Proportion of paediatric admissions with any stage of noma at the Anka General Hospital, northwest Nigeria.

INTRODUCTION: Noma is a rapidly spreading infection of the oral cavity which mainly affects young children. Without early treatment, it can have a high mortality rate. Simple gingivitis is a warning sign for noma, and acute necrotizing gingivitis is the first stage of noma. The epidemiology of noma is not well understood. We aimed to understand the prevalence of all stages of noma in hospitalised children. METHODS: We conducted a prospective observational study from 1st June to 24th October 2021, enrolling patients aged 0 to 12 years who were admitted to the Anka General Hospital, Zamfara, northwest Nigeria. Consenting parents/ guardians of participants were interviewed at admission. Participants had anthropometric and oral examinations at admission and discharge. FINDINGS: Of the 2346 patients, 58 (2.5%) were diagnosed with simple gingivitis and six (n = 0.3%) with acute necrotizing gingivitis upon admission. Of those admitted to the Inpatient Therapeutic Feeding Centre (ITFC), 3.4% (n = 37, CI 2.5-4.7%) were diagnosed with simple gingivitis upon admission compared to 1.7% of those not admitted to the ITFC (n = 21, CI 1.1-2.6%) (p = 0.008). Risk factors identified for having simple gingivitis included being aged over two years (2 to 6 yrs old, odds ratio (OR) 3.4, CI 1.77-6.5; 7 to 12 yrs OR 5.0, CI 1.7-14.6; p = <0.001), being admitted to the ITFC (OR 2.1; CI 1.22-3.62) and having oral health issues in the three months prior to the assessment (OR 18.75; CI 10.65, 33.01). All (n = 4/4) those aged six months to five years acute necrotizing gingivitis had chronic malnutrition. CONCLUSION: Our study showed a small proportion of children admitted to the Anka General Hospital had simple or acute necrotizing gingivitis. Hospital admission with malnutrition was a risk factor for both simple and acute necrotizing gingivitis. The lack of access to and uptake of oral health care indicates a strong need for oral examinations to be included in routine health services. This provision could improve the oral status of the population and decrease the chance of patients developing noma.

Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study.

OBJECTIVES: Necrotizing ulcerative gingivitis (NUG) has been seen in military populations throughout history. This study aims to determine the prevalence, treatment modality and risk factors associated with NUG in the British Armed Forces. MATERIALS AND METHODS: A whole population dataset of the British Armed Forces was searched to determine cases of NUG during the period 1 January to 31 December 2012. Individual case records were identified, and a case-control study undertaken with data gathered and analysed against a randomised control group, matched for age, sex and service. RESULTS: A prevalence rate for NUG of 0.11 % was determined against the whole military population. The majority of cases received (alone or in combination) the following: oral hygiene instruction (66.5 %), antibiotics (64.4 %) and a mouthwash (58.1 %). Of the cases, 48.7 % received debridement. Analgesics were only prescribed in 8.4 % of the cases, and smoking cessation advice was only given in 10.7 % of the cases. Analysis of risk factors against the control group showed an increase in odds ratios for diagnosis of NUG of 3.4 (95 % CI 2.0-5.7) for current smokers and 7.3 (95 % CI 1.9-28.0) for individuals with an overall Basic Periodontal Examination (BPE) score of 3. CONCLUSIONS: Whilst NUG is a rare disease, it is evident from this study that it still occurs within the British Armed Forces. A strong association was shown between NUG and current smokers and those cases with an overall BPE score of 3. CLINICAL RELEVANCE: This study provides prevalence data for NUG in the British Armed Forces and description of its treatment and associated risk factors. Oral hygiene and smoking must be addressed in patients with NUG and prescribing protocols should be carefully followed.

Periodontal disease in children and adolescents of Latin America.

