Burning Sensation In Mouth Research Articles

Prevalence of Various Orofacial Pain Symptoms and Their Overall Impact on Quality of Life in a Tertiary Care Hospital in India

Pain is a major public health problem and is the most commonly reported symptom of oral and dental disease that has a significant impact on both individual and community. The present study was prevalence of various orofacial pain symptoms and their overall impact on the quality of life in a tertiary care hospital. This study was carried out in the outpatient department of the Government Dental College and Research Institute, Bangalore. The severity of the chronic orofacial pain symptoms was assessed using the Chronic Pain Grade Questionnaire by Von Korff. The results showed that toothache (57.6%) was the most commonly reported symptom and burning mouth sensation (6.4%) was the least commonly reported. Majority of the patients had grade 3 level of pain-related disability (34.8%) followed by grade 2 (26.8%), grade 1 (22.4%) and grade 4 levels (16%). The mean pain intensity was reported to be more among females and maximum among patients with facial pain. The present study demonstrated that orofacial pain symptoms have a significant impact on the patients suffering from it. Therefore, proper measures should be taken for the management of the patients with these symptoms and associated conditions.

Erratum to: Reconstructive management of the rare bilateral oral submucos fibrosisusing nasolabial flap in comparison with free radial forearm flap - a randomisedprospective trial

BackgroundOral sub mucous fibrosis is a rare chronic, progressive, pre malignant collagen disorder of oral mucosa in people of Asian descent characterized by trismus, blanching and stiffness of mucosa, burning sensation in mouth and hypomobility of soft palate and tongue with loss of gustatory sensation. Betel nut chewing is the most common etiological agent. Surgery remains the main stay in severe cases and aims at release of fibrotic bands and resurfacing the raw areas with different options. Reconstruction can be done by using nasolabial flap or radial free forearm flap. The purpose of this study was to compare the mouth opening after the reconstruction with either nasolabial flap or radial free forearm flap.MethodsThis study was carried out on fifty (50) patients with oral sub mucous fibrosis. Twenty five (25) of these were reconstructed by nasolabial flap and twenty five (25) were reconstructed by radial free forearm flap. At different intervals of their post-operative visits, they were evaluated for the interincisal distance and the difference between the two groups was assessed.ResultsAverage increase in interincisal distance was greater in patients reconstructed with radial free forearm flap compared with patient reconstructed by nasolabial flap i.e. 18.96 mm and 15.16 mm respectively with ‘P’ value > 0.05.ConclusionsBased on the results of this study, there was no significant difference in mouth opening after reconstruction with radial forearm free flap compared to nasolabial flap.

Reconstructive management of the rare bilateral oral submucos fibrosis using nasolabial flap in comparison with free radial forearm flap - a randomised prospective trial

BackgroundOral sub mucous fibrosis is a rare chronic, progressive, pre malignant collagen disorder of oral mucosa in people of Asian descent characterized by trismus, blanching and stiffness of mucosa, burning sensation in mouth and hypomobility of soft palate and tongue with loss of gustatory sensation. Betel nut chewing is the most common etiological agent. Surgery remains the main stay in severe cases and aims at release of fibrotic bands and resurfacing the raw areas with different options. Reconstruction can be done by using nasolabial flap or radial free forearm flap. The purpose of this study was to compare the mouth opening after the reconstruction with either nasolabial flap or radial free forearm flap.MethodsThis study was carried out on fifty (50) patients with oral sub mucous fibrosis. Twenty five (25) of these were reconstructed by nasolabial flap and twenty five (25) were reconstructed by radial free forearm flap. At different intervals of their post-operative visits, they were evaluated for the interincisal distance and the difference between the two groups was assessed.ResultsAverage increase in interincisal distance was greater in patients reconstructed with radial free forearm flap compared with patient reconstructed by nasolabial flap i.e. 18.96 mm and 15.16 mm respectively with ‘P’ value > 0.05.ConclusionBased on this study radial forearm free flap is a superior method compared to transposition of nasolabial flap to cover the surgical wound of oral submucous fibrosis.

