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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

July-Sept 2018JJuullyy-SSept 2018

DENTISTIN UNIFORM Maj Gen (R) Dato’ Paduka ProfDr Mohamad Termidzi Junaidi

2026th MDA SCATE 2019

Malaysia-International Dental Exhibitionand Conference (MIDEC) 2018

11Oral Health Day 2018 atSJK Chung Hua No.4

14

MDA Northern Zone’s BLSand CPR Course

25

serving his countryin more ways than one

July-September 2018

EditorDr Mas Suryalis Ahmad Dr Goh Seong Ling

Contributing writersDr Ng Woan TyngDr Siow Ang YenDr Chong Zhen FongDr Lynn KoDr Che Tang YangDr Jeannette WongDr Sharon TayDr Raj Rattan

Ex-officioDr Chow Kai Foo

TreasurerDr Koh Mei Yen, Eileen

Advertisement LiaisonDr Wong Chin Mee, AngieDr Ng Su Chin, JanicePuan Razana Abdul Karim

MALAYSIAN DENTAL ASSOCIATIONMalaysian Dental AssociationD-5-1, Pusat Komersial Parklane,Jalan SS7/26, Kelana Jaya,47301 Petaling Jaya, Selangor.

Tel: 603-7887 6760 603-7887 6762Fax: 603-7887 6764E-mail: mdaassoca@mda.org.my mdentalassoc@gmail.comWebsite: www.mda.org.my

Conceptualised & Produced byPaul & Marigold (DeCalais Sdn Bhd)No. 23A-6 Strata Office,KL Eco City, Lot 215,Pantai Baru, Jalan Bangsar,59200 Kuala Lumpur

Tel: 603-2201 6499Email: arvind@paulandmarigold.comWebsite: www.paulandmarigold.com

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.

Messagefrom the Honorary Publication Secretary

Hello everyone!

I am delighted to welcome everyone to the quarter of 2018! It has been a very busy year for MDA. I am sure that everyone is also excited to stroll along the last few months of this year, with many annual targets to achieve before the year ends.

I want to wish everyone all the best with the rest of the year, no matter what you are pursuing… I am sure, the roles that each and every one of us play, are important in ensuring the advancement of the dental profession in Malaysia.

Till we meet again in the next event and issue!

Regards,

Dr Mas Suryalis Ahmad Honorary Publication Secretary Malaysian Dental Association 2017/2019

28 Great Expectations

30 Dentist in Uniform

InsideFeatures

Activities

11 Malaysia-International Dental Exhibition and Conference (MIDEC) 2018

14 Oral Health Day 2018 at SJK Chung Hua No.4

18 2nd Comprehensive Aesthetic Composite Course “Dream It! Learn It! Do It!” by Dr Anthony Tay

20 26th MDA Scientific Convention and Trade Exhibition (SCATE) 2019

25 MDA Northern Zone’s BLS and CPR Course

26 Public Engagement and Roadshow on Dental Regulation

July-September 2018

5Dear esteemed MDA members,

Time flies… and the council of 2017/2019 has cruised into the second year of its term. It has been an eventful and challenging time for the MDA councils and committee since our installation ceremony in

July 2017. I take this opportunity to express my heartfelt appreciation to all my councils and committee members for their support, as well as our members who have put their faith in us to steer the association.

Looking back at my inaugural message posted in the MDA Newsletter July-September 2017, I would like to make a brief review in a few fields I had mentioned.

MDA has done very well in the past years and I pledge to continue and expand upon the good work of the past councils to advance the interests of our members and the profession as a whole.

I intend to build on this success with the following aspirations, with the support of my dedicated council members. I humbly urge members to give their continuous blessing and support.

1. Maintain the financial stability of MDA;

2. Focus on shaping leadership capacity at all levels, including the zones, and to ensure membership in councils and associated positions are granted on the basis of merit;

3. Engage strongly and meaningfully with all the stakeholders in the profession, especially affiliate associations;

4. Guard the best interest and rights of the profession in the face of the Dental Act 2018 (Act 804), and the enforcement of new regulations that have bearing on the dental profession. Direct greater attention and deliberation in addressing pressing issues of policy and regulatory guidelines in an intelligent and effective manner;

5. Improve our dental conferences through smart management of CPD programmes; and

6. Enhance MDA’s public image.

The MDA council vows to continue to listen, learn, adapt and change, as well as build on the excellent relationships, collaborations and mutual trust we have established with all our stakeholders thus far.

Message from the President

Dr Ng Woan TyngPresident Malaysian Dental Association

MALAYSIAN DENTAL ASSOCIATION

MDA News

6

situations. Adherence and compliance to these principles will enable the dental profession to earn and maintain the respect and trust of our patients.

