Comparison between self-estimated and clinical oral malodor

Abstract

Objectives. The aims were to evaluate the validity of patients' self-estimation and clinical diagnosis of oral malodor and to examine the relationship of oral malodor with oral health status. Methods. The subjects were 252 patients (mean age 43.7 ± 10.7 years) who complained of oral malodor. Oral malodor was assessed by patients' self-estimation, organoleptic test and Oral Chroma. Oral health status, including dental and periodontal conditions, oral hygiene status and flow rate of saliva, was examined. The N-benzoyl-DL-arginine-2-napthilamide (BANA) positive bacteria in tongue coating were evaluated by BANA test. A Spearman's correlation coefficient was used to test correlation between self-perceived and clinical oral malodor. The stepwise multiple regression analysis was used to assess predictors of patients' self-estimated and clinical oral malodor. Results. The percentage of patients who were diagnosed with pseudo-halitosis was 38.5%. Patients' self-estimated oral malodor was significantly correlated with organoleptic test (r = 0.61), H₂S (r = 0.50) and CH₃SH (r = 0.46). There were 47.1% of patients who estimated correctly their oral malodor's scores with those by examiner. The highest correspondence was found in patients without oral malodor (52.6%), followed by in those with moderate or strong oral malodor (46.7%) and in those with slight oral malodor (33.3%). The significant predictors of patients' self-estimated and clinical oral malodor were bleeding on probing, tongue coating, BANA test and flow rate of saliva. Conclusion. Patients' self-estimated oral malodor was found to correspond significantly with clinical oral malodor and be associated with oral health status. Current findings suggest that self-estimation can be used to judge one's own oral malodor.     

Effects of long‐term use of HAART on oral health status of HIV‐infected subjects

J Oral Pathol Med (2010) 39 : 397–406 Background: The aim of this study was to determine the effects of long‐term use of highly active antiretroviral therapy (HAART) on oral health status of HIV‐infected subjects. Methods: Oral examination and measurement of saliva flow rate of both unstimulated and wax‐stimulated whole saliva were performed in HIV‐infected subjects with and without HAART, and in non‐HIV individuals. The following data were recorded; duration and risk of HIV infection, type and duration of HAART, CD4 cell count, viral load, presence of orofacial pain, oral dryness, oral burning sensation, oral lesions, cervical caries, and periodontal pocket. Multiple logistic regression analysis was performed to determine the effects of long‐term use of HAART on oral health status of HIV‐infected subjects. Results: One hundred and fifty‐seven HIV‐infected subjects – 99 on HAART (age range 23–57 years, mean 39 years) and 58 not on HAART (age range 20–59 years, mean 34 years) – and 50 non‐HIV controls (age range 19–59 years, mean 36 years) were enrolled. The most common HAART regimen was 2 NRTI + 2 NNRTI. HIV‐infected subjects without HAART showed greater risks of having orofacial pain, oral dryness, oral lesions, and periodontal pockets than those with short‐term HAART (P < 0.01). The subjects with long‐term HAART were found to have a greater risk of having oral lesions than those with short‐term HAART (P < 0.05). The unstimulated and stimulated salivary flow rates of the subjects with HAART were significantly lower than in those without HAART (P < 0.05). Conclusion: We conclude that long‐term HAART has adverse effects on oral health status of HIV‐infected subjects.     

