INCONCLUSIVE EVIDENCE INDICATES COMMUNITY BASED COMPREHENSIVE ORAL HEALTH INTERVENTION IMPROVES ORAL HEALTH STATUS COMPARED TO ONLY ORAL HEALTH EDUCATION.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Tsai C, Raphael S, Agnew C, McDonald G, Irving M. Health promotion interventions to improve oral health of adolescents: A systematic review and meta-analysis. Community Dent Oral Epidemiol. 2020 Dec;48(6):549-560. doi: 10.1111/cdoe.12567. Epub 2020 Aug 7. PMID: 32767825. SOURCE OF FUNDING: Information not available TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

Limited quality evidence suggests children and adolescents with down syndrome have lower prevalence of dental caries compared to non-syndromic children.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Silva MCPMD, Lyra MCA, Almeida HCR, Alencar Filho AV, Heimer MV, Rosenblatt A. Caries experience in children and adolescents with Down Syndrome: A systematic review and meta-analysis. Arch Oral Biol. 2020 Jul;115:104,715. doi:10.1016/j.archoralbio.2020.104715. Epub 2020 Apr 8. PMID: 32,422,361. SOURCE OF FUNDING: The Hungarian Human Resources Development Operational Program, the Higher Education Excellence Program of the Hungarian Ministry of Human Capacities to the Therapy Research Module of Semmelweis University, National Research, Development and Innovation Office, Hungarian Scientific Research Fund and the Economic Development and Innovation Operative Programme Grant. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

Randomised clinical trial of a motivational interviewing intervention to improve oral health education amongst older adults in Philadelphia: 12-month evaluation of non-clinical outcomes.

OBJECTIVES: We conducted a trial to assess the treatment fidelity of an individual-based oral health education intervention utilising motivational interviewing (MI) techniques and its efficacy when compared to a group-based traditional oral health education intervention (TOHE) and a standard of care group (SC) in a sample from Philadelphia during a 12-month follow-up. BACKGROUND: There is lack of information on how different types of oral health educational interventions affect older adults on non-clinical outcomes including changes in oral health-related quality of life (OHRQoL), oral health self-efficacy (SE) and oral health knowledge (OHK). MATERIALS AND METHODS: One hundred and eighty patients were randomly allocated to TOHE, MI and SC groups. Treatment fidelity was measured in 16 non-study patients. The MI intervention was administered by a public health dental hygienist (PHDH). All interviews were audio-recorded and coded by an expert using the Motivational Interviewing Treatment Integrity (MITI) Code. Multivariable longitudinal regression analyses accounting for baseline demographics and correlated errors due to repeated measures via generalised estimating equation were conducted following an intention to treat approach. RESULTS: Over the 1-year follow-up, SE and OHRQoL scores significantly improved amongst the MI group whereas both outcomes worsened amongst the SC group. During the same period, SE and OHRQoL did not change in the TOHE group. CONCLUSION: Findings from the study support the fidelity of this intervention and the improvement of all non-clinical outcomes after 12 months amongst the MI group.

Pediatric dentists who accept new Medicaid-enrolled children report higher willingness to advocate for community water Fluoridation.