Frequency Analysis of Heart Rate Variability: A Useful Assessment Tool of Linearly Polarized Near-Infrared Irradiation to Stellate Ganglion Area for Burning Mouth Syndrome

Burning mouth syndrome (BMS) is characterized by the following subjective complaints without distinct organic changes: burning sensation in mouth or chronic pain of tongue. BMS is also known as glossodynia; both terms are used equivalently in Japan. Although the real cause of BMS is still unknown, it has been pointed out that BMS is related to some autonomic abnormality, and that stellate ganglion near-infrared irradiation (SGR) corrects the autonomic abnormality. Frequency analysis of heart rate variability (HRV) is expected to be useful for assessing autonomic abnormality. This study investigated whether frequency analysis of HRV could reveal autonomic abnormality associated with BMS, and whether autonomic changes were corrected after SGR. Eight subjects received SGR; the response to SGR was assessed by frequency analysis of HRV. No significant difference of autonomic activity concerning low-frequency (LF) norm, high-frequency (HF) norm, and low-frequency/high-frequency (LF/HF) was found between SGR effective and ineffective groups. Therefore, we proposed new parameters: differential normalized low frequency (D LF norm), differential normalized high frequency (D HF norm), and differential low-frequency/high-frequency (D LF/HF), which were defined as differentials between original parameters just before and after SGR. These parameters as indexes of responsiveness of autonomic nervous system (ANS) revealed autonomic changes in BMS, and BMS seems to be related to autonomic instability rather than autonomic imbalance. Frequency analysis of HRV revealed the autonomic instability associated with BMS and enabled tracing of autonomic changes corrected with SGR. It is suggested that frequency analysis of HRV is very useful in follow up of BMS and for determination of the therapeutic efficacy of SGR.

Salivary tests associated with elderly people’s oral health

The saliva constitutes essential condition for the individual's health. Identify the relation of the salivary flow and saliva pH with medicine use and oral discomfort in elderly. Cross-sectional study with 68 elderly living in a long staying institution. Salivary tests were performed based on Bo Krasse's methodology. For pH, the Universalindikator - Merck tape was used. A questionnaire was applied, organising data through Software SPSS version 17. Pearson's qui-square distribution, Fisher's exact test and t-test for paired data were used, with significance level of 5% and confidence interval of 95%. Among the 68 elderly (average of 70.4 years, SD ± 7.27), 80% showed normal pH. The rate of salivary flow was as follows: very low, 32.3%; lowered, 41.2%; and normal, 25.5%; 30.9% reported dry mouth; 22.1% problems with taste; 17.6%, dysphagia; and 14.7%, burning mouth. 76.5% used medicines. There was statistical significance between medicine use and dry mouth (p = 0.015). They showed an association between salivary flow and medicine use (p = 0.048), feels dry mouth (0.018) and difficulty to swallow (p = 0.046), and saliva pH without stimulation and feels dry mouth (p = 0.003), difficulty to swallow (p=0.006) and burning mouth sensation (p = 0.014). Low salivary flow and saliva pH interfere on elderly people's health and medicine use influences on results.

Intralesional Injection versus Mouth Rinse of Triamcinolone Acetonide in Oral Lichen Planus

To compare the efficacy, relapse, and adverse effects between intralesional injection and mouth rinse of triamcinolone acetonide (TA) in patients with oral lichen planus (OLP). A randomized controlled study. College medical center. Forty consecutive patients, who had been diagnosed with OLP, were recruited. Participants were randomly divided into 2 groups using intralesional injection or mouth rinse of TA. The severity of pain and burning sensation on a 10-cm visual analog scale (VAS) and the Oral Health Impact Profile-14 (OHIP-14) were assessed at weeks 0, 1, 2, 3, 4, and 6. The signs of OLP were quantified using a special scoring system for OLP. The rate of relapse and the adverse effects were compared between both groups. The VAS scores for pain and burning mouth sensation and objective scoring for OLP were significantly improved at 1, 2, 3, 4, and 6 weeks in both groups. The changes in the VAS for burning mouth sensation, OHIP-14, and objective scoring for OLP were similar between both groups. The change in the VAS for pain from baseline to week 1 in the intralesional injection group was significantly higher than in the mouth rinse group. The rate of adverse effects was significantly higher in the mouth rinse group than in the intralesional injection group (44.4% vs 5.0%). The efficacies of both treatments were similar. The rate of adverse effects was significantly lower for intralesional injection of TA than mouth rinse of TA.

