Development and initial evaluation of the molar incisor hypomineralisation early detection and intervention training module (MIH-EDIT) for dental therapists / Sarah Lim Wan-Lin

Sarah Lim , Wan-Lin (2024) Development and initial evaluation of the molar incisor hypomineralisation early detection and intervention training module (MIH-EDIT) for dental therapists / Sarah Lim Wan-Lin. Other thesis, Universiti Malaya.

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Abstract

In Malaysia, dental therapists (DTs) are uniquely positioned to assist with molar incisor hypomineralisation (MIH) early detection and intervention. However, existing literature has highlighted that majority of DTs have not received sufficient training in this area. The objectives of this study were to 1) develop and implement the MIH-EDIT among DTs; 2) assess DTs’ awareness about MIH and aspects on continuous education at baseline; 3) compare DTs’ perception towards MIH and confidence in MIH early detection and intervention before (T0) and immediately after implementing the MIHEDIT (T1); 4) compare DTs’ knowledge scores (KS) and 5) scores for MIH detection using photographic scoring (PS) at T0, T1 and two weeks after implementing the MIHEDIT (T2) and 6) determine the association between DTs’ sociodemographic characteristics (SC) and their KS and PS at T1. This study was divided into two phases: Phase I (Development) and Phase II (Implementation and Evaluation). In Phase I, module content development and validation, consensus photographic scoring, questionnaire adaptation and pilot study were systematically carried out until all module materials and study instruments were finalised. In Phase II, the MIH-EDIT e-booklet was distributed and a 1-day training using pre-recorded presentation slides with live question and answer (Q&A) sessions was implemented among DTs in Sarawak. DTs answered the questionnaire and MIH detection using photographic scoring at T0, T1 and T2. Besides descriptive statistics, DTs perception and confidence at T0 - T1 (McNemar test), KS and PS at T0, T1 and T2 (repeated measures ANOVA) were compared. Association (independent sample t test/ one way ANOVA and ANCOVA) between DTs’ SC and their KS and PS at T1 were determined. The MIH-EDIT was first developed and then implemented among 187 DTs (89.9% response rate). At baseline, only 31.3% reported receiving information regarding MIH and 79.5% were keen for further training. There was a significant increase in the proportion of positive responses for all questions related to perception towards MIH and confidence in MIH early detection and intervention from T0 - T1 (p<0.001). There was a significant increase (p<0.001) in the mean KS from T0 (31.95�}11.68) - T1 (49.76�}3.76) and T0 - T2 (48.18�}4.83) but not from T1 - T2 (p=0.098). There was a significant increase (p<0.001) in the mean PS from T0 (13.94�}4.52) - T1 (21.41�}5.04) and T0 - T2 (20.14�}5.50) whilst there was a significant decrease (p<0.001) from T1 - T2. No significant association (p>0.05) was found between DTs’ SC and their mean KS at T1 whereas the mean PS for DTs who had a clinical job scope (21.35�}4.89) was significantly higher (p=0.025) compared to those who had a nonclinical job scope (18.62�}5.57) at T1. Within the study limitations, the MIH-EDIT immediately improved DTs perception towards MIH and confidence in MIH early detection and intervention. The MIH-EDIT increased DTs knowledge level on MIH and improved their ability to detect MIH over the short-term. Knowledge-wise, the MIHEDIT was suited to all DTs regardless of their SC. However, DTs with a clinical job scope performed better in the MIH detection using photographic scoring.

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