BACKGROUND: Dentists, who advocate for Community Water Fluoridation (CWF), can help decrease the dental caries disparity gap between low and high socioeconomic groups. Advocating for CWF, a cause that promotes oral health at the population level is an altruistic behavior. Dentists who accept and provide services to Medicaid-insured children, who are from low socioeconomic backgrounds, are also considered altruistic. We tested the association between accepting new Medicaid-insured children every month, and willingness to advocate for CWF programs in pediatric dentists (PDs). METHODS: In 2016, a 22-item pilot tested online survey was sent to 5394 PD members of the American Academy of Pediatric Dentistry. Descriptive analysis and a multiple adjusted logistic regression model was conducted. RESULTS: Dentists who accept new Medicaid-insured children every month (OR: 1.62; 95% CI: 1.06-2.47; p = 0.02) were more willing to advocate for CWF compared to their counterparts. Those practicing primarily in rural (OR = 4.67; 95% CI: 1.82-11.9; p = 0.001), and urban areas (OR = 2.27; 95%CI: 1.05-4.89; p = 0.04), and those willing to promote fluoridated water consumption to parents in the clinic (OR = 3.40; 95% CI: 1.87-6.21; p = < 0.0001) were significantly more likely to be willing to advocate for CWF. PDs trained in public health advocacy during pediatric residency alone (OR = 2.37; 95% CI: 1.24-4.51; p = 0.009), or during both pre-doctoral dental education and pediatric residency (OR = 3.51; 95% CI: 1.87-5.6; p = < 0.0001) were more willing to advocate for CWF compared to their counterparts. CONCLUSIONS: PDs who accepted new Medicaid-insured children every month were more willing to advocate for CWF programs compared to those who did not.

Oral health promotion practices: a survey of Florida child care center directors.

BACKGROUND: To understand the oral health promotion practices (OHPPs) in Florida licensed childcare centers (CCCs), we surveyed the childcare center directors (CCCDs) employed at these centers. We determined if CCC's affiliation with Early Head Start/Head Start (EHS/HS) programs was associated with the number of OHPPs implemented. METHODS: For this cross-sectional study we emailed a pretested 45-item online survey to unduplicated email addresses of 5142 licensed CCCDs as listed in the publicly available Florida Department of Child and Family services database. Univariate and bivariate analyses were conducted. In addition, a Poisson regression model predicting higher numbers of OHPPs implemented was conducted. RESULTS: A response rate of 19.4% was estimated. CCCDs reporting to implement a higher number of OHPPs in their CCCs were more likely to have longer work experience (b = 0.006, 95% CI: 0.001,0.012 p = 0.03), work in EHS/HS affiliated centers (b = 0.7, 95%CI: 0.48,0.91) p < 0.001), and have more positive attitudes about pediatric oral health (b = 0.08, 95%CI: 0.05, 0.10) p < 0.001). CCCDs with more self-perceived barriers reported implementing a lower number of OHPPs (b = - 0.046, 95% CI: -0.09, - 0.003 p = 0.035) compared to their counterparts. CONCLUSIONS: A significant association between a CCC's affiliation with EHS/HS programs and the number of OHPPs implemented was observed. In addition, CCCD's years of experience, attitudes towards oral health, and self-perceived barriers in implementing OHPPs were also associated with the number of OHPPs implemented.

Limited-Quality Evidence Suggests That Early Caries Experience at Age 6 years May Predict Low Oral Health-Related Quality of Life at Age 10 years.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Early Caries Predicts Low Oral Health-Related Quality of Life at a Later Age. Kragt L, van der Tas JT, Moll HA, Elfrink ME, Jaddoe VW, Wolvius EB, Ongkosuwito EM. Caries Res. 2016; 50(5):471-9. SOURCE OF FUNDING: This study was funded by (1) the Erasmus Medical Center, Rotterdam, the Erasmus University, Rotterdam, (2) the Netherlands Organization for Health Research and Development, (3) an unrestricted grant from GABA, Therwil, Switzerland, (4) the Netherlands Organization for Health Research and Development (VIDI 016.136.361), and a (5) consolidator grant from the European Research Council (ERC-2014- CoG-64916). TYPE OF STUDY/DESIGN: Prospective Cohort Study.

Smoking status, dental visits and receipt of tobacco counseling in dental office among mobile and trailer home adolescents.