On this note, I would like to bring your attention to matter deemed important to me:

“Application for the Annual Practising Certificate (APC) by dental practitioners MUST be accompanied by continuing professional development (CPD) and evidence of professional indemnity cover, as stated in Act 804, Chapter 3, Practising Certificate Clause 37 (4 )(a) &(4) (b).”

The public has a right to expect an acceptable standard of professional excellence and competence from dental practitioners. The dental practitioners should be able to convince the public that we are implicitly trustworthy in providing service to maintain and improve their oral health and general wellbeing.

We are expected to serve our patients to the best of our abilities and maintain the standard of our professional competence, if not, striving for better standards as it is our duty and obligation to uphold the morals and standard of our professionalism.

Dental practitioners are expected to keep abreast with the most appropriate methods of dental procedures, as well as other therapeutic and operative techniques throughout our careers.

I am honoured to be part of MDA, to help build a motivational culture that supports our membership and improves performances and productivity that will lead to financial stability and growth of our association.

Approval Of Constitutional Amendments By The Registrar Of Society On July 9, 2018I am delighted to announce all amendments to the MDA Constitution that were resolved by the house in the recently concluded AGM 2018 on June 10, have been approved by the Registrar of Society (ROS).

Please access the latest MDA Constitution via the link www.mda.org.my/504-constitution.html.

Dental Act 2018 (Act 804)Act 804 was finally gazetted on June 6, 2018, two months after its passing in the Parliament on April 4, 2018. The draft regulations were put up on the MDA website for engagement since Aug 24.

I hope members will take this opportunity to provide feedback on pressing issues impacting the practice of dentistry.

The principles prescribed in Dental Act & Regulations and well reflected in the Codes of Professional Conducts are applicable to a wide variety of circumstances and

July-September 2018

7We are professionals who are expected to demonstrate a set of skills in our chosen fields, and the validity of our expertise is maintained by ongoing training throughout the course of our careers.

Continuing Professional Development (CPD) is one of the many ways by which dental practitioners can maintain and improve our professional expertise. However, fulfilment of mandatory CPD requirements does not by itself necessary fulfil the practitioner’s ethical obligation to maintain his professional expertise.

The value a CPD programme is able to add to a practitioner’s competency must be the primary consideration when one decides to sign up for a CPD programme.

Unethical AdvertisingThe MDA have been receiving many complaints from our members that unethical advertising of dental treatments from dental practitioners in Malaysia is still on the rise. Such unethical advertising includes but not limited to giving discounts, promotions, publishing fees for certain dental treatment outside the clinic premises, and hiring companies to obtain third-party referrals by practising fee splitting which violate the current Dental Act and the Private Healthcare Facilities and Services Act.

These unethical practices clearly tarnish the image of the profession in the eyes of the public and fellow colleagues with some perceiving them as purely profit oriented and not service oriented.

The MDA council had previously sent a notice to all our members on Jan 17, 2018 to remind them about certain sections of the Private Healthcare Facilities and Services (Private Medical Clinics or Private Dental Clinics) Regulation 2006, Code of Professional Conduct and Guidelines & Provisions for Public Information.

However, to our dismay, we received feedback from some members that they will only comply if there is a notice from the Malaysian Dental Council (MDC). Hence, these unethical advertising continue to grow as many perceive that the MDC and the Health Ministry’s enforcement unit have no issue with this.

Visit drive.google.com/file/d/0B8O6e1_34ZBVYzJuUmd1Vk9HU0lydE9JRU0zUHNHVVlKQXpJ/view?usp=sharing to view the reminder for yourselves.

Hence, the MDA council would appreciate if the MDC will undertake stern proactive measures against errant dental practitioners who constantly ignore and violate the Code of Professional Conduct.

On this note, I humbly appeal for the MDC president to issue a circular to practitioners regarding unethical advertising.

MIDEC 2018

For MIDEC 2018’s post-show report, visit drive.google.com/file/d/0B8O6e1_34ZBVdThUWHpxSmJSVE9lNk5iU3NrMUZ0TlZYUUd3/view?usp=sharing. Also click on the video URL to enjoy some of the memorable scenes from our flagship event.

Best wishes

Dr Ng Woan Tyng President Malaysian Dental Association

MDA News

Dr Siow Ang YenHonorary General SecretaryMalaysian Dental Association

MALAYSIAN DENTAL ASSOCIATION

Dear esteemed MDA members,

I would like to take my hat off to the legal fraternity for receiving an opportunity to draft a new bill to replace the Legal Profession Act 1976. I fully support the Attorney-General’s call for the independence of the Malaysian Bar

and I feel the same should be applied to all professional councils in Malaysia.

The government should reduce the influence and involvement in professional councils and entrust those in their respective professions to self-regulate, keeping in mind the need to protect public interest.