Detection of Malignancies through Camp Approach in Navodaya Medical College, Raichur

Total participants in this camp were 139 out of which, males were 93 (67%) and females were 46 (33%). Mean age of the participant was 44.50.Males using Tobacco/Gutka, Alcohol and Smokers were more and most of them were labourers. Use of Tobacco, gutka, Alcohol and smoking were observed as one of the predisposing factors as addicted people's common complaints were dysphagia, burning sensation in mouth, oral pain, and red patch in mouth etc. Gutka, Tobacco addiction was more in younger age group as well as in 56 to 66 age group. Total numbers of cancer cases detected were 5.There is need of awareness about warning signs of cancers and about screening at regular intervals through camp approach as screening may result in detection of cancer at early stage. Thus mortality and morbidity due to cancers can be avoided.

Orraall mmaanniiffeessttaattiioonnss,, mmiiccrroobbiiaall ssttuuddyy aanndd ssaalliivvaarryy IIggAA ssttuuddyy iinn llyymmpphhoommaa ppaattiieennttss rreecceeiivviinngg cchheemmootthheerraappyy

Background: Lymphoma is a general term that includes 40 different sub-types of the disease. These can be divided into two main types: Hodgkin Lymphoma and Non-Hodgkin lymphoma. Lymphomas are a cancer of white cells produced by the bone marrow and matured in the lymphatic system. The cancer may originate in the lymph glands or organs such as the liver, spleen, bowel or bone marrow. The aims were to determine the prevalence of oral manifestations in lymphoma patients, isolate and identify different microorganism (aerobic, anaerobic and fungi), from oral micro flora from lymphoma patients under chemotherapy and detect the level of salivary IgA in comparison with healthy control. Subjects, materials and methods: The study included 52 lymphoma patients (17 Hodgkin’s and 35 Non Hodgkin’s) of both sexes (27 male and 25 female) those patients were matched in age and sex with 15 healthy control subjects. Results: The most frequent oral manifestations in the lymphoma patients in this study was taste alteration (52.2%), burning mouth sensation (37.3%), dry mouth (37.3%), halitosis (16.4%) and (7.5%) white coated tongue respectively. Various species of bacteria were isolated; the main bacteria isolated were streptococcus viridians, Neisseria, Staphylococcus aureus, Staphylococcus albus, Pseudomonas, Actinomyces, Lactobacillus, Klebsiella, and Escherichia-coli and anaerobic bacteria such as Peptostreptococcus and Bacillus. Fungi such as Candida albicans were also identified. Level of Salivary IgA was significantly decreased in lymphoma patients under treatment in comparison to healthy control. Conclusions: The finding of this study shows obvious differences in the prevalence of micro-organisms between lymphoma patients and healthy control. The most frequent oral manifestations in lymphoma patients were taste alterations, xerostomia, and burning mouth sensation. A significant decreased in level of salivary IgA was noticed in all lymphoma patients. It is highly recommended that all patients to have thorough dental examination before starting treatment.

Oral manifestations in type-2 diabetes and related complications

Background:Knowledge of the wide spectrum of the oral markers of diabetes is imperative as one frequently encounters individuals with undetected, untreated or poorly controlled diabetes.Objectives:The objective was to study the oral manifestations in type 2 diabetes mellitus (DM) and to establish an association between oral manifestations and associated microvascular and macrovascular complications.Materials and Methods:50 cases of DM were selected who had oral complications. The control group comprised 50 age- and sex-matched diabetic patients without any oral complications.Results:Oral manifestations in DM included periodontal disease in 34%, oral candidiasis in 24%, tooth loss in 24%, oral mucosal ulcers in 22%, taste impairment in 20%, xerostomia and salivary gland hypofunction in 14%, dental caries in 24%, and burning mouth sensation in 10% cases. Fasting [(FBG) (P = 0.003)] and postprandial blood glucose [(PPBG) (P = 0.0003)] levels were significantly higher among cases. The P values for neuropathy, retinopathy, nephropathy, cardiovascular disease, dyslipidemia, and sepsis were 0.0156, 0.0241, 0.68, 0.4047, 0.0278, and 0.3149, respectively, which were significant for neuropathy, retinopathy, and dyslipidemia.Conclusions:Several oral complications are seen among diabetics. Association of oral markers in DM and microvascular complications suggests that there is a significant association between the two.

