Oral Symptoms Research Articles

Viral infection and antiviral immunity in the oral cavity.

Individual tissues have distinct antiviral properties garnered through various mechanisms, including physical characteristics, tissue-resident immune cells and commensal organisms. Although the oral mucosa has long been appreciated as a critical barrier tissue that is exposed to a continuous barrage of pathogens, many fundamental aspects of the antiviral immune response in this tissue remain unknown. Several viral pathogens, such as herpesviruses and human papillomaviruses, have been acknowledged both historically and at present for infections in the oral cavity that result in substantial clinical burden. However, recent viral outbreaks, including those with SARS-CoV-2 and mpox, featured oral symptoms even though these viruses are not generally considered oral pathogens. Ensuing studies have shown that the oral cavity is an important locale for viral infection and potential transmission of newly emergent or re-emergent pathogens, highlighting the need for an increased understanding of the mechanisms of antiviral immunity at this site. In this Review, we provide a broad overview of antiviral immune responses in the oral cavity and discuss common viral infections and their manifestations in the oral mucosa. In addition, we present current mouse models for the study of oral viral infections.

Efficacy of combined administration of Baekhogainsam-Tang and low-dose pilocarpine on frequent intractable xerostomia: Study protocol for a randomized controlled trial.

Intractable xerostomia is defined as the subjective perception of dry mouth and persistent salivary gland hypofunction. Pilocarpine is an approved salivary sialagogue that is frequently prescribed for the treatment of intractable xerostomia; however, it often exhibits more side effects at high-doses and limited effectiveness at low-doses. Baekhogainsam-Tang (BIT) is a common herbal formula used by patients complaining of sore throats and thirst. It seems that BIT can compensate for the insufficient effect of low-dose pilocarpine. However, no clinical trials have studied the efficacy of combined administration of BIT and low-dose pilocarpine for intractable xerostomia. We aim to assess the non-inferior efficacy and fewer side effects of combined administration of BIT and low-dose pilocarpine compared with the administration of high-dose pilocarpine. A randomized, open-label, parallel-group, multi-center trial will be conducted. A total of 120 patients with Sjogren's syndrome having an unstimulated salivary flow rate (SFR) ≤0.1 mL/min or who have undergone radiotherapy to the head and neck with an unstimulated SFR ≤0.25 mL/min will be recruited competitively. They will be randomly allocated to either the experimental or control groups. The experimental group will receive BIT herbal granules three times and pilocarpine (2.5-mg) four times daily; meanwhile, the control group will receive only 5-mg pilocarpine four times daily for 12 weeks. The primary outcome is unstimulated SFR after 12 weeks of treatment. Secondary outcomes are stimulated SFR after 12 weeks of medication, as well as differences and mean percentage changes in unstimulated and stimulated SFR, visual analog scale, salivary scintigraphy, and questionnaires for both oral symptoms and quality of life during the clinical trial. An independent T test or Mann-Whitney U test will be performed to compare values between the two groups. The Paired T test or Wilcoxon signed-rank test will be performed to compare intragroup continuous values. This trial will be significant evidence on the efficacy and safety of combined use of BIT and low-dose pilocarpine to treat intractable xerostomia. The Clinical Research Information Service of the Republic of Korea (ISRCTN, KCT0005982). Registered on 10 February 2021.

The impact of oral health on depression: A systematic review.