The Dental Act 2018 had been passed in the Parliament by the previous government on April 2, 2018, the same day the Anti-Fake News Act 2018 was passed, despite objections raised by the Malaysian Dental Association and other parliamentarians. The Anti-Fake News Act 2018 has since been repealed by the Parliament on August 16, 2018.

Being a dental practitioner but without legal qualifications, reading thoroughly the Dental Act 2018 and comparing it with the Dental Act 1971 was not an easy task. With the help of a lawyer friend, I managed to list areas of concerns that required urgent attention of the current Health Minister.

I hope that the Act can be strengthened to address the real need of the dental fraternity.

Under the repealed Dental Act 1971, the Malaysian Dental Council (MDC), the statutory body that regulates the practice of dentistry in the country, is a government-controlled council whereby the its president has to be the Health Director-General and majority of its members are appointed by the Health Minister.

With the Dental Act 2018, the previous government had promised dental practitioners a more inclusive MDC by diversifying the council’s composition with members from private and public sectors.

However, MDC president remains by virtue of the Health Director-General’s office and the appointed council members still outnumber elected members.

8Message from the Honorary General Secretary

July-September 2018

9

In the Dental Act 2018, the MDC president is also prescribed with additional authority. Under the Dental Act 1971, the council has the power to appoint members of the Preliminary Investigation Committee, Medical Review Panel and others.

However, in the Dental Act 2018, the power to appoint members of Complaints Committee, Preliminary Investigation Committee and Disciplinary Committee now lies with the president. The council can only appoint people to other committees under MDC. This centralisation of power is clearly not in line with the policy of the Pakatan Harapan government.

Furthermore, the Dental Regulation 1976 not only stated that the MDC president shall be the returning officer in the election of council members, but also has the casting vote should there be a tie. This is a clear conflict of interest as the returning officer in any kind of election should be neutral.

Such provision in the Dental Regulation must be amended to avoid misuse of power.

There should be a separation of power between the Health Ministry and MDC. The Health DG should not be burdened by being the president of all healthcare professional councils (Malaysian Medical Council, MDC, Pharmacy Board Malaysia).

The ministry should be focused on government dental health services while leaving regulation of the profession to its practitioners. The MDC composition should be made similar like the Malaysian Bar where positions of the council are elected, and the president is elected from the council members.

Dental practitioners, being professionals, should be self-regulated by our elected representatives. By having all council positions elected, it will create an independent statutory body like the Malaysian Bar.

This is in line with the manifesto of Pakatan Harapan government who promised institutional reforms for decentralisation of power.

In addition, the Dental Act 2018 has prescribed a high number amount of offences with huge fines and even jail terms. I understand that some of these punishments are necessary to curb and deter illegal or unregistered practitioners. But there are other offences that may be caused by clerical errors rather than misconduct, which can cause harm to the public.

The ministry should be focused on

government dental health

services while leaving regulation of the profession to its

practitioners.

The prime objective of the MDA:

To promote the art and science of dentistry for the benefit of the public.

For example, Section 44 of the Dental Act 2018 stated that if a dental practitioner fails to notify the Registrar that he has changed the address of his home or practice, he has committed an offence and on conviction, be liable to a maximum fine of RM20,000.

While notifying the Registrar of the change of address is important, it should not be listed in the Act as an offence that needed to be brought to the court.

Besides, Section 66 of the Dental Act 2018 stated that a practitioner without a valid practicing certificate is committing an offence and shall, on conviction, be liable to a maximum fine of RM50,000 or up to a jail term of one year, or both.

There are certain circumstances that may cause the practicing certificate to be delayed. It can be that the practitioner forgot to submit the application due to a busy schedule providing dental services to the public or the certificate was issued late by the council or delayed by post.

One should also note that, once a practitioner is convicted by a court in Malaysia or elsewhere of any offence punishable with imprisonment, whether in itself only or in addition to or in lieu of a fine will be referred for disciplinary proceedings and the most severe punishment is to strike him or her off from the register. This means he or she can no longer practice dentistry.

Such harsh punishment for clerical mistakes does not commensurate with the severity of the offence. In my opinion, offences relating to dental practitioners should be removed from the Act and moved to MDC’s guidelines, which is binding to all practitioners.

Those who fail to abide by the guidelines should be subjected to disciplinary proceedings. Failure to appear for proceedings or failure to abide by the decision of proceeding should then be listed as an offence and punishable by fines and jail terms.

The disciplinary proceeding is one of the key pillars of self-regulation that should be practised by all professional councils. With disciplinary proceedings, it is taxing on the court of law that has a case overload.

I sincerely hope that the Health Minister and MDC members will consider my proposal for the betterment of the dental profession.