Dental patients’ self-reports of xerostomia and associated risk factors

Most studies regarding xerostomia focus on elderly people. Therefore, the authors conducted a study of dental patients 18 years or older to determine the prevalence of self-reported xerostomia and associated risk factors. The authors sent a total of 2,200 questionnaires to four dental clinics to assess patients' self-reported xerostomia. They also collected sociodemographic data and information regarding personal behavior. They used logistic regression models to estimate odds ratios (OR) and 95 percent confidence intervals (CI) to explore the relationship between self-reported xerostomia and risk factors that reasonably might be expected to be associated with self-reported xerostomia. The overall prevalence of xerostomia in participants was 7 percent. Participants with burning-mouth sensations were associated with having higher odds of experiencing dry mouth (OR, 2.1; 95 percent CI, 0.9-5.2). Participants 51 years or older were significantly more likely to report having dry mouth than were younger participants (P < .04). The prevalence of self-reported xerostomia increased with increasing numbers of medications patients reported using. The authors found that medication use and age were highly significant risk factors for dental patients reporting xerostomia. Clinicians should interview their patients carefully regarding their use of medications and provide proper oral health care to improve xerostomia resulting from medication use.

Mercury (Hg) burden in children: The impact of dental amalgam

The risks and benefits of using mercury (Hg) in dental amalgam have long been debated. This study was designed to estimate Hg body burden and its association with dental amalgam fillings in 182 children (ages: 5–15 years) living in Taif City. Hg was measured in urine (UHg), hair (HHg) and toenails (NHg) by the Atomic Absorption Spectrophotometer with Vapor Generator Accessory system. Urinary Hg levels were calculated as both micrograms per gram creatinine (μg/g creatinine) and micrograms per liter (μg/L). We found that children with amalgam fillings ( N = 106) had significantly higher UHg-C levels than children without ( N = 76), with means of 3.763 μg/g creatinine versus 3.457 μg/g creatinine, respectively ( P = 0.019). The results were similar for UHg ( P = 0.01). A similar pattern was also seen for HHg, with means of 0.614 μg/g ( N = 97) for children with amalgam versus 0.242 μg/g ( N = 74) for those without amalgam fillings ( P = 0). Although the mean NHg was higher in children without amalgam (0.222 μg/g, N = 61) versus those with (0.163 μg/g, N = 101), the relationship was not significant ( P = 0.069). After adjusting for many confounders, the multiple logistic regression model revealed that the levels of UHg-C and HHg were 2.047 and 5.396 times higher, respectively, in children with dental amalgam compared to those without ( P < 0.01). In contrast, a significant inverse relationship was seen between NHg levels and dental amalgam fillings ( P = 0.003). Despite the controversy surrounding the health impact of dental amalgam, this study showed some evidence that amalgam-associated Hg exposure might be related with symptoms of oral health, such as aphthous ulcer, white patches, and a burning-mouth sensation. Further studies are needed to reproduce these findings. The present study showed that significant numbers of children with or without amalgam had Hg levels exceeding the acceptable reference limits. The detrimental neurobehavioral and/or nephrotoxic effects of such an increased Hg on children should be a cause of concern, and further investigation is warranted. Our results are alarming and indicate an urgent need for biomonitoring and assessment of exposure. Changes in dental practices involving amalgam, especially for children, are highly recommended in order to avoid unnecessary exposure to Hg.