Periodontal diseases are a group of infectious diseases that mainly include gingivitis and periodontitis. Gingivitis is the most prevalent form of periodontal disease in subjects of all ages, including children and adolescents. Less frequent types of periodontal disease include aggressive periodontitis, acute necrotizing ulcerative gingivitis and various diseases of herpesviral and fungal origin. This review aimed to retrieve relevant information from Latin America on the prevalence of periodontal diseases among children and adolescents of the region. Gingivitis was detected in 35% of young Latin American subjects and showed the highest frequencies in Colombia (77%) and Bolivia (73%) and the lowest frequency in Mexico (23%). The frequency of gingivitis in subjects from other Latin American countries was between 31% and 56%. Periodontitis may affect <10% of the young population in Latin America, but the data are based on only a few studies. A more precise assessment of the distribution and severity of periodontal disease in children and adolescents of Latin America may help policy makers and dentists to institute more effective public health measures to prevent and treat the disease at an early age to avoid major damage to the permanent dentition.

[NUG--necrotizing ulcerative gingivitis: a review].

Necrotizing Ulcerative Gingivitis (NUG) is an acute and rare (0.5-11% of the population) infectious disease of the gum tissue, which is characterized by ulceration and inflammation of the inter-dental gum tissue. NUG was documented by historians since the fourth century BC, most of the reports from the ancient world were in the context of illness among fighting troops, present studies of NUG in the modern world are still common among soldiers. NUG is associated with poor oral hygiene and weakening of the host, especially in immunocompromised patients, malnutrition and poor living conditions, as well as in the context of mental stress. NUG is more common in young adults, but reports of morbidity in young children with malnutrition in the background are not uncommon. NUG diagnosis is based on three essential symptoms: sore gums, bleeding gums and the most diagnostic characteristic, ulceration and necrosis of the interdental papillae. The disease is considered to have a clear initial infectious etiology, when the main bacteria, associated with the disease, include: Bacteroides intermedius and Fusobacterium sp. The infection involves anaerobic \ aerobic bacteria with a majority of Gram-negative bacteria. The treatment of NUG is based on combining mechanical removal of tartar with local and systemic delivery of antimicrobial agents. Adequate treatment usually prevent the progression of the disease and ulcer healing is expected in a few days. Nevertheless, lack of treatment can lead to deterioration in the form NUP to Noma.

Gender differences in oral manifestations among HIV-infected Brazilian adults.

AIM: The purpose of this study was to compare gender differences in the prevalence of oral lesions in HIV-infected Brazilian adults. METHODOLOGY: A retrospective study was conducted of medical records from HIV/AIDS patients from 1993 to 2004. Oral lesions were only included in this study if definitively diagnosed through microscopic analysis, therapeutic test or according to EC-Clearing house criteria. RESULTS: A total of 750 men and 237 women were included in the study. Statistically significant differences were observed only for oral hairy leukoplakia, Kaposi sarcoma and lymphadenopathy (P < 0.01). However, a model of logistic regression showed that only oral hairy leukoplakia presented a significant association with gender and males had a significantly likelihood (four times higher than females) of presenting with this oral manifestation [OR 4.3 (95% CI: 1.39-13.36)]. CONCLUSION: These data shows that oral manifestations are less prevalent in females than in males, particularly oral hairy leukoplakia.

Prevalence of oral lesions of autoimmune etiology in patients with primary Sjogren's syndrome.

OBJECTIVE: The primary objective of this study was to determine the prevalence of oral lesions of autoimmune etiology (OLAIE) in a cohort of patients with primary Sjögren's syndrome (pSS). MATERIALS AND METHODS: A multi-center retrospective cohort study was conducted at the oral medicine practices of Carolinas Medical Center (CMC), Baylor College of Dentistry (BCD), and the University of Florida (UF). Each site performed a chart review of patients with well-characterized pSS. Clinical variables such as OLAIE, traumatic lesions, and medical conditions were compiled at each site. The association between clinical variables and the presence of OLAIE was then assessed for significance. RESULTS: We evaluated 155 patients diagnosed with pSS. Nineteen patients with pSS (12.3%) had an OLAIE. CMC reported 11 (21.2%) patients with OLAIE, while BCD and UF reported 4 (7.3%) and 4 (8.3%), respectively. Eleven of the 19 (58%) patients with OLAIE had lichen planus, 6 (32%) had aphthous stomatitis, 1 (5%) had chronic ulcerative stomatitis, and 1 (5%) had lesions of systemic connective tissue disease by immunofluorescence. CONCLUSION: The results of our analysis suggest that patients with pSS have a 12% prevalence of OLAIE with a wide range (7.3-21.2%) found between practices. This difference is likely related to the different screening protocols for oral dryness between sites.

