Oral mucosal lesions and oral hygiene habits in the home-living elderly

summary A large epidemiological health investigation, the Helsinki Ageing Study (HAS), was performed in 1989–1991 in Helsinki, Finland. We report here the prevalence of oral mucosal lesions in 338 76-, 81- and 86-year-old home-living elderly people, who completed the oral health investigation at the Institute of Dentistry, University of Helsinki. One or more lesions were found in 128 subjects (38%). Fifty-one per cent of the edentulous complete-denture wearers and 31% of the elderly with some natural teeth had mucosal lesions. The most common finding was inflammation under the denture, which occurred alone or combined with other lesions in 25% of the denture wearers. The three most common mucosal changes not related to denture wearing were coated changes of the tongue (7%), angular cheilitis (6%) and varicose veins under the tongue (4%). No differences were found in the number of mucosal lesions among the three age groups. Angular cheilitis and inflammation under removable dentures were more frequent in women than in men. However, no other differences were found in the presence of mucosal lesions between sexes. The total number of mucosal lesions correlated positively with the number of medications used daily. Ninety-six per cent of the subjects with complete dentures, and 98% of those with some natural teeth reported cleaning their dentures at least once a day. Of the denture wearers, 88% reported cleaning their oral mucosa also, as part of their oral hygiene routine. The presence of mucosal lesions was related to self-reported cleaning of the denture-bearing mucosa. However, no association was observed between cleaning frequency and presence of mucosal changes.     

A Scottish cost analysis of interceptive orthodontics for thumb sucking habits

Abstract

Objective: There is a potential cost saving to be made within the NHS by providing simple interceptive treatment rather than comprehensive treatment at a later date. The focus of this study is to determine the size of this potential cost by looking at the cost to NHS Tayside for the provision of interceptive treatment for cessation of thumb sucking and where this has been unsuccessful (or not provided) the costs of correction of the associated malocclusion.

Design: A cost analysis is described, investigating the costs of treatment solely to the NHS, both in the primary and secondary setting.

Methods: Three potential treatment pathways are identified with the costs calculated for each pathway. The actual cost of providing this treatment in NHS Tayside, and the potential cost saving in Tayside if there was a change in clinical practice are calculated. Both discounting of costs and a sensitivity analysis are performed.

Results: The cost to NHS Tayside of current practice was calculated to be between £123,710 and £124,930 per annum. Change in practice to replace use of a removable with a fixed habit breaker for the interceptive treatment of thumb sucking reduced the calculated cost to between £99,581 and £105,017.

Conclusion: A saving could be made to the NHS, both locally and nationally, if the provision of a removable habit breaker was changed to a fixed habit breaker. In addition, increasing the proportion receiving active treatment, in the form of a fixed habit breaker, rather than monitoring, would appear to further reduce the cost to the NHS considerably.     

Precancerous and other oral mucosal lesions related to chewing, smoking and drinking habits in Thailand

In a field study (1979-1984) four out of six major hilltribes of Northern Thailand, namely the Lahu, Karen, Lisu and Meo, as well as a group of rural Thai, were examined. Chewing, smoking and drinking habits and lesions of the oral mucosa (leukoedema, preleukoplakia, leukoplakia and chewer's mucosa) were recorded. 1866 individuals were examined. Considerable differences in the chewing and smoking habits among the various tribes were recorded and some of them were considered tribe-specific. Chewing of betel and miang was more prevalent among older people; these habits seem to have lost their attraction for the younger people. Cigarette smoking was more prevalent among middle-aged individuals. Leukoedema was observed in 12.4%, preleukoplakia in 1.8%, leukoplakia in 1.1% and chewer's mucosa in 13.1%. Men and the older generation were affected more often, except that more women (Karen and Thai) revealed chewer's mucosa. A positive correlation could be demonstrated between some mucosal lesions (leukoedema, chewer's mucosa) and some smoking and chewing habits.     

Histomorphometric analysis of epithelial changes in chemically induced oral mucosal carcinogenesis in rats

Quantitative analysis of rat palatal mucosa after the carcinogen 4-nitroquinoline-1-oxide had been applied to the epithelium for varying periods of time showed that there was a significant increase in epithelial thickness, due largely to an increase in thickness of the basal compartment. This alteration was measurable before epithelial dysplasia could be recognised.     

Histomorphometric analysis of epithelial changes in chemically induced oral mucosal carcinogenesis in rats

Quantitative analysis of rat palatal mucosa after the carcinogen 4- nitroquinoline-1-oxide had been applied to the epithelium for varying periods of time showed that there was a significant increase in epithelial thickness, due largely to an increase in thickness of the basal compartment. This alteration was measurable before epithelial dysplasia could be recognised.     

An assessment of a new reminder therapy technique for ceasing digit sucking habits in children

Twenty-one digit-sucker children aged 4-12 old years participated in the assessment of a new reminder therapy technique called "long sleeve sleeping gown ". The result of this study indicated that fifteen children (71.4%) out of 21 were able to stop digit-sucking habits after the application of long sleeve's gown during child's bedtime for 6 weeks. The children who failed to cease this digit-sucking habit (28.6%) were found to not accept to complete the trial period or their mothers thought that they were too young to stop the habit. Among the success group no child was reported to return to digit-sucking 3 months after implementation of long sleeves gown.     

