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Abstract

The dawn to dusk fast in the Islamic month of Ramadan is obligatory for all Muslims. During fasting, Muslims abstain from food, drink whilst going about their normal daily activities. Poor understanding and appreciation of the practices by the medical professional may lead to compromise in treatment and inability to provide good service for the patients. This article provides insight to dentists around the globe to carry out comprehensive and preventive dental treatment to fasting patients in the month of Ramadan
| European Journal of General Dentistry | Vol 3 | Issue 1 | January-April 2014 | || 82 ||
Management of muslim dental patient while fasting
ABSTRACT
e dawn to dusk fast in the Islamic month of Ramadan is obligatory for all Muslims. During fasting, Muslims abstain from
food, drink whilst going about their normal daily activities. Poor understanding and appreciation of the practices by the medical
professional may lead to compromise in treatment and inability to provide good service for the patients. is article provides
insight to dentists around the globe to carry out comprehensive and preventive dental treatment to fasting patients in the month
of Ramadan.
Key words
Fasting patients, muslim dental patient, Ramadan
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DOI:
10.4103/2278-9626.126219
Faizal C. Peedikayil, Abraham Thomas1, M. C. Naushad2, Arun Narayanan3
Departments of Pedodontics, 1Orthodontics, Malabar Dental College, Edappal, 2Endodontics and
3Periodontics, Kannur Dental College, Kannur, Kerala, India
Address for correspondence:
Dr. Faizal C. Peedikayil,
Department of Pedodontics,
Kannur Dental College, Kannur,
Kerala - 670 567, India.
E-mail: drfaizalcp@gmail.com
INTRODUCTION
Ramadan is the 9th month of the Islamic calendar (Hijra).
Fasting is obligatory for all adult Muslims all over the
world during the daylight hours. Since Hijra is a lunar
calendar of about 350 days a year, Ramadan occurs
at different times in a 33‑year cycle. Fasting during
Ramadan is total abstention from food, uid during the
daylight hours.[1] Therefore, it is important for healthcare
professionals to know about their patients’ cultural and
religious rituals, which are obligatory. Certainly, with
respect to their patients, this understanding is likely to
result in increased satisfaction in the delivery of care.
Patients will feel that their beliefs have been taken into
consideration, and health professionals will be able
to deliver care that their patients nd acceptable and
appropriate.[2]
Fasting during Ramadan is obligatory for all Muslims,
with certain exemptions such as pre‑pubertal children,
ill person, women during menstruation, pregnancy,
post‑childbirth rest and lactation, travelers, and the
frail elderly person.[1] However, some persons because of
certain tradition and beliefs or due to personal reasons
who have the right to be excused from fasting may
observe the fast.[1‑3]
Therefore, it is important that healthcare professionals
are aware of how fasting can affect routine treatment, and
also how the treatment plan can be modied to patients’
benet. Table 1 shows a brief idea of general prescribing
pattern for Muslim patient during Ramadan.
ORAL MEDICATION
A fasting patient is not able to take medication by the
oral route. If a person becomes ill within the period of a
fast, however, it is allowable to break the fast. It is for the
patient to judge the degree of illness, and if the illness is
‘harmful’ or life‑threatening, they are advised to undergo
treatment; because under Islamic law, preservation of
life has the greatest priority.
Information in the dental literature on the implications of
prescribing during the month of Ramadan is scarce. In a
study[4] which reviewed the drug regimens of 81 Muslim
patients during Ramadan found that drug dosage pattern
was changed in about 46% patients while fasting. This
included mainly missing doses, altered timing of doses,
or taking heavy single dose at one time. In some cases,
this irregular medication and improper dosage can at
times have serious consequences. A larger dose taken
once daily may have toxic side‑effects, especially in the
children and in the elderly. Therefore, dentists must be
aware of possible non‑compliance, and make allowances
to accommodate the religious practices of their patients by
making some modications in medicine prescriptions.[3‑5]
SHORT COMMUNICATION
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Peedikayil, et al.: Fasting dental patients
|| 83 || | European Journal of General Dentistry | Vol 3 | Issue 1 | January-April 2014 |
Simple solutions
(A) Instead of penicillin V, which requires four doses
daily, amoxycillin could be prescribed, which
requires only three doses a day. The three doses may
be rotated, thereby allowing the patient to take the
medication outside the hours of fasting
(B) Prescribe slow‑release formulations of medication.
