Oral Burns Research Articles

Paraquat Poisoning: A Growing Homicidal Threat: Insights and Strategies

Abstract Paraquat is a widely used non-selective herbicide in Indian agriculture. It has gained popularity for its misuse in suicidal poisoning, primarily because it lacks an antidote, and ingestion often leads to death. When examining the historical trends of pesticide-related suicidal poisonings in India, there is a noticeable transition from endrin, organophosphates and rodenticides to the current prevalent use of paraquat. This review delves into globally reported cases of homicidal paraquat poisonings, which are sporadically reported in India as well, although not published in mainstream academia. Clinicians must remain vigilant in homicidal paraquat poisoning situations as there is often improper history at the time of presentation. Such cases typically present with some non-specific symptoms such as oral and pharyngeal burns and appear like any other typical acute gastroenteritis or a flu-like illness which ultimately leads to death as a result of pulmonary complications. At the same time, forensic pathologists need to be well versed in the characteristic autopsy findings and analytical toxicology considerations of paraquat-induced criminal poisoning, given the occasional incidents in India. The use of paraquat as a weapon in poisoning cases is a significant public health concern that underscores the need for a ban on paraquat in India.

The Impact of E-Cigarettes on Oral Injuries and Bone Fractures

Introduction The rising prevalence of electronic cigarette (e-cigarette) use has prompted concerns regarding its potential health implications. While much attention has focused on respiratory and cardiovascular effects, injuries, oral trauma, and bone fractures linked to e-cigarette use have received less scrutiny. This paper aims to comprehensively review the landscape of injuries, oral trauma, and bone fractures induced by e-cigarettes, shedding light on this underexplored facet of e-cigarette-related harm. Material and Methods This literature review has analyzed 16 papers. Inclusion criteria: researches and case reports published after 2015. PubMed and Google Scholar has been searched to identify the papers. Analysis of the Literature Existing literature suggests a growing incidence of injuries, oral trauma, and bone fractures associated with e-cigarette use, albeit with limited systematic investigation. Mechanisms underlying these injuries range from device malfunctions to inadvertent impacts during use. Case reports highlight a spectrum of injuries, including oral burns, dental trauma, and skeletal fractures, often involving the face and mouth regions. Conclusions Despite the lack of comprehensive epidemiological data emerging evidence underscores the need for heightened awareness and preventive measures to mitigate e-cigarette-related injuries. Enhanced education, regulation of e-cigarette devices, and promotion of safer usage practices are crucial steps towards reducing the burden of e-cigarette-related harm on oral and skeletal health.

A case of severe benzalkonium chloride intoxication in a cat

BackgroundBenzalkonium chloride (BAC) is a quaternary ammonium compound (QAC), that can be found in a wide variety of household products–from disinfectants to medicaments and home fragrances–but also professional products. In pets, cats have long been reported as more sensitive than dogs to QACs; in fact, signs of irritation such as oral ulcerations, stomatitis and pharyngitis can be observed after contact with concentrations of 2% or lower. In a review of 245 cases of BAC exposure in cats, reported by the Veterinary Poisons Information Service (United Kingdom) only 1.2% of the cases died or were euthanized. Nevertheless, BAC toxidromes in cats can result in transitory CNS and respiratory distress, as well as severe mucosal and cutaneous lesions. Currently, only a few reports are available concerning BAC poisoning in this species.Case presentationA 4 month-old kitten presented with severe glossitis, lameness in the hindlimbs and episodes of vomiting and diarrhoea. The cause was unknown until the owners reported use of a BAC-containing mould remover (5%) 4 days later. The patient developed severe oral burns requiring a pharyngeal tube for feeding and severe cutaneous chemical burns. The kitten was managed with supportive therapy and required hospitalization for 10 days. The symptoms disappeared completely 3 weeks after exposure.ConclusionsBAC is a very common compound contained in several household and professional products but, to the best of our knowledge, no previous case had been reported in Italy. We hope that this report will help raise awareness on the hazards of BAC products for cats in both domestic and work contexts.

