Use of lip protecting agents in the prevention of Actinic cheilitis, Herpes labialis and cancer of lip: a systematic review

Background: Actinic cheilitis, herpes labialis and lip cancer are relatively common conditions presenting on the lips associated with exposure to periods of sun exposure and thereby ultraviolet radiation. Objective: This systematic review aimed to determine the efficacy of the application of sunscreen-containing lip-protecting agents (LPA) in the prevention of actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC). Methods: This review was conducted in accordance with the PRISMA guidelines and registered with the PROSPERO database. A literature search was conducted using SCOPUS, Google Scholar, Medline (Ovid), Pubmed, CINAHL, Cochrane Library databases and manual search using search terms actinic cheilitis (AC), recurrent herpes labialis (RHL) and lip cancer (LC) along with lip protecting agents and their variations as keywords. A total of 1,567 papers were yielded. Of them, nine studies were eligible for qualitative data synthesis. Results: Nine articles (3 AC, 5 RHL, 1 LC) were deemed eligible and thus selected for qualitative synthesis. Three studies on AC identified approximately 21.7% lower prevalence of lesions when some form of lip protection was used. Eighty percent of studies on RHL identified that the application of LPA is effective in preventing RHL. Subjects who applied LPA more than once daily only had half the risk of having LC compared to those who applied once daily. Conclusion: This review of randomised controlled trials (RCTs) and observational studies supports the use of LPA as an effective method in preventing lip-associated lesions. Further, RCTs and observational studies should aim at determining a definitive LPA application regime and optimal SPF strength to prevent lip-associated lesions

Congenital double upper lip: review of literature and report of a case

Congenital maxillary double lip is a rare anomaly in which a fold of redundant labial tissue becomes apparent at rest or while smiling. This might pose cosmetic or functional problems, as well as serious impact on psychological well-being, especially when it affects young children or adolescents. The treatment of choice is surgical excision. This paper presents a successfully managed case of maxillary double lip using elliptical incision under local anesthesia in a 15-year-old female patient

Traumatic oral mucosal lesions: a mini review and clinical update

Oral mucosal lesions are a common occurrence and very often dentists are called upon to see such patients. Among many causes trauma is one of the leading for oral mucosal diseases. Oral traumatic lesions are diverse in which some present as acute lesions while the majority are chronic lesions. Clinical presentation of traumatic lesions vary significantly and most of the occasions the cause and the effect can be established with thorough history and clinical examination. Although, biopsy of such lesions are not required in most of the occasions some may warrant histological investigations to exclude conditions which clinically mimic traumatic lesions. This paper provides an overview of common and some rare traumatic conditions of the oral mucosa

Trends of lip, oral cavity and oropharyngeal cancers in Australia 1982–2008: overall good news but with rising rates in the oropharynx

Background: Considerable global variation in the incidence of lip, of oral cavity and of pharyngeal cancers exists. Whilst this reflects regional or population differences in risk, interpretation is uncertain due to heterogeneity of definitions of sites and of sub-sites within this anatomically diverse region. For Australia, limited data on sub-sites have been published. This study examines age-standardised incidence trends and demography from 1982 to 2008, the latest data available.\ud \ud Methods: Numbers of cases within ICD10:C00-C14 were obtained from the Australian Institute of Health and Welfare, recorded by sex, age, and sub-site. Raw data were re-analysed to calculate crude, age-specific and age-standardised incidence using Segi's world-standard population. Time-trends were analysed using Joinpoint regression.\ud \ud Results: Lip, Oral Cavity and Pharyngeal (excluding nasopharynx) cancers, considered together, show a biphasic trend: in men rising 0.9% pa from 1982 to 1992, and declining 1.6% pa between 1992 and 2008. For females: rises of 2.0% pa 1982–1997; declines of 2.8% pa 1997–2008. Lip cancer is declining especially significantly. When the Oropharynx is considered separately, steadily increasing trends of 1.2% pa for men and 0.8% pa for women were observed from 1982 to 2008.\ud \ud Conclusions: Although overall rates of lip/oral/oropharyngeal cancer are declining in Australia, these are still high. This study revealed steady increases in cancers of the oropharynx, beginning in the late 1990s. Continued efforts to reduce the burden of these cancers are needed, focused on reduction of the traditional risk factors of alcohol and tobacco, and with special emphasis on the possible role of human papillomavirus and sexual hygiene for cancers of the oropharynx