Oral health status among hospitalized patients

To cite this article:
Int J Dent Hygiene 9 , 2011; 21–29
DOI: 10.1111/j.1601‐5037.2009.00423.x
Carrilho Neto A, De Paula Ramos S, Sant’ana ACP, Passanezi E. Oral health status among hospitalized patients. Abstract: Aim: To investigate into oral health status and its association with health status in hospitalized patients. Methods: A total of 82 patients were examined and 49 (59.7%) patients were men. The patients answered a survey and oral examinations to detect the number of teeth, oral hygiene index, prostheses hygiene, oral lesions, caries, dental plaque index (DPI), gingival inflammation index (GI), gingival bleeding index, periodontitis and periodontal index. Results: Oral hygiene was associated with age, but it was not related to physical disability. Difficulty eating was mainly associated with age and tooth loss. All full and partially dentate patients presented dental plaque, 38 (69%) poor oral hygiene, 58 (98.1%) gingival inflammation, 41 (74.5%) periodontal disease and 33 (60%) caries. Oral lesions were detected in 30 (36.5%) and candidiasis (n = 16, 19.6%) was the most frequent mucous lesion. Caries were associated with smoking and poor oral hygiene. Hospital length of stay and age were associated with increased DPI and GI. Conclusions: The majority of hospitalized patients did not present satisfactory oral hygiene. Caries and periodontal diseases are associated with health behaviours. Increased time length at hospital could increase gingival inflammation and dental plaque accumulation.     

Oral Mucosal Conditions in Chronic Hepatitis C Brazilian Patients: A Cross-Sectional Study

Objective: Our purpose was to carry out an epidemiological study to assess the prevalence of oral mucosal conditions in Brazilian patients with chronic hepatitis C. Methods: A cross-sectional survey was carried out on 215 patients with chronic hepatitis C who were examined for oral mucosal conditions, including oral mucosal lesions and variations of normality. Results: The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent (207 patients). Oral mucosal lesions were present in 147 patients (68.4 percent), whereas variations of normality were observed in 173 patients (80.5 percent). The most common lesions included cheek biting in 42 cases (19.5 percent), candidiasis in 39 cases (18.1 percent), and leukoplakia in 28 cases (13.0 percent). The association of oral lichen planus with hepatitis C virus (HCV) infection proved to be statistically significant ( P =  0.002). The most frequent variations of normality included Fordyce's spots in 96 cases (44.7 percent), lingual varicosities in 67 cases (31.2 percent), and fissured tongue in 60 cases (27.9 percent). Conclusion: The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent. Despite this high prevalence, only the association between oral lichen planus and hepatitis C showed statistical significance. Considering that HCV infection may be associated with extrahepatic disorders, such as oral manifestations, efforts should be made to clarify the possible relation between oral conditions and HCV infection. This may be helpful in the earlier diagnosis of the infection mainly in asymptomatic patients.     

Mode of HIV transmission associated with risk of oral lesions in HIV‐infected subjects in Thailand

J Oral Pathol Med (2010) 39 195–200 Background: The aim of this study was to determine if route of human immunodeficiency virus (HIV) transmission is associated with the risk of oral lesions in HIV‐infected subjects in Thailand. Methods: A cross‐sectional study was performed in 186 HIV‐infected heterosexuals (aged 21–65 years, mean 32 years), and 82 HIV‐infected intravenous drug users (IVDUs) (aged 16–50 years, mean 30 years). The following information was recorded: route of HIV transmission, total lymphocyte cell counts, weight, smoking habit, alcohol consumption, medications, presence of denture, plaque index, and presence of oral lesions. The association between mode of HIV transmission and the risk of oral lesions among the subjects was determined by multiple logistic regression analysis. Results: Oral lesions were found in 138 HIV‐infected heterosexuals (75%) and in 37 HIV‐infected IVDUs (46%). Oral candidiasis (OC) was the most common lesion among both groups (44% vs. 28%), followed by hairy leukoplakia (HL) (33% vs. 10%). Multiple logistic regression analysis showed a significant association between mode of HIV transmission and the risk of oral lesions after controlling for the total lymphocyte cell counts and other confounding factors [OR 3.1; 95% CI 1.5–6.4; P = 0.002]. OC was significantly associated with heterosexual route of HIV transmission [OR 2.4; 95% CI 1.2–4.7; P = 0.014]. Similar association was also observed with HL [OR 3.7; 95% CI 1.5–9.1; P = 0.004]. Conclusions: Mode of HIV transmission is associated with the risk of oral lesions in HIV‐infected subjects in Thailand. Further studies should be performed to determine if the risk of oral lesions is associated with differences in HIV‐subtypes.     