Clinical questionnaire study of oral health care and symptoms in diabetic vs. non-diabetic predialysis chronic kidney disease patients

This paper aims to study oral symptoms (burning mouth sensation, xerostomia, dysphagia, and dysgeusia) and background characteristics among chronic kidney disease (CKD) patients. The hypothesis was that patients experience oral discomfort and show interest towards dental care differently depending on the origin of their kidney disease. One hundred thirty-eight CKD patients at predialysis stage (94 men, 44 women, mean age 54years) at the Helsinki University Central Hospital participated in the study. The patients were divided into a diabetic nephropathy group and a group of patients with other kidney diseases. The patients had a clinical oral examination and filled in a structured questionnaire. The data were analyzed and compared between the groups (SPSS for Windows version 15.0). T test was used for parameters normally distributed while binomial data were analyzed with cross-tabulations and chi-square test. Contrary to our study hypothesis, no statistically significant differences were seen in the questionnaire study between the diabetic vs. non-diabetic CKD patients in any other study parameter except in the use of medication (10 ± 2.3 vs. 8 ± 3.1 drugs daily, p < 0.05), and working status (23.5% vs. 50% working full time, p < 0.01). No difference was seen in the frequency of oral discomfort among the different groups. Xerostomia, however, was frequently observed among the predialysis patients investigated (41.7% in diabetic, 48.2% in non-diabetic patients). No difference was seen in the frequency of oral discomfort among the different groups of predialysis patients investigated. Clinicians should be aware of nephropathy patients who frequently suffer from oral discomfort, particularly xerostomia.

Oral sensorial complaints, salivary flow rate and mucosal lesions in the institutionalized elderly

The aims of this study were to determine the prevalence of oral sensorial complaints, salivary flow rate and oral mucosal lesions in the institutionalized and non-institutionalized elderly. The study included 280 institutionalized and 61 non- institutionalized elderly people. Dry mouth, burning mouth sensations, taste disturbances, salivary flow rate and oral mucosal lesions were assessed and compared between groups. A greater number of the institutionalized elderly had dry mouth (P = 0.001) and taste disturbance (P = 0.035) compared to non-institutionalized elderly. The institutionalized elderly also had significantly lower salivary flow rate (P < 0.0001). Positive correlation was found between salivary flow rate and perception of dry mouth in the institutionalized elderly (r(s) = 0.26; P < 0.05), as well as in the non-institutionalized elderly (r(s) = 0.35; P < 0.05). Moreover, positive correlation was observed between salivary flow rate and the sensation of burning mouth in the institutionalized elderly (r(s) = 0.13; P < 0.05) and non-institutionalized elderly (r(s) = 0.31; P < 0.05). The number of institutionalized elderly people with oral mucosal diseases was higher compared with non-institutionalized ones (P = 0.01). The most common oral mucosal lesions in both groups were related to wearing dentures. It can be concluded that the institutionalized elderly are significantly affected with oral sensorial complaints, including dry mouth and taste disturbance, as well as decreased salivary flow rate and oral mucosal diseases compared with the non-institutionalized elderly.

The effects of parafunctional habit control and topical lubricant on discomforts associated with burning mouth syndrome (BMS)

The BMS is a common chronic pain condition which mainly affects old women. The high prevalence of oral parafunctional habits and dry mouth symptoms in patients with BMS suggests that inflammation at the subclinical level due to repetitive microtrauma may cause burning mouth sensations. In this study, using a comprehensive questionnaire, we have investigated the efficacy of oral habit control and use of topical lubricant or corticosteroid on oral complaints associated with BMS. Twenty-five patients with BMS (1 man and 24 women, mean age 59.4 ± 8.3 years) were included to investigate the effects of habit control and topical lubricant on discomforts associated with BMS. Another 29 patients (2 men and 27 women, mean age 55.0 ± 10.6 years) were included to investigate the effects of habit control and topical dexamethasone (DXM). The burning and aching qualities of discomfort, and the effect of oral complaints on daily life were significantly decreased by both types of treatments. However, there were no significant differences between the different treatment groups. The salivary flow rate did not affect the treatment outcome. We concluded that the concomitant prescription of topical lubricants with oral habit control is an effective initial approach for patients with BMS.