The epidemic of oral cancer in India continues unabated: need for new policy initiatives

[Extract] The Indian sub-continent remains the global epicentre of oral cancer, first described in Sushruta Samhita, a Sanskrit treatise of ~600 B.C. The burden: incidence, mortality, survival; disease determinants and stretched healthcare resources are under-appreciated. Approximately 70,000 cases and >48,000 oral cancer-related deaths occur yearly. Cases [ICD10, C00–08] are predicted to be ~103,000 pa by 2020. This is the second-most common malignancy in men: fourth in women; many go unrecorded and/or are lost to follow-up

Oral cancer in India continues in epidemic proportions: evidence base and policy initiatives

Objectives: India has the highest number of cases of oral cancer in the world and this is increasing. This burden is not fully appreciated even within India, despite the high incidence and poor survival associated with this disease. Because the aetiology of oral cancer is predominantly tobacco-related, the immense public health challenge can be meliorated through habit intervention.\ud \ud Methods: We reviewed current rates of incidence, mortality and survival, and investigated the determinants of disease and current prevention strategies.\ud \ud Results: In addition to tobacco smoking and the myriad other forms of tobacco use prevalent in India, risk factors include areca nut consumption, alcohol consumption, human papillomavirus, increasing age, male gender and socioeconomic factors. Although India has world-leading cancer treatment centres, access to these is limited. Further, the focus of health care services remains clinical and is either curative or palliative.\ud \ud Conclusions: Although the efforts of agencies such as the Ministry of Health and Family Welfare and the Indian Dental Association are laudable, enhanced strategies should be based on common risk factors, focusing on primary prevention, health education, early detection and the earliest possible therapeutic intervention. A multi-agency approach is required

Depigmentation of oral mucosa as the earliest possible manifestation of oral submucous fibrosis in Sri Lankan oreschool children

This article reports the presentation of oral submucous fibrosis in five Sri Lankan preschool children, aged 2–3 years, with loss of pigmentation of the lips as the sole clinical feature. Oral submucous fibrosis has not been reported in this age group of children. The five 2–3 year olds did not display any classical features of oral submucous fibrosis, due to the disease having been detected at a very early stage. The present study attempts to establish that depigmentation of the lips and oral mucosa is perhaps the earliest feature to develop in the natural history of oral submucous fibrosis. The differential diagnosis of oral mucosal depigmentation relevant to these cases is also discussed. Previously-reported cases of oral submucous fibrosis in children are reviewed

Epidemiology and site-specific risk factors for oral cancer

To outline the global epidemiology of oral cancer and recent changes in disease prevalence with the emergence of HPV-induced cancers

Use of single- and multi-drug regimens in the management of classic (idiopathic) trigeminal neuralgia: an 11-year experience at a single Sri Lankan institution

Aim: The aim of this retrospective study was to evaluate the outcome of medical treatment of classic trigeminal neuralgia and to assess the factors affecting the choice of drug regimen (single or multiple), and the duration of treatment for pain control.\ud \ud Methods: A total of 260 consecutive patients were included in the study. Sixty-one patients with less than 6 months' follow up were excluded. All patients were treated with carbamazepine alone or in combination with other drugs. The dosage was adjusted according to the level of pain control and side-effects.\ud \ud Results: Treatment was terminated in 99 patients (49.7%) after a mean follow-up period of 36.46 months (standard deviation: ±26.5). Of these, 39.4% were on a single drug. Carbamazepine was the drug used in 36 patients. The rest (61%) needed various combinations of drugs. One-hundred patients (50.3%) continued with medical treatment during the follow-up period. Of these, 67.4% were on multi-drug therapy.\ud \ud Conclusion: The present study showed that the administration of multidrug regimens is a useful alternative in controlling trigeminal neuralgia in patients who are unable to tolerate higher doses of carbamazepine. Age, sex, ethnicity, and the side of affliction did not have a significant influence on the choice of drug regimen and the duration of treatment for pain control