As of 2020, about 21% of adults in the United States have a diagnosable mental health disorder, excluding substance use and developmental disorders. Depression, predicted by the WHO to be the leading cause of disease burden by 2030, is linked to various systemic conditions and has been associated with poor oral health. Both behavioral factors, like poor dental hygiene and irregular visits, and biological mechanisms, such as changes in salivary immunity, contribute to this connection, which impacts overall well-being and quality of life. This systematic review aims include: (1) Does tooth loss affect depression? (2) Does oral pain, such as that experienced during chewing and speaking, impact depression? (3) Does oral functionality, including chewing and speaking, influence depression? (4) Does overall oral health affect depression? We conducted a systematic search of PubMed, EBSCO host, Medline, and Google Scholar databases from January 2000 to June 2024 using relevant keywords. Studies examining the impact of oral health parameters (tooth loss, oral pain, oral functionality, overall oral health) on depression were included. Articles were included if (1) full text manuscripts in English were available, (2) the study described the association of oral health and depression, and (3) the independent value was an oral related factor and the dependent value was depression. The following were excluded from our analysis: (1) any articles where oral factors were not the independent value, (2) systematic reviews, (3) case reports, and (4) duplicate studies among our databases. Thirty-one studies met the inclusion criteria. Tooth loss, oral pain, and impaired oral functionality were consistently associated with increased depressive symptoms across the included studies. Greater tooth loss was linked to higher odds of both onset and progression of depression. Oral pain exacerbated depressive symptoms, while difficulties in chewing or speaking were associated with elevated risks of depression. There is a bidirectional relationship between oral health and depression, highlighting the urgent need for comprehensive public health initiatives. Integrating oral health assessments into routine medical care, and developing targeted interventions are crucial steps to mitigate the impact of poor oral health on mental health outcomes.

The Potential Risk: Evaluation of HgA1c Levels Prior to Dental Implant Surgery in Patients without a Diagnosis of Diabetes Mellitus.

Diabetes Mellitus (DM) poses a significant global health concern, with approximately one in two affected individuals remaining undiagnosed. The failure to diagnose or inadequately control DM can lead not only to systemic complications but also to decreased dental implant survival rates, increased marginal bone loss, and increased susceptibility to peri-implantitis. This study aims to evaluate glycated hemoglobin (HbA1c) levels in patients who have not been diagnosed with DM but exhibit oral DM symptoms prior to dental implant surgery. This study was designed as a retrospective cohort. It was conducted on patients who previously presented to the Department of Oral and Maxillofacial Surgery for dental implant surgery and had not been diagnosed with DM. The inclusion criteria included the need for dental implants and augmentation, presence of oral DM symptoms, and having blood tests that included HbA1c. Patients with a prior diagnosis of DM were excluded from the study. A retrospective analysis was conducted on data from 253 patients who applied for dental implant surgery. Among them, 72 patients underwent HbA1c levels assessment through blood tests. Patients with previously uncontrolled DM (n:21) and those whose blood tests were performed at different institutions (n:8) were excluded from the study. Consequently, the study encompassed a cohort of 43 patients. Among the participants, 55% were female and 45% were male. The HbA1c values of the patients ranged from 5.1 to 10.9, with an average value of 6.57±1.44. Of the patients, 41.8% were diagnosed with DM, 30.2% were prediabetic (preDM), and 27.9% did not receive any diagnosis. There was no statistically significant relationship between the combinations of xerostomia, delayed wound healing, oral infection, burning sensation in the mouth, periodontitis, and dental caries with HbA1c levels (p>0.05). In this study, patients presenting to the clinic for dental implant surgery were directed based on oral symptom findings, and the rates of diagnosed DM and preDM were determined to be 7.11% and 5.14%, respectively. Considering the negative effects and prevalence of uncontrolled DM, it may be recommended to assess the HbA1c levels in patients with oral symptoms before dental implant surgery.

Role of Laboratory Tests in Enhancing Diagnosis and Treatment Planning for Dentists: A Review of Evidence-Based Practices.

The purpose of this review is to simplify and guide dentists through the main laboratory investigations frequently used in dentistry for diagnosis and patient management. It emphasizes the critical role of laboratory tests in dental practice, highlighting their significance for accurate diagnosis, effective treatment planning, and ongoing monitoring of oral health. Systemic conditions often manifest through oral symptoms, making laboratory assessments essential for identifying undiagnosed health issues that may impact dental treatment outcomes.A comprehensive literature search was conducted using PubMed and Google Scholar to gather relevant studies, ensuring a thorough examination of existing knowledge on the subject. This review defines commonly used laboratory tests, including complete blood count (CBC), coagulation tests, hemoglobin A1c (HbA1c), liver function tests, immunological assays, and microbiological and virological evaluations. Each test provides valuable insights into patient health, aiding in the detection of conditions such as anemia, diabetes, and liver disease, which can complicate dental procedures. By adopting an evidence-based, personalized approach to patient care, dental professionals can enhance safety and treatment success. This article underscores the necessity of integrating laboratory assessments into routine dental practice, promoting a holistic understanding of patient health and improving overall treatment outcomes.

