Home About us Contact
|
Home About us Contact | ||
|
|
||
Oral Examination (oral + examination)
Kinds of Oral Examination Selected AbstractsA Japanese case of Kindler syndromeINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2000Yasushi Suga MD A 25-year-old Japanese woman presented with contracture of the fingers and toes, and difficulty in opening her mouth. Her grandparents are first cousins, but none of the other members of the family are affected. Bulla formation started at birth on areas of the skin that received pressure, and in infancy and early childhood the lesions were limited only to the acral areas. She also had bilateral, incomplete syndactylies involving all web spaces ( Fig. 1a). The formation of blisters ceased after the age of 15 years, but a generalized progressive poikiloderma then appeared with accompanying cutaneous atrophy of the skin of the neck, trunk, and extremities ( Fig. 1b). The patient experienced mild photosensitivity of the face and neck. At age 18 years, surgical removal of the webbing of all her fingers was performed. Oral examination showed atrophy of the buccal mucosa, and an inability to fully open the mouth. The patient also suffered from poor dentition and easily bleeding gums, but had no symptoms of esophageal dysfunction. Figure 1. Clinical manifestations of the patient with Kindler syndrome. (a) Dorsal surface of the patient's hands. Note the marked cutaneous atrophy with a severely wrinkled appearance on the dorsal surface of the hands, as well as the proximal fusion of the fingers. (b) Lower left leg of the patient. Atrophic thinning of the skin and poikiloderma with reticular pigmentation are evident Histology of separate biopsy specimens, taken from the poikilodermatous pretibial and trunk skin, showed classical features of poikiloderma, namely epidermal atrophy with flattening of the rete ridges, vacuolization of basal keratinocytes, pigmentary incontinence, and mild dermal perivascularization ( Fig. 2a). Interestingly, dyskeratotic cells ( Fig. 2b) and eosinophilic rounded bodies (colloid bodies) ( Fig. 2c) were frequently found at the basal keratinocyte layer and in the upper dermis, respectively. Pigment was also present in the upper epidermis. Figure 2. Hematoxylin and eosin staining of a biopsy specimen taken from pretibial skin. (a) Epidermal atrophy with flattening of the rete ridges. Note the dyskeratotic cells (arrowheads) and vacuolar degeneration of the basal layer in the epidermis. Bar = 50 ,m. (b) Higher magnification of dyskeratotic cells (arrowheads). Bar = 10 ,m. (c) Higher magnification of colloid bodies (arrowheads) in the superficial dermis. Bar = 10 ,m To rule out the possibility of a congenital epidermolysis bullosa, ultrastructural and immunofluorescence studies were performed. Ultrastructural studies demonstrated the reduplication of the basal lamina with branching structures within the upper dermis and cleavage between the lamina densa and the cell membrane of the keratinocytes ( Fig. 3a). The numbers of associated anchoring fibrils did not seem to be reduced, and colloid bodies and dyskeratotic cells were detected. Immunofluorescence studies with the antibody against type VII collagen (LH 7 : 2) were subsequently carried out. The results showed extensive broad bands with intermittently discontinuous and reticular staining at the dermo-epidermal junction (DEJ) ( Fig. 3b), whereas a linear distribution is typically seen in healthy tissue (data not shown). Interestingly, direct immunofluorescence studies revealed intracellular accumulation of immunoglobulin G (IgG), IgM, IgA, and C3 in colloid bodies under the basement membrane ( Fig. 3c). Figure 3. Ultrastructural and immunohistochemical findings of the patient with Kindler syndrome. (a) Ultrastructural study of the dermo-epidermal junction. The branching structures of the lamina densa (arrowheads) were frequently seen. The asterisks show the cleavage in the lamina lucida. Bar = 1 ,m. (b) Immunohistochemical studies with the antibody to type VII collagen (LH 7 : 2). An extensive broad band with reticular patterns is evident. Bar = 50 ,m. E, epidermis; D, dermis. (c) Direct immunofluorescence study. Intracytoplasmic deposition of IgM in the basal keratinocytes is evident (arrowheads). Bar = 50 ,m. E, epidermis; D, dermis [source] The oral health of children considered very high risk for infective endocarditisINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2010RICHARD BALMER International Journal of Paediatric Dentistry 2010; 20: 173,178 Background., Children with previous experience of infective endocarditis or with prosthetic heart valve are considered at very high risk for infective endocarditis. Aim., The aim of this study was to compare the dental health of a group of these children with a group of healthy controls and to determine parental awareness of the importance of good oral health. Design., Oral examination was carried out in 28 children with previous infective endocarditis or a prosthetic heart valve to assess oral health. Findings were compared to a healthy control group of 28. Questionnaires were distributed to the parents to assess awareness of oral health. Results., There was no significant difference in DMFT scores of study and control group (2.43 +/- 3.72 and 1.36 +/- 2.5 respectively) or in DMFT scores of study and control group (1.5 +/- 1.73 and 1.15 +/- 1.42 respectively), 36% of the study group had untreated caries. Parental knowledge of the link between oral health and infective endocarditis was excellent. Conclusions., There were no significant differences between the oral health of cardiac children and healthy children although the dmft and DMFT scores of the study group were high. Of concern was the proportion of children with untreated caries in spite of good dental awareness and attendance. [source] CLINICAL TRIALS ON THE USE OF WHITENING STRIPS IN CHILDREN AND ADOLESCENTSJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2005K.J. Donly ABSTRACT Objective: This article reported the cumulative findings from three controlled, randomized clinical trials evaluating the efficacy and tolerability of tooth whitening in children and adolescents using disposable polyethylene strip systems. Materials and Methods: The study population included 132 children and adolescents, ages 10 to 18 years. (Please note that 71 of these subjects were identified in the previous review.) Fifty-three percent of the subjects were female and 47% were male, with a mean age of 14.4 years. Subjects were divided into experimental treatment groups by balancing groups with respect to demographic characteristics and baseline tooth colors. Subiects were treated with either 5.3% or 6.5% hydrogen peroxide gel polyethylene strips. All subjects had to have all permanent anterior