The prevalence of HIV associated oral lesions among adults in the era of HAART.

INTRODUCTION: The overall prevalence of HIV associated oral lesions among adults has decreased since the advent of highly active anti-retroviral therapy (HAART). AIMS AND OBJECTIVES: This study describes the prevalence and types of oral mucosal lesions in adults, who accepted a dedicated oral and dental programme for HIV-infected patients. The incidence of oral lesions and the CD4 cell counts on those patients, were related to cases receiving HAART and to those who were not. DESIGN: This was a retrospective, descriptive cross-sectional study. METHODS: Patients were interviewed, using a structured questionnaire to obtain information regarding medical history, current medications and demographic details. Data relating to CD4 cell counts were extracted from clinical medical records of the patent. In each case, the oral cavity of the sitting patient was examined under artificial light, by a clinician using a mouth mirror. Oral lesions were categorised in accordance with EC-Clearinghouse diagnostic criteria. RESULTS: The prevalence of HIV-associated oral lesions was significantly reduced (p < 0.001) in patients receiving HAART. There was, however, no significant difference (p = 0.29) in mean CD4 counts between patients receiving HAART and those not receiving HAART. The presence of oral lesions was statistically significantly, associated with both CD4 counts of < 200 cells/mm3 (p < 0.001) and the absence of HAART (p = 0.033). CONCLUSIONS: The study confirmed that the incidence of oral lesions and of pseudo-membranous candidiasis in particular, were statistically significantly reduced in patients receiving HAART.

Prevalence of necrotizing ulcerative gingivitis and associated factors in Koranic boarding schools in Senegal.

BACKGROUND: Necrotizing ulcerative gingivitis is the most common clinical syndrome preceding noma. It is found in developing countries and in malnourished children and especially in deprived groups such as children at Koranic boarding schools. The objective of this study was to determine the prevalence of necrotizing ulcerative gingivitis and factors associated with its occurrence in a boarding school population. METHODS: This was a cross-sectional study of children in Koranic boarding schools in the city of Touba, Senegal. A multistage sampling strategy was used and 8 out of 17 schools were selected. The variables collected were gender, age, oral hygiene habits, duration of residence, presence of ulcerative gingivitis and plaque, and gingival bleeding index. A logistic regression analysis with R software using the manual procedure down was used to identify factors associated with the dependent variables. RESULTS: There were 501 participants and boys made up 92% of the study group. The mean age was 9.3 (sd 4.0) years. The mean of duration residence was 3.4 (sd 1.5) years. The prevalence of necrotizing ulcerative gingivitis was 37% and 81% of children did not use a toothbrush or a chewing-stick. The length of residence, school size, hygiene habits and plaque and bleeding indices were significantly associated with necrotizing gingivitis after adjustment for other variables. CONCLUSION: It is necessary to develop oral hygiene programs, to establish policies to manage the oral health of children and to improve health and nutrition at Koranic boarding-schools.

Reporte de una posible correlación entre la gingivitis ulceronecrotizante y la mononucleosis / Report a possible correlation between necrotizing ulcerative gingivitis and mononucleosis

Necrotizing ulcerative gingivitis is a relatively uncommon periodontal disease, characterized by ulceration, necrosis, pain and gingival bleeding. Factors often related to its occurrence include stress and systemic viral infections, such as those caused by cytomegalovirus and Epstein-Barr virus type 1, the latter being also considered the causative agent of infectious mononucleosis. This article aims to describe a clinical case of a female patient who presented with necrotizing ulcerative gingivitis associated with a clinical picture of infectious mononucleosis, as well as to review the literature concerning a possible correlation between these pathologies. This patient presented to our health care facility with necrotizing ulcerative gingivitis accompanied by lymphadenopathy, fever and prostration, after laboratory tests, Epstein-Barr virus type 1 infection was confirmed, as well as the co-occurrence of pathologies: necrotizing ulcerative gingivitis and infectious mononucleosis. Symptom remission in both disorders also occurred concomitantly, after instruction in plaque control measures and palliative medication for control of systemic symptoms. Therefore, although there is no scientific validation of an association between these two pathologies, it is imperative that all diagnostic alternatives be considered and investigated, in order to establish the therapeutic approach most appropriate to the patient(AU