The Association Between Specific Oral Behaviors and the Number of Temporomandibular Disorder Symptoms in the General Population: A Cross-Sectional Study.

This study aimed to thoroughly explore the relationship between individual oral behavior and the differing numbers of temporomandibular disorder (TMD) symptom in the general population. A total of 565 participants were recruited and completed a questionnaire containing demographic characteristics, eight specific oral behaviors, and five major TMD symptoms (5Ts) checklist. Multivariate linear regression analysis was performed to assess the relationship between individual oral behavior and the number of TMD symptoms, after controlling for confounders. The prevalence of TMD symptoms was up to 38.2% in the general population, with 64.6% of the participants engaging in one or more oral behaviors. Female participants showed a stronger positive association with most oral behaviors than males. Moreover, wake oral behaviors exhibited a higher correlation coefficient value with TMD symptom number than sleep oral behaviors. Among the eight oral behaviors, bruxism in sleep exhibited no significant correlation with the of TMD symptom number (P>0.05). Seven other specific oral behaviors were significantly correlated with the number of TMD symptoms by multivariate linear regression analysis (P<0.01). The associations between the seven oral behaviors and TMD symptom number remained significant in sleep posture pressuring jaw (β: 0.165, 95% CI: 0.080-0.250), bruxism in awake (β: 0.341, 95% CI: 0.132-0.550), teeth clenching (β: 0.422, 95% CI: 0.264-0.580), pressing, holding, or touching teeth together (β: 0.282, 95% CI: 0.169-0.395), holding or tightening muscles without clenching (β: 0.447, 95% CI0.304-0.589), holding jaw forward or to the side (β: 0.694, 95% CI0.526-0.861), and holding jaw in rigid or tense position (β: 0.571, 95% CI0.418, 0.724) after adjustment for demographic factors (P<0.01). There was a positive association between seven specific oral behaviors and TMD symptom number. Individuals with higher frequency of specific oral behaviors are more likely to suffer from more TMD symptoms. Sleep bruxism exhibited no association with TMD symptoms and symptom number.

The Effects of Depression and Anxiety on Oral Symptoms in Delivery Riders: Focusing on the Mediating Effect of Somatic Symptoms

The Effects of Depression and Anxiety on Oral Symptoms in Delivery Riders: Focusing on the Mediating Effect of Somatic Symptoms

Comparison of oral disease symptoms according to eating habits of adolescents from Korean families and adolescents from multicultural families

Objectives: This study used the 18th Youth Online Health Behavior Data to compare oral disease symptoms according to the eating habits of adolescents from Korean families and adolescents from multicultural families. The total number of subjects was 40,913. Methods: The Rao-Scott chi-square test was used to compare general characteristics, eating habits, and experience with oral disease symptoms. In the final multiple logistic regression analysis, general characteristics and eating habits-related characteristics were used as correction variables to investigate eating habits related to oral disease symptoms in Korean adolescents and adolescents from multicultural families. Results: In Korean family the experience of oral disease symptoms was found to be lower when sweet drink 5-6 times a week 0.89 times, 3-4 times a week 0.77 times, 1-2 times a week 0.65 times, and 0.56 times when not consuming them than when consuming them daily. In multicultural families, the incidence of experiencing oral disease symptoms was 0.47 times lower in those who sweet drink daily than in those who consumed them 1-2 times a week, and 0.32 times lower in those who did not consume them. Conclusions: Based on the above research results, it is thought that customized nutrition education and oral health education programs should be continuously developed and utilized to promote oral health among adolescents from Korean families and multicultural families and to change their eating habits.