Reactivity to food cues in spicy food cravers: Physiological and behavioral responses

In China, the rate of spicy food consumption is rising, and chili pepper is among the most popular spicy foods consumed nationwide. According to the ‘cued overeating’ model, visual and olfactory cues of food can lead to changes in physiological responses and increase the likelihood and amount of food intake. However, no studies have explored the role of spicy food cues in cue reactivity among spicy food cravers. The exploratory study aimed to investigate cue-induced physiological responses, subjective cravings, eating behaviors and their associations in spicy food cravers. A group of spicy cravers (n = 59) and a group of age- and sex-matched non-cravers (n = 60) were exposed to food cues that contained or did not contain chili, during which physiological responses and food consumption were measured. The results revealed that spicy food cravers showed increased salivation and heart rate in response to food cues that contained chili compared to cues without chili and consumed significantly more chili oil after chili exposure. For cravers, heart rate during chili exposure was positively correlated with changes in subjective spicy food craving, and increases in subjective spicy food craving during chili exposure positively predicted subsequent chili oil consumption. The current exploratory study confirms the ‘cued overeating’ model and extends previous findings on food cravings, showing that even though chili peppers can elicit aversive oral burns and pain, they share the same physiological mechanism underlying cue reactivity as other kinds of cravings.

Matrix Rhythm Therapy – A Novel Treatment

Abstract Matrix rhythm therapy (MRT) is an advanced electrotherapeutic modality, which works on mechanical and magnetic vibrations and delivers physiological rhythmical oscillations, whose frequency changes according to the individuals’ tissue requirement that synchronizes with internal body rhythm. The aim of the study is to find in which conditions MRT can be effective with or without conventional physiotherapy. Databases used were Google scholar, PubMed, with keywords MRT advance physiotherapy. Studies published in English, original articles from 2018 to 2023 were included. All types of studies were included: systemic reviews, reviews, randomized controlled trials (RCTs), case series, and case report. Duplicate and irrelevant articles were excluded. Fifteen articles were found of which 9 studies were included. In this study, 1 systemic review, 1 review, 3 RCT, 1 case series, and 3 case reports were there. However, MRT with conventional physiotherapy was found to be superior in reducing pain and improving range of motion, strength, balance, gait parameters, muscle tone, strength, and quality of life. MRT may show great effects in decreasing spasticity when used with other conventional physical therapy. This brief study found that the MRT is effective, which exists as new development in the stream of physiotherapy. MRT is a recent tool in rehabilitation that is being used in conditions such as chronic back and neck pain, frozen shoulder, stroke, plantar fasciitis, decubitus ulcer, trigeminal neuralgia, oral submucous fibrosis, burns, and lymphedema.

Burns of oral mucosa – A review

The objective of this review is to understand burns of oral mucosae as a type of injury, the different etiologies, clinical features and management of these oral burns in clinical practice. This review aims to aid dentists to evaluate and assess patients sustaining burn injuries in a better way and to understand the varied treatment protocols for particular types of burns in order to help patients restore their oral health.Articles from PubMed and Google Scholar (from1991 to 2019) were reviewed. All articles relevant to the topic, case reports and literature reviews were included in this review. No articles were excluded.All included articles suggested that burns are a type of tissue injury that can produce localized or diffuse areas of tissue damage depending on the severity and extent of the insult. Burns of the oral mucosa may be caused by thermal, mechanical, chemical, electrical or radiation injury. Thermal burns are usually caused due to ingestion of high temperature foods or drinks. Similarly, chemical burns occur due to exposure of oral mucosa to acids or alkalis or certain drugs. Electrical burns are less common, however, they are mostly noted in children due to biting onto electrical cables or wires etc. Clinical features of all types of burns range from whitish red erythema to necrotic patches. The sites of burns usually vary based on their etiology. Although, there are some contemporary guidelines, there exists no specific standard of care with regards to management of different kinds of burns. This article aims to form a general review of burns of the oral mucosa and its treatment guidelines.

Enhanced healing of oral chemical burn by inhibiting inflammatory factors with an oral administration of shengFu oil.

