Demographic factors, denture status and oral health-related quality of life

OBJECTIVES: This study investigated the association between denture status, demographic factors, and oral health-related quality of life (OHRQoL). METHODS: OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G, 53 items), which was administered in a personal interview to 2050 subjects (60% of eligible subjects responded) 16-79 years of age in a national survey. Median regression was used to analyze the influence of denture status (no, removable, complete dentures), age, gender, education (less than 10 years of schooling, 10-12 years, more than 12 years), and residential area (rural, urban) on the OHIP-G summary score. RESULTS: In bivariable analyses, compared to the base category, the OHIP-G median increased 8.0 U for subjects with removable dentures, 20.0 U for subjects with complete dentures, 1.7 U for each 10-year age period, 2.0 U for men, 3.0 U for less than 10 years of schooling (compared to > or =10 years.), and 1.0 U for urban areas (P < 0.05 for all effects except for residential area). In the multivariable analysis, compared to subjects without dentures, subjects with removable dentures had a 7.5 (95% CI: 5.2-9.8) higher OHIP-G median and subjects with complete dentures had a 18.5 (95% CI: 14.7-22.4) higher median when demographic variables were controlled. No demographic variables were statistically significant except for residential area (P = 0.04). CONCLUSIONS: Denture status was a stronger predictor for impaired OHRQoL than demographic variables and rendered age and education almost negligible in their influence on OHRQoL.     

口腔健康行为的影响因素

个体的口腔健康行为直接影响到个体的口腔健康状况。而个体的口腔健康行为受个体因素、家庭因素和社会因素等的影响。口腔健康教育和口腔健康促进就是通过改善人群的口腔健康行为,达到改善人群的口腔健康状况的根本目的。所以,只有深刻认识口腔健康行为的各种影响因素,才能为更好地实施口腔健康教育和口腔健康促进提供依据。本文对口腔健康行为的影响因素作一综述。     

Demographic, health and lifestyle factors associated with dental service attendance by young adults

BACKGROUND: The aim of this study was to describe the demographic and health and lifestyle factors associated with dental service attendance in the previous 12 months by young Australian adults (18-24 years). METHODS: Population-based data from the 2001 Australian National Health Survey were analysed. Proportions and single associations between variables of interest and dental service attendance were calculated. A logistic regression analysis using significant single association variables was then conducted. RESULTS: Overall, 41 per cent of young adults in this study had visited a dental professional in the previous 12 months. Females, those in cities, those with private insurance, those who spoke languages other than English, those in the highest socioeconomic group and those with healthy behaviours were subgroups most likely to have visited a dental professional. With logistic regression, factors found to be associated with dental services attendance were being female, having private health insurance and low alcohol consumption. CONCLUSIONS: In this study, the proportion of young adults who had visited a dental professional in the previous 12 months was only 41 per cent. It is therefore suggested that oral health policy and promotion activities be encouraged for this group, paying attention to young adults in groups with low attendance.     

Cryotherapy for treatment of oral lesions

Cryotherapy is the deliberate destruction of tissue by application of extreme cold. It is well received by patients due to a relative lack of discomfort, the absence of bleeding and minimal to no scarring after healing. It has many applications in oral medicine and clinical oral pathology, and is extremely usefu in patients for whom surgery is contra-indicated due to either age or medical history. In this paper we outline the principles, mechanisms of action, and current applications of cryotherapy in the treatment of oral lesions, and present some clinical cases.     

A systematic approach to improve oral and maxillofacial surgery education

To improve teaching quality and student satisfaction, a new curriculum in Oral Surgery was implemented at Karolinska Institutet in 2007. This paper describes the curriculum change as well as the results regarding quality, satisfaction, cost‐effectiveness and workload for teachers and staff. To design the new curriculum, all members of the teaching staff participated in a series of group discussions where problems with the previous curriculum were identified and ideas on how to improve the curriculum were discussed. Cost‐effectiveness was evaluated by comparing the number of teaching sessions between the new and the old curriculum. A questionnaire was used to investigate the staffs’ perceived change in workload and teaching quality. The students’ satisfaction and attitudes to learning was screened for by on‐line questionnaires. The large amount of passive observational teaching was considered as the main problem with the old curriculum. Half of these sessions were replaced by either clinical seminars or demonstrations performed in an interactive form. Students rated the new curriculum as a clear improvement. Analyses of time and cost‐effectiveness showed a decrease in teaching sessions by almost 50%. Generally, the teachers were more positive towards the changes compared to the non‐teaching staff. The students rated the new type of learning activities relatively high, whilst the traditional observational teaching was seen as less satisfactory. They preferred to learn in a practical way and few indicated analytic or emotional preferences. The majority of the students reported a good alignment between the new course curriculum and the final exam.     