teeth erupted, a baseline Vita shade (Vita Zahnfabrik, Bad Säckingen, Germany) score of A2 or darker, and a desire that their teeth be whitened. One study included subjects who had previously received comprehensive orthodontic treatment. Digital images were collected for all subjects at baseline, 2 weeks, and 4 weeks. Oral examinations and interviews were conducted at each appointment to evaluate adverse events. Color change was calculated from the digital images in the same manner previously described. Results: The 5.3% and 6.5% hydrogen peroxide strips used for 30 minutes twice a day yielded significant tooth whitening (p < .0001) after 14 days. For the primary whitening parameter, ,b*, continued treatment during the 14- to 28-day period resulted in significant additional reduction in yellowness (p < .0001). Subjects treated with 6.5% hydrogen peroxide strips experienced significantly (p < .03) greater reduction in yellowness (approximately 0.8 ,b* units) compared with those who used the 5.3 hydrogen peroxide strips. The hydrogen peroxide strips were tolerated well in all of these studies, with minor tooth sensitivity and oral irritation being the primary complaints. Eighteen subjects (14%) reported oral irritation, whereas 30 subjects (23%) reported tooth sensitivity. All adverse events were relieved upon discontinuance of product use. Conclusion: The 5.3% and 6.5% hydrogen peroxide gel strips used for 30 minutes twice a day effectively whitened teeth, and both regimens were well tolerated. [source] Dental health status of liver transplant candidatesLIVER TRANSPLANTATION, Issue 2 2007James Guggenheimer A prerequisite dental evaluation is usually recommended for potential organ transplant candidates. This is based on the premise that untreated dental disease may pose a risk for infection and sepsis, although there is no evidence that this has occurred in organ transplant candidates or recipients. The purpose of this study was to assess the prevalence of dental disease and oral health behaviors in a sample of liver transplant candidates (LTCs). Oral examinations were conducted on 300 LTCs for the presence of gingivitis, dental plaque, dental caries, periodontal disease, edentulism, and xerostomia. The prevalence of these conditions was compared with oral health data from national health surveys and examined for possible associations with most recent dental visit, smoking, and type of liver disease. Significant risk factors for plaque-related gingivitis included intervals of more than 1 yr since the last dental visit (P = 0.004), smoking (P = 0.03), and diuretic therapy (P = 0.005). Dental caries and periodontal disease were also significantly associated with intervals of more than 1 yr since the last dental visit (P = 0.004). LTCs with viral hepatitis or alcoholic cirrhosis had the highest smoking rate (78.8%). Higher rates of edentulism occurred among older LTCs who were less likely to have had a recent dental evaluation (mean 88 months). In conclusion, intervals of more than 1 yr since the last dental visit, smoking, and diuretic therapy appear to be the most significant determinants of dental disease and the need for a pretransplantation dental screening evaluation in LTCs. Edentulous patients should have periodic examinations for oral cancer. Liver Transpl 13:280,286, 2007. © 2007 AASLD. [source] Relationship of smoking and smoking cessation with number of teeth present: JPHC Oral Health Study,ORAL DISEASES, Issue 1 2009T Yanagisawa Background:, Smoking is associated with the number of teeth. The purpose of this study was to determine the relationship of number of teeth with smoking and smoking cessation. Methods:, Subjects included 547 males aged between 55 and 75 years. Oral examinations were conducted in 2005. Smoking status information was collected from questionnaire surveys conducted in 1990, 1995, 2000, and 2005. The relationship between having more than eight missing teeth and smoking status was estimated with adjusted odds ratio. Results:, Comparing with never smokers, odds ratios of having more than eight missing teeth among current and former smokers were 1.96 and 1.86, respectively. The odds ratios in those who had stopped smoking for ,10 years was 3.02, and for those who had ceased smoking for 11,20 years was 2.66. In those who stopped smoking for 21 years or more, there was no increase in the odds ratio. Conclusion:, Smoking had a positive association with the number of missing teeth and smoking cessation is beneficial for maintaining teeth. The odds of having more than eight missing teeth in those who had never smoked was equal to that of individuals who reported that they had stopped smoking for 21 years or more. [source] The association between incisor trauma and occlusal characteristics in individuals 8,50 years of ageDENTAL TRAUMATOLOGY, Issue 2 2004Jay D. Shulman Abstract,,, To explore the association between incisal trauma and occlusal characteristics using oral examination and health interview data from the Third National Health and Nutrition Examination Survey 1988,1994 (NHANES III). Incisal trauma examinations were performed on 15 364 individuals 6,50 years of age using an ordinal scale developed by the National Institute of Dental and Craniofacial Research. Occlusal examinations were performed on 13 057 individuals 8,50 years of age. We fitted separate multivariate logistic regression models for maxillary and mandibular incisor trauma adjusting for socio-demographic variables (age, gender, race-ethnicity) and occlusal characteristics (overbite, overjet, open bite). 23.45% of all individuals evidenced trauma on at least one incisor, with trauma more than four times more prevalent on maxillary (22.59%) than on mandibular incisors (4.78%). Males (OR = 1.67) had greater odds of trauma than females; Whites (OR = 1.37) and non-Hispanic Blacks (OR = 1.37) had greater odds of trauma than Mexican,Americans. The odds of trauma increased with age, peaked from age 21 to 30 (OR = 2.92), and declined. As overjet increased, so did the odds of trauma. Compared to individuals with ,0-mm overjet, odds of trauma increased from 1,3 mm (OR = 1.42) to 4,6 mm (OR = 2.42) to 7,8 mm (OR = 3.24) to >8 mm (OR = 12.47). Trauma to incisors is prevalent but mostly limited to enamel. Trauma to maxillary incisors is associated with overjet, gender, race-ethnicity, and age, while trauma to mandibular incisors is associated with gender, age, and overbite. [source] The art and science of oral examinationDERMATOLOGIC THERAPY, Issue 3 2010Rania Agha ABSTRACT Performing an accurate oral examination is an integral part of a complete dermatological evaluation. As dermatologists, we are frequently asked to assess and treat numerous oral pathologies, which include, but are not limited to, normal