Content analysis of oral (mouth) cancer-related posts on Instagram.

OBJECTIVE: To examine the content of Instagram posts about oral cancer and assess its usefulness in promoting oral cancer awareness and early detection practices. METHODS: A systematic search of Instagram for posts about oral (mouth) cancer was conducted using the hashtags #oral cancer and #mouth cancer. Posts usefulness in promoting awareness and early detection was assessed using the early detection usefulness score, and caption readability was assessed using the Flesch Kincaid readability score. RESULTS: A total of 81,000 posts were identified, and 200 posts were thoroughly evaluated. Included posts gathered a total of 48,118 (mean = 420.59 likes) and 27,898 views. Most posts (81.5%) were educational to the lay person, and India and the UK were the major contributors. The most discussed topics were prevention and early detection (55%). Representative clinical images were present in 35.5% of posts. Only 9.5% of posts mentioned the source of information, and the mean usefulness score was only 2.1 out of 10. The mean reading ease score was 56.7 ± 43.8 (range from 1 to 98 out of 100). CONCLUSION: Instagram shows potential for promoting oral cancer awareness, particularly in prevention and early detection. However, concerns regarding content quality, scientific validity, and clarity persist.

Expanding the phenotype in Pitt-Hopkins syndrome; description of new oral finding and dental management considerations.

BACKGROUND: Pitt-Hopkins syndrome (PTHS) is a rare neurodevelopmental disorder with physical, cognitive, and behavioral characteristics that is caused by heterozygous mutations in the TCF4 gene. Patients with PTHS might present a unique challenge for oral healthcare professionals because of the associated comorbidities. CASE REPORT: Here we describe a new case of PTHS in a 13-year-old girl with particular emphasis on oro-dental findings and oral healthcare management. Observed oro-dental findings in our case included shallow palate, absence of lingual frenum, gingival enlargement, thick lips and relative microdontia. The patient was unable to tolerate dental care under local anesthesia. Therefore, comprehensive dental treatment was performed under general anesthesia after a careful pre-anesthetic cardio-respiratory, neurological, and hematological evaluation. The patient was closely monitored intra-operatively for breathing rhythm, O2 saturation, and signs of respiratory distress. The patient was observed for 24 h post-op for respiratory distress and was discharged then uneventfully. CONCLUSION: Dental treatment under general anesthesia in these patients might be complicated by the abnormal breathing rhythm, and close monitoring and follow up for signs of respiratory distress after general anesthesia is necessary. Recognition of oral and dental findings might help to expand the phenotype and better characterize rare syndromes.

The oral phenotype and dental management in patients with maple syrup urine disease; case report and scoping review.

BACKGROUND AND OBJECTIVES: The literature about oral manifestations and dental management in maple syrup urine disease (MSUD) is sparse. The aim of this report is to present a new case of MSUD with special emphasis on oral findings and to review the relevant literature. METHOD: A case report of a 4-year-old boy with MSUD was described according to the CARE guidelines for describing case reports. Scoping review of relevant literature was performed, according to the PRISMA-ScR guidelines, by searching PubMed, Medline, Embase, and the grey literature for articles describing dental management and/or oral manifestations in MSUD. RESULTS: The initial search identified 219 articles, but only 4 met the inclusion criteria. Rampant caries and plaque induced gingivitis were the main oro-dental findings in MSUD. Other oral findings included enamel hypoplasia, skeletal abnormalities, and abnormal oral behaviors. Disease-related factors appeared to play a major role in the development of the observed oral phenotype. CONCLUSION: Oral health in MSUD seems to be influenced by the reliance on semi-synthetic diet and associated neurocognitive complications. Tailored oral health promotional interventions should be included in the multidisciplinary management of patients with MSUD.

Mechanisms underlying sex bias in oral immune-mediated conditions, an insight.

