Garlic burn of the oral mucosa: A case report and review of self-treatment chemical burns.

BACKGROUND AND OVERVIEW: Inappropriate self-treatment with topically applied therapeutic or nontherapeutic agents frequently results in mucosal burns. Although such chemical burns typically are associated with misuse of analgesics, investigators also have reported them in conjunction with topical application of a variety of other agents. CASE DESCRIPTION: The authors report an unusual case of a 49-year-old man seeking care for maxillary tooth pain who had an oral mucosal burn of the maxillary vestibule caused by topical application of crushed raw garlic. The patient believed this treatment would alleviate his dental pain. Localized tissue necrosis was visible at the site of application. The authors instructed the patient to cease self-treatment with raw garlic but deemed treatment was otherwise unnecessary. To the best of the authors' knowledge, this is the second reported case of a garlic burn of the oral mucosa. The authors discuss the history of garlic as a naturopathic remedy, as well as the development of chemical burns associated with its topical use. The authors also review the literature on chemical burns caused by inappropriate self-treatment. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Dentists should consider the possibility of an oral chemical burn when a patient has a destructive or necrotic mucosal lesion located near a painful tooth. In this report, the authors highlight the importance of obtaining a detailed clinical history to establish a proper diagnosis and proper patient education to prevent future mucosal injury from inappropriate self-treatment. Awareness and early recognition of this condition also will help diminish the probability of overtreatment.

Suppression of Proinflammatory and Prosurvival Biomarkers in Oral Cancer Patients Consuming a Black Raspberry Phytochemical-Rich Troche.

Black raspberries (BRB) demonstrate potent inhibition of aerodigestive tract carcinogenesis in animal models. However, translational clinical trials evaluating the ability of BRB phytochemicals to impact molecular biomarkers in the oral mucosa remain limited. The present phase 0 study addresses a fundamental question for oral cancer food-based prevention: Do BRB phytochemicals successfully reach the targeted oral tissues and reduce proinflammatory and antiapoptotic gene expression profiles? Patients with biopsy-confirmed oral squamous cell carcinomas (OSCC) administered oral troches containing freeze-dried BRB powder from the time of enrollment to the date of curative intent surgery (13.9 ± 1.27 days). Transcriptional biomarkers were evaluated in patient-matched OSCCs and noninvolved high at-risk mucosa (HARM) for BRB-associated changes. Significant expression differences between baseline OSCC and HARM tissues were confirmed using a panel of genes commonly deregulated during oral carcinogenesis. Following BRB troche administration, the expression of prosurvival genes (AURKA, BIRC5, EGFR) and proinflammatory genes (NFKB1, PTGS2) were significantly reduced. There were no BRB-associated grade 3-4 toxicities or adverse events, and 79.2% (N = 30) of patients successfully completed the study with high levels of compliance (97.2%). The BRB phytochemicals cyanidin-3-rutinoside and cyanidin-3-xylosylrutinoside were detected in all OSCC tissues analyzed, demonstrating that bioactive components were successfully reaching targeted OSCC tissues. We confirmed that hallmark antiapoptotic and proinflammatory molecular biomarkers were overexpressed in OSCCs and that their gene expression was significantly reduced following BRB troche administration. As these molecular biomarkers are fundamental to oral carcinogenesis and are modifiable, they may represent emerging biomarkers of molecular efficacy for BRB-mediated oral cancer chemoprevention.