La gingivitis ulcerativa necrótica es una enfermedad periodontal no común caracterizada por ulceración, necrosis, dolor y sangrado gingival. Los factores a menudo relacionados con su ocurrencia incluyen el estrés y las infecciones virales sistémicas como aquellas causadas por Cytomegalovirus y el virus Epstein-Barr tipo 1, donde este último es el agente causal de la mononuclerosis infecciosa. El objetivo de este trabajo fue describir el caso clínico de una mujer con gingivitis ulcerativa necrótica asociada a un cuadro clínico de mononucleosis infecciosa, así como hacer una revisión de la literatura concerniente a una posible correlación entre estas enfermedades. Esta paciente se presentó con una gingivitis ulcerativa necrótica acompañada de linfadenopatía, fiebre y postración después de las pruebas de laboratorio, donde se confirmó una infección por Epstein-Barr tipo 1 así como la ocurrencia conjunta de gingivitis ulcerativa necrótica y mononucleosis infecciosa. También se produjo una remisión concomitante de los síntomas en ambos trastornos después de la instrucción en medidas para el control de placas y una medicación paliativa para el control de los síntomas sistémicos. Por lo tanto, aunque no existió una validación científica de una asociación entre estas dos entidades, es imperativo que se consideren e investiguen todas las alternativas diagnósticas para establecer el enfoque terapéutico más apropiado para el paciente(AU)

Comportamiento de la gingivitis ulceronecrotizante aguda: departamento de estomatología de Conuco Viejo / Behavior of acute ultranecrotizing gingivitis at the stomatologic Department of Conuco Viejo

Se realizó un estudio observacional descriptivo prospectivo de corte transversal, con el objetivo de determinar el comportamiento de la gingivitis ulceronecrotizante aguda, en 37 pacientes entre 15 y 50 años de edad, quienes acudieron al servicio de estomatología de Conuco Viejo, municipio García, en el período comprendido de enero a diciembre de 2009. Se caracterizaron a los pacientes estudiados según variables sociodemográficas, y se identificó los factores de riesgo presentes, así como el nivel de conocimientos sobre salud bucodental. Se les realizó un examen clínico minucioso y se le aplicó una encuesta de conocimiento de salud bucal. Se encontró que los adolescentes de 15-20 años y adultos jóvenes de 21-26 años fueron los más afectados, con un 32,44 por ciento y 29,73 por ciento, respectivamente. El sexo femenino, con un 62,16 por ciento, el nivel educacional secundaria básica con 40,55 por ciento fueron los de mayor porcentaje. Dentro de lo factores de riesgo, los mayores por cientos correspondieron a la gingivitis crónica en los locales, con un 75,67 por ciento, mientras que el estrés en los generales, con 59,45 por ciento. Al aplicarse la encuesta de conocimientos un 54,05 por ciento de los pacientes estudiados fue evaluado de mal.

We carried out a transversal prospective descriptive observational study with the objective of determining the behavior of acute ultranecrotizing gingivitis, in 37 15 to 50 years-old patients, who visited the Stomatologic Service of Conuco Viejo, municipality of García, in the period from January to December 2009. The studied patients were characterized according to sociodemographic variables and the present risk facts were identified, and also the level of knowledge on buccal dental health. A thorough clinic examination was made and the patients applied an inquiry of knowledge on buccal health. We found that 15-20 years-old adolescents and 21-25 years-old young adults were the most affected patients, with 32,44per cent and 29,73 per cent respectively. The female genre, with 62,16 per cent, and the high school scholarship with 40,55 per cent showed the highest percentages. Among the local risk facts, the highest percents corresponded to chronic gingivitis, with 75,67 per cent, while stress represented the highest percent among general risk facts, with 59,45 per cent. As the result of the enquiry, the knowledge of 54,05 per cent of the studied patients were evaluated as unsatisfactory.