BACKGROUND: Mobile and trailer home (MTHs) residents are an understudied group. In this study we determined the cigarette smoking status, dental visits in the past 12 months, and receipt of tobacco counseling in adolescents living in MTHs compared to adolescents living in other types of housing. METHODS: For this secondary data analysis study, we used data of adolescents aged 10 to 19 years (n = 74,890) from the 2012 Florida Youth Tobacco Survey (FYTS). Weighted multiple logistic regression model was conducted to understand the differences between adolescents living in MTHs compared to those living in other types of housing. RESULTS: Approximately 6 % of the sample reported living in MTHs. The regression model showed that older (p < 0.0001), female (p = 0.0091), and middle school (p < 0.0001) adolescents were more likely, and those who identified as Asians (p = 0.0006), Black/African Americans (p < 0.0001), and Hispanics (p < 0.0001) were less likely to be living in MTHs compared to their counterparts. Current established smokers (p < 0.0001) and non-established smokers (p < 0.0001) were more likely to report living in MTHs compared to non-smokers. Those reporting to have not visited a dental office (p < 0.0001) were more likely to be living in MTHs. Those who visited a dental office but not received any tobacco counseling (p < 0.0001) were less likely to be living in MTHs compared to their counterparts. CONCLUSIONS: Current cigarette smokers and those not visiting a dental office were more likely to be MTH adolescents. Adolescents reporting to have received tobacco counseling in a dental office were more likely to be living in MTHs.

Florida child care center directors' intention to implement oral health promotion practices in licensed child care centers.

BACKGROUND: To determine the factors associated with child care center directors' (CCCDs) intention to implement oral health promotion practices (OHPPs) in licensed childcare centers (CCCs) within the next year, and their self-perceived barriers in successfully implementing those practices. METHODS: For this cross-sectional study, a pretested 45-item online survey was sent to 5142 CCCDs assessing pediatric oral health knowledge, attitudes towards oral health, intention to implement OHPPs, and self-perceived barriers to implementing OHPPs. An adjusted logistic regression model determined the factors associated with CCCDs intention to implement OHPPs within the next year. RESULTS: Participants were 877 CCCDs, with mean age of 48.5 ± 10.5 years, of whom 96 % were women, and 74 % were whites (Response rate = 19.4 %). The majority (67 %) of respondents reported that they intended to implement OHPPs in their center within a year. Insufficient funding, lack of enough training in oral health, and limited time to promote oral health were the most frequently cited barriers to implementing OHPPs. CCCDs of non-White race (p = 0.02), with a college degree or above (p = 0.05), and with positive attitudes (p < 0.0001), were more likely to report that they will implement OHPPs within the next year compared to their counterparts. CONCLUSIONS: CCCDs reported fewer barriers to implementing OHPPs within the next year, indicating that CCCs can be a suitable setting to promote oral health. CCCDs race, educational status and attitudes towards oral health strongly predicted their intention to implement OHPPs. Though this study assessed the intention of CCCDs to implement OHPPs in CCCs, it did not access the actual implementation of OHPPs by them. Therefore future research could longitudinally assess predictors for true implementation of OHPPs. In addition, researchers should adopt a more comprehensive, multi-level approach to assess the actual dental health needs of children attending these centers, along with parental, staff and center level characteristics, and other relevant factors related to implementing OHPPs.

Baseline Caries Risk Assessment Using CAMBRA May Predict Caries Only in High and Extreme Caries Risk Groups.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Baseline caries risk assessment as a predictor of caries incidence. Chaffee BW, Cheng J, Featherstone JD.J Dent 2015;43(5):518-24. REVIEWERS: Marisol Tellez, BDS, MPH, PhD, Vinodh Bhoopathi, BDS, MPH, DScD, Sungwoo Lim, MS, DrPH PURPOSE/QUESTION: To determine, with each increasing category of baseline caries risk as assessed by Caries Management by Risk Assessment (CAMBRA) in a patient, whether a greater or higher number of new decay/restored teeth can be predicted at a subsequent 6-month periodic oral evaluation. SOURCE OF FUNDING: National Center for Advancing Translational Sciences, National Institutes of Health (KL2TR000143) TYPE OF STUDY/DESIGN: Retrospective cohort study LEVEL OF EVIDENCE: Level 2: Limited-quality, patientoriented evidence STRENGTH OF RECOMMENDATION GRADE: Not applicable.

