Prevention and treatment of undesirable symptoms caused by irradiation in the oral cavity

Patients during radiotherapy for head and neck tumours show side effects in the oral cavity that might influence further treatment, or even cause temporary or total break in the irradiation. For this reason, prevention and treatment are essential to avoid or reduce the possibility of such complications. Sanitation of the oral cavity by a dentist is indispensable, and afterwards, regular screening of the teeth and the mucous membrane condition. Proper hygiene plays a particularly important role, leading to alleviation of symptoms and reduction in the discomfort, which in conesquence, contributes to the increase in the living comfort of patients undergoing radiotherapy

Child sexual abuse as an etiological factor of overweight and eating disorders — considerations for primary health care providers

Despite the recognition of the clinical importance of child sexual abuse, primary health care providers are often not ad­equately prepared to perform medical evaluations and diagnose child sexual maltreatment. Paper presents basic symptoms and signs of CSA, which may suggest the need for further patient’s diagnosis and referral. Since the great majority of sexually abused children do not have any abnormal physical findings, special attention is paid to the silent warning signs of CSA, such as changes in attitude towards own body and eating habits. Numerous studies suggest that victims of CSA may develop obesity or eating disorders of various forms and intensities

Obecność Candida albicans w jamie ustnej a całkowita liczba limfocytów u chorych z nowotworami głowy i szyi

StreszczenieWstępLeczenie promieniami jonizującymi powoduje pojawienie się i/lub nasilenie zakażenia grzybiczego. Celem pracy była ocena występowania zmian grzybiczych w jamie ustnej u chorych objętycń radioterapią z powodu nowotworów głowy i szyi oraz stwierdzenie, czy istnieje zależność pomiędzy liczbą limfocytów i granulocytówobojętnocńłonnycń a zwiększeniem się liczby kolonii Candida albicans.Materiał i metodaMateriał z jamy ustnej pobrano od 50 pacjentów leczonych w Wielkopolskim Centrum Onkologii w Poznaniu promieniami jonizującymi w dawce 60–70 Gy przez okres 6–7 tygodni z powodu nowotworów głowy i szyi. Grupę kontrolną stanowiło 20 chorych leczonych w tym Ośrodku z powodu innych nowotworów. U tych osób nie zastosowano radioterapii. U wszystkich wykonano posiew w kierunku zakażenia grzybiczego jak również oceniono stan odporności na podstawie całkowitej liczby limfocytów (CLL), jak i poziomu granulocytów obojętnocńłonnycń.WynikiWyniki wykazały, że po przeprowadzonym leczeniu wzrosła liczba osób z dodatnim wynikiem posiewów w kierunku Candida. Jednocześnie stwierdzono spadek CLL, u 34% chorych po radioterapii CLL w 1 mm3 był mniejszy niż 1 000, a liczba kolonii Candida powyżej 5 w porównaniu z 4% badanych przed radioterapią. Poziom granulocytów obojętnocńłonnycń u żadnego z chorych nie obniżył się poniżej 2 000 w 1 mm3.PodsumowaniePrzeprowadzone badania sugerują, że radioterapia może mieć wpływ na rozwój zakażeń grzybiczych m.in. poprzez spadek odpomości.SummaryObjectivesRadiation therapy induces and/or exacerbates mycotic infection. The purpose of the present work was to determine the exis-tence of mycological changes in the oral cavity in patients (pts) treated by radiotherapy because of head and neck neoplasms, and to determine the existence of dependence between the number of lymphocytes and neutrocytes and the increase in the number of Candida albicans.Materials and methodThe material from the oral cavity was taken from 50 pts with head and neck neoplasms treated at the Wielkopolskie Centrum Onkologii (Great Poland Cancer Centre) in Poznań. Patients received radiotherapy in a dose of 6 000 – 7 000 cGy over a period of 6 – 7 weeks. The control group consisted of 20 pts treated at the same hospital for cancer other than head and neck cancer. The patients did not receive radiotherapy treatment. In all pts mycological culture was carried out and the condition of immunity was examined on the basis of the total number of lymphocytes (CLL) and the level of neutrocytes.ResultsThe data showed that after treatment the number of pts with positive results of the mycologically cultured examinations on Candida ID increased. At the same time a decrease in CLL was observed. After radiotherapy CLL per 1 mm3 was less than 1000, and the number of Candida more then 5, compared with 4% of pts before radiotherapy. The level of neutrocytes in non of the pts decreased to less than 2 000 per 1 mm3.ConclusionOur study suggess that radiotherapy may have an effect on the development of mycological infection, among other things, through the decreace in immunity

Salivary Biomarkers and Oral Microbial Load in Relation to the Dental Status of Adults with Cystic Fibrosis

The mutation of cystic fibrosis transmembrane conductance regulator (CFTR) can modify the physical and chemical properties of saliva, which in turn can affect the oral microflora and oral health in patients with cystic fibrosis (CF). The aim of the study was to examine oral health status, salivary properties, and total oral bacteria count in CF adults. Dental status was assessed using the decayed missing filled surfaces (DMF-S) index, and oral clearness using the approximal plaque index (API). The Saliva-Check BUFFER test was used to assess saliva, and real-time polymerase chain reaction (PCR) test to determine the total oral bacteria count. CF patients in comparison to healthy controls showed a higher level of examined clinical indices, higher total oral bacteria count, lower salivary flow rate, lower salivary pH, and increased viscosity. Conclusions: In CF patients, saliva properties, accompanied by insufficient dental care, might be an essential dental caries risk factor. In CF patients, among the etiological factors for dental caries, the bacterial agent seems to be less significant. The frequent and long-term infectious pharmacotherapy can probably explain that. A great deal of the information collected on the oral environment in CF patients, which has helped us understand the etiological conditions for inflammation and infection in this area of the body, indicates that proper dental care can mostly counteract these pathologies