variants, infections, ulcers, granulomas, lymphomas, as well as primary and metastatic tumors of the mouth and lips. The oral mucosa can be the window through which one can see and make numerous systemic diagnoses. Some clinicians are apprehensive about performing this evaluation, or feel that this examination is outside of their realm of expertise. These concerns may reflect limited exposure and education during training. Therefore, this article aimed to educate the readers on how to complete an oral examination, demonstrate normal variants, and highlight potential pitfalls and limitations of performing oral biopsies. [source] Magnetic resonance imaging features of an extranodal T cell rich B cell lymphoma in the pharyngeal mucosa in a horseEQUINE VETERINARY EDUCATION, Issue 6 2008V. Jakesova Summary An 11-year-old Warmblood gelding was presented for inspiratory stridor and dysphagia. Based on history and clinical examination, a solitary mass localised in the oropharynx was suspected. Due to its inaccessibility and defensive behaviour of the horse, it was difficult to visualise this mass either by upper airway endoscopy or by oral examination and the conventional imaging methods (radiology and ultrasound) provided only limited information. Fine needle aspiration cytology was suggestive of lymphoma, but the exact localisation and the extent of tissue infiltration of the tumour could only be defined by magnetic resonance imaging (MRI). MRI has proved to be a very useful diagnostic tool in equine lameness investigation and, as this case illustrates, it has considerable diagnostic potential for soft tissue examination of the equine head. [source] Experiences of oral care in patients with haematological malignancies or head and neck cancerEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2003ASSISTANT PROFESSOR , K.E.O. ÖHRN RDH The aim of the present study was to investigate cancer patients' experiences of oral hygiene information, oral care and self-care, information on oral complications, examination of the oral cavity, and ability to eat and drink during cancer treatment, and to explore patient attitudes to oral examination and oral hygiene. The sample consisted of 41 consecutive patients treated with radiotherapy for head and neck cancer (n = 18) or with chemotherapy for haematological malignancies (n = 23). Patients were interviewed at the end of radiotherapy or the second/third chemotherapy cycle. Compared with patients receiving chemotherapy, those who received radiotherapy had significantly more often visited hospital dentistry, been informed about oral complications and oral hygiene, received instructions in oral hygiene procedures, and been examined by hospital staff. More of the radiotherapy patients experienced oral symptoms and difficulties to eat and drink during treatment. There were no significant differences between the groups with regard to patient experiences of the oral hygiene procedures. Only one patient objected to having hospital staff discuss oral hygiene procedures, and three did not want hospital staff to examine their oral cavity. Patients undergoing radiotherapy or chemotherapy need to be monitored during treatment with regard to their oral status and oral symptoms and complications. There are no acceptable reasons for allowing patients to suffer from oral symptoms that can be reduced. [source] Original article: Prevalence of oral and dental disorders in institutionalised elderly people in Rasht, IranGERODONTOLOGY, Issue 3 2010Maryam Rabiei doi:10.1111/j.1741-2358.2009.00313.x Prevalence of oral and dental disorders in institutionalised elderly people in Rasht, Iran Objective:, The aim of this study was to determine the prevalence of dental and oral mucosal lesions in institutionalised elderly people in Rasht. Background:, Oral health in the elderly people is important to tailor the health programmes for this increasing age group within the population. Methods:, A total of 216 elderly people residing in a geriatric nursing home were included in the study. Subjects were interviewed and examined clinically and registered in a data collection form and analysed using spss version 11 program (SPSS Inc, Chicago, Illinois, USA). Results:, The prevalence of dental and oral disorders was 44.9% and 86.1% respectively. The most frequent oral disorders were dry mouth (42.1%), fissure tongue (25.9%), atrophic of tongue (25%), sublingual varicosity (22.7%), burning sensation (16.7%) and varix (15.3%). The prevalence of edentulousness was 56% (95%CI: 49,63%). The mean level of retained teeth was 3.22. The odds of an oral mucosal disorder in females were significantly more than in males (OR = 2.79, 95%CI: 1.25,6.23). Discussion:, The findings revealed a high prevalence of dental and oral disorders in institutionalised elderly people in Rasht in comparison to similar studies. The mean of retained teeth was also much lower than in other reports. Therefore, the necessity for regular oral examination of these rapidly expanding age groups of people is essential. [source] Dental status and dental caries in 85-year-old DanesGERODONTOLOGY, Issue 1 2007Lene Vilstrup Objectives:, This study reports findings on the dental status and the prevalence of dental caries among a group of 85-year-old Danes from the Glostrup 1914 Cohort, Denmark. The purpose of the study was to analyse whether caries experience was related to number of teeth and to indicators of functional ability and cognitive function. Methods:, A total of 191 individuals (78 men and 113 women) participated in a cross-sectional population study conducted in 2000. Using mobile dental equipment, a clinical oral examination and an interview were administered to all participants in their homes. Functional ability was measured by the Mob-H scale and cognitive function was assessed by the Mini-Mental State Examination. Results:, Fifty-nine per cent of the participants had their own natural teeth and for the dentate participants, the mean number of teeth was 13 (range 1,27). A high prevalence of active caries on coronal and root surfaces was observed. Older adults with few natural teeth had a higher prevalence of active coronal and root caries and a higher unmet treatment need than older adults with many teeth. Further, the study showed that 85-year-old persons with reduced functional ability and cognitive impairment tended to have more active caries than 85-year-olds with no impairment. Conclusions:, A substantial proportion of 85-year-old individuals had retained a natural dentition; however, active dental caries is a problem of concern among the most elderly. [source] A study to evaluate the relationship between periodontitis, cardiovascular disease and serum lipid levelsINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 2 2009R Sridhar Abstract:, Background:, The