Serving together with you, Dr Siow Ang Yen Honorary General Secretary Malaysian Dental Association

MDA News

10

July-September 2018

11M

DA’s Malaysia-International Dental Exhibition and Conference (MIDEC) 2018 was held at the Kuala Lumpur Convention Centre from July 20 to 22. The event has been chalked up as a success with participation from more than 3,000 local and

international dentists.

This conference is an annual fixture on the national and regional CPD calendar. More than 50 world renowned speakers were invited to share information on dental practice, technological advancements and current research in all dental specialties.

Keynote speakers included digital smile design guru and prosthodontics expert Dr Marcelo Calamita with his technician Dr Edson Da Silva, and a bio-emulator who invented the Elab protocol oral designer Sascha Hein.

Others were implant specialist Associate Professor Dr Homa Zadeh, who is also the director of graduate Periodontology Programme at University of Southern California, and speakers in fields of endodontics, paediatric dentistry, and dental photography.

Held alongside the conference were five hands-on workshops from July 19 to 23 that provided participants with the opportunity to master new clinical skills.

Malaysia-International Dental Exhibition and Conference (MIDEC) 2018

Reported by:Dr Chong Zhen Feng

MDA News

12Delegates were able to interact with the best and brightest leaders in the dental community who shared their latest research, techniques and clinical applications.

Meanwhile, there was a one-day Allied Dental Health Symposium offering a wide variety of topics for dental assistants and dental nurses, as well as a Joint Affiliate Association Symposium where updates on dentistry were contributed by various dental associations and related bodies. There were also concurrent sessions such as academic presentations by representatives from local universities.

Besides that, MIDEC also had the Young Dentist Forum that aspired to inspire the young additions to the dental community, and a Dental Act 2018 Forum.

MIDEC this year had a meaningful meeting with the other National Dental Associations with the theme of “Sustainability in Oral Healthcare for the underprivileged, and the role of volunteerism through global partnership”.

This forum serves to lay down a foundation in enhancing friendship and camaraderie of those in the dental fraternity, to consolidate an understanding, and as a permanent avenue for leaders to exchange ideas and insights, as well as experience.

July-September 2018

13

In conjunction with MIDEC 2018, a free communication session was held where participants were able to present their volunteer work involving the underprivileged communities to compete for the Making a Difference-Community Volunteerism Excellence (MAD-CVE) Award.

Delegates also had the opportunity to browse through more than 160 exhibition booths that displayed the latest in dental equipment, technology and materials.

The MIDEC 2018 Gala Night coincided with MDA’s 80th anniversary celebrations. Aside from its nostalgic theme, “Celebrating Our Past; Shaping Our Future”, event organisers expressed their gratitude to Wisma MDA donors and partners for their support and contributions.

The gala night’s guest-of-honour was Dato’ Seri Dr Chen Chaw Min, Health Ministry Secretary General. The night’s highlights include the 80th anniversary video presentation and the launch of the MDA History Book 2.

MDA would like to thank platinum sponsor Colgate-Palmolive, gold sponsor GSK, and members of the dental trade industry for their undivided support.

MMIDEC 2018 was the culmination of a year’s planning and preparation by a small army of dentists from all over Malaysia, led by MDA President and MIDEC Organising Chairperson Dr Ng Woan Tyng.

MDA News

14S

JK Chung Hua No.4, in Kuching collaborated with MDA Eastern Zone (MDAEZ) and the Section Concerning Dental Officers and Specialists (SCODOS) to organise an oral health day on April 28, 2018.

This half-day community social responsibility programme involved 15 government and private dentists, four dental nurses, an attendant and 70 teachers.

The objectives are to instil dental health knowledge among the pupils and empower them to take note of their oral hygiene, where dentists demonstrate good oral hygiene through fun activities.

The programme, led by MDAEZ exco member Dr Lynn Ko, benefitted about 1,200 pupils, from Standard One to Six.

Some of the activities carried out were colouring competition, dental health exhibition, toothbrushing drill, dental health quiz, poster drawing competition and dental health talk.

Oral Health Day 2018 at SJK Chung Hua No.4

Reported by:Dr Lynn KoExco, MDAEZ

A colouring competition was held for pupils in Standard One to Three.

July-September 2018

15

Standard Four, Five and Six pupils in a competition for best poster. Standard One, Two and Three pupils learning about caries, gingivitis, smoking and the importance of a healthy diet.

A group photo was taken after the closing ceremony.

MDA News

16

Toothbrushing drill by the school dental team.

Standard Four pupils attended a dental health talk. Topics covered were caries, gingivitis, smoking, healthy diet, oral cancer, fake braces and illegal nano-veneers.

Standard Four, Five and Six pupils in a competition for best poster. Standard One, Two and Three pupils learning about caries, gingivitis, smoking and the importance of a healthy diet.

July-September 2018

17

MDAEZ volunteers posed for a picture at the end of the programme.

