Gender differences in oral health behavior and general health habits in an adult population

This study aimed to evaluate gender differences in oral health behavior and general health habits in adults. The subjects were 207 males and 196 females aged 20-64 yrs who were public officials in the city or town administrations in Chiba Prefecture, Japan. The questionnaire survey included three items: (1) self assessment of oral health status, (2) oral health behavior and (3) general health habits. Statistical analysis was performed using the chi-square test for differences of responses between males and females. The proportion of subjects with cognition of symptoms of oral disease ranged from 14.3 to 23.0%. The percentage of those who had not visited a dentist in the last year were 52.7% for males and 36.7% for females (p < 0.01). Subjects who brushed their teeth almost every day at bed time were 60.9% of males and 88.8% of females (p < 0.01). A comparison of the numbers of positive responses regarding general health habits found no differences in the distribution of general health habits score between males and females. Examining the relationship between oral health behavior and general health habits revealed that males with general habit high scores tended to have positive oral hygiene behavior. These results support the thesis that gender specificities in oral health depend on individual attitudes to oral health and dental utilization. In addition, understanding the cognitive factors of males and females would accelerate dental approaches to modifying oral health behavior of both groups, thus contributing to lifelong health maintenance.     

Identification of Candida dubliniensis among oral yeast isolates from an Italian population of human immunodeficiency virus-infected (HIV+) subjects

Candida dubliniensis, an emerging oral pathogen, phenotypically resembles Candida albicans so closely that it is easily misidentified as such. The aim of the present study was to evaluate the usefulness of two phenotypic methods, growth at 45 degrees C and 2,3,5-triphenyltetrazolium chloride (TTC) reduction, for confirming presumptive identification of C. dubliniensis and C. albicans by colony color on CHROMagar Candida (CAC) medium. A combination of these methods was used to establish the prevalence of oral C. dubliniensis in an Italian population of 45 human immunodeficiency virus (HIV)-infected subjects. Twenty-two samples (48.9%) were positive for yeasts on CAC medium producing a total of 37 fungal isolates. The colony color and 45 degrees C growth ability test correctly identified all C. dubliniensis and C. albicans isolates (5/37, 13.5%, and 16/37, 43.2%, respectively), while assessment of TTC reduction misidentified one C. albicans isolate. The isolation rate of C. dubliniensis was 11.1% (5/45 patients). All of the C. dubliniensis isolates were highly susceptible to fluconazole (MIC = 0.5 microg/ml). The combination of CAC medium screening with growth at 45 degrees C and TTC reduction tests may represent a simple, reliable and inexpensive identification protocol for C. dubliniensis.     

Oral mucosal lesions and risk habits among men in an Italian study population

A randomly selected study population of 118 male subjects (> or = 40 years) living on the Mediterranean island of Pantelleria (southwest of Sicily, Italy) was examined for the presence of oral mucosal lesions, with particular emphasis on the early diagnosis of oral precancerous and cancerous lesions. The study population was interviewed for socioeconomic and behavioural information, and clinically examined using WHO criteria. The prevalence of oral mucosal lesions observed, and data obtained about oral hygiene, tobacco smoking, alcohol drinking and exposure to actinic radiation, were analysed. Alcohol drinking was the most common habit in the study population (73%), followed by tobacco smoking (58.5%, of whom 96% were cigarette smokers). Only 3% showed good oral hygiene and 25% were edentate. Oral lesions were observed in 81.3% of the study group, mainly coated tongue (51.4%), leukoplakia (13.8%), traumatic oral lesions (traumatic ulcers and frictional white lesions) in 9.2%, actinic cheilitis (4.6%), and squamous cell carcinoma in one case (0.9%). Statistically significant associations were found between the prevalence of coated tongue and tobacco smoking (P<0.0001), and between the prevalence of actinic cheilitis and tobacco smoking/alcohol drinking (P<0.05). Analysis of clinical and anamnestic data underlined the effective presence, in the population examined, of the behavioural risk factors for oral precancerous and cancerous lesions, and the lack of cultural motivation towards primary prevention activities, such as the elimination of risk habits.     