Factors related to oral health and subjective health among Korean adolescents: the 18th Korea Youth Risk Behavior Survey (KYRBS)

Objectives: This study was conducted to investigate factors related to oral health and subjective health in Korean adolescents, a total of 51,850 people. Methods: Subjective health by general characteristics, subjective health by oral health characteristics, and subjective health by oral health symptoms were analyzed by a cross-analysis. Factors influencing subjective health were analyzed using multiple regression analysis. Results: As a factor influencing subjective health, the number of times teeth were brushed 0.62 times lower (p&lt;0.001) for 0 times, and 0.91 times lower (p&lt;0.05) for 1-2 times. The risk was 1.33 times higher (p&lt;0.001) if teeth were brushed before going to bed, and 1.10 times higher (p&lt;0.05) if an intrdental brush was used, In cases where oral health education was not received, subjective health was 0.86 times lower (p&lt;0.001). In cases where there was no pain subjective health was 1.44 times higher (p&lt;0.001), gingival bleeding was 1.51 times higher (p&lt;0.001), or malodor was 1.53 times higher (p&lt;0.001). Conclusions: Based on the above results, the relationship between oral health and subjective health was confirmed, and it is thought that opportunities to develop preventive programs to promote youth health should be expanded.

Factors Associated with Dental Care Utilization for Oral Disease Prevention Among Adolescents in Multicultural Families in Republic of Korea.

This study utilized data from the 2022 Korea Youth Risk Behavior Survey to examine the utilization of preventive dental care among adolescents from multicultural families and analyze the associated factors. The number of adolescents from multicultural families, based on parental nationality, was 1361. The dependent variables were asymptomatic dental visits, sealant experience, and scaling experience. The independent variables included health perception factors (subjective health status, subjective oral health status), health behaviors (fruit consumption frequency, vegetable consumption frequency, sugary drink consumption frequency, drinking experience, smoking experience), and oral health behaviors (daily tooth-brushing frequency, tooth brushing after lunch, use of oral care products, oral symptom experience). Confounding variables included demographic variables (age, grade) and socioeconomic variables (academic performance, economic level, parental education level, mother's nationality). Statistical analyses were conducted using a complex samples cross-tabulation and complex samples logistic regression. Asymptomatic dental visits were significantly associated with subjective oral health status and sugary drink consumption. Those who perceived their oral health as "Healthy" had an odds ratio (OR) of 3.34 (CI = 1.76-6.32; p < 0.001), and those who perceived themselves "Normal" had an OR of 2.03 (CI = 1.08-3.82; p = 0.029). A sugary drink consumption of less than three times per week was linked with an OR of 1.68 (CI = 1.05-2.70; p = 0.031). Sealant experience was associated with brushing before bedtime (OR = 2.27, CI = 1.18-4.35; p = 0.014) and using more than one oral care product (OR = 1.97, CI = 1.27-3.07; p = 0.003). Scaling experience associated with oral symptoms (OR = 1.94, CI = 1.21-3.11; p = 0.006). To enhance access to preventive dental care utilization for adolescents from multicultural families, efforts are needed to raise subjective oral health awareness, improve oral health behaviors, and develop strategies that ensure timely preventive dental care.

Development of a risk index for cognitive decline predicted by adverse radiation events and diet in older oral cancer patients

Professor Norimasa Ogama, Faculty of Nursing, Soka University, is interested in how symptoms such as dry mouth and changes in taste in elderly oral cancer patients could predict the risk of decline in cognitive function with the use of different sensory food experiences. He is developing an index to predict this. While previously at the Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Ogama saw a range of problems among patients caused by radiation and chemotherapy, including reduced eating and swallowing function, changes in body image and ongoing issues with being able to eat and speak. He began to consider how it might be possible to improve quality of life for such patients, including the ability to enjoy food. This inspired him to work to develop an oral rehabilitation programme that takes into account post-operative life evaluation and its influencing factors in order to significantly increase patientsâ–™ life satisfaction. Ogama and the team are developing a risk index for cognitive decline predicted by the adverse events of radiation and the diet of elderly patients with oral cancer. The goal is to accurately determine the risk of cognitive decline early based on changes to eating preferences and the taste of food, as well as worsening of oral mucositis and symptoms of dry mouth due to radiation therapy. This will be done through the concept of ‘eating deliciously’, based on personal preferences and characteristics.