There was a simple closing ceremony at the end of the event with a short speech by the school headmaster Chai Hon Mun and a prize giving ceremony for winners of the colouring and poster competitions, followed by a photo taking session.

The organising committee would like to express gratitude to Sung Hoe Trading Sdn Bhd as the prize sponsor. We would like to extend our thanks to Chai and the teachers, especially Mdm Chung, Mdm Kueh and Mdm Lei of the Guidance & Counselling Unit for the help rendered.

Closing speech by Chai Hon Mun, headmaster of SJK Chung Hua No. 4.Souvenir from SJK Chung Hua No.4.

It is the hope of the MDAEZ and SCODOS that such programmes can contribute to the improvement of the oral health status of school children in Sarawak.

For video and pictures of the event, visit www.facebook.com/mdaeasternzone.

MDA News

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For the second time this year Malaysian Dental Association for Southern Zone has organised the “Comprehensive Aesthetic Composite Workshop - Dream It! Learn It! Do it! by Dr Anthony Tay” at Holiday Villa Johor Bahru. Improvements and adjustments were made after receiving

feedback for the first programme that was on May 13 and 14.

The programme had 15 participants and the day started with them try on loupes that were brought by a few suppliers.

Participants were allowed to use the loupes throughout the day and switched between brands and types. Almost all the participants were first-time loupe users and this programme had exposed them to different designs and magnifications.

Dr Tay started with a brief introduction before moving on to the four modules that would be presented over the two days.

The programme on the first day included posterior composite restoration and semi direct composite restoration with hands-on learning. Participants were provided with comprehensive instruments as well as quality materials.

The next day, participants were focused on anterior restorations and aesthetic smile designing. Tips and tricks were given in order for participants to better understand the materials and techniques.

The programme ended with a certificate presentation ceremony.

Participant feedback were obtained and would be reviewed to improve the third programme in October.

2nd Comprehensive Aesthetic Composite Course “Dream It! Learn It! Do It!” by Dr Anthony Tay

Reported by:Dr Che Tang YangOrganising Committee MDA Southern Zone

July-September 2018

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MDA News

20A

fter a successful staging of the last SCATE earlier this year, the MDA is all geared up for its 26th edition, which will be held from Jan 18 to 20, 2019 at the Kuala Lumpur Convention Centre (KLCC).

Themed “A Lifetime of Oral Health for All”, SCATE 2019 will be bringing in distinguished speakers that includes Dr Nazariy Mykhaylyuk, Dr Ralph George, Dr Ronnie Yap, Dr Stephen Lampl, Dr Alvin Tjiptarahardja and Dr Ang Chee Wan.

Plans are under way to rope in more regional and international speakers. This to provide an excellent opportunity for clinicians to acquire new skills and gather latest information in the rapidly-advancing and ever-evolving field of dentistry, and at the same time fulfil their continuing education and professional development requirements.

Running alongside the scientific conference, the trade exhibition will host dental manufacturers, distributors and traders showcasing myriads of products and cutting-edge advancements in dentistry, where visitors and delegates will get to source for dental products and services.

With a combination of a dynamic scientific programme of plenary sessions, hands-on workshops, forums and symposiums, and a trade exhibition, this is a not-to-be-missed event for dental practitioners, researchers and allied health professionals.

It is the best platform for networking, connecting speakers, exhibitors and colleagues to share experiences and practices, under one roof.

SCATE 2019 is open for registration. To learn more, visit www.mda.org.my/mdascate/2019/index.html.

26th MDA Scientific Convention and Trade Exhibition (SCATE) 2019

Author:Dr Sharon Tay

July-September 2018

25M

DA Northern Zone conducted its Basic Life Support (BLS) and Cardiopulmonary Resuscitation (CPR) course on Sept 2, 2018. In collaboration with the Penang CPR Society and ZOLL Medical Malaysia, the full-day course was held at the

Allied Healthcare Centre of Excellence in Penang.The course started with two lectures presented by Dr Chow Chee Toong from the Penang CPR Society. He gave the participants an introduction to BLS and CPR as well as discussed medical emergencies that one may face in a dental practice.

This was followed by a hands-on session where participants were divided into groups of three. Each group had an instructor and participants were taught how to perform high-quality CPR and relief choking on an adult, child and infant, how to use the automated external defibrillator (AED) as well as rescue breathing techniques.

When performing CPR on the dummies, participants were able to review their performances as the dummies were connected to an application that gauged the parameters required for a high-quality CPR.

The AEDs provided by ZOLL Medical Malaysia were easy to use as the machines came with clear instructions that allowed laymen and healthcare professionals to use them during an emergency.

The course concluded with a theory test. Upon passing the test, each participant received a CPR provider certificate that is valid for two years.