The predilection for women in systemic autoimmune diseases is well established. However, this sex bias in oral autoimmune diseases has been classically reported from an epidemiological perspective without any elaborate attempts to unveil the underlying mechanisms. The unique nature of the oral environment is likely to impose a combination of systemic and local factors that ultimately result in the sex bias in autoimmune diseases of the oral cavity. Variations of immune responses, target organ vulnerability, endocrine and genetic factors, sex chromosomes and modes of parental inheritance are potential systemic factors, while the oral microbiome, oral tolerance, saliva, and oral epithelial stem cells may account for local contributing factors. This review will discuss the preponderance of women in oral immune-mediated diseases, the potential systemic and local mechanisms underlying this predominance and highlight the crucial need for further research in this area.

A novel lightweight deep convolutional neural network for early detection of oral cancer.

OBJECTIVES: To develop a lightweight deep convolutional neural network (CNN) for binary classification of oral lesions into benign and malignant or potentially malignant using standard real-time clinical images. METHODS: A small deep CNN, that uses a pretrained EfficientNet-B0 as a lightweight transfer learning model, was proposed. A data set of 716 clinical images was used to train and test the proposed model. Accuracy, specificity, sensitivity, receiver operating characteristics (ROC) and area under curve (AUC) were used to evaluate performance. Bootstrapping with 120 repetitions was used to calculate arithmetic means and 95% confidence intervals (CIs). RESULTS: The proposed CNN model achieved an accuracy of 85.0% (95% CI: 81.0%-90.0%), a specificity of 84.5% (95% CI: 78.9%-91.5%), a sensitivity of 86.7% (95% CI: 80.4%-93.3%) and an AUC of 0.928 (95% CI: 0.88-0.96). CONCLUSIONS: Deep CNNs can be an effective method to build low-budget embedded vision devices with limited computation power and memory capacity for diagnosis of oral cancer. Artificial intelligence (AI) can improve the quality and reach of oral cancer screening and early detection.

The Online Attention to Cleft Lip and Palate Research: An Altmetric Analysis.

OBJECTIVES: To identify research articles related to cleft lip and/or cleft palate (CL/P) that generated the highest online attention. METHODS: Altmetric Explorer was used to identify the 100 articles with the highest Altmetric Attention Score (AAS). Descriptive and correlation statistics were performed to study the characteristics of these articles in relation to their publication data, research type and domain, number of Mendeley readers, and dimensions citations. Citation counts were extracted from Scopus and Google Scholar. RESULTS: The median AAS for the top 100 outputs was 22 (range from 12 to 458). The outputs were mostly discussed on Twitter (median = 8; range = 0-131). Topics discussing treatment and care for patients with CL/P accounted for 38% of the articles with the highest AAS followed by etiology and risk factors (32%). The majority of articles originated from the USA (46%) followed by Europe (16%) and the United Kingdom (15%). No significant differences were observed in AAS among different study designs, topic domains, journals' ranking and impact factor, and the number of citations in Scopus and Google Scholar. CONCLUSIONS: Researchers should consider use of social platforms to disseminate their work among scholars and nonscholars. Altmetrics can be combined with traditional metrics for a more comprehensive assessment of research impact.

The online attention to oral cancer research: An Altmetric analysis.

OBJECTIVES: Altmetrics, or alternative metrics, have recently emerged as a web-based metrics measuring the impact of research with an emphasis on the public engagement with the research output. In this study, we aimed to identify and analyze research articles about oral cancer that provoked the most online attention. METHODS: Altmetric Explorer was used to identify articles about oral cancer that generated the highest online attention. Descriptive and correlational statistics were performed, and the top 100 articles were identified and analyzed. RESULTS: A total of 7,940 articles were identified. Topics were mostly discussed on Facebook, Twitter, Mendeley, and news outlets. The top 100 articles that generated the highest online attention discussed mainly topics related to treatment outcomes and quality of life. Human papilloma virus (HPV) was the most commonly discussed individual topic in the list of top 100 outputs (n = 20). Most articles originated from the USA (n = 46) and Europe (n = 33; mainly from UK [24 articles]). Articles were published in 47 journals that belong to different specialities; journals with a social media account had significantly higher Altmetric scores for their articles compared to those without an account. CONCLUSION: Topics of general interest to the public such as HPV transmission and vaccination, risk factors, and treatment generated the highest online attention.