Ulcerativas Necrotizantes / Necrotizing Ulceratives

Las lesiones ulcerativas necrotizantes han sido documentadas a través de la historia. Su denominación, diagnóstico y tratamiento ha evolucionado con el paso de los años, hasta el presente, partiendo en Gingivitis Ulcerativa Necrotizante (GUN) caracterizada como una lesión de rápida evolución, de dolor paroxístico, confinada al margen gingival y papilar. La Periodontitis Ulcerativa Necrotizante (PUN), es ampliamente considerada como una evolución de GUN, involucrando al tejido óseo y a las estructuras de inserción, la falta de medidas terapéuticas ante estas entidades, generará la evolución a Estomatitis Ulcerativa Necrotizante (EUN), la cual involucra estructuras diferentes a los tejidos dentales y de soporte, como las mucosas circundantes. Dichas entidades exhiben signos patognomónicos comunes como sangrado, ulceración, necrosis papilar, supuración, dolor y mal olor, con predominio de microflora específica: fusobacterias y espiroquetas asociadasa factores predisponentes como stress, cigarrillo, desnutrición y alcohol. En la actualidad, la más fuerte asociación epidemiológica es con el Virus de inmunodeficiencia humana (VIH), en pacientes que presentan estados de inmunosupresión menores a 200.000 linfocitos T CD4, por tal motivolos portadores de cualquiera de estos tipos de lesión deben orientar al clínico la necesidad de confirmar el diagnóstico presuntivo de seropositividad. Los parámetros de tratamiento están encausados a la erradicación del agente etiológico, empleando medios mecánicos, como detartraje y alisado radicular apoyado en empleo de antimicrobianos locales y sistémicos, y el control de los factores de riesgo.

Necrotizing ulcerative lesions have been documented throughout history. Your name, diagnosis and treatment has evolved over the years, to date, starting in Necrotizing Ulcerative Gingivitis (NUG) characterized as a rapidly developing lesion, paroxysmal pain, confined to the gingival margin and papillary. Necrotizing Ulcerative Periodontitis (NUP) is widely regarded as an evolution of NUG, involving the bone and the insertion structures, lack of therapeutic measures against these entities generate evolution, Necrotizing Ulcerative Stomatitis (EUN), which involves different structures to the dental tissues and support, as the surrounding mucosa. Such entities exhibit common pathognomonic signs such as bleeding, ulceration, papillary necrosis, suppuration, pain and bad smell, with a predominance of specific microflora: Fusobacteria and spirochetes associated with predisposing factors such as stress, smoking, malnutrition and alcohol. Currently, the strongest epidemiological association is with the human immunodeficiency virus (HIV) in patients with immunosuppressive states below 200.000 CD4 T cells, as such carriers of either type of injury should guide the clinician to confirm the presumptive diagnosis of HIV infection. The treatment parameters are prosecuted to the eradication of the causative agent using mechanical means such as scaling and root planning supported employment for local and systemic antimicrobials, and control of risk factors.

Contextual effects in the occurrence of periodontal attachment loss and necrotizing gingival lesions among adolescents.

The aim of this study was to assess and quantify the random effects resulting from clustering in the following individual-level periodontal outcomes: presence of clinical attachment loss of > or = 1 mm (CAL1), presence of clinical attachment loss of > or = 3 mm (CAL3), and presence of necrotizing ulcerative gingivitis (NUG); or in the following class-level periodontal outcomes: number of students with CAL1, number of students with CAL3, and number of students with NUG. Mixed-effects logistic regression analysis was used to model these outcomes among 9,162 adolescents in 310 classes in 98 schools spread over 20 communes in the Province of Santiago, Chile, who had been examined for clinical attachment level and NUG, and had completed questionnaires on oral health-related behaviors. The results of all six analyses demonstrated statistically significant random effects, which in all analyses were particularly related to the schools, whereas the class effects were smaller and the commune random effects were almost negligible. The random effects were quantified using the median odds ratio (MOR), and the class-level MOR ranged between 1.05 and 1.51, whereas the school-level MOR values ranged from 2.07 to 2.39. The results of the study demonstrate the potential of the application of multilevel modeling to periodontal epidemiologic data, over and beyond the conventional use of the technique to account for the intrinsic sites-teeth-subject hierarchy in periodontal data.

Impact of PI and NNRTI HAART-based therapy on oral lesions of Brazilian HIV-infected patients.