search for cellular mechanisms linking periodontitis to changes in systemic health has resulted in the evolution of a new area of lipid research. So far the causality and possible pathways of the association between periodontal disease and cardiovascular disease is obscure. Method:, A total of 120 subjects were included in the study with 30 subjects in each of the following groups: healthy group (A), chronic periodontitis group (B), coronary heart disease (CHD + periodontitis group) (C) and CHD , periodontitis group (D). All subjects underwent oral examination and their Gingival Index, Oral Hygiene Index, Periodontal Disease Index scores and attachment loss were recorded. Two millilitres of fasting venous blood sample was drawn and tested for the level of total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride level. Results and Conclusion:, The results revealed no significant difference with respect to the lipid profile levels between the four groups. Interpreting the results of the study, periodontal disease did not cause an increase in total CHL, LDL or triglyceride levels or a decrease in the HDL levels in an otherwise systemically healthy individual or in a CHD patient. Periodontitis in a CHD patient did not seem to exacerbate the destruction of periodontal tissue. Higher triglyceride levels did not have any correlation with the severity of attachment loss in a periodontitis subject. [source] A vicious cycle in the oral health status of schoolchildren in a primary school in rural CambodiaINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2007Emiko Koito Shidara Abstract, Objective:, To investigate the oral health status and the risk factors contributing to dental caries and gum disease of schoolchildren in Cambodia. Methods:, A cross-sectional survey was conducted in a primary school in the Puok District, Siem Reap Province of Cambodia. An oral examination and self-reported questionnaire were used to evaluate oral health status of schoolchildren, ranging in age from 6,16. Of the 512 children that were enrolled in first through sixth grade at the primary school, 332 children (62.8%) participated. Results:, Of the schoolchildren that were involved in this study, the prevalence of dental caries in permanent dentition was 53.5% and gum disease was present in 46.2%. Among the participants 80% had plaque, 68.6% suffered from tooth pain and only 44.2% of the schoolchildren owned their own toothbrush. There was an association between the schoolchildren that suffered from tooth pain and those that had dental caries (P < 0.03). Plaque was related to dental caries in permanent dentition (P < 0.003), calculus (P < 0.0001) and gum disease (P < 0.0001) and was linked to the schoolchildren who did not own a toothbrush (P < 0.03) and who suffered from tooth pain (P < 0.03). Conclusion:, The following sequence of events may result in a vicious cycle in the oral healthcare of schoolchildren in rural Cambodia: the lack of a personal toothbrush leads to plaque buildup, which may increase the incidence of dental caries, which has been linked to tooth pain and gum disease. Ultimately, this poor oral healthcare impacts an individual's quality of life and can lead to more serious health issues later in life. [source] Prevalence and impact of oral pain in 8-year-old children in Sri LankaINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2005N. RATNAYAKE Summary.,, Objective., The present study aimed to determine the prevalence and impact of oral pain in 8-year-old Sri Lankan children and their parents. Design., A cross-sectional study using a multistage cluster sampling technique was carried out in a sample of 614 children attending schools in the Education Division of Badulla, Uva province, Sri Lanka. Data were collected by means of a pre-tested questionnaire that was sent to each of the children and their parents. The children were also given an oral examination. Of the 614 questionnaires which were sent to parents, 30 were not returned and eight had to be excluded from the analysis because the respondents had answered only two questions. Therefore, the present analysis is limited to data from 576 children and their parents. Results., The lifetime prevalences of oral pain, as reported by the children and parents, were 49% and 53%, respectively. According to the children's report, 25% had experienced oral pain in the past 2 months while 31% of the parents reported that their child had experienced oral pain within the same period. Of those children who reported that they had experienced oral pain in the past 2 months, nearly 45% stated that the pain was severe. In 48%, the pain was triggered when biting. ,Presence of cavity/decayed tooth' was cited as the most common cause of oral pain (67%). Overall, 74% of children had experienced a negative impact as a result of the pain whilst 66% of the parents said that the child's pain had had an impact on them. Ethnic group, parental income and level of education, and the caries experience of the child were significantly associated with the reporting of oral pain in the past 2 months. Conclusions., The prevalence of oral pain was high among these children, and had a considerable impact on both the children and their parents. [source] Detection of Mild Hyposalivation in Elderly People Based on the Chewing Time of Specifically Designed Disc Tests: Diagnostic AccuracyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2009DrOdont, Isabelle Madinier DDS OBJECTIVES: To compare sialometry with chewing time (including swallowing) of specifically designed disc tests. DESIGN: Index test versus reference standard (sialometry; 60 patients); reliability study (10 patients). SETTING: Outpatient dental clinic and geriatric ward, Nice University Hospital, France. PARTICIPANTS: Thirty adults and 30 older patients (mean ages 47 and 84). INTERVENTION: Index test assessment in patients with and without hyposalivation. MEASUREMENTS: Data from medical files, interviews and oral examination were collected. Sialometry (stimulated salivary flow rate (SSFR) mL/min) and disc chewing times (seconds) were measured. RESULTS: Sialometry was too long and was inappropriate for five of the 30 older persons. Chewing times were negatively correlated to sialometry results (Spearman correlation coefficient (R)=0.77, P<.001). The threshold to diagnose hyposalivation (SSFR <1 mL/min) was 40 seconds (area under the receiver operating characteristic curve (AUC)=0.921, 100% sensitivity, 72% specificity). Twenty-seven subjects with a SSFR less than 1.5 mL/min had a chewing time longer than 40 seconds, suggesting that mild hyposalivation and eating difficulties were related (AUC=0.941, 93% sensitivity, 88% specificity). Mean chewing time was greater with xerostomia (51.9 vs 30.7 seconds, P<.001) but