ShengFu oil is a compounded Chinese medicinal prescription, and provides antibacterial, anti-inflammatory, and analgesic effects, favoring burn wound repair. In this study, we aimed at investigating the effects of topical applications of ShengFu oil and its active ingredients in oral chemical burns and elucidating its regulatory effects on β-catenin, COX-2, and MMP-9 expression caused by exposure to acid or alkaline agents. ShengFu oil contains 16 components, such as Frankincense, Radix Scutellariae and Radix Rehmanniae, and the main active ingredients from Frankincense are α-pinene, linalool, and n-octanol. Mouse models of oral chemical burns were induced by using glacial acetic acid or sodium hydroxide. Hematoxylin and eosin staining and immunohistochemical staining were used to detect the protein expressions of β-catenin, COX-2, and MMP-9 in wound tissues. They were further quantified by multispectral imaging analysis to clarify the effective mechanism of ShengFu oil for intervening inflammatory factors and active components. Our results indicated that the application of ShengFu oil on oral chemical burns effectively stopped the oral burn bleeding and reduced the inflammatory reaction in the damaged tissues, demonstrating that ShengFu oil can promote wound tissue repair in burns caused by heat, acids, and alkalis. The immunohistochemical staining results illustrated that ShengFu oil and its active ingredients significantly reversed the abnormal changes in inflammation-related proteins in mouse tongue tissues that were caused by chemical burns. Regarding long-term toxic effects of ShengFu oil on the gastrointestinal tract, liver, and kidney system, the results of hematoxylin and eosin staining experiments depicted that ShengFu oil was safe and effective for liver, kidney, intestine, esophagus, and tongue. All of these demonstrated that ShengFu oil and its active ingredients are effective and safe in preventing and treating oral chemical burns by interfering with the inflammatory microenvironment.

The prevalence of oral mucosal lesions and related factors in systemic lupus erythematosus patients

BackgroundSystemic lupus erythematosus (SLE) is a chronic inflammatory multi systematic disease of unknown aetiology. SLE has a wide range of symptoms. The most common symptoms are joint pain, skin rash and fever. Oral lesions in SLE manifest in a variety of forms, such as oral mucosal ulceration, mouth burns, xerostomia and salivary gland diseases, temporomandibular joint disease, periodontal disease, dysgeusia, white lesions, oedema, bleeding and petechiae.ObjectiveThis study was conducted to evaluate the prevalence of oral mucosal lesions and their related factors in patients with SLE, giving the lack of comprehensive statistical data in Syria and the differences between reported prevalence.Patients and methodsA cross-sectional study was performed in the Al-Mouassat University Hospital in Damascus. Patients were evaluated appropriating observation, clinical examination, completing questionnaires, studying patient’s medical records and paraclinical laboratory tests if required. Four types of oral lesions were evaluated: ulcer, erythema, white plaque and spots. The diagnosis of these lesions was made according to observation and clinical examination, and the location of each lesion was also recorded. Data were analysed using SPSS version 16.0.ResultIn this study, 42 (70% %) out of 60 patients (38 women and 4 men) had oral lesions, while 18 (30%) had none. The most common areas for the lesions were the buccal mucosa (26.1%) and the lips (14.2%). Of the 42 patients with oral lesions, 12 (27.6%) showed ulcers. There was a significant relationship between the following factors and oral lesions: oral hygiene status, the duration of the disease involvement, frequency of pregnancies, the amount of daily use of corticosteroids without significant difference between dosage groups, and medications used for SLE treatment other than corticosteroids (p < 0.008) without mentioned names or dosages. Conversely, age, sex, cigarette smoking and medications other than those used for SLE treatment were not significantly related to the presence of oral lesions (p value was greater than 0.05 in all subjects).

Use of “tilapia” as a therapeutic agent in oral mucosal burns: An unprecedented proposal

Water bodies purvey plenty of natural resources that are utilized to manufacture materials or are employed as novel medicines in medical and dental practice. Among sponges, corals, fishes, and other marine life forms, one promising source is the “tilapia fish.” It is principally farmed for the utilization and construction of therapeutic biomaterials. As oral physicians or dental practitioners, we grapple with many oral lesions and wounds in routine practice, “burns” being one of them. Tilapia skin and its collagen are being applied for dermatological burns. Since the branch of medicine encourages innovative ideas and research work in the treatment of challenging oral lesions, this article aims to communicate the idea of its usefulness in oral burns and alike lesions, making tilapia a neoteric healing agent, keeping in mind the remarkable biological properties it possesses.