An example is the long‑acting version of the non‑steroidal,
anti‑inammatory drug diclofenac (SR 75 mg): Only two
doses are required per day.
INJECTIONS
Local anesthetics
This is an acceptable form of treatment for a fasting
patient;[4‑6] however, the dentist should be aware that
some Muslim patients may be reluctant to undergo it.
According to Islamic fatwa’s by scholar’s, administration
of local anesthetics for dental treatment does not
invalidate the fast.
Intramuscular and intravenous injections
Intramuscular and intravenous injections are generally
allowed.[4‑6] Examples that may be of particular
importance to dentists are the insulin injections for
diabetics and antibiotics given by the intramuscular
or intravenous routes. However, the use of IV uids for
nutrition is prohibited while fasting as it energizes the
fasting patient.[4]
MOUTHWASHES
Chlorhexidine is a commonly prescribed antiseptic
mouthwash. It may be used as a mouthwash, spray, or
gel for a variety of conditions.
Allowance is made for these, and others commonly
prescribed in dentistry, to be used if required. However,
patients may be reluctant to use any mouthwash for
fear of absorption from the mucosa and of inadvertently
swallowing some.
It may be advisable to discuss these issues with the
patient concerned and to suggest that, if the patient is
reluctant to use the mouthwash during the fasting period,
he or she should use it outside fasting hours.[4,5]
TOPICAL FLUORIDE APPLICATIONS
Fluoride application is often used for prevention of dental
caries and also as a treatment for tooth sensitivity; in
either case, the fasting patient may be reluctant to accept
this treatment, the concern being that he or she could
inadvertently swallow the varnish or paste. Dentists
should thus recommend that adjunctive treatment is
carried out outside the hours of fasting.[4,5]
PULP CAPPING MEDICAMENTS
The pulp capping medicaments such as calcium
hydroxide, ledermix, iodoform pastes etc., are placed
directly into the canal, or on to the pulp, and are often
used in the treatment of acute pulpitis. This is allowed
during fasting and does not invalidate the fast.[5]
ALVOGYL
Localized placement of Alvogyl or a similar substance,
often used in the treatment of dry socket, is acceptable
during Ramadan.[5]
TOPICAL GELS AND LOZENGES
Intra‑oral gels and lozenges are mainly prescribed for
ulcers, oral thrush, and denture stomatitis. If this is
applied during the fasting hours, it will invalidate the
fast. Therefore, use of these medications will be poor in
fasting patients. So, it is recommended to schedule these
medications after fasting hours.[4,5]
MEDICAL EMERGENCIES IN DENTAL
PRACTICE
Medical emergencies that may occur in dental clinic include
anaphylaxis, asthma, cardiac emergencies, epileptic
seizures, hypoglycemia, adrenal insufciency, and syncope.
Table 1: General principles of prescribing during the
fast of ramadan5
Medication
route/type
Permissibility for
fasting patients
Provisions
Oral medication Not permissible Emergencies;
deteriorating illness
where patient feels
unable to continue
fasting; when harm may
result from avoiding
taking medication
Medication by
injection
Permissible Injection is
non‑nutritional. IV uids
Mouthwash Permissible Care taken to avoid
swallowing; patients
may be reluctant to use
Varnish
(sustained-release
of uoride)
Permissible Patients may prefer
to have alternative
treatment or treatment
outside fasting hours
Pulp capping
medicaments
Permissible -
Local anesthesia Permissible Patients may be
reluctant, so best to
delay or re-schedule
treatment, especially if
patient is not in acute
pain/discomfort
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Peedikayil, et al.: Fasting dental patients
| European Journal of General Dentistry | Vol 3 | Issue 1 | January-April 2014 | || 84 ||
Almost without exception, these conditions will
necessitate administration of medication
immediately (e.g. adrenaline injection in the case of
anaphylaxis), or immediately after the initial event
has taken place (e.g. diazepam injection in the case of
prolonged epileptic seizures). Islamic rules governing
fasting are very clear; one of the acceptable reasons for
breaking the fast is if life is threatened. Thus, if a person
has a condition that is a threat to his or her life (perhaps
he or she has poorly controlled diabetes), it is forbidden
by Islamic law for them to continue fasting.[6‑9]
TREATMENT OF CHILDREN