Pemphigus vulgaris associated with significant periodontal findings: A case report

The purpose of this article is to report a case of Pemphigus vulgaris (PV) associated with periodontitis and role of dermatologist and periodontist in its management in the routine practice. Periodontitis is a plaque induced inflammation involving and destroying the supporting alveolar bone, cementum and periodontal ligament. Pemphigus is a group of bullous diseases that affect the oral mucosa and the skin, leading to acantholysis that causes painful oral ulceration, making ineffective oral hygiene which allows for the accumulation of more plaque, a causative factor for the periodontitis. A 47 year-old male, a known case of PV presented with a complaint of oral ulceration and burning sensation of mouth and ulcerative skin lesions over the skin, since 3 years. A clinical examination revealed the existence of poor oral hygiene status, bleeding on probing, significant clinical attachment loss and probing pocket depth. Radiograph showed combination of horizontal and vertical alveolar bone loss. This case reaffirms the fact plaque control is the most important procedure in preventing periodontal infection in PV patients. These patients should be informed about the risk of periodontitis, and encouraged to pursue long-term periodontal follow up by the dental professionals to prevent their periodontal disease progression. Key words: Pemphigus vulgaris (PV), periodontitis, plaque.

ドライマウスの臨床─ ドライマウス外来での対処─

All of the persons who attended the Dry Mouth Clinic at Tsurumi University Dental Hospital complaining of dry mouth sensation were regarded to be dry mouth patients even if no hyposalivation was apparent. The management of dry mouth patients at the Dry Mouth Clinic is herein described. This study addressed two subjects, namely, the effectiveness of cevimeline hydrochloride on saliva secretion for Sjögren's syndrome patients, and the effectiveness of using a night guard for the treatment of sleep related dry mouth.There was a female preponderance among the dry mouth patients and the most common age group was individuals in their 60's. Dry mouth(44.1 %)was the most frequent complaint, followed by pain(28.7 %). It was noteworthy that 70 % of all dry mouth patients had pain, such as a burning mouth sensation. Oral candidiasis was the most important causes of the pain in most dry mouth patients. Sjögren's syndrome(SS)was diagnosed according to either the Japanese or American-European diagnostic criteria and 7 % of the dry mouth patients fulfilled these criteria. In other cases, the causes of dry mouth were complex and the cause of hyposalivation could not be easily determined.Cevimeline hydrochloride, a muscarinic(M3)receptor agonist, is widely used as a secretagogue for SS patients. However, the correlation between the severity of SS and the effectiveness of cevimeline has not been well documented. The current results demonstrated a relationship between the effect of cevimeline on saliva secretion and the degree of salivary gland destruction as evaluated by sialography and the histopathological findings in the labial minor salivary glands. These diagnostic approaches could provide useful prognostic information on the efficacy of cevimeline in SS patients.Nocturnal xerostomia is a sensation of dry mouth associated with a complaint of either mouth and/or throat discomfort which thus causes individuals to have to wake up in the middle of the night in order to drink water. The application of a night guard is a useful and simple method for the management of nocturnal xerostomia. This device is fabricated from a soft material, which is often used as a sports mouth guard or as a night guard for the treatment of nighttime bruxism and it covers the dental arch and the hard palate. This device may be useful even for SS patients.

Estudo de alterações na cavidade oral em pacientes com doença do refluxo gastroesofágico

The gastroesophageal reflux disease, which has become highly and increasingly incident, may be manifested by typical (pyrosis and regurgitation) and atypical (pulmonary, otorhinolaryngological and buccal) symptoms. To analyze alterations in the oral cavity patients with gastroesophageal reflux disease. One hundred patients were studied being 50 gastroesophageal reflux disease patients (group 1) and 50 controls (group 2). All patients were submitted to an oral clinical exam and specific survey. Patients in group 1 were submitted to upper endoscopy, manometry and esophageal pH monitoring. The upper endoscopy revealed esophagitis in all patients, 20 erosive esophagitis, 30 no-erosive esophagitis and 38 hiatal hernia. Average pressure of the lower esophageal sphincter was 11 +/- 4,8 mm Hg and of the upper esophageal sphincter 75 +/- 26,5 mm Hg. In 42 patients of group 1 (84%) pathological gastroesophageal reflux was observed. Clinical exams revealed: dental erosions in group 1: 273 faces and in group 2: 5 tooth decays in group 1: 23 and 115 in group 2; abrasion in group 1: 58 and in group 2: 95; attrition wear: 408 in group 1 and 224 in group 2. The most damages was the palatine face. In group 1, 21 patients complained about frequent episodes of canker sores, 35 of tooth sensibility, 26 of burning mouth and 42 of sour taste in the mouth. In group 2 the complaints were observed in lower number of patients. Patients with gastroesophageal reflux disease present higher incidence of dental erosion, canker sores, mouth burning sensation, sensitivity and sour taste than controls. Patients with gastroesophageal reflux disease show lower incidence of tooth decays as compared to controls.

