaemic control (HbA1c >9.0%) suggesting that periodontitis may compromise diabetes control.

4

Non-sur-gical periodontal treatment in T2 diabetic pa-tients with periodontitis is shown to be beneficial and can improve glycemic control (reduction in HbA1c of approxi-mately 0.4%) for at least 3 months.

5

The American Academy of Periodontology (AAP), in col-laboration with the European Federation of Periodontolo-gy (EFP), recently published a series of consensus re-ports that analyze the scientific evidence linking

Cont. fr page 1

Recommendations

A “silent epidemic” of oral diseases is affecting some popula-tion groups limiting activities in school, work, and home, and often significantly reduces the quality of life. Individuals who are medically compromised are at greater risk for oral diseas-es, and, in turn, oral diseases further jeopardize their health.

7

Good oral hygiene as basis of disease prevention has been advocated by the Prophet SAW as narrated by Abu Hurairah that, said, "If I had not found it hard for my followers or the people, I would have ordered them to clean their teeth with siwak for every salah(prayer)." (Bukhari and Muslim).

MSP Roadshow Series : TERENGGANU

The evening lecture series in Terengganu was held at the Felda Residence Hotel,

Kuala Terengganu on Thursday 21st of May 2015. The theme was “ Periodontics In

General Practice: Current Concepts In Diagnosis And Management.”

The organizing committee for the event comprised of staff from the Periodontic

Units of KlinikPergigianJalan Sultan Mahmud, lead by Dr Hanizah Abdul Aziz.

The lectures were delivered by MSP members, Dr Hanizah Abdul Aziz and Dr

Ayros Asmawati Mohd Ayub from Periodontic Unit Klinik Pergigian Jalan Sultan

Mahmud, Kuala Terengganu.

Registration of participants started as early as 5.30pm. There were 32 paticipants,

comprising of private dental specialist and government dental officer from districts in

Terengganu. Dental supplier from Surgical Solutions (M) Sdn Bhd. This event was sup-

ported by Dental supplier from Surgical Solutions (M) Sdn Bhd, Bumi Saujana Sdn

Bhd, Bumi Tanjung Jaya Sdn Bhd and Galla Dental Sdn Bhd.

Lectures started at 6.00 pm with Dr Ayros Asmawati Mohd Ayub speaking on

Updates In Periodontics Diagnosis And Management. She highlighted the in-

crease in prevalence of periodontal disease as reported in the 2010 NOHSA results

and general dental practitioners play an important role in detection, prevention and

managing periodontal disease. A buffet dinner was served after the first lecture.

The second lecture Acute Periodontal Lesion was presented by Dr Hanizah Abdul

Aziz. She emphasized on the importance of diagnosing and treating the patient early as

these situations may cause rapid destruction of the periodontal tissue. The lecture also

gave an overview of latest and updates on the existing information on these conditions.

The evening ended at about 10.30 pm with Q&A session, photography session with the

participants and speakers, followed by supper.

Dr.Hanizah Abdul Aziz

Cont fr page 3

EDITORIAL BOARD 2/2015 Chief Editor: DR.KHAMIZA Z. ABIDIN Members: DR. NORHANI ABD RANI DR.CHAN YOON KIAN DR. HANIZA ABDUL AZIZ DR.BADIAH BAHARIN periodontologymalaysia.weebly.com

With dentist and physicians working closely to-gether, more patients with systemic diseases are likely to be successfully treated, and benefit from predictable treatment regimes to save and rehabili-tate their dentition. Periodontal treatment is shown to be highly effective in preventing long-term tooth loss and reversing many of the condition's other adverse effects.

Referrences 1. National Oral Health Survey of Adults 2010 (NOHSA 2010) 2. Malaysia to become ageing population country by 2030:http://www.thesundaily.my/news/1357641 3. Feisul MI, Azmi S. (Eds).. National Diabetes Registry Report, Volume 1, 2009-2012. Kuala Lumpur; Ministry of Health

Malaysia; 2013 Jul. 4. Taylor G W, Burt B A, Becker M P et al. Severe periodontitis and risk for poor glycaemic control in patients with non-insulin-

dependent diabetes mel-litus. J Periodontol 1996; 67: 1085–1093 5. Teeuw WJ, Gerdes VE, Loos BG. 2010 Feb. Effect of periodontal treatment on glycemic control of diabetic patients: a

systematic review and meta-analysis. Diabetes Care.;33(2):421-7. 6. New Reports Confirm Perio-Systemic Connection and Outline Clinical Recommendations. https://www.perio.org/ consumer/EFP_AAP_Workshop_Proceeding 7. Oral Health in America: A Report of the Surgeon General-- Executive Summary National Institutes of Health, 2000 Acknowledgement: Dr. Izin Awani Bt. Abd Majid

Dr.Norhani Abd Rani Pakar Perunding Periodontik Gred Khas C

The organizing committe

Dr Hanizah delivering her lecture on Acute Perio-dontal Lesions

Participants at the MSP Evening Lecture Series Terengganu