Dental Implications Research Articles

Craniofacial Microsomia: Aetiology, Classification and Clinical Features. Part 1

‘This article gives an overview of craniofacial microsomia (CFM), its diagnostic features and relevant classification systems. Craniofacial microsomia is the most common facial anomaly after cleft lip and palate. It has a wide phenotypic variance and requires a multidisciplinary approach for comprehensive management. We outline both the facial and dental manifestations and orthodontic implications. CPD/Clinical Relevance: CFM patients often require comprehensive dental and orthodontic care and it is necessary for the clinician to be aware of the clinical challenges in treating this cohort of patients. By having a thorough understanding of the aetiology and clinical features, it can help direct appropriate clinical care.

Dental implications of transoral robotic surgery (TORS) in the management of head and neck cancer

Transoral robotic surgery (TORS) is increasingly being used in the UK as an alternative to other treatment modalities for the management of head and neck cancer. This article describes key features of the robotic system, and discusses risks of peri-operative dental complications that can arise as a result of introducing large robotic instruments into the confined space of the oral cavity. It also explores potential solutions and the role of dentists in reducing the risks of inadvertent hard and soft tissue injuries occurring during the procedure. CPD/Clinical Relevance: A basic understanding of current surgical treatment modalities and their dental implications is important for GDPs.

Arthritis and dentistry.

Arthritis is a common condition affecting millions of people in the UK and worldwide. All members of the dental team will be seeing and treating patients with this condition, and it is important to understand the disease, its management and medications used. This article outlines the five most common types of arthritis: osteoarthritis (OA), rheumatoid arthritis (RA), axial spondyloarthritis (sPA), juvenile idiopathic arthritis (JIA), and gout. It further discusses the medications used to treat these conditions and any dental implications. Finally, advice is offered on considerations for the dental team when treating such patients.

Late dental effects of chemotherapy and radiotherapy in childhood cancer survivor: case report

Chemotherapy drugs and radiotherapy in the head and neck region are considered possible to interfere with odontogenesis. Patients may present alterations such as tooth agenesis, shortening or root malformation, enamel hypoplasia and microdontia. Such effects do not occur in adults, as they already have the dental structures formed. The objective of this study is to describe, through a case report, the dental alterations and implications for the clinical practice of a patient who received chemotherapy and radiotherapy in childhood. A 12- year-old female patient was diagnosed with embryonal rhabdomyosarcoma in the right parotid gland region at 5 years of age. Antineoplastic treatment consisted of IRS IV chemotherapy protocol: ifosfamide (IFO) - doxorubicin (DOXO) - etoposide (VP16) followed by vincristine - dactinomycin - cyclophosphamide (VAC) / vincristine - ifosfamide - etoposide (VIE) alternated, in addition to conventional radiotherapy, with a total dose of 45 Gy. The patient developed important dental alterations, such as root malformation in most teeth, microdontia and enamel hypoplasia, being essential the role of the dentist. Currently, after 6 years of anticancer treatment, she has regular dental follow-up.

COVID-19 Pandemic: Effects on the Dental Team and Implications on Dental Public Health

COVID-19 Pandemic: Effects on the Dental Team and Implications on Dental Public Health

Investigating different oral hygiene education techniques in children with attention deficit hyperactivity disorder: A randomised clinical trial

Purpose: Attention-deficit/hyperactivity disorder (ADHD) is among the most common behavioural disorders of childhood. There is few published reports in the dental literature have focused on ADHD and its dental implications and also oral hygiene habits. The study was conducted to determine oral hygiene and plaque scores of children suffering from attention deficit hyperactivity disorder (ADHD) and was compared with healthy children by using oral hygiene education techniques with or without self-educational manuals.Subjects and Methods: A total of 50 children, including 25 ADHD and 25 non-ADHD children were included in the study. They were divided into two sub-groups that included different oral hygiene programs. For the first sub-group only recommendations about oral hygiene practices were made, for the second sub-group recommendations were supported with self-educational manuals. The subjects were then examined at the end of 1 week, 1 month and 3 months.Results: This study demonstrated that Plaque Index scores evaluated for different evaluation periods; a statistically significant decrease was found for the test groups for both ADHD and non-ADHD but Gingival Index values were reached to the baseline averages in all groups from baseline to the third month.Conclusions: These results showed that approaches like as supporting materials, encourages the maintenance of long-term acquisition of oral hygiene habits. But further studies are necessary that performed in ADHD children.

"Oral Nutritional Supplements: Sugar Content and Potential Dental Implications".