Dental students' awareness and attitudes toward HPV-related oral cancer: a cross sectional study at the University of Jordan.

BACKGROUND: The incidence of human papilloma virus (HPV)-related oral cancer has recently increased worldwide. The role of dentists is of prime importance in the early detection of oral cancer which would result in a favourable outcome for the patients. The aim of the current study was to assess the knowledge, awareness and attitudes of dental students, interns and postgraduate maxillofacial residents at the University of Jordan (UJ) to different aspects of oral cancer, particularly those related to HPV. METHODS: A paper-based survey was conducted at UJ among all pre-clinical dental students (pre-clinical group), clinical dental students, interns and postgraduate maxillofacial residents (clinical group). The survey included five sections comprising 29 items. The sections included questions investigating oral cancer knowledge, oral cancer screening, HPV knowledge and the ability to discuss personal topics with patients. RESULTS: A total of 376 respondents out of 1052 potential participants completed at least one item of the survey (study coverage of 35.7%). Among the study participants, the pre-clinical group represented 41.2% (n = 155) and the clinical group represented 58.8% (n = 221). The majority of participants in the clinical group showed better knowledge on oral cancer potential anatomic sites, clinical presentation and possible risk factors compared to the pre-clinical group. Most participants in the clinical group (n = 195, 88.2%) correctly identified HPV as a risk factor for oral cancer development. The majority of participants in the clinical group displayed suitable attitude towards oral cancer screening despite their desire for a reliable screening device and additional training in oral cancer screening. A number of limitations in basic knowledge about HPV was noticed among participants in the clinical group particularly related to unawareness of the vaccine availability. The majority of participants in the clinical group displayed hesitancy in discussing personal topics with the patients, including the history of previous sexually transmitted infections and sexual abuse. CONCLUSIONS: Gaps in knowledge regarding HPV-related oral cancer has been detected which necessitate intervention measures including curricular changes, training workshops and awareness campaigns.

Medical reliability of a video-sharing website: The gingival recession model.

OBJECTIVES: To evaluate the quality of the scientific/clinical information in dentistry delivered by videos hosted by a popular video-sharing website. METHODS: The gingival recession condition was used as a model and YouTube™ as the video hosting service. A systematic observation of videos containing information on gingival recession was conducted. Videos were analysed to evaluate (i) the scientific reliability and quality of the information using Global Quality Scale (GQS) and DISCREN criteria; and (ii) the understandability of this information using a tailor-made custom comprehensiveness index (CI). RESULTS: One hundred and eighty videos were identified. Videos dealing with surgical procedures were not included in the present review. After selection, 41 videos were analysed. The mean GQS was 2.34 on a 0-5 scale, and 25 (61%) videos showed clear aims according to DISCREN criteria. Misleading content was observed in eight videos (19.5%). The scientific sources of information were unclear in 26 (63.4%) videos. All videos failed to give additional references for supplemental information. Only three videos (7%) provided basic information on aetiology, clinical presentations and management of gingival recession. Based on 0-2 CI scores, three, nine and 29 videos had a score of 2, 1 and 0, respectively. CONCLUSION: The present model indicates that social media websites aiming to provide health information should be carefully accounted, especially when dealing with dentistry. It also suggests professional involvement to improve the quality of the delivered information.

Dental trauma in social media-Analysis of Facebook content and public engagement.