Childhood dental caries and obesity: Opportunities for interdisciplinary approaches to prevention.

Dental caries and obesity are prevalent and preventable chronic childhood diseases. Evidence shows a strong connection between these two diseases, with overlapping common risk factors, including diet as a key driver of risk. Dental professionals are well-positioned to perform nutritional counseling and obesity prevention in dental clinic settings, but training and clinical integration remain key challenges. This paper highlights the potential for leveraging the common risk factor approach (CRFA) framework and its principles to reduce the impact of childhood dental caries and obesity. Strategies and methods are provided to integrate meaningful didactic and clinical training experiences in dental academia, and the need to include effective and evidence-based nutritional counseling techniques in dental settings is also described. Additionally, the potential for integrating CRFA and engaging health care providers across the spectrum of care, including primary care settings, to reduce the prevalence of these diseases in pediatric populations is highlighted. Finally, the authors propose future directions for multidisciplinary research to advance the scientific knowledge in this area and to inform effective and comprehensive interventions for dental settings.

Association between more complex special care needs and overweight status and adolescents' difficulty with dental caries.

OBJECTIVE: Little is known about dental caries experience in adolescents with overweight and complex special health care needs (SHCNs). METHODS: Adolescent data (10-17 years) from the 2016-2020 National Survey of Children's Health (n = 91,196) was analyzed. The sample was grouped into the following: more complex SHCN and overweight, more complex SHCN without overweight, less complex SHCN and overweight, less complex SHCN without overweight, no SHCN but with overweight, and neither SHCN nor overweight. A multivariable-adjusted logistic regression model was conducted. RESULTS: Adolescents with more complex SHCNs with (OR: 1.82, 95% CI: 1.44-2.30, p < 0.001) or without overweight (OR: 1.51, 95% CI: 1.30-1.76, p < 0.001) were at higher odds of experiencing dental caries compared to healthy adolescents. No significant associations were observed between adolescents with less complex or no SHCN regardless of the overweight status with healthy adolescents. CONCLUSIONS: Adolescents with more complex SHCNs, irrespective of overweight status, experienced a higher caries severity than adolescents with no SHCNs or overweight.

Los Angeles County dentists' opinions on discussing human papilloma virus-related oral health issues and recommending vaccine to patients.

Dentists are well-positioned to discuss oral health issues related to Human Papillomavirus (HPV) and recommend the HPV vaccine to their patients, mainly because the HPV virus causes oropharyngeal cancers.. We assessed Los Angeles (LA) County dentists' opinions on discussing HPV-related oral health issues and recommending the HPV vaccine to their patients. We tested if opinions differed between dentists whose primary patient population was only adults versus children and adults. We mailed a 19-item survey to 2000 randomly sampled LA County dentists for this cross-sectional study. The primary outcome variable was a summary opinion score of 7 opinion statements. We ran descriptive, bivariate comparisons and adjusted linear regression models. Overall, 261 dentists completed the survey. A majority (58.5%) worried they would lose patients if they recommended the vaccine; 49% thought dentists were not appropriate to educate, counsel, or advise on HPV-related issues; 42% were concerned about the safety of the vaccine; and 40% did not feel comfortable recommending the vaccine. The mean summary opinion score was 21.4 ± 5.4 for the total sample. Regression analysis showed no differences in opinions between dentists whose primary patient population was only adults versus children and adults (Coefficient = 0.146, p = 0.83). Overall, the responding dentists were not very favorable about discussing oral health-related HPV issues and recommending the HPV vaccine to their patients. Additionally, the overall opinions were similar between dentists whose primary patient population was only adults versus children and adults.

Utility of oral cancer diagnostic adjuncts in the adult US populations.

