Epidemiological Profile of the Pathologies of the Oral Cavity in a Peruvian Population: A 9-Year Retrospective Study of 18,639 Patients.

AIM: To determine the epidemiological profile of oral diseases in a marginal urban Peruvian population. METHODS: A 9-year retrospective study was conducted, analysing 18,639 clinical records from the María Auxiliadora Hospital between 2006 and 2015 with diagnoses of oral lesions using ICD-10 criteria. Clinical records were analysed for sex, tumour, periapical abscess and sinus, cysts of the oral region, other lesions of the oral mucosa and cavity, gingivitis and periodontal disease, dentofacial anomalies, diseases of pulp, etc. RESULTS: Of 18,639 cases, the prevalence was higher in women for the following pathologies: unspecified dental caries (30.6%); impacted tooth in the category of disorders of tooth development and eruption (2.0%); pulpitis (6.8%) in the category of diseases of pulp and periapical tissues; temporomandibular joint (TMJ) disorders (1.5%) in the category of dentofacial anomalies; acute gingivitis (7.5%); radicular cyst (0.3%) in the category of cysts of the oral region; and periapical abscess without sinus (2.0%). CONCLUSIONS: We found a significant association between sex and different types of dental caries, disturbances in tooth eruption, diseases of pulp and periapical tissues, and dentofacial anomalies. The study also shows a statistically significant association between sex and gingivitis, periodontal disease, and periodontal abscess and sinus.

[Oral allergies]. / Les allergies orales.

Oral allergies to dental materials are a growing problem and remain poorly diagnosed by health professionals. The complaints of patients with oral allergy are various and include sensations of burning or stinging of the oral mucosa, sensations of dryness of the oral cavity, or general symptoms such as headache, dyspepsia, asthenia, arthralgia, and myalgia. Signs suggestive of oral allergy include erythema, edema, purpuric patches on the palate, ulcerations of the oral mucosa (canker sore), gingivitis, glossitis mimicking geographic tongue, angular cheilitis, peri-oral eczema or the presence of lichenoid reactions of the oral mucosa. The diagnosis of an allergy will include data from the anamnesis, the clinical examination, as well as the results of allergy tests: epicutaneous tests (patch tests) or cutaneous tests (prick tests), possibly completed by a blood test ( in vitro lymphoblastic transformation test ou LTT).

Les allergies orales aux matériaux dentaires représentent un problème croissant et demeurent peu diagnostiquées par les professionnels de la santé. Les plaintes des patients présentant une allergie buccale sont variées et compor tent des sensations de brûlures ou de picotements de la muqueuse buccale, des sensations de sécheresse de la cavité buccale ou des symptômes généraux de type céphalée, dyspepsie, asthénie, arthralgies, myalgies. Les signes qui peuvent faire suspecter une allergie de la cavité buccale sont la présence d'un érythème, d'un oedème ou piqueté purpurique du palais, des ulcérations de la muqueuse buccale (aphtes), une gingivite, une glossite dépapillante, une perlèche, un eczéma péribuccal ou encore la présence de réactions lichénoïdes de la muqueuse buccale. Le diagnostic d'une allergie comprendra les données de l'anamnèse, de l'examen clinique, ainsi que les résultats des tests d'allergies : tests épicutanés (patch tests) ou cutanés (prick tests), complétés éventuellement par un test sanguin (test de transformation lymphoblastique in vitro ou LTT).

Schedule for Rating Disabilities; Dental and Oral Conditions. Final rule.

This document amends the Department of Veterans Affairs (VA) Schedule for Rating Disabilities by revising the portion of the schedule that addresses dental and oral conditions. The effect of this action is to ensure that the rating schedule uses current medical terminology and to provide detailed and updated criteria for evaluation of dental and oral conditions for disability rating purposes.

Comparing lifecourse models of social class and adult oral health using the 1958 National Child Development Study.

OBJECTIVE: To identify the lifecourse model that best describes the association between social class and adult oral health. METHODS: Data from 10,217 participants of the 1958 National Child Development Study were used. Social class at ages 7, 16 and 33 years were chosen to represent socioeconomic conditions during childhood, adolescence and adulthood, respectively. Two subjective oral health indicators (lifetime and past-year prevalence of persistent trouble with gums or mouth) were measured at age 33. The critical period, accumulation and social trajectories models were tested in logistic regression models and the most appropriate lifecourse model was identified using the structured modelling approach. RESULTS: The critical period model showed that only adulthood social class was significantly associated with oral health. For the accumulation model, a monotonic gradient was found between the number of periods in manual social class and oral health; and four out of eight social trajectories were found to be distinctive. Finally, the social trajectories model was not significantly different from the saturated model indicating that it provided a good fit to the data. CONCLUSION: This study shows the social trajectories model was the most appropriate, in terms of model fit, to describe the association between social class and oral health.