BACKGROUND/AIM: Social media sites such as Facebook are increasingly used to obtain healthcare-related information. The aim of this study was to examine Facebook content on dental trauma and to assess public engagement with this content. MATERIALS AND METHODS: An anonymous account was created to search Facebook for information on dental trauma using the key words "dental trauma," "broken tooth," "tooth fracture," and "tooth trauma" over a period of 1 year (from February 27, 2017, to February 27, 2018). The content was analyzed with regard to demographic characteristics, topic domains, and public engagement. RESULTS: A total of 395 Facebook pages and 149 groups were identified, but only one page and two groups met the inclusion criteria. There were 329 posts on dental trauma during the study period. More than half of the posts were event advertisements and personal highlights (56.2%), followed by posts mentioning articles in academia (17.9%). The average yearly engagement rate was 0.25%; news posts generated the highest engagement rate (0.76%), while academic posts generated the lowest engagement rate (0.16%). The singular post that generated the highest engagement rate (2.2%) was a news post referring to a dental trauma incident suffered by a professional football player. Only 14 posts (4.3%) contained information on prevention and immediate management of dental trauma. CONCLUSIONS: Facebook information on dental trauma is limited in quantity and quality. More emphasis should be placed on posting information suitable for the layperson and concerned with the basics of prevention and immediate management of dental trauma.

Oral Cancer Early Detection: What Do Patients Need To Know?

The purpose of the present study was to examine the educational needs of patients regarding early detection of oral cancer. A total of 790 patients without cancer were interviewed and shown a set of validated clinical images of various oral lesions including early oral cancer. Participants were asked about their perception of cancer and the action that they would take if they notice a similar lesion. Lower risk lesions (e.g., lumps) were more likely to be perceived as cancer (52.4%), while higher risk lesions (e.g., red patches) were least likely to be perceived as cancer (8.8%). The perceived appearance of the lesions was correlated with patients' perceived need for medical advice. Higher risk lesions were less likely to make patients feel the need to seek professional advice. High-risk patients were less aware about oral cancer appearance and were less likely to take action if they notice an oral lesion. Patients are not aware of the various presentations of early oral cancers, especially higher risk lesions. Patients need to know more about the clinical appearance of early oral cancer. The use of representative clinical images of early oral cancer and educational videos on self-inspection of oral mucosa is important.

Sanjad-Sakati Syndrome: Oral Health Care.

OBJECTIVES: The aim of this report is to describe the orofacial manifestations and dental management of a girl with Sanjad-Sakati syndrome. CLINICAL PRESENTATION AND INTERVENTION: The facial features included microcephaly, thin lips, beaked nose, low set ears, and a retrognathic mandible. An oral examination revealed oligodontia/hypodontia, small dental arches, a high arched palate, and a deep overbite and increased overjet. Oral rehabilitation involved full coverage prosthetic crowns on the upper central incisors, stainless steel crowns on the lower molars, and removable partial prostheses to replace missing teeth. CONCLUSION: Recognition of orofacial features might help in the diagnosis of Sanjad-Sakati syndrome. Dental management of affected patients might be complicated by intellectual, neurological, and endocrine abnormalities.

Impaction of lower third molars and their association with age: radiological perspectives.

BACKGROUND: Third molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth. METHODS: A total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient's age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA). RESULTS: In patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years. CONCLUSION: Frequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.

YouTube as a source for parents' education on early childhood caries.

BACKGROUND: Patients can and do search the Internet for information on various health-related topics. YouTube™ is one popular website they may consult. AIM: To examine the quality of information offered by YouTube™ for patients seeking information on early childhood caries (ECC). DESIGN: YouTube™ was searched for videos on ECC. The usefulness of selected videos in providing adequate information about ECC was evaluated using a 13-point usefulness score. The guidelines of the American Academy of Pediatric Dentistry were used for benchmarking. RESULTS: Most videos were uploaded by healthcare professionals (60%, n = 18). Videos had generally low usefulness scores (mean: 5.1 ± 2.9; range: 1-11). An average YouTube™ video on ECC was viewed two times/day (range: 0.07-34.4 views/day). Less useful videos ranked early on the viewing list, and viewer's interactions with videos were not affected significantly by their usefulness. CONCLUSION: YouTube™ should not be used as a trusted site for educating patients on ECC.

The Immune System: Basis of so much Health and Disease: 4. Immunocytes.

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covers cells of the immune system (immunocytes). Clinical relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.

The Immune System: Basis of so much Health and Disease: 2. Innate Immunity.

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covering innate immunity. Clinical relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.