Before the age of puberty, Muslims are not obliged to
fast. Therefore, prescribing and offering treatment for
this age group should not differ from the norm. However,
treatment of children above this age will follow patterns
similar to those mentioned for adults.[3,5,7]
ORAL HYGIENE
Toothpastes are allowed.[3‑8] Some scholars of Islam
consider the use of toothpaste to be highly undesirable
because deliberate or accidental swallowing of them
will nullify the fast.[7] The use of miswaak, the twig
of Salvadora persica tree, is highly recommended,
including the fasting period. miswaak is commonly
used in Arab countries, and studies show that it
is equally effective as other modes of oral hygiene
maintenance.[8] The dental surgeons and the health
care givers should remind the fasting patients to brush
and floss thoroughly before sleeping at night and
recommend brushing after the pre‑dawn meal (sahur/
sehri). Brushing twice daily is sufcient for oral disease
prevention.[5,6]
Oral malodor and fasting
During fasting, the salivation decreases and mouth
becomes dry resulting in halitosis.[5] The increase in the
concentration of sulfur‑containing compounds causes
a marked halitosis, which may be misdiagnosed for oral
diseases or poor oral hygiene. The odor may reduce with
proper oral hygiene debridement with dentifrices or when
the individual breaks the fast.[1,6,7,9]
CONCLUSION
Some Muslims patients may wrongly perceive that some
dental treatments and preventive procedures invalidate
the fast even though most dental treatment will not
break the fast. This includes scaling, restorations,
and extractions. However, some patients may not be
willing to carry out certain procedures due to different
perceptions and way of thinking. Within the month of
Ramadan, most forms of prescribing are allowable, with
the notable exception of oral medication. Even with
acceptable types of medication, the dentist will often nd
open or hidden reluctance to comply with the regimen
prescribed. The healthcare professional must be aware
of this and should alter their prescribing practice or
advice accordingly. It is also important, when treating
a fasting patient on long‑term medication, to ensure
satisfactory compliance with the normal drug therapy.
With fasting patient in dental practice, it is important
for professionals to be aware of which treatments the
individual considers acceptable and offer treatment
accordingly.
REFERENCES
1. Leiper JB, Molla AM, Molla AM. Effects on health of uid restriction
during fasting in Ramadan. Eur J Clin Nutr 2003;57:30‑8.
2. Ramadan J. Does fasting during Ramadan alter body composition,
blood constituents and physical performance? Med Princ Pract
2002;11:41‑6.
3. Sakr AH. Fasting in Islam. J Am Diet Assoc 1975;67:17‑21.
4. Khalid A, Raman B Transcultural oral health care: Dental medication
for muslim patient. Dent Update 2000; 27:449‑52.
5. Available from: http://www.mda.org.my/assets/07public/
healthcare_pdf/dentalcare_in_ramadhan.pdf. [Last accessed on
2013 Feb 02].
6. Darwish S. The management of the Muslim dental patient. Br Dent
J 2005;199:503‑4.
7. Sheikh A, Gatrad AR. Caring for Muslim Patients. Kannur
(Cannanore), Kerala: Radcliffe Medical Press; 2000.
8. Khan FA, Williams SA. Cultural barriers to successful communication
during orthodontic care. Community Dent Health 1999;16:256‑61.
9. Trepanowski JF, Bloomer RJ. The impact of religious fasting on
human health. Nutr J 2010;9:57.
How to cite this article: Peedikayil FC, Thomas A, Naushad MC,
Narayanan A. Management of muslim dental patient while fasting. Eur J Gen
Dent 2014;3:82-4.
Source of Support: Nil, Conict of Interest: None declared.
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... The authors have stated that during the month of Ramadan, several Muslims are afraid to go to dental clinics even at the times of emergency as they perceive that ingestion of water during dental procedure, administration of anesthesia, accidental swallowing of saliva during intraoral examination, or any intraoral procedure will invalidate their fast. [14,15] Studies postulate the chances of showing up signs of irritability, tiredness, and inattention in these patients during fasting hours due to sleep disturbances and lack of intake of addictive substances such as nicotine and caffeine. [16] Taking into consideration the abovementioned studies, it is, therefore, recommended to schedule the elective dental procedures outside fasting hours. ...