not with dental pain (39.5 vs 39.9, P=.96). Masticatory percentage (e.g., pairs of antagonistic teeth) had no effect on chewing time (SSFR <1 mL/min, AUC=0.921; SSFR <1.5 mL/min, AUC=0.950). Reliability was better for the disc test than for sialometry (intraclass correlation 0.85 vs 0.70). CONCLUSION: This disc test was conceived to detect mild hyposalivation in geriatric patients with impaired dental health. Early detection of hyposalivation could help to suppress or avoid xerostomia-inducing drugs and to prevent oral infections and dental caries. [source] Immunoglobulin A deficiency and oral health status: a case,control studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2010Gudmundur H. Jorgensen Abstract Introduction: Immunoglobulin A (IgA) is important for mucosal health. Selective IgA deficiency (IgAD) is the most common primary immunodeficiency but its effect on oral health is unclear. The aim of this study was to investigate dental, periodontal and oral mucosal health in IgAD individuals. Material and methods: In total, 32 adult IgAD subjects were compared with 63 randomly selected individuals. Participants answered questionnaires regarding general and oral health and underwent oral examination, including examination using the periodontal screening and recording (PSR) system and dental examination using the DMF system. Results: The IgAD individuals had significantly more often undergone tonsillectomy (44%versus 24%, p=0.046) and adenoidectomy (31%versus 8%, p=0.003) compared with the controls. Furthermore, the IgAD subjects reported having pharyngitis, stomatitis and herpes labialis significantly more often. There was no significant difference in periodontal health (mean PSR index; 1.87 versus 1.77) or dental health (mean DMFS; 51.3 versus 53.7) between the two cohorts. A positive correlation between Helicobacter pylori infection and severity of periodontitis was found (p=0.036). Conclusion: IgAD predisposes to oral mucosal infections but does not influence periodontal or dental health. This is the first controlled study to include detailed clinical history and investigations, together with full oral and dental examination, in adults with IgAD. [source] Further evidence of genetic heterogeneity segregating with hereditary gingival fibromatosisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2009Xiaoqian Ye Abstract Aim: To clinically characterize and map the disease-associated locus in a five-generation Chinese family with autosomal dominant early-onset hereditary gingival fibromatosis (HGF). Material and Methods: A complete oral examination was conducted. Genomic DNA samples were obtained from 14 individuals. Short tandem repeats markers, which encompass four previously known loci related to HGF, were genotyped. Two-point log of the odds (LOD) scores were calculated using MLINK program of the LINKAGE software, multipoint and non-parametric linkage (NPL) analysis were performed using the GENEHUNTER software. Results: Clinical evaluation and histological examination of this family suggested typical features of HGF. The onset age was early in the generations, ranging between 1 and 2 years. None of the tested markers showed cosegregation among affected individuals. Genotyping data from four putative regions yielded significant negative two-point LOD scores (<,2.0) at ,=0. The maximum multipoint LOD scores and NPL analysis revealed exclusion of these loci as well. Conclusions: Exclusion of linkage in this family to any of the known HGF loci proved the existence of a novel locus for autosomal dominant HGF and showed that this rare disorder is far more heterogeneous than previously expected. [source] TOOTH WHITENING IN CHILDRENJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2005K.J. Donly ABSTRACT Objective: This clinical study evaluated the efficacy and tolerability of tooth whitening in children and adolescents, using a marketed, tray- based tooth-whitening system and a disposable polyethylene strip system. Materials and Methods: A study population of 106 children and adolescents, ages 11 to 18 years, participated in this study. There were 61 girls and 45 boys, with a mean age of 14.7 years. Subjects were divided into two experimental treatment groups, the groups being balanced with respect to demographic characteristics and baseline tooth color. All subjects had to have all permanent anterior teeth erupted, a baseline Vita shade (Vita Zahnfabrik, Bad Säckingen, Germany) score of A2 or darker, and the desire to whiten their teeth. One experimental group included 71 subjects who used a 6.5% hydrogen peroxide strip system (Crest Whitestrips Professional Strength, Procter & Gamble, Mason, OH, USA) for 30 minutes twice daily. The other experimental group included 35 subjects who used a 10% carbamide peroxide tray system (Opalescence, Ultradent Products, South Jordan, UT, USA) overnight. Subjects who had previously vital bleached their teeth, exhibited apparent caries or periodontal problems, had orthodontic appliances or anterior restorations, or reported dentin hypersensitivity were excluded. The study population was treated in two separate cohorts, by two independent investigations, to minimize the effects of examiner bias. Digital images were collected for all subjects at baseline, 2 weeks, and 4 weeks, with the maxillary and mandibular arches being treated separately for 4-week intervals. An oral examination was conducted at baseline and at all recall intervals. Subjects reported any adverse events in interviews. Color change was calculated from digital images where L* indicated lightness, a* redness, and b* yellowness. Comparisons between the two experimental groups were made using a two-sided analysis of covariance with a 5% significance level. Results: Both experimental systems exhibited significant (p < .001) tooth-whitening improvement relative to the baseline. Color change was greater in the maxillary teeth than in the mandibular teeth for both systems evaluated. The color change for maxillary teeth was not significantly different between the two systems evaluated; however, the tray system demonstrated significantly (p < .05) greater toothwhitening effectiveness for the mandibular teeth. Both treatment regimens were well tolerated. Minor tooth sensitivity and oral irritation were the most commonly reported adverse events, being reported by 49% of the subjects assigned to the strip group and 43% of the subjects in the tray group. All reported that adverse events were relieved immediately upon discontinuance of product use. Conclusion: The 6.5% hydrogen peroxide gel strips and the 10% carbamide peroxide gel delivered overnight in customized trays effectively whitened teeth, and both treatment regimens were well tolerated. [source] Knowledge and attitudes about oral cancer among