Formulación magistral en patología de la mucosa oral / Drug Compounding for Diseases of the Oral Mucosa

Los medicamentos industriales comercializados para uso tópico oral son muy escasos y con vehículos poco adecuados. En consecuencia, frecuentemente hay que recurrir a preparados magistrales que permitan aplicar principios activos en vehículos diseñados especialmente para su aplicación en la mucosa oral. La formulación magistral también permite incluir varios principios activos en un mismo vehículo y prescribir fármacos actualmente en desabastecimiento, entre otras ventajas. Describimos las principales fórmulas magistrales para el tratamiento de la patología de la mucosa oral más frecuente

Commercial topical medications for oral conditions are scarce and the vehicles used are not very suitable. Therefore, formulations containing active ingredients in vehicles specially designed for oral application must often be prepared. Drug compounding offers other advantages, including the possibility of combining several active ingredients in a single vehicle and prescribing drugs that are in short supply. In this article, we describe the main pharmaceutical formulations used to treat the most common diseases of the oral mucosa

Prevalencia de lesiones bucales en tejido blando encontradas en la Clínica de Estomatología de la Facultad de Odontología de la Universidad de los Andes: periodo 2015-2018 / Prevalence of oral lesions in soft tissue found in the Clinic of Stomatology of the Faculty of Dentistry of the University of los Andes: 2015-2018 period

Introducción: La epidemiología sobre alteraciones en tejidos blandos bucales es limitada cuando se compara con caries, enfermedades periodontales y maloclusiones, por lo que su estudio representa un paso adelante en la odontología más allá de los dientes. Objetivo: Describir la prevalencia de las lesiones bucales en tejido blando encontradas en la Clínica de Estomatología de la Facultad de Odontología de la ULA, del 2015 al 2018, con la finalidad de proporcionar una fuente de datos actualizada, que oriente a una mejor prevención y oportuno diagnóstico. Material y métodos: Se realizó una investigación descriptiva, documental, retrospectiva y multivariable. Resultados: De 1,000 fichas clínicas estudiadas, las patologías más frecuentes fueron: lengua saburral (50.6%), queilitis (33.4%), traumatismo de la mucosa de los carrillos (27.6%), várices linguales (18.3%), anquiloglosia (13.7%) y agrandamiento de rugas palatinas (11.7%). La zona con mayor alteración fue la lengua (92.1%), mientras que el paladar fue la menos afectada (29%). De los hábitos predisponentes a la formación de lesiones, el mordisqueo de mucosa fue el más común (16.5%). En cuanto a los factores locales asociados, una higiene oral regular/ deficiente resultó el principal (53.8%). Conclusión: La educación del paciente sigue siendo considerada la clave para disminuir la aparición de patologías y su evolución a entidades más graves (AU)

Introduction: Epidemiological studies on soft tissue alterations in the mouth are limited when compared with caries, periodontal diseases and malocclusions, so their study represents a step forward in dentistry beyond the teeth. Objective: To describe the prevalence of soft tissue oral lesions found in the Stomatology Clinic of the ULA School of Dentistry, from 2015 to 2018, in order to provide an up-to-date data source, to guide better prevention and timely diagnosis. Material and methods: A descriptive and documentary, retrospective and multivariable research was carried out. The statistical package IBM SPSS Statistics v 23 was applied for the analysis. Results: 1,000 clinical records studied, the most frequent pathologies were: saburral tongue (50.6%), cheilitis (33.4%), traumatism of the cheek mucosa (27.6%), lingual varices (18.3%), ankyloglossia (13.7%) and enlargement of palatal rugas (11.7%). The tongue was the most affected (92.1%), while the palate was the least affected (29%). Of the predisposing habits to the formation of lesions, mucosal nipping was the most common (16.5%). Regarding the associated local factors, a regular / deficient oral hygiene was the main one (53.8%). Conclusion: Patient education is still considered the key to diminish not only the appearance of pathologies but their evolution to more serious entities (AU)

Dermatologic manifestations associated with electronic cigarette use.

BACKGROUND: Electronic cigarette use continues to rise, yet there are no reviews summarizing dermatologic manifestations associated with electronic cigarettes in the literature. OBJECTIVE: To review the literature regarding cutaneous manifestations associated with electronic cigarette use and increase awareness of side effects associated with this rapidly developing public health epidemic. METHODS: The PubMed database was searched for related literature. All studies involving the effects of electronic cigarette use on the skin or mucosa were obtained and reviewed for evidence. RESULTS: Contact dermatitis, thermal injuries, and oral mucosal lesions have been reported with the use of electronic cigarettes. LIMITATIONS: The conclusions presented in individual case reports or series are not based on randomized controlled trials. CONCLUSION: Electronic cigarettes can present with harmful dermatologic manifestations.