MDA Northern Zone’s BLS and CPR Course

Reported by:Dr Jeannette Wong

MDA News

26

The Malaysian Dental Council (MDC) has drafted the Dental Regulation 2018 and it is open for public engagement. In relation to this, MDA has been compiling feedback from its members to be brought forward to the MDC.

In addition, the Dental Act 2018 roadshows have been held nationwide. The roadshow is an avenue for dental practitioners to gain insight and understanding as well as provide feedback on the Dental Act 2018.

The roadshow in Penang was held on Sept 21, 2018 at Auditorium Pusat Pergigian Kanak-Kanak & Kolej Latihan Pergigian Malaysia. It was open to all dental practitioners, graduates awaiting posting as well as dental students.

There were 240 dental practitioners from the government sector, 30 private practitioners, five dental students and two graduates who attended the roadshow.

The roadshow comprised a two-hour session with Deputy Director of Oral Health Legislation and Enforcement Section Dr Elise Monerasinghe. The session was moderated by MDA Northern Zone Chairman, Dr Tan Sock Hooi.

During the session, Dr Elise presented the important points in the Act. This was followed by a Q&A session where some voiced concerns while others provided feedback.

The questions ranged from illegal dentistry, professional indemnity for dental practitioners in the government sector, application process for community service, clarification on APC renewals, specialist registration and legal issues for locums.

A poll was also conducted during the roadshow whereby participants were asked “How well do you accept the Dental Act 2018?”. Fifty-two participated in the poll, out of which 30% said they “Fully Accept”, 58% “Partially Accept”, 12% “Do not know, have not read it yet”, and 0% were “Indifferent”.

Similar roadshows were also held in Ipoh, Perak on Sept 19 and Alor Star, Kedah on Sept 5.

Public Engagement and Roadshow on Dental Regulation

Reported by:Dr Jeannette Wong

30%

Fully Accept

58%

Partially Accept

12%

Do Not Know

0%

Indifferent

How well do you accept the Dental Act 2018?”

July-September 2018

27

The instructor from Penang CPR Society teaching a participant the correct position, depth and rhythm needed for chest compressions.

Dr Elise Monerasinghe highlighted the important contents of the Dental Act 2018 as well as answered many questions from the floor.

A participant attempting to relief choking on a dummy named ‘Choking Charlie’.

MDA News

28Managing Patient Expectations And InteractionsOur lives are enriched by our daily experiences. Our responses to these experiences are largely determined by our expectations – a surprise is only a surprise because we have no expectation of an event or occurrence.

Other responses, such as making a complaint, arise when expectations are not met. The “expectation disconfirmation” theory can help a dental team understand patient satisfaction in relation to expectations and outcomes.

The concept is best illustrated by the following sequence:

1. When a patient visits a dentist, they do so with a level of expectation. In the case of existing patients, prior experience of the service will influence these expectations. In the case of new patients, the experience of friends and family (or the person who recommended the practice) will play a part. For others, the expectations may be set by words and images that appear on websites and marketing literature.

2. These expectations are the standard against which the dental team and the practice will be judged.

3. When expectations are met, confirmation occurs.

4. Disconfirmation arises when there is a difference between expectation and outcome.

5. If the outcome is better than expected, there is positive disconfirmation that leads to satisfaction. Negative disconfirmation arises when the outcome is below the pre-set level of expectation that may lead to a complaint. Simple disconfirmation is the term used to describe a situation where expectation meets the outcome; it is neither better nor worse.

Complimenting and complaining behaviours are determined by this outcome. Clinical practice continues to advance, and improvements in techniques and materials allow clinicians to raise the bar when it comes to setting standards.

Where there is competition in the market among providers of services, advertising and marketing materials are one method of differentiation. It is all too easy to over-promote the benefits of care and influence expectation levels such that they cannot be met.

The adage that “first impressions count” is also relevant here. The practice environment itself contributes to expectation levels. It has been described as the “servicescape” of business. It also impacts the perceptions of quality, expectations and performance. (Interestingly, cleanliness is cited as an area of the “servicescape” that received the most complaints in the wider business world).

Great Expectations

By:Raj Rattan MBEDental Director of Dental Protection

July-September 2018

29Patient SatisfactionPatient satisfaction is a mental state and is a multidimensional construct affected by many variables. It influences positive patient behaviours such as loyalty.

Dissatisfaction has the opposite effect. Many studies have shown that patient satisfaction is determined by subjective and objective experiences and their dentist’s interpersonal and communication skills, and “communication of care and attention” has been cited as most influential in maintaining patient loyalty (Holt and McHugh).

Dentists should focus and develop effective communication skills before, during and after treatment sessions by involving patients in treatment decisions. For example, according to one study, patients who received more preparatory information and knowledge had superior post-operative pain control and satisfaction after undergoing third-molar extraction than patients who did not.

