World Workshop on Oral Medicine VIII: Barriers to research in oral medicine: results from a global survey.

OBJECTIVES: To explore factors influencing research interest and productivity and perceived barriers to conducting research in Oral Medicine (OM). METHODS: Invitations to participate in an online survey were e-mailed to a network of international OM practitioners and related professional organizations. Questions captured respondents' demographic/professional variables and gauged research interest, productivity, and perceived barriers to conducting research specifically in OM. Statistical analysis was conducted via descriptive, logistic regression, and multivariate modeling. RESULTS: Five hundred and ninety-three OM practitioners from 55 countries completed the survey, with 54%, 25%, and 21% practicing in high, upper-middle, and lower-middle-income countries, respectively. Eighty-six percent of respondents were interested in conducting research. Age (less interest with an increase in age), working in academia, and practicing in a lower-middle vs high-income country were significant predictors of research interest. Self-reported research productivity was significantly greater among males, those working in academia, and those who graduated from programs that mandated research presentation/publication. Obtaining research funding was a significant barrier among respondents from lower and upper-middle-income countries, whereas finding time for research was a reported barrier by respondents from high-income countries. CONCLUSION: The results of this survey identified perceived barriers to conducting research in OM and highlighted solutions to address such barriers.

Stylohyoid Ligament Calcification and Its Association With Dental Diseases.

OBJECTIVES: This research aimed at investigating the relationship between calcification of the stylohyoid ligaments (SHLs) and odontogenic inflammatory events. METHODS: Cone-beam computed tomography scans of 175 patients were retrospectively assessed for presence of SHL calcifications. Frequencies of 4 types of odontogenic inflammatory events were assessed using the same scans, namely dental extractions, root canal treatments, furcation lesions, and periapical lesions. Patients were telephone-interviewed and asked about histories of tonsillectomy and head and neck trauma. Mann-Whitney U and binary logistic regression tests were used to assess associations between SHL calcification and mean ranks of odontogenic inflammatory events. RESULTS: Calcification of SHLs was detected in 71 (41%) and 58 (33%) patients on the right and left sides, respectively. Tonsillectomy and trauma were reported in 14% and 10% of the sample, respectively. Amongst all inflammatory events, root canal treatments were significantly associated with SHL calcification (U = 2755; Z = -2.1; P = .035). This association was independent from patient age, tonsillectomy, trauma, and other inflammatory events (odds ratio, 1.2; 95% confidence interval, 1.0-1.4; P = .036). CONCLUSIONS: This study presents new evidence that intra-oral inflammatory events, particularly related to root canal treatments, have a stronger association with SHL dystrophic calcification than that associated with traditional predisposing factors (ie, old age, tonsillectomy, and trauma).

The effect of styloid process medial angulation on Eagle's syndrome's self-reported symptoms: A preliminary cross-sectional study.

OBJECTIVE: The aim of this study was to investigate whether the medial angulation of the styloid process (SP), regardless of its length, has an association with self-reported symptoms of Eagle's syndrome. STUDY DESIGN: In this cross-sectional study, we measured the length and medial angulation of the SP, including ossification of the stylohyoid ligaments, in archived cone beam computed tomography scans. Patients with valid contact details were interviewed by telephone and asked about the clinical symptoms related to Eagle's syndrome. RESULTS: Eighty-eight patients participated in this study. Their median age was 39.0 years and ranged from 18 to 75 years. Thirty-one (35.2%) of the participants reported cervicalgia with at least one other symptom related to Eagle's syndrome. The mean length and angulation of the right SP were 37.2 mm and 36.3°, respectively, with both readings showing positive correlation with the left SP (r = 0.746 and r = 0.670, respectively; P < .001). Medial angulation of the SP was a predictor of Eagle's syndrome self-reported symptoms (odds ratio, 1.082; 95% confidence interval, 1.003-1.167; P = .042), adjusted for SP length and the patient's age. CONCLUSIONS: Self-reported clinical symptoms of Eagle's syndrome appear to be more associated with the medial angulation of the SP than with its length. Further research on larger samples is needed to establish the medial angulation cutoff angle and the specific symptoms that are attributed to that angulation.

Oral candidal carriage and its association with dental carious lesions in asymptomatic adults: a cross-sectional study from the UAE.