Betel nut chewing behaviour and its association with oral mucosal lesions and conditions in Ghaziabad, India.

PURPOSE: To assess the practices and behaviour among Betel nut users in Ghaziabad and to detect the clinically associated oral mucosal lesions and conditions. MATERIALS AND METHODS: A community-based survey was conducted in Ghaziabad among 332 betel nut users. Data on betel nut use was obtained through a self-administered questionnaire. Oral mucosal lesions and conditions were recorded using WHO criteria. RESULTS: Out of 332 betel nut users, 32.8% consumed Gutkha. 62.3% users used betel nut with tobacco. Most of the study population started chewing betel nut because of peer pressure and the habit started at the workplace or school. A majority found that there was no physical discomfort due to the habit. The significant oral diseases detected were oral leukoplakia in 11.7% and oral submucous fibrosis in 6.1% of individuals. CONCLUSION: The findings of the present study revealed that 74.7% of the participants were current chewers. 30.4% of all participants had oral mucosal lesions and conditions.

Floor-of-mouth dermoid cysts: report of 3 variants and a suggested change in terminology.

PURPOSE: Dermoid cyst is a frequently used descriptive term, but its definition changes according to the clinician (eg, dermatologists, neurologists, gynecologists, oral and maxillofacial surgeons, and plastic surgeons). It is sometimes used synonymously with teratoma. In oral and maxillofacial surgery, it is applied to describe congenital floor-of-mouth cysts of 3 histologic types: epidermoid, dermoid, and teratoid. This terminology is confusing and has led to some ambiguity in the literature. The purpose of this report is to document 3 cases illustrating the utility of a more specific term, congenital germline fusion cyst of the floor of the mouth. PATIENTS AND METHODS: Patients who presented with floor-of-mouth swelling were evaluated by history, clinical examination, and imaging studies (magnetic resonance imaging and computed tomography). RESULTS: Three cases (1 epidermoid variant, 1 dermoid variant, and 1 teratoid variant) are documented to illustrate the new terminology. CONCLUSION: Congenital germline fusion cyst is more reflective of the embryologic origins of the lesion than dermoid cyst and is inclusive of all 3 histologic variants.

Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University.

BACKGROUND: Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults. METHODS: This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed. RESULTS: In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health. CONCLUSION: Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.

Ocular and oral grading of mucous membrane pemphigoid.

BACKGROUND: A variety of methods have been described for grading ocular mucous membrane pemphigoid (MMP), each with their own limitations. In contrast, there are no reported grading systems for involvement of the oral mucosa. We wished to evaluate two ocular (one established and one proposed) and an oral mucosal grading system for MMP. METHODS: Patients with MMP were assessed by three ophthalmologists and two oral medicine physicians. Ocular disease was graded using the system described by Rowsey and a proposed system based on measurement of vertical depth and horizontal width measured from the bulbar conjunctival aspect. Oral assessment used a 'mucosal disease severity score' originally described for lichen planus, in which 17 areas of the mouth are scored for involvement, together with a pain score. Levels of agreement were evaluated using Fleiss' Kappa Statistic (k). RESULTS: Forty-four patients with MMP encompassing mild to severe disease were included. Good levels of agreement were observed between observers for both vertical (k:0.86) (upper 95% CI: 1.03 mm) and horizontal (k:0.80) (upper 95% CI: 3.01 mm) involvement for the proposed ocular system and the Rowsey system (k: 0.83) (upper 95% confidence interval: 3.19 mm). There was a high coefficient of determination (R(2)) between the ocular grading systems (0.81, p < 0.01). Oral grading showed excellent levels of agreement (k: 0.71) between observers. There was no significant association between the severity of oral and ocular disease using described grading systems. CONCLUSIONS: The proposed grading systems for both oral and ocular involvement in MMP are easy to use, and show good agreement between observers. The proposed ocular system correlates well with a currently used system, and overcomes some of the difficulties encountered with existing systems. For the individual patient, changes greater than 1.5 mm (vertical) and 3 mm (horizontal) are significant. This may increase our ability to detect change or disease progression. Although the risk of ocular involvement in patients with only oral involvement has been demonstrated, the severity of oral and ocular disease are not well-correlated, due in part to an absence of an ocular disease activity score.

A review of common oral pathology lesions, with a focus on periodontology and implantology.

The recognition, diagnosis, and management of common oral conditions requires knowledge of the lesion's clinical characteristics as well as the underlying pathology of the lesion. A thorough medical history, knowledge of normal anatomy, and a complete head and neck examination are necessary for the early recognition of oral lesions. Once any oral pathology is noted, clinical characteristics of size, location, texture, color, symptoms, and duration are necessary to arrive at a working plan and eventually a definitive diagnosis. In the end, the diagnosis often requires a biopsy or culture of the lesion. The clinical and histopathologic and/or mycologic correlation renders a final diagnosis leading to therapeutic options. A thorough knowledge of common oral lesions will allow the dentist/specialist to provide proper therapy or allow for referral to an oral medicine or oral surgery specialist. This review covers common infectious, reactive/traumatic, white, red, and bone lesions, as well as the vesiculobullous/desquamative gingival conditions, with a focus on periodontology and implantology. We cover the etiology, clinical features, histopathology, and treatment of each oral pathological condition.