BACKGROUND: Utility of diagnostic adjuncts (DAs) in an adult population with a low oral and pharyngeal cancer (OPC) prevalence is unclear. In this study, we compare the effectiveness of DAs and clinicians' conventional oral examination (COE) in detecting oral and pharyngeal cancers (OPC), in high-risk (HR) users, low-risk (LR) and alcohol, and in the overall adult US populations (GP). METHODS: We assumed oral cancer DAs to have 99% sensitivity and specificity. For COE, 79.6% sensitivity and 97.7% specificity were used. Using Altman's mathematical model, the positive predictive values (PPV) for a DA and COE were estimated for HR, LR, and GP groups, respectively. Three different scenarios (sensitivity constant but decreasing specificity, specificity constant but decreasing sensitivity, and decreasing both sensitivity and specificity simultaneously) were developed to simulate the true effectiveness of DAs while keeping the prevalence of OPC in HR, LR, and GP groups constant at 0.4039%, 0.0362%, and 0.1109%, respectively. RESULTS: The PPVs for a DA in HR, LR, and GP groups in the United States were estimated at 29%, 3%, and 10%, while for COE, the PPVs would be at 12%, 1%, and 4%, respectively. CONCLUSIONS: Utility of DAs in LR and GP groups is negligible due to very low OPC prevalence in these populations. In HR population, DAs may have a slightly better effectiveness than clinicians only when assumed to have high sensitivity and specificity.

Dental care utilization among developmentally disabled adolescents experiencing difficulty with decayed teeth: A population-level study.

AIMS: To determine if adolescents with developmental disabilities (DDs) who experienced difficulty with dental caries differed by dental visits in the past 12 months and receipt of preventive services (fluoride treatment and dental sealants) during those visits compared to adolescents with no DDs or difficulty with dental caries. METHODS AND RESULTS: A cross-sectional study was conducted using data of 91 196 adolescents aged 10-17 years from the 2016-2020 National Survey of Children's Health. Descriptive and bivariate statistics and multivariable regression models were conducted. We derived the odds ratio for visiting a dental office (OR: 0.76, 95% CI: 0.57-1.03, p = .07), receiving fluoride treatments (OR: 1.20, 95% CI: 1.01-1.43, p = .04), and dental sealants (OR: 1.44, 95% CI: 1.19-1.75, p < .001) for DD adolescents who experienced difficulty with dental caries compared to adolescents with no DDs or difficulty with dental caries. CONCLUSIONS: DD adolescents who experienced difficulty with dental caries were more likely to receive fluoride treatments and sealants during dental visits but were equally likely to have a dental visit in the past 12 months than adolescents with no DDs or difficulty with dental caries.

A national sample of developmentally disabled adolescents with obesity and their utilization of preventive dental care services.

Background: Previous literature indicates that adolescents with developmental disabilities and obesity may have more oral health complications than healthy adolescents. However, dental care utilization among adolescents with developmental disabilities (DDs) and obesity is unclear. We investigated the differences in the utilization of preventive dental services between this high-risk group of adolescents and those with no DDs or obesity. Methods: Parent-reported data of adolescents 10-17 years (n = 68,942) from the 2016 to 2019 National Survey of Children's Health was used. In addition to descriptive and bivariate statistics, we ran three multiple logistic regression models guided by Andersen's Behavioral Model of Health Services Use, predicting the use of dental cleanings, fluoride treatments, and dental sealants. Results: Among adolescents with DDs and obesity, dental cleanings, fluoride treatments, and dental sealant utilization prevalence were 76%, 48%, and 21%, respectively. In comparison, adolescents with no DDs or obesity had a prevalence of 83%, 50%, and 19%, respectively. Multiple logistic regression analysis showed that adolescents with DDs and obesity did not significantly differ in their receipt of dental cleanings (p = .07), fluoride treatments (p = .55), and dental sealants (p = .23) compared to those with neither DDs nor obesity. Adolescents with DDs but no obesity were 22% and 30% more likely to receive fluoride treatments (p < .0001) and dental sealants (p < .0001), respectively. Conclusions: Fewer than half of adolescents with DDs and obesity utilized fluoride treatments, and less than one quarter utilized dental sealants but used all three preventive services at the same rate as those with no DDs or obesity. Implications: This study identified no differences in preventive dental care services utilization in adolescents with developmental disabilities (DDs) and obesity compared to those without DDs and obesity. However, the utilization of preventive dental services in this population is influenced by the federal poverty level and family background.