Effect of Clinacanthus nutans leaf extract on oral mucosal burns and tongue wounds: An in-vivo study

Background: Clinacanthus nutans exhibits antioxidant, anti-inflammatory, antiviral, anticancer, and anti-biofilm activities. Wounds in the oral cavity can affect the quality of life. Wound healing is a complex process to restore functions of injured tissues. The effect of C. nutans on oral mucosal burns and tongue wounds of rats is investigated. Methods: Forty male Sprague Dawley rats were divided into negative control and treatment groups with 25, 50, and 100 mg/mL of C. nutans. Oral mucosal burns and tongue wounds were observed on days 7 and 14 based on the fibroblast count and collagen deposits. Data were analyzed by analysis of variance and post hoc Tukey’s test with P < 0.05. Results: Results revealed that on day 7, the fibroblast count of mucosal burns and tongue wounds increases. The maximum mucosal burns were observed for the 100 mg/mL group, whereas the maximum tongue wounds were observed for the 25 mg/mL group. On day 7, collagen deposits were increased in case of mucosal burns. The number of collagen deposits increased on day 14, the highest mucosal burns were observed for the 100 mg/mL group, and in case of tongue wounds, the highest number was observed for the 50 mg/mL group. Conclusion: Ethanol extracts of C. nutans leaves can increase the fibroblast count on day 7 and collagen deposits on day 14 after injury in case of oral mucosal burns and tongue wounds during the wound healing of Sprague Dawley rats.

An extreme oral chemical burns caused by an accidental contact with sodium hydroxide in a young adult: A case report

An extreme oral chemical burns caused by an accidental contact with sodium hydroxide in a young adult: A case report

Allium sativum: Oral mucosal burn

Introduction: Oral medicine practitioner has reported many cases of chemical burn in the oral mucosa. Inappropriate self-treatment with topical application of various therapeutic or non-therapeutic agents often causes chemical burns. Garlic is a century old herb, commonly used in culinary which can cause oral mucosal burns when misused. Case Description: A male patient aged 55 years, reported to the department with a history of tooth pain since one month which had increased in intensity 3 days back. To alleviate the dental pain he had applied crushed raw garlic (Allium sativum) at the site of pain for 60 minutes consecutively for 3 days before visiting the hospital. On intra-oral clinical examination, white pseudo membranous lesion surrounded by erythema was noted on right posterior maxillary and mandibular attach gingiva. At the site of crushed raw garlic application, localized tissue necrosis was observed. The patient was advised to stop self-treatment with raw garlic and was prescribed systemic and topical analgesics to relieve the dental pain. Conclusion: This case report highlights the importance of clinical case history recording. The oral physician should be aware of the herbs like garlic which are commonly used to alleviate pain, which can cause adverse effects like mucosal burn if used inappropriately. Keywords: Chemical burn, garlic, Allium sativum, Oral soft-tissue burns, Mucosal burn.

Intoxicación por paraquat y convulsiones: a propósito de un caso en una institución de salud de Pasto, Nariño

Caso clínico de un hombre de 20 años, procedente de área rural de un municipio de Nariño, que consulta a un centro de salud después de 36 horas de haber ingerido de modo no intencional 20-30 mL de gramoxone (dicloruro de paraquat) mientras estaba en estado de embriaguez, con síntomas digestivos, hiperbilirrubinemia, elevación de azoados, leucocitosis y neutrofilia, por lo que es referido a un hospital de alta complejidad en la ciudad de Pasto. Durante su hospitalización, presenta epistaxis, falla renal con requerimiento de hemodiálisis, quemaduras orales, hipertermia y dos episodios de crisis convulsivas tónico-clónico generalizadas. Se toman paraclínicos: azoados, gases arteriales, electrolitos, glicemia, entre otros, cuyos resultados se enmarcan dentro de la normalidad durante los episodios convulsivos. Es relevante proporcionar elementos para construir un criterio clínico que explique el compromiso neurológico, ya que, es raro y complejo en intoxicaciones por herbicidas como el paraquat.

