Khon Kaen University Dental Journal

The Perspective of Village Health Volunteers towards Diabetes Mellitus and Periodontitis: An Explanatory Model

Kiatsuda Wongsriya — 2025-03-24

Objective: Previous studies have described the characteristics and progression of Diabetes Mellitus (DM) and periodontitis. However, these explanations were mainly from the perspective of health personnel, and the perspectives on these diseases among laypeople have not been extensively studied in Thailand. This qualitative study aimed to explore the experiences and meanings of Diabetes and periodontitis through an Explanatory model of Village Health Volunteers (VHVs) in Wangyang Subdistrict, Wangyang, District, Nakhon Phanom.

Materials and Methods: Data were collected through in-depth interviews using the Explanatory model with 5 elements consisting of etiology, time and mode of onset of symptoms, pathophysiology, course of sickness, and treatment. The samples were purposively selected, including 25 VHVs divided into 3 groups: 10 VHVs with DM, 10 VHVs with Periodontitis, and 5 VHVs without either disease. The data collection period was from February 2023 to September 2023.

Results: The results showed that all 3 groups explained DM and periodontitis according to the Explanatory model, summarized into 3 themes: 1) Understanding of DM according to modern medical principles -VHVs explained that DM is a chronic disease caused by genetics and excessive consumption of sweets. Symptoms indicating DM are frequent urination, frequent hunger, and drastic weight loss. 2) Periodontitis is a disease that VHVs are not familiar with -they explained the disease based on their predictions and what they heard people talk about. It is mostly known as “Rummanad”. Most of them do not think they have an oral disease because there is no pain, and they live their lives as usual, without feeling the need for treatment or visiting the dentist regularly. 3) Only some VHVs mentioned the link between DM and periodontitis-for example, VHVs said that DM can cause teeth to loosen and fall out. However, most participants said that both diseases were not related.

Conclusion: In conclusion, most VHVs did not know about periodontitis, and they did not know that periodontitis could affect DM. Therefore, this study suggests further patient-centered interventions to develop knowledge about periodontitis relating to health among VHVs.

Clinical Outcomes of Probiotic Lactobacillus Rhamnosus SD11 Supplementation for Dental Caries Prevention in Young Children: A Randomized Controlled Trial

Natthinee Janwong — 2025-03-24

Objective: The objective of this double-blind randomized controlled trial was to assess the effect of the probiotic L. rhamnosus SD11 on salivary mutans streptococci and lactobacilli counts, and on dental caries in young children. The potential side effects and the persistence of this probiotic were also observed.

Materials and Methods: One hundred children aged 2 to 5 years were allocated into two groups: the probiotic group received milk powder containing 10⁷CFU/g of L. rhamnosus SD11, while the control group received standard milk powder. Three grams of milk powder were provided daily for 3 months. Compliance and side effects were recorded daily. Salivary mutans streptococci and lactobacilli counts were assessed at baseline, 3 months, and 6 months. Dental caries examination was conducted at baseline and at 6 months.

Results: The findings indicated a statistically significant reduction in salivary mutans streptococci in the probiotic group at both 3 and 6 months (p<0.01). However, no significant difference in lactobacilli counts was observed between the two groups. At 6 months, a significantly lower caries progression (p=0.036) was found in the probiotic group (3.48%) compared to the control group (4.55%). Additionally, the presence of the probiotic strain was noted in 11.11% of the children. No adverse effects were reported in either group.

Conclusion: The use of probiotic L. rhamnosus SD11 could be considered an option for reducing caries progression and preventing the occurrence of new cavities in young children.