dentists in SpainJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2010Pia López-Jornet PhD MD Abstract Objectives, Detecting oral cancer (OC) at an early stage is the most effective means of improving survival and reducing morbility from disease. The objective was to study the knowledge, opinions and attitudes held by general dentists in Spain regarding aspects of OC in general clinic practice. Methods, A 44-item questionnaire relating to OC was randomly distributed by email to 1000 dentists in the different autonomous communities in Spain. Results, The response rate was 42.7%. Only 49.7% of the dentists who replied considered themselves to have up-to-date knowledge on OC. A total of 94.7% of those interviewed hold the opinion that it is the dentists who are qualified to carry out the oral examination. In addition, 41.8% felt that family doctors and 13.8% that dental hygienists were also capable of making this examination. We should highlight that dentists who rated their undergraduate OC training favourably were more likely to agree that their OC knowledge was current than those who rated their undergraduate training unfavourably [odds ratio (OR) = 4.1, 95% confidence interval (CI) = 1.1,4.2, P = 0.019). Respondents who performed oral cancer examinations on all patients 40 years of age or older were 1.8 times more likely to agree that their OC knowledge was current; however, the differences were not significant (OR = 1.3, 95% CI = 0.6,2.7, P = 0.392). Conclusions, Gaps in knowledge exist, strongly suggesting the need for continued courses of education detection and prevention of OC. [source] Oral cancer over four decades: epidemiology, trends, histology, and survival by anatomical sitesJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 4 2010Avraham Zini J Oral Pathol Med (2010) 39: 299,305 Background:, Oral cancer is one of the few life-threatening oral diseases. The subtypes and different sites of oral cancer has different etiology epidemiology and survival rate. Prevalence of the various anatomical oral sites provided potential baseline for improvement of clinical approach. Methods:, Incidence and survival rates were derived from the Israel National Cancer Registry and included all registered data between 1970 and 2006. Oral cancer included the lips, tongue, buccal mucosa, gums, vestibulum, floor of the mouth, and palate. Results:, Most prevalent oral cancer subtype was squamous cell carcinoma (SCC) among men above the age of 55 years. Females had a higher incidence of SCC in lateral border of tongue, gums and buccal mucosa. Lymphoma and sarcoma were the most prevalent under the age of 20. Melanomas and metastatic disease revealed the lowest survival rate, while invasive or infiltrating basal cell carcinoma in the lips had the highest rate. The highest oral survival rate was for the lip, and the lowest was for the tongue and gums. Conclusions:, Early detection of oral cancer is important for all the medical health team. Decrease in lip carcinoma may be a result of occupational or awareness changes and should be studied. Non-epithelial tumors under the age of 20 should be considered as a differential diagnosis. A basic oral examination should be included in all routine medical examinations, with emphasis on high-risk patients and high-risk oral sites. [source] The association between clinical oral health status and oral impacts experienced by older individuals in Sri LankaJOURNAL OF ORAL REHABILITATION, Issue 9 2004L. Ekanayake summary, The aim of this study was to determine the association between clinical oral status and oral impacts experienced by older individuals in Sri Lanka. A total of 585 individuals who were above 60 years and were residents of an urban area was selected using a multistage cluster sampling combined with probability proportionate to size technique. However the present analysis is limited to 235 individuals who were subjected to a clinical oral examination. An interviewer administered Sinhala translation of the Oral Health Impact Profile-14 (OHIP-14) scale was used to assess the oral impacts experienced by the sample. An oral examination was carried out following the interview. Of the 235 subjects clinically examined 64 (27%) were edentulous. The associations between clinical parameters and oral impacts were assessed in the 171 dentate subjects. There were positive, weak but significant correlations between the number of missing teeth, the number of teeth with third degree mobility and the OHIP score. Also those who wore dentures and had halitosis had significantly higher OHIP scores than those who did not wear dentures and did not have halitosis. Logistic regression analysis revealed that ,wearing denture' and ,having halitosis' were significant predictors of the OHIP score. In conclusion, there was a weak association between clinical parameters and oral impacts experienced by these older individuals. [source] Periodontitis and premature death: a 16-year longitudinal study in a Swedish urban populationJOURNAL OF PERIODONTAL RESEARCH, Issue 4 2007B. Söder Background and Objective:, Growing experimental evidence implicates chronic inflammation/infection due to periodontal diseases as a risk factor for death. The objective was to evaluate the role of periodontitis in premature death in a prospective study. Methods:, The causes of death in 3273 randomly-selected subjects, aged 30,40 years, from 1985 to 2001 were registered. At baseline, 1676 individuals underwent a clinical oral examination (Group A) and 1597 did not (Group B). Mortality and causes of death from 1985 to 2001 were recorded according to ICD-9-10. Results:, In Groups A (clinically examined group) and B, a total of 110 subjects had died: 40 subjects in Group A, and 70 in Group B. In Group A significant differences were present at baseline between survivors and persons who later died, with respect to dental plaque, calculus, gingival inflammation and number of missing molars in subjects with periodontitis (p < 0.001). The multiple logistic regression analysis results of the relationship between being dead (dependent variable) and several independent variables identified periodontitis with any missing molars as a principal independent predictor of death. Conclusions:, Young individuals with periodontitis and missing molars seem to be at increased risk for premature death by life-threatening diseases, such as neoplasms, and diseases of the circulatory and digestive systems. [source] Clinical comparison of two self-directed bleaching systemsJOURNAL OF PROSTHODONTICS, Issue 4 2003Katherine Karpinia DMD Purpose This randomized clinical trial compared the clinical efficacy and tolerability of 2 marketed self-directed vital tooth-whitening systems. Materials and Methods Balancing for baseline tooth color, self-reported