... [25] For managing such a situation, placement of topical medicament such as Alvogyl on the dry socket is permitted during Ramadan. [14] For managing acute pulpitis, pulp capping medicaments such as calcium hydroxide, Ledermix, and formocresol paste can be placed directly on to the pulp. This is permitted during fasting and does not refute the fast. ...
... [32][33][34] As the American Dental Association suggests brushing the teeth two times daily; therefore, the dental specialists ought to remind the fasting patients to brush and floss completely before sleeping and after Suhoor. [14] Mouthwashes, for example, chlorhexidine, can be used, yet patients might be hesitant because of the possibility of incidental swallowing. Hesitant patients might be encouraged to perform the mouthrinse outside the fasting hours. ...
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Fasting during the holy month of Ramadan is considered obligatory for all Muslims. It is regarded as one of the five pillars of Islam in which all the followers observe complete abstinence from food and fluid during daylight hours. Such a strict practice has built up hesitations among the followers to go for a dental treatment. This article aims to describe the modifications in the dental practice required for Muslims during this month alongside the oral health-care tips. A dentist should consider these alternatives and appreciate the religious custom so as to provide a compassionate service.
... Several authors hypothesized that Muslim dental patients may perceive dental procedures during fasting month will nullify their fast which will result in reduced dental attendance during the fasting month 3,5,8 . Yet, there is little study that examined the reality behind this hypothesis. ...
... The results from this study revealed that most of the respondents perceived most of the dental procedures did not invalidate their fast. These findings were contradict with what most authors had been postulated that patients may perceive dental treatment will nullify their fast 3,4,5,8 . Another smaller scale study in Pakistan also found most of the respondents perceived that procedure such as gargles, miswak and using toothpaste will invalidate their fast and is forbidden during fasting 12 . ...
... Therefore, further research on this could be done in the future. Review articles concluded that the use of sublingual tablets, drilling of teeth, extraction or polishing of teeth, tooth brushing, gargling and applying topical medications do not invalidate fasting 4,5,13,15 . However, it is also stated that procedures like oral medication during fasting hours and parenteral nutrition will invalidate fasting. ...
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This study aims to assess the perceptions among Muslims in Malaysia on common dental procedures during fasting. A structured questionnaire was used to assess the perception about common dental procedures during fasting on 377 Muslim adults in Kuantan, Malaysia. The total cumulative score derived from the perception section was categorized into good and poor perception based on the median score, where a score less than median score was categorized as poor perception and a score equal to or more than median score was categorized as good perception. We further examined association between perception score with sociodemographic data. Majority respondents perceived that most of the dental procedures will not nullify their fast with 50.9% of them categorized as having good perception based on median score. There was significant association between perception with education level (p=0.04) and Islamic education level (p<0.001). Majority of the Muslims perceived that most dental procedures did not nullify their fast. Hence, further research is necessary to explore the reason for reduced dental attendance among Muslim patients during fasting month despite their good perception. Clinical article,(J Int Dent Med Res 2019; 12(2): 597-601)
... This halitosis may be misdiagnosed as a symptom of oral disease. 43 Patients must be motivated to improve their oral hygiene care, to brush once before going to sleep and once following the predawn meal. Patients can be advised to use additional supportive methods, such as mouthrinses, outside the fasting hours. ...
... It has been reported that a few populations still follow traditional methods of plaque control, such as the use of miswak twigs. 43 Although these twigs have reported antimicrobial and antiplaque effects, their continuous use can still lead to periodontal diseases, possibly because their cleaning abilities are inferior to those of toothbrushes. 44 Their use has been associated with caries, gingival recession, and an associated yellow tinge over the tooth surface. ...
... For such patients, application of a topical medicament such as Alvogyl (Septodont, Inc.) can be prescribed. 43 Alvogyl is composed of butamben, which is an anesthetic; eugenol, which acts as an analgesic; and iodophorm to provide antimicrobial properties. One study reported that irradiating an extraction socket with low-level laser therapy (808 nm, 100 mW, 60 seconds, 7.64 J/cm 2 ) after irrigation increased the rate of wound healing and could be an effective method for management of alveolar osteitis. ...