Increase in detection of oral cancer and precursor lesions by dentists: Evidence from an oral and maxillofacial pathology service

BackgroundDentists play an important role in the detection and diagnosis of oral diseases, including oral cancer and its precursor lesions. There are few comprehensive reviews in the recent literature that examine the scope and trends of oral disease diagnoses by dentists.MethodsThe authors analyzed all accessions to the Toronto Oral Pathology Service at the Faculty of Dentistry at the University of Toronto in Toronto, Ontario, Canada, from 2005 through 2015 using a custom-built database. They used these data to calculate the temporal trends in the diagnoses of oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC).ResultsA total of 63,483 biopsy specimens were submitted primarily by dentists from 2005 through 2015. From these, 2,679 cases of OED and 828 OSCC were diagnosed. The authors’ results show a 3.8-fold increase in the number of epithelial dysplasias and a 1.8-fold increase in mucosal carcinomas over the study period. The rate of increase of OED and OSCC was significantly higher than the rate of increase of total oral carcinomas diagnosed in the region, the population changes, and the number of dentists in the region.Conclusions and Practical ImplicationsWithin the limitations of a study of a single large oral pathology biopsy service, the analysis of diagnoses shows that dentists are increasingly involved in the detection of oral mucosal carcinoma and precursor lesions. The dental community plays an important and increasing role in the detection of oral cancer and potentially malignant disorders. Increased awareness among oral health care and nonoral health care professionals may increase early detection of OSCC.     

Clinical, social and psychosocial factors associated with self-rated oral health in Brazilian adolescents

OBJECTIVE: The objective of this study is to investigate the main social, psychosocial and clinical factors associated with poor self-rated oral health in adolescents. METHODS: A cross-sectional survey was carried out in two cities of the Distrito Federal, Brazil. Data were collected by clinical examinations and by self-administered questionnaires from 1302 adolescents aged 14- 15 years in 39 schools. Data analysis was carried out using a Poisson regression model taking into account the cluster sample. RESULTS: Adjusting for social, psychosocial and clinical factors, results showed that poor self-rated oral health was significantly associated (P < 0.001) with sex (males) [prevalence ratio (PR) = 0.8, 95% confidence interval (95% CI): 0.7-0.9]; low social class (PR =1.4, 95% CI: 1.2-1.6); poor self-rated general health (PR = 2.6, 95% CI: 2.3-3.1); mouth appearance (PR = 1.9, 95% CI: 1.6-2.2) and with presence of untreated dental decay (PR = 1.4, 95% CI: 1.3-1.6). CONCLUSIONS: The single question on self-rated oral health appears to be a simple and easy way to collect dental health information in adolescents. Assessment and understanding of self-rated oral health should take into account social, psychosocial and oral factors.     

The scope of liquid biopsy in the clinical management of oral cancer

Oral squamous cell carcinoma (OSCC) is one of the most prevalent forms of head and neck cancer, and it remains a leading cause of death in developing countries. Failure to detect the disease at an early stage is the main reason for the lack of improvement in the overall survival rate over the decades. Even though tissue biopsy is considered as the gold standard for diagnosis and molecular workup, it is an invasive, expensive and time-consuming procedure. Besides, it may not indicate the genetic status of the entire tumour owing to the heterogeneity of the cancer. In this context, liquid biopsy could be quite useful as it provides a more representative picture of the circulating tumour cells, circulating tumour DNA, circulating RNA, and tumour-derived exosomes obtained from all types of body fluids. This technique provides real-time assessment of variations in the molecular profile of the whole tumour and enables the serial monitoring of the disease status. The method has many advantages, such as easy accessibility, reliability, reproducibility and the possibility for early detection of the disease. However, the concept is still in its infancy, and the research on its application in various tumours including OSCC is rapidly progressing.     

A clinical evaluation of a novel data logger to determine compliance with the use of powered toothbrushes

