Oral Cancer Treatment Through the Ages: Part 2.

PURPOSE: Understanding how oral cancer treatment evolved can pave the way for future management. The literature holds an expansive collection of historical findings regarding oral cancer, yet the authors were unable to find a comprehensive review of oral cancer treatment throughout the ages. MATERIALS: A thorough literature review was carried out using multiple scientific databases and languages, as well as examination of historical archives. Articles were included for their relevance and their findings were assimilated. RESULTS: Part two of this article considers the development of specific surgical concepts relating to head and neck cancer over the previous two centuries, including neck dissection and reconstruction, as well as exploration of non-surgical cancer therapies. CONCLUSION: This paper demonstrates historical landmarks made in oral cancer treatment and the prominent figures who pioneered them, confirming that head and neck cancer surgeons of today have valuable lessons to learn from their previous counterparts.

Oral Cancer Treatment Through the Ages: Part 1.

PURPOSE: Understanding how oral cancer treatment evolved can pave the way for future management. The literature holds an expansive collection of historical findings regarding oral cancer, yet the authors were unable to find a comprehensive review of oral cancer treatment throughout the ages. METHODS: A thorough literature review was carried out using multiple scientific databases and languages, as well as examination of historical archives. Articles were included for their relevance and their findings were assimilated. RESULTS: Part one of this article reveals a rich history of oral cancer treatment commencing in ancient times, with discussion of Egyptian, Greek and Roman practices, and travelling through the age of discovery to arrive at the dawn of scientific medicine in the 19th century. CONCLUSION: Part one demonstrates how fundamental concepts of oral cancer were discovered, and the significant impact medical innovation had on the success of oral cancer treatment.

Unusual Presentation of Epstein-Barr Virus-Positive Diffuse Large B-Cell Non-Hodgkin Lymphoma of the Elderly.

This report describes the case of a 76-year-old woman diagnosed with Epstein-Barr virus-positive diffuse large B-cell non-Hodgkin lymphoma of the elderly. She had an unusual presentation of the disease with widespread skeletal muscle, masticatory muscle, and parotid gland involvement and the development of interesting erythematous lesions in the neck during chemotherapy. One month after completion of chemotherapy, positron-emission tomography (PET) showed features of persistent lymphoma, but a repeat PET scan a month later showed no active disease. This case reiterates 2 important points: first, to consider lymphoma a differential diagnosis in masticatory muscle enlargement and second, to question false positivity when interpreting post-treatment PET scan results, especially in the absence of clinical disease.

Among Patients Undergoing Ablative Treatment for Oral Cancer, Does the Provision of Oral Rehabilitation Improve the Quality of Life? A Review of the Current Literature.

PURPOSE: The impact of oral cancer and its treatment is well documented; therefore, oral rehabilitation (OH; eg, with prosthetics, osseointegrated implants, etc) can be indicated to restore some level of form, function, and well-being. The purpose of this study was to review the current literature and evaluate the impact of OH on quality of life (QoL) after ablative surgery. MATERIALS AND METHODS: A systematic literature search was conducted using EMBASE, MEDLINE, and PsychINFO. The study population was composed of all articles published from 2000 to 2015. To be included, studies had to use validated, specific head and neck QoL measurements (European Organization for Research and Treatment of Cancer QoL Head and Neck Module or University of Washington QoL Questionnaire). Only 8 articles met these inclusion criteria. In this review, OH was the primary predictor variable and QoL was the primary outcome variable. RESULTS: The 8 articles reviewed used a range of designs, including 1 randomized controlled trial, 3 prospective cohort studies, 3 case series, and 1 single-measurement cross-sectional descriptive study. Sample sizes were small (n = 26 to 102), and there was limited randomization and control of intervention and comparator groups. The overall level of evidence was weak. All studies showed a link between OH and QoL, but the results varied in significance (P < .01 to P = .95). CONCLUSION: Overall, there appears to be improvement in QoL to varying degrees after OH. However, a more systematic use of QoL measurements is needed before any definitive conclusions can be drawn.

Changes in demographics of patients undergoing third molar surgery in a hospital setting between 1994 and 2012 and the influence of the National Institute for Health and Care Excellence guidelines.

PURPOSE: To evaluate changes in demographics of patients undergoing third molar surgery (TMS). MATERIALS AND METHODS: This retrospective study used the World Health Organization's International Classification of Diseases, Tenth Revision codes F091 and F093 to generate data on patients (N = 10,447) undergoing TMS from 1994 through 2012 at the authors' institution. The data is described in terms of mean, median, mode and were analyzed using analysis of variance and the Student t test. RESULTS: Fewer female patients were treated after implementation of the National Institute for Health and Care Excellence (NICE) guidelines. The mean patient age increased from 29 years (1994) to 36 years (2012), with the median increasing from 27 to 31 years (P < .001). There was a significant difference in the age of patients treated before and after the introduction of the NICE guidelines (P < .001). CONCLUSIONS: The increase in age appears to be influenced by the NICE guidelines. Given the increased risk of complications in older patients, consideration should be given to the removal of a similarly impacted, asymptomatic, contralateral third molar without obvious radiographic relation to the inferior dental canal, if a young patient is undergoing general anesthesia.

Dental caries in children: a sign of maltreatment or abuse?

Healthcare professionals are required to complete regular training in safeguarding children and, in this training, dental caries and poor oral hygiene are often cited as potential indicators of neglect. Nurses may be the first healthcare professionals to detect poor oral health in a child, although unfortunately the relationship between neglect and dental caries in children is unclear. Any healthcare professional suspicious of child abuse or neglect has responsibility to follow the appropriate protocol and report their concerns. If dental neglect is suspected then the opinion of a dentist will be required as part of the investigation.