Oral Care Recommendation for Cystic Fibrosis Patients–Recommendation for Dentists

Cystic fibrosis (CF) is a genetic disease that is caused by a defect in the gene coding for the transmembrane cystic fibrosis transmembrane conductance regulator (CFTR). Research papers published so far point out that despite the numerous dental treatment needs of CF patients, there are no oral care guidelines for this group of patients. The aim of the article is to propose standards of dental prophylactic and therapeutic procedures for CF patients in different age groups. Regardless of the CF patient’s age, dental check-ups should be scheduled at least every 6 months. However, taking into account the actual condition of the individual CF patients, therapeutic visits may be scheduled for earlier dates, to provide well-fitting treatment, considering the level of risk of oral diseases. The described management standards may be helpful and may improve the quality of dental care provided to CF patients

Prediction of Early Childhood Caries Based on Single Nucleotide Polymorphisms Using Neural Networks

Background: Several genes and single nucleotide polymorphisms (SNPs) have been associated with early childhood caries. However, they are highly age- and population-dependent and the majority of existing caries prediction models are based on environmental and behavioral factors only and are scarce in infants. Methods: We examined 6 novel and previously analyzed 22 SNPs in the cohort of 95 Polish children (48 caries, 47 caries-free) aged 2–3 years. All polymorphisms were genotyped from DNA extracted from oral epithelium samples. We used Fisher’s exact test, receiver operator characteristic (ROC) curve and uni-/multi-variable logistic regression to test the association of SNPs with the disease, followed by the neural network (NN) analysis. Results: The logistic regression (LogReg) model showed 90% sensitivity and 96% specificity, overall accuracy of 93% (p < 0.0001), and the area under the curve (AUC) was 0.970 (95% CI: 0.912–0.994; p < 0.0001). We found 90.9–98.4% and 73.6–87.2% prediction accuracy in the test and validation predictions, respectively. The strongest predictors were: AMELX_rs17878486 and TUFT1_rs2337360 (in both LogReg and NN), MMP16_rs1042937 (in NN) and ENAM_rs12640848 (in LogReg). Conclusions: Neural network prediction model might be a substantial tool for screening/early preventive treatment of patients at high risk of caries development in the early childhood. The knowledge of potential risk status could allow early targeted training in oral hygiene and modifications of eating habits

Limited Mandibular Movements as a Consequence of Unilateral or Asymmetrical Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis Patients

This study aimed to assess the asymmetry of the lower face and motor dysfunction of the masticatory system resulting from unilateral or asymmetrical bilateral temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) patients. The study consisted of clinical examination and cone beam computed tomography (CBCT) of TMJs. Statistical analysis showed correlations between several factors: facial asymmetry and mandibular lateral deviation; the direction of mandibular deviation and the degree of radiological deformities in TMJs; the child’s age at the time of the onset and the range of lateral movement towards the healthy or less destructed joint. In addition, there was a significant difference in ranges of lateral movements; a significantly smaller range was observed for the joint with fewer condylar abnormalities compared to the range in the opposite direction. In JIA children, among the clinical markers of unilateral or asymmetrical TMJ involvement, the asymmetry of the lower face, deviation of the mandible on opening, and an uneven range of mandibular lateral movements deserve attention. The obtained results do not show a relationship between the degree of condylar changes and the asymmetry of the lower face and the presence and degree of mandibular motor dysfunction

Clinical Consequences of Dental Caries, Parents’ Perception of Child’s Oral Health and Attitudes towards Dental Visits in a Population of 7-Year-Old Children

This cross-sectional study aimed to assess the occurrence of the consequences of dental caries and factors affecting dental service utilization in a population of 7-year-old children. The research included oral examination of 7-year-old schoolchildren and socio-medical study of their parents/legal caregivers. It was carried out in five primary schools of two provinces, i.e., Greater Poland and Lubusz. Dental examination was performed in accordance with World Health Organization (WHO) recommendations. The socio-medical study consisted of questionnaires with close-ended questions concerning socioeconomic characteristics of the family, reasons and time of the last visit at the dental office, consequences of child’s oral health problems, parents’ attitude towards dental visits, and parental opinion about their child’s teeth. Factors affecting utilization of dental services were statistically analyzed using univariate logistic regression assuming p < 0.05. The pufa index of examined children ranged from 0 to 7 (mean 0.80 ± 1.49), while the dmf index ranged from 0 to 14 (3.86 ± 3.32). Low financial burden of oral health expenditures and university education of at least one of the parents significantly increased the chance of visiting a dentist despite lack of pain (OR = 3.0 and 2.5, respectively). In spite of the availability of free dental care for children, socioeconomic factors still determine the utilization of dental services in Poland. Poor oral health status of examined population and negligence of regular dental check-ups emphasize a need to strengthen oral health literacy of parents and children, promoting proper attitudes towards dental care