Comparison of Cyclic Fatigue Resistance of E-Flex Rec and Reciproc® Blue Using Reciprocating Motion in Artificial Canal

Chalermkwan Phuvoravan — 2025-03-24

Objective: This study compared the cyclic fatigue resistance of two types of Nickel-Titanium rotary files: E-Flex Rec and Reciproc^® Blue in reciprocating motion in an artificial canal

Materials and Methods: E-Flex Rec size 25 (Taper 0.06) and Reciproc^® Blue size R25 (Taper 0.08) were rotated in an artificial stainless-steel canal with a 60° curvature and a 5 mm radius of curvature, while maintaining a constant speed. The number of rotations before fracture (NRF) were recorded. Data was statistically analysed with Unpaired T-Test to compare the difference between 2 groups.

Results: Results showed that the mean NRF of E-flex Rec was found to be significantly higher than Reciproc^® Blue (P <0.05).

Conclusion: According to the data, E-Flex Rec, which modified alloy structure by heat treatment process, had higher cyclic fatigue resistance than Reciproc^® Blue when preparing in root canal with severe curvature.

Data Management and Completeness of Dental Data in the 43-File Standard Dataset for Longitudinal Tooth Loss Study Using R Program

Nutnicha Jirachaiprasit — 2025-03-27

Objective: This study aimed to 1) describe the methods of data management and the results of data processing, and 2) analyze the completeness of dental data from the 43-standard dataset files to conduct survival analysis of tooth loss after dental examination.

Materials and Methods: The sample group consisted of individuals utilizing the Universal Health Coverage Scheme who received dental check-ups at Ministry of Public Health-affiliated healthcare units in a southern province during 2019-2021. Dental examination data and dental service information were obtained from the dental health status files and outpatient procedure files. The data were linked through general data files, managed, and analyzed descriptively using the R program.

Results: The study found the following steps for data management: 1) data importation, 2) handling of missing values, 3) filtering the sample group based on inclusion and exclusion criteria, 4) data quality screening by checking data accuracy, 5) removing duplicate data using unique fields, and 6) linking files via hashed national ID numbers. The completeness of the dental health status files revealed that 6,820 records (20.33%) out of 33,553 imported records were complete for individuals who had undergone dental examinations. From the 4,051,350 records imported from the outpatient procedure files, 4,177 records (0.10%) had complete information for those who had undergone a dental examination and received either tooth extraction or other dental services, providing data to analyze tooth loss survival after dental check-ups. In conclusion.

Conclusion: after managing and linking all files, the sample group with complete dental data was sufficient for long-term studies on tooth loss, accounting for 24.56%. The R programming is effective tool for managing electronic dental health records to create a dataset suitable for conducting longitudinal studies on tooth loss.

Completeness of Dental Data in Health Data Center of Community Hospitals in Ratchaburi Province

Nattanich Saleewan — 2025-03-27

Objective: Dental data, according to the indicators used to monitor operations in Ratchaburi Province and stored in the Health Data Center, revealed discrepancies between the reported performance data and the actual situation. This mixed-method research aimed to assess the completeness of dental data and explain factors that may be related to the dental data imported into the Health Data Center according to the standard structure of health data.

Materials and Methods: The sample consisted of data from the dental files of outpatient departments in four community hospitals in Ratchaburi Province for the fiscal year 2022, totalling 50,345 records. The percentage of data completeness was assessed in both column and row dimensions using Python 3.11. Subsequently, factors potentially related to the completeness of the dental data were collected through observation and in-depth interviews with five relevant personnel at each hospital, followed by content analysis.

Results: After structuring, the data consisted of 11,685 records. In each hospital, column completeness for various oral health examination data fields during dental visits ranged from 11.6% to 96.3%. However, the data field for denture necessity had the lowest completeness in all hospitals, ranging from 0.3% to 93.0%. Row completeness for dental visits ranged from 0.3% to 93.0%. When comparing by age group, it was found that in two hospitals, row completeness for the 0-12 years’ age group was 45.4% and 56.2%, respectively, which differed from other age groups, where row completeness was 5.0% and 1.3%. Column completeness for individual cases ranged from 0.8% to 98.3%, while row completeness for individual cases ranged from 0.8% to 94.3%. Factors potentially related to the varying completeness of dental data across hospitals included data needs and utilization, monitoring indicators, data recording guidelines, initial settings, and the user interface of the data recording program.