coffee/tea use, and age, 57 adult volunteers were randomized to either a whitening strip containing 6% hydrogen peroxide or a tray-based 10% carbamide peroxide/dentifrice/mouth rinse combination system. Following the manufacturer' s directions, the strip group bleached twice daily for 30 minutes, whereas the tray group bleached twice daily for 20,30 minutes, preceded by tooth brushing with a whitening dentifrice and followed by mouth rinsing with a whitening solution. Treatment extended for 14 days, with evaluation at day 7 and again at day 14. Whitening response was measured objectively as L*a*b* from standardized digital images of maxillary anterior teeth. Tolerability was assessed by oral examination and subject interview. Efficacy comparisons were made using analysis of covariance, whereas tolerability was compared using the nonparametric Wilcoxon rank-sum test. Results Both treatments resulted in statistically significant (P < 0.01) improvements from baseline for all color parameters. For between-group comparisons, the 6% hydrogen peroxide strips yielded a nearly 3-fold reduction in yellowness (,b*), a nearly 2-fold improvement in lightness (,L*), 2.6 times greater redness reduction (,a*), and a more than 2-fold change in overall color (,E*) compared to the tray-based combination system. Between-group comparisons were statistically significant for the all color parameters at both the day 7 and day 14 evaluations (P < 0.001). In general, 7-day use of the whitening strips provided significantly greater color improvement relative to the combination dentifrice/gel/rinse system at day 14. In addition, the groups differed significantly (P < 0.05) in bleaching tolerability severity-days, with the strip system demonstrating better overall tolerability compared to the combination system. Conclusions The single-step 6% hydrogen peroxide strips demonstrated better overall clinical response, in terms of both tooth-whitening efficacy and tolerability, than the multiple-step tray-based combination system. [source] Oral pathology in untreated coelic diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2007G. CAMPISI Summary Background Many coeliac disease patients with atypical symptoms remain undiagnosed. Aim To examine the frequency of oral lesions in coeliac disease patients and to assess their usefulness in making coeliac disease diagnosis. Patients and methods One hundred and ninety-seven coeliac disease patients and 413 controls were recruited and the oral examination was performed. Results Forty-six out of 197 coeliac disease patients (23%) were found to have enamel defects vs. 9% in controls (P < 0.0001). Clinical delayed eruption was observed in 26% of the pediatric coeliac disease patients vs. 7% of the controls (P < 0.0001). The prevalence of oral soft tissues lesions was 42% in the coeliac disease patients and 2% in controls (P < 0.0001). Recurrent aphthous stomatitis disappeared in 89% of the patients after 1 year of gluten-free diet. Multi-logistic analysis selected the following variables as the most meaningful in coeliac disease patients: dental enamel defects (OR = 2.652 CI = 1.427,4.926) and soft tissue lesions (OR = 41.667, CI = 18.868,90.909). Artificial Neural Networks methodology showed that oral soft tissue lesions have sensitivity = 42%, specificity = 98% and test accuracy = 83% in coeliac disease diagnosis. Conclusions The overall prevalence of oral soft tissue lesions was higher in coeliac disease patients (42%) than in controls. However, the positive-predictive value of these lesions for coeliac disease diagnosis was low. [source] Use of a structured interview to assess portfolio-based learningMEDICAL EDUCATION, Issue 9 2008Vanessa C Burch Context, Portfolio-based learning is a popular educational tool usually examined by document review which is sometimes accompanied by an oral examination. This labour-intensive assessment method prohibits its use in the resource-constrained settings typical of developing countries. Objectives, We aimed to determine the feasibility and internal consistency of a portfolio-based structured interview and its impact on student learning behaviour. Methods, Year 4 medical students (n = 181) recorded 25 patient encounters during a 14-week medical clerkship. Portfolios were examined in a 30-minute, single-examiner interview in which four randomly selected cases were discussed. Six standard questions were used to guide examiners in determining the ability of candidates to interpret and synthesise clinical data gathered during patient encounters. Examiners were trained to score responses using a global rating scale. Pearson's correlation co-efficient, Cronbach's , coefficient and the standard error of measurement (SEM) of the assessment tool were determined. The number of students completing more than the required number of portfolio entries was also recorded. Results, The mean (± standard deviation [SD], 95% confidence interval [CI]) interview score was 67.5% (SD ± 10.5, 95% CI 66.0,69.1). The correlation coefficients for the interview compared with other component examinations of the assessment process were: multiple-choice question (MCQ) examination 0.42; clinical case-based examination 0.37; in-course global rating 0.08, and overall final score 0.54. Cronbach's , coefficient was 0.88 and the SEM was 3.6. Of 181 students, 45.3% completed more than 25 portfolio entries. Conclusions, Portfolio assessment using a 30-minute structured interview is a feasible, internally consistent assessment method that requires less examination time per candidate relative to methods described in published work and which may encourage desirable student learning behaviour. [source] Number III Mucous membrane pemphigoidORAL DISEASES, Issue 4 2005J Bagan Mucous membrane pemphigoid (MMP) is a sub-epithelial vesiculobullous disorder. It is now quite evident that a number of sub-epithelial vesiculobullous disorders may produce similar clinical pictures, and also that a range of variants of MMP exist, with antibodies directed against various hemidesmosomal components or components of the epithelial basement membrane. The term immune-mediated sub-epithelial blistering diseases (IMSEBD) has therefore been used. Immunological differences may account for the significant differences in their clinical presentation and responses to therapy, but unfortunately data on this are few. The diagnosis and management of IMSEBD on clinical grounds alone is impossible and a full history, general, and oral examination, and biopsy with immunostaining are now invariably required, sometimes supplemented with other investigations. No single treatment regimen reliably controls all these disorders, and it is not known if the specific subsets of MMP will respond to different drugs. Currently, apart