A systematic review of randomized trials for the treatment of burning mouth syndrome.

OBJECTIVES: Burning mouth syndrome (BMS) is characterized by burning of the oral mucosa in the absence of underlying dental or medical causes. The results of previous systematic reviews have generally been equivocal. However, findings for most interventions are based on searches of 5-10years ago. This study therefore updates previous searches of randomized controlled trials (RCTs) for pain as assessed by Visual Analogue Scales (VAS). Secondary outcomes included quality of life, mood, taste and salivary flow. METHODS: A search of MEDLINE and Embase up to 2016. RESULTS: 24 RCTs were identified. Meta-analyses were impossible because of wide variations in study method and quality. The commonest interventions were alpha-lipoic acid (ALA) (8 comparisons), capsaicin or an analogue (4 comparisons), clonazepam (3 comparisons) and psychotherapy (2 comparisons). ALA and capsaicin led to significantly greater improvements in VAS (4 studies each), as did clonazepam (all 3 studies), at up to two month follow-up. However, capsaicin led to prominent dyspepsia. Psychotherapy significantly improved outcomes in one study at two and 12month follow-up. Catauma and tongue-protectors also showed promise (one study each). There were no significant differences in any of the secondary outcomes except in the one study of tongue protectors. CONCLUSIONS: At least in some studies and for some outcomes, ALA, clonazepam, capsaicin and psychotherapy may show modest benefit in the first two months. However, these conclusions are limited by generally short follow-up periods, high study variability and low participant numbers. Further RCTs with follow-up of at least 12months are indicated.

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

BACKGROUND: The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. METHODS/DESIGN: The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. DISCUSSION: There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

Analysis of public dental service waiting lists in Queensland.

Information on public dental service waiting lists is available as part of the Queensland Government open data policy. Data were summarised across the care categories and health districts to present the total number and percentage of people waiting for care and who have waited beyond the desirable period. As of 31 December 2012 there were 130546 people on the dental waiting list; of these 85.8%, 8.5% and 2.2% were waiting for general care desirable within 24, 12 and 3 months, respectively. Across all care categories, almost 56% of those on the waiting list were beyond the desirable waiting period. The average number of people on the waiting list and the average number waiting beyond the desirable time differ substantially per clinic by district. Ongoing analysis of the Queensland public dental service waiting list database will determine the impact on patient waiting times of Federal Government initiatives announced in 2012 to treat an estimated 400000 patients on waiting lists nationwide over the next 3 years and to expand services to assist low-income adults to receive dental services.

The impact of ebinyo, a form of dental mutilation, on the malocclusion status in Uganda.

INTRODUCTION: The practice of extraction of ebinyo or false teeth is based on the belief that the rubbing of herbs on the gum (in the region of the canine) or the removal of the primary and/or permanent canine tooth buds will lead to the relief of childhood fevers and diarrhoea. The reported prevalence of this practice in Uganda and neighbouring countries is varied. OBJECTIVE: A survey carried out in Kampala to determine the occlusal traits of fourteen-year-old children offered an opportunity to assess the effects of ebinyo (a dental mutilation based on local customs and superstitions) on the occlusal status of the sample population. METHODS: 402 children aged fourteen years were examined according to the criteria of the Federation Dentaire Internationale Commission on Classification and Statistics for Oral Conditions method for measuring occlusal traits (COCSTOC-MOT) proposed by Baume et al. (1973). RESULTS: The most common dental anomaly was teeth missing due to extraction or trauma. Canines (28%) and mandibular first molars (28%) exhibited the highest frequency. Missing canines were four times more common in girls than boys, and three times greater in the maxilla than the mandible. Canines also accounted for 12.8% of the malformed teeth observed in the study. CONCLUSION: The results of this study show that the practice of ebinyo, although carried out early in the life of the child, can impact on the occlusal status in the permanent dentition years later.