Orofacial Pain : Molecular Mechanisms, Diagnosis, and Treatment 2021

The Special Issue “Orofacial Pain: Molecular Mechanisms, Diagnosis, and Treatment 2021” contains 6 articles published by 41 authors from different countries focusing on nucleus accumbens core GABAergic neurons, receptor-interacting serine/threonine-protein kinase 1, pannexin 1-mediated ATP signaling, ultra-low-frequency transcutaneous electrical nerve stimulation, and triamcinolone acetonide. The content covers several pain models, including neuropathic pain caused by peripheral nerve constriction or malpositioned dental implants, tongue cancer, myogenous temporomandibular dysfunction, and oral ulcerative mucositis. In addition, a review paper on trigeminal neuralgia is included

Global Interest for Health Professions Education: A Geographic and Temporal Analyses Through Web Search Differences from 2010-2019

Purpose: The purpose of this study was to analyze the spatio-temporal differences in web search trends for dental degrees (DD), medical degrees (MD), and nursing degrees (ND) across 197 countries from 2010 to 2019. Method: A search string was used to initiate a search query using Google Trends. The parameters used were DD, MD, and ND as search terms; worldwide as Location; 2010 to 2019 as time range; health education & medical training as category; and web search as database. Data were downloaded and analyzed. Results: Via one-way ANOVA and post hoc Dunnett test, the searches for DD were found to be significantly lower in 2011 (3.2 ± 0.3, p = .044), 2012 (2.6 ± 0.2, p \u3c .001), 2013 (2.8 ± 0.3, p = .006), 2014 (3.0 ± 0.3, p = .017), and 2015 (2.9 ± 0.3, p = .010) compared to the year 2010 (4.5 ± 0.6); the searches for MD was significantly higher in 2019 (84.5 ± 2.5, p = .002) compared to the year 2010 (73.0 ± 1.7); and the searches for ND were statistically significantly higher in 2015 (28.9 ± 1.1, p = .024) and 2019 (31.7 ± 1.1, p = .001) compared to the year 2010 (24.5.0 ± 1.2). The search trend for MD increased in 31 countries and decreased in 14 countries while searches for ND increased in 40 countries and decreased in 5 countries as determined by a two-way ANOVA with Holm-Sidak’s multiple comparison test. The 12-month forecast for the search interests of these health professions predicted a rise in the third quarter and an abrupt decline at the end of the year. Conclusions: Geographic and time factors affect the search interests for health professions. In a span of a decade, the disparity of interests shown by the low interests for DD and ND compared to MD in some countries underscores the need to promote these professions to fill the future health care workforce

ヒシゲンセイ シツウ ノ ハッショウ キジョ シンダン チリョウ

Nonodontogenic toothache is a painful condition that occurs in the absence of any pathophysiological problems in the tooth or periodontal tissue. Nonodontogenic toothache has not been given adequate attention in undergraduate student education, and there is little information on diagnosis or management. The Japanese Society of Orofacial Pain published clinical practice guidelines for nonodontogenic toothache in 2012. These guidelines introduce nonodontogenic toothache and provide basic information on orofacial pain. In this review, electronic databases were used to search and assess the most reliable scientific evidence. Publications with a high evidence level, according to the nonodontogenic toothache guidelines, were selected and evaluated. This review encompasses all facets of clinical practice, ranging from basic scientific knowledge to therapeutic strategies, and targets all medical personnel involved in dental treatment. This review should be given due consideration by clinical personnel, and is anticipated to contribute to improving the quality of life of patients who suffer from nonodontogenic toothache

Effect of COVID-19 on Oral Cancer Search

Objective: Oral cancer is one of the most common malignancies in developing countries, but studies using global data are scarce. The aim of this study is to analyze the search interests for oral cancer using mouth cancer, tongue cancer, gum cancer, and lip cancer as common keywords. Methods: Internet searches relating to oral cancer from 2010 to 2020, from 250 countries and dependent areas, were retrieved from Google Trends. Color densities in a heat map were used to show geographic differences. Kruskal-Wallis test with post hoc Dunn’s analysis was used to perform yearly comparisons of searches for mouth cancer, tongue cancer, gum cancer, and lip cancer. Search results within 2020 were also compared to determine differences. Forecasting searches from 2021 to 2022 were done by fitting time series models. Results: From 29 of 250 (11.6%) countries, the highest search values were observed for mouth cancer in Sri Lanka, Qatar, Bangladesh, Finland, Netherlands, Spain, and France. Compared to 2020, greater searches were seen in 2018 (Mdn = 91%, P = 0.023) and 2019 (Mdn = 94%, P = 0.012) for mouth cancer, and 2019 (Mdn = 17%, P = 0.035) for lip cancer. The relative search volumes for gum cancer and lip cancer were substantially lower than mouth cancer during the COVID-19 pandemic. Conclusion: Higher-income countries tend to be more interested in seeking information about oral cancer. Noteworthy decline in the interest in seeking information online for oral cancer may have crucial implications during the COVID-19 pandemic. Google Trends offer an invaluable and inexpensive means for oral cancer surveillance and health-seeking behavior

Targeted Therapy for Orofacial Pain : A Novel Perspective for Precision Medicine

Orofacial pain (OFP) is a dental specialty that includes the diagnosis, management and treatment of disorders of the jaw, mouth, face, head and neck. Evidence-based understanding is critical in effectively treating OFPs as the pathophysiology of these conditions is multifactorial. Since OFP impacts the quality of life of the affected individuals, treating patients successfully is of the utmost significance. Despite the therapeutic choices available, treating OFP is still quite challenging, owing to inter-patient variations. The emerging trends in precision medicine could probably lead us to a paradigm shift in effectively managing the untreatable long-standing pain conditions. Precision medicine is designed based on the patient’s genetic profile to meet their needs. Several significant relationships have been discovered based on the genetics and genomics of pain in the past, and some of the notable targets are discussed in this review. The scope of this review is to discuss preclinical and clinical trials that include approaches used in targeted therapy for orofacial pain. Future developments in pain medicine should benefit from current trends in research into novel therapeutic approaches