Oral manifestations in HIV/AIDS infected patients from India

OBJECTIVES: To assess types and prevalence of HIV-related oral lesions among HIV-infected individuals in south India and to correlate common oral findings with co-morbidities, gender, age and medication. SUBJECTS AND METHODS: One hundred and one patients with HIV infection or AIDS at infectious diseases units of Attavar Hospital, Mangalore, and medical wards of Kasturba Medical College, Manipal, were selected. Sociodemographic information was obtained using a structured questionnaire. Oral lesions were diagnosed according to the presumptive criteria of EEC-Clearinghouse Classification. Clinical history was retrieved from patient's medical records. RESULTS: Erythematous candidiasis (44.5%), melanotic hyperpigmentaion (34.6%) and xerostomia (29.7%) were among the most common oral manifestations. A significant association was found between oral candidiasis and advanced immunosuppression (P < 0.05). Oral hairy leukoplakia (OHL) was predominant in individuals <35 years (P < 0.05). Melanotic hyperpigmentation was significantly associated with highly active antiretroviral therapy (P < 0.05). OHL was more frequent in patients with HIV-associated tuberculosis. Linear gingival erythema was more predominant in females. CONCLUSIONS: Oral hairy leukoplakia showed a positive relationship with patients younger than 35 years. Oral candidiasis can act as a marker for immunosuppression. Angular cheilitis was predominant in the symptomatic stage.     

Effect of PI-HAART on the prevalence of oral lesions in HIV-1 infected patients. A Greek study

OBJECTIVE: To investigate the association between the prevalence of oral lesions and highly active antiretroviral therapy (HAART) including a protease inhibitor (PI). DESIGN: Prospective study. PATIENTS AND METHODS: Ninety-five consecutive patients, attending an AIDS Unit, in Greece entered the study. Fourty-four patients were receiving PI- HAART, 14 patients were on double antiretroviral therapy, and 37 patients were not receiving antiretroviral therapy at the time of oral examination. Oral lesions were diagnosed by established presumptive clinical criteria. MAIN OUTCOME MEASURES: Oral lesions were scored. CD4 counts and viral load were determined and related to the prevalence of oral lesions. RESULTS: Oral lesions, and specifically oral candidiasis, were significantly reduced (P < 0.001) in patients receiving PI-HAART. Oral lesions were significantly increased in patients with CD4 counts <200 cells microl(-1) and viral load >20,000 copies ml(-1) (P < 0.001). The percentage of patients, with lesions on PI-HAART, and with CD4 < 200 and viral load >20,000 was 1.5 times lower (37.5%vs 58.8%, P < 0.001) than that of patients not receiving antiretroviral therapy, but with similar immune and viremic status. CONCLUSIONS: Oral lesions were significantly reduced in patients on PI-HAART. A direct anticandidal effect of PI was suggestive and seemed to have accounted, beyond the HAART-related immune reconstitution, for the reduction of candidiasis and all other oral lesions.     

Oral mucosa in children with Prader–Willi syndrome

J Oral Pathol Med (2011) 40 : 778–784 Prader–Willi syndrome is a genetic disorder. Abnormal saliva secretion, emotional and behaviour problems, may affect the health status of the oral mucousa. Objectives: To assess the impact of self‐destructive behaviour and abnormal saliva secretion on the oral mucosa in children with Prader–Willi syndrome (PWS). Materials and methods: Fifteen PWS’s children (mean age 9.8 ± 4.4 years) and 15 healthy children (mean age 11.5 ± 3.5 years) were assessed for self‐destructive behaviours, such as picking at the skin, physical and chemical saliva characteristics, mycology, and the clinical status of the oral mucosa. Results: Picking at the skin was only in children with PWS (n = 12). In contrast to the control group, the moistening rate of the lower lip mucosa was slower, and the mean pH of the resting saliva was reduced in the affected subjects. Sticky frothy or frothy saliva, decreased secretion rate of the stimulated saliva, and a reduced buffer capacity were more frequently in PWS’s children; Candida spp. and oral candidiasis were also more common. Injurious lesions in the oral mucosa were found in one control child, and in eight PWS’s subjects. In affected children, the lesions were concurrent with picking at the skin. A statistical correlation was noted between the presence of Candida spp. and oral candidiasis, and unfavourable saliva properties, and between injurious lesions and a slow moistening rate of the lower lip mucosa, and oral candidiasis. Conclusions: Abnormal saliva secretion and self‐destructive behaviours in children with Prader–Willi syndrome predispose them to injurious lesions in the oral mucosa, and possibly, to oral candidiosis.     