The objectives of this article are to list the most commonly prescribed Oral Nutritional Supplements in the UK and Ireland and their sugar content; and to raise awareness among the dental profession regarding their uses and potential dental risks involved. Many older patients benefit from Oral Nutritional Supplements. Prescribers may not consider dental implications of these. Patients may not think to disclose these medications to their dentist. A list of commonly prescribed Oral Nutritional Supplements in the UK and Ireland was compiled. Nutritional information was obtained from the manufacturers' website and arranged in order of decreasing sugar content. Potential dental implications are discussed and recommendations made for dental practitioners. Pre-formed Oral Nutritional Supplements can contain between 6.6 and 27.2 g of sugar per serving. Powdered Oral Nutritional Supplements, which are to be mixed with 200 ml whole milk, contain between 16.4 and 35.0g sugar per serving. The "shot"-type Oral Nutritional Supplements contain less sugar, ranging from 0.0 to 4.0g per serving. The sugar content of frequently prescribed Oral Nutritional Supplements can be high. While they are beneficial in assisting the patient to maintain a healthy BMI, they may increase the risk of dental caries. Dental professionals should enquire specifically about Oral Nutritional Supplements during history taking, particularly in groups who are likely to be prescribed such supplements. Consideration should also be given to increasing caries-preventive measures for patients who take these supplements.

The Restoration of Severe Generalized Dental Erosive Wear using Direct Composite: A Case Report

Introduction: This case report describes a conservative restorative approach in the management of severe generalized tooth wear. Case report: The male, aged 57 years, was mainly concerned with the poor appearance of his teeth with short and discolored upper incisors. History revealed that he suffered from gastric reflux for 25 years, for which he was prescribed Ranitidine and was advised to self-medicate with cider vinegar. Furthermore, he divulged that he ground his teeth at night and during the day and had a high intake of carbonated cola drinks. On examination, dentine was exposed in several areas, and to a significant extent, on the incisal aspects of the lower incisors, the palatal surfaces of the upper incisors, and the occlusal surfaces of the molars. Mandibular tori were present. The primary diagnosis was erosive tooth wear with elements of attrition and abrasion. The intervention included dietary advice and restoration with direct composite resin at an increased occlusal vertical dimension of 1.5mm on the retruded axis. The patient reported no functional problems and was pleased with the aesthetic result. Conclusion: Vinegar is promoted to have health benefits, especially with respect to glucose response, but the dental implications are overlooked. This paper reviews the literature on vinegar as a medicament and considers its role as a co-factor for erosion in this case. The clinical steps used to restore the eroded dentition by direct composite are described. The use of this approach is a safe, conservative and successful treatment option without recourse to complex and biologically costly conventional alternatives. The application of direct composite in tooth wear cases meets the European consensus requirements.

Long-term dental implications of infant oral mutilation: a case series.

Infant oral mutilation (IOM) is a ritual ceremony practised mostly in African cultures, in which the primary tooth bud of the deciduous canine is extracted. Complications and risks of IOM include pain, heavy bleeding and infection that may deteriorate to life-threating conditions. The main long-term consequence of IOM is future dental abnormalities. The scientific literature lacks in-depth analyses of the dental sequelae of this practice among adults who underwent it, and particularly of the aspect of dental treatment. Eight new cases of IOM are presented in this case series, with emphasis on dental diagnosis and treatment modalities. We describe different outcomes of this practice, such as enamel hypoplasia and crown deformations with later necrosis and infection of the root canal system, severe discolouration, immature root apex, impaction of a canine, failure of development and missing lower permanent incisors and canines, an odontoma-like structure, severe periodontal defect and root dilaceration. Familiarity with the practice of IOM is vital in order to identify its manifestations and arrive at the correct diagnosis and optimal course of treatment.

Relevance of Oral Cavity in COVID-19: An Explorative Review

The novel Coronavirus disease (COVID-19) which is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) has had a massive worldwide impact as a result of its mode of infection spread. The World Health Organisation(WHO) had declared it a pandemic on the 11th of March,2020 after evaluating its high infectivity and disease fatality rate. Existing evidence suggests that Angiotensin-converting enzyme- 2(ACE-2), is highly expressed on the cells of the tongue and salivary glands, in addition to the lungs, thereby giving a probable explanation of dysgeusia in patients affected by the virus. This article is based on our extensive search of available literature and aims to extrapolate the previous findings for a better understanding of the disease pattern. It focuses on elucidating some indispensable knowledge, besides exploring the various aspects of SARS-CoV-2, like its etiopathogenesis, clinical manifestations and treatment, and the dental implications associated with it. Keywords: Coronavirus, COVID-19, Oral manifestations, Oral ulcers, SARS-CoV-2

Personality traits and body image in adults with oral piercing: a questionnaire analysis.