Conclusion: The completeness in summary, the completeness of oral health examination data varies across hospitals. Data for the child age group is more complete than that of other age groups, and coding for denture necessity is the least complete. Improving the related factors may enhance the overall completeness of the data.

A Comparison of Indices for Evaluating Dental Arch Relationships of The Primary Dentition in Patients with Unilateral Cleft Lip and Palate

Krispijyakorn Sangharn — 2025-03-28

Objectives: To evaluate the validity and correlation of indices used for assessing dental arch relationships in 5-year-old children with complete unilateral cleft lip and palate (UCLP) compared to a gold standard index.

Materials and methods: The study included 63 UCLP patients who underwent primary surgery at Srinagarind Hospital between January 1997 and December 2023 and had 3D dental models available at ages 4 to 6 years. Dental arch relationships were assessed by two examiners using the 5-Year-Olds’ index, GOSLON Yardstick, Modified 5-Year-Olds’ index, and Modified Huddart/Bodenham index. The reliability, validity, and correlation of each index were then evaluated and compared to the standard 5-Year-Olds’ index.

Results: Intra- and inter-examiner reliability for all indices were high (ICC > 0.90). The Modified 5-Year-Olds’ index demonstrated the highest concurrent validity compared to the 5-Year-Olds’ index (Lin’s Concordance correlation coefficients = 0.90 and weighted kappa statistic = 0.83). The correlation between the Modified 5-Year-Olds’ index and the 5-Year-Olds’ index was the highest and in the same direction (Spearman's rank correlation coefficient = 0.90).

Conclusion: The Modified 5-Year-Olds’ index has been validated as an alternative index for assessing dental arch relationships in 5-year-old children with UCLP.

Household Pattern, Elderly Role, Oral Health Status and Dental Service Utilization of Elderly in Wiang-Nong-Long District, Lamphun Province

Kanchana Saeyub — 2025-04-08

Objective: This cross-sectional descriptive study aimed to examine household patterns and the roles of the elderly, and to compare differences in oral health status and dental service utilization among them. The sample consisted of 354 elderly individuals aged over 60 years old from Wiang-Nong-Long district, Lamphun province.

Materials and Methods: Participants were selected using proportional and systematic sampling method. The questionnaire was developed by the researcher and included 1) households patterns, categorized by the types of family members; 2) the role of the elderly, determined by the activities on which they spent most of their time within a week during the last 6 months; 3) oral health status, including number of decayed, filled and missing teeth (DMFT), periodontal disease, the number of teeth and occluding pairs; and 4) dental service utilization in the past 12 months. Data were collected by three trained dental nurses who achieved inter-rater reliability with a kappa score of 0.82.

Results: The mean age of sample was 68.63±5.43, and 57.9% were female. Of the sample, 24.5% of elderly lived with working-age individuals, 18.7% lived alone, 28.6% belonged to families composed solely of elderly members, and 28.2% lived with children aged <15 years, with 44.4% of them were the carer. The lowest percentage of dental service utilization (15%), the highest caries prevalence (71.9%), a higher mean DMFT (14.12±8.04) and a higher prevalence of periodontal disease (32.3%) were found among the elderly living with children compared to those living in other family patterns, with statistically significance (p<0.001).

Conclusion: This study found differences in dental service utilization and oral health status among elderly based on family patterns. Therefore, these factors should be considered when designing dental service delivery systems to increase access and utilization.

Clinical Outcome of Implant Placement with Xenograft Augmentation

Nichapa Varraveethrachodt — 2025-04-08

Objective: Exposed implant threads with good primary stability are common condition in implant dentistry practice. This issue is usually corrected with various types of bone substitutes, including xenografts. However, many complications, such as graft displacement and foreign body reaction, have been reported. The objective of the study was to evaluate clinical and radiographic outcomes, as well as the patient-reported outcome measures (PROM) of patients receiving implant placement with xenograft augmentation.