An analysis of interdental cleaning habits

A study using a method of questioning regarding the interdental cleaning habits of 766 patients in the Periodontics Department of the Brisbane Dental Hospital revealed: 1. Only 11.5 percent used an interdental aid once or more daily. 2. Only 14.3 percent of those who had received regular dental treatment used an aid at least once daily. 3. Thirty percent of patients who had received regular dental treatment had received some instruction in the use of interdental aids. 4. Significantly more patients receiving periodontal treatment used an aid once daily. 5. There was no difference between institutional and private practice patients in the use of an aid, but more of the last named continued to follow instructions in their use. 6. Significantly more daily users of woodsticks than of dental floss were found. These findings demonstrate a major defect in dental health communication in the sample studied which is probably reflected in a more widespread fashion in a broad cross section of the population.     

Dental arch diameters and relationships to oral habits

The objective was to analyze variations in dental arch width in relation to oral habits. Maxillary and mandibular intercanine and intermolar distance were determined in relation to certain oral habits in 1297 children (ages 3 to 6 years). After an oral examination, the parents of each child completed a questionnaire about oral habits, including the use of a dummy or a bottle (or both), finger sucking, mouth breathing, breast- or bottle-feeding, and duration of these habits. Data were subjected to statistical analysis by the chi-square test for qualitative variables and analysis of variance for quantitative variables with homogeneous variances. Statistical significance was P < .05. In general, the maxillary arch was larger than the mandibular arch with regard to both the intercanine and the intermolar distances and more significantly so in boys. In relation to age, a significant increase was found only for the mandibular intercanine distance (P = .001). When arch width was analyzed in relation to various oral habits, the maxillary intercanine distance was less in children who used a dummy, especially one of a round design (P = .003). The maxillary intercanine distance was also less in children who breathed through their mouth (P = .002). In most cases, dummy use and mouth breathing were associated with a reduction in the intercanine distance in the maxillary arch. A dummy habit leads to a reduction in maxillary arch width, and mouth breathing causes a reduction in the size of both arches.     

口腔黏膜病抗菌药物应用分析

目的:分析口腔黏膜病治疗中抗菌药物的应用现状及趋势。方法:抽取上海交通大学医学院附属第九人民医院口腔黏膜科2011~2013年抗菌药物使用量及药费等数据,采用限定日剂量法来分析抗菌药用药频度、日均药费,并对各类抗菌药物使用情况进行分析。结果:抗菌药物费用占总药费比重较低,每年比重均小于2%;头孢呋辛酯、甲硝唑、氟康唑是口腔黏膜病的常用抗菌药物,最常用抗菌药物为头孢呋辛酯。结论:抗菌药物占口腔黏膜病用药比重较低,2011~2013年各大类抗菌药物比重变化不大,常用抗菌药物即可满足口腔黏膜病的临床需要。     

大学生口腔保健意识和饮食习惯的调查研究

目的了解在校大学生的口腔保健意识和饮食习惯,为完善口腔健康教育提供原始数据,探讨更优化的教育模式。方法采用分层抽样的方法,对四川大学1 500名大学生以问卷调查的形式对其口腔保健意识和饮食习惯进行调查。结果大学生主要为保持口气清新而刷牙,甜食食用频率主要为每周1～2次,数量集中在100～400 g,女生食用甜食的频率显著高于男生,而男生饮用饮料的频率和量更高,食用甜食后多数学生不做清洁措施,大多数学生在牙疼或变色时不会及时就诊,仅当疼痛难忍时才就医。结论大学生的口腔保健行为缺乏,食用甜食频率数量较高,就诊意识淡薄,学校等机构应该加强口腔保健知识的宣传和教育来提高大学生自我口腔保健意识。     

口腔黏膜黑色素瘤51例临床分析

目的 探讨口腔黏膜黑色素瘤（oral mucosal melanoma,OMM）的治疗和预后。方法对51例OMM患者的临床资料进行回顾性分析。结果51例中病理证实淋巴结转移31例,其中29例限于Ⅰb～Ⅲ区;本组3、5年生存率分别为35％和21％。切取活检与切除活检、有无色素沉着未显著影响预后;接受手术+生物治疗或生物化疗者生存率显著高于其他治疗模式(P =0.003)。结论OMM颈淋巴结转移主要限于Ⅰb～Ⅲ区;切取活检和色素沉着未显著影响预后;该病预后差,手术+生物治疗或生物化疗有利于改善预后。     

An investigation of bioadhesion for periodontal and oral mucosal drug delivery

Abstract Gel delivery vehicles have ideal placement characteristics for periodontal and oral mucosal drug delivery. However, the retention of the vehicle at the site may be of short duration thereby limiting its therapeutic effect. Bioadhesion has received little attention as a means of enhancing vehicle retention in the periodontal pocket and this study aimed to investigate the possible role of this phenomenon to aid oral drug delivery. Chitosan, xanthan gum and poly (ethylene oxide) were selected as potential vehicles from previous in vitro studies, since all 3 had shown good bioadhesive properties. Retention in the periodontal pocket was assessed by means of an insoluble fluorescein marker in 8 patients, and to the oral mucosa by the retention of a small plastic film in 12 subjects. The results showed that fluorescein release from the periodontal pocket was significantly longer for chitosan than for other gels or a water control. In contrast, xanthan gum gave the most prolonged adhesion time on the oral mucosa (153.5 min) followed by poly (ethylene oxide) (89.3 min) and chitosan (42.6 min), and these times were all significantly different from each other (p<0.05). The results from this study would tend to suggest that the bioadhesive properties of an aqueous gel may be directly related to its retention both in the periodontal pocket and on the oral mucosa. However, other important factors for mucosal adhesion include the patient acceptability of the formulation and the choice of application site.