Health literacy and its association with human papilloma virus vaccination among adults: Findings from the behavioral risk factor surveillance system.

Health literacy is associated with the utilization of preventive health services. We examined the association between health literacy (HL) levels and receipt of at least one dose of the human papilloma virus (HPV) vaccination. We analyzed the data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) among adults aged 18 to 32. The primary outcome variable was the 'yes/no' response to the question that assessed whether the participant received at least the first dose of HPV vaccination. The primary independent variable was a summative HL score (range 3 through 12) we created for each respondent by adding the scores for all three HL questions. We performed bivariate and multivariable (logistic regression) analyses to examine the relationship between study variables. The analytical sample of 6,731 adults aged 18 to 32 met the eligibility criteria. Regression analyses showed that the odds of having received at least one dose of HPV vaccination increased by 13% for every unit increase in health literacy score (Odds ratio: 1.13, 95% CI:1.06-1.21, p < .0001). Age, gender, marital status, race/ethnicity, insurance status, and having regular access to a personal doctor were predictors of HPV vaccination status. This study showed that higher levels of HL may contribute to the uptake of at least one dose of the HPV vaccine. Health care and public health organizations, health care professionals, and policymakers should emphasize improving the health literacy levels of the patients and the public to increase the uptake of the HPV vaccine.

Hospital emergency department visits made by developmentally disabled adolescents with oral complications.

Purpose: We used Andersen's Behavioral Model in a cross-sectional study to determine the factors associated with utilization of the emergency department (ED), controlling for whether an adolescent has a developmental disability (DD) and one or more oral complications (toothaches, decayed teeth, bleeding gums, eating or swallowing problems). Methods: Data from the 2016-2019 National Survey of Children's Health (NSCH) was used for this secondary data analysis study. We used frequencies and percentages to describe the sample characteristics. Chi-square tests were used for bivariate analyses. Multivariable logistic regression modeling was conducted to predict ED visits by adolescents aged 10-17 controlling for predisposing, enabling, and need variables. Results: The sample consisted of 68,942 adolescents who were primarily male, non-Hispanic White, and born in the U.S. Parents reported that 69% of the adolescents had neither a DD nor an oral complication; 10% had no DD but experienced one or more oral complication; 16% had a DD but no oral complication; and 5% had both DDs and one or more oral complication. Adolescents with both a DD and an oral complication reported the highest level of ED visits at 33%, compared to 14% of adolescents with neither DD nor oral complication. Regression analysis showed that adolescents with a DD and oral complication (OR: 2.0, 95% CI: 1.64-2.54, p < 0.0001), and those with DDs but no oral complications (OR: 1.45, 95% CI: 1.25-1.68, p < 0.0001) were at higher odds of having an ED visit compared to those with neither a DD nor an oral complication. Not having a Medical Home increased the likelihood of ED visits by 14% (p = 0.02). Those with private insurance (OR: 0.63, 95% CI: 0.53-0.75, p < 0.0001) and those from a family where the highest level of education was some college and above (OR: 0.85, 95% CI: 0.73-0.98, p = 0.03) were less likely than their counterparts to have had an ED visit. Conclusion: Adolescents with DDs and oral complications utilize ED visits more frequently than those with neither DDs nor oral complications. Integrating the dental and medical health systems and incorporating concepts of a Patient-Centered Medical Home could improve overall health care and reduce ED visits for adolescents.