Materials and Methods: The patients who received implant placement with xenograft augmentation at Dental Implant Clinic, Faculty of Dentistry, Bangkokthonburi University, over 6 to 12-month period were included in this study. Clinical examinations were performed and PROM Functional and Esthetic Questionnaires were used to evaluate the clinical outcomes. Cone beam CT was also used to evaluate surrounding bone volume three-dimensionally. The percentage of bone gain was calculated using adjacent tooth’s cemento-enamel junction as reference point. Descriptive statistics were used to demonstrate all data.

Results: For the results, from clinical evaluation, all 36 implants in 18 patients were clinically successful with no mobility, symptom or history of infection. From PROM evaluation, 94.4% of patient could intake regular food, whereas 33.3% had problems about food impaction. All of patients were satisfied in the esthetic outcomes. Radiographic evaluation showed that the percentages of bone gain at the buccal, mesial and distal aspects were 45.4 ± 17.6%, 37.4 ± 19.5% and 35.9 ± 16.4%, respectively.

Conclusion: For conclusion, during the short follow-up period, good clinical, PROM and radiographic outcomes were achieved with implant placement combined with xenograft augmentation. The results are consistent with previous short-term studies. Compared with other bone substitutes, xenografts have low turn-over rate property which lead to stable bone levels, as well as good functional and esthetic outcomes. However, long-term follow up is suggested in this group of patients.

Determinants Affecting Job Embeddedness Among Generation Y Dentists Working in Provincial Health Office in Thailand

Krittanun Bubpachune — 2025-04-08

Objective: 1) to evaluate job embeddedness and 2) to explain the determinants affecting job embeddedness among Generation Y dentists working in Provincial Health Offices (PHOs).

Materials and Methods: This study used a mixed-methods sequential explanatory design. Quantitative data was collected through questionnaires distributed to 83 Generation Y dentists in PHOs, with Cronbach's Alpha ranging between 0.797 and 0.949, and qualitative in-depth interviews were conducted with 10 selected questionnaire respondents. Data were collected from August to October 2023 and analyzed using descriptive statistics and content analysis.

Results: The findings showed that (1) job embeddedness among Generation Y dentists in PHOs was high across all dimensions, average scores range from 2.73 to 3.07, exceeding 2.51 on a 4-point Likert scale. (2) The five main determinants influencing job embeddedness is: 1) community factors 2) colleagues within the same generation 3) leader-member exchanges 4) work patterns, particularly in clinical dentistry and 5) Compensation and benefits differ from those in the hospital.

Conclusion: The determinants affecting job embeddedness among Generation Y dentists working in PHOs involve community, Job attributes, and organizational benefits. Organizations can use this research to establish standard operating procedures and promote modern incentive measures for the upcoming era, enhancing job embeddedness and enabling new-generation dentists to work effectively and happily.

The Effect of Disclosing Agent Color Stained on Removable Complete Denture Effect on Perception Among Older People with Visual Impairment

Patawee Sareebot — 2025-04-09

Objective: This study aimed to investigate how different colors of disclosing agents affect the perception of removable complete dentures in older people with visual impairment.

Materials and Methods: The removable dentures were used to create an artificial plaque on both the tissue surface and the artificial tooth side. The red color group (Erythrosin), green color group (Fast green FCF), and blue color group (Brilliant blue FCF) stains were compared to a control group that did not undergo plaque staining. The sample size of this study was 10 older people with visual impairment.

Results: When compared to the control group, there was a statistically significant difference (P<0.05) in the green and blue group plaques' visibility.

Conclusion: A green or blue color group of disclosing agents was recommended for staining on removable complete dentures. As a result of a color group that help older people, it enables individuals with visual impairments to see more clearly and allows for more efficient cleaning of removable complete dentures.