The Immune System: Basis of so much Health and Disease: 3. Adaptive Immunity.

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system; this article covers adaptive immunity. Clinical relevance: Dental clinicians need a basic understanding of the immune system as it underlies health and disease.

Salivary changes in oral mucosal diseases.

Saliva is a unique biological fluid that can be easily collected and analyzed with low cost and low morbidity. Therefore, there is a growing attention for using salivary biomarkers in the diagnosis and monitoring of disease progress and response to treatment. Salivary changes have been described in relation to oral mucosal diseases. This article discusses the causes and consequences of salivary hypofunction and presents a review of the literature related to changes in salivary parameters in various oral mucosal diseases and in systemic diseases with possible oral mucosal involvement.

Areca nut alkaloids induce irreparable DNA damage and senescence in fibroblasts and may create a favourable environment for tumour progression.

BACKGROUND: Oral submucous fibrosis (OSMF) is a pre-malignant condition that is strongly associated with the areca nut alkaloids, arecoline (ARC) and arecaidine (ARD). The condition is characterised by the presence of senescent fibroblasts in the subepithelial mesenchyme which have the potential to promote malignancy in the neighbouring epithelial cells. We tested the hypothesis that areca nut alkaloids induce senescence in oral fibroblasts and promote the secretion of invasion-promoting transforming growth factor ß (TGF-ß) and matrix metalloproteinase-2 (MMP-2). METHODS: Two oral fibroblast lines were treated for 48h with ARC and ARD. Senescence-associated ß-galactosidase (SA-ßGal) activity, Ki67 (cycling cells), large 53BP1 foci (irreparable DNA strand breaks) and p16(INK) (4A) (late senescence) were used as markers of cellular senescence and were quantified using indirect immunofluorescence and the ImageJ program. TGF-ß and MMP-2 levels were measured using ELISA. Statistical analyses were performed with the two-tailed unpaired t-test where n = 3 and the Wilcoxon-Mann-Whitney test where n = 6. RESULTS: ARC (100 and 300 µM) and ARD (30 and 100 µM) significantly (P < 0.05) induced fibroblast senescence, as determined by the increased expression of SA-ßGal, 53BP1 staining and CDKN2A/p16(INK) (4A) ; there was also a non-significant reduction in Ki67 staining. Treated cells also showed a three- fivefold increase in TGF-ß and a small non-significant increase in MMP-2. CONCLUSIONS: Areca nut alkaloids induce senescence in oral fibroblasts and promote increased secretion of TGF-ß and perhaps MMP-2 that may create a tissue environment thought to be critical in the progression of OSMF to malignancy.

Factors Influencing Dental Patient Participation in Biobanking and Biomedical Research.

OBJECTIVES: To study the willingness of dental patients to donate biospecimens for research purpose and to examine factors that may influence such a decision. MATERIALS AND METHODS: A face-to-face interview was conducted using a pretested structured survey instrument on 408 adult dental patients attending a university hospital for dental care. Descriptive statistics were generated, and the x03C7;2 test was used to examine differences between groups. p values ≤0.5 were considered statistically significant. RESULTS: Of the 408 participants, only 71 (17.4%) had heard of the terms biobanking/biospecimens, but 293 (71.9%) approved of the idea of using biospecimens for biomedical research, and 228 (55.9%) were willing to donate biospecimens and give personal information for research purposes. In participants who were unwilling to participate in biobanking, fear of information leakage was the most frequently reported reason, while in participants who were willing to donate biospecimens, the potential to provide more effective and less costly treatments was the most frequently reported reason. The preferences of the 228 participants who were willing to donate biospecimens were as follows: give a sample of removed oral tissues including extracted teeth (n = 105, 46.1%), donate a blood sample (n = 52, 23%), donate a sample of saliva (n = 43, 18.6%), and give a urine sample (n = 28, 12.3%). CONCLUSION: Dental patients had a generally positive attitude towards biomedical research and biobanking. The most preferred types of biospecimens to donate in a dental setting were removed tissues, including extracted teeth and blood samples.