Factor XIIIa-containing cells and fibrosis in oral and maxillofacial lesions: an immunohistochemical study

The distribution of subunit A of blood coagulation factor XIII (FXIIIa) was investigated by the avidin-biotin-peroxidase complex (ABC) method in various oral and maxillofacial tissues. These tissues were from normal tongue, gingiva, lip, and submandibular gland, and from Dilantin gingival hyperplasia (one case), pyogenic granuloma (three cases), peripheral fibroma (four cases), squamous cell carcinoma (seven cases), chronic sclerosing submandibular adenitis (two cases), and fibrous dysplasia of the mandibular bone (one case). The distribution of collagenous components was examined in the same tissues by means of the Sirius red F3BA method. By means of the ABC method, FXIIIa was detected in the cytoplasm of certain connective tissue cells in each of the tissues examined. These FXIIIa-containing cells were sparse in the normal tissues but evidently abundant in the fibrous connective tissue of inflammatory and neoplastic lesions. In the present study, the close relationship between the distribution of FXIIIa-containing cells and that of collagenous components is demonstrated. The role that FXIIIa-containing cells play in the process of fibrosis is discussed.     

Identification of Candida dubliniensis among oral yeast isolates from an Italian population of human immunodeficiency virus‐infected (HIV+) subjects

Candida dubliniensis, an emerging oral pathogen, phenotypically resembles Candida albicans so closely that it is easily misidentified as such. The aim of the present study was to evaluate the usefulness of two phenotypic methods, growth at 45°C and 2,3,5‐triphenyltetrazolium chloride (TTC) reduction, for confirming presumptive identification of C. dubliniensis and C. albicans by colony color on CHROMagar Candida (CAC) medium. A combination of these methods was used to establish the prevalence of oral C. dubliniensis in an Italian population of 45 human immunodeficiency virus (HIV)‐infected subjects. Twenty‐two samples (48.9%) were positive for yeasts on CAC medium producing a total of 37 fungal isolates. The colony color and 45°C growth ability test correctly identified all C. dubliniensis and C. albicans isolates (5/37, 13.5%, and 16/37, 43.2%, respectively), while assessment of TTC reduction misidentified one C. albicans isolate. The isolation rate of C. dubliniensis was 11.1% (5/45 patients). All of the C. dubliniensis isolates were highly susceptible to fluconazole (MIC = 0.5 µg/ml). The combination of CAC medium screening with growth at 45°C and TTC reduction tests may represent a simple, reliable and inexpensive identification protocol for C. dubliniensis.     

唾液分泌型免疫球蛋白A对口腔白假丝酵母菌黏附的影响

目的 从唾液分泌型免疫球蛋白A(sIgA)的质量浓度和白假丝酵母菌黏附率变化的角度探讨人类免疫缺陷病毒(HIV)感染者易感染口腔假丝酵母菌病的原因.方法 检测唾液sIgA的质量浓度,并通过体外黏附试验观察白假丝酵母菌标准株(SCAL)和临床分离株(CCAL)在含和不含sIgA环境中与颊上皮细胞的黏附率,比较HIV感染组与健康对照组口腔内白假丝酵母菌的黏附率.结果 HIV感染组sIgA的质量浓度低于健康对照组(P＜0.05);在含sIgA环境中,SCAL和CCAL的黏附率总体均值低于不含sIgA环境中SCAL和CCAL的黏附率总体均值,两组问差异有统计学意义(P=0.001):在含sIgA环境中,HIV感染组口腔中的白假丝酵母菌的黏附率明显高于健康对照组(P＜0.05).结论 HIV感染组易感染口腔假丝酵母菌病与唾液sIgA的质量浓度变化和白假丝酵母菌黏附力改变密切相关.     

Molecular lesions in human oral cancer: The Indian scene

Carcinogenesis is a multi-step process including aberrant expression of two interacting classes of genes—oncogenes and tumour suppressor genes. With recent technological advances, it is feasible to identify the various molecular lesions underlying the different stages of neoplasia. Squamous cell carcinomas of the head and neck, although representing 2–4% of the malignancies in the West, comprise a large fraction (40%) of total cancers in India, posing a major health problem. Further, epidemiological and experimental evidence unequivocally confirms a causal association between tobacco chewing habit, highly prevalent in India, and oral cancers. Thus, the oral cancers offer an excellent in vivo system for the study of the environmental tobacco-carcinogen induced molecular alterations in the malignancy, and associated premalignant lesions such as leukoplakia. With a view to elucidating the molecular lesions involving oncogenes in oral carcinogenesis, we have investigated myc/ras/EGF-R activation by amplification, point mutation, gene rearrangement and allelic losses. Further, a functionally activated potent transforming gene was detected in a NIH3T3 transfection/tumorigenicity assay, unrelated to myc/ras/EGF-R. Studies on the involvement of p53 gene in oral cancer, indicates p53 allelic loss as an event observed in leukoplakia and tumour tissues. Advanced oral cancer stages demonstrate cumulative molecular aberrations, with greater than 95% samples showing oncogene involvement, thus indicating a multi-step process of oral carcinogenesis. The review presents a comparative picture of the oral malignancies seen in Western countries and India, significance of molecular lesions and future perspectives of oncogenes and tumour suppressor gene involvement in oral cancer.     