Pentoxifylline therapy : A new adjunct in the treatment of oral submucous fibrosis

This study was designed to determine the effect of pentoxifylline (Trental) on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy) in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets). The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls) were included in this study and 100% compliance was reported at the end ofthe test period. Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test). Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000), tongue protrusion (t= 3.898, p = 0.002), and relief from perioral fibrotic bands (p = 0.0001554). Subjective symptoms of intolerance to spices (p = 0.0063218), burning sensation of mouth (p = 0.0005797), tinnitus (p=0.000042), difficulty in swallowing (p=0.0000714). and difficulty in speech (p=0.0000020) were also recorded significant improvement at the end of the trial period. This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.

The prevalence of dental erosion in Nigerian patients with gastro-oesophageal reflux disease

BackgroundIn various people of the Western world, gastro-oesophageal reflux (GOR) has been reported to be a common problem. Various studies have also assessed the relationship between GOR and dental erosion. The authors are not aware of such studies in Nigerians. It is therefore the aims of the present study to estimate the prevalence of GOR; to estimate the prevalence of dental erosion in patients with GORD; to document the oral findings in patients diagnosed with GORD and to compare these findings with previous studies elsewhere.MethodsA total of 225 subjects comprising of 100 volunteers and 125 patients diagnosed with GORD were involved in this study. History of gastric juice regurgitation and heartburn were recorded. Oral examination to quantify loss of tooth structure was done using the tooth wear index (TWI) designed by Smith and Knight (1984).ResultsTwenty patients with GORD presented with dental erosion in the maxillary anterior teeth with TWI scores ranging from 1–3. The prevalence of erosion was found to be statistically significant between GORD patients (16%) and control (5%) (p < 0.05), but not significant between endoscopic diagnostic groups (p > 0.05).ConclusionThe present study supports the consideration of dental erosion as the extra-oesophageal manifestation of GORD. However the association between GORD and burning mouth sensation needs more investigation.

口腔乾燥症患者における保湿ジェルの効果

Efficacy of moisturizing gel (Oral Balance®) in patients with dry mouth was investigated. Thirty patients, 27 females and 3 males, with the average age of 62.5 years old were the subjects of this study. These patients were instructed to use moisturizing gel 4 times a day for 2 weeks. The effect of the moisturizing gel was evaluated by change of visual analog scale (VAS) scores in subjective and objective symptoms of dry mouth and its associated conditions. Change in average VAS scores in subjective symptoms was significant in dry mouth (p=0.0186), eagerness to drink (p=0.0102), abnormality in taste (p=0.0320) and difficulty in taking food (p=0.0049), but was not significant in viscous sensation of saliva (p=0.4473), pain in mouth (p=0.0927) and burning sensation in mouth (p=0.0781). Change in average VAS scores in objective symptoms was significant in dry mouth (p=0.0029), ulcer or fissure in mouth (p=0.0104) and angular cheilitis (p=0.0089), but was not siginificant in redness in mouth (p=0.0772), atrophy of tongue papilla (p=0.0607) and poor oral hygiene (p=0.5885). Frequency of the use of moisturizing gel varied from 1 to 4 times a day, but none of the patients abandoned using it within the 2 weeks. Discomfort was observed in 4 cases, 2 of them being soft stool and others related to nausea and sweetness. Total evaluation by patients was scored as poor in 0%, fair in 17%, slightly good in 40%, good in 23% and very good in 20%. In conclusion, moisturizing gel is useful for the palliation of dry mouth and its associated conditions in patients with dry mouth.