DNA ploidy in oral lichen planus,determined by image cytometry

J Oral Pathol Med (2010) 39 : 206–211 Background: The objective of this study was to use image cytometry to determine the degree and frequency of DNA ploidy in biopsies of reticular and atrophic‐erosive oral lichen planus and to analyze 14 karyometric measurements of the nuclei of epithelial cells from each specimen. Methods: A total of 40 slides were analyzed, each of them representing one biopsy of one oral lichen planus (OLP) lesion from each one of the 40 patients (cases) studied. Specimens were embedded in paraffin and comprised 20 slides of reticular oral lichen planus (group R) and 20 slides of atrophic‐erosive oral lichen planus (group AE). Results: Group R, the reticular lichen samples, had 18 diploid cases and two aneuploid cases. Group AE, the atrophic‐erosive lichen samples, had 10 diploid cases, one tetraploid case, and nine aneuploid cases. Of the 14 karyometric measurements of the nuclei of OLP epithelial cells analyzed, the group R mean values for mean density and minimum density were significantly greater than the group AE mean values, and mean roundness in group AE was significantly greater than in group R (t‐test: P < 0.05). Conclusions: The most common degree of DNA ploidy in OLP lesions was diploidy. Comparing the two groups (chi‐square test of association P = 0.021) demonstrated that diploidy was associated with the reticular clinical form of OLP, while aneuploidy was associated with the atrophic‐erosive clinical form of oral lichen planus.     

Is workplace screening for potentially malignant oral disorders feasible in India?

J Oral Pathol Med (2010) 39 : 672–676 Background: Because of delays in diagnosis, oral cancer usually presents for therapy at a late stage. Patients are unaware of having lesions as they are mostly asymptomatic and physicians generally do not examine the mouth sufficiently. People in rural areas or are underserved may not frequently visit the dentist who can easily pick up these lesions early. Screening programs are useful in that regard. Such programs in general are conducted by either inviting people to come to a screening center or by health care workers visiting the individual households. However, those who work during the day may not visit screening centers or be at home during the day of the screening by a visiting health care worker. Workplace screening overcomes these challenges. Methods: To assess the feasibility of a screening program to detect potentially pre‐malignant oral disorders in a workplace in India, clinically visible mucosal lesions were compared with the clinical photographs of the same lesions assessed by an expert. Role of smoking, alcohol, and chewing betel quid and tobacco in the etiology of those lesions were assessed. Results: Sixty‐nine percent of the eligible subjects participated in the screening (n = 1613). Prevalence of leukoplakia was 5%. Bidi (OR = 35.6), and cigarette smoking (OR = 22.8), alcohol (OR = 17.6), and tobacco and areca nut chewing (OR = 7.5), were significantly associated with leukoplakia and erythroplakia (all P < 0.05). Conclusions: Conduction of a screening program by valid visual inspection to detect potentially malignant oral disorders within a workplace is not only feasible but also effective.     

Oral health‐related quality of life in patients with tooth wear

The aim of this study was to investigate the impact of tooth wear (TW) on patients' oral health‐related quality of life. A total of 198 participants were included in the study. They belonged to the following four different diagnostic categories: 51 patients with TW, 46 patients with painful temporomandibular disorders (TMD), 43 complete denture wearers and 58 healthy controls. The Dutch version of the Oral Health Impact Profile (OHIP‐NL) was used to assess the patients' oral health‐related quality of life. The results of the study show that patients with TW have an impaired oral health‐related quality of life compared with healthy controls (P < 0·001). Furthermore, the impact of TW and of edentulousness do not differ significantly, while both of these oral conditions seem to have a lower impact on quality of life compared with painful TMD (P < 0·05). It was concluded that TW has a negative impact on patients' quality of life. This impact is comparable with that of edentulousness.     