Role of a Dentist in the Diagnosis of Child Abuse and Neglect: A Literature and Narrative Review

Background:Child Abuse (CA) is defined as any physical or psychological harm inflicted upon children. The most commonly affected anatomical region in these cases is the orofacial complex, thereby placing dentists in a dominant position for detecting CA. The statistical figures referred to CA are high, and many cases go unreported.Objective:To determine the level of knowledge, the aptitudes and capacity of dentists in reporting cases of CA; the barriers facing the reporting of cases; and the key clinical characteristics for the detection of CA.Methodology:A search was made of the PubMed (MEDLINE), ScienceDirect, LILACS and SciELO databases for articles published up until March 2019, involving analytical observational and descriptive studies relevant to the objectives of our study. All articles were independently reviewed by two authors.Results:Injuries caused by CA are largely located in the orofacial region – the most prevalent being caries, burns and fractures. The most frequently identified risk factor is behavioral alterations on the part of the parents or caregivers. The reviewed studies reflect a discrepancy between suspected and reported cases of CA.Conclusion:Although dentists are able to detect injuries, there is a great lack of knowledge about how to report cases of CA to the authorities. It is interesting to establish guidelines for the detection and reporting of suspicious cases. Improved training in forensic and legal dentistry is needed, together with the establishment of detection and reporting protocols. The clinical signs detected in the case of CA and neglect include untreated caries, poor oral hygiene, traumatisms, burns, lacerations and biting. The recognition of such signs and correct case history compilation are essential for the detection of CA.

Customized Microstomia Prevention Appliance Therapy: A Case Report

Microstomia is a condition with abnormally small oral aperture which is associated with compromised aesthetics and function of stomatognathic system. In young children, the leading cause of microstomia is oral electrical or chemical burns. Management of microstomia requires multidisciplinary approach including surgery, physiotherapy and appliance therapy. Appliance therapy in form of microstomia prevention appliance plays a pivotal role in prevention of contraction of tissue during healing. Numerous appliances have been described in literature to prevent microstomia. However, decision to use a particular appliance require meticulous planning considering the efficacy and effectiveness of the appliances and various patient factors like age, dentition status and compliance. This paper presents an unusual clinical condition where a unique customized microstomia prevention appliance therapy was instituted to prevent microstomia in 2 year old female patient following lip surgery. This appliance was constructed easily and inexpensively, could be adjusted so that it was almost painlessly inserted, and was progressively adapted. It was convenient for use in young child with minimal compliance offering improved mouth opening and consequently functional outcomes.

Oral electric injury in a child as a result of a home accident

Exposure to electricity may have results ranging from a mild injury to severe cardiopulmonary arrest in children. As children are restless and in search of new things, they are generally injured by contacting with low-voltage domestic electrical cords, sockets, and tool. Oral burns are often seen in crawling infants taking a live cable into their mouth. In literature, only a limited number of cases are reported regarding oral commissure injuries associated with low-voltage electric shocks. In this study, we presented a case, which is limited in literature, of one-year-old boy brought to our emergency department upon oral commissure injury as a result of the contact with low-voltage electricity in home accident.

Chemical oral burn cum erosive gingival lesion arising from self-medication for toothache

Chemical burn of the oral mucosa occurring as a result of a noxious agent placed in direct contact with the mucosa either by the patient or a dentist is frequently associated with gingival erosion. The objective of this study was to report a case of chemical oral burn with erosive gingival lesion due to self medication with nonsteroid anti inflammatory drug topically in patient with acute apical abscess. We report a case of 63-year-old male public servant with health insurance that presented to the periodontology clinic with chemical oral burns and erosive gingival lesion due to topical application of nonsteroidal anti-inflammatory drug for relief of toothache from apical abscess of lower left central incisor (tooth 31). The patient was advised to discontinue topical application of Anacin. Full-mouth scaling was done, oral hygiene instructions given, warm saline mouthrinse therapy prescribed, and patient referredb to the conservative clinic where root canal treatment. Increased public awareness is required regarding chemical injuries that can result from topical self-medication. Dentists must recognize the local effects of topically applied aspirin as well as other medications on the oral mucosa and incorporate them into the treatment plan to prevent complications.

TOXIC EXPOSURES IN CHILDREN INVOLVING LEGALLY AND ILLEGALLY COMMERCIALIZED HOUSEHOLD SANITIZERS.