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During the sacred month of Ramadan, Muslims abstain from the consumption of food from dawn until dusk. Extended fasting hours produce changes in the body's metabolism during this period. A majority of the population who fast also restrict themselves from undergoing dental treatments due to a fear of breaking the fast. Even among health professionals, a certain amount of uncertainty prevails about the implications of treating a patient who is fasting. To help clinicians carry out safe and effective treatment without hampering a patient's religious beliefs, the present article focuses on the effect of Ramadan fasting on the body's metabolism and the ramifications for treatment aspects, including medications and dental procedures.
... This can be inferred from the fact that most people inquire about the effect of oral hygiene practices such as brushing and use of mouthwash on fasting 5 . Also, the ratio of attending dental appointments has been documented to decline during Ramadan, which delays the treatment and may lead to poor oral health outcomes as well 6,7 . It can only be expected that they will have little knowledge about proper dental treatments during Ramadan. ...
... It can also be assumed that the results are generalizable to the Muslim population anywhere as external validity was assured by devising inclusion/exclusion criteria and collecting data at the same timing. In places where Muslims are a minority, this could prove to be helpful in understanding the knowledge and attitude of people who are fasting, as people often tend to miss appointments during Ramadan and, even if they attend, usually do not undergo any form of treatment 7 . The study also emphasizes the importance of information regarding patients available to the dentist. ...
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Background: Fasting places prohibitions on eating and drinking for a certain period. Although many dental treatments have been said to be safe and can be performed while fasting, others may break the fast. The study aims to evaluate the perception of dental patients regarding the effect of such treatments and hygiene measures during fasting. Methodology: A cross-sectional survey was carried out in two dental teaching hospitals of Lahore, Pakistan. A self-administered structured questionnaire was developed to assess the knowledge and perception of patients regarding dental treatments and hygiene practices while fasting. The chi-squared test was used to observe differences between knowledge amongst gender, occupation and education status. Moreover, multinomial regression analysis was performed to assess the relationship between these variables. Results: Among 374 responses, about 76.2% of respondents believed that undergoing extraction broke fast. Scaling thought to nullify the fast by 45.5%. 52.9% perceived root canal treatment (RCT) to break the fast, along with 67.6%, who believed anesthesia administration broke fast. Brushing was reported to break the fast by 57.5%, with mouthwash invalidating fast by 63.4%. Conclusion: Most respondents thought most oral hygiene measures broke the fast, whereas responses were split regarding procedures where few were perceived to break the fast, and the rest did not.
... 5 Also, the ratio of attending dental appointments have been documented to decline during Ramadan, which not only delays the treatment but may lead to poor oral health outcomes as well. 6,7 It can only be expected that they will have little knowledge about permissible dental treatments during Ramadan. ...
... In places where Muslims are a minority; this could prove to be helpful in understanding the knowledge and attitude of people who are fasting, as people often tend to miss appointments during Ramadan and even if they attend, usually do not undergo any form of treatment. 7 The study also emphasizes on the importance of information regarding patient available to the dentist. For example, a study conducted amongst Muslims in India depicted that most of the respondents believed using eye drops during Ramadan would break their fast. ...
Preprint
Full-text available
Background: Fasting places prohibitions on eating and drinking for a certain period of time. Although many dental treatments have been said to be safe and can be performed while fasting, other may result in breaking of fast. The study aims to evaluate the perception of dental patients of Lahore, Pakistan regarding effect of such treatments and hygiene measures during fasting. Methods : It was a cross-sectional survey carried out in 2 dental teaching hospitals of Lahore, Pakistan from September- October 2018. Patients were asked to complete a self-administered structured questionnaire developed to assess the knowledge regarding dental treatments, and hygiene practices while fasting. The questionnaire consisted of 7 items regarding the influence of dental treatments such as filling, scaling, and extraction etc. on fasting. Questions were also added regarding maintenance of oral hygiene such as brushing and its effect on fast. Frequencies and percentages are used to display results. Chi-squared test was used for statistical analysis to estimate difference between gender, and educational status with perception of procedures breaking fast. Results : Out of 415 responses, 374 were included for analysis. About 76.2% respondents believed that undergoing extraction broke fast. Scaling was thought to nullify the fast by 45.5% of respondents. 52.9% perceived root canal treatment to break fast along with 67.6%, who believed anaesthesia administration broke fast. As far as oral hygiene was concerned, brushing was reported to break fast by 57.5% with the use of mouthwash invalidating fast by 63.4%. Conclusion : The respondents were generally aware of some procedures not breaking fast however, most thought that administration of anaesthesia, undergoing root canal treatment, and extraction invalidated fast. Also, hygiene maintenance measures such as brushing and use of mouthwash during was also thought to break fast. It is imperative that the healthcare providers should be familiar with the effect of dental treatments and oral hygiene measures on fasting state that can influence the treatment plan of the patients.
