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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-24Achieving Low Percentage of Alveolar Osteitis Incidence among Patients in PrimaryDental Clinics in PerlisAifaa NAS1, Nur SIM1, Farah AMK2, Goh MJ2, Chong FM2, Nurul SMAS3, Mior MA4, Vallar M51Klinik Pergigian Kampung Gial, Perlis State Health Department Ministry of Health Malaysia2Klinik Pergigian Beseri, Perlis State Health Department Ministry of Health Malaysia3Klinik Pergigian Simpang Empat, Perlis State Health Department Ministry of Health Malaysia4Klinik Pergigian Kuala Perlis, Perlis State Health Department Ministry of Health Malaysia5Klinik Pergigian Arau, Perlis State Health Department Ministry of Health MalaysiaSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Alveolar Osteitis (AO), the most common complication of tooth removal, often requires invasivetreatment. A study from October to December 2022 found 19.20% (n=163/849) of extractions in threeprimary dental clinics in Perlis resulted in severe pain and empty sockets, indicative of AO. The studyaimed to decrease the incidence of AO following tooth extraction in primary dental clinics in Perlis.KEY MEASURES FOR IMPROVEMENT:The indicator used was the percentage of AO cases in tooth extraction. A standard of %u22640.30% was setbased on the literature review.PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted involving all patients undergoing non-surgical and surgicalextractions from October 2022 to February 2024, excluding primary teeth extractions. Study instrumentsincluded a Knowledge Analysis Survey for operators, a clinical audit form, and an AO criteria checklist.Remedial measures were implemented between February-April and August-November 2023.Post-remedial data collection occurred in two cycles: April-July 2023 and December 2023-February 2024.ANALYSIS AND INTERPRETATION:The contributing factors were improper case selection (30.00%), improper practice among operators(80.00%), poor post-procedure care by operators (66.70%) and patients%u2019 incompliance to post-operativeinstructions (50.00%).STRATEGIES FOR CHANGE:The strategies for dentists include developing a standard extraction protocol that incorporatespre-extraction assessment of blood glucose level for diabetes mellitus patients, provision of atraumaticextraction training courses, mentorship programme pairing new and senior dentists, and providinginstruments checklist. Patients will receive a post-operation instruction leaflet and a review three daysafter extraction, immediate chair-side review after 10 minutes, oral hygiene promotion through flipchartsand i-Read innovation, and enhanced follow-up through phone calls to reduce missed appointments.EFFECT OF CHANGE:The percentage of Alveolar Osteitis cases reduced to 8.00% and 2.67% in Cycle 1 and 2 respectively. Allcontributing factors were reduced to 0.00% except for patients%u2019 incompliance with post-operativeinstructions (18.42%).THE NEXT STEP:We plan to continue implementing the strategies until the standard is achieved.49 | Page