To avoid complaints, we must focus on the human and psychological aspects of the dentist/patient relationship, and adapt our communications to better manage patient

expectations within the expectancy disconfirmation paradigm. It is also worth paying attention to the “servicescape”, as it is the antecedent to the experience itself and can mould patient perceptions.

Case StudyA patient attended for the removal of lower impacted third molars. After the removal of the first tooth, his dentist called him in the evening to make sure he was comfortable and that there were no post-operative issues. The call was not expected and the patient expressed his gratitude for the care he was shown.

Two weeks later, the same dentist removed a molar on the other side and, on this occasion, did not call the patient as a local postgraduate student meeting had taken longer than expected.

On the patient’s return to the practice a few days later for a review appointment, he commented that he was surprised to not get a call on the second occasion.

In a matter of two weeks, the patient’s baseline expectations had changed and he had crossed from the positive to the negative side of the disconfirmation continuum. It is a reminder of the importance of setting realistic expectations that can be met consistently.

At first glance, the mantra of under-promise and over-deliver offers a solution. But lowering expectations also potentially lowers the appeal of the service or product, especially in a competitive market. It is a matter of striking a balance.

Some leading researchers in the field suggested that there are three types of expectations.

1. The desired service - a level that the patient hopes to receive.

2. Adequate service - this is the minimum tolerable level, because patients will have recognised that the desired service is not always achievable.

3. Predicted service - the level of service a patient thinks they are likely to receive on the basis of probability.

The gap between one and two is the so-called “zone of tolerance” and the predicted service is likely to lie within that zone. It is a zone in which the dental team can perform in comfort. It is only when the experience falls outside the zone of comfort that a patient demonstrates complaint behaviours.

The extent of the tolerance is contextual. It varies among patients and may vary at different times for the same patient, depending on what else is happening in their daily lives.

Patient satisfaction is determined by subjective and objective experiences

and their dentist’s interpersonal and communication

skills.

3030Dentist in Uniform

Maj Gen (R) Dato’ Paduka Prof Dr Mohamad Termidzi Junaidi, 66, has dedicated his life to the armed forces and later, founded the Kulliyyah of Dentistry at the International Islamic University of Malaysia (IIUM).

Interviewee: Maj Gen (R) Dato’ Paduka Prof Dr Mohamad Termidzi Junaidi

Interviewed by: Khaw Chia Hui

MDA News

July-September 2018

31As a young boy growing up in Kuching, did you feel a calling like many others to join the military?I cannot truly say I had a grand plan to join the army. But life in uniform did intrigued me. While studying at SMK St Thomas in Kuching, the Boys’ Brigade were often dressed in their uniform to practice their march. Of course, they looked smart and shared a camaraderie that was unique.

Also at the time, the Konfrontasi Indonesia-Malaysia was in full swing, hence a lot of British military personnel were stationed at Kuching. So, I got to witness them going about their military business.

In Form One, a teacher of mine had shared in class that the military school in the peninsula provided military training and education for free. That got me thinking.

Was it then you decided to apply for the said military school?A couple of years later when I was in Form Three, a group of recruiters came to my school handing out flyers about the cadet officer training in the peninsula. There was a boys’ wing as well.

My father had no objection when I expressed interest to apply. I was the first few Sarawakians to be accepted to the boys’ wing. I didn’t know what to expect when I got to the Royal Military College in Sungai Besi in January 1968. It was my first time away from home for such a long period. In fact, I had not left Sarawak before. When one is young, one is fearless.

How was your experience at the Royal Military College in the early days?There was definitely some ragging going on. Seniors gave the newbies a lot of chores, scolding, exercises and all that. It didn’t occur to me to write home about these things. I took it well, just went about doing what I had to do.

I only told my late mum about my experience years later. I think she would have persuaded me to return home if she had known then. But through the “punishments”, I formed lifelong friendships and camaraderie with my mates that are evident to this day.

After the training, you served as a cadet offer for three months in 1972 before you received a military scholarship to study dentistry in Universiti Malaya. What your experience from being in a military setting to an academic one?Studying at UM was not a big change for me. But one would say I stirred some trouble when I was part of the student activism at the university. In the 1960s and 1970s, student activism was a big part of campus life in UM, especially if you are part of the student council.

In 1974, I was a student council member, hence politically aware of the issues at the time. Then you also had Vietnam War going on and the sentiments that came with that. Then, we had a speaker’s corner where students were giving speeches to motivate others to join the cause. For my activism, my name was struck off the VC list but I manage to graduate in 1978. In 1980, I continued my studies in Public Health Dentistry at the University of Sydney. After that, I returned to the military as I had a 10-year bond due to the scholarship I had received.

Through the “punishments”, I formed lifelong friendships and camaraderie with my mates that are evident to this day.