... 5 Also, the ratio of attending dental appointments have been documented to decline during Ramadan, which not only delays the treatment but may lead to poor oral health outcomes as well. 6,7 It can only be expected that they will have little knowledge about permissible dental treatments during Ramadan. Thus, information about the patients' cultural and religious rituals is of great importance for healthcare professionals, as this knowledge will result in gratification of patients regarding dental healthcare delivery. ...
... In places where Muslims are a minority; this could prove to be helpful in understanding the knowledge and attitude of people who are fasting, as people often tend to miss appointments during Ramadan and even if they attend, usually do not undergo any form of treatment. 7 The study also emphasizes on the importance of information regarding patient available to the dentist. For example, a study conducted amongst Muslims in India depicted that most of the respondents believed using eye drops during Ramadan would break their fast. ...
Preprint
Full-text available
Background: Fasting places prohibitions on eating and drinking for a certain period of time. Although many dental treatments have been said to be safe and can be performed while fasting, other may result in breaking of fast. The study aims to evaluate the perception of dental patients of Lahore, Pakistan regarding effect of such treatments and hygiene measures during fasting. Methods : It was a cross-sectional survey carried out in 2 dental teaching hospitals of Lahore, Pakistan from September- October 2018. Patients were asked to complete a self-administered structured questionnaire developed to assess the knowledge regarding dental treatments, and hygiene practices while fasting. The questionnaire consisted of 7 items regarding the influence of dental treatments such as filling, scaling, and extraction etc. on fasting. Questions were also added regarding maintenance of oral hygiene such as brushing and its effect on fast. Frequencies and percentages are used to display results. Chi-squared test was used for statistical analysis to estimate difference between gender, and educational status with perception of procedures breaking fast. Results : Out of 415 responses, 374 were included for analysis. About 76.2% respondents believed that undergoing extraction broke fast. Scaling was thought to nullify the fast by 45.5% of respondents. 52.9% perceived root canal treatment to break fast along with 67.6%, who believed anaesthesia administration broke fast. As far as oral hygiene was concerned, brushing was reported to break fast by 57.5% with the use of mouthwash invalidating fast by 63.4%. Conclusion : The respondents were generally aware of some procedures not breaking fast however, most thought that administration of anaesthesia, undergoing root canal treatment, and extraction invalidated fast. Also, hygiene maintenance measures such as brushing and use of mouthwash during was also thought to break fast. It is imperative that the healthcare providers should be familiar with the effect of dental treatments and oral hygiene measures on fasting state that can influence the treatment plan of the patients.
... (5) However, to date, there is no study really assessing the views of Muslims regarding attending dental treatment during fasting Therefore, the purpose of this study is to assess the willingness of Muslims in Malaysia to attend dental treatment during fasting and to find out whether it is similar with what have been postulated. In addition, the result of this study shall help the dentists as well as dental students in providing a better dental treatment plan during the fasting month for their patients (8). ...
Article
Full-text available
Background and objective: Some authors reported that there was reduce in dental attendance among Muslim patients during fasting month. The objective of this study is to assess the willingness among Muslims in Malaysia to have dental treatment during fasting month. Method: A cross sectional study was carried out on 246 Muslim adults attended primary care clinic in Kuantan, Malaysia. Face-to-face interviews with a structured questionnaire were used to collect sociodemographic profile and to assess the willingness to come for dental treatment during fasting month. We examined association between sociodemographic profile and their willingness to come for dental treatment. Result: Majority participants (70.7%) were unwilling to have dental treatment during fasting month. However, 89% of them were willing to have dental treatment during emergency. Only 11.4% will advise others not to have dental treatment during fasting months. There was no significant association between their willingness to have dental treatment during fasting and the sociodemographic profile. Conclusion: Majority of the Muslims were unwilling to have common dental treatment during fasting but still willing to have it during emergency situation.