Prevalence and risk indicators of oral mucosal lesions in an urban population from South Brazil

Oral Diseases (2011) 17 , 171–179 Objective: The objective of the study was to assess the prevalence of oral mucosal lesions (OML) and to perform a multivariable risk assessment of demographic, socioeconomic, behavioral, and oral risk indicators for its occurrence in an urban population in South Brazil. Methods: This cross‐sectional study selected 1586 subjects (719M/867F, age: 14–104 years) using a multistage probability sampling strategy (65.1% response rate). Prevalence, odds ratios (OR), and confidence intervals (95% CI) were calculated accounting for the survey design. Results: Leukoplakia and lichen planus were observed in 1.01% and 1.02% of subjects, respectively. In the multivariable analysis, these lesions were significantly associated with moderate/heavy smoking (OR = 9.0, 95% CI = 2.1–39.1) and heavy drinking (OR = 2.0, 95% CI = 1.1–3.7). Candidiasis and proliferative lesions were observed in 14.09% and 3.80% of the subjects, respectively. These lesions were significantly associated with female gender (OR = 2.2, 95% CI = 1.5–3.2 and OR = 1.7, 95% CI = 1.0–2.8), older age (OR = 22, 95% CI = 8.0–60.8 and OR = 8.9, 95% CI = 3.4–23.7), and low socioeconomic status (OR = 1.9, 95% CI = 1.0–3.5 and OR = 3.0, 95% CI = 1.2–7.2). Conclusions: This population is in need of OML prevention and treatment. Future studies should validate the findings that premalignant lesions are causally related to smoking and alcohol consumption, and that other OML are associated with socioeconomic‐demographic disparities in this and similar populations.     

Assessment of predictors of global self‐ratings of oral health among Korean adults aged 18‐95 years

Objectives: The aims of this study were to assess predictors of global self‐ratings of oral health (GSROH) and to examine whether they varied by age among Korean adults aged 18‐95 years. Methods: Data from 4,546 adults aged 18‐95 years completing the Korean National Oral Health Survey 2006 were included in the analysis. Results: Subjects' mean age was 43.5 years, with 12.1 percent aged ≥65 years; 47.8 percent were men; and 2.5 percent were edentulous. The predictors of GSROH in adults were number of missing teeth, concern about oral health, and difficulty in chewing. While wearing removable dentures was associated only in elders, perceived treatment need was associated in younger age groups. The number of decayed and filled teeth was significant only in the 18‐44 age group. Conclusions: GSROH status was associated with measures of oral disease, oral functional problems, oral health behaviors, concerns, and perceived treatment needs, and it varied by age.     

Low prevalence of human papillomavirus infection in the healthy oral mucosa of a Northern Italian population

J Oral Pathol Med (2012) 41 : 16–20 Background: Oral cancer is the sixth most common malignancy in developed countries, representing almost 3% of malignant tumors. Tobacco use and alcohol consumption are well‐established risk factors. However, the observation that most patients with oral cancer have not been exposed to these risk factors suggests that additional causes may promote oral carcinogenesis. A link has been suggested between human papillomavirus (HPV) and oral cavity cancer but the significance of HPV contribution to oral carcinogenesis as well as the prevalence of HPV infection in normal oral cavity mucosa remains debated. Methods: In this study, the prevalence of oral HPV infection was evaluated in 81 randomly selected Northern Italian subjects with clinically normal oral mucosa using a nested PCR on DNA extracted by oral smears. Results and conclusions: No HPV‐related lesions were detectable in any of the smears analyzed by cytological approach. nPCR identified HPV DNA in only one (1.2%) of the specimens obtained from clinically healthy oral mucosa and subsequent characterization assigned the positive case to HPV type 90. These data suggest that the incidence of HPV infection in the healthy population might be very low and that other risk factors are likely responsible to promote oral carcinogenesis.     