BACKGROUND: Candida's potential association with dental caries has previously been reported in children. This research aimed at investigating the associations between Candida species in whole saliva and dental and periodontal health indices in a sample of adult patients. METHODS: A cross-sectional study involving 160 patients investigated the associations between Candida species collected by oral rinse technique, and Decayed, Missing, and Filled Surfaces (DMFS), and periodontal health indices. Chi-square and Independent Samples t-test were used to assess the associations between Candida carriage and confounding variables. Binary logistic regression was used to assess association strengths between Candida carriage and DMFS, adjusted for socio-demographic variables, diabetes mellitus and plaque index. RESULTS: Candida colonies were identified in 49 (30.6%) patients with CFUs ranging from 103 to 105 colonies per mL. The quantity of Candida CFUs increased with age (r = 0.200; p < 0.05). Among all dental and periodontal health indices, only DMFS was significantly associated with higher values of Candida carriage (p = 0.034), and this association was independent from sex, age, smoking, diabetes mellitus and plaque index (OR: 1.014; 95% CI 1.0-1.03; p = 0.048). CONCLUSION: The association between Candida species in whole saliva and DMFS reported here supports an etiological role of Candida in dental cariogenesis among adults.

Vitamin D and hematinic deficiencies in patients with recurrent aphthous stomatitis.

OBJECTIVES: Recurrent aphthous stomatitis (RAS) represents a dysfunction in focal inflammatory processes. With the emerging anti-inflammatory roles of vitamin D (VD), we wanted to investigate the association between the onset and severity of RAS and serum VD level. METHODS: Fifty-two RAS cases and sex and age-matched controls were screened for serum iron, B12, folic acid, VD and red cell indices. Variables were compared using independent samples t test and chi square. Binary logistic regression was used to assess the association between the severity of RAS and various hematinic deficiencies. RESULTS: VD was deficient in 53% of the study population with no statistically significant difference between the RAS patients and healthy controls (53.6 versus 51.5 nmol/l, respectively). In comparison with controls, RAS patients had lower means of iron (81.0 versus 89.3 µg/dl), vitamin B12 (368.5 versus 412.7 pg ml) and most of the red cell indices; however, these differences were not statistically significant. No correlations were seen between RAS severity assessed by ulcer diameter, number of ulcers and their frequency and hematinic deficiencies. However, logistic regression showed a significant association between the number of ulcers (single or multiple) and VD deficiency (OR 4.978; 95% CI 1.204-20.576; p value = 0.027), adjusted for age, sex and other hematinics. CONCLUSIONS: VD deficiency appears to have a role in aggravating RAS ulcerative episodes, but not their onset. CLINICAL RELEVANCE: Multiple aphthous ulcers might represent a subcategory of RAS lesions in which VD deficiency plays a role in aggravating the oral ulcerative condition.

Pharmacists' clinical competency towards oral mucosal diseases: Results from a mystery shopper study.

OBJECTIVES: To investigate the clinical advices pharmacists would give to patients who present with various oral mucosal lesions. SUBJECTS AND METHODS: One hundred and twenty pharmacists in three major cities in the United Arab Emirates (UAE) were approached by senior dental students acting as mystery shoppers. Pharmacists were shown an image of one of four oral mucosal lesions representing candidosis, aphthous ulcer, erosive lichen planus and squamous cell carcinoma (SCC). Pharmacists' referral pattern and choices of medications were recorded and assessed against demographic variables. RESULTS: Eighty-eight per cent (88%) of pharmacists dispensed a non-prescription medication to treat the oral lesions, including SCC, while only 12% recommended that the lesion shown to them be assessed by a clinician. Among all referral recommendations, 32% were for SCC (p = .006). Geographical proximity of a clinic to the pharmacy was a significant factor in determining pharmacists' referral recommendation (p = .036). CONCLUSION: Most pharmacists dispensed a medication for oral mucosal lesions, including potentially malignant and malignant ones, without referring patients to a medical or dental practitioner. Pharmacists should be aware of the serious nature of some oral mucosal lesions and the necessity to refer those cases to a qualified practitioner for proper clinical assessment.

Oral cancer in young Jordanians: potential association with frequency of narghile smoking.

OBJECTIVE: The aim of this study was to investigate the relationship between narghile (water-pipe) smoking and the age of patients when diagnosed with oral cancer. STUDY DESIGN: Patients with oral cancer registered in the Jordanian National Cancer Registry were asked about frequency of cigarette, narghile, and alcohol use. Relationship between age at diagnosis and risk factors was assessed using multiple regression analysis. RESULTS: In this sample, 66% of patients were cigarette smokers, and 36% and 17% were narghile smokers and alcohol drinkers, respectively. The multivariate regression analysis adjusted for sex, cigarette smoking, and alcohol drinking found that narghile smokers were significantly younger when diagnosed with oral cancer compared with nonsmokers. CONCLUSIONS: Narghile smoking is an independent risk factor associated with the development of oral cancer at a younger age. Prospective studies of its effect on the earlier development of oral cancer are needed to establish a cause-effect relationship.