Tongue lesions and anomalies in a sample of Yemeni dental patients: a cross-sectional study

Background: Tongue examination helps considerably in diagnosing the underlying health state of the patient, especially in the cases of chronic diseases. The aim of this study is to determine the prevalence and association of tongue lesions with risk factors among Yemeni dental patients. Materials and methods: An oral medicine specialist examined all 713 patients attending the dental polyclinics at the University of Sciences and Technology (Sana’a, Yemen). The examination sheet was designed to include information related to patient characteristics, medical history, dental history, habits, and tongue lesions. Results: The prevalence of tongue lesions among the examined participants was 76.5 percent. The prevalence rate was 83.4 percent for males and 69.2 percent for females. Fissured tongue was the most common condition. Logistic regression analysis indicated that older age (p<0.001), gender (p=0.007), khat chewing (p<0.001), and smoking (p=0.001) were associated with fissured tongue; gender (p<0.001), khat chewing (p<0.001), and smoking (p<0.001) were associated with hairy tongue; and older age (p<0.001), khat chewing (p=0.001), and smoking (p=.021) were associated with coated tongue. Conclusion: The prevalence of tongue lesions among this sample of Yemeni population was 76.5 percent; fissured tongue and hairy tongue were the most prevalent lesions. Khat chewing, smoking, and older age were the associated risk factors for many of studied lesions and anomalies.

Black Hairy Tongue: Predisposing Factors, Diagnosis, and Treatment.

Black hairy tongue (BHT) is a benign condition commonly found among people who smoke, have poor oral hygiene, are immunocompromised, or have a medical condition limiting their ability to practice good oral hygiene. Though this condition is harmless, patients need to be educated on etiology as many common medications are associated with this condition. Patients being placed on certain antibiotics or antipsychotics should be educated on the importance of good oral hygiene or cessation of habits that promote BHT. Similarly, those with medical conditions increasing the risk for the development of BHT should schedule routine visits with their dentist or dental hygienist. Prognosis is good, and treatment consists of gentle brushing of the tongue, but many anecdotal reports exist demonstrating the use of medications or other products to treat this condition. This review addresses the epidemiology, clinical presentation, pathophysiology, etiology, histology, differential diagnosis, and treatment of BHT and lists all of the medications reported to cause this condition.

Black hairy tongue syndrome.

Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient's re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.

Tongue lesions in a Jordanian population. Prevalence, symptoms, subject’sknowledge and treatment provided

Tongue lesions constitute a considerable proportion of oral mucosal lesions, and are health concern to both oralhealth care providers and public.Objectives: The aim of this study was to determine the prevalence of tongue lesions and conditions among a groupof Jordanian population attending dental clinics, in addition to assessment of their symptoms, knowledge, andtreatment provided for their tongue lesions. Study design: A total of 2000 dental out-patients were screened fortongue lesions.Results: Fissured tongue was the most common tongue lesion diagnosed in 11.5% of the subjects, followed bycoated tongue (8.2%), geographic tongue (4.8%), hairy tongue (2.4%) and median rhomboid glossitis (0.5%).Symptoms were reported by 28% of the subjects with geographic tongue and 23% with fissured tongue. The majorityof the subjects (ranging from 61.1%-86.4%) were neither aware about their tongue lesions nor worried abouttheir prognosis. Less than 50% of those who were aware of their tongue lesions sought medical advice.Conclusion: The high prevalence of tongue lesions necessitates higher awareness of the general dental practitionerby their etiology, diagnosis and management (AU)

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The prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area.

OBJECTIVES: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area. SUBJECTS AND METHODS: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents. RESULTS: One hundred eighty-one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P < 0.05). CONCLUSIONS: Distribution characteristics of tongue lesions in Malaysians are important as local reference data in the daily clinical practice.

Drug-induced black hairy tongue.

Black hairy tongue (BHT) is a benign, self-limiting disorder characterized by abnormally hypertrophied and elongated filiform papillae on the surface of the tongue. The prevalence of BHT is quite variable, ranging from 0-53.8% depending on the population. Many predisposing factors to BHT exist, and several drugs and drug classes have been implicated in causing this disorder. A modified Naranjo adverse drug reaction probability nomogram specific for BHT was used to rate causality for the available published case reports of drug-induced BHT. From the available data, antibiotics and drugs capable of inducing xerostomia are the drug classes that have modest evidence of causality and a rational mechanism. The presence of underlying predisposing factors in these cases along with the variable prevalence of BHT make drawing firm conclusions difficult. Treatment for BHT involves eliminating any predisposing issues and practicing scrupulous oral hygiene. Drug therapy and physical removal of the elongated filiform papillae are available for resistant cases. Clinicians should be aware of the prevalence, the predisposing factors and drug classes that may play a role in the development, and the treatment of BHT.

Prevalence of tongue lesions among Turkish schoolchildren.