BACKGROUND: The incidence of oral lesions related to human immunodeficiency virus (HIV) infection have been investigated after treatment with highly active antiretroviral therapy (HAART) including protease inhibitors (PI) but no data are available on the effect of non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy on incidence of acquired immunodeficiency syndrome (AIDS) oral manifestations or impact of HAART on oral manifestations of HIV infection in Brazil. The aim of this study was to describe the effects of anti-HIV therapy on the incidence of oral lesions during 17 years of AIDS epidemics in a Brazilian population. METHODS: From 1989 to 2006, we collected data from 1595 consecutive HIV patients at the Special Care Dentistry Center, São Paulo, Brazil. We compared the effect of PI- and NNRTI-based antiretroviral therapy (ARVT) on the annual incidence of Kaposi sarcoma (KS), oral candidiasis (OC) and hairy leukoplakia (HL). The chi-squared test was used to test the association between oral lesions and therapeutic regimen (P < 0.05). RESULTS: None of patients on ARVT presented with KS. Patients who used (nucleoside reverse transcriptase inhibitors) NRTI + PI were 0.9 times as likely to present with HL as those who used NRTI + NNRTI. This finding, however, was not statistically significant (P = 0.5). The relative risk for OC was 0.8 in patients with PI-based HAART. The increased risk among those on PIs was statistically significant (P = 0.004). CONCLUSIONS: The superiority of NNRTI regimens in decreasing OC incidence is consistent with current therapeutic guidelines which recommend NNRTI-based therapy as the treatment of choice for initial ARVT.

Oral manifestations of HIV/AIDS in China: a review.

PURPOSE: The purpose of this study is to review the Chinese-language medical and dental literature from 1982 to 2008 on oral manifestations (OMs) of patients with HIV/AIDS for introducing the spectrum of OMs of the patients in China. MATERIALS AND METHODS: All data were extracted from 18 references which had used diagnostic criteria for HIV/AIDS. Four of the references had used the EC-Clearinghouse classification for oral lesions in HIV infection. The feasible overall rate and 95% confidence interval (95%CI) of the data on OMs were calculated. RESULTS: Risk group analysis revealed that, of 203 patients, 64.3% were men and 35.7% were women (age range, 5 months to 64 years; mean age in three studies, 34.0, 34.3, and 36.1 years). Of these patients, 22.2% were infected by sexual contacts, 11.8% by intravenous drug use (IDU), 59.6% by blood or its products, 2.9% by mother to child transmission, and 3.4% were unclear. In 203 patients, oral candidiasis (OC) was the most common lesion (66%, 95%CI = 59.48-72.52%), followed by herpes simplex (HS) (22.2%, 95%CI = 16.48-27.92%), ulcerative stomatitis (14.8%, 95%CI = 9.92-19.68%), salivary gland disease (11.3%, 95%CI = 6.94-15.66%), oral hairy leukoplakia (OHL) (9.8%, 95%CI = 5.71-13.89%), necrotizing gingivitis (5.9%, 95%CI = 2.66-9.14%), Kaposi's sarcoma (2.9%, 95%CI = 0.59-5.21%), other malignant tumors (2.9%, 95%CI = 0.59-5.21%), and linear gingival erythema (2.0%, 95%CI = 0.07-3.93%). CONCLUSIONS: The spectrum of OMs reported from China is similar to that described in the international literature. Present data are useful to supplement international resources of HIV/AIDS research.

Cannabis use and destructive periodontal diseases among adolescents.

AIM: The aim of this experiment was to investigate the association between cannabis use and destructive periodontal disease among adolescents. MATERIAL AND METHODS: Data from a population screening examination carried out among Chilean high school students from the Province of Santiago were used to determine whether there was an association between the use of cannabis and signs of periodontal diseases as defined by (1) the presence of necrotizing ulcerative gingival (NUG) lesions or (2) the presence of clinical attachment loss (CAL) > or =3 mm. The cannabis exposures variables considered were "Ever use of cannabis" (yes/no) and "Regular use of cannabis" (yes/no). The associations were investigated using multiple logistic regression analyses adjusted for age, gender, paternal income, paternal education, frequency of tooth-brushing and time since last dental visit. RESULTS: Multiple logistic regression analyses showed that "Ever use of cannabis" was significantly negatively associated with the presence of NUG lesions (OR=0.47 [0.2;0.9]) among non-smokers only. No significant associations were observed between the presence of CAL > or =3 mm and cannabis use in either of the smoking groups. CONCLUSIONS: There was no evidence to suggest that the use of cannabis is positively associated with periodontal diseases in this adolescent population.