Adequacy of Oral Health Information for Patients with Diabetes

Objective: We investigated the perception of dental hygienists regarding their adequacy of providing diabetics with diabetes‐related oral health preventive education. Methods: A one‐page questionnaire printed on both sides was mailed to 2,237 licensed registered dental hygienists with a South Carolina (SC) mailing address. In addition to the dental hygienists' background and practice characteristics, their perception of adequacy for educating patients with diabetes on various diabetes‐related oral health topics and reasons for inadequate coverage of materials were queried in the survey. Results: After two follow‐up mailings, 995 completed and usable surveys were returned. An average of 93.6 percent of respondents indicated that they adequately covered topics of oral hygiene and general oral health issues. However, about 60 percent of respondents reported not covering all essential materials related to oral health when educating diabetic patients. The three most common reasons were: a) insufficient time (60.1 percent); b) patient disinterest (41.2 percent); and c) insufficient information on oral care and diabetes (39.7 percent). Respondents reporting insufficient information were less likely to adequately address the effect of periodontal disease on diabetes (P < 0.001), effect of uncontrolled diabetes on periodontal disease (P < 0.001), and dry mouth management (P = 0.03). Conclusion: This study indicates that SC dental hygienists do not routinely provide patient education on diabetes‐related oral health and healthy lifestyle topics. Lack of time, patient disinterest, and insufficient information were the three main reasons for respondents not covering these essentials. A practical method for improving dental hygienists' comprehensive service to patients with diabetes is to offer them more continuing education on diabetes and oral health to supplement their knowledge, skills, and confidence to educate this growing population.     

A German version of the GOHAI

Abstract – Objectives: Translation, reliability analysis and validation of a German version of the Geriatric/General Oral Health Assessment Index (GOHAI) was the aim of this study. Methods: Translation was performed by a forward–backward process. Validity was assessed as convergent validity in comparison with another self‐perceived assessment of oral health (OHIP‐14) and as group validity (n = 218; mean age 73 years). Reliability was proved in terms of internal consistency, inter‐item and item‐scale correlations, and stability (test–retest procedure; n = 36; mean age 77 years). The responsiveness to change in oral health status was assessed by pre‐ and post‐treatment comparison (n = 21; mean age 63 years). Results: A German version of the GOHAI is presented. Convergent validity was sufficient (r = ?0.76 compared with OHIP‐14); group validity could be demonstrated for self‐perceived need for treatment, chewing problems, number of own teeth, caries lesions present and dental status. The internal consistency was high (Cronbach's alpha = 0.92) as were inter‐item and item‐scale correlations, for which good homogeneity of the index was apparent. The test–retest correlation for the summary score was r = 0.84, single item correlations ranged from r = 0.36 to r = 0.89. The GOHAI sum score increased significantly after patients received new dentures, indicating responsiveness of the GOHAI to clinical change in the expected direction. Conclusions: The German version of the GOHAI had sufficient reliability, validity and responsiveness to be used as measure of oral health‐related quality of life in cross‐sectional and longitudinal studies of the elderly.     

Recurrence patterns of oral leukoplakia after curative surgical resection: important factors that predict the risk of recurrence and malignancy

