Botulinum toxin assessment, intervention and aftercare for paediatric and adult drooling: international consensus statement.

Many individuals with neurological problems or anatomical abnormalities of the jaw, lips or oral cavity may drool, which can impact on health and quality of life. A thorough evaluation of the patient's history, examination of the oral region by a speech pathologist and, in individuals over 3 years, a dental examination is warranted. Questionnaires with established validity such as the Drooling Impact Scale are useful assessment tools. A hierarchical approach to treatment is taken from least invasive therapies, such as speech pathology, to more invasive, such as injection of botulinum neurotoxin type-A (BoNT-A) into the salivary glands (parotid and submandibular). The wishes of the individual and their carer are crucial considerations in determining the suitability of the intervention for the patient. In the presence of dysphagia and cerebral palsy (CP), careful assessment is required prior to the injection of BoNT-A. Favourable responses to intervention include a reduction in the secretion of saliva and in drooling, as well as psychosocial improvements. BoNT-A is usually well tolerated, although potential side effects should be discussed with the patient and carer.

Surgical correction of an equine deviated anterior maxilla.

The surgical correction of midfacial deformities of the horse have rarely been undertaken. This article describes the successful management of a submucous cleft of the maxilla in a young colt. Details of the operative and perioperative medical and surgical management are described. The horse, now 5 years of age, has sired eight normal progeny.

A case of neurocristopathy that manifests facial clefting and maxillary duplication.

A case of a 6-year-old child with three facial clefts and maxillary duplication is presented. Computerized three-dimensional reconstruction from computerized tomography imaging was used in the diagnosis of this patient, and an explanation of the possible embryologic causes of this malformation is discussed.

The surgical correction of a deviated anterior maxilla in a horse.

The surgical correction of facial deformities of the horse have rarely been undertaken. The surgical and medical management of submucous clefting of the anterior maxilla in a young colt is described.

Erythema multiforme and Mycoplasma pneumoniae infection. Report and discussion of a case presenting with stomatitis.

A case report is presented in which a respiratory tract infection with M. pneumoniae appears to have provoked a generalised mucocutaneous disease, described as Stevens Johnson syndrome. The patient possessed complement-fixing antibodies to M. pneumoniae to a titre of 1/2048 compared with the general population titre of 1/32. The oral mucosal lesions are described in particular and a likely pathogenesis of erythema multiforme is discussed.

Unilateral mandibular cherubism: brief review and case report.

A case of unilateral cherubism is presented in which only one side of the mandible was affected. The associated diagnostic features are discussed.

An in vivo comparison of chlorhexidine and picloxydine mouthrinses: a possible association between chemical structure and antiplaque activity.

A double blind clinical trial was conducted in which both the plaque-inhibiting ability and the in vivo effects on the oral flora of chlorhexidine and picloxydine mouthwashes was compared. While picloxydine in higher concentration suppressed the oral flora more effectively than chlorhexidine, the latter agent inhibited plaque development to a much greater extent. This lack of correlation between antibacterial and antiplaque activity can be related to structural differences between these two bis-biguanides.