OBJECTIVES: The primary objective of this study was to evaluate the viability of an electronic data logger to record the brushing episodes of patients receiving standardised oral hygiene instructions. The secondary objective was to estimate the compliance of a group of patients diagnosed with chronic periodontal disease with brushing time instructions for the daily use of a powered toothbrush over a 2-month period. MATERIAL AND METHODS: 17 modified Philips Jordan Sensiflex 2000 powered toothbrushes (PTBs) were provided to patients (32-67 years) attending for non-surgical management of chronic periodontal disease. The PTBs incorporated an electronic data logger which recorded, for each individual brushing event: the length of time the brush was used (identifying the brushing speed setting); the maximum, minimum and average current during operation; and the time spent charging in between two consecutive brushing events. The patients were given detailed instructions with the PTB and were told to use it for 2 min each morning and 2 min in the evening. The patients returned for non-surgical management over two visits prior to reinforcement of the oral hygiene instructions 1 month after PTB allocation. Subjects were asked to complete a simple brushing diary to record their use of the toothbrush on a daily basis. After 2 months of using the PTBs at home, the brushes and diaries were collected and the data downloaded from the data loggers. RESULTS: Of the 17 data loggers allocated, two recorded no information and two subjects did not return for the follow-up appointments. The data from the remaining 13 data loggers were evaluated for level of compliance. An event of brushing between 120 and 130 s was considered to be compliant, one of between 90 and 120 or 130-150 s was partially compliant and brushing for < 90 s or > 150 s was recorded as non-compliant. Percentage compliance for all the events (2087 recordings) was 34%, partial- and non-compliance were calculated as: 18%; 48% of events, respectively. CONCLUSION: This data logger has provided previously unrecorded data on the brushing times for a group of patients using a powered toothbrush at home during non-surgical management of chronic periodontal disease. The data suggested that almost half (48%) of the brushing events recorded by the data loggers were greater than 30 s above or below the instructed brushing time.     

Localised oral histoplasmosis lesions associated with HIV infection

Opportunistic fungal infections account for a significant amount of morbidity associated with HIV disease. We report here a case of localised oral histoplasmosis without evidence of disseminated disease in a patient who lacked stigmata of HIV disease at the time of initial presentation. The diagnosis is based on histology with special stains, complement fixing antibodies in serum, and culture of the organism from fresh tissues. Activation of subclinical disease following an infection in Uganda may explain the development of these exophytic oral lesions in this British resident.     

口腔颌面部间隙感染患者预后不良的影响因素分析

目的 ：探讨口腔颌面部间隙感染患者不良结局的发生情况及相关影响因素,为其治疗和预防提供参考。方法 ：选择长沙市第四医院2011年1月—2020年6月收治的口腔颌面部间隙感染的患者为研究对象。通过医院信息管理系统（hospital information system,HIS）收集患者的临床资料,采用描述流行病学分析方法进行分析,采用单因素分析和多因素Logistic线性回归方法对口腔颌面部间隙感染患者不良结局的相关影响因素进行分析。结果：共收集到249例口腔颌面部间隙感染患者的临床资料,其中32例出现不良结局,发生率为12.85%,其中发生相关严重并发症27例、放弃治疗3例、死亡2例。多因素Logistic回归分析结果显示,年龄越大（OR=0.563）、感染至就诊时间越长（OR=1.324）、累及间隙越多（OR=0.441）、呼吸困难（OR=1.715）、合并糖尿病（OR=2.261）、中性粒细胞计数>0.9×109/L(OR=1.505)、C-反应蛋白≥10 mg/mL(OR=2.231)是口腔颌面部间隙感染患者发生不良结局的危险因素。结论：口腔颌面部间隙感染患者不良结局的发生...     

E-Learning 在口腔颌面外科教学中的探索应用

随着电子信息时代的到来,医学教育的发展,E-Learning在医疗教育行业已不再是一个陌生的理念。然而在口腔颌面外科专业教学中还很少提及。E-Learning 以其强大的更新学的发展,特点以及在口腔颌面外科教学中的探索应用,为医学高校开展E-Learning教学提供参考。     

Amalgam associated mercury accumulations in normal oral mucosa, oral mucosal lesions of lichen planus and contact lesions associated with amalgam

Fourty-three patients with oral mucosal lesions were divided into 3 groups based on the relationship between lesions and amalgam restorations. Group I consisted of patients with contact lesions confined to mucosal areas in contact with amalgam fillings. Group II patients had lichen planus lesions exceeding the area of contact with an amalgam filling and Group III comprised patients with lichen planus lesions without relation to amalgam fillings. Biopsies were embedded in epon and subjected to autometallography in order to demonstrate a possible accumulation of mercury in the affected mucosa. In 20 our of 21 patients in Group I, 4 of 11 patients in Group II and 4 of 11 patients in Group III, mercury was found in the lysosomes of macrophages and fibroblasts. In Group I the number of cells loaded with mercury was much higher than in Group II and in particular Group III. In the latter groups autometallographically demonstrated mercury was found almost exclusively in macrophages. Nineteen biopsies taken from patients with normal mucosa served as controls. Ten had occlusal (Group IV) and seven buccal fillings (Group V). The biopsies from the latter group were taken from areas opposing amalgam restorations. Two patients had no amalgam fillings (Group VI). The histochemical technique showed that three biopsies in Group IV (occlusal fillings only) and two in Group V (opposing buccal fillings) contained traces of mercury in the juxtaepithelial connective tissue. The silver enhanced mercury was found in macrophages. The two controls (Group VI) without amalgam fillings were devoid of precipitates.(ABSTRACT TRUNCATED AT 250 WORDS)