Prevalence of oral mucosal lesions and related factors in 200 HIV+/AIDS Iranian patients.

BACKGROUND: Human immunodeficiency virus infection is a worldwide problem, which affects both developed and developing countries the same. Oral lesions related to this disease are important because they affect the patient's quality of life. In developed countries, these lesions are well classified, but fewer reports on this subject are available in developing countries. Regarding the wide range of oral lesions and lack of solid status in Iran, this study has been performed on the prevalence of oral mucosal lesions and related factors in human immunodeficiency virus positive/acquired immune deficiency syndrome patients referred to behavioural disease management centres of Shahid Beheshti University in 2008-2009, Tehran. METHODS: This descriptive cross-sectional study was performed by means of observations, clinical examination, completing questionnaire and also evaluating the 200 patients' medical records to find oral mucosal lesions. Sampling was made by sequential method and after recording the finding a SPSS (version 16) software, and ordinal regression, Fisher and k^2 tests were used to analyse the results. RESULTS: One hundred and forty-nine of 200 human immunodeficiency virus positive/acquired immune deficiency syndrome patients (193 men and 7 women) had oral lesions (74.5%). Oral candidiasis (22%), linear gingival erythema (16.55%) and lymphadenopathy (13.5%) were the most common lesions. CONCLUSION: With respect to the resulted prevalence in this study (74.5%), early detection of oral lesions must be emphasized on the diagnosis and early management of human immunodeficiency virus positive/acquired immune deficiency syndrome patients.

Complications of oral and peri-oral piercings: a summary of case reports.

OBJECTIVE: To systemically search the literature for case reports concerning adverse effects associated with oral and peri-oral piercings on oral health and/or general health. MATERIAL AND METHODS: MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up through 1 April 2010 to identify appropriate studies. RESULTS: Independent screening of the titles and abstracts identified 1169 papers from MEDLINE and 73 papers from CENTRAL. Subsequently, 67 papers describing 83 cases were processed for data extraction. The case reports described complications in oral and general health. In this review, 96 complications were described for 83 cases. Of the 96 reported complications, 81% (n=84) occurred in cases of tongue piercings, 20% (n=21) in cases of lip piercings and 1% (n=1) in cases of other oral piercings. In eight cases, subjects had two oral and/or peri-oral piercings. Gingival recession was the most frequently described complication. Periodontitis and gingival recession were seen at the central mandibular incisors. Tooth fracture is mostly reported in subjects with tongue piercings. CONCLUSION: Among the case reports, there were complications like normal post-operative swelling and localized inflammation but also more serious complication that may even have been life threatening. Also in the long term, piercing may be associated with gingival recession and tooth fracture. Therefore, oral and/or peri-oral piercings are not without risks. Patients considering a piercing should be made aware of this. Those patients wearing a piercing should be screened by a dental professional for possible complications on a regular basis.

Oral health status among hospitalized patients.

AIM: To investigate into oral health status and its association with health status in hospitalized patients. METHODS: A total of 82 patients were examined and 49 (59.7%) patients were men. The patients answered a survey and oral examinations to detect the number of teeth, oral hygiene index, prostheses hygiene, oral lesions, caries, dental plaque index (DPI), gingival inflammation index (GI), gingival bleeding index, periodontitis and periodontal index. RESULTS: Oral hygiene was associated with age, but it was not related to physical disability. Difficulty eating was mainly associated with age and tooth loss. All full and partially dentate patients presented dental plaque, 38 (69%) poor oral hygiene, 58 (98.1%) gingival inflammation, 41 (74.5%) periodontal disease and 33 (60%) caries. Oral lesions were detected in 30 (36.5%) and candidiasis (n = 16, 19.6%) was the most frequent mucous lesion. Caries were associated with smoking and poor oral hygiene. Hospital length of stay and age were associated with increased DPI and GI. CONCLUSIONS: The majority of hospitalized patients did not present satisfactory oral hygiene. Caries and periodontal diseases are associated with health behaviours. Increased time length at hospital could increase gingival inflammation and dental plaque accumulation.

[Potentially malignant disorders of the oral mucosa: terminology and classification]. / Affections potentiellement malignes de la muqueuse buccale: nomenclature et classification.

