FOCUS GROUP III:
ORAL HEALTH SERVICES

The Oral Health Services Research Focus group is not a separate entity but shares a degree of commonality with the other two research focus groups. Its role is to embark on research and development projects that Support and Facilitate the Mission of the Faculty of Dentistry.

The essential function of Teaching is supported through Dental Education Research while Clinical Care is supported by research that investigates the Oral Health Status in Singaporeans and by evaluating Health Outcomes. Research in the Oral Health Services FG further facilitates Teaching, Research and Clinical Care through the use of Computer/Information Technology.

In Dental Education Research, current teaching methodologies used in the Faculty are evaluated. Since its introduction to the Faculty in 1996, Problem-Based Learning (PBL) has been used substantially in the dental curriculum. Research has been carried to examine its impact on student learning as well as to examine the perspectives of PBL facilitators. In the discipline of orthodontics, students learn orthodontic diagnosis and treatment planning through Orthodontic Diagnostic Case Modules which were also introduced into the undergraduate curriculum in 1996. In this module, students are exposed to a selection of patient records from which they make the diagnoses and discuss orthodontic treatment options. A study that evaluated its impact on student learning found that this method of learning permitted students to achieve desired learning objectives, and gave them confidence for future diagnosis and planning treatment exercises.

Research that investigates the oral health status of Singaporeans focuses on Epidemiology and Identification of Risk Markers. Under Epidemiology, two National Oral Health Surveys are being performed. The first survey aims to establish a database on the oral health of pre-schoolers; this study has received funding from the National Institutes of Health, USA. The second study aims to determine the genetic epidemiology of non-syndromic oral clefts in Singapore; this is a current collaborative study with Johns Hopkins Singapore, NUH, SGH, and KKWCH. Research has also started on identifying risk markers of caries and periodontal disease through salivary research and microbiological studies.

Oral Health outcomes following intervention are also evaluated. In the area of cleft palate deformity, a 3D quantitative collaborative study between the cleft palate centres of Stockholm, Helsinki and Singapore examined the effect of primary lip surgery on early cleft palate shape change in complete unilateral cleft lip and palate infants within the first year of life. This study will identify the palatal shape change following surgical repair of the cleft lip and attempts to quantify cleft palate deformity through the development of a score of cleft severity. In the area of sleep disorder, an intra-oral snoring therapy appliance is being evaluated for its effect on a common sleep disorder known as Obstructive Sleep Apnoea, and examines how this appliance modifies the airway space below the level of the base of the tongue by changing the position of the mandible and hyoid bone.

The facilitation of teaching, research and clinical care at the Faculty of Dentistry is being achieved through harnessing Information and Computer technology. In collaboration with the Department of Electrical and Computer Engineering in NUS, computer vision systems have been developed and used for analyses of dental crowding in 3D space and cleft palate shape. Current research are focused on (i) the development of 3D cephalometry integrated with 3D CT with the 3DLab at the University of Copenhagen, and (ii) on the development a 3D full-featured orthognathic surgical simulator in collaboration with CNRS, Medical Imaging Institute in Grenoble, France.

A significant development in the area of computer information system for clinical dentistry is the Computer-aided Diagnostic System for TMJ disorders. This system, developed in collaboration with the School of Computing in NUS, is currently being considered for global use by an international consortium for TMD research funded by the NIDCR.

Teaching will be facilitated when development of a web-based interactive learning tool for cephalometric analyses and a 3D computer vision simulator for training in orthodontic treatment planning are completed in year 2002.

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