Association of oral manifestations with severity of the disease in ulcerative colitis patients

ObjectiveInflammatory bowel diseases (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC), are chronic conditions primarily affecting the intestines. This study aims to identify the nature and frequency of oral symptoms and signs in patients with ulcerative colitis and to explore the connection between these complications and the activity of the disease.MethodsThis descriptive-analytical study involved ulcerative colitis patients who visited the gastroenterology clinic at Shahid Sayad Shirazi Hospital in Gorgan, along with an equal number of healthy companions as a control group in 2019. A gastroenterology internist assessed the disease severity through clinical examination and a simple clinical disease activity index for colitis patients. The collected data were then analyzed statistically using SPSS version 19.ResultsThe average age of patients in the case group was 41.84 ± 11.66 years, while in the control group it was 40.43 ± 12.67 years. There was a significant correlation between difficulty swallowing, burning sensation in the mouth, vomiting, acidic taste, the presence of oral ulcers, and a coated tongue with the severity of disease activity (p < 0.05). However, no significant relationship was found between other variables and the severity of disease activity (p > 0.05).ConclusionThe results of this study confirm that as the severity of ulcerative colitis increases, the occurrence of oral lesions also rises, particularly during severe disease activity. Among oral symptoms, dry mouth had the highest incidence, followed by bad breath and changes in taste. The most common oral lesions observed were a coated tongue, grooved tongue, and oral ulcers, respectively.

Oral acute graft‐versus‐host disease

AbstractOral acute graft‐versus‐host disease (aGVHD) is rare and with no diagnostic criteria. We report a case of oral aGVHD with three clinical phases. A self‐limited prodrome of largely subjective oral symptoms was followed by concurrent oral and upper gastrointestinal aGVHD. Six months after transplantation, the patient was diagnosed with severe oral and upper gastrointestinal chronic GVHD. We compared the salivary microbiota of our patient at the time of diagnosis of aGVHD with 50 contemporaneous transplant recipients and found no evidence for oral microbiota involvement in pathogenesis. This in‐depth N‐of‐1 analysis reveals novel aspects of oral aGVHD pathogenesis.

Curcumin as a complementary treatment in oncological therapy: a systematic review.

Curcumin, the active ingredient in turmeric, is employed by numerous cancer patients to support conventional cancer therapy. This systematic review aims to summarize the existing clinical evidence and to provide an overview of the potential benefits and risks associated with curcumin supplementation. In January 2024, we conducted a systematic search of five electronic databases (Embase, Cochrane, PsycInfo, CINAHL, and Medline) using a complex search strategy. We included randomized controlled trials on the use, effectiveness, and potential harm of additional curcumin therapy in adult patients under cancer treatment. The risk of bias was assessed using Cochrane revised Risk of Bias Tool 2.0. This systematic review included 34 randomized controlled trials involving 2580 patients out of 11143 search results. Included patients were primarily diagnosed with head and neck cancer, followed by breast, prostate, and colorectal cancer. Therapy concepts encompassed topical or systemic curcumin administration. The studies reported heterogeneous results concerning oral and skin symptoms, pain, weight alteration and changes in body composition, survival, and disease progression. Significant findings were reported for oral mucositis and weight loss. Considering risk of bias, all studies had moderate to high risk of bias. Regarding side effects, one study reported significantly more vomiting in the curcumin group. Although the results suggest promise in reducing mucositis and weight loss, a clear statement regarding the effectiveness of curcumin therapy on cancer patients cannot be made due to heterogeneous results and methodological limitations of the involved studies. Further investigations of higher quality are necessary to derive a definite recommendation for action.

HPV Status and Oral Health Symptom Patterning During Treatment and Survivorship in Patients With Head and Neck Cancer: A Longitudinal Analysis.

To describe longitudinal oral health symptom patterns of patients receiving concurrent chemotherapy and radiation therapy for head and neck cancer (HNC) and examine associations between phenotypic characteristics, including human papillomavirus (HPV) status and oral health symptoms. A pilot retrospective longitudinal chart review (N = 270) of patients with HNC at a northeastern U.S. regional cancer institute. HPV status and oral health symptoms (pain, mucositis, taste alteration, xerostomia, dysphagia, and candidiasis) were examined during treatment (six weeks) and survivorship (three months). Latent transition analysis was conducted across each time point. The latent transition analysis revealed classes with moderate to high symptom expression persisted into survivorship. The HPV-negative phenotype had higher symptom expression across treatment and survivorship. Patients with HPV-negative HNC may require early intervention, while considering social determinants of health to attenuate symptom expression and improve outcomes.