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Can you share with us your career in the military?By July 1984, I was holding the rank of Lieutenant Colonel, and later appointed as the commander of the KUG School (now known as Armed Forces Health Training Institute or Insan). I was told that I was the only dental surgeon to have held that position.

By May 1988, I was a Colonel and took on the post of Deputy Director of Health Services (Dentistry) for the armed forces. In August 1993, the role was upgraded to Director. In October 1999, I was promoted to Brigadier General and in February 2003, I am a Major General.

As a young boy who was fascinated with the military, I did not foresee I would achieve such recognition.

Your illustrious military career saw that you help to lay the foundation for implementation of digital health records for members of the armed forces. What were the challenges you faced?Some 30 years ago, computers were something new and foreign. But I felt that it was important to that health services should take advantage of the technology available so I pushed hard for that. Of course, there was a lot of resistance to change, aside from cost and training.

Somehow as a military man, you learn not to take no for an answer and in my own stubborn ways, “dragged”

July-September 2018

33my team to implement it. Once, detractors could see for themselves what good the system could bring, it was a matter of good execution of the plan.

Finally, in 1997, I successfully set up SIAP (Sistem Informasi Automasi Pergigian). Once the system had matured, it was used for all dentistry units in the armed forces via the Corporate Information Network Superhighway (COINS). Malaysian Administrative Modernisation and Management Planning Unit (MAMPU) later used it as a benchmark for other organisations.

I’m proud to note that our peers in developed countries were surprised we even had a digital system for dental records. I always opined that the public dental health should have a similar digital setup so the data can be used, for example, to easily identify Malaysian victims of the MH17 crash. But implementing something in the public healthcare system is vastly different than getting it done in the military.

What were the common dental injuries you had seen among military personnel?You will be surprised to note that jaw fractures are common. A soldier is trained to fall forward. So, a lot of them suffered from jaw fractures as a result of falling during training, parades and so on. It was important to beef up our maxillofacial surgery teams.

Forensic dentistry has also become an important subspecialty. Many of our forensic dentists were dispatched to the MH17 site to render assistance.

I’m of the opinion that medical and dental fields should work closer together. In the battlefield, if you are a medical personnel, you cannot remain in your silo.

Some 30 years ago, computers were something new and foreign. But I felt that it was important to that health services should take advantage of the technology available.

You will have to help in all areas in a military hospital, for example. Scientific disciplines should not be compartmentalised.

The dental teams get a lot of on-site training whenever we bring our mobile clinics to rural areas. We would set up our clinic in a suitable spot and the army trucks would drive around and announce over the loudspeakers that the clinic was opened.

Sometimes in rural Sabah and Sarawak, people would walk for a day or two just to get to the clinic. They would have problems that were not dental related. Yet, we try our best to treat them because we cannot in good conscience send them away, knowing they have no access to healthcare.

I remembered we had a clinic near the foothills of Mount Kinabalu. A gatherer had a big cyst on his back. Every day he had to deal with the pain whenever he carried his big basket to gather produce to sell in the markets.

We took an x-ray with our dental equipment and found that he needed the cyst removed before it caused permanent damage to his spine. My team was confident we could carry out this procedure. So as the highest ranking officer there, I gave the go ahead. The man recovered well and with the cyst removed he could improve his working opportunities.

Did you consider starting a private practice after serving your bond?I thoroughly enjoyed my military career. Besides, I only had clinical experience for a handful of years before I was moved into more administrative roles in the military. So, that thought of setting up a private practice did not cross my mind.

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34What in your opinion on care for army veterans in Malaysia?Of course, the system should be better organised, starting with areas relating to psychology. We have seen effects of PTSD play out in many instances across the world. We should learn how other countries help their vets to manage it, and if possible adopt the best practices here.

Currently, they are in the public healthcare system. But I feel that a specialised setup will be more advantageous for the patients. Perhaps civil societies can help for and advocate for better health services for our vets too.

We should also look at the various advancement in technology and improve health data accessibility and weed out inefficiency.

After you retired from the military, you were invited by IIUM to establish its dentistry faculty. Can you share your experience there?I was the founding dean of the Kulliyyah of Dentistry and served from 2006 to 2009. There were a lot of new areas to cover as well as how lessons could be conducted better. There were new materials, techniques, technology and work procedures that students needed to know.

One of the teaching tools I got the university to invest in was a multimedia AV setup where the lecturers could monitor students’ work in class through a central monitor. Every student’s workbench had an intraoral camera that is linked to the lecturer’s computer. Grading, examinations and demos can be easily done using this setup. Unlike the old days where the lecturer had to walk around looking at the student’s work or the student crowd around trying to view the demos.

One of the lessons I learnt over the years is a teacher must be proud that his or her students are better. I’m happy to see my early labours come to fruition and improved on by others.

We should also look at the various advancement in technology and improve health data accessibility and weed out inefficiency.