Changing trend of caries from 1989 to 2004 among 12-year old Sardinian children

Background. During the past decades, the prevalence of caries disease in the population of Western industrialized countries has decreased markedly. In children also, a reduction of dental caries experience has been reported by many authors. The aim of this paper was to evaluate the trend of dental caries prevalence in 12-year-old children living in the city of Sassari, (Italy), by five cross-sectional studies conducted in 1989, 1992, 1995, 1998 and 2004. Methods. In all cohorts, dental caries (DMFT and SiC Index according to WHO indications), was measured. For each variable measured (DMFT and sub-indices, SiC Index), differences in proportions among the five cohorts during the fifteen years were tested using χ2-square test. Results. The mean DMFT index decreased from 4.3 ± 3.1 in 1989 to 0.8 ± 1.5 in 2004. The prevalence of untreated caries (DT) had a notable decrease between 1992 and 1995, increased slightly between 1995 and 1998 and had the greatest decrease in 2004. The number of filled teeth remains low. The percentage of caries-free children increased from 10% to 64%, whereas the percentage of untreated caries changed from 44% in 1989 to 62% in 2004. SiC Index decreased from 7.8 in 1989 to 3.9 in 2004. Conclusion. On the basis of the results of DMFT and SiC Index, caries experience has been reduced. The vigilance and the promotion of a higher standard of personal oral hygiene and dental check-ups are necessary to obtain an improvement of oral status in the future adult population and to reach the new WHO global goals

Osteoporosis and Bisphosphonate-Related Osteonecrosis of the Jaw Bone

The aim of this longitudinal study is to present data from 76 female patients treated with bisphosphonates (BPs) for postmenopausal osteoporosis and referred to the Unit of Oral Diagnosis and Day Surgery of the University of Milano for diagnosis and treatment. All patients received a thorough oral examination. The diagnosis of osteonecrosis of the jaw bone (ONJ) was made from radiographic and clinical findings. 9% of individuals had BRONJ at first visit. Patients with dental or periodontal abscess were significantly more likely to develop BRONJ (OR: 2.9, 95% CI 0.5–15.9). Patients with osteoporosis receiving BPs may develop BRONJ, especially in the presence of an active infectious process in the mouth. Clinicians should carefully follow up on individuals receiving bisphosphonates therapy to avoid the occurrence of osteonecrotic lesions

Oral Cancer and Precancer: A Narrative Review on the Relevance of Early Diagnosis

Oral cancer (OC) is an uncommon malignancy in Western countries, being one of the most common cancers in some high-risk areas of the world. It is a largely preventable cancer, since most of the different risk factors identified, such as tobacco use, alcohol consumption, and betel nut chewing, are behaviors that increase the likelihood of the disease. Given its high mortality, early diagnosis is of utmost importance. Prevention and the anticipation of diagnosis begin with identification of potentially malignant lesions of the oral mucosa and with local conditions promoting chronic inflammation. Therefore, every lesion must be recognized promptly and treated adequately. The clinical recognition and evaluation of oral mucosal lesions can detect up to 99% of oral cancers/premalignancies. As stated by the World Health Organization, any suspicious lesion that does not subside within two weeks from detection and removal of local causes of irritation must be biopsied. Surgical biopsy remains the gold standard for diagnosis of oral cancer. Adjunctive tools have been developed and studied to help clinicians in the diagnostic pathway, such as toluidine blue vital staining and autofluorescence imaging. In the near future other methods, i.e., identification of salivary markers of progression may help in reducing mortality due to oral cancer

Clinical-pathologic Agreement for Oral Lesions in an Oral Medicine Setting

Abstract Background: Histopathological examination remains the gold standard for the diagnosis of oral mucosal lesions. To date little is known on the clinical-pathologic agreement for oral lesions diagnosed by oral medicine experts. Objective: This retrospective study attempts to quantify the clinical-pathologic agreement for oral lesions diagnosed by oral medicine experts. Methods: Data were collected retrospectively from the medical records of all new oral medicine consultations. The clinical diagnosis provided by an oral medicine expert was compared to the histopathological diagnosis. Clinical-pathologic agreement was estimated as the percentage agreement and was measured using weighted Kappa. Results: The most common oral lesions were oral lichen planus (34.7%), traumatic fibroma (23.4%), squamous cell carcinoma (SCC) or severe dysplasia (6.7%), mucous membrane pemphigoid (MMP) (5.7%), leukoplakia (5.6%) and squamous papilloma (4.3%). The overall clinical-pathologic agreement for all lesions had a weighted kappa of 0.81 [95%CI 0.78% to 0.85%]. The concordance for the most common oral lesions in the study population was 90.2%, with a weighted kappa of 0.88 [95%CI 0.85% to 0.92%]. The clinicalpathologic agreement for SCC/severe dysplasia was 78.7%, for traumatic fibroma 91.4%, for leukoplakia 97.4%, for oral lichen planus 93.8%, for squamous papilloma 96.7% and for MMP 65%. Conclusions: The overall concordance between clinical and histopathological diagnosis for oral lesions was excellent. Dentists have the unique opportunity to refer patients to oral medicine experts for diagnosis and management of oral diseases. Given their expertise patients may require fewer visits for diagnostic purposes

Diagnosis and management of xerostomia and hyposalivation

Xerostomia, the subjective complaint of dry mouth, and hyposalivation remain a significant burden for many individuals. Diagnosis of xerostomia and salivary gland hypofunction is dependent upon a careful and detailed history and thorough oral examination. There exist many options for treatment and symptom management: salivary stimulants, topical agents, saliva substitutes, and systemic sialogogues. The aim of this review is to investigate the current state of knowledge on management and treatment of patients affected by xerostomia and/or hyposalivation