Community Oral Healthcare
Introduction
The following programmes of Community Oral Healthcare are conducted through population approach or targeting communities or individuals at high-risk.
1) Fluoridation of Public Water Supply Programme
2) School-based Fissure Sealant Programme
3) School-based Fluoride Mouth Rinsing Programme
4) Fluoride Varnish Programme for Toddlers
5) Primary Prevention and Early Detection of Oral Potentially Malignant Disorders and Oral Cancers Programme
6) Community Outreach Programmes
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Fluoridation of Public Water Supply Programme
Fluoridation of public water supplies is recognised by the World Health Organisation (WHO) as an effective community preventive programme to reduce tooth decay and was accepted in Malaysia as a government policy in 1972. Since 2006, between 72-78% of the population benefitted from the water fluoridation programme. The existing, extensive piped water supply, together with the co-operation between the Ministry of Health and various water authorities has contributed significantly towards the success of the programme.The monitoring of fluoride level in the public water supply is conducted by District Dental Officer. Any violations of fluoride level will be notified to the water authority.
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School-based Fissure Sealant Programme
School-Based Fissure Sealant Programme is a clinical preventive programme aimed at preventing dental caries in permanent dentition among schoolchildren. Fissure sealants are materials that are commonly placed on deep pits and fissures of permanent molar teeth in order to prevent the occurence of dental caries. Fissure sealants play an important role in caries prevention because they can protect caries-susceptible pits and fissures that are least protected by fluoride. The School-Based Fissure Sealant Programme was implemented nationwide in 1999. Under this programme, fissure sealants are placed to tooth/teeth with deep fissures in children at risk for caries.
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School-based Fluoride Mouth Rinsing Programme
School-based Fluoride Mouth Rinsing Programme is a means of controlling and preventing dental caries among school children, particularly in fluoride-deficient/non fluoridated areas. Fluoride mouth rinse is a fluoride solution intended for daily or weekly use where the fluoride is retained in dental plaque and saliva to help prevent dental caries. In this programme Year 1 to Year 6 schoolchildren in selected schools would be involved and are required to rinse weekly with 0.2% sodium fluoride solution for one minute, and for maximum benefit each child should rinse at least 40 times per year.
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Fluoride Varnish Programme for Toddlers
Fluoride Varnish application is the only professionally-applied topical fluoride recommended for controlling and preventing dental caries in toddlers. Varnishes are painted on the tooth surface so that progression of early caries lesion is retarded, arrested, or even reversed. For effective caries prevention, four Fluoride Varnish applications are recommended at 6 monthly intervals. Fluoride Varnish programme was introduced for toddlers in order to further strengthen the Early Childhood Oral Healthcare programme. To optimise resources, the Fluoride Varnish programme will focus on high-risk toddlers in the communities. The programme is carried out at identified locations such as child care centres, health clinics and dental clinics.
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Primary Prevention and Early Detection of Oral Potentially Malignant Disorders and Oral Cancers Programme
The Primary Prevention and Early Detection of Oral Potentially Malignant Disorders and Oral Cancers Programme, targeting groups at risk, was first launched in 1996. In 2014, in addition to screening for identified high-risk communities, emphasis was also on opportunistic screening for walk-in patients at all dental clinics and community outreach services. The aim of this programme is to raise awareness on risk factors associated with oral cancer, educate individuals to detect early signs and symptoms (Mouth Self Examination) and carry out screening on lesions and risk habits for patients aged 18 years and above. Patients found with risk factors and/or oral lesions will be referred for further management.
Warning Signs in the Oral Cavity to look out for:
• Ulcer that does not heal in 2 weeks
• White or red lesion
• Lump or thickening of oral soft tissues
• Difficulty in chewing or swallowing
• Ear pain
• Difficulty in moving jaw or tongue
• Numbness of tongue or mouth
Detect Oral Cancer Early – You can make a difference!
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Community Outreach Programmes
Oral health services at communities are delivered mainly through use of mobile dental clinics/teams/laboratories. The targeted communities are mostly the marginalised groups such as the elderly and people with disability in institutions, Orang Asli of Peninsular Malaysia, indigenous peoples in remote areas of Sabah and Sarawak as well as the B40 group of the population. Dental services are also provided at dental clinics in Urban Transformation Centres (UTC) and Rural Transformation Centres (RTC), which are one stop centres that offer multiple services for the urban and rural population, respectively. Aside from oral health promotion and education, outreach services provide dental examination, oral cancer screening as well as basic treatment such as clinical prevention, scaling, filling, dental extraction and construction of dentures.