J Oral Pathol Med (2012) 41 : 682–688 Background: Oral leukoplakia can be treated using a variety of treatment procedures; however, the lesions recur in many cases irrespective of the treatment procedure used. The rate of recurrence was from 7.7% to 38.1%. This study aims to identify the important factors that can lower the risk of recurrence of oral leukoplakia treated by curative surgical resection. Methods: The clinical records of 52 patients with oral leukoplakia (53 lesions) who underwent curative surgical resection between 2004 and 2009 were retrospectively analyzed for the rate of recurrence, clinical outcome, epithelial dysplasia, lesion location, and resection margins. Results: The recurrence rate following curative surgical resection was 15.1%, with the most common site being the gingiva. Malignant transformation occurred in a single patient (1.9%). Minimal resection margins (<3 mm) were observed in many patients with recurrent disease, and recurrence was more likely in cases with positive margins (epithelial abnormalities at the resection margins) than in those with negative margins. There was no significant association between recurrence and the degree of epithelial dysplasia. Conclusions: Our data suggest that surgical resection of oral leukoplakia is curative only if all areas of epithelial abnormalities are identified and resected. Moreover, an adequate resection margin may reduce the risk of recurrence.     

Oral health care needs and oral health‐related quality of life (OHIP‐14) in homeless people

Daly B, Newton T, Batchelor P, Jones K. Oral health care needs and oral health‐related quality of life (OHIP‐14) in homeless people. Community Dent Oral Epidemiol 2010. © 2009 John Wiley & Sons A/S Abstract – Objectives: The aim of this study was (i) to determine the oral health status and oral health care needs of this population, (ii) to assess oral health‐related quality of life using OHIP‐14 and (iii) to explore whether there is a relationship between oral health status and oral health‐related quality of life. Methods: A convenience sample was drawn from eight facilities catering for homeless people in south east London. Participants were invited to attend an outreach dental clinic and receive a clinical oral health and treatment needs assessment. The impact of oral disease was assessed using OHIP‐14. Results: There were 102 people from a range of vulnerable housing situations invited to participate in the study. The mean age was 39.5 (SD ± 12.3) and 92% (n = 92) were men. The mean DMFT of dentate participants (n = 94) was 15.5 (SD ± 7.6), mean DT was 4.2 (SD ± 5.2), mean MT was 6.8 (SD ± 6.0) and mean FT was 4.6 (SD ± 4.8). Normative needs were extensive with 76% having a restorative need, 80% having a need for oral hygiene measures and periodontal treatment and 38% having a prosthetic treatment need. Ninety one per cent of homeless people experienced at least one impact and the mean number of impacts (n = 90) was 5.9 (SD ± 4.8).The most commonly experienced oral health‐related quality of life impacts were in the dimension of pain, with aching in the mouth having a prevalence of 65% and discomfort while eating foods having a prevalence of 62%. Forty‐four per cent felt handicapped by their oral condition. The experience of oral impact had only a slight relationship with clinical status and there were no differences in clinical status or oral impact by vulnerability of housing situation. Conclusions: Oral health care needs were extensive and greater than that of the general population in the UK, although disease levels were similar. While homeless people experienced many more oral impacts (as measured with OHIP‐14) compared with adults of the same age in the general population in the UK, there was only a slight relationship with clinical status and oral health‐related quality of life.     

A clinicopathological study on verrucous hyperplasia and verrucous carcinoma of the oral mucosa

J Oral Pathol Med (2012) 41 : 131–135 Background: Oral verrucous hyperplasia (VH) and verrucous carcinoma (VC) are two clinicopathologically distinctive oral verrucous lesions. The objective of this study was to investigate the clinicopathological features of the two verrucous lesions and estimate their relationship from China. Methods: Retrospective review of two series of patients with histologically confirmed VH (n = 121) and VC (n = 56) between 1996 and 2009 in our hospital were conducted. Results: The average age of VH was 58.5 years (ratio male:female = 1.37) with the tongue being the predominant site. The average age of VC was 64.3 years (ratio male:female = 1.15) with the lower lip being the predominant site. Multivariate analysis revealed that the elderly patient with verrucous lesion (≥60 years) was associated with 3.06‐fold (P = 0.007) increased carcinoma risk compared with the non‐elderly patient. The lesion located on lower lip was associated with 13.54‐fold (P < 0.001) increased carcinoma risk compared with other sites. Conclusion: Clinicopathological features of VH and VC in China were elucidated. Elderly patient with oral verrucous lesion located on the lower lip correlates with higher risk of carcinoma.