The graduates of the DClinDent Endodontology programme, Dr Farah Eziana Hussein (third from left), Dr Wong Lishen (fifth from left) and Dr Nurul Ain Ramlan (sixth from left) with external examiners from the United Kingdom and Head of DClinDent programme Associate Professor Dr Dalia Abdullah (fourth from left).
Dr Farah Eziana Hussein performing a root canal treatment at the UKM Postgraduate Clinic.

Universiti Kebangsaan Malaysia’s (UKM’s) Faculty of Dentistry recently saw the graduation of its first batch of postgraduate students from the Doctor of Clinical Dentistry (DClinDent) Endodontology programme, making them the first three locally-trained endodontic specialists.

The three graduates — Dr Wong Lishen, Dr Nurul Ain Ramlan and Dr Farah Eziana Hussein — said their interest in preserving teeth was the reason they decided to specialise in endodontics.

Wong, who will be joining UKM’s Faculty of Dentistry said: “I have chosen to be an endodontist because it is a specialisation in saving teeth. It is important to preserve form and function of the dentition by avoiding extraction that can cause significant dysfunction.”

Endodontics is the branch of dentistry that focuses on treating the dental pulp in teeth.

When a tooth is injured or decaying, the pulp —which is in the centre of each tooth, and contains living tissue and cells — can become inflamed or infected. An endodontist can treat the teeth by performing root canal therapy, commonly referred to as a root canal, to save teeth.

“The procedure involves a very delicate work dealing with the intricate anatomy of teeth that have been infected,” said Farah Eziana, a dental officer at the Defence Ministry. Her interest in the field grew during her earlier attachment with an endodontic specialist.

She added that specialising in endodontics had taught her not only to be patient but also to be a perfectionist.

Nurul Ain said: “Endodontic is an important field in dentistry that is often overlooked. It is in line with the current trend of saving teeth for function and aesthetic.”

She added that besides her interest in preserving teeth, being able to eliminate pain via root canal treatment also drove her to pursue this niche specialty.

Programme head Associate Professor Dr Dalia Abdullah said DClinDent Endodontology is one initiative of UKM’s dentistry faculty to create a more sustainable dental workforce and encourage more dentists to venture into this field.

Previously, endodontists practicing in Malaysia were all trained overseas from the endodontic programmes offered by other universities in Hong Kong, Australia, New Zealand and the United Kingdom.

“Endodontics is a young and emerging specialty in dentistry worldwide. Currently, the number of endodontists in Malaysia is still low to cater the needs of the Malaysian population.

“In Malaysia, this field was recognised independently last year as a specialty by National Specialist Register.

Endodontics has developed significantly over the past century from its early beginnings as part of operative or conservative dentistry. It has evolved into a well-defined area of dentistry, with its own set of specialised skills and techniques for the safe and effective treatment of patients.

It first gained recognition as a dental specialty in the United States in 1963 and then in the UK more than three decades later.

As countries around the world progressed to a suitable stage of development in their national healthcare systems and organised the recognition of dental specialties, it is accepted and recognised widely as a distinct clinical specialty in dentistry.

General dental practitioners (GDP) are trained from their undergraduate studies to perform root canal treatment. However, the undergraduate training in endodontic treatment is limited to performing non-surgical root canal treatment of low to moderate complexity cases.

Dalia said: “Patients suffering from pulpal diseases and from previous treatment failures need endodontists, who are experts in managing moderate to high complexity cases. They are able to provide various types of non-surgical endodontic treatment and re-treatment as well as surgical endodontics.

It is the accepted practice for such patients to be referred by a GDP to endodontists who have the relevant training and experience to manage complex cases.

Nurul Ain said: “With the lack of public awareness and rising cost of prostheses and implants in replacing missing teeth, endodontics becomes a relevant option with evidence showing a success rate of more than 90 per cent.”

Nurul Ain will be serving the Dentistry Faculty of Universiti Teknologi Mara (UiTM) as an endodontic specialist next month.

Commenced in 2012, UKM’s DClinDent Endodontology is designed to meet the current and future needs of the country in training local graduates to become future endodontists and deal with root canal treatment.

To join the programme, the candidate must be a dentist (holder of Bachelor’s degree in Dental Surgery), who has at least two years’ clinical experience in general dental practice.

The four-year postgraduate programme is benchmarked with the standard set by the Royal College of Surgeons of Edinburgh in Scotland, making UKM the only university in Malaysia offering this programme with a conjoint qualification.

A memorandum of agreement, signed in 2015 for both institutions, allows the DClinDent Endodontology and the Membership of Endodontics (MEndo) to be taken as a conjoint examination. MEndo is a gold standard exit examination and an internationally recognised qualification in the specialty.

Healthcare tourism industry had been identified by the government of Malaysia to be developed as a significant income contributor to our country’s economy in a globalised world.

Dalia said: “At present, we see more foreign tourists, who seek endodontic treatment as part of their dental work to be done while they are in Malaysia. This demand will certainly be expected to increase as promotional efforts increase awareness of our healthcare facilities abroad.”

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