from improving oral hygiene, immunomodulatory,especially immunosuppressive,therapy is typically used to control oral lesions. The present paper reviews pemphigoid, describing the present understanding of this fascinating clinical phenotype, summarising the increasing number of subsets with sometimes-different natural histories and immunological features, and outlining current clinical practice. [source] Fruit and vegetable consumption among older adults by tooth loss and socio-economic statusAUSTRALIAN DENTAL JOURNAL, Issue 2 2010DS Brennan Abstract Background:, The aim of this study was to examine consumption of fruit and vegetables in relation to tooth loss and income. Methods:, Data were collected in 2004,06, using a three-stage, stratified clustered sample, involving a computer-assisted telephone interview (CATI), oral examination and mailed questionnaire followed by a food frequency questionnaire. Results:, A total of 14 123 adults responded to the CATI (49% response) of whom 5505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. In the nutrition sub-study, a total of n = 1218 persons were approached in New South Wales and Queensland, with n = 1129 responding (92.7% response rate). Among respondents aged 55 years or more 34.5% had <21 teeth. Adjusting for income the prevalence of infrequent consumption (,never or less than once a month') was associated with [PR = prevalence ratio (95% CI)] fewer teeth for the fruits, ,peach, nectarine, plum, apricot' PR = 1.91 (1.12, 3.25) and ,grapes or berries' PR = 1.69 (1.03, 2.76), and for the vegetables ,stir-fried or mixed' PR = 2.34 (1.14, 4.78), ,sweetcorn' PR = 1.45 (1.001, 2.10), ,mushrooms' PR = 1.62 (1.05, 2.50), ,lettuce' PR = 3.99 (1.31, 12.17) and ,soy beans' PR = 1.11 (1.01, 1.21). Conclusions:, An inadequate dentition was associated with lower consumption of a range of fruits and vegetables indicating that dentition-related impairment of chewing ability could have adverse consequences on nutritional intake among Australian adults. [source] Oral mucosal malignancy and potentially malignant lesions: an update on the epidemiology, risk factors, diagnosis and managementAUSTRALIAN DENTAL JOURNAL, Issue 2010MJ McCullough Abstract An oral examination for the assessment for malignant and potentially malignant oral mucosal lesions is routine in general dental practice. It may be uncommon for general dental practitioners to encounter oral cancer, with anecdotal reports suggesting that this occurs about once every 10 years in a busy general dental practice. However, potentially malignant oral mucosal lesions are relatively common, occurring in about 2.5% of the population. This update highlights the epidemiology, risk factors, diagnosis and management of these oral mucosal lesions. [source] Self-reported and clinically determined oral health status predictors for quality of life in dentate older migrant adultsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2008R. Mariño Abstract,,, Objective:, This paper reports the impact of oral health on the quality of life (QOL) of Southern European, dentate older adults, living independently in Melbourne, Australia. Participants were recruited through ethnic social clubs and interviewed about oral health, general health, socio-demographics, and QOL using the Medical Outcomes Study Short-Form 12 (SF-12). The SF-12's physical and mental health component summary scores (PCS and MCS, respectively) were computed. The Oral Health Impact Profile (OHIP-14) assessed the specific impact of oral health on QOL. Participants were also given a clinical oral examination. Results:, A total of 603 eligible older adults volunteered; 308 were from Greek background and 295 were from Italian background. Mean age was 67.7 years (SD 6.2), with 63.7% being female. The PCS score had a mean value of 45.8 (SD 11.8), and MCS had a mean of 47.8 (SD 5.7). PCS was associated with, periodontal status, chronic health condition, self-perceived oral health needs, self-assessed oral health status, oral health impact score and the interaction between gender and level of education [F(11 552) = 10.57; P < 0.0001]. These independent variables accounted for 16% of the variance in PCS. The multivariate model predicting MCS had only one significant variable (self-reported gingival bleeding), explaining 1.5% of the variance. The OHIP-14 ranged from 0 to 48 with a mean score of 5.6 (SD 9.3). The model predicting OHIP-14 contained four significant variables: perceived oral health treatment needs, number of missing natural teeth, reports of having to sip liquid to help swallow food, and gender [F(4576) = 33.39; P < 0.0001], and explained 18% of the variance. The results demonstrated a negative association between oral health indicators and both the oral health-related QOL and the physical component of the SF-12. Conclusion:, The present findings support a growing recognition of the importance of oral health as a mediator of QOL. However, the self-selected sample and modest predictive power of the multivariate models suggest that further research is needed to expand this explanatory model. [source] Clinical dental examinations of 357 donkeys in the UK.EQUINE VETERINARY JOURNAL, Issue 4 2009Part 1: Prevalence of dental disorders Summary Reasons for performing study: Dental disorders have a high prevalence in older donkeys and horses, but the nature and pathogenesis of many of these disorders have yet to be established. Objectives: The identification and determination of the prevalence of important dental disorders in different age groups in a large single population of donkeys, to establish a better understanding of the nature and pathogenesis of these disorders. Methods: A prospective cross-sectional study was performed on the donkey population at The Donkey Sanctuary with detailed oral examinations of 357 donkeys within 7 different age groups (age range 2,53 years) recorded. Results: The prevalence of dental disease in all donkeys was 73%, increasing in prevalence from 28% in the youngest to 98% in the oldest age group. There was an increase in prevalence of commonly recognised dental disorders with increasing age, such as: diastemata (3.8% in youngest to 86% in oldest group); missing teeth (0,56%); overgrown teeth (15,86%); worn teeth (8,84%); displaced teeth (0,38%); and periodontal disease (0,28%). Conclusions: There was a significant increase in the prevalence of dental disorders with increasing age with the largest significant increase for most dental disorders occurring in the 15,20 year age group. Potential significance: Most dental disorders significantly increase in prevalence in the 15,20 year age group and, therefore, prophylactic geriatric dental treatment in donkeys should be commenced from age 15 years. [source] | ||||||||||||||||||||||||||||