Self-preventive oral behavior in an Italian university student population

BACKGROUND, AIM: The aim of this study was to assess the oral hygiene attitude and the professional preventive examination compliance in Italian university students. METHOD: A sample of 202 students attending the University of Bologna was randomly selected and interviewed about their preventive oral health attitude and compliance. All students reported using toothpaste and most of them (92.1%) brushed their teeth at least 2x a day using artificial, medium stiffness bristles. The toothbrush was generally (81.6%) replaced within 3 months. Few subjects (14.9%) said they used dental floss daily or utilized other devices. A majority of subjects (59.9%) had a dental examination within the year previous to the interview. Cluster analysis was performed. RESULTS: 4 groups were identified with homogeneous oral hygiene behavior and compliance toward professional preventive examination. Only one cluster, representing 33.6% of the sample, showed consistent frequency and modalities of oral hygiene habits. The other clusters seemed to be defective with interproximal cleaning procedures and compliance toward professional preventive care. Since the sample was characterized by a young, urbanized, homogeneous group with a high educational level and frequently from an upper middle class social status, the analysis probably gives a supra-estimation of the positive behavior. CONCLUSION: It is rational to suppose that strategies to promote dental service utilization, patients' compliance and a professional style oriented toward prevention may be useful to improve the oral health condition in the young adult Italian population.     

Fast-track referrals for oral lesions: a prospective study

Since the introduction of the 14-day rule for referrals for cancer in 1999 there has been some suspicion that rates of detection of cancer are low and the number of inappropriate referrals is high. We undertook a prospective study of 150 consecutive patients with oral lesions referred to a department of oral and maxillofacial surgery in a teaching hospital that uses a "two week wait" fast-track referral system for head and neck cancers. The main outcome measures were the number of cancers detected, the age and sex of the patients, the number seen within 2 weeks, by whom, and the final diagnosis. Most patients (n=120, 80%) were referred with oral ulceration. All patients were seen within 2 weeks (mean 6 days). Nine patients (6%) had a diagnosis of malignancy and 17 (11%) had no detectable abnormality. The study confirms what others have shown, that the yield of diagnoses of malignant disease from fast-track referrals is low and the number of non-urgent referrals is high.     

Dermatitis herpetiformis: oral lesions as an early manifestation

Dermatitis herpetiformis is an uncommon chronic skin disease that rarely affects the oral cavity. An unusual case of dermatitis herpetiformis, starting with oral lesions 6 months prior to the onset of skin lesions, is reported. The diagnosis was based on the typical histopathologic features and on positive direct immunofluorescence. The literature is briefly reviewed. Evaluation of laboratory findings, clinical picture, and response to sulfones is essential to the final diagnosis and is emphasized.     

Gender differences in pain

A review of the literature on gender and clinical pain reveals a disproportionate representation of women receiving treatment for many pain conditions and suggests that women report more severe pain, more frequent pain, and pain of longer duration than do men. Gender differences in pain perception have also been extensively studied in the laboratory, and ratings of experimentally induced pain also show some sex disparity, with females generally reporting lower pain thresholds and tolerance than males. However, there is little consensus on whether these apparent differences reflect the way men and women respond to pain, differing social rules for the expression of pain, or biologic differences in the way noxious stimuli are processed. In this paper, our working hypothesis is that the higher prevalence of chronic orofacial pain in women is a result of sex differences in generic pain mechanisms and of as-yet unidentified factors unique to the craniofacial system. We will review the evidence concerning gender differences in the prevalence of pain conditions, with a focus on orofacial pain conditions. Evidence and hypotheses concerning biologic and psychosocial factors that could influence prevalence rates will also be discussed.     