Pediatric dentists' participation in advocacy and acceptance of new medicaid children in clinical practice.

Introduction: Advocacy involves promoting a noble cause or voicing on behalf of a program, policy, or population group. Previous literature shows that dentists who provide services to Medicaid-enrolled, underserved, and vulnerable children are more compassionate than those who do not. Aim: To explore the association between pediatric dentists' (PDs) participation in various advocacy-related activities (ARAs) and their monthly acceptance of new Medicaid-enrolled children in their clinical practice to provide dental care services. Methods: A 14-item pilot-tested survey was created on the SurveyMonkey® online platform and emailed to 5591 PDs, active American Academy of Pediatric Dentistry members. Data from 789 PD respondents were analyzed. Frequencies, percentages, means, and standard deviations were used to describe the sample. Independent t-tests and chi-square tests assessed the differences between PDs accepting new Medicaid-enrolled children in their clinical practice every month vs. PDs who did not. A multivariable adjusted logistic regression model determined if there was an association between PDs' participation in ARAs and their acceptance of new Medicaid-enrolled children in their clinical practice, controlling for other independent variables. Results: The mean number of different ARAs performed by PDs was 2.2 ± 1.8. Approximately 65% reported that they accepted new Medicaid-enrolled children every month in their dental clinic to provide dental care services. The multivariable logistic regression model showed that the odds of a PD accepting new Medicaid-enrolled children every month increased by 13% for each additional unit increase in ARA completed, with other variables being held constant (Odds ratio: 1.13, 95% CI: 1.03-1.25, p = 0.01). Conclusion: PDs who performed more ARAs had greater odds of accepting new Medicaid-enrolled children into their dental practice every month. Education and training in oral health advocacy during dental education for dental students may promote performing ARAs and providing dental care services to Medicaid patients after graduation.

Effectiveness of oral surgeons compared with OralCDx brush biopsy in diagnosing oral dysplastic lesions.

PURPOSE: To evaluate oral surgeons' effectiveness in diagnosing oral dysplastic lesions and compare it to OralCDx brush biopsy. MATERIALS AND METHODS: In this cross-sectional study, the oral surgeon's ability to diagnose dysplasia among 152 consecutive cases (tissue samples) that had previously tested either "positive" (n = 3) or "atypical" (n = 149) for dysplasia by OralCDx brush biopsy was determined by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value using the scalpel biopsy as the gold standard. PPV for oral surgeons and atypical brush biopsy was compared stratified by age, gender, and lesion site. RESULTS: The PPV, negative predictive value, sensitivity, and specificity for oral surgeons were 10.3%, 100%, 100%, and 23.5%, respectively. After controlling for age, gender, and lesion site, oral surgeons were 19% to 58% more likely to diagnose a dysplastic lesion compared to OralCDx brush biopsy. CONCLUSIONS: Oral surgeons' effectiveness in diagnosing oral dysplastic lesions was slightly better than the OralCDx brush biopsy; hence, it is recommended that patients be referred to an oral surgeon for evaluation.

Zinc-replacement therapy may not reduce oral pain in patients with zinc-deficient burning mouth syndrome (BMS).

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects. Cho GS, Han MW, Lee B, Roh J, Choi S, Cho K, et al. J Oral Pathol Med 2010;39(9):722-7. REVIEWERS: Vinodh Bhoopathi, BDS, MPH, DScD, Ana Karina Mascarenhas, BDS, MPH, DrPH PURPOSE/QUESTION: In patients with BMS and low serum zinc levels, does zinc-replacement therapy reduce pain? Authors using an animal model also attempted to demonstrate a causal relationship between BMS and zinc deficiency SOURCE OF FUNDING: Information not available TYPE OF STUDY/DESIGN: Randomized controlled trial LEVEL OF EVIDENCE: Level 2: Limited-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE: Not applicable.