The last WHO expert workgroup recommended abandoning the distinction between potentially malignant lesions and conditions. The term to use is "potentially malignant disorders". Leukoplakia is the most common of these disorders, while erythroplakia is rather rare. The diagnosis is still made by excluding other documented white or red lesions. Despite progress in molecular biology, no marker allows predicting malignant transformation. These lesions are treated surgically with or without dysplasia. It is unknown if this surgery can really prevent transformation into squamous cell carcinoma. The potential malignancy of oral lichen planus is still debated. The risk of malignant transformation is lower than that of leukoplakia. No treatment may prevent this. Other potentially malignant conditions such as oral submucous fibrosis, actinic cheilitis, lupus, and immunodeficiency are rare.

Feline oral cavity lesions diagnosed by histopathology: a 6-year retrospective study in Portugal.

OBJECTIVES: The aim of this study was to analyse the frequency of oral cavity lesions in cats, their anatomical location and histological diagnosis, and the effect of life stage, breed and sex on different diagnoses. METHODS: For this purpose, a retrospective study comprising 297 feline oral cavity lesions was performed over a 6-year period between 2010 and 2015. Histopathological records from the DNAtech Pathology Laboratory (Lisbon, Portugal) were analysed. RESULTS: The incidence of oral disease was higher in male cats (n = 173; 58.4%), mature adults (ranging from 7 to 10 years old [n = 88; 33.0%]) and in the European Shorthair breed (n = 206; 73.6%). The gingiva was the site where oral lesions were most commonly found, with 128 samples (43.1%). Incisional biopsies were used to obtain the majority of samples (n = 256; 86.2%), while excisional biopsies and punch biopsies were performed in 36 (12.1%) and five (1.7%) cases, respectively. Inflammatory and neoplastic lesions accounted for 187 (63%) and 110 (37%) of the studied cases, respectively. Malignancies were found in >80% of neoplastic cases. Feline chronic gingivostomatitis was the most common histological diagnosis (n = 116; 39.1%), followed by squamous cell carcinoma (n = 49; 16.5%) and eosinophilic granuloma complex (n = 33; 11.1%). CONCLUSIONS AND RELEVANCE: The present work, involving a large series of samples of feline oral cavity lesions, from numerous geographically scattered practices and all examined at a reference veterinary pathology laboratory, adds important new understanding of the epidemiology of feline oral disease.

Differences between the oral changes presented by patients with solid and hematologic tumors during the chemotherapeutic treatment.

OBJECTIVE: This study sought to identify the differences between the oral changes presented by patients with solid and hematologic tumors during chemotherapeutic treatment. METHODOLOGY: This is an observational, prospective and quantitative study using direct documentation by follow-up of 105 patients from 0 to 18 years using the modified Oral Assessment Guide (OAG). Of the 105 patients analyzed, 57 (54.3%) were boys with 7.3 years (±5.2) mean age. Hematologic neoplasms accounted for 51.4% of all cases. RESULTS: Voice, lips, tongue, and saliva changes were not significantly different (p>0.05) between patients with solid or hematologic tumors and during the follow-up. From the 6th until the 10th week of chemotherapeutic treatment alterations in swallowing function, in the mucous membrane (buccal mucosa and palate), in the labial mucosa, and in the gingiva occurred and were distributed differently between the two tumors groups (p<0.05). The main alterations were observed in patients with hematologic tumors. CONCLUSION: It was concluded that the oral changes during the chemotherapeutic treatment occurred especially in swallowing function, in the mucous membrane, in the labial mucosa and in the gingiva, and these alterations were found mainly in patients with hematologic tumors.

Oral Manifestations of Nutritional Deficiencies: Single Centre Analysis.

INTRODUCTION: Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations. METHODS: 250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken. RESULTS: 250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%). CONCLUSION: The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.

Oral manifestations in human immunodeficiency virus infected children in highly active antiretroviral therapy era.

OBJECTIVE: Conducted a literature review to identify studies that reported on the oral manifestations in human immunodeficiency virus (HIV) infected children in highly active antiretrovial therapy (HAART) era. METHODS: A search electronic data base were used and the terms used were 'oral lesions' and 'oral manifestations'. The studies of prevalence of oral manifestation in children with HIV worldwide, descriptive studies, case reports, studies on the association of oral lesions and levels of immune suppression, use of HAART and transmission of HIV were included. RESULTS: There have been substantial changes in the management of HIV disease, especially in the past decade because of the use of HAART. However, children are still being infected and present some peculiarities when compared with adults. Molecular epidemiology, transmission and therapy of the common opportunistic oral infections of HIV disease need to be better understood as a consequence of improved anti-HIV strategies. Treatment with HAART improves the immune function and decreases mortality, morbidity, and opportunistic infections in HIV-infected persons. CONCLUSION: The frequency and severity of oral disease associated with HIV infection have reduced considerably, although the use of HAART may be associated with an increased appearance of oral lesions associated with human papillomavirus and potentially increase the risk of later oral squamous cell carcinoma.