Complications causing patients to discontinue using oral appliances for treatment of obstructive sleep apnea

Purpose: Oral appliances (OAs) are commonly used as a noninvasive treatment for obstructive sleep apnea syndrome (OSAS). These devices are worn during sleep and create mandibular anterior traction to enlarge the upper airway. Continuous use of the device is essential for the success of OA therapy, but some patients stop using the OA for various reasons. The purpose of this research was to investigate complications in OA therapy that might prevent continuous use of these devices. Methods: The progress of 90 OSAS patients who visited Tokushima University Hospital and underwent OA therapy was investigated with a mailed questionnaire. All patients had been receiving OA therapy for more than 12 months. Results: Forty patients responded to the questionnaire and of these, 22 were not wearing their OA during sleep. The average period before stopping OA therapy was 9.6 months. Answers from 38 patients who were treated with two-piece Herbst®-type oral appliances were analyzed. The main reasons for stopping OA therapy were: (1) it was bothersome to use; and (2) it did not effectively prevent sleep apnea. Comparison of OA complications between current OA users and nonusers revealed significant differences for the items ‘‘difficulty sleeping’’ and ‘‘stifling feeling’’. OA users recorded better scores for sleep quality than nonusers. Conclusions: The results of this study indicate that patients discontinued OA therapy because the appliance was ‘‘bothersome to use’’ and because it had ‘‘little or no effect’’ rather than because they experienced the typical complications of OA therapy

Masticatory performance alters stress relief effect

Purpose: We evaluated the effects of gum chewing on the response to psychological stress induced by a calculation task and investigated the relationship between this response and masticatory performance. Methods: Nineteen healthy adult volunteers without dental problems undertook the Uchida–Kraepelin (UK) test (30 min of reiterating additions of one-digit numbers). Before and immediately after the test, saliva samples were collected from the sublingual area of the participants. Three min after the UK test, the participants were made to chew flavorless gum for 3 min, and the final saliva samples were collected 10 min after the UK test. The experiment was performed without gum chewing on a different day. Masticatory performance was evaluated using color-changing chewing gum. Results: Salivary CgA levels at immediately and 10 min after the UK test were compared with and without gum chewing condition. Two-way repeated measures analysis of variance revealed significant interaction between gum chewing condition and changes in CgA levels during post 10 min UK test period. A significant correlation was found between changes in CgA levels and masticatory performance in all participants. Conclusion: Our results indicate that gum chewing may relieve stress responses; however, high masticatory performance is required to achieve this effect

Filipinos’ Interest in Oral Cancer

Objective: This study analyzed the health-seeking behavior of Filipinos through relative search volume in Google Trends using oral cancer, mouth cancer, tongue cancer, gum cancer, and lip cancer as predetermined search terms. Methods: Comma-separated values files containing relative search volumes of search trends pertaining to oral cancer from 2009 to 2019 were assessed. Brown-Forsythe one-way ANOVA was used to measure differences of oral cancer between years and among months. Repeated measures two-way ANOVA measured differences among the searches for mouth cancer, tongue cancer, gum cancer, and lip cancer through the years. Time series models were fitted and used to forecast search interests. Results: The results revealed that interests in oral cancer were significantly higher in 2019 (43.75±5.5, p<0.05) compared to 2009 (29.0 ± 6.7). In terms of months, searches were higher in February (45.0 ± 6.6) compared to May (24.8 ± 3.4, p=0.015), June (25.3 ± 4.4, p=0.020), and December (26.5 ± 4.0, p=0.038). Search interests for gum cancer and lip cancer remained significantly lower from 2011 to 2019, and tongue cancer from 2016 to 2018 but approximated mouth cancer in 2019. The forecast shows mouth cancer (31.67%), tongue cancer (23.75%), and lip cancer (3.83%) fluctuating through the year, while gum cancer (8%) will remain steady in 2020. Conclusion: Health-seeking behavior through search trends show an increased interest in oral cancer in 2019 and during February. Search interests will fluctuate in 2020, but at the end of the year will decrease for mouth cancer and tongue cancer, will increase for lip cancer, and will remain steady for gum cancer

中長期的なメンテナンスを受けている患者の歯の喪失の危険因子 : 後ろ向き研究

In this retrospective study, we identified risk factors for tooth loss in patients undergoing mid–long-term maintenance therapy. We surveyed 674 maintenance patients for ≥5 years after active treatment who visited a dental clinic between January 2015 and December 2016. Of these, 265 were men (mean age 54.6 ± 8.0 years old) and 409 were women (mean age 54.0 ± 7.9 years old). Study variables included patient compliance, sex, number of teeth lost, cause of tooth loss (dental caries, periodontal disease, root fracture, others, vital or non-vital teeth), age at start of maintenance, number of remaining teeth at start of maintenance, smoking, use of salivary secretion inhibitors, presence of diabetes mellitus, condition of periodontal bone loss, and use of a removable denture. Most lost teeth were non-vital teeth (91.7% of all cases) and the most common cause of tooth loss was tooth fracture (62.1% of all cases). A statistically significant risk factors for tooth loss was number of remaining teeth at the start of maintenance (p = 0.003)