Sarcoidosis: oral manifestations (case report)

Relevance. Sarcoidosis is a multisystem granulomatous disease of unknown origin, commonly presenting with bilateral hilar lymphadenopathy, pulmonary infiltrates, and involvement of the eyes, skin, gums, and oral mucosa. This clinical case illustrates the oral manifestations of this rare systemic disease. Gingival hypertrophy and soft tissue lesions on the lip mucosa were the initial signs of the condition. Following an extended diagnostic process, the patient underwent treatment by both a dentist and a rheumatologist, leading to a stable remission of the disease.Case description. This article presents a clinical case of sarcoidosis manifesting in the mouth as gingival hypertrophy and a soft tissue lesion on the upper lip. In most cases, a diagnosis of sarcoidosis is made before any oral symptoms appear. Diagnosing a systemic disease based on primary oral symptoms poses a unique challenge, as dental professionals may not always be familiar with the oral manifestations of systemic conditions. In cases of suspected sarcoidosis, the oral mucosa should be thoroughly examined, and systemic sarcoidosis should be considered in the differential diagnosis of granulomatous lesions in the mouth.Conclusion. Early initiation of treatment can significantly improve the patient's quality of life and prognosis.

Oral Manifestations in Paraneoplastic Syndromes: ASystematic Review and Meta-Analysis.

This study examined the prevalence of oral signs and symptoms in paraneoplastic syndromes. A systematic search on oral paraneoplastic syndromes was conducted in MEDLINE/PubMed, Ovid, and Scopus databases from inception to April 1, 2024. Risk of bias was evaluated using the MURAD or Quality in Prognosis Studies tools, and a random-effects meta-analysis was performed. Evidence quality was rated using the GRADE approach. The study sample comprised 811 participants from 487 studies. Oral manifestations predominantly affected patients with paraneoplastic pemphigus, mucous membrane pemphigoid, and acanthosis nigricans. Palate is the most frequently affected site (18.2%; 95% confidence interval [CI] 14.7-21.9), while erosion was the most common lesion type (83.3%; 95% CI 72.2-92.0) associated with the underlying malignancy. The prevalence of death in people with paraneoplastic syndromes was 50.9% (95% CI 39.9-61.7), while the prevalence of remission after neoplasm treatment was 63.4% (95% CI 49.9-76.0). GRADE assessment revealed uniformly low to very low certainty for all outcomes studied. Further research is needed to understand the mechanisms behind these oral manifestations, which is crucial for earlier paraneoplastic syndrome diagnosis and optimal patient management. PROSPERO number: CRD42022328921.

Adipose derived or bone-marrow derived mesenchymal stem cell treatment for hyposalivation: protocol for a systematic review and network meta-analysis

BackgroundSalivary hypofunction leads to debilitating oral symptoms and has major complications for overall quality of life. Two of the most frequent causes of xerostomia are radiotherapy in the head and neck and Sjögren’s syndrome. Only symptomatic treatment is available today. An increasing number of both preclinical and clinical studies have suggested that mesenchymal stem cell (MSC) transplantation treatment can increase the salivary flow rate and ameliorate symptoms of xerostomia. However, both adipose-derived and bone marrow–derived MSCs are used, although they differ in important ways. The primary objective of this study is an indirect comparison of the change in the unstimulated salivary flow rate after intervention between patients treated with adipose-derived or bone marrow–derived MSCs.MethodsThis systematic review and network meta-analysis will search for eligible studies in the MEDLINE, EMBASE, and Cochrane CENTRAL register of Controlled Trials. Eligible studies are as follows: clinical studies including human patients with salivary hypofunction due to either radiotherapy or Sjogren’s syndrome who were subsequently treated with either adipose-derived MSCs or bone marrow–derived MSCs. Studies with no control group will be excluded. The search phrase has been peer-reviewed following the PRESS guidelines. The primary outcome is the change in the unstimulated salivary flow rate after treatment with either adipose-derived or bone marrow–derived MSCs. Secondary outcomes are as follows: change in patient reported outcomes, methods of intervention administration, number of injected MSCs, and safety. Data from included studies will be pooled and compared with a fixed-effects or random effects model dependent on signs of heterogeneity, presented with a forest plot, and indirectly compared with a meta-regression in a network meta-analysis. Risk of bias will be assessed with the tools ROBINS-I or RoB-2 depending on type of study.DiscussionBoth adipose-derived and bone marrow–derived MSCs are used today for experimental treatment of salivary hypofunction in humans as no direct or indirect comparisons have been made. Therefore, an evaluation of the effect of adipose-derived vs bone marrow–derived MSC treatment is needed to support future decision-making on the type of MSC used in a clinical trial.Systematic review registrationPROSPERO ID CRD42024527183.