... 1) Trans-cultural counseling of patients suffering from oral diseases is extremely important [14,15]. ...
Chapter
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There are aspects of the practice of the religion of Islam that have some relevance to receiving dental treatment. This article aims to provide dentists with background knowledge of normal practices which may affect the treatment offered. The author does not attempt to inform the reader about Islam, but to assist the dentist in the management of a Muslim patient. Much of the content of this article describes how to manage a patient who is fasting during the Islamic month of Ramadan. Ramadan takes place this year in early October, lasting for 29 or 30 days. During Ramadan patients may present to dentists with the signs and symptoms described in this article.
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Summarized are the significance of fasting in Islam, the rules and regulations of fasting, types of fasting, nullification of fasting, and food practices and habits of Muslims during the fasting month of Ramadan. Some problems pertaining to fasting and their solutions are also considered, and applications of fasting to America have been pointed out. It is hoped that this paper may bring a new dimension to the sphere of cultural nutrition and encourage partial fasting as a means of curbing inflation and helping the poor, the needy, and hungry all over the world.
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To determine to what extent barriers related to culture and language, and how inappropriate expectations might impede orthodontic care, among Pakistani Muslims when compared to white Caucasians from similar socio-economic backgrounds in Bradford, UK. Semi-structured interviews. Dentists were interviewed in the clinic. Parents and children were interviewed separately in the waiting room or in adjacent rooms depending on availability. Four dentists working in the Community and Hospital Dental Services, 30 children and 10 parents of white and Pakistani origin. Among the white Caucasian groups, three-way communication involving parents, children and dentist enhanced understanding, supported orthodontic treatment and reinforced the need for good home care. Among Pakistani families communication was primarily two-way, involving the dentist and the child. Parents and families had limited understanding of the process and were unable to offer a comparable level of support that would benefit their children most. This can place additional burdens on the Pakistani child patient and requires a very positive approach from the dental team. There is a clear need for chairside support, through patient advocates or interpreters, as well as the provision of appropriate educational material to match parents' educational needs on behalf of their children.
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To study the effect of Ramadan fast (RF) on body composition, plasma constituents, hematology, and cardiorespiratory responses to constant submaximal exercise. Sixteen sedentary healthy Kuwaiti adult males were included in the study. The subjects were tested under thermo-neutral conditions during a spring-like month of Ramadan and 2 months thereafter. They were tested during the week before RF (Pre1); the last 3 days of RF (End1); the week before a non-Ramadan month (Pre2), and the last 3 days of the non-Ramadan month (End2). The following measurements were made: body composition, cellular and biochemical constituents of blood, heart rate, ventilatory responses and blood pressure. No significant changes were observed in body composition, cellular and biochemical constituents of blood. The heart rate and ventilatory responses to the moderately intense bouts of submaximal aerobic exercise ( approximately 70% of VO(2max)) were significantly reduced (p < 0.04) while systolic blood pressure increased (p < 0.05) by the end of RF. Ramadan fasting had no adverse effect on the subjects when performing aerobic exercise at submaximal level. The mild changes in cardiorespiratory responses could be due to dehydration, abstention from consumption of substances with negative inotropy and circadian rhythms.
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During the 9th month (Ramadan) of the Islamic calendar (Hijra) many millions of adult Muslims all over the world fast during the daylight hours. Since Hijra is a lunar calendar, Ramadan occurs at different times in the seasonal year over a 33-year cycle. Fasting during Ramadan is partial because the abstention from food, fluid, tobacco and caffeine is from sunrise to sunset. Several categories of people are exempt or can postpone the Ramadan fast. The effect on health and well being of the month-long intermittent fast and fluid restriction has been studied in various potentially vulnerable groups in addition to normal healthy individuals in many countries. The majority of the studies have found significant metabolic changes, but few health problems arising from the fast. A reduction in drug compliance was an inherent negative aspect of the fast. Common findings of the studies reviewed were increased irritability and incidences of headaches with sleep deprivation and lassitude prevalent. A small body mass loss is a frequent, but not universal, outcome of Ramadan. During the daylight hours of Ramadan fasting, practising Muslims are undoubtedly dehydrating, but it is not clear whether they are chronically hypohydrated during the month of Ramadan. No detrimental effects on health have as yet been directly attributed to negative water balance at the levels that may be produced during Ramadan.