Predicting HIV in a public dental facility using group I oral lesions.

UNLABELLED: Group I oral lesions have been strongly associated with HIV and in resource-poor settings could be useful predictors of HIV. No study has evaluated the predictability of these lesions in diagnosing HIV/AIDS in patients who attend dental public facilities in South Africa. OBJECTIVES: To determine the HIV status, prevalence of Group I oral lesions and their predictive value amongst patients attending a dental clinic in Soweto, South Africa. METHODS: This cross sectional analytical study comprised of adult patients attending a dental facility over one week in 2006. All patients underwent a clinical examination by calibrated dentists. RESULTS: A total of 165 patients (100% response) were screened of which 87 (53%) were female. The HIV prevalence was 28% (n = 46) and of those who tested positive, 15% (7) manifested with Necrotizing Ulcerative Gingivitis (NUG). This proved to be highly predictive for HIV (positive predictive value = 93.8%, specificity = 99.6% and likelihood ratio = 40). CONCLUSION: The high prevalence rate of HIV in dental facilities confirms the heavy burden of the HIV epidemic. NUG proved to be a good predictor of HIV in this setting.

Oral manifestations of HIV/AIDS in clients attending TASO clinics in Uganda.

The objective of the study is to establish the prevalence of oral manifestations and their influence on oral functions. A total of 514 subjects aged 18 to 58 years (mean 42 years) were randomly recruited from five The AIDS Support Organization (TASO) clinics in Uganda. They were clinically examined for oral lesions under field conditions by four trained dentists based on World Health Organization criteria. Women constituted 74.5% of the study population. Oral manifestations were recorded in 72% of the subjects, out of which 70% had candidiasis of pseudomembranous, erythematous, and angular cheilitis variants. Non-Hodgkin's lymphoma, atypical ulcers, necrotizing periodontitis, and hairy leucoplakia were least frequently observed in the subjects. Of those who had oral lesions (n = 370), 68.4% had some form of discomfort in the mouth. Tooth brushing, chewing, and swallowing were frequently associated with discomfort. Reported forms of discomfort were dry mouth, increased salivation, and burning sensation especially on taking salty and spicy foods or acidic drinks. Only 8.5% (n = 44) of the subjects were taking medications specifically for oral lesions, which included antifungal, antiviral, and antibacterial agents. None of the subjects were on antiretroviral therapy. Oral lesions associated with human immunodeficiency virus/acquired immunodeficiency syndrome in TASO clients is a major public health problem requiring education in recognition and appropriate management.

Gingivitis úlcero-necrosante y su relación con el VIH/SIDA / Necrotizing ulcerative gingivitis and its relationship with HIV/AIDS

En el presente trabajo se realizó una revisión de la literatura, con el fin de compartir con la comunidad odontológica la información recolectada sobre la Gingivitis Ulcero Necrosante (GUN) y su relación con el Virus de Inmunodeficiencia Humana y el Síndrome de Inmunodeficiencia Adquirida (VIH/SIDA).

This paper reports a literature review which shares the gathered information with the Dental community about Necrotizing Ulcerative Gingivitis associated to opportunistic infections related to the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome (HIV /AIDS).

Social gradients in periodontal diseases among adolescents.

OBJECTIVE: To investigate the association between socioeconomic position and periodontal diseases among adolescents. METHODS: Data were obtained from 9203 Chilean high school students. Clinical examinations included direct recordings of clinical attachment level and the necrotizing ulcerative gingival lesions. Students answered a questionnaire on various dimensions of socioeconomic position. Seven periodontal outcomes were analyzed. Logistic regression analyses were used to identify socioeconomic variables associated with the periodontal outcomes. RESULTS: The occurrence of all periodontal outcomes investigated followed social gradients, and paternal income and parental education were the most influential variables. CONCLUSIONS: The study demonstrates the existence of significant social gradients in periodontal diseases already among adolescents. This is worrying, and indicates a new potential for further insight into the mechanisms of periodontal disease causation.