Smokeless tobacco- and quid-associated localized lesions of the oral cavity: A cross-sectional study from a dental institute.

There is a well-established link between the use of smokeless tobacco (ST) and the development of oral cancer. This study was conducted to evaluate the impact of tobacco use, quid use, and other adverse habits related to smoking and alcohol consumption on ST-induced localized lesions. The aim of the study was to examine the demographic data, frequency and contact duration of ST on the lesion, as well as to conduct a clinical evaluation of these parameters. A total of 13,442 patients who had been experiencing oral and dental symptoms for a period of at least 6 months were screened. Of these, 334 patients were diagnosed with STor quid-induced localized lesions and had a positive history of ST or quid use. A structured questionnaire was employed to conduct interviews with participants regarding their use of ST and other adverse habits, including smoking and alcohol consumption. Other information related to the use of ST or quid and clinical findings were also recorded, along with the patients' demographic details. A statistical analysis was carried out using the χ2 test and the regression analysis. The overall prevalence of ST-induced localized lesions was found to be 2.48%. In the study population, the majority of participants (58.7%) reported a habit of using khaini, while 26.8% reported using gutkha. The study found significant differences in the severity of ST-induced localized lesions and contact duration, frequency of the habit, and the presence of additional habits such as smoking and/or alcohol consumption. Based on this study, we proposed a modified Greer and Poulson's classification of ST-induced lesions, dividing them into 4 clinical types. Smokeless tobacco-induced localized lesions frequently remain asymptomatic, with patients unaware of their presence. Other adverse habits, including smoking and alcohol consumption, as well as increased ST contact duration were associated with the development of more severe ST-induced localized lesions.

Oral State and Salivary Cortisol in Multiple Sclerosis Patients.

Background: MS patients experience gradual and progressive functional limitation, bulbar symptoms, cognitive dysfunction, and psychiatric disorders that can impinge on oral status. This study aimed to investigate the oral state, oral hygiene habits, and salivary cortisol levels in patients with relapsing-remitting multiple sclerosis (RRMS) compared to healthy controls. It also evaluated systemic parameters: disease duration, type of Disease Modifying Therapy (DMT), disability score, professional activity, and smoking in the study group. Methods: This study included 101 patients (71 women and 30 men, aged 16-71 years) and 51 healthy volunteers (36 women and 15 men, aged 28-82 years). The oral examination assessed the number of teeth, type and number of dental fillings and prosthetic restoration, oral hygiene state, and salivary cortisol. Results: It was found that MS patients had significantly more professional activity, swallowing problems, pronunciation issues, dry mouth, and taste disturbances than the control group. They brushed their teeth twice daily significantly less often. The API was higher, while the SBI was lower in MS patients. Disease duration positively correlated with age and number of missing teeth. The Expanded Disability Status Scale positively correlated with age, disease duration, number of missing teeth, number of composite fillings, and right and left-hand Nine Hole Peg test scores, and negatively correlated with the Sulcus Bleeding Index. Salivary cortisol levels did not differ between groups and correlated only with the disability scale. Conclusions: MS patients require ongoing dental care and preventive measures to manage both general and oral health symptoms effectively.