OBJECTIVES: To collect data on the prevalence of tongue lesions of Turkish schoolchildren in 3 different population samples in Ankara, and to analyze the relationship between tongue lesions and gender, oral hygiene, and income levels. METHODS: Nine hundred and six schoolchildren aged 6-12 participated in this study between March 2004 and July 2004 in Ankara, Turkey. Of the 906 schoolchildren, 442 were girls and 464 were boys from 3 primary schools. We examined all the children for the presence of the following tongue lesions: 1) ankyloglossia, 2) bifid tongue, 3) fissured tongue, 4) geographic tongue, 5) median rhomboid glossitis, 6) lingual thyroid nodule, 7) atrophic tongue, 8) hairy tongue, 9) crenation tongue, 10) furred tongue, 11) macroglossia, 12) microglossia, and 13) lingual or sublingual varicosities. RESULTS: Of the 906 subjects, we detected 45 subjects with tongue lesions with a prevalence of 4.95%. We found lesions more frequently in boys (6%) than in girls (4.5%). However, these results were statistically insignificant. Oral lesions commonly found were geographic tongue (1.8%), ankyloglossia (1.3%), fissured tongue (0.9%), bifid tongue (0.4%), hairy tongue (0.2%) and macroglossia (0.2%), lingual thyroid nodule (0.1%). We did not find any of the following lesions: median rhomboid glossitis, atrophic tongue, crenation tongue, furred tongue, microglossia, lingual, or sublingual varicosities. CONCLUSION: The tongue has a special importance due to its localization. It can readily affect a patient's social life because of lesions and various symptoms. The localization of tongue may also play important role in diagnosis for systematic, hormonal, and allergic disorders.

The prevalence of tongue lesions in 5150 Turkish dental outpatients.

OBJECTIVE: The aim of this study was to assess the prevalence of nine tongue conditions and relate to data obtained about oral hygiene or habits in Turkish dental outpatients. SUBJECTS: A total of 5150 subjects (2837 women, 2313 men) were included in this study. RESULTS: Of the 5150 subjects, 2690 subjects were detected as having tongue lesions with a prevalence of 44.2 and 62.0% for women and men, respectively. The difference was found to be statistically significant (P < 0.0001). There was a strong correlation between tongue lesions and increasing age. There was also a strong association between tongue lesions and smoking, black tea drinking, and fair or poor oral hygiene. Hairy and coated tongue was significantly higher in males. Contrary to this, papillary atrophy was more prominent in women. CONCLUSION: A strong correlation was found between tongue lesions and age, sex, oral hygiene and habits in Turkish dental outpatients. An efficient oral health program such as the elimination of risk habits and attention to cultural practices may improve tongue hygiene.

Prevalence of tongue lesions in 1013 Jordanian dental outpatients.

Over a period of 10 months, 1013 consecutive dental outpatients attending the Screening Clinic in Faculty of Dentistry, Jordan University of Science and Technology, in the city of Irbid were investigated for the presence of tongue lesions. All subjects were seeking treatment for caries and periodontal diseases and none was complaining of oral mucosal disorder. The results showed that 240 subjects (23.7%) had one or more tongue lesions. Geographic tongue and fissured tongue were detected in 6.8% and 11.4% of the examined population respectively, and an association of the two conditions was observed in 2.9% of the subjects. Hairy tongue was diagnosed in 3.4% of the subjects with significantly higher prevalence in males (P < 0.0005). A strong correlation was found between hairy tongue and smoking.

A clinical survey of oral soft tissue lesions in institutionalized geriatric patients in Israel.

A clinical survey of oral soft tissue lesions in 298 geriatric patients in Israel was conducted. White lesions were found in 9.5% of smokers and 2.19% of non-smokers. Varicosities increased from 11.1% to 41.1% between ages 50-99 years. Pigmentation, hairy tongue, and papillary atrophy of the tongue all increased with age. Hairy tongue was found in 12.8% of men and 4.5% of women.

[Findings from the clinical examination of the oral cavity of one hundred drug addicts]. / Euremata apo ten klinike exetase tou stomatos ekato chronion toxikomanon asthenon.

The authors studied the findings from the clinical examination of the oral cavity of one hundred drug addicts that were prisoners at Korydalos prison, in order to evaluate the incidence and the possible correlation of these findings to the drug abuse. This study revealed that drug addicts present lesions of the oral mucosa such as redness of the pharyngeal mucosa (57%), melanchromatic spots on the lips (35%) and hairy tongue (57%). Also, a high incidence of carious lesions was found (46%), of missing teeth (42%) and of periodontal disease (57%). These percentages are much higher than those found in a random population. It was also revealed that in the above group there was a high incidence of serum hepatitis (23%) and of AIDS (8%), while other systemic diseases were also found.

Prevalence of different morphologic forms of the human tongue in young Finns.

Morphologic variations on the surface of the human tongue were examined in 381 patients divided by age into three groups (Group I--3 to 8 years old; Group II--9 to 16 years old; and Group III--17 to 35 years old). In Group I there were 84 pre-school children; in Group II there were 146 schoolchildren; in Group III there were 151 dental students and dental nurse students. The prevalence of variations in the morphology of the tongue surface in the three groups combined was as follows: fissured tongue, 5.0 percent; filiform atrophy, 5.5 percent; geographic tongue, 2.1 percent, and hairy tongue, 8.3 percent. Prevalence of both fissured tongue (p less than 0.05) and filiform atrophy (p less than 0.01) increased with the age of the population. Geographic tongue and hairy tongue did not increase significantly with age. Fissured tongue was more common in males than in females (p less than 0.05). The amount of filiform atrophy and hairy tongue was not significantly different in males and females.