Factitial oral lesions in an autistic paediatric patient

Self Injurious Behaviour (SIB) is a deliberate harm to the body that may lead to factitial injuries. Its origin may be functional or biological and it has a higher prevalence in females and in psychologically impaired individuals. Seventy per cent of autistic patients have SIB. Seventy-five per cent of factitial injuries are located in the head and neck region. A paediatric case report concerning a 4-year-old autistic female is presented. Detailed medical history, physical examination, clinical intraoral and radiographic examination, incisional biopsy, neuropaediatrical, psychological and speech evaluation were undertaken. Diagnosis included hypochromic macrocytic anaemia, caries, coronal fracture, factitial ulcer, factitial periodontitis, self-extraction of primary teeth and permanent teeth buds, non-specific oral ulcer with inflammatory reaction, mild mental retardation, speech impairment, autistic syndrome and self injurious behaviour consisting of putting fingers and foreign objects in the gingiva, fingernail biting and hair pulling. Differential diagnosis included hystiocitosis X, prepuberal periodontitis and leukocyte adhesion deficiency. Dental preventive and restorative treatment was performed. Non-contingent reinforcement therapy was successfully used to diminish SIB. Treatment of factitial oral injuries must be interdisciplinary and requires cooperation of the patient, the parents, health care providers, and medical team.     

Gender differences in suprathreshold taste scaling ability in an older population

Taste sensitivity was evaluated by suprathreshold scaling of six concentrations each of sodium chloride, sucrose, citric acid, and quinine hydrochloride. Magnitude estimation was used as the method of scaling. The study group was composed of 22 males and 19 females were either patients (institutionalized) or staff members of the Jewish Institute for Geriatric Care. Data from each patient were used to compute individual slopes and Y-intercepts of the log to log transformations for each solution sequence. The mean age of the persons who were institutionalized was significantly higher than that of the staff members. In addition, the mean age of the females was 10 years older than that of the males. The older adult males seemed to have impaired taste function that resulted in significant decreases in total perceived intensity of several taste solutions. No significant differences were shown in taste ability between the relatively healthy younger staff member subjects and the older, more infirm, institutionalized subjects.     

Podoplanin expression in human tooth germ tissues and cystic odontogenic lesions: an immunohistochemical study

J Oral Pathol Med (2010) 39 : 115–120
Background:  Podoplanin expression was described in mouse tooth germ and apical bud cells. The aim of this study was to analyse the podoplanin expression of human tooth germ tissues, adult teeth and odontogenic lesions immunohistochemically.
Study Design:  Nine human tooth germ biopsies and seven healthy permanent teeth extracted for orthodontic reasons were examined. Anti-podoplanin (D2-40) reactivity was investigated immunohistochemically. Five well-defined cystic odontogenic lesions (10 radicular cysts, 10 follicular cysts, three keratocystic odontogenic tumours, five ameloblastomas, and two adenomatoid odontogenic tumours) were analysed simultaneously.
Results:  Podoplanin expression was detected in the majority of epithelial and ecto-mesenchymal cells of human tooth germ tissues, odontoblasts and superficial dental pulp fibroblasts of permanent teeth. Cystic odontogenic lesions revealed positive reactions predominantly at the invasion front edge within basal epithelial layers.
Conclusion:  Podoplanin appears to be involved in the orthologic and pathologic processes of the formation of elongated cell extensions and odontoblastic fibers, in the epithelial–mesenchymal transition and local invasion during tooth germ development as well as in both reactive and neoplastic odontogenic cystic lesions.     

Papillary lesions of the oral cavity: relationship to human papillomaviruses

Human papillomaviruses are a group of genetically related organisms that infect stratified squamous epithelium. Unlike many other viruses that infect oral epithelium and induce lysis of the cells they penetrate, HPVs induce proliferative changes in these cells that result in both benign and malignant tumors. The common skin wart (verruca vulgaris) is induced by HPV 2 and 4. Genital warts (condylomas) and the common solitary oral papilloma are associated with HPV 6 and 11. Either HPV 13 or 32 causes focal epithelial hyperplasia. All of these wart-like lesions are benign growths of the stratified squamous lining of the oral cavity and lips and can be treated by surgical excision or laser ablation. HPV 16 and other less frequently encountered genotypes are associated with uterine cervix cancer in 95 percent to 98 percent of cases, and the evidence for a causal role is robust. There are emerging data that implicate HPV in certain subsets of oral cancer, particularly those that arise in the oropharynx/tonsillar region. Some instances of the various histologic subtypes subsumed under proliferative verrucous leukoplakia and verrucous carcinoma also harbor HPV.