ABSTRACTObjectives: To analyze and to compare clinical repercussions of accidents involving legally and illegally commercialized household sanitizers in children under 7 years of age. Methods: A descriptive cross-sectional design was used to collect data from electronic database of a regional Poison Control Center during one year. Data were analyzed by means of descriptive non-parametric statistics and association tests. Results: The sample had 737 reported cases. Most of the accidents occurred with children under 3 years of age (median: 1 year of age; interquartile interval: 1-3 years of age), at home (92.9%), by ingestion (97.2%). Products involved were cleaning products with low toxicity and no caustic effects (38.9%); caustics (24.1%); hydrocarbons (19.3%); pesticides/rodenticides (16.6%), and other products (1.1%). Seventy accidents were due to exposures to illegal products, mainly caustics (n=47) and rodenticides (n=15). Among the 337 children presenting post-exposure clinical manifestations, the most frequent were vomiting (n=125), oral burns (n=74), cough (n=35), drooling (n=26), and abdominal pain (n=25). Clinical manifestations were significantly more frequent after illegal products exposure (55/70 versus 282/667, p<0.01). Nineteen children had to be hospitalized (caustics, n=17; illegal products, n=12; median time of hospitalization: 2 days), 22 were submitted to esophagogastroduodenoscopy (sodium hydroxide, n=14; illegal products, n=14); and 12 cases had endoscopic alterations (severe in 2). No deaths occurred. Conclusion: Toxic exposures owing to illegal household sanitizer products are associated with greater morbidity when compared with legal ones.

Oral Chemical Burns Reported to the Poisons Information Centre in Erfurt, Germany, from 1997 to 2014

Devastating oral burns often followed by lifelong complications can result from ingestion of caustic substances. However, although being one of the most challenging situations in clinical practice, literature data on the epidemiology of oral burns are still scarce. Retrospective analysis of all cases of oral burns after ingestion of corrosive substances reported to the Poisons Information Centre in Erfurt, Germany, from 1997 to 2014 was performed. In total, 482 calls because of oral burns were registered, with no change in the numbers of cases during the years. In the majority of the instances (47%), toddlers were affected, followed by middle-aged adults (33%). In both age groups, the male sex prevailed. Ingestion of corrosive substances with babies, schoolchildren, adolescents, and elderly were much less frequent. In most cases (78%), the injury occurred accidentally and only in 5% of the instances in suicidal intent; 85% of the suicidal attempts were committed by middle-aged adults and 15% by elderly. Main agents involved in oral burns were cleansing agents (37%), remedies (12%), disinfectants (7%), acids or bases (6%), technical fluids (6%), cosmetics (5%), and foods (5%). Mostly, the calls came from emergency department doctors (58%), in 19% laymen were calling from home, and in 18% the calls came from a doctor's office. Most of the injuries occurred accidentally, in the domestic setting and in toddlers, and would have been preventable. Thus, a more comprehensive education of the population, especially of parents, regarding the dangers arising from household chemicals is still needed.

Electronic cigarette explosion: Case report of an emerging cause of orofacial trauma

Electronic cigarettes are a type of electronic nicotine delivery system. In the United States, electronic cigarettes have surged in popularity since their introduction to the market in 2007. Health and safety concerns primarily have focused on e-liquid/aerosol composition and whether these devices represent a gateway versus lower risk alternative to conventional cigarettes. Furthermore, recent incidents have demonstrated the potential for significant orofacial injury caused by device explosion while in use. Herein we report a case of a 20-year-old male who sustained oral burns, lacerations, and tooth loss when an electronic cigarette exploded in his mouth shortly after he charged the battery. Only seven other cases of trauma from intraoral electronic cigarette explosions have been reported in the scientific literature to date, although several similar incidents also have been reported by the news media. Treatment of such patients often requires a multidisciplinary approach. Design/manufacturing issues and improper handling may cause an increase in internal battery temperature. An investigation by the United States Fire Administration concluded that user education may aid in preventing some electronic cigarette explosions, and safety design improvements also could help. Although some studies and authorities support the use of electronic cigarettes for tobacco cessation and harm reduction, recent reports of electronic cigarette explosions raise important safety concerns and point to the need for further studies.