Due to the growing popularity of body modifications, dental practitioners are increasingly confronted with oral piercing and its implications. Successful consultation and subsequent change of patient behavior require an understanding of the patient's personality and the deep reasons that explain this self-injurious behavior. This is the first study evaluating personality traits and aspects of body perception in a cohort of adults with oral piercing. Sixty-two individuals with labial and/or tongue piercing completed three validated questionnaires assessing body perception and personality traits (Questionnaire for assessing one's own body; Sensation Seeking Scale; Big Five Inventory Scale). Fisher Exact probability test and Mann-Whitney U test were used to determine differences in frequency data and in psychologic parameters between subgroups. Eighteen single- and 44 multiple-pierced individuals completed the study (53 women, 9 men). The odds for being multiple pierced was significantly higher for tongue than for labial piercing (3.89 and 0.63, respectively; P = .003). In all psychologic parameters measured, the sample showed score distributions within reference norms. However, multiple-pierced individuals displayed a significantly lesser feeling of attractiveness, less self-confidence, and more uncertainty/anxiety towards their body than single-pierced probands (P < .05). Psychologic characteristics of individuals with oral piercing do not fundamentally differ from those of the average population. Therefore, dental practitioners should focus on the medical and dental implications of oral piercing in the counseling of patients who have or intend to have such done.

Fibrous Dysplasia: Dental and Orthodontic Implications

Fibrous dysplasia is a benign condition characterized by replacement of bone by a fibro-osseous tissue. This article describes the aetiology, diagnosis and classification of the condition. We discuss the clinical presentation of fibrous dysplasia along with its craniofacial effects. The presentation of fibrous dysplasia in the dental setting is described, along with specific implications for dental and orthodontic management of these patients. CPD/Clinical Relevance: Given the wide array of conditions that can present to GDPs, it is important to be aware of fibrous dysplasia as a possible cause of some signs and symptoms. The presentation, diagnosis and dental management of this group of patients is presented from a clinical perspective.

Ramadan Fasting and Dental Implications: A Special Review

Fasting during the holy month of Ramadan is considered obligatory for all Muslims. It is regarded as one of the five pillars of Islam in which all the followers observe complete abstinence from food and fluid during daylight hours. Such a strict practice has built up hesitations among the followers to go for a dental treatment. This article aims to describe the modifications in the dental practice required for Muslims during this month alongside the oral health-care tips. A dentist should consider these alternatives and appreciate the religious custom so as to provide a compassionate service.

Awareness of COVID-19 and the Dental Implications of its Oral Manifestations among Dental Health Practitioners in Nigeria.

There are many aspects of COVID-19 that are related to dental practice. Hence, this study aimed to assess the level of awareness of COVID-19 concerning its symptoms, transmission and prevention and the dental implications of its oral manifestations among dentists in Nigeria. This is a cross-sectional study that sampled dentists who work in Nigeria regardless of their place of work with an online questionnaire using Google forms to collect the data. The questionnaire was anonymous to maintain the privacy and confidentiality of all information collected in the study. The survey was a structured questionnaire divided into three sections: Dentists' demographics, knowledge of the disease and dental implications of COVID-19. This study included 206 dentists practising in Nigeria, with 126 (61.2%) males and 80 (38.8%) females. A total of 191 (92.7%) dentists perceived COVID-19 as highly contagious and deadly. Almost all the participants (n=205, 99.5%) were knowledgeable about the mode of transmission of the disease through respiratory droplets. A total of 204 (99.0%) affirmed that dental practitioners were at risk of becoming infected with COVID-19. About 84.5% reported that salivary glands can serve as a potential reservoir for COVID-19. The awareness of COVID-19 concerning the mode of transmission, symptoms and prevention among the dental professionals was encouraging. This would lead to enhanced infection control in dental settings. The majority of the participants reported that saliva can be used as a promising non-invasive specimen for diagnosis, monitoring and infection control in patients with COVID-19.

Progressive Systemic Sclerosis and its Dental Implications: A Case Report

Scleroderma is a complex autoimmune rheumatic disease characterised by the widespread fibrosis of skin and visceral organs, dysregulation of immune system and vasculopathy. The aetiology of this disease remains unknown till now. It is known to exist in two forms namely localised and generalised/progressive. It is known to affect females more commonly than males, and also shows a wide range of oral and paraoral manifestations including xerostomia, periodontal disease, restricted mouth opening, burning mouth syndrome, dysphagia, gastroesophageal reflux. Here, authors presents a case of 76-year-old female patient presented with the chief complaint of dry mouth, restricted mouth opening, burning sensation in mouth and reduced taste perception for the past seven years. On the basis of gastrointestinal disorder, Raynaud’s phenomenon, fish mouth appearance and various other extraoral and intraoral features a diagnosis of Progressive Systemic Sclerosis (PSS) was made. The present case also emphasised upon the crucial role of a general dentist in diagnosing such rare systemic diseases. This disease is known to carry a significant burden in the form of pain and disability which potentially limits the proper functioning of major internal organs and results in various life limiting complications. Thus, early diagnosis with appropriate investigations followed by specialist and multidisciplinary approach to treatment, is the key for the successful management of disease.

Barodontalgia: Dental Implications at High Altitudes

Barodontalgia is a symptom of a pre-existing subclinical oral diseases rather than a pathological conditionitself. It was considered earlier as a “flyer’s toothache,” barodontalgia is described as pain that occurs in thetooth utilizing changes in ambient pressure usually in people who fly or dive. It is the whole responsibilityof the dental health professionals to provide the aviators with the best dental treatment as well as awarenessabout the hazards to the dental treatments at higher altitudes. This piece of writing gives sufficient informationabout the need and protocols to be followed especially for the patients commonly at higher altitudes. Thisarticle aims at providing adequate knowledge about barodontalgia and the responsibilities towards itsprevention both by the dentist and the flight crew members.

COVID- 19 Dental Implications

This article covers a lot of topic about coronavirus and covid-19 dental implication. Given the wealth of information about coronavirus, this paper attempted to present in different ways. In the first part of this paper, author cover all about coronavirus and in second part, cover dental implications i.e. case selection for dental treatment, before any dental treatment what protocol used in institutions and dental clinics, how to manage staff and students in institutions and dental clinics, treatment wise recommendations and how to manage covid-19 patient either confirmed cases or suspected cases. Lastly,how to change oral medicine and radiology department setup during and after pandemic. What to accept in future and How too little brighter attitude towards this entire pandemic situation

Management of Diabetes in People Undergoing Dental Treatment in Primary Care.

Diabetes mellitus is a condition resulting from loss of production of insulin, or insufficient production/insulin resistance leading to high blood glucose levels. Management of the condition can be provided in a variety of settings and is tailored to the person's requirements. The condition has a lifelong, systemic impact due to microvascular and macrovascular complications. Diabetes mellitus has dental implications due to increased risk of infections, poor wound healing, rapid progression of periapical pathology, xerostomia, burning mouth syndrome, and a bidirectional link with periodontal disease. Two clinical cases of patients with diabetes are discussed and their dental management described. Many people with diabetes can be treated in primary care, however, some with suboptimal glycaemic control may require specialist input and liaison with the patient's diabetes team.

Co-morbidity of down syndrome with autism spectrum disorder: Dental implications

Over the past several years, numerous studies have emerged documenting the high incidence (1–11%) of comorbidity of autism spectrum disorders (ASD) in Down syndrome (DS). While children with these health issues are reported to be more cognitively impaired presenting significantly lower IQ scores, they also demonstrate differences in social and expressive language skills when compared to their coequals with DS only. More than that subjects with DS and ASD comorbidity exhibit atypical behaviour manifested by stereotypic anxiety and social withdrawal when compared to DS alone.This article provides a brief understanding of this challenging concurrence along with a case report of a 12-year-old male patient with ASD-DS condition reporting with multiple missing teeth (Oligodontia).

Deciphering novel chemotherapy and its impact on dentistry.

In the last few decades, the number of targeted chemotherapies approved for cancer treatment and undergoing clinical trials has risen. In comparison to conventional chemotherapy, targeted therapies (TTs) act on specific molecular targets involved in cancer development and progression, with reduced detrimental effects to normal tissues. TTs have now been recognised as key treatments in a number of common cancers, including solid tumours and haematological malignancies. The number of patients undergoing novel cancer treatment will continue to increase, and a significant population will likely present to the dental environment. This paper aims to provide an insight into TTs currently available, including monoclonal antibodies, fusion proteins, tyrosine kinase inhibitors, histone deacetylase inhibitors, mammalian target of rapamycin inhibitors, phosphoinositide 3-kinase inhibitors, proteasome inhibitors and hedgehog pathway inhibitors. The mechanisms of action, indications for use and how to identify the medications will be summarised. Dental implications of these novel therapies include medication-related osteonecrosis of the jaw, delayed healing, immunosuppression and thrombocytopenia. These will be discussed to ensure oral healthcare providers are aware of their impact in a dental setting.